Enhancing Inhalation Drug Delivery: A Comparative Study and Design Optimization of a Novel Valved Holding Chamber.

This paper presents an innovative approach to the design optimization of valved holding chambers (VHCs), crucial devices for aerosol drug delivery. We present the design of an optimal cylindrical VHC body and introduce a novel valve based on particle impaction theory. The research combines computational simulations and physical experiments to assess the performance of various VHCs, with a special focus on the deposition patterns of medication particles within these devices. The methodology incorporates both experimental and simulation approaches to validate the reliability of the simulation. Emphasis is placed on the deposition patterns observed on the VHC walls and the classification of fine and large particles for salbutamol sulfate particles. The study reveals the superior efficacy of our valve design in separating particles compared to commercially available VHCs. In standard conditions, our valve design allows over 95% of particles under 7 µm to pass through while effectively filtering those larger than 8 µm. The optimized body design accomplishes a 60% particle mass flow fraction at the outlet and an average particle size reduction of 58.5%. When compared numerically in terms of size reduction, the optimal design outperforms the two commercially available VHCs selected. This study provides valuable insights into the optimization of VHC design, offering significant potential for improved aerosol drug delivery. Our findings demonstrate a new path forward for future studies, aiming to further optimize the design and performance of VHCs for enhanced pulmonary drug delivery.

Design and evaluation of a dynamic air cushion for pressure ulcers prevention.

Wheelchair users have a higher risk of developing pressure ulcers due to prolonged seated pressure. Pressure ulcers can be painful, may require surgical intervention, and even become life-threatening if infection occurs. To prevent pressure ulcers from forming the patient must either offload themselves or rely on a caregiver to move them allowing pressure redistribution over the seated area. In this work, we designed a dynamic air cushion to relieve pressure on loaded areas using sequences of inflation and deflation of the air cushion cells. The purpose of these sequences is to offload pressure from high-risk areas. To evaluate the effect of the alternating sequences on seated pressure and blood perfusion, we recorded interface pressure, skin blood flow, superficial tissue oxygen saturation, blood concentrations of oxygenated hemoglobin, and deoxygenated hemoglobin from twenty-one healthy volunteers who were asked to sit on the air cushion for static mode recording (3 min) and during the inflation/deflation sequences (up to 22 min). The alternating sequences consisted of ten combined inflation and deflation steps. Results showed that, after applying the alternating sequences, interface pressure reduced significantly (p=0.02) compared to the static mode. Moreover, the coefficient of variation of the seated pressure was higher (p<0.001) during the alternation sequence compared to the static mode. However, interface pressure under the right and left ischial tuberosities increased (p<0.001) during the alternation sequence compared to the static mode. In addition, during the alternating sequences, males had larger dispersion index values of both right and left ischial tuberosities pressure compared to females. Furthermore, the maximum value of oxygen saturation (p=0.04) and skin blood flow (p=0.001) increased during the pressure alternation sequences compared to the static mode. The study findings highlighted the positive effects of the designed dynamic air-cushion to relieve pressure on compressed areas and enhance blood perfusion similar to manual offloading approaches. The outcomes of this study are encouraging to evaluate the performance of the designed air cushion in studies involving wheelchair users.

The dynamics of electric powered wheelchair sideways tips and falls: experimental and computational analysis of impact forces and injury.

BACKGROUND: To reduce the occurrence of wheelchair falls and to develop effective protection systems, we aimed to quantify sideways tip and fall dynamics of electric power wheelchairs (EPWs). We hypothesized that driving speed, curb height and angle of approach would affect impact forces and head injury risk for wheelchair riders. We further expected that fall dynamics and head injury risk would be greater for unrestrained riders compared to restrained riders. METHODS: Sideways wheelchair tip and fall dynamics were reconstructed using a remotely operated rear wheel drive EPW and a Hybrid III test dummy driving at different approach angles (5 to 63°) over an adjustable height curb (0.30 to 0.41 m) at speeds of 0.6-1.5 m/s. Rigid body dynamics models (Madymo, TASS International, Livonia, MI) were developed in parallel with the experiments to systematically study and quantify the impact forces and the sideways tip or fall of an EPW user in different driving conditions. RESULTS: Shallower approach angles (25°) (p < 0.05) and higher curbs (0.4 m) (p < 0.05) were the most significant predictors of tipping for restrained passengers. Unrestrained passengers were most affected by higher curbs (0.4 m) (p < 0.005) and fell forward from the upright wheelchair when the approach angle was 60°. Head impact forces were greater in unrestrained users (6181 ± 2372 N) than restrained users (1336 ± 827 N) (p = 0.00053). Unrestrained users had significantly greater head impact severities than restrained users (HIC = 610 ± 634 vs HIC = 29 ± 38, p = 0.00013) and several tip events resulted in HICs > 1000 (severe head injury) in unrestrained users. CONCLUSIONS: Sideways tips and forward falls from wheelchairs were most sensitive to curb height and approach angle but were not affected by driving speed. Sideways tips and falls resulted in impact forces that could result in concussions or traumatic brain injury and require injury prevention strategies. Seat belts eliminated the risk of falling from an upright chair and reduced head impact forces in sideways wheelchair tips in this study; however, their use must be considered within the ethical and legal definitions of restraints.

Decoding Brain Signals to Classify Gait Direction Anticipation.

The use of brain-computer interface (BCI) technology has emerged as a promising rehabilitation approach for patients with motor function and motor-related disorders. BCIs provide an augmentative communication platform for controlling advanced assistive robots such as a lower-limb exoskeleton. Brain recordings collected by an electroencephalography (EEG) system have been employed in the BCI platform to command the exoskeleton. To date, the literature on this topic is limited to the prediction of gait intention and gait variations from EEG signals. This study, however, aims to predict the anticipated gait direction using a stream of EEG signals collected from the brain cortex. Three healthy participants (age range: 29-31, 2 female) were recruited. While wearing the EEG device, the participants were instructed to initiate gait movement toward the direction of the arrow triggers (pointing forward, backward, left, or right) being shown on a screen with a blank white background. Collected EEG data was then epoched around the trigger timepoints. These epochs were then converted to the time-frequency domain using event- related synchronization (ERS) and event-related desynchronization (ERD) methods. Finally, the classification pipeline was constructed using logistic regression (LR), support vector machine (SVM), and convolutional neural network (CNN). A ten-fold cross-validation scheme was used to evaluate the classification performance. The results revealed that the CNN classifier outperforms the other two classifiers with an accuracy of 0.75. Clinical Relevance - The outcome of this study has the potential to be ultimately used for interactive navigation of the lower-limb exoskeletons during robotic rehabilitation therapy and enhance neurodegeneration and neuroplasticity in a wide range of individuals with lower-limb motor function disabilities.

Family Experiences of Decreased Sound Tolerance in ASD.

Decreased sound tolerance (DST) is the most common sensory difficulty experienced by autistic individuals. Parents of 88 autistic children and young adults between the ages of 3 and 30 described coping strategies and physical and emotional responses used to deal with distressing sounds, and their impact on daily activities. Loud, sudden, and high-pitched sounds were most commonly endorsed as distressing, most often causing autistic children and young adults to cover their ears or yell, while producing stress, irritation, fear, and anxiety. Parents reported warning their child, providing breaks, or avoiding noisy settings as the most used coping strategies. Overall, findings indicate that DST leads to fewer opportunities for autistic children and young adults to participate at home, at school, and in the community. Further, results suggest hyperacusis, misophonia, and phonophobia, subtypes of DST, are present in autistic children and young adults.

Design and performance analysis of a 3-RRR spherical parallel manipulator for hip exoskeleton applications.

This paper presents the design and performance analysis and experimental study of a 3-RRR spherical parallel manipulator in the context of hip exoskeleton applications. First, the mechanism's inverse kinematics analysis and Jacobian matrix development are revisited. Manipulability, dexterity, and rotational sensitivity indices are then evaluated for two different methods of attachment to the human body. The superior attachment method in terms of these performance measures is indicated, and an experimental study based on the selected method is conducted; the experiment involves testing the capability of a 3-RRR manipulator's end-effector in tracking the motions experienced by a human hip joint during normal gait cycles. Finally, the results of the experimental study indicate that the manipulator represents a feasible hip exoskeleton solution providing total kinematic compliance with the human hip joint's 3-degree-of-freedom motion capabilities.

Discrimination of tooth layers and dental restorative materials using cutting sounds.

Dental restoration begins with removing carries and affected tissues with air-turbine rotary cutting handpieces, and later restoring the lost tissues with appropriate restorative materials to retain the functionality. Most restoration materials eventually fail as they age and need to be replaced. One of the difficulties in replacing failing restorations is discerning the boundary of restorative materials, which causes inadvertent removal of healthy tooth layers. Developing an objective and sensor-based method is a promising approach to monitor dental restorative operations and to prevent excessive tooth losses. This paper has analyzed cutting sounds of an air-turbine handpiece to discriminate between tooth layers and two commonly used restorative materials, amalgam and composite. Support vector machines were employed for classification, and the averaged short-time Fourier transform coefficients were selected as the features. The classifier performance was evaluated from different aspects such as the number of features, feature scaling methods, classification schemes, and utilized kernels. The total classification accuracies were 89% and 92% for cases included composite and amalgam materials, respectively. The obtained results indicated the feasibility and effectiveness of the proposed method.

Preliminary results on quantification of Seismocardiogram morphological changes, using principal component analysis.

A methodology, based on principal component analysis, is proposed to quantify beat to beat Seismocardiogram changes. The proposed method was tested over a population of 94 subjects including 35 ischemic heart disease patients. The results showed that there was an insignificant overlap between the diseased and the healthy populations in the number of principal components (NPC) and that further development of this method might yield a classification index for myocardial abnormalities. In addition such an index has potential utility in patient monitoring.