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High-pressure processing (HPP) of donor human milk (DM) minimally impacts the concentration and bioactivity of some important bioactive proteins including lactoferrin, and bile salt-stimulated lipase (BSSL) compared to Holder pasteurization (HoP), yet the impact of HPP and subsequent digestion on the full array of proteins detectable by proteomics remains unclear. We investigated how HPP impacts undigested proteins in DM post-processing and across digestion by proteomic analysis. Each pool of milk (n = 3) remained raw, or was treated by HPP (500 MPa, 10 min) or HoP (62.5 °C, 30 min), and underwent dynamic in vitro digestion simulating the preterm infant. In the meal, major proteins were minimally changed post-processing. HPP-treated milk proteins better resisted proximal digestion (except for immunoglobulins, jejunum 180 min) and the extent of undigested proteins after gastric digestion of major proteins in HPP-treated milk was more similar to raw (e.g., BSSL, lactoferrin, macrophage-receptor-1, CD14, complement-c3/c4, xanthine dehydrogenase) than HoP.
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Digestión , Recien Nacido Prematuro , Proteínas de la Leche , Leche Humana , Pasteurización , Proteómica , Humanos , Leche Humana/química , Leche Humana/metabolismo , Proteínas de la Leche/metabolismo , Proteínas de la Leche/química , Proteínas de la Leche/análisis , Presión , Recién Nacido , Lactoferrina/análisis , Lactoferrina/metabolismo , Manipulación de Alimentos , Femenino , Lactante , Modelos BiológicosRESUMEN
High ammonia-nitrogen digestate has become a key bottleneck limiting the anaerobic digestion of organic solid waste. Vacuum ammonia stripping can simultaneously remove and recover ammonia nitrogen, which has attracted a lot of attention in recent years. To investigate the parameter effects on the efficiency and mass transfer, five combination conditions (53 °C 15 kPa, 60 °C 20 kPa, 65 °C 25 kPa, 72 °C 35 kPa, and 81 °C 50 kPa) were conducted for ammonia stripping of sludge digestate. The results showed that 80% of ammonia nitrogen was stripped in 45 min for all experimental groups, but the ammonia transfer coefficient varied under different conditions, which increased with the rising of boiling point temperature, and reached the maximum value (39.0 mm/hr) at 81 °C 50 kPa. The ammonia nitrogen removal efficiency was more than 80% for 30 min vacuum stripping after adjusting the initial pH to above 9.5, and adjustment of the initial alkalinity also affects the pH value of liquid digestate. It was found that pH and alkalinity are the key factors influencing the ammonia nitrogen dissociation and removal efficiency, while temperature and vacuum mainly affect the ammonia nitrogen mass transfer and removal velocity. In terms of the mechanism of vacuum ammonia stripping, it underwent alkalinity destruction, pH enhancement, ammonia nitrogen dissociation, and free ammonia removal. In this study, two-stage experiments of alkalinity destruction and ammonia removal were also carried out, which showed that the two-stage configuration was beneficial for ammonia removal. It provides a theoretical basis and practical technology for the vacuum ammonia stripping from liquid digestate of organic solid waste.
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Amoníaco , Temperatura , Eliminación de Residuos Líquidos , Amoníaco/química , Concentración de Iones de Hidrógeno , Vacio , Eliminación de Residuos Líquidos/métodos , Nitrógeno , Aguas del Alcantarillado/química , PresiónRESUMEN
To address the conflict between pressure relief and support effectiveness caused by large-diameter boreholes in roadway surrounding rock, this paper proposes a method involving variable-diameter boreholes for pressure relief and energy dissipation. With a typical rock burst coal mine as the engineering context, the study establishes a mechanical model for variable-diameter boreholes through theoretical analysis to examine the elastic stress distribution around boreholes within the coal body. Physical similarity simulation tests are conducted to investigate the influence of conventional borehole and variable diameter borehole on the transmission pattern of dynamic load stress waves. Furthermore, numerical simulations are employed to explore the effects of reaming diameter, depth, and spacing on pressure relief, energy dissipation, and attenuation of dynamic stress wave transmission in roadway surrounding rock. The results demonstrate that stress within the coal surrounding the variable-diameter borehole correlates with the borehole radius, lateral pressure coefficient, and distance from the point to the borehole center, the extent of the plastic zone is influenced by borehole diameter, spacing, and depth. Increased diameter, reduced spacing, and greater depth of deep reaming holes exacerbate the transfer of stress concentration from the surrounding rock of the roadway to the deeper regions, facilitating the formation of stress double peak areas. Moreover, the variable diameter position should be within the original stress peak position of the surrounding rock in the roadway, with deep reaming passing through the stress concentration area for optimal results. This study offers guidance on the prevention and control technology for rock bursts in deep coal mining operations.
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Presión , Modelos Teóricos , Minas de Carbón , Estrés Mecánico , Simulación por Computador , Carbón MineralRESUMEN
The objective of this study was to study the impact of pressing time on the microstructure of goat cheese and its relationship with sensory attributes. The microstructure of the artisanal cheeses was performed by scanning electron microscopy and image analysis. The validation of the microstructural complexity was carried out experimentally with sensory attributes. The pressing time influenced the microstructural parameters Feretmax, Geodiam, and τ and the cheese type influenced the parameters Feretmax, Geodiam, and Geoelong. The correlation values between microstructural complexity and sensory attributes were 0.85 and 0.84 for fresh cheeses and matured cheeses, respectively. The pressure times of 12 and 18 h resulted in cheese microstructures with the highest complexity in terms of Feretmax, Geodiam, Geoelong, and τ parameters. The obtained results are supported by the correlation values between microstructural complexity and sensory attributes.
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Queso , Manipulación de Alimentos , Cabras , Microscopía Electrónica de Rastreo , Gusto , Queso/análisis , Animales , Humanos , Factores de Tiempo , PresiónRESUMEN
Audible very-high frequency sound (VHFS) and ultrasound (US) have been rated more unpleasant than lower frequency sounds when presented to listeners at similar sensation levels (SLs). In this study, 17 participants rated the sensory unpleasantness of 14-, 16-, and 18-kHz tones and a 1-kHz reference tone. Tones were presented at equal subjective loudness levels for each individual, corresponding to levels of 10, 20, and 30 dB SL measured at 1 kHz. Participants were categorized as either "symptomatic" or "asymptomatic" based on self-reported previous symptoms that they attributed to exposure to VHFS/US. In both groups, subjective loudness increased more rapidly with sound pressure level for VHFS/US than for the 1-kHz reference tone, which is consistent with a reduced dynamic range at the higher frequencies. For loudness-matched tones, participants rated VHFS/US as more unpleasant than that for the 1-kHz reference. These results suggest that increased sensory unpleasantness and reduced dynamic range at high frequencies should be considered when designing or deploying equipment which emits VHFS/US that could be audible to exposed people.
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Estimulación Acústica , Percepción Sonora , Ondas Ultrasónicas , Humanos , Masculino , Femenino , Adulto , Adulto Joven , Sonido , Percepción Auditiva , Presión , Umbral AuditivoRESUMEN
The formation of starch-polyphenol complexes through high-pressure homogenization (HPH) is a promising method to reduce starch digestibility and control postprandial glycemic responses. This study investigated the combined effect of pH (5, 7, 9) and polyphenol structures (gallic acid, ferulic acid, quercetin, and tannic acid) on the formation, muti-scale structure, physicochemical properties, and digestibility of pea starch (PS)-polyphenol complexes prepared by HPH. Results revealed that reducing pH from 9 to 5 significantly strengthened the non-covalent binding between polyphenols and PS, achieving a maximum complex index of 13.89 %. This led to the formation of complexes with higher crystallinity and denser structures, promoting a robust network post-gelatinization with superior viscoelastic and thermal properties. These complexes showed increased resistance to enzymatic digestion, with the content of resistant starch increasing from 28.66 % to 42.00 %, rapidly digestible starch decreasing from 42.82 % to 21.88 %, and slowly digestible starch reducing from 71.34 % to 58.00 %. Gallic acid formed the strongest hydrogen bonds with PS, especially at pH 5, leading to the highest enzymatic resistance in PS-gallic acid complexes, with the content of resistant starch of 42.00 %, rapidly digestible starch of 23.35 % and slowly digestible starch of 58.00 %, and starch digestion rates at two digestive stages of 1.82 × 10-2 min-1 and 0.34 × 10-2 min-1. These insights advance our understanding of starch-polyphenol interactions and support the development of functional food products to improve metabolic health by mitigating rapid glucose release.
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Digestión , Ácido Gálico , Pisum sativum , Polifenoles , Almidón , Concentración de Iones de Hidrógeno , Polifenoles/química , Almidón/química , Almidón/metabolismo , Pisum sativum/química , Ácido Gálico/química , Taninos/química , Presión , Ácidos Cumáricos/química , Manipulación de Alimentos/métodos , Quercetina/químicaRESUMEN
The basic function of the tongue in pronouncing diadochokinesis and other syllables is not fully understood. This study investigates the influence of sound pressure levels and syllables on tongue pressure and muscle activity in 19 healthy adults (mean age: 28.2 years; range: 22-33 years). Tongue pressure and activity of the posterior tongue were measured using electromyography (EMG) when the velar stops /ka/, /ko/, /ga/, and /go/ were pronounced at 70, 60, 50, and 40 dB. Spearman's rank correlation revealed a significant, yet weak, positive association between tongue pressure and EMG activity (ρ = 0.14, p < 0.05). Mixed-effects model analysis showed that tongue pressure and EMG activity significantly increased at 70 dB compared to other sound pressure levels. While syllables did not significantly affect tongue pressure, the syllable /ko/ significantly increased EMG activity (coefficient = 0.048, p = 0.013). Although no significant differences in tongue pressure were observed for the velar stops /ka/, /ko/, /ga/, and /go/, it is suggested that articulation is achieved by altering the activity of both extrinsic and intrinsic tongue muscles. These findings highlight the importance of considering both tongue pressure and muscle activity when examining the physiological factors contributing to sound pressure levels during speech.
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Electromiografía , Presión , Habla , Lengua , Humanos , Lengua/fisiología , Electromiografía/métodos , Adulto , Masculino , Femenino , Adulto Joven , Habla/fisiología , FonéticaRESUMEN
OBJECTIVE: Femoral access site complications (ASC) are frequent yet significant conditions associated with percutaneous intervention procedures that affect patient-physician comfort. In this study, we compared ASC rates between patients who received compression with a sandbag, the standard practice in many clinics, and patients monitored solely with bedrest without sandbag compression. METHODS: This study included patients undergoing any transfemoral percutaneous intervention (mostly coronary interventions) between April 2019 and May 2023 at our clinic. Patients were classified into two groups: those monitored without a sandbag (n = 160) and those with a sandbag (n = 158). ASC rates (ecchymosis, pseudoaneurysm, hematoma, bleeding) were compared between the two groups. RESULTS: No differences were observed between the two groups in gender, age, sheath size, and bed rest times. Complications were observed in 16.9% (n = 27) of patients without sandbags and 25.3% (n = 40) of patients with sandbags. The most common complication was ecchymosis, seen in 10.6% (n = 17) of the no-sandbag group and 13.9% (n = 22) of the sandbag group. CONCLUSION: Following manual compression after femoral sheath removal, patients receiving bedrest without sandbag use are less likely to develop ASC. Additionally, dismissing sandbag use leads to a significant increase in patient comfort.
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Arteria Femoral , Humanos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Intervención Coronaria Percutánea/métodos , Intervención Coronaria Percutánea/efectos adversos , Presión , Estudios de SeguimientoRESUMEN
BACKGROUND: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. AIM: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. DESIGN: Prospective cohort study, longitudinal. SETTING: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). POPULATION: Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). METHODS: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). RESULTS: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. CONCLUSIONS: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. CLINICAL REHABILITATION IMPACT: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.
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Tirantes , Pie , Presión , Escoliosis , Humanos , Escoliosis/terapia , Escoliosis/fisiopatología , Adolescente , Femenino , Masculino , Estudios Prospectivos , Niño , Pie/fisiopatología , Estudios Longitudinales , Resultado del Tratamiento , Terapia Combinada , MarchaRESUMEN
BACKGROUND: Endotracheal intubation is a frequently performed procedure in anesthesia practice, and ensuring the correct inflation of the cuff is essential for maintaining the airway seal. Overinflation of endotracheal tube (ETT) cuffs can lead to complications, such as postoperative sore throat. This study aimed to compare the incidence of elevated ETT cuff pressure between saline and air inflation in elective laparoscopic abdominal surgery. METHODS: The study involved 60 participants ranging in age from 18 to 65, with American Society of Anesthesiologists physical status levels 1-2, who underwent laparoscopic abdominal surgery. We randomly assigned patients to two groups: Group A (air-filled ETT cuffs, N.=30) and Group S (saline-filled ETT cuffs, N.=30). Intra-cuff pressure was recorded before and after CO
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Abdomen , Intubación Intratraqueal , Laparoscopía , Solución Salina , Humanos , Intubación Intratraqueal/métodos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Abdomen/cirugía , Anciano , Solución Salina/administración & dosificación , Aire , Adulto Joven , Presión , AdolescenteRESUMEN
BACKGROUND: The superimposed pressure is the primary determinant of the pleural pressure gradient. Obesity is associated with elevated end-expiratory esophageal pressure, regardless of lung disease severity, and the superimposed pressure might not be the only determinant of the pleural pressure gradient. The study aims to measure partitioned respiratory mechanics and superimposed pressure in a cohort of patients admitted to the ICU with and without class III obesity (BMI ≥ 40 kg/m2), and to quantify the amount of thoracic adipose tissue and muscle through advanced imaging techniques. METHODS: This is a single-center observational study including ICU-admitted patients with acute respiratory failure who underwent a chest computed tomography scan within three days before/after esophageal manometry. The superimposed pressure was calculated from lung density and height of the largest axial lung slice. Automated deep-learning pipelines segmented lung parenchyma and quantified thoracic adipose tissue and skeletal muscle. RESULTS: N = 18 participants (50% female, age 60 [30-66] years), with 9 having BMI < 30 and 9 ≥ 40 kg/m2. Groups showed no significant differences in age, sex, clinical severity scores, or mortality. Patients with BMI ≥ 40 exhibited higher esophageal pressure (15.8 ± 2.6 vs. 8.3 ± 4.9 cmH2O, p = 0.001), higher pleural pressure gradient (11.1 ± 4.5 vs. 6.3 ± 4.9 cmH2O, p = 0.04), while superimposed pressure did not differ (6.8 ± 1.1 vs. 6.5 ± 1.5 cmH2O, p = 0.59). Subcutaneous and intrathoracic adipose tissue were significantly higher in subjects with BMI ≥ 40 and correlated positively with esophageal pressure and pleural pressure gradient (p < 0.05). Muscle areas did not differ between groups. CONCLUSIONS: In patients with class III obesity, the superimposed pressure does not approximate the pleural pressure gradient, which is higher than in patients with lower BMI. The quantity and distribution of subcutaneous and intrathoracic adiposity also contribute to increased pleural pressure gradients in individuals with BMI ≥ 40. This study introduces a novel physiological concept that provides a solid rationale for tailoring mechanical ventilation in patients with high BMI, where specific guidelines recommendations are lacking.
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Obesidad , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Adulto , Obesidad/fisiopatología , Obesidad/complicaciones , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tomografía Computarizada por Rayos X/métodos , Mecánica Respiratoria/fisiología , Manometría/métodos , Índice de Masa Corporal , PresiónRESUMEN
BACKGROUND: Foot ulcers and infections are a major and costly problem in patients with diabetes and a major cause of amputations. Plantar peak pressure plays an essential role in plantar ulceration. Off-loading is a common tool to reduce plantar peak pressure and risk of ulceration. The goal of this study was to determine whether reduction of plantar peak pressure can be achieved using a walking bike (a bike without pedals) compared with walking. METHODS: The study starts with a PubMed literature review. In a blinded prospective protocol, 14 healthy individuals (seven men, seven women; mean ± SD age, 39.5 ± 11.3 years) are included. In-shoe pedobarography sensors were attached between the skin and the standardized shoes, then participants walked 10 m three times and then moved over the same distance using a walking bike without removal of the sensor (three times) in a gait laboratory (84 measurements). RESULTS: In this single-blinded prospective study, mean ± SD plantar peak pressure was significantly reduced from 49.4 ± 12.9 N/cm2 with walking to 35.2 ± 14.6 N/cm2 using a walking bike (P = .003). Mean ± SD step length increased significantly from 0.68 ± 0.13 m to 0.91 ± 0.19 m (P < .001) due to a significantly reduced number of steps (from 7.7 ± 1.4 steps per 10 m of walking to 5.7 ± 1.1 steps per 10 m of using a walking bike; P < .001). CONCLUSIONS: Plantar peak pressure is a risk factor for ulceration in diabetes. Herein, a significant reduction of plantar peak pressure was seen using a walking bike compared with walking (P = .003). Walking bikes may be a tool for off-loading for diabetic patients, especially if both feet are ulcerated. Additional studies to validate these findings in patient care are planned.
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Ciclismo , Pie Diabético , Presión , Caminata , Humanos , Masculino , Femenino , Adulto , Caminata/fisiología , Estudios Prospectivos , Ciclismo/fisiología , Pie Diabético/fisiopatología , Pie Diabético/prevención & control , Persona de Mediana Edad , Método Simple Ciego , Pie/fisiopatología , Diabetes Mellitus/fisiopatologíaRESUMEN
INTRODUCTION: Hindfoot varus deformity is common in people with unilateral upper motor neuron syndrome (UMNS) and can be dynamic or persistent. The aims of this study were (1) to gain insight into plantar pressure characteristics of people with chronic UMNS in relation to hindfoot varus and (2) to propose a quantitative outcome measure, based on plantar pressure, for the scientific evaluation of surgical interventions. METHODS: In this retrospective study, a cohort comprising plantar pressure data of 49 people with UMNS (22 "no hindfoot varus", 18 "dynamic hindfoot varus", and 9 "persistent hindfoot varus"), and 586 healthy controls was analyzed. As an indication of plantigrade foot contact, the ratio between the plantar contact area of the affected and the non-affected foot was calculated. To investigate spatial and temporal aspects of plantar pressure, normalized plantar pressure patterns and center of pressure trajectories were computed. RESULTS: People with UMNS had lower plantar pressure area ratios compared to healthy controls. Additionally, increased plantar pressure underneath the lateral foot was found in people with a persistent hindfoot varus. Center of pressure trajectories were more lateral during the first 26% of the stance phase in people with a dynamic hindfoot varus and during the first 82% of the stance phase in people with a persistent hindfoot varus compared to healthy controls. CONCLUSION: Spatial and temporal differences in plantar pressure were found in people with dynamic or persistent hindfoot varus deformity. We propose to primarily use the medio-lateral center of pressure trajectory as outcome measure for the scientific evaluation of surgical interventions targeting hindfoot varus.
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Pie , Enfermedad de la Neurona Motora , Presión , Humanos , Femenino , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Pie/fisiopatología , Enfermedad de la Neurona Motora/fisiopatología , Enfermedad de la Neurona Motora/complicaciones , Adulto , Anciano , Estudios de Casos y Controles , Deformidades Adquiridas del Pie/fisiopatología , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/cirugía , Fenómenos BiomecánicosRESUMEN
BACKGROUND: The bronchial suction has been applied in speeding lung collapse. Low suction pressure may not speed lung collapse, but high pressure causes occult lung injury. The aim of the study was to explore efficacy and safety of different suction pressure for speeding lung collapse. METHODS: Eighty-four subjects undergoing uniport video-assisted thoracoscopic surgery (VATS) were randomly assigned for non-suction (Group 0), -10 cmH2O suction pressure (Group - 10), and - 30 cmH2O suction pressure (Group - 30). The primary outcome were the lung collapse scores (LCS) at 0 min (T0) after the visualization of the lung using a 10-point visual analogue scale and area under the curve (AUC) of LCS over time. The secondary outcomes included disconnection from the ventilator, the assessment of occult lung injury using NOS-3 expression, histologic scores of lung injury, and lung W/D weight ratio, intraoperative hypoxemia, the incidence of perioperative pulmonary complications. RESULTS: Both the LCS at T0 and AUC analysis showed that compared with Group 0, Group - 10 and Group - 30 significantly achieved good lung collapse (P < 0.05), but no difference between Group - 10 and Group - 30. Four patients in Group 0 were treated with disconnection maneuver. The assessment of occult lung injury showed no differences. CONCLUSIONS: Applying - 10 cmH2O suction pressure for 1 min when pleural incision is a relatively safe method to promote lung collapse without the occurrence of occult lung injury. TRIAL REGISTRATION: Chinese Clinical Trial Registry number, ChiCTR2200062991. Registered on 26/08/2022.
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Cirugía Torácica Asistida por Video , Humanos , Cirugía Torácica Asistida por Video/métodos , Masculino , Femenino , Persona de Mediana Edad , Succión/métodos , Anciano , Resultado del Tratamiento , Atelectasia Pulmonar/etiología , Atelectasia Pulmonar/prevención & control , Adulto , PresiónRESUMEN
Plantar shear stress may have an important role in the formation of a Diabetic Foot Ulcer, but its measurement is regarded as challenging and has limited research. This paper highlights the importance of anatomical specific shear sensor calibration and presents a feasibility study of a novel shear sensing system which has measured in-shoe shear stress from gait activity on both healthy and diabetic subjects. The sensing insole was based on a strain gauge array embedded in a silicone insole backed with a commercial normal pressure sensor. Sensor calibration factors were investigated using a custom mechanical test rig with indenter to exert both normal and shear forces. Indenter size and location were varied to investigate the importance of both loading area and position on measurement accuracy. The sensing insole, coupled with the calibration procedure, was tested one participant with diabetes and one healthy participant during two sessions of 15 minutes of treadmill walking. Calibration with different indenter areas (from 78.5 mm2 to 707 mm2) and different positions (up to 40 mm from sensor centre) showed variation in measurements of up to 80% and 90% respectively. Shear sensing results demonstrated high repeatability (>97%) and good accuracy (mean absolute error < ±18 kPa) in bench top mechanical tests and less than 21% variability within walking of 15-minutes duration. The results indicate the importance of mechanical coupling between embedded shear sensors and insole materials. It also highlights the importance of using an appropriate calibration method to ensure accurate shear stress measurement. The novel shear stress measurement system presented in this paper, demonstrates a viable method to measure accurate and repeatable in-shoe shear stress using the calibration procedure described. The validation and calibration methods outlined in this paper could be utilised as a standardised approach for the research community to develop and validate similar measurement technologies.
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Pie Diabético , Zapatos , Estrés Mecánico , Humanos , Pie Diabético/fisiopatología , Pie Diabético/diagnóstico , Calibración , Masculino , Pie/fisiopatología , Pie/fisiología , Femenino , Fenómenos Biomecánicos , Persona de Mediana Edad , Marcha/fisiología , Caminata/fisiología , Presión , AdultoRESUMEN
Pressure-relieving footwear helps prevent foot ulcers in people with diabetes. The footwear design contributes to this effect and includes the insole top cover. We aimed to assess the offloading effect of materials commonly used as insole top cover. We measured 20 participants with diabetes and peripheral neuropathy for in-shoe peak pressures while walking in their prescribed footwear with the insole covered with eight different materials, tested in randomized order. Top covers were a 3 mm or 6 mm thick open or closed-cell foam or a 6 mm thick combination of open- and closed-cell foams. We re-assessed pressures after one month of using the top cover. Peak pressures were assessed per anatomical foot region and a region of interest (i.e., previous ulceration or high barefoot pressure). Walking comfort was assessed using a 10-point Likert scale. Mean peak pressure at the region of interest varied between 167 (SD:56) and 186 (SD:65) kPa across top covers (p < 0.001) and was significantly higher for the 3 mm thick PPT than for four of the seven 6 mm thick top covers. Across 6 mm thick top covers, only two showed a significant peak pressure difference between them. Over time, peak pressures changed non-significantly from -2.7 to +47.8 kPa across top cover conditions. Comfort ratings were 8.0 to 8.4 across top covers (p = 0.863). The 6 mm thick foams provided more pressure relief than the 3 mm thick foam during walking in high-risk people with diabetes. Between the 6 mm thick foams and over time, only small differences exist. The choice of which 6 mm thick insole top cover to use may be determined more by availability, durability, ease of use, costs, or hygienic properties than by superiority in pressure-relief capacity.
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Pie Diabético , Presión , Zapatos , Caminata , Humanos , Masculino , Femenino , Pie Diabético/fisiopatología , Persona de Mediana Edad , Caminata/fisiología , Anciano , Ortesis del Pié , Diseño de Equipo , Diabetes Mellitus/fisiopatología , Úlcera del Pie/fisiopatología , Úlcera del Pie/prevención & control , Pie/fisiología , Pie/fisiopatologíaRESUMEN
An increase in plantar pressure and skin temperature is commonly associated with an increased risk of diabetic foot ulcers. However, the effect of insoles in reducing plantar temperature has not been commonly studied. The aim was to assess the effect of walking in insoles with different features on plantar temperature. Twenty-six (F/M:18/8) participants-13 with diabetes and 13 healthy, aged 55.67 ± 9.58 years-participated in this study. Skin temperature at seven plantar regions was measured using a thermal camera and reported as the difference between the temperature after walking with an insole for 20 m versus the baseline temperature. The mixed analyses of variance indicated substantial main effects for the Insole Condition, for both the right [Wilks' Lambda = 0.790, F(14, 492) = 4.393, p < 0.01, partial eta squared = 0.111] and left feet [Wilks' Lambda = 0.890, F(14, 492) = 2.103, p < 0.011, partial eta squared = 0.056]. The 2.5 mm-tall dimple insole was shown to be significantly more effective at reducing the temperature in the hallux and third met head regions compared to the 4 mm-tall dimple insole. The insoles showed to be significantly more effective in the diabetes group versus the healthy group, with large effect size for the right [Wilks' Lambda = 0.662, F(14, 492) = 8.037, p < 0.000, Partial eta-squared = 0.186] and left feet [Wilks' Lambda = 0.739, F(14, 492) = 5.727, p < 0.000, Partial eta-squared = 0.140]. This can have important practical implications for designing insoles with a view to decrease foot complications in people with diabetes.
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Pie Diabético , Ortesis del Pié , Pie , Presión , Temperatura Cutánea , Humanos , Persona de Mediana Edad , Masculino , Femenino , Temperatura Cutánea/fisiología , Pie/fisiopatología , Pie/fisiología , Pie Diabético/fisiopatología , Zapatos , Caminata/fisiología , Anciano , Diabetes Mellitus/fisiopatología , Adulto , TemperaturaRESUMEN
Colonoscopy has a limited field of view because it relies solely on a small camera attached to the end of the scope and a screen displayed on a monitor. Consequently, the quality and safety of diagnosis and treatment depend on the experience and skills of the gastroenterologist. When a novice attempts to insert the colonoscope during the procedure, excessive pressure can sometimes be applied to the colon wall. This pressure can cause a medical accident known as colonic perforation, which the physician should prevent. We propose an assisting device that senses the pressure applied to the colon wall, analyzes the risk of perforation, and warns the physician in real time. Flexible pressure sensors are attached to the surface of the colonoscope shaft. These sensors measure pressure signals during a colonoscopy procedure. A simple signal processor is used to collect and process the pressure signals. In the experiment, a colonoscope equipped with the proposed device was inserted into a simulated colon made from a colon extracted from a pig. The processed data were visually communicated to the gastroenterologist via displays and light-emitting diodes (LEDs). The device helps the physician continuously monitor and prevent excessive pressure on the colon wall. In this experiment, the device appropriately generated and delivered warnings to help the physicians prevent colonic perforation. In the future, the device is to be improved, and more experiments will be performed in live swine models or humans to confirm its efficacy and safety.
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Colon , Colonoscopía , Perforación Intestinal , Presión , Colonoscopía/instrumentación , Colonoscopía/métodos , Porcinos , Colon/diagnóstico por imagen , Humanos , Animales , Perforación Intestinal/prevención & control , Colonoscopios , Diseño de EquipoRESUMEN
This study addresses the need for highly sensitive tools to evaluate hand strength, particularly grasp and pinch strength, which are vital for diagnosing and rehabilitating conditions affecting hand function. Current devices like the Jamar dynamometer and Martin Vigorimeter, although reliable, fail to measure extremely low force or pressure values required for individuals with severe hand impairments. This research introduces a novel device, a modified Martin Vigorimeter, utilizing an ultra-soft latex chamber and differential pressure measurement to detect minute pressure changes, thus significantly enhancing sensitivity. The device offers a cost-effective solution, making advanced hand strength evaluation more accessible for clinical and research applications. Future research should validate its accuracy across diverse populations and settings, exploring its broader implications for hand rehabilitation and occupational health.
Asunto(s)
Fuerza de la Mano , Presión , Fuerza de la Mano/fisiología , Humanos , Mano/fisiología , Fuerza de Pellizco/fisiología , Dinamómetro de Fuerza Muscular , Diseño de EquipoRESUMEN
This study presents an IoT-based gait analysis system employing insole pressure sensors to assess gait kinetics. The system integrates piezoresistive sensors within a left foot insole, with data acquisition managed using an ESP32 board that communicates via Wi-Fi through an MQTT IoT framework. In this initial protocol study, we conducted a comparative analysis using the Zeno system, supported by PKMAS as the gold standard, to explore the correlation and agreement of data obtained from the insole system. Four volunteers (two males and two females, aged 24-28, without gait disorders) participated by walking along a 10 m Zeno system path, equipped with pressure sensors, while wearing the insole system. Vertical ground reaction force (vGRF) data were collected over four gait cycles. The preliminary results indicated a strong positive correlation (r = 0.87) between the insole and the reference system measurements. A Bland-Altman analysis further demonstrated a mean difference of approximately (0.011) between the two systems, suggesting a minimal yet significant bias. These findings suggest that piezoresistive sensors may offer a promising and cost-effective solution for gait disorder assessment and monitoring. However, operational factors such as high temperatures and sensor placement within the footwear can introduce noise or unwanted signal activation. The communication framework proved functional and reliable during this protocol, with plans for future expansion to multi-device applications. It is important to note that additional validation studies with larger sample sizes are required to confirm the system's reliability and robustness for clinical and research applications.