scholarly journals Investigating the Design and Manufacture of PneuNet Actuators As a Prosthetic Tongue for Mimicking Human Deglutition

2020 ◽  
Author(s):  
Francis Darmont Araya ◽  
Pradeep Radhakrishnan
Keyword(s):  
United States ◽  
Nationwide Inpatient Sample ◽  
Deposition Process ◽  
The United States ◽  
Decision Matrix ◽  
Kinematic Data ◽  
Prosthetic Devices ◽  
Nationwide Inpatient Sample Database ◽  
Increasing Trend ◽  
Design And Manufacture

Abstract The number of Total Glossectomy cases in the United States is seeing an increasing trend as per the Nationwide Inpatient Sample Database. Patients, who have undergone such aggressive surgical procedures, have extensive limitations performing basic oral functions such as swallowing (deglutition), eating and speaking. Current rehabilitation prostheses do little in restoring the functionality of the original tongue. This is true especially in deglutition, which is necessary to transfer a bolus to the esophagus. Such patients need advanced prosthetic devices and through this research, investigations into potential solutions for prosthetic tongues to aid in deglutition were carried out. Different designs were considered and based on a decision matrix, PneuNets (pneumatic networks) were adopted as the foundational basis for generating prosthetic tongue designs. Several prototypes were fabricated that used the Fused Filament Deposition process for producing the mold and silicone Eco-flex 00-30 for producing the mechanism. The resulting mechanism was powered using a pneumatic input and kinematic data was collected. Details from literature review, design iterations, simulations, validation processes, manufacturing challenges and conclusions will be discussed in depth in this paper.

scholarly journals Investigating the Design and Manufacture of Pneunet Actuators as a Prosthetic Tongue for Mimicking Human Deglutition

2021 ◽  
Author(s):  
Francis Darmont Araya ◽  
Pradeep Radhakrishnan
Keyword(s):  
United States ◽  
Nationwide Inpatient Sample ◽  
Deposition Process ◽  
The United States ◽  
Decision Matrix ◽  
Kinematic Data ◽  
Prosthetic Devices ◽  
Nationwide Inpatient Sample Database ◽  
Increasing Trend ◽  
Design And Manufacture

Abstract The number of Total Glossectomy cases in the United States is seeing an increasing trend as per the Nationwide Inpatient Sample Database. Patients, who have undergone such aggressive surgical procedures, have extensive limitations performing basic oral functions such as swallowing (deglutition), eating and speaking. Current rehabilitation prostheses do little in restoring the functionality of the original tongue. This is true especially in deglutition, which is necessary to transfer a bolus to the esophagus. Such patients need advanced prosthetic devices and through this research, investigations into potential solutions for prosthetic tongues to aid in deglutition were carried out. Different designs were considered and based on a decision matrix, PneuNets (pneumatic networks) were adopted as the foundational basis for generating prosthetic tongue designs. Several prototypes were fabricated that used the Fused Filament Deposition process for producing the mold and silicone Eco-flex 00-30 for producing the mechanism. The resulting mechanism with dimensions 2.4in x 1.8in x 0.24in was powered using a pneumatic input and kinematic data was collected. The experiments carried out showed potential in the concept but at the same time, there were challenges related to validating the kinematics and in the transfer of the bolus due to uncontrolled silicone expansions. Details from literature review, design iterations, simulations, validation processes, manufacturing challenges and conclusions will be discussed in depth in this paper.

scholarly journals Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004–2011

2014 ◽  
Vol 80 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
Hossein Masoomi ◽  
Ninh T. Nguyen ◽  
Matthew O. Dolich ◽  
Steven Mills ◽  
Joseph C. Carmichael ◽  
...  
Keyword(s):  
United States ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Nationwide Inpatient Sample ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
The United States ◽  
Hospital Charges ◽  
Nationwide Inpatient Sample Database

Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database, we examined patients who underwent appendectomy for acute appendicitis from 2004 to 2011. A total of 2,593,786 patients underwent appendectomy during this period. Overall, the rate of LA was 60.5 per cent (children: 58.1%; adults: 63%; elderly: 48.7%). LA rate significantly increased from 43.3 per cent in 2004 to 75 per cent in 2011. LA use increased 66 per cent in nonperforated appendicitis versus 100 per cent increase in LA use for perforated appendicitis. The LA rate increased in all age groups. The increased LA use was more significant in male patients (84%) compared with female patients (62%). The overall conversion rate of LA to OA was 6.3 per cent. Compared with OA, LA had a significantly lower complication rate, a lower mortality rate, a shorter mean hospital stay, and lower mean total hospital charges in both nonperforated and perforated appendices. LA has become an established procedure for appendectomy in nonperforated and perforated appendicitis in all rates exceeding OA. Conversion rate is relatively low (6.3%).

scholarly journals 765. Pyomyositis in the United States: Trends and Associations From the Healthcare Utilization Project Nationwide Inpatient Sample Database

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S340-S341
Author(s):  
Rheanne K Maravelas ◽  
Thomas Melgar ◽  
Sapna Sadarangani ◽  
Neiberg Lima ◽  
Zachary Rich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Healthcare Utilization ◽  
Nationwide Inpatient Sample ◽  
Myositis Ossificans ◽  
Organ Transplant ◽  
The United States ◽  
Nationwide Inpatient Sample Database ◽  
Duration Of Hospitalization

Abstract Background Pyomyositis is a spontaneous infection of skeletal muscle that can lead to abscess formation and sepsis. The purpose of our study was to better describe the characteristics, risk factors, and trends of primary pyomyositis in the United States. Methods This study is a retrospective review of data from the Healthcare Utilization Project Nationwide Inpatient Sample Database from 2002 to 2014. We systematically searched ICD-9 codes and included diagnoses of infective myositis and/or tropical pyomyositis and excluded progressive myositis ossificans and/or traumatic myositis ossificans. We compiled lists of codes for co-occurring infections, candidate risk factors, and microbiological data. Each group of related ICD-9 codes was combined into a single composite indicator. SAS studio was utilized for analysis. Results The database included a total of 100,790,900 discharges accounting for 482,872,274 weighted discharges with 13,011 pyomyositis cases accounting for 62,657 weighted cases. The patients with pyomyositis were significantly more likely to be younger, male, and have a longer duration of hospitalization. The proportion of discharges with pyomyositis has steadily risen more than 3-fold from 0.0054% to 0.0209%. Of the cases of pyomyositis, a minority had co-occurring deep tissue infections: 16.9% had osteomyelitis and 8.8% had septic arthritis. We found significantly higher rates of co-occurrence with HIV, diabetes mellitus, organ transplant, alcohol abuse, and chronic kidney disease compared with the general hospitalized population, suggesting these as relevant risk factors. When microorganisms were diagnosed, Staphylococus aureus was most common, followed by Streptococcus spp. Conclusion Our study identified a rapid increase in pyomyositis cases in the United States over our 12-year study period. Our results substantiate risk factors for pyomyositis related to immunosuppression and suggest that diabetes mellitus may be an important risk factor in the United States. Identifying causative organisms is helpful for empiric treatment. It is important that clinicians be aware of this emerging diagnosis relevant in both temperate and tropical areas of the globe. Disclosures All authors: No reported disclosures.

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