Comfort Of Device Research Articles

Surveying the Social Comfort of Body, Device, and Environment-Based Augmented Reality Interactions in Confined Passenger Spaces Using Mixed Reality Composite Videos

Augmented Reality (AR) headsets could significantly improve the passenger experience, freeing users from the restrictions of physical smartphones, tablets and seatback displays. However, the confined space of public transport and the varying proximity to other passengers may restrict what interaction techniques are deemed socially acceptable for AR users - particularly considering current reliance on mid-air interactions in consumer headsets. We contribute and utilize a novel approach to social acceptability video surveys, employing mixed reality composited videos to present a real user performing interactions across different virtual transport environments. This approach allows for controlled evaluation of perceived social acceptability whilst freeing researchers to present interactions in any simulated context. Our resulting survey (N=131) explores the social comfort of body, device, and environment-based interactions across seven transit seating arrangements. We reflect on the advantages of discreet inputs over mid-air and the unique challenges of face-to-face seating for passenger AR.

Sleep Quality and Comfort Reported by Sleep Bruxism Individuals Wearing the Occlusal Splint and Mandibular Advancement Splint: Revisiting Two Crossover Studies.

To assess (1) whether an occlusal splint (OS) or mandibular advancement splint (MAS) allowed better sleep quality and was more comfortable in individuals with sleep bruxism (SB); and (2) the relationship between sleep quality, comfort, and reduction in RMMA related to SB. Polysomnographic data from 21 SB subjects (mean ± SD age 25.6 ± 4.5 years) collected in two previous studies were compared. Morning self-reports on sleep quality and comfort of the oral device, polysomnographic data, and RMMA index data from no-device nights were compared to nights using an OS or MAS. The reduction ratio of the RMMA index was calculated for both devices. A responder to the oral device was identified when the RMMA index was less than 2 and when it showed a reduction of at least 50% from the no-device control night. Self-reports for sleep quality and comfort of the oral device showed a mild advantage of the OS when compared to the MAS (r2 = 0.47, r2 = 0.32; P ≤ .01). In responders, the MAS induced a greater reduction in the RMMA index (P = .03) than the OS. In the short term, the comfort of the oral device seemed to influence sleep quality in SB individuals. However, despite the slightly higher degree of comfort offered by the OS, the MAS induced a greater effect on the RMMA index. Int J Prosthodont 2022;36:138-147. doi: 10.11607/ijp.7525.

ChroniSense National Early Warning Score Study: Comparison Study of a Wearable Wrist Device to Measure Vital Signs in Patients Who Are Hospitalized.

Wearable devices could be used to continuously monitor vital signs in patients who are hospitalized, but they require validation. This study aimed to evaluate the clinical validity of the prototype of a semiautomated wearable wrist device (ChroniSense Polso) to measure vital signs and provide National Early Warning Scores (NEWSs). Vital signs and NEWSs measured using the wearable device were compared with standard, nurse-lead manual measurements. We enrolled adult patients (aged ≥18 years) who required vital sign measurements at least every 6 hours in a UK teaching district general hospital. Wearable device measurements were not used for clinical decision-making. The primary outcome was the agreement on the individual National Early Warning parameter scores and vital sign measurements: respiratory rate, oxygen saturation, body temperature, systolic blood pressure, and heart rate. Secondary outcomes were the agreement on the total NEWS, incidence of adverse events, and user acceptance. To compare the wearable device measurements with the standard measurements, we analyzed vital sign measurements by limits of agreement (Bland-Altman analysis) and conducted κ agreement analyses for NEWSs. A user experience survey was conducted with questions about comfort of the wrist device, safety, preference, and use. We included 132 participants in the study, with a mean age of 62 (SD 15.81) years; most of them were men (102/132, 77.3%). The highest weighted κ values were found for heart rate (0.69, 95% CI 0.57-0.81 for all 385 measurements) and systolic blood pressure (0.39, 95% CI 0.30-0.47 for all 339 measurements). Weighted κ values were low for respiration rate (0.03, 95% CI -0.001 to 0.05 for all 445 measurements), temperature (0, 95% CI 0-0 for all 231 measurements), and oxygen saturation (-0.11, 95% CI -0.20 to -0.02 for all 187 measurements). Weighted κ using Cicchetti-Allison weights showed κ of 0.20 (95% CI 0.03-0.38) when using all 56 total NEWSs. The user acceptance survey found that approximately half (45/91, 49%) of the participants found it comfortable to wear the device and liked its appearance. Most (85/92, 92%) of them said that they would wear the device during their next hospital visit, and many (74/92, 80%) said that they would recommend it to others. This study shows the promising use of a prototype wearable device to measure vital signs in a hospital setting. Agreement between the standard measurements and wearable device measurements was acceptable for systolic blood pressure and heart rate, but needed to be improved for respiration rate, temperature, and oxygen saturation. Future studies need to improve the clinical validity of this wearable device. Large studies are required to assess clinical outcomes and cost-effectiveness of wearable devices for vital sign measurement. RR2-10.1136/bmjopen-2018-028219.

Axial loading lumbar magnetic resonance imaging with a new device in asymptomatic individuals

Axial loading magnetic resonance imaging (MRI) of lumbar spine is of great significance in the diagnosis of lumbar diseases. However, the axial loading device used in clinic is unique and has some defects. Therefore, we aimed to investigate the effect and examinee comfort of a new device for axial loading lumbar MRI in asymptomatic volunteers. A new axial loading MRI device for the lumbar spine was developed. A total of 30 asymptomatic individuals underwent conventional lumbar MRI and axial loading lumbar MRI sequentially. The dural sac cross-sectional area (DSCA), sagittal vertebral canal diameter (SVCD), and disc height (DH) at L3-4, L4-5, and L5-S1 before and after axial loading were compared by two experienced radiologists. Examinee comfort during the two examinations was assessed. All 30 volunteers completed the examinations with the new device. No difference in examinee comfort was found between conventional and axial loading MRI. After axial loading, the DSCA, SVCD, and DH showed the largest decreases at L4-5 followed by L5-S1 and L3-4, with the decreases in DSCA and SVCD at L4-5 being significant (P<0.05). Definite imaging-diagnosable disc herniation or bulging was shown at three intervertebral disc levels of three participants. The new device could effectively implement axial loading of the lumbar spine without causing obvious discomfort for the examinee. The present study has demonstrated that significant changes occur in the lumbar spine of asymptomatic individuals after axial loading.

A Rigid and Flexible Combined Finger Exoskeleton Design with Variable Curvature

Some hand exoskeletons have been used in the rehabilitation treatment of paralyzed patients caused by stroke and cerebral apoplexy as a result of research into hand exoskeletons. However, how to make the patient more comfortable to use and how to make the exoskeleton more precise are still key issues that need to be studied. Aiming at the motion law and skeletal characteristics of the human hand, this paper proposes a soft exoskeleton machine for hand rehabilitation training that combines rigidity and flexibility. Using a simplified two-layer sliding spring mechanism, the device combines the comfort and fit of a flexible device with the accurate kinematics of a rigid device. The mechanism requires only one degree of freedom to drive the normal flexion and expansion of the three finger joints. By changing the section thickness of the spring sheet to change its section moment of inertia, the bending effect of the mechanism is optimized to better fit the bending characteristics of the finger joints. To simplify the simulation of the mechanism, the method of the pseudo-rigid-body model is used to target the spring leaf’s nonlinear deformation, to achieve intuitively understandable kinematics. Finally, the accuracy of the design is demonstrated through simulation and prototype models.

0367 Novel 3D-Printed Custom Oral Appliance Therapy: A Pilot Study

Abstract Introduction Oral appliance (OA) therapy protrudes the jaw in a more anterior position during sleep to treat obstructive sleep apnea. OA therapy can be used in combination or as an alternative to positive airway pressure (PAP) therapy. Most custom oral devices are fabricated with expensive manufacturing equipment or individually hand-made increasing treatment costs that prevent access to care for patients. Previous studies report concerns of cost-effectiveness of OA therapy and surveys of sleep physicians with cost concerns leading to barriers in prescribing OA therapy. More recent technological advancements in additive technology have allowed low-cost, custom fabrication of digitally designed OA. To date there have been no clinical studies that the authors are aware of that have investigated the feasibility of offering 3D printed custom OA therapy. Methods A novel OA was designed specifically for 3D-printing with additional features to improve clinician efficiency, patient comfort, and patient safety. A review of 3D-printed materials was completed to ensure biocompatibility requirements prior to clinical testing. Approval from the Committee for Protection of Human Subjects of University of Texas Health Science Center at Houston was obtained. Five participants had novel OA digitally designed based on scans of upper and lower teeth in addition to a bite registration recorded using a George Gauge. Participants were surveyed based on comfort of device and safety monitoring. Results Participants found the novel OA generally comfortable. Comfort questions were presented on a scale of 1 – 10, where ten is the highest level of comfort. On average participants found that the novel OA had comfort levels of 9.0 ± 0.77 on gums, 8.2 ± 0.92 on teeth, and 9.8 ± 0.20 of the jaw joints. No major adverse events were reported and the most common minor adverse event reported was increased salivation. Conclusion This pilot study illustrates the clinical feasibility of a novel 3D printed OA. Future studies will further investigate patient outcomes and clinician efficiency during clinical implementation of this novel OA. Though the use of 3D-printing technologies OA therapy has the potential to be offered at lower cost and delivered to the patient in one visit representing a paradigm shift. Support (If Any)

Assessment of the overall energy performance of an SPD smart window in a hot desert climate

In this study, the overall energy consumption and visual comfort of a switchable suspended particle device (SPD) smart window were investigated as part of the glazing integration of an adaptive building designed to consume less energy in a hot desert climate. A typical floor of a commercial office building in Riyadh was chosen for the energy and visual comfort simulation, which was based on Energy-Plus and Diva-for-Rhino software for cardinal orientation. A comprehensive simulation analysis of various state of SPD glazing, namely opaque (OFF), transparent (ON) and automated controlled (based on solar radiance: from 100w/m2 – 900w/m2), was conducted and the results were compared against traditional single glazing and double-glazing low emissivity (DG low-e) coated windows for reference. The simulation results indicated that switchable SPD smart windows (in the OFF and automated states) achieved a promising reduction of net energy by up to 58% against DG low-e, apart from at the northern orientation. Conversely, the opaque (OFF state) had a counterproductive impact on lighting energy consumption and visual comfort. Acceptable daylight autonomy (DA300lux) and Useful daylight illuminance (UDI100lux–2000lux) was observed for the SPD smart window in the ON and automated controlled states; moreover, it offered a significant reduction in daylight glare probability (DGP). Thus, controlled switchable SPD glazing can be a good alternative to standard glazing in a hot desert climate in terms of reducing energy use and providing visual comfort.

Visual Comfort of Tablet Devices under a Wide Range of Ambient Light Levels

E-reading devices are becoming more and more common in our daily life, and they are used under a wide range of ambient light levels, from completely dark to extremely bright conditions. In this study, a psychophysical experiment is carried out to investigate how ambient light level affects the visual comfort of an e-reading device. Human observers compare the visual comfort of pairs of different text-background lightness combinations on a tablet device under three ambient light levels (i.e., 150, 1500, and 15,000 lx). With our previous work, the experimental results show that the trend of visual comfort interval scales below 1500 lx (i.e., Dark, 150, 300, and 1500 lx) are similar to each other but not for those under illuminance above the 1500 lx (i.e., 3000 and 15,000 lx). For the same lightness difference between text and background, the observers tend to read the text with a white background compared to a black background, especially for 3000 and 15,000 lx. Moreover, a black text on a light-gray background is the most comfortable combination under these two illuminance levels. An evaluation model is proposed based on ambient illuminance, screen parameters, and visual estimation to design an optimal viewing condition when reading on the tablet display.

First proof-of-concept evaluation of the FUSION-X-US-II prototype for the performance of automated breast ultrasound in healthy volunteers

PurposeThe FUSION-X-US-II prototype was developed to combine 3D-automated breast ultrasound (ABUS) and digital breast tomosynthesis in a single device without decompressing the breast. We evaluated the technical function, feasibility of the examination workflow, image quality, breast tissue coverage and patient comfort of the ABUS device of the new prototype.MethodsIn this prospective feasibility study, the FUSION-X-US-II prototype was used to perform ABUS in 30 healthy volunteers without history of breast cancer. The ABUS images of the prototype were interpreted by a physician with specialization in breast diagnostics. Any detected lesions were measured and classified using BI-RADS® scores. Image quality was rated subjectively by the physician and coverage of the breast was measured. Patient comfort was evaluated by a questionnaire after the examination.ResultsOne hundred and six scans were performed (61 × CC, 23 × ML, 22 × MLO) in 60 breasts. Image acquisition and processing by the prototype was fast and accurate. Breast coverage by ABUS was approximately 90.8%. Sixteen breast lesions (all benign, classified as BIRADS® 2) were identified. The examination was tolerated by all patients.ConclusionThe FUSION-X-US-II prototype allows a rapid ABUS scan with mostly high patient comfort. Technical developments resulted in an improvement of quality and coverage compared to previous prototype versions. The results are encouraging for a test of the prototype in a clinical setting in combination with tomosynthesis.

Design of combined lower limb elastic compression device and comparative study with elastic bandage

To compared with the modified Robert Jones bandage of 3M elastic bandage, to evaluate the fitness, convenience, safety and comfort of the modular combination lower limb elastic compression device. Forty healthy adult college students, including 28 males and 12 females, aged 16 to 25 (20.3±2.2) years old and weighing 40 to 81 (60.4±20.2) kg, were randomly divided into two groups with 40 samples in each group. According to the body surface parameters of Chinese lower limbs and guided by the concept of modularization, a group of modular combined lower limb elastic compression device was designed. Each module was combined to evaluate the fitness of the modular combined compression device in thelength and circumference of the lower limbs. The left and right lower limbs were randomly paired and divided into groups, with 40 samples in each group. The convenience of the operation time, adjustment times and required time were compared between two groups. The safety of the two groups after 24 hours of application of pressure injury was compared. The subjective pain feeling changes within 24 hours were recorded by visual analogue scale (VAS) to evaluate the comfort. The device was composed of several elastic compression outer lining modules with different length and width of 15 cm, an inner lining module for buffering, positioning and attaching the main body, and an elastic ankle compression module. The length of the elastic compression outer lining module covers the circumference of the human lower limbs. The length of a single outer lining module increased from 15 cm to 80 cm every 5 cm interval, and the length of a single inner lining module increased from 62 cm to 83 cm every 3 cm interval. After the modules were selected and combined, the length and circumference of the lower limbs can reach 100% fitness. The operation time of the first placement(118.23±7.33) s and re operation(60.08±5.88) s of experimental group were significantly shorter than those of control group (164.68±8.93) s and re operation (131.23±7.91) s. The adjustment times (3) and operation time (3.50±0.71) s of experimental group were significantly shorter than those of control group(11)and operation time(139.00±5.66) s (P<0.05), but there was no significant difference between two groups (P>0.05). The VAS score of experimental group was significantly lower than that of control group at each time point (P<0.01). The modular combined elastic compression device has good fitness, better placement and flexible adjustment, convenience and safety, and better comfort than modified Robert Jones bandage of 3M elastic bandage.

Braille and Morse Code Based Tactile Information Coding and its Applications

Tactile sensing has recently been used in pattern recognition technology for pilots’ posture information and environmental information. Human tactile sensing is limited, however, through control of the spatial distribution and vibration intensity of each contact in the tactile stimulation array, the accuracy, convenience, and comfort of the tactile device can be comprehensively improved. Moreover, the recognition rate of most current flight posture information methods is low. In this paper, the principle of vibration haptic coding is optimized. A combined coding scheme of “vibration [Formula: see text] sequence” is used to recognize pilot’s flight posture. A novel triangular coding scheme is proposed for the first time. Compared to other commonly used coding schemes such as “needle scheme“ and “rectangle scheme”, experimental results show that the triangular coding scheme is 1.5% more accuracy with response time reduced by nearly 1.25s in recognition pilots’ flight posture information.

Diagnosis of Sleep-Disordered Breathing in the Home Environment.

Polysomnography, a gold standard for the diagnosis of sleep-disordered breathing, is a complex investigation requiring access to the sleep laboratory. Thus, sleep-disordered breathing could be underdiagnosed. The aim of this paper was to investigate the feasibility and effectiveness of self-performed investigation of obstructive sleep apnea (OSA) in the home setting, using a portable device, and to assess the comfort and simplicity of the procedure from the patient's perspective. The study included 68 middle-aged patients (21 women and 47 men), who were examined at home with the ApneaLink Air device in search for the underlying reason of reported nighttime snoring and occasionally disordered breathing pattern. The apnea-hypopnea index was quantified and matched with body mass index (BMI), age, and other characteristics. OSA was diagnosed in 37 patients (27 men and 10 women): 22 had mild, 4 had moderate, and 11 patients had severe OSA. All cases of severe OSA were present in men. Patients with severe OSA had significantly higher BMI than those from the other groups. All of the patients pointed to the comfort and ease of the diagnostic device. We conclude that home diagnosis of OSA is a relatively easy and cost-effective way to substitute for the hospital-linked polysomnography, particularly in severely ill patients who have a movement difficulty. A wider implementation of home-based diagnosis of OSA may substantially increase the number of patients investigated in a short time span, also leading to the plausibly upward correction of the disease prevalence.

Heart rate extraction from PPG signals using variational mode decomposition

Monitoring of vital signs using the photoplethysmography (PPG) signal is desirable for the development of home-based healthcare systems in the aspect of feasibility, mobility, comfort, and cost-effectiveness of the PPG device. In this paper, a new technique based on the variational mode decomposition (VMD) for estimating heart rate (HR) from the PPG signal is proposed. The VMD decomposes an input PPG signal into a number of modes or sub-signals. Afterward, the modes which are dominantly influenced by the HR information are selected and further processed for extracting HR of the patient. The proposed scheme is validated over a large number of recordings acquired from three independent databases, namely the Capnobase, MIMIC, and University of Queens Vital Sign (UQVS). Experiments are performed over different data length segments of the PPG recordings. Using the data length of 30s, the proposed technique outperformed the existing techniques by achieving the lower median (1st quartile, 3rd quartile) values of root mean square error (RMSE) as 0.23 (0.19, 0.31) beats per minute (bpm), 0.41 (0.31, 0.56) bpm and 1.1 (0.9, 1.22) bpm for the Capnobase, MIMIC, and UQVS datasets, respectively. Since the shorter data length is more suitable for the clinical applications, the proposed technique also provided satisfactory agreement between the derived and reference HR values for the shorter data length segments. Performance results over three independent datasets suggest that the proposed technique can provide accurate and reliable HR information using the PPG signal recorded from the patients suffering from dissimilar problems.

Automatic Computer-Based Detection of Epileptic Seizures.

Automatic computer-based seizure detection and warning devices are important for objective seizure documentation, for SUDEP prevention, to avoid seizure related injuries and social embarrassments as a consequence of seizures, and to develop on demand epilepsy therapies. Automatic seizure detection systems can be based on direct analysis of epileptiform discharges on scalp-EEG or intracranial EEG, on the detection of motor manifestations of epileptic seizures using surface electromyography (sEMG), accelerometry (ACM), video detection systems and mattress sensors and finally on the assessment of changes of physiologic parameters accompanying epileptic seizures measured by electrocardiography (ECG), respiratory monitors, pulse oximetry, surface temperature sensors, and electrodermal activity. Here we review automatic seizure detection based on scalp-EEG, ECG, and sEMG. Different seizure types affect preferentially different measurement parameters. While EEG changes accompany all types of seizures, sEMG and ACM are suitable mainly for detection of seizures with major motor manifestations. Therefore, seizure detection can be optimized by multimodal systems combining several measurement parameters. While most systems provide sensitivities over 70%, specificity expressed as false alarm rates still needs to be improved. Patients' acceptance and comfort of a specific device are of critical importance for its long-term application in a meaningful clinical way.

The comfort and safety of a novel rolling mechanical indentation device for the measurement of lumbar trunk stiffness in young adults

BackgroundThe measurement of Posterior-Anterior (P-A) spinal stiffness is a common component of the physical examination of patients presenting with spinal disorders. The aim of this assessment is to provoke pain and/or to determine the degree of resistance or compliance of these structures and the associated soft-tissues to loading. This information, combined with other patient-specific history and examination findings, is integrated into the clinical reasoning process and is used to guide treatment decisions. Unfortunately, there are inter-rater reliability and standardisation issues associated with the manual performance of this type of assessment. In an attempt to remedy these issues researchers have developed mechanical devices for the measurement of spinal stiffness. The aim of this research is to investigate the comfort and safety of a novel device for measuring P-A trunk stiffness in a sample of young adults.MethodsA sample of young adults from a general population was recruited in May 2016 from Sydney, Australia. Demographic, anthropometric and clinical variables were collected prior to participants undergoing a lumbar P-A trunk stiffness assessment involving a mechanical indentation device called the VerteTrack. The primary outcomes for the study were key feasibility items; overall assessment time, perceived comfort measured both during and after the procedure, and adverse events. Univariate ordinal logistic regression was used to identify key variables associated with a participant’s subjective report of comfort both during and after the VerteTrack assessment.ResultsEighty four participants (35% female) with a median age of 23 years (IQR = 3) took part in the research. The mean assessment time for the Vertetrack assessment was 11.6 min (SD = 2.1). Increasing load (p < 0.001) and increasing number of days with lower back pain (p = 0.009) were associated with decreased comfort ratings during the procedure. The vast majority 63/84 (75%) of participants rated the overall assessment experience as comfortable. There were two minor, short-lived adverse events recorded leading to an adverse event rate of 2.4% (2/84).ConclusionsThe results of this study suggest that the VerteTrack device is well-tolerated and can be used safely and efficiently when measuring P-A stiffness of the lumbar trunk in young adults.Trial registrationNot applicable.

EMG-based decoding of grasp gestures in reaching-to-grasping motions

Predicting the grasping function during reach-to-grasp motions is essential for controlling a prosthetic hand or a robotic assistive device. An early accurate prediction increases the usability and the comfort of a prosthetic device. This work proposes an electromyographic-based learning approach that decodes the grasping intention at an early stage of reach-to-grasp motion, i.e. before the final grasp/hand pre-shape takes place. Superficial electrodes and a Cyberglove were used to record the arm muscle activity and the finger joints during reach-to-grasp motions. Our results showed a 90% accuracy for the detection of the final grasp about 0.5 s after motion onset. This paper also examines the effect of different objects’ distances and different motion speeds on the detection time and accuracy of the classifier. The use of our learning approach to control a 16-degrees of freedom robotic hand confirmed the usability of our approach for the real-time control of robotic devices.

Strategy of postoperative TR-Band tourniquet to stop bleedingin coronary interventional treatment

Objective To observe the different methods of hemostasis and comfort of the TR-Band compression hemostasis device after coronary intervention and to find the best strategy for TR-Band to stop the bleeding. Methods 150 patients with coronary artery disease were randomly divided into three groups according to the digital table method. The initial time of TR-Band compression hemostasis of group A was 3h,(once per hour,2m L per time, total compression timewas10h), while that of group B was 2h(once in every two hours, 3mL per time, total compression time was 8h), and that of group C was 1h(once per hour,2mL per time, total compression time was 6 h). Thumb oxygen saturation, complications and comfort level in the three groups of patients were observed and compared. Results The differences between the three groups of oppression hemostasis before and after 2 h thumb oxygen saturation were normal, the three groups had no statistical significance(P＞0.05). lesions, hematoma, bruising and radial artery occlusion occurred rate of group A were respectively 4,3,5,2 cases, those of group B were 3,4,6,1 cases, and those of group C were 2,5,6,0 cases. Lesions, hematoma, bruising, radial artery occlusion of local complication incidence of the three groups showed no statistical significance(P＞0.05). The comfort level(numbness, swelling, pain)of the three groups had statistically significant differences(F numbness＝8.215,Fswelling＝7.657,F pain＝7.985,all P＜0.01). Conclusion TR-Band compression hemostasis device can achieve effective hemostasis in the treatment of coronary artery intervention. And the reasonable adjustment of different bleeding time，compression time and the amount of bleeding can affect the comfort of patients. Key words: Hemostasis; TR-Band hemostat; Coronary intervention

The dose–response relationship between lateral foot wedging and the reduction of knee adduction moment

BackgroundLateral foot wedges represent a biomechanical intervention aimed at reducing medial knee loads. However, the effects of varying wedge amounts on biomechanical variables and orthotic comfort have not been systematically studied. Further, arch height may influence the comfort of laterally wedged devices. Therefore, the primary purpose of this study was to examine the effect of incrementally increasing lateral wedge amounts on knee adduction moment parameters and subjective comfort. The secondary purpose was to relate arch height measures to the comfort of the devices. MethodsTwenty-five healthy subjects underwent three-dimensional instrumented gait analysis testing using seven inclinations of lateral wedging (0°, 2°, 4°, 6°, 8°, 10°, 12°). Subjects reported comfort level for each orthotic condition. Arch heights were measured in standing and sitting, and rigidity index and stiffness were calculated. FindingsThe knee adduction moment decreased with wedge amounts up to 6°, but more aggressive amounts did not yield additional reductions. Comfort ratings did not change from baseline until wedge amounts exceeded 8°. In addition, arch height measures, arch rigidity index and stiffness did not relate to the comfort of the orthotic device regardless of the wedge amount. InterpretationKnee adduction moment decreased with mild wedge amounts while maintaining comfort. Wedge amounts greater than 6° yielded little additional mechanical benefit and amounts greater than 8° compromised comfort. It appears that 4°–6° of lateral wedging are optimal in regard to desirable biomechanical change and comfort level in healthy individuals.

Patients Prefer the Use of a Patient Decision-Making Aid When Discussing Surgical Options for Nephrolithiasis

METHODS: The magnetic Blackstar DJ is a 7 french ureteral stent with a small magnet fixed with a string at the distal DJ loop. To remove the DJ a customized catheter with a magnetic Tiemann tip is used. The catheter is inserted after transurethral application of a standard lubricant and removed with the DJ after getting in contact with the DJ’s magnet. The study was approved by local ethics committee. We placed the magnetic DJ in 20 consecutive patients after ureteroscopy for stone removal. No additional foley catheter was placed. The DJ was removed the next day with the magnetic retrieval catheter either by a physician or a nurse. Retrieval time, patient comfort and feasibility of the retrieval device were assessed. RESULTS: The DJ could be removed with the retrieval device within less than 30 seconds in 19 out of 20 patients. In the first patient the removal was not successful due to an enlarged prostate middle lobe. For this patient a cystoscopical removal was needed. In the second patient the removal was performed under fluoroscopic control to ensure save handling of the retrieval device by the surgeon. In all other patients the removal of the catheter was performed in the patients room on the ward. CONCLUSIONS: The removal of the magnetic DJ using the retrieval device is fast and easy and can be performed by physicians as well as nurses. The patients didn’t complain about a lot of discomfort during the removal. This technique might lead to significant cost reduction compared to the standard cystoscopical removal of ureter stents with sterile instruments in the endourological operation room. Our feasibility study indicates this magnetic DJ to significantly reduce patient’s discomfort by DJ removal and therefore seems to be a promising new device for endourologists.

PD37-11 BLACK-STAR® - MAGNETIC DJ REMOVAL

You have accessJournal of UrologyStone Disease: New Technology II1 Apr 2014PD37-11 BLACK-STAR® - MAGNETIC DJ REMOVAL Marie-Claire Rassweiler, Maurice-Stephan Michel, and Manuel Ritter Marie-Claire RassweilerMarie-Claire Rassweiler More articles by this author , Maurice-Stephan MichelMaurice-Stephan Michel More articles by this author , and Manuel RitterManuel Ritter More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2029AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteral stenting is a common procedure in endourology. One routine indication is after ureteroscopic stone extraction if small urothelial lesions occured. The cystoscopic removal of a ureteral stent can cause unpleasant side effects, such as urinary frequency, urgency, incontinence, haematuria, bladder pain and flank pain, which have a negative impact on a patient's life. It is necessary to minimize the pain during stent removal in order to increase the patient’s quality of life. Therefore we prospectively assessed the feasibility of a newly developed ureter stent (DJ) with a small magnet at its distal end (Magnetic Black Star, Urotech (Achenmühle, Germany) and a customized magnetic retrieval catheter. METHODS The magnetic Blackstar DJ is a 7 french ureteral stent with a small magnet fixed with a string at the distal DJ loop. To remove the DJ a customized catheter with a magnetic Tiemann tip is used. The catheter is inserted after transurethral application of a standard lubricant and removed with the DJ after getting in contact with the DJ’s magnet. The study was approved by local ethics committee. We placed the magnetic DJ in 20 consecutive patients after ureteroscopy for stone removal. No additional foley catheter was placed. The DJ was removed the next day with the magnetic retrieval catheter either by a physician or a nurse. Retrieval time, patient comfort and feasibility of the retrieval device were assessed. RESULTS The DJ could be removed with the retrieval device within less than 30 seconds in 19 out of 20 patients. In the first patient the removal was not successful due to an enlarged prostate middle lobe. For this patient a cystoscopical removal was needed. In the second patient the removal was performed under fluoroscopic control to ensure save handling of the retrieval device by the surgeon. In all other patients the removal of the catheter was performed in the patients room on the ward. CONCLUSIONS The removal of the magnetic DJ using the retrieval device is fast and easy and can be performed by physicians as well as nurses. The patients didn’t complain about a lot of discomfort during the removal. This technique might lead to significant cost reduction compared to the standard cystoscopical removal of ureter stents with sterile instruments in the endourological operation room. Our feasibility study indicates this magnetic DJ to significantly reduce patient’s discomfort by DJ removal and therefore seems to be a promising new device for endourologists. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e949-e950 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Marie-Claire Rassweiler More articles by this author Maurice-Stephan Michel More articles by this author Manuel Ritter More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...