Foam Mattress Research Articles

Innovative air mattress for the prevention of pressure ulcers in neonates.

Pressure ulcers (PUs) severely impact health outcomes in neonatal intensive care, with up to 28% prevalence and doubled mortality rates. Due to their only partially developed stratum corneum, neonates are highly susceptible to PUs because of a lack of adequate support surfaces. The occipital region of the head and hip are the main risk areas due to immobility and newborn body proportions. The main goal of the study was to investigate the impact of reduction in local pressure in these body areas by two air mattress designs and different filling states. Two innovative air-filled mattress prototypes (prototype 1 and prototype 2), consisting of three different segments (head, trunk and feet regions), were developed to reduce local interface pressures by optimising pressure distribution, and were assessed with three air pressure filling states (0.2kPa, 0.4kPa and 0.6kPa). A baby doll was used to investigate pressure distribution and local pressure impact. It measured 51cm and the weight was modified to be 1.3kg, 2.3kg and 3.3kg, representing premature to term newborn weights, respectively. A specialised foam mattress and an unsupported surface were considered as controls. The interface pressures at the hip region for newborn models could be reduced by up to 41% with mattress prototype 1 and 49% with prototype 2 when filled with 0.2kPa air pressure. It was found that the size and the pressure inside air segments was crucial for interface pressure. Our results demonstrated that air mattresses achieved lower interface pressures compared to conventional support surfaces, and that the benefit of the air mattresses depended on their filling status. The importance of using innovative, segmented designs that were tailored to meet the specific needs of highly vulnerable paediatric patients was demonstrated.

Sleep disruption and sleep position: Increased wake frequency in supine predicts lateral position preference.

Little is known about the physiological and biomechanical factors that determine individual preferences in lying posture during sleep. This study investigated relationships between position preference and position-specific arousals, awakenings, limb movements and limb movement arousals to explore the mechanisms by which biomechanical factors influence position preference. Forty-one mature-aged adults underwent 2 nights of at-home polysomnography ~2 weeks apart, on a standardised firm foam mattress, measuring nocturnal sleep architecture and position. The lateral supine ratio and restlessness indices specific to lateral and supine positions including limb movement index, limb movement arousal index, arousal index, wake index, respiratory arousal index and apnea-hypopnea index were calculated and analysed via linear mixed-effects regression. In the supine position, all restlessness indices were significantly increased compared with the lateral position, including a 379% increase in respiratory arousals (β = 7.0, p < 0.001), 108% increase in arousal index (β = 10.3, p < 0.001) and 107% increase in wake index (β = 2.5, p < 0.001). Wake index in the supine position increased significantly with more lateral sleep (β = 1.9, p = 0.0013), and significant correlation between lateral supine ratio polysomnography 1 and lateral supine ratio polysomnography 2 (β = 0.95, p < 0.001) indicated strong consistency in sleep preference. Overall, the findings suggest that some individuals have low tolerance to supine posture, represented by a comparatively high wake index in the supine position, and that these individuals compensate by sleeping a greater proportion in the lateral position.

Knowledge and Attitudes Toward Pressure Ulcer Prevention Evidence-based Guidelines among Nursing Students at Jazan University, Saudi Arabia.

Pressure ulcers (PUs) are a common global problem. They affect health-care costs and patient health because of increased morbidity and mortality rates. Critically ill patients are more prone to acquiring PUs than other patients. As the prevalence of PUs is high in Saudi Arabia, more attention is required for PU prevention. Nurses' knowledge and attitudes toward PU prevention are crucial. This study aimed to assess the knowledge and attitudes of nursing students regarding PU prevention evidence-based guidelines. This descriptive, cross-sectional study was conducted among nursing students at Jazan University. Data were collected using an electronic questionnaire. Data were entered, coded, and analyzed using the SPSS version 23. A total of 378 participants were included. The mean age was 22.4 ± 3.4 years, and the mean knowledge score was 7.6 ± 2.64 (range = 0-16). Of the participants, 365 (96.6%) and 13 (3.4%) were considered to have poor and good knowledge about PUs, respectively. Only 72 (19%) correctly identified a lack of oxygen as the cause of PUs; other participants answered malnutrition and moisture. Conversely, 200 (52.9%) participants indicated that recent weight loss below patients' ideal weight increases the risk for PUs. Concerning knowledge about preventive measures, 64 (16.9%) participants correctly answered that a backward sitting position, with both legs resting on a footrest, can reduce the amount of pressure. Meanwhile, 169 (44.7%) participants correctly selected thick air cushion as a means to reduce the magnitude of pressure when patients are sliding down on a chair. Some participants answered that PUs can be reduced if patients are mobilized. Seventy-two (19%) participants indicated that patients laying on a visco-elastic foam mattress should be repositioned every 2 h to reduce the duration of pressure. Age, year of education, training experience, and department were not significantly associated with knowledge about PUs (P = 0.333, P = 0.370, P = 0.700, and P = 0.810, respectively). The general knowledge and attitudes toward PUs of the nursing students at Jazan University were poor. Nevertheless, they had an average knowledge level regarding PU prevention. Age and training experience were not significantly associated with knowledge about PUs.

Mechanical recycling of foam from end-of-life mattresses by AIR-LAY process for the production of new mattresses with a fully circular approach

A novel method for the recycling of end-of-life mattresses foam, using an AIR-LAY process which employs a bi-component fiber as a binder for the polyurethane foam, have been developed and optimized. This method permits to obtain materials with the same density of the starting foam (25 kg/m3) and with a significantly lower density with respect to that obtainable with the rebonding process (above 70 kg/m3) that uses isocyanates to bond the foam particles. The obtained recycled foams have been tested by mechanical compression and recovery tests showing that compression values of 3.7 KPa, similar to that of the mattress foam (3.0 KPa), can be achieved using 20 % of bi-component fibers as binders and a density of 35 kg/m3. On the contrary, only 3 times stiffer and denser materials can be obtained using the rebonding technology, thus making them not suitable for application in mattresses. On the basis of the results of the optimization tests a set of mattresses containing a layer of the recycled foams have been prepared. The results of the tests on the prepared mattresses have shown that they have the same compression behavior, recovery time and durability (after 30,000 cycles of compression) of a standard mattress without the recycled layer, thus proving that a fully circular approach in the recycling of the foam of the mattresses is possible using the AIR-LAY process.

A novel in-bed body posture monitoring for decubitus ulcer prevention using body pressure distribution mapping

BackgroundDecubitus ulcers are prevalent among the aging population due to a gradual decline in their overall health, such as nutrition, mental health, and mobility, resulting in injury to the skin and tissue. The most common technique to prevent these ulcers is through frequent repositioning to redistribute body pressures. Therefore, the main goal of this study is to facilitate the timely repositioning of patients through the use of a pressure mat to identify in-bed postures in various sleep environments. Pressure data were collected from 10 healthy participants lying down on a pressure mat in 19 various in-bed postures, correlating to the supine, prone, right-side, and left-side classes. In addition, pressure data were collected from participants sitting at the edge of the bed as well as an empty bed. Each participant was asked to lie in these 19 postures in three distinct testing environments: a hospital bed, a home bed, and a home bed with a foam mattress topper. To categorize each posture into its respective class, the pre-trained 2D ResNet-18 CNN and the pre-trained Inflated 3D CNN algorithms were trained and validated using image and video pressure mapped data, respectively.ResultsThe ResNet-18 and Inflated 3D CNN algorithms were validated using leave-one-subject-out (LOSO) and leave-one-environment-out (LOEO) cross-validation techniques. LOSO provided an average accuracy of 92.07% ± 5.72% and 82.22% ± 8.50%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively. Contrastingly, LOEO provided a reduced average accuracy of 85.37% ± 14.38% and 77.79% ± 9.76%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively.ConclusionThese pilot results indicate that the proposed algorithms can accurately distinguish between in-bed postures, on unseen participant data as well as unseen mattress environment data. The proposed algorithms can establish the basis of a decubitus ulcer prevention platform that can be applied to various sleeping environments. To the best of our knowledge, the impact of mattress stiffness has not been considered in previous studies regarding in-bed posture monitoring.

Impact of filler and gelling catalyst/agent on properties of flexible polyurethane foam

AbstractIn this study, the physiomechanical properties of carboxymethylcellulose sodium salt (Na‐CMC salt) filler‐loaded foam and its impact on the wicking capacity of the foam were investigated in juxtaposition with the increasing tin concentration. According to the study's findings, standard unfilled foam demonstrated no wicking at all, while flexible PU foam filled with Na‐CMC salt, even with low porosity and subpar mechanical traits, displayed wicking heights of 4 mm, 3.4 mm, and 2.8 mm in test specimens of thicknesses of 6 mm, 8 mm, and 10 mm. Moreover, filled foam with a higher porosity level exhibited significantly better wicking heights of 11.4 mm, 10.8 mm, and 8.2 mm. The inclusion of CMC filler in the PU foam matrix is the reason for enhanced wicking property in foam. The sample thickness and wicking height trends are consistent among all foams; as foam sample thickness increases, wicking height progressively falls. The correlation between the foam's porosity value and the number of closed cell windows is confirmed by stereomicroscopy and the porosity values. According to this study, the infused filler's characteristics have a greater influence on the foam's wicking capacity than the foam's porosity. This study contributes significant insights into ongoing initiatives to enhance user experience, well‐being, and hygiene through innovative and meticulously designed new developed mattress foam using Na‐CMC as a filler.Highlights Co‐relation between concentration of tin and infused filler on wicking property. Standard unfilled foam demonstrated no wicking at all. Na‐CMC salt filled foam displayed wicking heights. After 15% increase in tin level, mechanical properties of foam degrade. Wicking depends on nature of infused filler and the foam's porosity.

A budget impact analysis of a powered hybrid mattress to prevent pressure ulcers in the Austrian inpatient setting: An original research.

Pressure ulcer is a considerable health problem and is associated with an increased hospital length of stay (LOS), nursing effort, costs, and reduced quality of life. The aim of this analysis is to compare the economic, clinical, and nursing benefit after the implementation of the powered hybrid mattress Dyna-Form Mercury Advance SMARTcare® in 2019 with the situation in 2017 (rental systems Arjo BariAir® and Arjo TheraKair Visio®, and purchased foam mattresses Arjo Simuflex®) using a single center. In the framework of a budget impact analysis, a difference-in-difference approach was used to compare pre-implementation longitudinal data (2017) with post-implementation data (2019). The longitudinal data comprise the mattress resource use, patient characteristics, and LOS. The care effort was gathered based on a full survey of all 75 members of the nursing staff using the online tool "LimeSurvey." In this survey, the resource use of the different mattress systems was identified in terms of time (minutes or days). This analysis was performed from the hospital perspective and included direct costs of mattress systems, Austrian diagnostic-related group costs for the hospital stay and nursing staff costs for 2019. Based on 1253 patients "at-risk," the total yearly costs implementing the powered hybrid mattress amounts to 654,248€ compared with 901,469€ when using Arjo products. The budget impact shows a cost advantage of 247,221€. Furthermore, the powered hybrid mattress system leads to fewer nursing-staff time in minutes per year (-1,031,097 min [1,993,204 vs. 3,024,302]); 242€ are saved per patient. Compared with the Arjo products, fewer inpatient cases of pressure ulcers (-44 cases [0 vs. 44]) were documented. Despite the higher total outlay of costs associated with the powered hybrid mattress, the long-term savings potential showed a significant cost advantage per annum for the single center. Therefore, the use of the hybrid mattress leads to considerable economic, clinical, and nursing benefits.

Exploring body morphology, sacral skin microclimate and pressure injury development and risk among patients admitted to an intensive care unit: A prospective, observational study

ObjectiveTo determine the association between body morphology, sacral skin microclimate and their impact on the development and risk of pressure injuries among patients in an intensive care unit. MethodologyA prospective observational exploratory study was conducted over 30 weeks. Repeat study observations occurred multiple times a week for 28 days or until discharge. Participant inclusion criteria were ≥ 18 years of age, expected intensive care length of stay > 24 h and intact skin over the sacrum region. SettingThe study was conducted in a 36-bed intensive care unit of a major metropolitan public hospital in Queensland, Australia. Outcome measuresPressure injuries were staged and independently verified according to the international pressure injury classification system. Pressure injury risk was determined by the Braden scale score and subepidermal oedema, using a subepidermal moisture scanner at the sacrum. ResultsOf the 93 participants recruited, an inverted triangle body shape (p =.049), a BMI > 25 kg/m2 (p =.008), a standard foam mattress type (p =.017) and increased length of stay (p <.001) were associated with an increased pressure injury risk according to subepidermal oedema. Participants with increased sacral skin temperature (p <.001), mechanical ventilation (p <.001), vasoactive drugs administered (p =.003), increased sequential organ failure assessment score (p =.047), neurovascular diagnosis (p =.031) and increased length of stay (p =.027) were associated with increased pressure injury risk according to the Braden scale score. ConclusionBody morphology and skin microclimate are associated with pressure injury risk during critical illness. Implications for Clinical PracticeSubepidermal oedema was associated with a patient’s shape, body mass index and mattress type, factors that directly influence the pressure loading and the skin, whereas the Braden scale was associated with sacral temperature and clinical measures of critical illness. Consideration of body morphology and skin microclimate in pressure injury risk assessment could lead to more specific prevention strategies targeting high risk patients.

Study on the structural and properties of composite films prepared by blending EUL and NBRL

In order to address issues such as poor dimensional stability caused by low modulus and tensile stress of nitrile butadiene rubber latex (NBRL) films, as well as poor wearing comfortability due to its good adhesion to the human skin, and the inability to meet the requirements of medical special occasions due to low tensile and tear strength. A new strategy is proposed to develop the Eucommia ulmoides latex (EUL) by using the emulsion solvent evaporation technique. EUL was then blended into the NBRL, successfully preparing the NBR/EUG composite latex film. As the Eucommia ulmoides gum (EUG) content increased from 0 to 40 %, the crystallinity of the NBR/EUG composite latex film gradually increased from 0 to 10 % or so. The tensile strength increases from 5.17 MPa to 15.94 MPa, the tear strength increases from 22.17 kN/m to 37.79 kN/m, the modulus increases from 6.40 MPa to 24.80 MPa. The very important point is that the elongation at break keep stable with the increase of EUG. On the contrary, the elongation at break will decrease with addition of conventional fillers into the latex, such as silica. These enhance mechanical properties and keep the dimensional stability of the film. Therefore, it can be utilized for the development of latex film products with high modulus and big deformation, such as sky balloon and foam mattress. Additionally, the crystalline nature of EUG effectively reduces the adhesion force on the surface of the composite latex film, thus improving its compatibility with human skins. This meets the requirements of special environments, such as medical gloves. At last, as a kind of biobased latex, it can increase the content of renewable resources and reduce the carbon emission of NBRL.

Use of a novel pressure distribution system for severely ill neonates: a clinical pilot study carried out by the PREPICare consortium

BackgroundPressure Injuries are not exclusively an adult phenomenon; various risk factors contribute to a high prevalence rate of 43% in the neonatal and pediatric intensive care population. Effective preventive measures in this population are limited.MethodsWe performed a pilot study to analyze the distribution and localization of support surface interface pressures in neonates in a pediatric intensive care unit (PICU). The hypothesis was that pressure redistribution by a novel air mattress would reduce pressure peaks in critical neonates. The measurements were conducted in a 27-bed level III PICU between November and December 2020. This included measuring pressure distribution and pressure peaks for five neonates positioned on either a state-of-the-art foam mattress or a new prototype air mattress.ResultsWe confirmed that the pressure peaks were significantly reduced using the prototype air mattress, compared with the state-of-the-art foam mattress. The reduction of mean pressure values was 9–29%, while the reduction of the highest 10% of pressure values was 23–41%.ConclusionsThe journey to an effective, optimal, and approved product for severely ill neonates to reduce Pressure Injuries is challenging. However, a crucial step was completed by this pilot study with the first pressure measurements in a real-world setting and the successful realization of a decrease in pressure peaks obtained using a prototype air mattress.

Coating Characteristics and Dynamics of Sponge Roller Coatings with Different Viscosities and Linear Speeds for Different Diameters of Rollers

Coating technology, as a common coating method, is widely used in many industrial fields, among which the mattress industry utilizes it to bond sponges to produce foam mattresses. The thickness of the coating on the sponge is crucial to the quality and performance of the mattress. Hence, this study took the CNCHK-10 high-performance intelligent sponge roller coating as a model; simulated the roller coating process under different viscosities and linear speeds using fluid simulation; analyzed the effects of different viscosities of the coating liquid and the linear speeds of the rollers on the thickness of the coating; and derived the relationships between the viscosity of the coating liquid and the linear speed of the rollers and the thickness of the coating. The relationship between the viscosity of the coating liquid and the linear speed of the roller and coating thickness was obtained. The results show that in the viscosity range of the glue, the viscosity is 1.5 Pa·s when the coating thickness is the smallest, and, at this time, the amount of glue is about 74.1927 g/m2; in the adjustment range of the roller linear speed, the linear speed is 20 m/min when the coating thickness is the smallest, and, at this time, the amount of glue is about 74.1931 g/m2. The results of the study can be used for determining the coating process parameters for a reasonable selection and control to provide a theoretical basis.

Dosimetric characterization of foam padding with posterior fields in palliative radiation therapy

Patients undergoing external beam radiation therapy for the palliative treatment of painful bony metastases may have difficulty maintaining a still position on a rigid uncovered couch top, both during CT simulation as well as during patient setup, image guidance, and treatment on the linear accelerator. For these patients, a thin foam pad or mattress is sometimes used to mitigate patient discomfort. It was desired to quantify the effect of the padding in cases in which the patient is to be treated supine with posterior beams when the majority of the beam weighting traverses both the couch and the pad. Ion chamber measurements in-phantom were acquired with 6 MV, 10 MV, and 15 MV photon beams. At depths of maximum dose, the pad resulted in a difference of signal collected ≤1%. At the phantom surface, the pad resulted in an increase in signal ranging from 1% to 6.5% for the measured beams. CT data of the pad, both with and without applied pressure, indicated that the pad had average HU values close to air.

A Mathematical Model Relating Foam Material Properties to Heightened Interface Pressure between a Human and Mattress Surface

Hospital patients often develop pressure injuries when lying in bed for an extended time due to relatively high contact pressures breaking down skin tissues. Pressure injuries adversely affect patients by potentially leading to infection and creating advanced health risks. Our prior research identified children experience highest risk of pressure ulcer in the head region. Thus, this study aimed to gather pressure data and create a corresponding model relating foam material properties to predicted interface pressure between the head and a foam mattress overlay surface. Research findings provide data guiding clinicians and designers to mattresses with material properties capable of reducing the incidence of pressure ulcers in children and adults.

Optimization of Spatial and Temporal Configuration of a Pressure Sensing Array to Predict Posture and Mobility in Lying.

Commercial pressure monitoring systems have been developed to assess conditions at the interface between mattress/cushions of individuals at risk of developing pressure ulcers. Recently, they have been used as a surrogate for prolonged posture and mobility monitoring. However, these systems typically consist of high-resolution sensing arrays, sampling data at more than 1 Hz. This inevitably results in large volumes of data, much of which may be redundant. Our study aimed at evaluating the optimal number of sensors and acquisition frequency that accurately predict posture and mobility during lying. A continuous pressure monitor (ForeSitePT, Xsensor, Calgary, Canada), with 5664 sensors sampling at 1 Hz, was used to assess the interface pressures of healthy volunteers who performed lying postures on two different mattresses (foam and air designs). These data were down sampled in the spatial and temporal domains. For each configuration, pressure parameters were estimated and the area under the Receiver Operating Characteristic curve (AUC) was used to determine their ability in discriminating postural change events. Convolutional Neural Network (CNN) was employed to predict static postures. There was a non-linear decline in AUC values for both spatial and temporal down sampling. Results showed a reduction of the AUC for acquisition frequencies lower than 0.3 Hz. For some parameters, e.g., pressure gradient, the lower the sensors number the higher the AUC. Posture prediction showed a similar accuracy of 63-71% and 84-87% when compared to the commercial configuration, on the foam and air mattress, respectively. This study revealed that accurate detection of posture and mobility events can be achieved with a relatively low number of sensors and sampling frequency.

Organohalogenated flame retardants and organophosphate esters from home and preschool dust in Sweden: Pollution characteristics, indoor sources and intake assessment

This study analysed settled dust samples in Sweden to assess children's combined exposure to 39 organohalogenated flame retardants (HFRs) and 11 organophosphate esters (OPEs) from homes and preschools. >94 % of the targeted compounds were present in dust, indicating widespread use of HFRs and OPEs in Swedish homes and preschools. Dust ingestion was the primary exposure pathway for most analytes, except BDE-209 and DBDPE, where dermal contact was predominant. Children's estimated intakes of ∑emerging HFRs and ∑legacy HFRs from homes were 1–4 times higher than from preschools, highlighting higher exposure risk for HFRs in homes compared to preschools. In a worst-case scenario, intakes of tris(2-butoxyethyl) phosphate (TBOEP) were 6 and 94 times lower than the reference dose for children in Sweden, indicating a potential concern if exposure from other routes like inhalation and diet is as high. The study also found significant positive correlations between dust concentrations of some PBDEs and emerging HFRs and the total number of foam mattresses and beds/m2, the number of foam-containing sofas/m2, and the number of TVs/m2 in the microenvironment, indicating these products as the main source of those compounds. Additionally, younger preschool building ages were found to be linked to higher ΣOPE concentrations in preschool dust, suggesting higher ΣOPE exposure. The comparison with earlier Swedish studies indicates decreasing dust concentrations for some banned and restricted legacy HFRs and OPEs but increasing trends for several emerging HFRs and several unrestricted OPEs. Therefore, the study concludes that emerging HFRs and OPEs are replacing legacy HFRs in products and building materials in homes and preschools, possibly leading to increased exposure of children.

0959 Use of a Memory Foam Mattress Improves Sleep Quality and Consistency

Abstract Introduction Previous research has shown that comfort, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, the structure and firmness of a mattress may play a role in sleep quality. More empirical research is needed to establish the impact of particular mattresses on both objective and self-reported measures of sleep. This study compared sleep on a memory foam mattress to participants’ prior sleep on their original mattress. Methods Healthy adults (65% female, ages 24-59) participated in a 10-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular mattress at home. During the 4-week intervention period, which occurred following a 2-week adjustment period, they used a Sleepy’s Memory Foam mattress at home. Sleep was measured objectively using SleepScore Max every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance. Results There were over 1,000 nights of tracked sleep across 25 participants. Objective sleep measurements showed many nightly improvements during the intervention compared to baseline: less WASO, both in duration (-7 minutes, p&amp;lt;.001) and proportion of the night (p&amp;lt;.001); fewer awakenings (p=.002); and better sleep efficiency (p&amp;lt;.001) and sleep maintenance (p&amp;lt;.001). Improvement also was observed in SleepScore, a measure of sleep quality (p=.008). Self-report measures revealed greater comfort when using the memory foam mattress, as well as improvement in a variety of perceived sleep outcomes, including time to fall asleep, waking less often, spending less time awake after initially falling asleep, longer sleep duration, better sleep quality, and feeling more rested in the morning (ps&amp;lt;.05). Conclusion Objectively-measured sleep and self-reported sleep improved in quality and consistency when using the memory mattress compared to healthy adults’ original mattresses. Furthermore, qualitative and quantitative self-report results suggested that the intervention was perceived as comfortable. Support (if any) Mattress Firm INC

PENGARUH LITERASI DAN PENGALAMAN KEUANGAN TERHADAP PENGELOLAAN KEUANGAN MELALUI NIAT BERPERILAKU PADA PENGRAJIN KASUR BUSA KECAMATAN PAKISAJI KABUPATEN MALANG

In developing a business, financial management of MSMEs plays an important role. This study aims to examine the effect of financial literacy and experience on the financial management of foam mattress craftsmen, as well as to examine whether behavioral intention is a mediating variable between financial literacy and experience with financial management. The survey was conducted on foam mattress craftsmen using total sampling technique, and the data were analyzed using Path Analysis. The results showed a significant positive influence between financial experience and financial management behavior. In addition, this study proves that financial literacy has an indirect effect on financial management through behavioral intentions. The managerial implications of this study emphasize the importance of having good financial experience in improving financial management. In addition, this study provides new insights that individuals with high financial literacy also need to have good Financial behavioral intentions to manage their business finances more carefully.

Preventing pressure injury in open-heart surgical patients: A systematic review.

Cardiac surgical patients are highly prone to developing surgery-related Pressure injuries (PIs). Prevention of PIs is an important patient safety priority in healthcare settings and patients care. So the aim of this study is to detect the effectiveness of prevention strategies to decrease PIs prevalence and incidence in patients undergoing open heart surgery. We identified studies through Web of Science, Scopus, PubMed, Cochrane, and ProQuest databases from inception through September 2022 with restrictions on the English language. Cochrane RoB 2, JBI, and NIH checklist were carried out as critical appraisal Tools to investigate the studies risk of bias. Finally, 10 studies with a total sample No. 1348, which fulfilled eligibility criteria were included in final systematic review. Most common interventions investigated in included studies were addressing impairments skin care which included the use of multilayer silicone foam, Care bundle and multiple intervention programs, alternative head inflatable pads, pressure-reducing foam mattresses, and electric bed frames as the effective PIs Prevention (PIP) strategies. While repositioning is one of the important causes mentioned in most PIP protocols, there was not adequate evidence to recommend any special turning regimens for PIP. Given current evidence, multilayer silicone foam, Care bundle and multiple intervention programs, alternative inflatable head pads, pressure-reducing foam mattresses, and electric bed frames are effective strategies to prevent pressure ulcers. Further investigations are needed to specify the cost-effectiveness of mentioned strategies and RCTs to determine other PIP strategies such as repositioning and mobilization, nutritional supplementation, creams, and co-interventions effects.

Multi-objective Optimization of Multi-cells Foam Mattress

Body pressure dispersion mattresses are useful tools for preventing pressure ulcers in patients with limited mobility who experience prolonged body weight-related compression loads at their body contact areas over time. The objective of this study is to propose and optimize a multicell finite element (FE) model of foam mattress to prevent patients from developing pressure ulcers (bed sores), by improving the contact pressure distribution on the upper mattress surface and immersion in the mattress. The NSGA-II multi-objective genetic algorithm was used to predict different configurations of cell materials to provide a more comfortable sleep. Our mattress model contains many cells (50 × 50 × 50), each of which can contain one of the nine different foam firmnesses. The NSGA-II algorithm attempts to combine the properties of soft and firm foams into a single mattress. however, the complexity and intersection of the fitness function objectives and the high number of possible chances forced the optimal solutions set to extend into the area under the result of foams that have a compressive strength between soft and firm. Based on the overall optimization results, the standard deviation ranged from 0.00325 to 0.00175 MPa and the maximum mattress immersion ranged from 50 mm to less than 20 mm. Mattresses with optimal configurations disperse body pressure smoothly to fit the patient's body shape.

An efficient constructive heuristic for the cutting stock problem applied in a foam mattress industry

An efficient constructive heuristic for the cutting stock problem applied in a foam mattress industry