Proceedings of the Institution of Mechanical Engineers,Part H: Journal of Engineering in Medicine

The human hand is the most frequently used body part in activities of daily living. With its complex anatomical structure and the small size compared to the body, assessing the functional capability is highly challenging. The aim of this review was to provide a systematic overview on currently available 3D motion analysis based on skin markers for the assessment of hand function during activities of daily living. It is focused on methodology rather than results. A systematic review according to the PRISMA guidelines was performed. The systematic search yielded 1349 discrete articles. Of 147 articles included on basis of title, 123 were excluded after abstract review, and 24 were included in the full-text analysis with 13 key articles. There is still limited knowledge about hand and finger kinematics during activities of daily living. A standardization of the task is required in order to overcome the nonrepetitive nature and high variability of upper limb motion and ensure repeatability of task performance. To yield a progress in the analysis of human hand movements, an assessment of human kinematics including fingers, wrist, and thumb and an identification of relevant parameters that characterize a healthy motion pattern during functional tasks are needed.

The objective of this study is to investigate the effects of ligament and tendon detachment on human middle ear sound transfer. For this purpose, a geometric human middle ear model was reconstructed based on the computed tomography scanning data of the temporal bones from healthy adult volunteers. For the ear model, pars tensa was assumed to be fit for a 5-parameter Maxwell model and inverse method was used to obtain the necessary coefficients. Furthermore, frequency response method was implemented to investigate the vibration behaviors of tympanic membrane umbo and stapes footplate under an acoustic stimulus of 90 dB within 0.2–8 kHz. Meanwhile, nine patterns of fractured ligaments and tendons, whose effects on the middle ear sound transfer function were simulated by setting free the nodes of the ligaments and tendons of interest. The results indicate that the displacement of tympanic membrane umbo and stapes footplate as well as the velocity transfer function lies within the bounds of the published experimental data. The detachments of ligaments or tendons except for lateral mallear ligament may incur both gains as much as 15 dB and losses of –8 dB in the velocity of stapes footplate at low frequencies (f≤ 1 kHz), while no significant changes were observed at high frequencies (f > 1 kHz). However, detachment of the ligaments or tendons induces tiny changes in the displacement of stapes footplate at the frequencies of 0.2–8 kHz.

Type 2 diabetes has an increasing prevalence and high cost of treatment. The goal of type 2 diabetes treatment is to control patients’ blood glucose level by pharmacological interventions and to prevent adverse disease-related complications. Therefore, it is important to optimize the medication treatment plans for type 2 diabetes patients to enhance the quality of their lives and to decrease the economic burden of this chronic disease. Since the treatment of type 2 diabetes relies on medication, it is vital to consider adverse drug reactions. Adverse drug reaction is undesired harmful reactions that may result from some certain medications. Therefore, a Markov decision process is developed in this article to model the medication treatment of type 2 diabetes, considering the possibility of adverse drug reaction occurring adverse drug reaction. The optimal policy of the proposed Markov decision process model is compared with clinical guidelines and existing models in the literature. Moreover, a sensitivity analysis is conducted to address the manner in which model behavior depends on model parameterization and then therapeutic insights are obtained based on the results. The satisfying results show that the model has the capability to offer an optimal treatment policy with an acceptable expected quality of life by utilizing fewer medications and provide significant implications in endocrinology and metabolism applications.

Comfort is a critical aspect in the application of wearable device, such as rehabilitation robots and upper limb prostheses. As a physical interface between human body and prosthetic limb, the socket and its comfort largely contribute to the user’s acceptance. Traditional sockets are static, lacking dynamic adjustment mechanism for the contact pressure. To ensure a reliable suspension during daily activities, the socket is usually designed to be tightly attached, with a large stress, on the residual limb, which may introduce considerable discomfort during long-term use. In this article, we present a novel adaptive transhumeral socket, in which we employ four independent bladders contacting with the stump. Not only can these bladders provide a necessary suspension for the device but also form an air cushion (soft body) that helps relieve the pressure concentration between the biological body and physical prosthesis. In real time, this adaptive socket continuously monitors the limb posture, the operating load, and the contacting pressure between the socket and the limb, and then dynamically adjusts the clamping force to ensure a reliable attachment during various daily activities. Since well adapting to the contours of the stump, the bladders can effectively accommodate the volume change of the stump, making a balanced load distribution on load-tolerant areas. Through modeling and numerical analysis, we established a dynamic strategy for estimating the external load and an automatic scheme for adjusting the bladders’ air pressure. Finally, a close-loop control was constructed based on the contact pressure measured by our self-developed force sensors. Our preliminary experiments on one normal (i.e. non-amputee) subject verified the effectiveness of the proposed method, showing that the adaptive socket can considerably reduce the socket–limb contact pressure while sustaining a secure suspension on the upper arm.

Stress intensity factor and energy release rate are important parameters to understand the fracture behaviour of bone. The objective of this study is to predict stress intensity factor and energy release rate using finite element method, element-free Galerkin method, and extended finite element method and compare these results with the experimentally determined values. For experimental purpose, 20 longitudinally and transversely fractured single-edge notched bend specimens were prepared and tested according to ASTM standard. All specimens were tested using the universal testing machine. For numerical simulations (finite element method, element-free Galerkin method, and extended finite element method), two-dimensional model of cortical bone was developed by assuming plane strain condition. Material properties of the cortical bone were considered as anisotropic and homogeneous. The values obtained through finite element method, element-free Galerkin method, and extended finite element method are well corroborated to experimentally determined values and earlier published data. However, element-free Galerkin method and extended finite element method predict more accurate results as compared to finite element method. In the case of the transversely fractured specimen, the values of stress intensity factor and energy release rate were found to be higher as compared to the longitudinally fractured specimen, which shows consistency with earlier published data. This study also indicates element-free Galerkin method and extended finite element method predicted stress intensity factor and energy release rate results are more close to experimental results as compared to finite element method, and therefore, these methods can be used in the different field of biomechanics, particularly to predict bone fracture.

During root canal shaping, pain could result from the high level of force or vibration generated. This could be related to file kinematics or geometry. In the present study, a comparison is made between forces and vibrations generated by endodontic files having three different kinematics. Square pillar resin blocks were used as simulated root canals to study forces and vibrations generated by the file having reciprocating motion (WaveOne Gold), transline motion (Self-Adjusting File), and rotary motion (2Shape). The forces and vibrations were measured using the dynamometer and accelerometer, respectively. Recorded time domain signals were processed in MATLAB to calculate the root mean square value. A one-way analysis of variance and Tukey’s test for post hoc comparison at 95% confidence interval were applied over the root mean square data of different files. From a statistical analysis of the file systems, the null hypotheses could not be accepted (P < 0.05) as 95% of the confidence interval. Differences between the means were statistically significant. The root mean square values of force and vibration for WaveOne Gold significantly exceeded those of Self-Adjusting File, 2Shape1, and 2Shape2 while the root mean square values of vibration for 2Shape1 and 2Shape2 were significantly less than the Self-Adjusting File; however, the root mean square value of force for the 2Shape2 was significantly more than for the Self-Adjusting File. Under the present experimental conditions, significant differences in the root mean square values of force and vibration of the three endodontic files of different kinematics have been observed. The WaveOne Gold file system generated higher apical force and vibration than the transline and rotary file system.

The work investigates the effect of proposed novel semi-rigid stabilization device on lumbar segment L2-L3 so as to preserve motion at vertebral level. Here, the biomechanical behavior of intact spine with three instrumented spinal models (semi-rigid stabilization device, rigid implant and dynamic stabilization system NFlex) have been compared under the motion conditions of flexion, extension, bending and twist. Three-dimensional non-linear finite models of intact spine, semi-rigid stabilization device, rigid implant and dynamic stabilization system NFlex were developed in the present study. All the four models were subjected to a combined load of 400 N in axial compression along with 2, 4, 6, 8 and 10 N m as bending moment individually. Dynamic stabilization system NFlex shows the maximum variation in motion and reflects range of motion as 89.7% during lateral bending, 53.4% in flexion, 34.6% in twist and 28.0% in extension with respect to intact spine. However, semi-rigid stabilization device and rigid implant shows the range of motion of 60%, 48.7%, 32% and 21.8% and 60%, 32.3%, 22.3% and 21.7% of intact, respectively, during bending, flexion, twist and extension. Finite element simulation results reveal that semi-rigid stabilization device shows comparatively lower values than dynamic stabilization system NFlex and higher as compared to rigid implant for measured intradiscal pressure and von Mises strain at intervertebral disc-23.

The intervertebral disk cushions the load generated by human activity and absorbs energy to keep the spine moving steadily. Vibration condition is one of the important causes of disk degeneration. Creep experiments using the sheep lumbar intervertebral disk were carried out under vibration compression. Regularities of the strain of the disk with time were obtained and compared with those of static load. The influence of vibration frequency and time on the creep properties of the intervertebral disk was analyzed. An intervertebral disk three-parameter solid creep constitutive model considering vibration factors was established and the parameters in the model were identified. The results show that the strain of the lumbar intervertebral disk exhibits an exponential relationship with time and is unrelated to static compression or vibration load. Under the same vibration amplitude, the creep increases with vibration frequency and the relationship between them is nonlinear. The vibration frequency has a significant effect on the strain. The creep rate decreases gradually with time and is obviously influenced by vibration frequency at low vibration amplitudes. The creep prediction results obtained using the constitutive model with the time-varying material parameters are in good agreement with the experimental results. The two elastic moduli in the model decrease with time and the viscosity coefficient increases with time.