Feasibility study of intelligent autonomous determination of the bladder voiding need to treat bedwetting using ultrasound and smartphone ML techniques : Intelligent autonomous treatment of bedwetting

Treatment of Nocturnal Enuresis Using Miniaturised Smart Mechatronics With Artificial Intelligence

Our study was designed to develop a customisable, wearable, and comfortable medical device - the text so-called "MyPAD" that monitors the fullness of the bladder, triggering an alarm indicating the need to void, in order to prevent badwetting - i.e., treating Nocturnal Enuresis (NE) at the text pre-void stage using miniaturised mechatronics with Artificial Intelligence (AI). The developed features include: multiple bespoke ultrasound (US) probes for sensing, a bespoke electronic device housing custom US electronics for signal processing, a bedside alarm box for processing the echoed pulses and generating alarms, and a phantom to mimic the human body. The validation of the system is conducted on the text tissue-mimicking phantom and volunteers using Bidirectional Long Short-Term Memory Recurrent Neural Networks (Bi-LSTM-RNN) and Reinforcement Learning (RL). A Se value of 99% and a Sp value of 99.5% with an overall accuracy rate of 99.3% are observed. The obtained results demonstrate successful empirical evidence for the viability of the device, both in monitoring bladder expansion to determine voiding need and in reinforcing the continuous learning and customisation of the device for bladder control through consecutive uses. Clinical impact: MyPAD will treat the NE better and efficiently against other techniques currently used (e.g., post-void alarms) and will i) replace those techniques quickly considering sufferers' condition while being treated by other approaches, and ii) enable children to gain control of incontinence over time and consistently have dry nights. Category: Early/Pre-Clinical Research.

Cleaning Quality Control Management of Medical Equipment in Hospital Disinfection Supply Room Based on Smart Medicine

With the continuous improvement of medical level, the demand for medical devices increases year by year, and it is necessary to track the quality and safety of medical devices. Establishing the cleaning quality control management of medical devices can not only reduce medical accidents and inhibit the spread of counterfeit or substandard medical devices but also help enterprises find the source of problems, determine the flow of the same batch of products, and warn relevant enterprises to take measures after the occurrence of problem products, and ultimately ensure the rights and interests of consumers. This study aims to study the cleaning quality control management of medical equipment in the hospital disinfection supply room based on smart medical care and proposes related concepts of smart medical care, as well as related theories of Internet of Things technology and medical equipment tracking system and related concepts of medical equipment cleaning. In this study, by comparing the cleaning compliance rates of the two groups of medical devices through smart medical care, it can be seen that 100% of the research group applying program-based management is significantly higher than 76.6% of the conventional management path. There was statistical significance in the data comparison between groups (P < 0.05). Therefore, programmatic management is more targeted than conventional management paths.

A comprehensive survey on non-invasive wearable bladder volume monitoring systems

Measuring the volume of urine in the bladder is a significant issue in patients who suffer from the lack of bladder fullness sensation or have problems with timeliness getting to the restroom, such as spinal cord injury patients and some of the elderlies. Real-time monitoring of the bladder, therefore, can be highly helpful for urinary incontinence. Bladder volume monitoring technologies can be divided into two distinct categories of invasive and non-invasive. In invasive techniques, a catheter is directly inserted into the urethra to measure the amount of urine accurately. However, it is painful, limits the user's ordinary movements, and may hurt the urinary tract. Current non-invasive techniques measure the volume of the bladder from the skin using different stationary or portable apparatus at health centers. Both techniques have difficulties and are not cost-effective to use for a long period. Recently, both invasive and non-invasive methods have been attempted to be produced in the form of wearable devices utilizing different sensing and communication technologies. Wearable bladder monitoring devices can be easily used by patients with no or few clinical steps, making them much more affordable than non-wearable devices. While wearable devices seem to be a highly convenient and effective solution, they suffer from few drawbacks, such as relatively low precision. Hence, a great number of studies have been conducted to address these issues. In this article, we review and discuss non-invasive and minimally invasive methods for monitoring the bladder volume. We focus on the most practical and state-of-the-art methods employed in wearable devices, classify them by engineering and medical characteristics, and investigate their specifications, architectures, and measurement algorithms. This study aims to introduce the latest advances in this field to practitioners while comparing the advantages and disadvantages of existing approaches. Our study concludes with open problems and future trends in the area of bladder monitoring and measurement systems. Graphical abstract Wearable bladder monitoring system.

Patient Engagement in Medical Device Design: Refining the Essential Attributes of a Wearable, Pre-Void, Ultrasound Alarm for Nocturnal Enuresis

BACKGROUND

To date, no pre-void wearable alarm exists to treat nocturnal enuresis (NE)-night-time bedwetting, and children with NE and their families are disappointed in relation to the post-void moisture alarms and medicine currently available. Development of a safe, comfortable and non-invasive wearable pre-void alarm and associated technology, using advanced mechatronics, is underway (the MyPAD device). Each stage of development includes patient and public involvement (PPI), particularly with respect to human factors, in collaboration with physicians, radiologists, psychologists, nurses, engineers and designers.

OBJECTIVES

The aim of this study was to help us understand the families' experience of the condition of enuresis, and to provide opinion relating to existing NE alarms, designed to detect moisture, and most importantly, the initial design of the MyPAD wearable technology.

METHODS

A PPI workshop in the form of a focus group, made up of children with enuresis and their parents, was conducted during the early stage of the MyPAD product development. The key research questions (RQs) were: (RQ1) What were the families' experiences of using existing post-void enuresis alarms? (RQ2) What do families like about the MyPAD prototype? and (RQ3) What do families not like about the MyPAD prototype? A nurse specialised in terms of NE treatment, including post-void alarms, from the Lancashire Teaching Hospitals NHS Foundation Trust, and two MyPAD design engineers were also present, to explain the MyPAD design concept. Braun and Clarke's six-phase approach to thematic analysis was implemented, which included familiarisation with the data, initial descriptive coding, identifying themes, reviewing themes, defining and labelling themes and producing a report.

RESULTS

Four common themes were identified from the focus group discussions: the importance of sleep; children do not want to feel different; parents feel frustrated and concerned; resilience and perseverance. These themes applied across the research questions; for example, sleep disruption was highlighted as an issue with existing post-void alarms and as an important requirement for the design of MyPAD. The evaluation of the early version of the MyPAD device has prompted the consideration of changes to some existing facets of the device, including providing multiple alarm types, more options for the design of the garment that houses the device, and the need for clear, age-appropriate and informative instructions relating to how the device should be used, in order to maximise its performance/efficiency and acceptance.

CONCLUSIONS

The qualitative data derived from the focus group discussion was incredibly valuable as it enabled the research and design team to experience the perspectives of the families in terms of the challenges and conflicts of managing the condition and the limited utility of existing post-void alarms. This has improved our understanding of the social and environmental challenges that will need to be considered during the design process.

Intelligent autonomous treatment of bedwetting using non-invasive wearable advanced mechatronics systems and MEMS sensors : Intelligent autonomous bladder monitoring to treat NE

Post-void alarm systems to monitor bedwetting in nocturnal enuresis (NE) have been deemed unsatisfactory. The aim of this study is to develop a safe, comfortable and non-invasive pre-void wearable alarm and associated technologies using advanced mechatronics. Each stage of development includes patient and public involvement and engagement (PPI). The early stages of the development involved children with and without NE (and parents) who were tested at a hospital under the supervision of physicians, radiologists, psychologists, and nurses. The readings of the wearable device were simultaneously compared with B-mode images and measurements, acquired from a conventional ultrasound device, and were found to correlate highly. The results showed that determining imminent voiding need is viable using non-invasive sensors. Following on from "proof of concept," a bespoke advanced mechatronics device has been developed. The device houses custom electronics, an ultrasound system, intelligent software, a user-friendly smartphone application, bedside alarm box, and a dedicated undergarment, along with a self-adhesive gel pad-designed to keep the MEMS sensors aligned with the abdomen. Testing of the device with phantoms and volunteers has been successful in determining bladder volume and associated voiding need. Five miniaturised, and therefore more ergonomic, versions of the device are being developed, with an enabled connection to the cloud platform for location independent control and monitoring. Thereafter, the enhanced device will be tested with children with NE at their homes for 14 weeks, to gain feedback relating to wearability and data collection involving the cloud platform. Graphical Abstract Design of the MyPAD advanced mechatronics system.

Smartphone technology and its applications in urology: a review of the literature

PURPOSE

Smartphone technology has propelled the evolution of health-related mobile technology, referred to as mobile health (mHealth). With the rise of smartphone ownership and the growing popularity of health-related smartphone usage, mHealth offers potential benefits for both patients and health care providers. The objective of this review is to assess the current state of smartphone technology in urology.

METHODS

A literature search of PubMed database was conducted to identify articles reporting on smartphone technology in urology. Publications were included if they focused on smartphone mHealth technology pertinent to the field of urology or included an evaluation of urological applications in digital stores.

RESULTS

We identified 50 publications focused on the use of smartphones in urology. Studies were then grouped into the following categories: smartphones employing the built-in camera and light source, applications specific to prostate cancer, urolithiasis, pediatric urology, and as educational tools for urologists. In 23/50 (46%) studies, smartphone technology/intervention was compared to a control group or to standard of care. In this regard, smartphone technology did not demonstrate benefit over standard of care in 13 studies. In contrast, in 10 studies, smartphone interventions were proven beneficial over current practice.

CONCLUSIONS

Smartphone technology is constantly evolving and has the potential to improve urological care and education. Of concern to consumer and urologist alike is that these downloadable programs are limited due to the accuracy of their content, risk of confidentiality breach, and the lack of central regulation and professional involvement in their development.