Emotional Journey of Patients with Eosinophilic Esophagitis.

INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic and progressive disease associated with dysphagia and eosinophilic infiltration of the esophageal mucosa. EoE can have a negative impact on a patient's quality of life (QoL); however, there is very limited data reflecting the emotional journey of patients with EoE or their perceived unmet needs. The aim of this study was to determine the emotional impact of EoE on patients at each stage of the patient journey. METHODS: In this cross-sectional and qualitative research study, adult patients with EoE from eight different countries provided their experiences and feelings across each stage of the patient journey through one-on-one semi-structured interviews. RESULTS: Twenty-one patients with EoE were enrolled in the study. The results of the one-on-one interviews showed that patients living with EoE go through an exhausting emotional experience during the different stages of the patient journey. In the pre-seeking-care stage, patients feel confused, afraid, frustrated, anxious, lonely, and misunderstood. During the diagnostic process, patients feel highly frustrated and angry because of the long and burdensome process. When EoE is finally diagnosed, patients feel liberated and relieved. When treatment is initiated, patients feel relief and enthusiasm, and, once the treatment starts to be effective and during the monitoring stage, they feel happier, less stressed, more confident, more relaxed, less fearful, and more in control owing to the improvement of their symptoms. CONCLUSIONS: This study pays attention to the different stages of the journey of patients with EoE. There is a lack of awareness by both physicians and patients that negatively affects every stage of the patient journey, but especially the initial phases of pre seeking care and diagnosis. We intend for this article to represent an opportunity to increase EoE awareness and to show the importance of considering the emotional impact on a patient with EoE's journey.

Hyperelastic Membrane Actuators: Analysis of Toroidal and Helical Multifunctional Configurations.

Technologies that provide mechanical assistance are required in the medical field, such as implants that regenerate tissue through elongation and stimulation. One of the challenges is to develop actuators that combine the benefits of high axial extension at low pressures, modularity, multifunction, and load-bearing capabilities into one design while maintaining their shape and softness. Overcoming such a challenge will provide implants with enhanced capacity for mechanical assistance to induce tissue regeneration. We introduce two novel actuators (M2H) built of stacked Hyperelastic Ballooning Membrane Actuators (HBMAs) that can be realized using helical and toroidal configurations. By restraining the HBMA expansion deterministically using a semisoft exoskeleton, the actuators are endowed with axial extension and radial expansion capabilities. These actuators are thus built of modules that can be configured to different therapeutical needs and multifunctionality, to provide anatomically congruent stimulation. We present the design, fabrication, testing, and numerical and experimental validation of the M2H-HBMAs. They can axially extend up to 41% and 32% in their helical and toroidal configurations at input pressures as low as 26 and 24 kPa, respectively. If the axial extension module is used separately, its extension capacity reaches >170%. The M2H-HBMAs can perform independent and simultaneous expansion and extension motions with negligible intraluminal deformation as well as stand at least 1 kg of axial force without collapsing. The M2H-HBMAs overcome the limitations of hyperexpanding machines that show low resistance to load. We envisage M2H-HBMAs as promising tools to perform tissue regeneration procedures.

Deflected Versus Preshaped Soft Pneumatic Actuators: A Design and Performance Analysis Toward Reliable Soft Robots.

Soft pneumatic actuators (SPAs) are customizable and conformable devices that enable desired motions in soft robots. Interactions with the environment or handling during their fabrication could introduce defects into SPAs that affect their performance. These defects could lead to high-stress concentrations in the SPA body and heterogeneous, unrepeatable, or inconsistent expansion affecting their reliability. In this work, we aim to improve the reliability of soft robots by modeling and characterizing the performance of SPAs with widely used chamber shapes and cross-sectional geometries under variable loading conditions. We also compare their capacity to provide homogeneous, repeatable, and time-wise consistent expansion with low-stress concentrations and provide a set of principles for the design of reliable SPAs. Expansion of SPAs with Straight chambers demonstrated to be more repeatable, with an average deviation of 0.06 mm and showed more than a thousand times less stress than any other chamber types. The expansion of preshaped SPAs with helical chambers showed to be up to 500% more homogeneous and 300% more efficient than their deflected counterparts. SPAs with squared cross-sectional geometries displayed more than 1000 times more time-wise consistent expansion over their circular counterparts. We conclude that SPAs that retain less potential energy or are less affected by its effects are more reliable. We derive these results into a set of principles for the design of reliable SPAs. These principles offer solutions to make informed decisions before fabrication to mitigate the most common reliability problems for SPAs and soft robots.