Abstract: In this study, experiments were carried out to achieve a promising multifunctional and modified silicate based bioactive glass (BG). The main aim of the study was investigating the effect of lithium (Li) and magnesium (Mg) substitution, on in vitro bioactivity of substituted-58S BG. Moreover, it is noteworthy to state that modified BGs were synthesized in 60SiO2–(36-x)CaO–4P2O5–(x)Li2O and 60SiO2–(36-x)CaO–4P2O5–(x)MgO (where x = 0, 5, 10 mol.%) quaternary systems, by sol-gel method. Their performance was investigated through different aspects such as biocompatibility, antibacterial activity as well as their effect on alkaline phosphatase (ALP) activity, and proliferation of MC3T3 cells. The antibacterial efficiency was evaluated against methicillin-resistant Staphylococcus aureus bacteria. To do so, CaO was substituted with Li2O and MgO up to 10 mol % in 58S-BGs and then samples were immersed in simulated body fluid up to 14 days and then, characterized by X-ray diffraction, Fourier transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometry, and scanning electron microscopy. Results indicated that this modification led to a retarding effect on in vitro hydroxyapatite (HA) formation due to the lower supersaturation degree for nucleation of HA compared with 58s-BG. Meanwhile, magnesium revealed further pronounced effect. The 3-(4,5 dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) and ALP analysis illustrated that substitutions of both Li2O and MgO, up to 5 mol %, had increasing effect on biocompatibility and stimulating proliferation of the pre-osteoblast MC3T3 cells in comparison to the control specimen. Regarding to bactericidal efficiency, the substitution of either Li or Mg for Ca in the 58s BG composition led to statistically significant difference in antibacterial behaviors of substituted-BGs. Meanwhile, the sample containing 5 mol % CaO/Li2O substitution (BG-5L) was selected as a multifunctional biomaterial in bone repair/regeneration due to the improved biocompatibility, enhanced ALP activity and antibacterial efficiency among all of the synthesized L-BGs and M-BGs.
Abstract: Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.
Abstract: Ultrasound (US) is widely used in medical field for
a variety diagnostic techniques but, in recent years, it has also
been creating great interest for therapeutic aims. Regarding drug
delivery, the use of US as an activation source provides better
spatial delivery confinement and limits the undesired side effects.
However, at present there is no complete characterization
at a fundamental level of the different signals produced by
sono-activated nanocarriers. Therefore, the aim of this study
is to obtain a metrological characterization of the cavitation
phenomena induced by US through three parallel investigation
approaches. US was focused into a channel of a customized
phantom in which a solution with oxygen-loaded nanodroplets
(OLNDs) was led to flow and the cavitation activity was
monitored. Both quantitative and qualitative real-time analysis
were performed giving information about the dynamics of
bubble formation, oscillation and final implosion with respect
to the working acoustic pressure and the type of nanodroplets,
compared with pure water. From this analysis a possible
interpretation of the observed results is proposed.
Abstract: Biosensors play a significant role in the healthcare
sectors, scientific and technological progress. Developing electrodes
that are easy to manufacture and deliver better electrochemical
performance is advantageous for diagnostics and biosensing. They
can be implemented extensively in various analytical tasks such as
drug discovery, food safety, medical diagnostics, process controls,
security and defence, in addition to environmental monitoring.
Development of biosensors aims to create high-performance
electrochemical electrodes for diagnostics and biosensing. A
biosensor is a device that inspects the biological and chemical
reactions generated by the biological sample. A biosensor carries
out biological detection via a linked transducer and transmits the
biological response into an electrical signal; stability, selectivity,
and sensitivity are the dynamic and static characteristics that affect
and dictate the quality and performance of biosensors. In this
research, a developed experimental study for laser scribing technique
for graphene oxide inside a vacuum chamber for processing of
graphene oxide is presented. The processing of graphene oxide (GO)
was achieved using the laser scribing technique. The effect of the
laser scribing on the reduction of GO was investigated under two
conditions: atmosphere and vacuum. GO solvent was coated onto a
LightScribe DVD. The laser scribing technique was applied to reduce
GO layers to generate rGO. The micro-details for the morphological
structures of rGO and GO were visualised using scanning electron
microscopy (SEM) and Raman spectroscopy so that they could
be examined. The first electrode was a traditional graphene-based
electrode model, made under normal atmospheric conditions, whereas
the second model was a developed graphene electrode fabricated
under a vacuum state using a vacuum chamber. The purpose was
to control the vacuum conditions, such as the air pressure and the
temperature during the fabrication process. The parameters to be
assessed include the layer thickness and the continuous environment.
Results presented show high accuracy and repeatability achieving low
cost productivity.
Abstract: Few people would dispute the fact that one of the most common applications of energy is creating comfort in buildings, so it is probably true to say that management of energy consumption is required due to the environmental issues and increasing the efficiency of mechanical systems. From the geographical point of view, Iran is located in a warm and semi-arid region; therefore, air-cooled chillers are usually used for cooling residential buildings, commercial buildings, medical buildings, etc. In this study, a heat exchanger was designed for providing laundry hot water by utilizing condenser heat lost base on analytical results of a 540-bed hospital in the city of Mashhad in Iran. In this paper, by using the analytical method, energy consumption reduces about 13%, and coefficient of performance increases a bit. Results show that this method can help in the management of energy consumption a lot.
Abstract: Over the last decades, biomedical engineering prosthetics become one of the most essential grounds. Prosthetic hands are rapidly evolving. Therefore, for designing prosthetic components, it is essential to improve quality such as make it affordable and improve patient comfort and mobility by making them lightweight and easy to wear. In this paper, we proposed a myoelectric controlled prosthesis hand. We can fabricate and manufacture customized cost-effective, small volumes of 3D printed hand which is interesting. The total weight of an adult hand is about 1000 gm including a battery. The prosthetic hand is built up with low-cost materials and techniques, the cost of manufacturing will be approximately US$145. The hand can grip objects of different shapes and sizes. The 3D printed hand can rotate its wrist like a human hand. The prosthetic hand is capable of showing some types of human gestures.
Abstract: The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.
Abstract: Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.
Abstract: With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.
Abstract: Bayesian Network (BN) is one of the most efficient classification methods. It is widely used in several fields (i.e., medical diagnostics, risk analysis, bioinformatics research). The BN is defined as a probabilistic graphical model that represents a formalism for reasoning under uncertainty. This classification method has a high-performance rate in the extraction of new knowledge from data. The construction of this model consists of two phases for structure learning and parameter learning. For solving this problem, the K2 algorithm is one of the representative data-driven algorithms, which is based on score and search approach. In addition, the integration of the expert's knowledge in the structure learning process allows the obtainment of the highest accuracy. In this paper, we propose a hybrid approach combining the improvement of the K2 algorithm called K2 algorithm for Parents and Children search (K2PC) and the expert-driven method for learning the structure of BN. The evaluation of the experimental results, using the well-known benchmarks, proves that our K2PC algorithm has better performance in terms of correct structure detection. The real application of our model shows its efficiency in the analysis of the phosphate laundry effluents' impact on the watershed in the Gafsa area (southwestern Tunisia).
Abstract: Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.
Abstract: The management of COVID-19 patients based on chest imaging is emerging as an essential tool for evaluating the spread of the pandemic which has gripped the global community. It has already been used to monitor the situation of COVID-19 patients who have issues in respiratory status. There has been increase to use chest imaging for medical triage of patients who are showing moderate-severe clinical COVID-19 features, this is due to the fast dispersal of the pandemic to all continents and communities. This article demonstrates the development of machine learning techniques for the test of COVID-19 patients using Chest X-Ray (CXR) images in nearly real-time, to distinguish the COVID-19 infection with a significantly high level of accuracy. The testing performance has covered a combination of different datasets of CXR images of positive COVID-19 patients, patients with viral and bacterial infections, also, people with a clear chest. The proposed AI scheme successfully distinguishes CXR scans of COVID-19 infected patients from CXR scans of viral and bacterial based pneumonia as well as normal cases with an average accuracy of 94.43%, sensitivity 95%, and specificity 93.86%. Predicted decisions would be supported by visual evidence to help clinicians speed up the initial assessment process of new suspected cases, especially in a resource-constrained environment.
Abstract: Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.
Abstract: Elastic compression stockings (ECSs) have been widely applied in prophylaxis and treatment of chronic venous insufficiency of lower extremities. The medical function of ECS is to improve venous return and increase muscular pumping action to facilitate blood circulation, which is largely determined by the complex interaction between the ECS and lower limb tissues. Understanding the mechanical transmission of ECS along the skin surface, deeper tissues, and vascular system is essential to assess the effectiveness of the ECSs. In this study, a three-dimensional (3D) finite element (FE) model of the leg-ECS system integrated with a 3D fluid-solid interaction (FSI) model of the leg-vein system was constructed to analyze the biomechanical properties of veins and soft tissues under different ECS compression. The Magnetic Resonance Imaging (MRI) of the human leg was divided into three regions, including soft tissues, bones (tibia and fibula) and veins (peroneal vein, great saphenous vein, and small saphenous vein). The ECSs with pressure ranges from 15 to 26 mmHg (Classes I and II) were adopted in the developed FE-FSI model. The soft tissue was assumed as a Neo-Hookean hyperelastic model with the fixed bones, and the ECSs were regarded as an orthotropic elastic shell. The interfacial pressure and stress transmission were simulated by the FE model, and venous hemodynamics properties were simulated by the FSI model. The experimental validation indicated that the simulated interfacial pressure distributions were in accordance with the pressure measurement results. The developed model can be used to predict interfacial pressure, stress transmission, and venous hemodynamics exerted by ECSs and optimize the structure and materials properties of ECSs design, thus improving the efficiency of compression therapy.
Abstract: Robotic assistance in nursing care is an increasingly
important area of research and development. Facing a shortage of
labor and an increasing number of people in need of care, the
German Nursing Care Innovation Center (Pflegeinnovationszentrum,
PIZ) aims to address these challenges from the side of technology.
Little is known about nurses experiences with existing robotic
assistance systems. Especially nurses perspectives on starting points
for the development of robotic solutions, that target recurring
burdensome tasks in everyday nursing care, are of interest. This
paper presents findings focusing on robotics resulting from an
explanatory mixed-methods study on nurses experiences with and
their expectations for innovative technologies in nursing care in
stationary and ambulant care facilities and hospitals in Germany.
Based on the findings, eight scenarios for robotic assistance are
identified based on the real needs of practitioners. An initial system
addressing a single use-case is described to show perspectives for the
use of robots in nursing care.
Abstract: Spaceflight is considered the last frontier in terms of science, technology, and engineering. But it is also the next frontier in terms of human physiology and performance. After more than 200,000 years humans have evolved under earth’s gravity and atmospheric conditions, spaceflight poses environmental stresses for which human physiology is not adapted. Hypoxia, accelerations, and radiation are among such stressors, our research involves suborbital flights aiming to develop effective countermeasures in order to assure sustainable human space presence. The physiologic baseline of spaceflight participants is subject to great variability driven by age, gender, fitness, and metabolic reserve. The objective of the present study is to characterize different physiologic variables in a population of STEM practitioners during an aerobatic flight. Cardiovascular and pulmonary responses were determined in Science Astronaut Candidates (SACs) during unusual attitude aerobatic flight indoctrination. Physiologic data recordings from 20 subjects participating in high-G flight training were analyzed. These recordings were registered by wearable sensor-vest that monitored electrocardiographic tracings (ECGs), signs of dysrhythmias or other electric disturbances during all the flight. The same cardiovascular parameters were also collected approximately 10 min pre-flight, during each high-G/unusual attitude maneuver and 10 min after the flights. The ratio (pre-flight/in-flight/post-flight) of the cardiovascular responses was calculated for comparison of inter-individual differences. The resulting tracings depicting the cardiovascular responses of the subjects were compared against the G-loads (Gs) during the aerobatic flights to analyze cardiovascular variability aspects and fluid/pressure shifts due to the high Gs. In-flight ECG revealed cardiac variability patterns associated with rapid Gs onset in terms of reduced heart rate (HR) and some scattered dysrhythmic patterns (15% premature ventricular contractions-type) that were considered as triggered physiological responses to high-G/unusual attitude training and some were considered as instrument artifact. Variation events were observed in subjects during the +Gz and –Gz maneuvers and these may be due to preload and afterload, sudden shift. Our data reveal that aerobatic flight influenced the breathing rate of the subject, due in part by the various levels of energy expenditure due to the increased use of muscle work during these aerobatic maneuvers. Noteworthy was the high heterogeneity in the different physiological responses among a relatively small group of SACs exposed to similar aerobatic flights with similar Gs exposures. The cardiovascular responses clearly demonstrated that SACs were subjected to significant flight stress. Routine ECG monitoring during high-G/unusual attitude flight training is recommended to capture pathology underlying dangerous dysrhythmias in suborbital flight safety. More research is currently being conducted to further facilitate the development of robust medical screening, medical risk assessment approaches, and suborbital flight training in the context of the evolving commercial human suborbital spaceflight industry. A more mature and integrative medical assessment method is required to understand the physiology state and response variability among highly diverse populations of prospective suborbital flight participants.
Abstract: Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.
Abstract: The number of people suffering from hemiplegia is growing each year. This lower limb disability affects all the aspects of their lives by taking away their autonomy. This implicates their close relatives, as well as the health system to provide the necessary care they need. The integration of exoskeletons in the medical field became a promising solution to resolve this issue. This paper presents an exoskeleton designed to help hemiplegic people get back the sensation and ability of normal walking. For this purpose, three step models have been created. The first step allows a simple forward movement of the leg. The second method is designed to overcome some obstacles in the patient path, and finally the third step model gives the patient total control over the device. Each of the control methods was designed to offer a solution to the challenges that the patients may face during the walking process.
Abstract: This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.
Abstract: The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.