Motion assistance analysis for robot-assisted tele-rehabilitation based on bilateral admittance control / 中国康复理论与实践

ObjectiveTo develop a bilateral rehabilitation robot motion assistance strategy based on admittance control, so that rehabilitation physicians can assist patients in rehabilitation training through remote teaching. MethodsA bilateral remote rehabilitation platform with upper limb terminal traction was constructed. Based on the velocity admittance control, the interactive movement between the master robot and the rehabilitation physician was realized, and the position information transmission of the master-slave robot was realized through the communication framework built. The slave robot received the position coordinates of the main robot, and drove the patient to carry out rehabilitation exercises under the attitude admittance controller. ResultsThe robot could drive the patient to accurately track the trajectory of the doctor's teaching in real time, and improve the safety and compliance of the training and human-computer interaction. ConclusionBy introducing two admittance controllers, the trajectory of the physician's end can be accurately tracked when driving the patient's movement from the robotic arm, which effectively avoids the discomfort of the patient's arm in process of rehabilitation.

Ubicación intrahospitalaria y tratamiento antimicrobiano inicial en pacientes con neumonía adquirida en la comunidad y su relación con la frecuencia y calidad del proceso de estratificación / Intrahospitalary location and antimicrobial initial treatment in patients with acquired pneumonia in the community and their relationship with the frequency and quality of the stratification process

La importancia de la evaluación inicial de la gravedad del paciente con neumonía es una acción diagnóstica de importancia bien establecida. El objetivo del trabajo fue evaluar la relación entre la frecuencia y calidad del proceso de estratificación de pacientes con neumonía, y el cumplimiento de las sugerencias de ubicación intrahospitalaria y de tratamiento antimicrobiano inicial de un instrumento de estratificación. Se realizó un estudio descriptivo sobre una población de 1,809 pacientes hospitalizados durante 10 años. Se analizó el comportamiento de los índices de ubicación intrahospitalaria y tratamiento antimicrobiano inicial acorde a la sugerencia de un instrumento de estratificación utilizado; en el análisis estadístico se utilizó el Odds ratio y el estadígrafo X2, con un nivel de significación de 95%. En los resultados se destacan que la ubicación intrahospitalaria estuvo acorde a la sugerencia del instrumento en el 96%, con el valor más bajo en los pacientes con neumonía grave y altas probabilidades de recuperación (82%, p<,05). Se constató mayor frecuencia de ubicación intrahospitalaria acorde a la sugerencia del instrumento en los pacientes bien estratificados (p<,05), fundamentalmente en los pacientes con neumonía grave y altas probabilidades de recuperación. La correspondencia del tratamiento antimicrobiano inicial con la propuesta del instrumento fue del 61%; el estrato IIIA mostró el valor más elevado (80%, p<,05). Como conclusiones del estudio se constató un elevado desempeño en el cumplimiento de la sugerencia de ubicación intrahospitalaria del instrumento de estratificación, no así en el cumplimiento de la sugerencia de tratamiento antimicrobiano inicial. Se demostró la existencia de una relación entre el proceso de estratificación y el cumplimiento de la ubicación intrahospitalaria sugerida por el instrumento empleado.

The initial evaluation of the patient's condition with pneumonia is a very important assistance action. The objective was evaluate the relationship between the frequency and quality of the stratification process of the patient with pneumonia, and the execution of suggestions of intrahospitalary location and the initial antimicrobial treatment of stratification instrument. A descriptive study was done on a population of 1,809 patients hospitalized during 10 years. The indexes of intrahospitalary location and of antimicrobian initial treatment were analized according to the suggestions of the instrument; in the statistical analysis it was used the odds ratio and the statistician X2, with a significant level of 95%. The intrahospitalary location was in agreement with the suggestion of the instrument in 96% of the cases, with the lowest value in patients with serious pneumonia and high recovery probabilities (82%, p <,05). The frequency of intrahospitalary location was bigger and veryfied with the suggestion of the instrument in the termed well stratified patients (p <,05), fundamentally in the patients with serious pneumonia and high recovery probabilities. The correspondence of the initial antimicrobial treatment with the proposal of the instrument was of 61%; the stratum IIIA showed the highest value (80%, p <,05). As conclusions, a high performance in the execution of the suggestion of the intrahospitalary location has been one of the characteristics of the process, although as a negative element it stands out the frequent non-fulfillment of the suggestion of the initial antimicrobial treatment. There was a relationship between the stratification process and the execution of the suggestion of the intrahospitalary location.

Control of a robotic knee exoskeleton for assistance and rehabilitation based on motion intention from sEMG

Introduction: This work presents the development of a novel robotic knee exoskeleton controlled by motion intention based on sEMG, which uses admittance control to assist people with reduced mobility and improve their locomotion. Clinical research remark that these devices working in constant interaction with the neuromuscular and skeletal human system improves functional compensation and rehabilitation. Hence, the users become an active part of the training/rehabilitation, facilitating their involvement and improving their neural plasticity. For recognition of the lower-limb motion intention and discrimination of knee movements, sEMG from both lower-limb and trunk are used, which implies a new approach to control robotic assistive devices. Methods A control system that includes a stage for human-motion intention recognition (HMIR), based on techniques to classify motion classes related to knee joint were developed. For translation of the user's intention to a desired state for the robotic knee exoskeleton, the system also includes a finite state machine and admittance, velocity and trajectory controllers with a function that allows stopping the movement according to the users intention. Results The proposed HMIR showed an accuracy between 76% to 83% for lower-limb muscles, and 71% to 77% for trunk muscles to classify motor classes of lower-limb movements. Experimental results of the controller showed that the admittance controller proposed here offers knee support in 50% of the gait cycle and assists correctly the motion classes. Conclusion The robotic knee exoskeleton introduced here is an alternative method to empower knee movements using sEMG signals from lower-limb and trunk muscles.

Acolhimento com classificação de risco em um hospital da rede pública: percepção dos usuários / Risk-classified admittance in a governmentrun hospital: clients´ perception

O objetivo deste estudo foi conhecer a percepção dos usuários quanto ao acolhimento com classificação de risco em um hospital público. Trata-se de um estudo transversal e quantitativo, com abordagens descritiva e analítica, realizado por meio de entrevista com 80 usuários de um hospital público em Itabaiana, Sergipe. Os resultados mostraram que, dentre os participantes que já haviam passado por atendimento médico na unidade hospitalar (n= 72), somente 19,4% (n= 14) referiram conhecimento sobre o que seria a classificação de risco. O tempo de espera ≥ 1 hora foi referido por 16,3% (n= 13) dos participantes. A maioria foi atendida por técnicos de enfermagem (65%; n= 52) e apenas 3,8% (n= 3) disseram ter recebido informação sobre a classificação de risco recebida. Ainda assim, muitos usuários mostraram-se satisfeitos com este atendimento. Concluiu-se que os usuários desconhecem o significado da classificação de risco na priorização dos atendimentos à saúde.

Clients´ perception with regard to risk-classified admittance in a public hospital is analyzed. Current transversal, quantitative, descriptive and analytic study comprised interviews with 80 clients of a government-run hospital in Itabaiana SE Brazil. Results showed that, out of the participants (n=72) who were attended to at the hospital, only 19.4% (n=14) knew anything about risk classification. Waiting time ≥ 1 hour was referred to by 16.3% (n=13) of participants. Most were attended by nursing technicians (65%; n=52) and a mere 3.8% (n=3) alleged to have received information on risk classification. However, most clients were satisfied with attendance. Results show that clients do not know anything about risk classification within the priority of health attendance.

High Frequency Tympanometry (1,000 Hz) for Neonates with Normal and Abnormal Transient Evoked Otoacoustic Emissions

BACKGROUND AND OBJECTIVES: This paper aimed at evaluating the characteristics of high-frequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group. SUBJECTS AND METHODS: Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0–104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram. RESULTS: The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group. CONCLUSIONS: There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.

Moral Defense for Ethical Review of Medical Technology Clinical Admittance / 中国医学伦理学

This paper discussed the main point specifically from the three aspects which are the certainty and uncertainty of technological function , the predictability and unpredictability of technological efficiency , and“should do”or“not should do”of technological application .It presented an ethics argument of medical technology clinical admittance restriction and defends the standpoint -what we can do does not mean what we should do , aiming to provide moral theoretical support of ethical review of medical technology application .

Requirements of Korea for admittance to medical device market / 医疗卫生装备

The concept and classification of Korean medical device were introduced. The phases for Korea to import medical device include selecting Korean certification holder, hospital admittance, device marketing and supervision after marketing. China and other countries can find references to export medical devices into Korea.

Perfil das internações por doenças crônicas não-transmissíveis sensíveis à atenção primária em idosos da metade sul do RS / Perfil de las hospitalizaciones de ancianos por Enfermedades Crónicas no Transmisibles Sensibles Atención Primaria Mitad Sur de RS / A profile of admittances to hospital due to non-contagious chronic diseases sensitive to primary health care among chronologically advantaged patients in the southern half of Rio Grande do Sul

Objetivou-se delinear, em municípios da metade sul do Rio Grande do Sul, o perfil das internações por Doenças Crônicas Não Transmissíveis Sensíveis à Atenção Primária (DCNTSAP) entre idosos. Trata-se de um estudo transversal com dados secundários do Departamento de Informática do SUS (DATASUS), englobando variáveis relacionadas às internações e à mortalidade hospitalar (de acordo com as causas, sexo, idade e tempo de permanência). As DCNTSAP são responsáveis por 43,99% das Internações por Todas as Causas (ITC), destacando-se as Doenças Pulmonares como o grupo mais prevalente (18%), seguida de Insuficiência Cardíaca (12,28%). O sexo feminino, com exceção das Doenças Pulmonares, é o que mais interna pelas demais causas. Encontrou-se também tendência linear de aumento na taxa de mortalidade das DCNTSAP agrupadas. Conclui-se que, dada a magnitude das internações, bem como o aumento da mortalidade pelas DCNTSAP, são urgentes reflexões mais aprofundadas sobre o cuidado na atenção primária aos idosos nesta região.

El objetivo del estudio fue delinear, en municipios del sur de Rio Grande do Sul, el perfil de las hospitalizaciones por enfermedades crónicas no transmisibles Sensibles a la Atención Primaria (DCNTSAP) en ancianos. Es un estudio transversal a partir de datos secundarios del Departamento del SUS (DATASUS), utilizando variables relacionadas con las hospitalizaciones y mortalidad hospitalaria (según la causa, el sexo, la edad y la duración de la estancia hospitalaria). Las DCNTSAP son responsables por el 43,99% de la hospitalización por todas las causas (ITC), destacando la enfermedad pulmonar como grupo más prevalente (18%), seguido de la insuficiencia cardíaca (12,28%). Las mujeres, con excepción de enfermedades pulmonares, son las más internadas de otras causas. Hay tendencia creciente en la tasa de mortalidad de DCNTSAP agrupados, 43,32 ± 1,11%. Dada la magnitud de las admisiones, así como aumento de mortalidad por DCNTSAP es urgente reflexionar sobre la atención primaria a los ancianos en esta región.

The purpose here established was that of establishing, within the municipalities in the southern part of the Brazilian State of Rio Grande do Sul, the profile of admittances to hospital resulting from Non-Contagious Chronic Diseases Sensitive to Primary Health Care (NCCDSPHC) among chronologically advantaged patients. This is a transversal study with secondary data obtained from the Information Technology Department of the Brazilian Public Health System - SUS (DATASUS), including variables related to admittance to hospital and also the mortality rates in hospitals (according to causes, gender, age, and time spent in hospital). The NCCDSPHC are responsible for 43.99% of hospital admittances for all causes (AAC), with Pulmonary Diseases standing out as the most prevalent single group (18%), followed by Heart Failure (12.28%). The female sex, with the exception of the Pulmonary Disease category, is the one that causes most admittances to hospital through other causes. We also found a linear trend towards an increase in the mortality rate of the NCCDSPHC when grouped together. Our conclusion is that, due to the magnitude of the admittances to hospital, as also the increase in the mortality caused by the NCCDSPHC, it is urgent to embark on more in-depth considerations about care to be taken as part of primary care for the chronologically advantaged in this region.

Practice and lessons learnt from building the“surgeon qualification admittance system” / 中华医院管理杂志

An introduction to the practice of introducing the“ surgeon qualification admittance system”in the hospital and a description of its management framework,basic principles,rules of classification for surgical operations,application and approval procedure,and supportive management regulations.The authors hold that this system has normalized behavior of medical activities,clarified operation authorities of medical doctors at various levels,and intensified the awareness of risk exposure.Therefore this system can safeguard the quality and safety of surgical operations and its efficiency to a great extent,in addition to better building the team and backup forces.

Evaluation criteria for admittance of medical techniques class Ⅰ and management in primary hospitals / 中华医学科研管理杂志

To enforce the application of medical techniques in the primary hospital so as to improve clinical quality and ensure clinical safety, we established the evaluation criteria for admittance of medical techniques class Ⅰ and the incentive system for new technique application. When both systems were applied, favorable results were obtained.

Tympanometric Screening Norms for Sichuan Young Adults / 听力学及言语疾病杂志

Objective The purpose of this study w as to obtain tympanometric norms in Sichuan young adult population and compare the results with data obtained for a non-Hispanic Caucasian population. Methods Normative values for peak compensated static acou stic admittance(Peak Ytm), acoustic equivalent volume(Vea), and tympanometric wi dth(TW) were obtained for 102 Sichuan young adults. Results Significant differences were fo und between Roup′s results and ous for Peak Ytm, Vea and TW. The present study showed lower Peak Ytm, smaller Vea and larger TW values overall. Gender differences were noted for Peak Ytm and Vea in Sichuan subjects . Male had higher Peak Ytm and bigger Vea values than female. Conclusion We should establish our own tympanometric norm s to guide our audiological clinical work.

Analysis of Nerve Excitability Test and Stapedial Reflex on the Prognosis of Facial Nerve Paralysis / 听力学及言语疾病杂志

Objective To evaluate the clinical application of nerve excitability test and stapedial reflex on the prognosis of facial nerve paralysis. Methods The threshold of excitability of the branches of facial nerves in both sides and stapedial reflex were tested in 50 patients.Results 34 patients out of 42 with differences of nerve excited threshold less than 3.5 mA showed complete recovery (81%),while only 2 patients out of 8 with the differences of nerve excited threshokd more than 3.5 mA showed recovery (25%), 32 patients out of 36 with positive response of stapedial reflex showed recovery (88.9%), but only 3 patients out of 14 recovered (21.4%) in non-response group.Conclusion The difference of nerve excited threshold of both sides less than 3.5 mA and positive response of stapedial refles showed a better prognosis, suggesting no severe injury to facial nerve and both nerve excitability test and stapedial reflex were useful chinical parameters to predict the prognosis of facial paralysis.

The observation of right chest electric admittance plethsmography in patients with coronary heart disease / 中国介入心脏病学杂志

The right chest electric admittance plethsmography (RCEAP) is a simple no invasive and reliable method in detecting the blood flow volume in the pulmomary artery and vein, an indirection of the left heart function. In this clinical study, the RCEAP, left heart catheterization for measurement of LVEDP and coronary angiogram and echocardiography for investigating the LVEF were performed on 34 patients with coronary heart disease. Of these 34 patients,24 had single or no left vessel lesion (Group A), 10 had left main coronary artery or its double branches lesions (Group B) ;8 underwent percutaneous trans-lumin coronary angioplasty (PTCA)and 10 had coronary artery bypass graft (CABG).The data obtained were analysed and compared to evaluate their respective diagnostic values. Correlation analysis demonstrated the values of hc/hz ratio, ha/hz ratio were moderated with LVEDP(r = 0. 68 or 0. 73,P

Establishment of Ethical Assessment System in the Admittance of the Limitative Medical Technologies / 中国医学伦理学

Objective to establish an ethical assessment system in the admittance of the limitative medical technologies.Method:literature review and Delphi method are employed to adjust and set the structure,index numbers,and index weights of ethical assessment system of the limitative medical technologies.Result:An ethical assessment system in the admittance of the limitative medical technologies was established,which included 3 primary indices,11 secondary indices and 35 tertiary indices.There were 4 qualitative levels with different weights in tertiary indices,based on which the global grade and proposed-admittance criterion were obtained.Conclusion:Establishment of ethical assessment system in the admittance of the limitative medical technologies provides an ethical evidence for the assessment of clinical admittance of the limitative medical technologies with qualitative and quantitative approaches and class-setting evidence.