Automatic Detection of Lung Ultrasound Artifacts using a Deep Neural Networks approach

The COVID-19 pandemic has challenged many of the healthcare systems around the world. Many patients who have been hospitalized due to this disease develop lung damage. In low and middle-income countries, people living in rural and remote areas have very limited access to adequate health care. Ultrasound is a safe, portable and accessible alternative;however, it has limitations such as being operator-dependent and requiring a trained professional. The use of lung ultrasound volume sweep imaging is a potential solution for this lack of physicians. In order to support this protocol, image processing together with machine learning is a potential methodology for an automatic lung damage screening system. In this paper we present an automatic detection of lung ultrasound artifacts using a Deep Neural Network, identifying clinical relevant artifacts such as pleural and A-lines contained in the ultrasound examination taken as part of the clinical screening in patients with suspected lung damage. The model achieved encouraging preliminary results such as sensitivity of 94%, specificity of 81%, and accuracy of 89% to identify the presence of A-lines. Finally, the present study could result in an alternative solution for an operator-independent lung damage screening in rural areas, leading to the integration of AI-based technology as a complementary tool for healthcare professionals. © 2023 SPIE.

Development of an acquisition system to monitoring asynchronous tele-ultrasound for lung patients

Lung ultrasound imaging allows the detection and evaluation of the lung damage generated by COVID-19. However, several infrastructure and logistical limitations prevent them from being carried out in isolated and remote areas. In this work, a system for the acquisition of medical images through asynchronous tele-ultrasounds was developed. The system is based on a graphical user interface, which records the three video cameras, the ultrasound image and the accelerometer simultaneously. The interface was developed according to the Volume Sweep Imaging acquisition protocol. The translational and rotational movement of the transducer are tracked and monitored by the accelerometer and the position of the transducer is obtained from the images acquired by the three video cameras. The results show a correct functioning of the system overall, being viable to be implemented for data acquisition and calculation of error, although in order to validate the error calculation there is still more research to be done. © 2023 SPIE.

MASI Ventilator: Implementing Peruvian Technology in Regions at High Altitude

The expanded use of the Masi ventilators to more regions of Peru is important, particularly for regions located at high altitudes, due to the ventilatory support latent need, which also represents a challenge in the calibration and the adjustment of metrological parameters to ensure its correct performance. In a previous study, in Puno city at 3800 m.a.s.l., it was found an error above 15.0% (minimum tolerance) in the tidal volume, for which a negative correction of 25.0% was applied. In the present study, a Masi ventilator was transported to Chachapoyas city, at an altitude of 2400 m.a.s.l. to continue evaluating the effect of altitude on the parameters of the device. Once there, ventilators were acclimated and calibrated. Tidal volume, inspiration-expiration ratio (LE), positive endexpiratory pressure (PEEP), peak inspiratory flow (PIF) and peak inspiratory pressure (PIP) were tested, and the maximum percentages errors presented were 13.5% and 13.9% in the tidal volume and the PIF, respectively. For that reason, although errors were under 15.0%, an update of the software of Masi was needed, applying a negative correction of 14.0%. Then, the parameters were tested again obtaining results with errors below 6.0% and 8.0% in volume controlled an pressure controlled ventilation modes, respectively. These results allowed the use of the Masi ventilator at ICU area. Finally, a software update for the Masi ventilator is performed by applying a linear equation that relates altitudes and percentage errors tested.

DECISION PROCESSES TO PRIORITIZE HEALTH INTERVENTIONS: THE EXPERIENCE OF MASI DEVELOPMENT AND IMPLEMENTATION DURING THE COVID-19 CRISIS IN PERU

Covid-19 pandemic has unveiled the major weakness of health systems across the world, being the shortage of intensive care beds and mechanical ventilators in low- and middle- income countries to provide acute care to critically ill patients one of this. Research has pointed to structural factors like the high cost of trained healthcare workers, infrastructure, and supplies. The main drivers of the limited development of intensive care units (ICUs) in low and middle- income countries. Based on the systematization of experience of the development and implementation of a mechanical ventilator based on a manual resuscitator with telemedicine capabilities for patients with ARDS (MASI) during the COVID-19 crisis in Peru, this paper argues that regulatory frames, including frameworks for prioritization of health interventions, including health technology assessment processes, are critical to guarantee the timely implementation of life-saving technology. The paper describes the regulatory gaps and challenges faced during the three steps of MASI's development and implementation (prototype development, massive production, and technology transfer and implementation). MASI's experience shows the negative effects of the lack of established decision processes to prioritize health interventions (including technology purchasing) on the efficient and transparent use of resources during a sanitary crisis, and in general on health system performance. MASI's experience provides evidence on the importance of having systems to determine the value of health technologies and innovations to the health systems.

Partner -Artificial Valuation to the Grown-Up's Caretaker

The essential objective of this article is to provide an up-to-date bibliographical material on elders' caretakers from the optic of criminology and crime victim with emphasis on the attention of this group in Cuba and its projection to face the coronavirus pandemic. We use as investigation model a dialectical-materialistic approach of reality that facilitated the engagement of the whole investigation, keeping in mind the theoretical-doctrinal character of the text, which determined that the method was framed around the methods: historical-logical, analytic-synthetic, inductive-deductive, theoretical-juridical and sociological. Conceiving as essential results a theoretical foundation from the criminology on the conceptualization of this figure, the determination of the elements configurative of the elderly' caretakers, we also value the attention from the State to this group ethereal before the introduction and propagation of the COVID-19 with a look from Cuba and inside we propose it organizational trials of the variants in that it can be presented, as well as the analysis of their artificial regulation in the national legislations.

THE BIGGEST ADULT'S CARETAKER: LOOK IN TIMES DE COVID-19

The figure of the biggest adult's caretaker is one of the lines of investigation of the project "Violence in the old age" that assumes as objective to provide an up-to-date bibliographical material on the topic from the optic criminological and crime victim. With emphasis in the care of the gerontes in Cuba and their projection to face the pandemic of the Coronavirus. The Methodical Investigative it provided us a dialectical-materialistic orientation of the environment that facilitated the investigation by means of the methods: historical-logical, analytic-synthetic, inductive-deductive, theoretical - juridical and sociological. Conceiving as essential results a theoretical foundation from the Criminology on the conceptualization of this figure, the determination of the elements configurative of the biggest adult's caretaker, we also value the attention from the State to this group ethereal before the introduction and propagation of the COVID-19 with a look from Cuba and inside we propose it organizational trials of the variants in that it can be presented, as well as the analysis of their artificial regulation in the national legislations.