ABSTRACT
Objectives: The effectiveness of prone positioning (PP) under VV-ECMO for severe COVID-19 still be unclear. Until now, PP under VV-ECMO was often performed as the trump card for refractory hypoxemia and weaning off ECMO. On the other hand, PP has the effect of promoting homogenization of Lung aeration and leading to prevention of VILI. Combine use of early prone positioning together VV-ECMO may have synergy effects of ultra-lung protective strategy. In this study, we analyzed early PP cases under VV-ECMO for severe COVID-19 in our hospital and examined their efficacy and feasibility. Method(s): We performed a retrospective study of patients with SARS-CoV-2-induced ARDS submitted to early PP during VV-ECMO. During VVECMO, PP was considered in case of "Type-H transition in imaging findings (CT / LUS) " and cases that the physician deemed necessary. The lung aeration is evaluated by LUS before and after each PP. If there is a finding that the dorsal collapsed lung is improved through PP, it is implemented as effective, and it continued. Result(s): From April 2021 to August 2021, there were a total of 10 early PP cases under ECMO, and the age was (average) 56 years. ECMO was implanted with P/F 98 and Murray score 3.3 points, and PP was started 14 hours after the ECMO implantation. The average PP duration is 17.4 hours and PP performed 5.8 times per patient. Comparing blood gas and respiratory mechanics before and after PP showed a significant difference in PaCO2 (before: 46 +/- 8 vs after: 42 +/- 9, p = 0.02). Finally, there were 10 ECMO successful weaning (100%) and 8 surviving discharges (80%). No major complications were observed. Conclusion(s): Early PP under VV-ECMO for severe COVID-19 can be safely performed, and it is suggested that the synergy effect of ultra-lung protective strategy may be associated with a reduction of hospital mortality.
ABSTRACT
Proximity interaction, such as hugging, plays an essential role in building relationships between parents and children. However, parents and children cannot freely interact in the neonatal intensive care unit due to visiting restrictions imposed by COVID-19. In this study, we develop a system of pseudo-proximity interaction with a remote infant through a VR headset by using an infant-like device that reproduces the haptic feedback features of the hugging sensation, such as weight, body temperature, breathing, softness, and unstable neck. © 2021 Copyright held by the owner/author(s).
ABSTRACT
The configuration of office environments is related to worker satisfaction and can improve work efficiency. Although open offices promote communication among co-workers, privacy issues surface as well as increased risks from such health concerns as viral infections and pandemics. On the other hand, territorial offices protect worker privacy and reduce infection risks. Unfortunately, such arrangements often hinder communication among co-workers. Although a physical office must satisfy different needs under various scenarios with limited space, the lack of flexibility in furniture designs prevents dynamic space management. In this paper, we propose a self-actuated stretchable partition whose physical height, width, and position can dynamically change to create secure workplaces (e.g., against privacy and infectious risks) without inhibiting group collaboration. To support secure workplace layouts and space reconfigurations, the partitions' height, length, and position are adapted automatically and dynamically. First, we consider the design space of a self-actuated stretchable partition and implement a proof-of concept prototype with a height-adjustable stand, a roll-up screen, and a mobile robot. We then show some example application scenarios to discuss potential future actuated-territorial offices. © 2021 ACM.