Work-in-Progress: DIY Ventilator - A CoVID-19 Action

In the Covid-19 pandemic, ventilators became scarce, especially in countries with lower medical standards. A special project has managed to develop a complete ventilator as a kit using cheap parts and 3D printers. In the first two phases of the project a demonstrator has been developed which allows first tests. With hands-on experiments, one can already control the ventilator together with an artificial lung and learn how the ventilator works and what types of pumps, sensors, and electronic components are necessary for this. Due to its multidisciplinary character this project provides an excellent basis for the elaboration of educational and instructional material. Disciplines addressed comprise among others: informatics, physics, mathematics, biochemistry, medicine, material science, and electronics. In addition, the use of tools is demonstrated on a wide range covering 3D printing, IDEs for software development, wiring and soldering, etc. The knowledge gained through this project could be used for setting up a startup enterprise or as reference when starting research in the Edge Computing or IoT domain. The education and training will be carried out in small groups (four persons ideally) using a system for blended learning. It is envisaged to use the Mediathread Development [1] from the Columbia University which provides an excellent framework for the flipped classroom approach. Besides the academic domain also industries are the target for using the educational material which will be delivered by the project. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Devices with Fuzzy Logic Control of Artificial Lung Ventilation

This article presents the development of a ventilator and its control algorithm. The main feature of the developed ventilator is compressed by a pneumatic drive. The control algorithm is based on the adaptive fuzzy inference system (ANFIS), which integrates the principles of fuzzy logic. The paper also presents a simulation model to test the designed control approach. The results of the experiment provide verification of the developed control system. The novelty of the article is, on the one hand, the implementation of the ANFIS controller, pressure control, with a description of the training process. On the other hand, in the article presented a draft ventilator with a detailed description of the hardware and control system. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Surface control approach for growth of cerium oxide on flower-like molybdenum disulfide nanosheets enables superior removal of uremic toxins

Due to the high incidence of kidney disease, there is an urgent need to develop wearable artificial kidneys. This need is further exacerbated by the coronavirus disease 2019 pandemic. However, the dialysate regeneration system of the wearable artificial kidney has a low adsorption capacity for urea, which severely limits its application. Therefore, nanomaterials that can effectively remove uremic toxins, especially urea, to regenerate dialysate are required and should be further investigated and developed. Herein, flower-like molybdenum disulphide (MoS2) nanosheets decorated with highly dispersed cerium oxide (CeO2) were prepared (MoS2/CeO2), and their adsorption performances for urea, creatinine, and uric acid were studied in detail. Due to the open interlayer structures and the combination of MoS2 and CeO2, which can provide abundant adsorption active sites, the MoS2/CeO2 nanomaterials present excellent uremic toxin adsorption activities. Further, uremic toxin adsorption capacities were also assessed using a self-made fixed bed device under dynamic conditions, with the aim of developing MoS2/CeO2 for the practical adsorption of uremic toxins. In addition, the biocompatibility of MoS2/CeO2 was systematically analyzed using hemocompatibility and cytotoxicity assays. Our data suggest that MoS2/CeO2 can be safely used for applications requiring close contact with blood. Our findings confirm that novel 2-dimensional nanomaterial adsorbents have significant potential for dialysis fluid regeneration. © 2022

ORGAN DONATION AND TRANSPLANTATION IN THE RUSSIAN FEDERATION IN 2021 14th Report from the Registry of the Russian Transplant Society.

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on data from the year 2021. Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. We performed a comparative analysis of data obtained over years from various federal subjects of the Russian Federation and transplantation centers. Results. Based on data retrieved from the 2021 Registry, 45 kidney, 29 liver and 17 heart transplantation programs were existing in the Russian Federation as of the year 2021. The kidney transplant waiting list in 2021 included about 10.5% of the 60, 000 patients receiving dialysis. Organ donation activity in 2021 was 4.5 per million population, with a 78.4% multi-organ procurement rate and an average of 3.0 organs procured from one effective donor. In 2021, there were 9.5 kidney transplants per million population, 4.2 liver transplants per million population and 2.0 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation increased by 18.3% compared to the year 2020, reaching the level of 2019. In Moscow, organ donation activity was 23.7 per million population, that of 2019. In 2021, the city of Moscow and the Moscow region accounted for 12 functioning organ transplant centers, performing 57.7% of all kidney transplants and 70.5% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation has exceeded 140 per million population. Conclusion. In 2021, donor activity and volume of transplant care in Russian regions recovered. This was after the decline in 2020 that resulted from the new coronavirus disease (COVID-19) pandemic. In addition, 7 new transplant programs were established. Further development of regional organ donation and transplantation programs, improvement in their efficiency, increase in the activity of transplant centers and development of inter-regional collaboration are expected in the Russian Federation in 2022. Copyright © 2022 Russian Transplant Society. All rights reserved.

Optimizing Control of IOT Device using Traditional Machine Learning Models and Deep Neural Networks

With the increasing threat of Covid-19 and now omicron infection across the world among people, there has been a significant surge in the demand for a fully-automated, self-controlled or mechanized ventilator which can provide sufficient air-pressure to weak human lungs continuously. It is our humble endeavor to mitigate the effects caused due to handful of trained-physicians over countless untreated patients and lack of enough health-infrastructure facilities to support in the time of dire need. We all dread losing another precious life on earth due to any one of the above mentioned reason. We have tried simulating the observations obtained from a lab-developed mechanical ventilator system under different lung settings. After preprocessing this dataset using NLP, training data is analysed to study the correlation between observations from numerous attributes. A couple of Machine Learning (LR, RF, SVM, LGBM) and Deep Learning (MLP, LSTM, Bi-LSTM) algorithms have been deployed to train our model individually, out of which Bi-LSTM performed exceptionally well above others. However, only after exhaustive clinical trials and recommendations a large of number of patients on life-support can get a new life through the large practical application of this device, in the near future. © 2022 IEEE.

Multidisciplinary Learning for Multifaceted Thinking in Globalized Society

Multifaceted thinking is essential to address global proposal. Learning experience in multidisciplinary fields is useful. Following steps are important: multifaceted understanding the purpose of instructions to society, considering advantages and disadvantages, considering options, and considering relationship between individual behavior and society. As a multidisciplinary field, Biomedical Engineering has been applied to the present study. As a topic of case study, COVID-19 has been selected. While answering the questions, the students (in Japan, and in Thailand) noticed the multifaceted problem and the diversity of related disciplines. The education system provided the experience of linking biomedical engineering learning (statistics, biomeasurement, cellular mechanics, micromachining, designing, immunology, artificial organs) to the proposal of the solution to the global problem. © 2022 IMCIC 2022 - 13th International Multi-Conference on Complexity, Informatics and Cybernetics, Proceedings. All rights reserved.

Pressure and Volume Control of a Non-invasive Mechanical Ventilator: A PI and LQR Approach

Many studies in recent years have been focused on treating diseases caused by the SARS-CoV-2 virus, such as the Covid-19 disease. In this regard, the development of mechanical ventilation systems became very important for the care of patients with moderate symptoms caused by the virus. Most of the works developed used the non invasive mechanical ventilation system, since this is rapidly assembled and replicated. This work is centered on automating the manual Bag-Valve-Mask (BVM) ventilation of the Emergency Mechanical Ventilator for ICU (UTEC-AE EMV-ICU). For this purpose, it is necessary to implement a satisfactory control system to reach the adequate volume or pressure for patients. The control system implemented for the UTEC-AE EMV-ICU is based on LQR method for the three non-invasive ventilation modes (volumen controlled ventilation, pressure controlled ventilation, and assisted ventilation). The LQR control system of the UTEC-AE EMV-ICU was tested in an artificial lung where the obtained results were compared and discussed with the obtained results from a PI control system. © 2021 IEEE.

Outcomes after extracorporeal membrane oxygenation support in COVID-19 and non-COVID-19 patients.

BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) support is increasingly used in the management of COVID-19-related acute respiratory distress syndrome (ARDS). However, the clinical decision-making to initiate V-V ECMO for severe COVID-19 still remains unclear. In order to determine the optimal timing and patient selection, we investigated the outcomes of both COVID-19 and non-COVID-19 patients undergoing V-V ECMO support. METHODS: Overall, 138 patients were included in this study. Patients were stratified into two cohorts: those with COVID-19 and non-COVID-19 ARDS. RESULTS: The survival in patients with COVID-19 was statistically similar to non-COVID-19 patients (p = .16). However, the COVID-19 group demonstrated higher rates of bleeding (p = .03) and thrombotic complications (p < .001). The duration of V-V ECMO support was longer in COVID-19 patients compared to non-COVID-19 patients (29.0 ± 27.5 vs 15.9 ± 19.6 days, p < .01). Most notably, in contrast to the non-COVID-19 group, we found that COVID-19 patients who had been on a ventilator for longer than 7 days prior to ECMO had 100% mortality without a lung transplant. CONCLUSIONS: These findings suggest that COVID-19-associated ARDS was not associated with a higher post-ECMO mortality than non-COVID-19-associated ARDS patients, despite longer duration of extracorporeal support. Early initiation of V-V ECMO is important for improved ECMO outcomes in COVID-19 ARDS patients. Since late initiation of ECMO was associated with extremely high mortality related to lack of pulmonary recovery, it should be used judiciously or as a bridge to lung transplantation.

The Roles of Membrane Technology in Artificial Organs: Current Challenges and Perspectives.

The recent outbreak of the COVID-19 pandemic in 2020 reasserted the necessity of artificial lung membrane technology to treat patients with acute lung failure. In addition, the aging world population inevitably leads to higher demand for better artificial organ (AO) devices. Membrane technology is the central component in many of the AO devices including lung, kidney, liver and pancreas. Although AO technology has improved significantly in the past few decades, the quality of life of organ failure patients is still poor and the technology must be improved further. Most of the current AO literature focuses on the treatment and the clinical use of AO, while the research on the membrane development aspect of AO is relatively scarce. One of the speculated reasons is the wide interdisciplinary spectrum of AO technology, ranging from biotechnology to polymer chemistry and process engineering. In this review, in order to facilitate the membrane aspects of the AO research, the roles of membrane technology in the AO devices, along with the current challenges, are summarized. This review shows that there is a clear need for better membranes in terms of biocompatibility, permselectivity, module design, and process configuration.