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Mechanical ventilators are advanced life-supporting machines in this century. The ventilator needs to be safe, flexible, and easy for competent clinicians to use. Since ventilators supply the patient with gas, they need pneumatic components to be present. First technology ventilators were typically powered by pneumatic energy. Gas pressure is used to power ventilators as well as ventilate patients. Nowadays, ventilators are operated electronically with the useful microprocessor tool. This proposal aims to design a simple portable mechanical ventilator that includes measuring some important physiological variables such as respiratory rate, heart rate, and O2 saturation, which can be utilized in hospital and at home. The proposed system includes Arduino, Raspberry pi4, touch screen, and graphical user interface. This study showed a significant individual performance for measuring some important parameters such as flow rate, tidal volume, and minute ventilation. The accuracy of measuring the flow rate was 72%. The Cohen's kappa (CK) was estimated to be 0.61. The accuracy of calculated the tidal volume was estimated at 83% with 0.80 CK. The accuracy of measuring the O2 saturation was estimated at 99% with 0.99 CK. The advantages of the proposed design are cost-effective, safe, flexible, and easy to use. Also, this system is smart and can control its transactions, so it can be used at home without the need for professional help. The operating parameters can also be set by the user with a simple user interface.Copyright © 2022 by ASME.
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With the onset of the Covid-19 pandemic, the health of people has become more of a concern. With this, temperature measurement has gained even more significance. Non-contact thermometers give the advantage of being used in extreme infectious environments, lightweight, repeatability, and many more. Thermal screening helps in identifying people with a high body temperature who are potentially at risk. This research work focuses on the non-contact human body temperature measurement with the assistance of a robotic arm. The robotic arm is used to dispense the power of mobility to the system. The robotic arm, interfaced with Raspberry PI, is used to dispense the power of mobility to the system. Non-contact infrared temperature sensor, MLX90614, is interfaced with Arduino Nano and is used to measure human body temperature. The temperature obtained from the thermal gun is fed to the serial monitor app in the mobile that is connected through the USB cable to Arduino Nano. The temperature sensor's data is displayed on a mobile phone in Celsius unit. The format in which the sensor data is displayed is programmed using Arduino IDE. © 2022 IEEE
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This study aimed to investigate the Chinese pregnant women's levels of knowledge, attitude, and practice (KAP) of self-protection against coronavirus disease 2019 (COVID-19) during the post-pandemic period, to aid the development of targeted health education. An online questionnaire was conducted for 2156 Chinese pregnant women from October 1, 2021, to December 31, 2021, to collect socio-demographic and KAP information. Structural equation modeling (SEM) was used to determine self-protection-related factors. The mean age of the participants was 30 ± 4.1 years. SEM indicated that pregnant women's level of knowledge can directly and indirectly affect the practice of self-protection (r = 0.23) through their belief, with a correlation coefficient of 0.56 and 0.46 between knowledge and belief and belief and practice, respectively. The "basic protection" and "hospital visits after infection" exerted the greatest impact on knowledge formation, with correlation coefficients of 0.85 and 0.89, respectively. Attitude had a direct effect on practice with a correlation coefficient of 0.46. "Awareness of prevention and control" and "family and social support" had the greatest impact on belief formation, with correlation coefficients of 0.77 and 0.73, respectively. Pregnant Chinese women were generally familiar with COVID-19 knowledge, and their levels of knowledge and beliefs particularly affect the practice of self-protection. Health education aimed at improving pregnant women's knowledge and belief toward self-protection against COVID-19 may be an effective way to guide them toward positive practices and promote their health and that of their babies.
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Background: Meta-analyses on venous thromboembolism (VTE) risk in admitted patients with COVID-19 have shown substantial heterogeneity among included studies. Aim(s): To explore sources of heterogeneity among studies estimating VTE risk in COVID-19 patients. Method(s): A systematic review using the databases PubMed and Embase was performed searching for studies reporting VTE risk in patients admitted to the ward or intensive care unit (ICU). Analysis was performed with studies from which a incidence proportion could be retrieved. The pooled incidence of VTE and heterogeneity (I2) were estimated in a random-effects model stratified by ICU or ward. Incidence estimates were logit-transformed. The effect of 12 pre-selected clinical and methodological variables were explored in a univariable linear meta-regression model. Because of limited degrees of freedom, a multivariable model was constructed in a stepwise fashion. The outcome measure was regression coefficient with a 95% confidence interval (CI). Result(s): Fifty-three and 26 studies reported on incidence of VTE at the ICU and ward respectively. The pooled incidence at the ICU was 20.3% (95% CI 16.4-24.8%, I2 95.4%) and at the ward was 4.7% (95% CI 3.0-7.3%, I2 96.2%). In studies concerning ICU patients, asian region, VTE-screening, standard error and date of publication were significantly associated with incidence of VTE in the univariable model. (Table Presented) Two multivariable models were fitted (Table 1). In the multivariable model only standard error remained significantly associated. In studies concerning ward patients, average age, VTE-screening, standard error were significantly associated in the univariable model. Two multivariable models were fitted (Table 2). Again, only standard error remained significantly associated. Conclusion(s): Studies with a high standard error yielded a higher VTE incidence in COVID-19, strongly suggesting publication bias. Remaining heterogeneity was not completely explained, but may be due to differences in setting/outcome definition and clinical practice.
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Purpose Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an aging population, relatively simple and safe diagnosis tasks may need to be performed using robotics and automation technologies, without specialists and hospitals. Since the 1800s, auscultation has been an essential component of clinical examination and is a highly costeffective screening tool to detect abnormal clinical signs [1]. Additionally, recent studies have reported that auscultation is a potential diagnostic tool for COVID-19 patients and can be used as a follow-up tool for noncritical COVID-19 patients [2]. In this study, we aim to develop a robotic auscultation platform that enables estimation of the landing positions and safe placement of the stethoscope at the estimated position. The contribution of this paper is to establish a proofof- concept of the robotic platform that enables autonomous positioning of the stethoscope based on external body information while satisfying the patient's safety in terms of the contact between the stethoscope and body surface. To the best of our knowledge, this is the first dedicated robotic system designed for autonomous auscultation. Methods The developed robotic platform is composed of a 6-degree-of-freedom cooperative robotic arm, the light detection and ranging (LiDAR), and a spring-based mechanism holding an electric stethoscope (Fig. 1). The platform enables autonomous stethoscope positioning based on external body information acquired using LiDAR camera-based multi-way registration. The platform also ensures safe and flexible contact, maintaining the contact force within a certain range through the passive-actuated mechanism. The pipeline for estimating the landing positions to place the stethoscope with the developed robotic auscultation platform is organized into three components: (i) acquisition of the point cloud data for covering the entire chest and registration of the acquired point cloud data to reconstruct the entire chest shape;(ii) estimation of the landing positions based on the reconstructed body shape and the anatomical landmarks on the body surface;(iii) placement of the stethoscope at the estimated positions while maintaining a certain safe contact force. Results Our preliminary results confirm that the robotic platform enables estimation of the landing positions required for cardiac examinations based on the depth and landmark information of the body surface. The registration error in the 3D space occurred in the range of 5.1 to 7.6 mm on average. It also handles the stethoscope while maintaining the contact force without relying on the push-in displacement by the robotic arm. The generated contact forces were precisely achieved to the targeted forces (5, 10, 15 N). The maximum error was 7.2% of the targeted force. Conclusion The developed robotic platform enables the estimation of the landing positions and handling the stethoscope while maintaining the contact force, which promises the potential of automatic remote auscultation. The developed robotic platform has the potential to address the critical issue of the increase in the number of patients per healthcare worker. The use of this technology may further enhance the efficiency of screening for abnormal clinical signs, including COVID-19.
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An explosion of research has occurred since the advent of the COVID-19 pandemic relating to its effect on the NHS, health consciousness and vaccine side effects, such as vaccine-induced thrombocytopenia and thrombosis (VITT). This project sought to establish the effects of the UK's national lockdowns and media coverage of VITT on the rate of referrals and outcomes of DVT clinic appointments at our hospital. There was a suspicion among nurses running the DVT clinic that referrals were lower, but rates of positive scans higher, during the first national lockdown and that the reverse was true following media reporting of the first cases of VITT, with large numbers of patients testing negative for DVT. We report the findings of a retrospective, observational case-control study of 3550 patients presenting to Norfolk and Norwich University Hospital outpatient DVT clinic from any referral source (usually GP or A + E) between 2/3/2020 and 10/5/2021. Data from 2015 to 2019 were also obtained, providing 5-year averages for comparison. Outcomes were classified as positive (for DVT), negative (including those where Doppler ultrasound scan was not indicated due to low Wells score and negative D-dimer) and DNA (did not attend). Chi-squared (χ2 ) analyses were undertaken to determine heterogeneity of weekly referrals during specific periods of the pandemic. With 2 degrees of freedom (2df), a χ2 result above 5.9 suggests heterogeneity. T -tests were run to compare the outcomes driving the χ2 results with the data from the preceding 5 years. Compared to the non-lockdown period, there was a significant reduction in the number of referrals seen during the dates of the 1st national lockdown (χ2 = 20.01, 2df, p = <0.01). This was primarily due to a reduction in the number of patients subsequently found to be negative for DVT (31.0 vs. 45.4, p = <0.01). The difference was less marked and did not reach statistical significance during the 2nd and 3rd lockdowns. A significant increase in total weekly referrals was observed during the period immediately following media reporting of the first cases of VITT related to the AstraZenaca COVID-19 vaccine (55.1 vs. 73.1, p = <0.01). This was driven by an increase in patients subsequently found to be negative for DVT (39.2 vs. 57.2 p = <0.01). The weekly number of positive patients during this time was not significantly higher than the preceding 5-year average for the same dates (9.7 vs. 10.2, p = 0.30). Comparison with 5-year averages confirmed that the pattern seen in different parts of the pandemic year described above did not follow the usual pattern of referrals across the year. Finally, throughout the observed period, there was a below average rate of DNA outcomes when compared to the preceding 5-year average. These findings suggest several phenomena unique to the COVID-19 pandemic. First, measures to prevent the spread of COVID-19 were associated with fewer patients without DVT being referred to the DVT clinic. Second, media reporting of VITT was associated with a higher rate of referral of patients without a DVT to the DVT clinic without any change in the number of positive patients compared to the preceding 5 years. Third, during the COVD-19 pandemic, there were fewer patients failing to attend their clinic appointment, which we hypothesise is as a result of increased awareness of the need not to waste NHS resources..
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Coupled oscillations can be found throughout the physical world on both micro and macro levels, from oscillating molecules to lattice vibrations in solids, up to the oscillations of macroscopic mechanical or electrical systems. Despite the fact that the dynamics of such systems is governed by forces originating from a variety of potentials, the harmonic-oscillator potential approximation can be used for almost every system close to equilibrium, which makes it fundamental in many fields of physics. The equations of motion of single harmonic-oscillators as well as of one-dimensional linear elastic multiple-degree-of-freedom systems can be solved analytically, which enables a quantitative study of idealized model systems and, furthermore, some qualitative insight into the behavior of more complex real-life systems. Multi-dimensional multiple-degree-of-freedom systems are, in general, no longer accessible to analytical solutions. A perpendicular spring configuration, for instance, introduces a nonlinearity of the Duffing type and can lead to chaotic behavior. In order to engage our students with the analysis of multiple-degree-of-freedom oscillatory systems, an interdisciplinary undergraduate student research project was initiated, which encompassed the development of computer programs for the simulation and visualization of elastically coupled particles aligned in a straight line, as well as for the simulation of two-dimensional arrays of coupled oscillators. The equation of motion of one-dimensional oscillatory systems was solved numerically and - for small systems - analytically in order to test the quality of the numerical integration. In the case of two-dimensional arrays, the conservation of total energy was used for validation. Three teams of three students each took up the challenge and worked simultaneously and competitively on that project, with the additional complication that the team members had to work in different locations due to the Covid-19 pandemic. The integration of the coupled systems of differential equations was programmed in C#, with a graphical user interface that provides a display of the vibrating systems, graphs of the mass displacements over time, and phase-space diagrams. The dynamic visual output of the program was designed to provide a playful insight into the behavior of multiple-degree-of-freedom lumped-mass systems. In this paper, the theoretical background, the approach to the problem and the outcome of the undergraduate student projects are presented and discussed. © American Society for Engineering Education, 2021
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Humanity has always aspired to provide life-like traits and characteristics to its products to discover a replacement for himself to carry out his commands and also to adapt easily in an unfriendly environment. Since the late 2019, covid-19 pandemic has spread all over the world cause immense damage in the healthcare unit worldwide.To make a comeback into normal lifestyle towards medical unit robots are used for better treatment of patients. By considering these features, the authors have designed and developed a Low-Cost 3D printed humanoid robotic arm which can also be controlled and operated wirelessly. The proposed model in this paper uses a wireless RF module which acts as a common interface between the master and slave part of the prototype. The software platform Arduino IDE is used to give instructions to the hardware via high level code. The controller executes the program and performs the necessary movements and functions of the robotic arm in desired manner. The proposed model works on wireless technology which not only makes it more sophisticated at low cost but also provides six degrees of freedom. This model can be a key ingredient to free police workers in hazardous conditions, towards intelligent local traffic management systems and smart cities. © 2021 IEEE.
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Introduction Musculoskeletal disorders associated with patients care and manipulation are frequent among healthcare workers, due to force exertion and sustained awkward postures (EU Commission 2011, Davis 2015). During the COVID-19 pandemic, intensive care units (ICUs) staffs had to perform prone-positioning (PP) of a large number of intubated patients suffering from Acute Respiratory Distress Syndrome (ARDS) many times a day. PP maneuver consists in repositioning a patient from a supine position (on the back) to a prone position (on the front side), which improves oxygenation and ventilatory mechanisms in ARDS patients (Guérin et al. 2013). PP is a delicate procedure (risk of extubation) which requires the medical staff to remain bent forward for several minutes (Figure 1). This posture result in back loading and in the long-term potential injuries in the low-back. Similar postures are common in industrial tasks, and recently occupational exoskeletons have started to be commercialized to help reduce physical load on workers (DeLooze et al. 2016). Exoskeletons therefore appear as a promising solution to support healthcare workers, though few studies focused on this sector (e.g. Miura et al. 2020;Iishi et al. 2015). But while studies overall agree that back-support exoskeletons, and specifically passive devices, have the potential to reduce lumbar muscle activity in tasks involving trunk bending, the exact efficacy and usability of such devices appear largely device-and task-dependent (Theurel et al. 2019). A preliminary study of our team (Settembre et al. 2020) identified the Laevo passive exoskeleton for lumbar support (Laevo, the Netherlands) as the exoskeleton that best matched the PP maneuver and ICU constraints, among 4 exoskeletons that were available at the time of the test during the COVID-19 first wave. The present study presents a pilot investigation of the biomechanical effects of using the Laevo during PP maneuver. 2. Methods 2.1. Experimental protocol Two healthy volunteers with PP experience performed PP maneuvers both with and without wearing the Laevo, on a patient simulator (manikin) at the Hospital Simulation Center of the University of Lorraine (Figure 1). Each maneuver lasted about 4 min. In a first experiment, the participants were equipped with the Xsens MVN Link inertial motion capture system (capture rate 240 Hz) to record wholebody kinematics. In a subsequent experiment, the participants were equipped with a Delsys Trigno EKG sensor to measure heart rate, and 12 Delsys Trigno sEMG sensors (sampling rate 4370 sa/sec) placed according to the Seniam recommendations bilaterally on the erector spinae longissimus (ESL), erector spinae iliocostalis (ESI), trapezius ascendens (TA), and biceps femoris long head (BF), and laterally on the right rectus abdominis at T10 level (RA), rectus femoris (RF), gluteus maximus (GM) and tibialis anterior (TAL). 2.2. Data analysis In order to analyze the kinematics and dynamics of the maneuver, we replayed the recorded motions in a physics-engine based simulation using a 43 degrees of freedom digital human model (DHM). The recorded motions were retargeted on the DHM directly in the Cartesian space by using a quadratic programming controller (QP) typically used for humanoid robots (Maurice et al. 2019). The QP control directly estimates the joint torques associated with the motion. This method has the advantage to blend the traditional inverse kinematics and inverse dynamics steps into one faster step, since the computation runs in close to real-time. Since we did not have a direct measurement of the support torque provided by the Laevo, we used the empirical calibration curve published by (Koopman et al. 2019) to estimate the lumbar support torque depending on the trunk flexion angle. We used the resulting L5/S1 flexion/extension estimated joint torque as a complement to the physiological measurements obtained with the sEMG. 3. Results and discussion Kinematic results: Using the Laevo did not significantly modify the kinematics of the motion during PP. Specific lly, the profile of the lumbar flexion angle remained overall similar (Figure 2). This result was confirmed by the subjective feedback of the participants who reported that they did not feel the exoskeleton was affecting the way they performed the task. Dynamic results: The median value of the estimated L5/S1 flexion/extension torque decreased by about 12% when using the Laevo (Figure 2). This result agrees with the reduced perceived lumbar effort reported by participants, and is aligned with the 15% reduction observed by (Koopman et al. 2019) in a similar static forward bending task. Yet those results should be considered cautiously, since only the assistive torque of the exoskeleton was modeled, and not the full effect of the load transfer. Physiological results: We did not observe any major change in heart rate when using the Laevo. This might be due to the short duration of the experimental task (4 min). The activity of the back extensor muscles (except ESI) and hip extensor muscles overall decreased when using the Laevo (Table 1). The other recorded muscles remained mostly unaffected by the exoskeleton. Those results are consistent with the perceived reduced effort reported by the participants. 4. Conclusions Our pilot study, though limited to a small number of participants, suggests that using the Laevo could help reduce the musculoskeletal load on the low back during PP maneuver, without causing any significant negative side-effect nor modifying the practice. Following this study, 2 Laevos have been successfully deployed in the ICU of CHRU Nancy and have been used there for the past 6 months. Recording quantitative measurements during this fieldtesting is not possible. However subjective feedback from users is collected through questionnaires and interviews, and will be analyzed in a future study.