Non-Invasive Data Acquisition and IoT Solution for Human Vital Signs Monitoring: Applications, Limitations and Future Prospects.

The rapid development of technology has brought about a revolution in healthcare stimulating a wide range of smart and autonomous applications in homes, clinics, surgeries and hospitals. Smart healthcare opens the opportunity for a qualitative advance in the relations between healthcare providers and end-users for the provision of healthcare such as enabling doctors to diagnose remotely while optimizing the accuracy of the diagnosis and maximizing the benefits of treatment by enabling close patient monitoring. This paper presents a comprehensive review of non-invasive vital data acquisition and the Internet of Things in healthcare informatics and thus reports the challenges in healthcare informatics and suggests future work that would lead to solutions to address the open challenges in IoT and non-invasive vital data acquisition. In particular, the conducted review has revealed that there has been a daunting challenge in the development of multi-frequency vital IoT systems, and addressing this issue will help enable the vital IoT node to be reachable by the broker in multiple area ranges. Furthermore, the utilization of multi-camera systems has proven its high potential to increase the accuracy of vital data acquisition, but the implementation of such systems has not been fully developed with unfilled gaps to be bridged. Moreover, the application of deep learning to the real-time analysis of vital data on the node/edge side will enable optimal, instant offline decision making. Finally, the synergistic integration of reliable power management and energy harvesting systems into non-invasive data acquisition has been omitted so far, and the successful implementation of such systems will lead to a smart, robust, sustainable and self-powered healthcare system.

Effect of Process Parameters on the Performance of Drop-On-Demand 3D Inkjet Printing: Geometrical-Based Modeling and Experimental Validation.

As additive manufacturing has evolved, 3D inkjet printing (IJP) has become a promising alternative manufacturing method able to manufacture functional multi-material parts in a single process. However, issues with part quality in terms of dimensional errors and lack of precision still restrict its industrial and commercial applications. This study aims at improving the dimensional accuracy of 3D IJP parts by developing an optimization-oriented simulation tool of droplet behavior during the drop-on-demand 3D IJP process. The simulation approach takes into consideration the effect of droplet volume, droplet center-to-center distance, coverage percentage of jetted droplets, the contact angle of the ink on the solid substrate and coalescence performance of overlapping droplets, in addition to the number of printed layers. Following the development of the simulation tool using MATLAB, its feasibility was experimentally validated and the results showed a good agreement with a maximum deviation of 2.25% for horizontal features. In addition, the simulated horizontal features are compared with the results of "Inkraster" software, which also illustrates droplet behavior, however, only in 2D. For vertical features, a dial gauge indicator is used to measure the sample height, and the validation results show that the simulation tool can predicate the height of the sample with an average error of 10.89% for a large droplet diameter and 8.09% for a small diameter. The simulation results were found to be in a good agreement with the dimensions of the printed parts. The developed tool was then used to elucidate the effect of resolution of processed TIFF image and droplet diameter on the dimensional accuracy of 3D IJP parts.

Multiobjective Optimization of Laser Polishing of Additively Manufactured Ti-6Al-4V Parts for Minimum Surface Roughness and Heat-Affected Zone.

Metal parts produced by additive manufacturing often require postprocessing to meet the specifications of the final product, which can make the process chain long and complex. Laser post-processes can be a valuable addition to conventional finishing methods. Laser polishing, specifically, is proving to be a great asset in improving the surface quality of parts in a relatively short time. For process development, experimental analysis can be extensive and expensive regarding the time requirement and laboratory facilities, while computational simulations demand the development of numerical models that, once validated, provide valuable tools for parameter optimization. In this work, experiments and simulations are performed based on the design of experiments to assess the effects of the parametric inputs on the resulting surface roughness and heat-affected zone depths. The data obtained are used to create both linear regression and artificial neural network models for each variable. The models with the best performance are then used in a multiobjective genetic algorithm optimization to establish combinations of parameters. The proposed approach successfully identifies an acceptable range of values for the given input parameters (laser power, focal offset, axial feed rate, number of repetitions, and scanning speed) to produce satisfactory values of Ra and HAZ simultaneously.

Cell-Free Protein Synthesis From Fast-Growing Vibrio natriegens.

Vibrio natriegens constitutes one of the fastest-growing nonpathogenic bacteria and a potential novel workhorse for many biotechnological applications. Here, we report the development of a Vibrio-based cell-free protein synthesis system (CFPS). Specifically, up to 0.4 g L-1 eGFP could be successfully synthesized in small-scale batch reactions using cell-free extract obtained from fast-growing V. natriegens cultures. Versatile CFPS system characterization attained by combining the analyses of key metabolites for translation and ribosomes revealed limitations regarding rRNA stability and critical substrate consumption (e.g., amino acids). Alternatively, rRNA showed increased stability by inducing Mg2+homeostasis in the reaction. Although the enormous translation capacity of the CFPS system based on the available ribosome concentration could not yet be fully exploited, its potential was successfully demonstrated by activating an endogenous transcription unit with V. natriegensRNA polymerase (RNAP) for protein expression. This allowed the use of in vitro screening for promoter strength, a critical factor for efficient gene expression in vitro and in vivo. Three different promoters were tested and output signals corresponded well with the expected affinity for V. natriegens RNAP. This established CFPS toolbox may provide a foundation to establish V. natriegens as a valuable platform in biotechnology as well as synthetic biology.

Replication of Overmolded Orthopedic Implants with a Functionalized Thin Layer of Biodegradable Polymer.

The present paper reports on the development of a biodegradable overmolded orthopedic implant: a metal bone fixing screw, which has been overmolded with a functionalized thin layer of biodegradable polymer to enhance cell adhesion during the healing process. The main challenges were to integrate precise, high-throughput and repeatable solutions to achieve a thin, defect-free structured polymer layer and to ensure a high and consistent implant quality. The work carried out entailed determining proper materials (Purasorb PDLG 5010) for the biodegradable overmolding layer and its economical substitute (NaKu PLA 100HF) to be used during initial tool and process development, designing the surface structure of the overmolded polymer layer, development of injection molding tools, as well as feeding and handling procedures. The injection overmolding process of Purasorb PDLG 5010 polymer was controlled, and the process parameters were optimized. In particular, the dominant process parameters for the overmolding, namely injection pressure, barrel temperature and mold temperature, were experimentally examined using a circumscribed three-factor central composite design and two quality marks; overmolding roughness and mass of polymer. The analysis of the experimental results shows that the mass of the overmolding is not feasible for use as the quality mark. However, the optimal parameters for the overmolding of a metallic implant screw with a thin, micro-structured polymer layer with a predefined roughness of the surface texture have been identified successfully.

[Diagnostic value of left bundle branch block in patients with acute myocardial infarction. A prospective analysis]. / Diagnostische Wertigkeit des Linksschenkelblocks bei Patienten mit akutem Myokardinfarkt. Eine prospektive Analyse.

BACKGROUND: In contemporary practice with early catheterization in most patients with suspected acute myocardial infarction, the clinical utility of new or presumably new left bundle branch block (LBBB) as a diagnostic criterion equivalent to ST-segment elevation is not well established. This study therefore aimed to determine the predictive value of LBBB for the diagnosis of acute transmural myocardial infarction (or ST-segment elevation myocardial infarction, STEMI). PATIENTS AND METHODS: Between November 2006 and December 2011, 1,139 consecutive patients presenting to the heart center of the University of Cologne with suspected STEMI were examined. Of these patients, 935 presented with ST elevation, 72 with LBBB, and 132 had neither of these ECG changes. The diagnosis was confirmed with immediate coronary angiography. RESULTS: Compared with ST-segment elevation, LBBB was associated with a higher prevalence of cardiovascular risk factors and end-organ damage, and more patients with LBBB presented with pulmonary edema or cardiogenic shock (Killip III/IV). STEMI was confirmed in 58.3 % of patients with LBBB and in 86.4 % with ST-segment elevation. The sensitivity (0.38 [0.29-0.46]; odds ratio: 1.24) and specificity (0.67 [0.58-0.77]) of LBBB for the prediction of STEMI were low. However, the additional assessment of troponin T (> 0.1 µg/l) increased the predictive value of LBBB significantly. After adjusting for age and gender, no difference in mortality was found between the groups. CONCLUSION: LBBB with acute chest pain characterizes a cohort of patients with high morbidity and mortality. For the triage of these patients at first contact, additional criteria should be evaluated, which could increase the specificity of LBBB for the diagnosis of STEMI.

Long-term medication adherence in patients with ST-elevation myocardial infarction and primary percutaneous coronary intervention.

AIMS: Besides early percutaneous coronary intervention (PCI) long-term medical treatment is crucial for outcomes after ST-elevation myocardial infarction (STEMI). The present study aimed to identify predictors of adherence to evidence-based medication in this high risk population. METHODS AND RESULTS: A total of 1025 consecutive patients with adjudicated STEMI treated by primary PCI in a single centre as part of the Cologne Infarction Model (KIM) were prospectively analysed. Gender-specific multivariate predictors of long-term medication adherence were identified. Follow-up with available information on drug use was completed for 610 of 738 (82.7%) patients confirmed to be alive after a median period of 36 months. Adherence was persistently high for evidence-based medication with 90.8% for acetylsalicylic acid (ASA), 88.2% for statins, 87.5% for beta-blockers and 79.2% for ACE-inhibitors or angiotensin-receptor blockers (ARBs). Patients with a history of heart failure had a higher medication adherence to beta-blockers, ACE-inhibitors/ARBs and diuretics, whereas long-term prescription rates for calcium channel blockers (CCBs) were lower in patients with reduced versus preserved ejection fraction. Patients with a history of hypertension presented higher medication adherence to CCBs, ACE-inhibitors/ARBs and diuretics but not to beta-blockers. On multivariate analysis, age, body mass index (BMI), hypertension, chronic kidney disease and lack of PCI were independently associated with prescription of diuretics at follow-up. In women, adherence was lower to beta-blockers and higher to CCBs compared to men. CONCLUSION: In the high risk population of STEMI patients long-term adherence to evidence-based medication is high. The lower adherence to beta-blockers and higher prescription rate for CCBs in women needs particular attention.