Automatic system for high-throughput and high-sensitivity diagnosis of SARS-CoV-2.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had severe consequences for health and the global economy. To control the transmission, there is an urgent demand for early diagnosis and treatment in the general population. In the present study, an automatic system for SARS-CoV-2 diagnosis is designed and built to deliver high specification, high sensitivity, and high throughput with minimal workforce involvement. The system, set up with cross-priming amplification (CPA) rather than conventional reverse transcription-polymerase chain reaction (RT-PCR), was evaluated using more than 1000 real-world samples for direct comparison. This fully automated robotic system performed SARS-CoV-2 nucleic acid-based diagnosis with 192 samples in under 180 min at 100 copies per reaction in a "specimen in data out" manner. This throughput translates to a daily screening capacity of 800-1000 in an assembly-line manner with limited workforce involvement. The sensitivity of this device could be further improved using a CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-based assay, which opens the door to mixed samples, potentially include SARS-CoV-2 variants screening in extensively scaled testing for fighting COVID-19.

A self-powered analog sensor-data-logging device based on Fowler-Nordheim dynamical systems.

Continuous, battery-free operation of sensor nodes requires ultra-low-power sensing and data-logging techniques. Here we report that by directly coupling a sensor/transducer signal into globally asymptotically stable monotonic dynamical systems based on Fowler-Nordheim quantum tunneling, one can achieve self-powered sensing at an energy budget that is currently unachievable using conventional energy harvesting methods. The proposed device uses a differential architecture to compensate for environmental variations and the device can retain sensed information for durations ranging from hours to days. With a theoretical operating energy budget less than 10 attojoules, we demonstrate that when integrated with a miniature piezoelectric transducer the proposed sensor-data-logger can measure cumulative "action" due to ambient mechanical acceleration without any additional external power.

A numerical efficient splitting method for the solution of two dimensional susceptible infected recovered epidemic model of whooping cough dynamics: Applications in bio-medical engineering.

Background and Objective The positivity property of the non-linear dynamical systems is one of the essential features in different fields of bio-medical engineering, science and many more. The state variables, involving in the models, describing the natural phenomenon such as concentration, density and population size etc. must be positive. Therefore, the computing techniques used to solve the system of non-linear differential equations must be consisted with the continuous nature of the models. But, unfortunately there are some existing techniques in the literature that do not preserve the positivity property, especially for the multi-space dimensional models. So there is a gap in the literature that should be filled up, by constructing the positivity preserving numerical algorithms. In this study, we consider a susceptible-infected-recovered (SIR) reaction diffusion epidemic model in two space dimensions from biomedical engineering and solved numerically to observe the behavior of the model. Since the state variables involved in this system are population densities therefore we design a novel computational method which is time efficient because of its splitting structure and holds the positivity as well as other important structure of epidemic system. Methods Three different computational techniques are designed to examine the numerical solution of SIR model of infectious disease. Two approaches are well-known existing computing methods named as forward Euler finite difference (FD) method and backward Euler operator splitting finite difference (OS-FD) method. The third approach is operator splitting nonstandard finite difference (OS-NSFD) method which is devised by using the NSFD rules. Results The proposed OS-NSFD technique retains efficiently the stability of equilibria as well as the positivity. Graphical behavior depicts that the existing computing methods can not get success to preserve the structure of the epidemic system of whooping cough dynamics. At the same time OS-NSFD computing method is proven to be reliable and suitable for the system of bio-medical engineering mathematically and graphically. Conclusion A reliable and novel computing technique is developed for the solution of two dimensional reaction diffusion problem. This technique preserves all the imperative characteristics of the model under study. Also the time efficiency of this method makes it easy to find the solution of physical system in two space dimension. The comparison with other techniques shows the efficacy and reliability of the designed technique.

Case Study: Developing an In-House Magnetic Resonance Imaging Maintenance Program.

In 2015, the Children's Hospital of Eastern Ontario (CHEO) developed an in-house magnetic resonance imaging service team. Within two years, the team achieved substantial savings in operational costs, generated new revenue, improved uptime and response time, and improved customer satisfaction within the hospital. Through careful planning and collaboration, the Clinical Engineering Department at CHEO was able to bring imaging services in house successfully, demonstrating improvements over historical original equipment manufacturer performance thresholds.

Women Break an Engineering Barrier: While Other Engineering Disciplines Stumble, BME Represents a Success Story in Attracting American Women to a Male-Dominated Field.

While the field of engineering as a whole is largely male-dominated, biomedical engineering (BME) is one area poised to overturn this trend. Women in the United States were awarded only 20% of all engineering B.S. degrees in 2015; in BME, however, 40.9% of the degree recipients were women. This stands in stark contrast to the more traditional fields of mechanical and electrical engineering, where women were awarded just 13.2% and 12.5% of B.S. degrees, respectively. This trend toward more female participation in BME continues at both the M.S. and Ph.D. degree levels. In fact, in 2015, BME had the highest percentage of female engineering M.S. degree recipients in the United States of all engineering disciplines, according to the American Society for Engineering Education (Figure 1).

Incorporation of stochastic engineering models as prior information in Bayesian medical device trials.

Evaluation of medical devices via clinical trial is often a necessary step in the process of bringing a new product to market. In recent years, device manufacturers are increasingly using stochastic engineering models during the product development process. These models have the capability to simulate virtual patient outcomes. This article presents a novel method based on the power prior for augmenting a clinical trial using virtual patient data. To properly inform clinical evaluation, the virtual patient model must simulate the clinical outcome of interest, incorporating patient variability, as well as the uncertainty in the engineering model and in its input parameters. The number of virtual patients is controlled by a discount function which uses the similarity between modeled and observed data. This method is illustrated by a case study of cardiac lead fracture. Different discount functions are used to cover a wide range of scenarios in which the type I error rates and power vary for the same number of enrolled patients. Incorporation of engineering models as prior knowledge in a Bayesian clinical trial design can provide benefits of decreased sample size and trial length while still controlling type I error rate and power.

Determinants in the number of staff in hospitals' maintenance departments: a multivariate regression analysis approach.

To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions-Healthcare Technology Management database. Two hundred and one healthcare organisations were included in our study. Our study revealed that on average, there are almost 14 biomedical technicians (BMETs) per clinical engineer and one FTE per 1083.72 devices (SD 545.69). The results of this study also revealed that the total number of devices and the total technology management hours devoted to these devices positively affects the number of FTEs in a CED, whereas the hospital complexity, measured by healthcare organisation patient discharges matters inversely. The most important factor that matters in the number of FTEs in CEDs was the total technology management hours devoted to devices. A value of explained variance (i.e. R2) of 85% was obtained, indicating the strong power of the prediction accuracy of our multivariate regression model.

Web of Science, Scopus, and Google Scholar citation rates: a case study of medical physics and biomedical engineering: what gets cited and what doesn't?

There are often differences in a publication's citation count, depending on the database accessed. Here, aspects of citation counts for medical physics and biomedical engineering papers are studied using papers published in the journal Australasian physical and engineering sciences in medicine. Comparison is made between the Web of Science, Scopus, and Google Scholar. Papers are categorised into subject matter, and citation trends are examined. It is shown that review papers as a group tend to receive more citations on average; however the highest cited individual papers are more likely to be research papers.

Pressure mapping with textile sensors for compression therapy monitoring.

Compression therapy is the cornerstone of treatment in the case of venous leg ulcers. The therapy outcome is strictly dependent on the pressure distribution produced by bandages along the lower limb length. To date, pressure monitoring has been carried out using sensors that present considerable drawbacks, such as single point instead of distributed sensing, no shape conformability, bulkiness and constraints on patient's movements. In this work, matrix textile sensing technologies were explored in terms of their ability to measure the sub-bandage pressure with a suitable temporal and spatial resolution. A multilayered textile matrix based on a piezoresistive sensing principle was developed, calibrated and tested with human subjects, with the aim of assessing real-time distributed pressure sensing at the skin/bandage interface. Experimental tests were carried out on three healthy volunteers, using two different bandage types, from among those most commonly used. Such tests allowed the trends of pressure distribution to be evaluated over time, both at rest and during daily life activities. Results revealed that the proposed device enables the dynamic assessment of compression mapping, with a suitable spatial and temporal resolution (20 mm and 10 Hz, respectively). In addition, the sensor is flexible and conformable, thus well accepted by the patient. Overall, this study demonstrates the adequacy of the proposed piezoresistive textile sensor for the real-time monitoring of bandage-based therapeutic treatments.

Lessons learned from the implementation of remote control for the interoperability standard ISO/IEEE11073-20601 in a standard weighing scale.

The Point of Care (PoC) version of the interoperability standard ISO/IEEE11073 (X73) provided a mechanism to control remotely agents through documents X73-10201 and X73-20301. The newer version of X73 oriented to Personal Health Devices (PHD) has no mechanisms to do such a thing. The authors are working toward a common proposal with the PHD Working Group (PHD-WG) in order to adapt the remote control capabilities from X73PoC to X73PHD. However, this theoretical adaptation has to be implemented and tested to evaluate whether or not its inclusion entails an acceptable overhead and extra cost. Such proof-of-concept assessment is the main objective of this paper. For the sake of simplicity, a weighing scale with a configurable operation was chosen as use case. First, in a previous stage of the research - the model was defined. Second, the implementation methodology - both in terms of hardware and software - was defined and executed. Third, an evaluation methodology to test the remote control features was defined. Then, a thorough comparison between a weighing scale with and without remote control was performed. The results obtained indicate that, when implementing remote control in a weighing scale, the relative weight of such feature represents an overhead of as much as 53%, whereas the number of Implementation Conformance Statements (ICSs) to be satisfied by the manufacturer represent as much as 34% regarding the implementation without remote control. The new feature facilitates remote control of PHDs but, at the same time, increases overhead and costs, and, therefore, manufacturers need to weigh this trade-off. As a conclusion, this proof-of-concept helps in fostering the evolution of the remote control proposal to extend X73PHD and promotes its inclusion as part of the standard, as well as it illustrates the methodological steps for its extrapolation to other specializations.

Reducing Accidental Dislodgement of the Percutaneous Endoscopic Gastrostomy: A Prospective Trial of the "SafetyBreak" Device.

BACKGROUND: The percutaneous endoscopic gastrostomy (PEG) is a ubiquitous feeding tube with high rates of accidental dislodgement, with significant morbidity and health care costs. We hypothesized use of a decoupling device is a safe and effective mechanism to reduce dislodgements. STUDY DESIGN: We studied a prospective cohort of 100 patients from an academic center. Enrollment included patients requiring PEG tube placement with follow up extending through an individual's lifetime use of their PEG tube. The primary endpoint was accidental dislodgement of the principally placed PEG tube. The secondary endpoint was time to accidental dislodgement of the PEG tube. RESULTS: All 100 patients received the SafetyBreak device and had complete follow-up. Half of the patients had at least a single episode of device decoupling, indicating prevention of dislodgement of the PEG. Eight patients ultimately had dislodgement, resulting in a significantly lower dislodgement rate when compared with a historical cohort (P = .036) and significantly longer survival of the PEG (log rank = 0.005). When compared with a concurrent cohort (without the device) there was also significantly lower dislodgement rate (P = .03) and a trend toward longer survival of the PEG (log rank = 0.08). CONCLUSIONS: When compared with both a historical and concurrent cohort of patients, the SafetyBreak device reduces accidental dislodgement of PEG tubes. As an increasing number of PEGs are being placed, an increasing number of patients are at risk for dislodgement. The SafetyBreak device is an innovative, economical solution to the problem of accidental dislodgement of the PEG tube.

Critical assessment and outlook for the 50 biomedical engineering undergraduate programs in Mexico.

Biomedical Engineering (BME) has been taught in Mexico at the undergraduate level for over forty years. The rationale for the introduction of this profession was to help manage and maintain the growing technological infrastructure in the health care system during the seventies. Owing to this, it is not surprising that early versions of the BME curricula were oriented towards clinical engineering and medical instrumentation. In the last decade the number of programs has grown from three in the seventies and eighties to fifty at present. This work is the result of the analysis of the BME programs in all the institutions that offer this degree in Mexico. Three main issues were studied: the curricula, the sub-disciplines that were emphasized in the programs and the job market. Results have shown a striking resemblance in most of the programs, which are mostly dedicated to teaching aspects of medical instrumentation and clinical engineering. These results reflect an agreement with the requirements of the job market, but since most job offerings are for low-paying positions in sales, service and hospital maintenance, we question the wisdom of stressing these sub-specialties at research universities, where faculties and research labs offer a wide variety of options. An analysis of work at these centers shows that most of the results are publications, so the need to emphasize translational research and partnerships with industry are suggested.

Influencing the job market by the quality of graduates--a biomedical engineering example.

Academic teaching of a new discipline, besides its contents and formal issues, requires participation of the university in development of a target job market. This was the case of biomedical engineering in Poland ten years ago. This paper presents examples of activities, taken up by our university in cooperation with prospective employers, and evaluated with a help of our first alumni. The evaluation survey shows that despite the immature job market, the number of graduates employed accordingly to their education systematically raises each year from 72,5% in 2011 to 93,8% in 2013. Another interesting result is the distribution of job searching period: 19.2% of graduates were already employed before the graduation, further 23.1% found their job in less than one month after the diploma examination and another 28.8% in less than three months. The paper also highlights the role the former graduates play in motivating teachers and students to efforts towards a better educational outcome.

Analysis of medical equipment management in relation to the mandatory medical equipment safety manager (MESM) in Japan.

Half a decade has passed since the fifth revision of the medical law and mandatory appointment of a medical equipment safety manager (MESM) in hospitals in Japan. During this period, circumstances have changed regarding maintenance of medical equipment (ME). We conducted a survey to examine these changes and the current situation in ME management. Maintenance of ME and related work were found to have increased in many hospitals, but the number of clinical engineering technologists (CETs) has only slightly increased. The appointed MESM was a CET or physician in most hospitals. In hospitals where physicians were appointed as the MESM, 81% had operation managers. Many respondents commented that it was difficult for one person to cover all the tasks required by the MESM, due to a lack of knowledge, too much work, or other reasons. This suggests the importance of an operation manager for ME to work under the MESM.

A 2012 survey of the Australasian clinical medical physics and biomedical engineering workforce.

A survey of the medical physics and biomedical engineering workforce in Australia and New Zealand was carried out in 2012 following on from similar surveys in 2009 and 2006. 761 positions (equivalent to 736 equivalent full time (EFT) positions) were captured by the survey. Of these, 428 EFT were in radiation oncology physics, 63 EFT were in radiology physics, 49 EFT were in nuclear medicine physics, 150 EFT were in biomedical engineering and 46 EFT were attributed to other activities. The survey reviewed the experience profile, the salary levels and the number of vacant positions in the workforce for the different disciplines in each Australian state and in New Zealand. Analysis of the data shows the changes to the workforce over the preceding 6 years and identifies shortfalls in the workforce.