Development of a low-cost robotized 3D-prototype for automated optical microscopy diagnosis: An open-source system.

In a clinical context, conventional optical microscopy is commonly used for the visualization of biological samples for diagnosis. However, the availability of molecular techniques and rapid diagnostic tests are reducing the use of conventional microscopy, and consequently the number of experienced professionals starts to decrease. Moreover, the continuous visualization during long periods of time through an optical microscope could affect the final diagnosis results due to induced human errors and fatigue. Therefore, microscopy automation is a challenge to be achieved and address this problem. The aim of the study is to develop a low-cost automated system for the visualization of microbiological/parasitological samples by using a conventional optical microscope, and specially designed for its implementation in resource-poor settings laboratories. A 3D-prototype to automate the majority of conventional optical microscopes was designed. Pieces were built with 3D-printing technology and polylactic acid biodegradable material with Tinkercad/Ultimaker Cura 5.1 slicing softwares. The system's components were divided into three subgroups: microscope stage pieces, storage/autofocus-pieces, and smartphone pieces. The prototype is based on servo motors, controlled by Arduino open-source electronic platform, to emulate the X-Y and auto-focus (Z) movements of the microscope. An average time of 27.00 ± 2.58 seconds is required to auto-focus a single FoV. Auto-focus evaluation demonstrates a mean average maximum Laplacian value of 11.83 with tested images. The whole automation process is controlled by a smartphone device, which is responsible for acquiring images for further diagnosis via convolutional neural networks. The prototype is specially designed for resource-poor settings, where microscopy diagnosis is still a routine process. The coalescence between convolutional neural network predictive models and the automation of the movements of a conventional optical microscope confer the system a wide range of image-based diagnosis applications. The accessibility of the system could help improve diagnostics and provide new tools to laboratories worldwide.

Advances and challenges in automated malaria diagnosis using digital microscopy imaging with artificial intelligence tools: A review.

Malaria is an infectious disease caused by parasites of the genus Plasmodium spp. It is transmitted to humans by the bite of an infected female Anopheles mosquito. It is the most common disease in resource-poor settings, with 241 million malaria cases reported in 2020 according to the World Health Organization. Optical microscopy examination of blood smears is the gold standard technique for malaria diagnosis; however, it is a time-consuming method and a well-trained microscopist is needed to perform the microbiological diagnosis. New techniques based on digital imaging analysis by deep learning and artificial intelligence methods are a challenging alternative tool for the diagnosis of infectious diseases. In particular, systems based on Convolutional Neural Networks for image detection of the malaria parasites emulate the microscopy visualization of an expert. Microscope automation provides a fast and low-cost diagnosis, requiring less supervision. Smartphones are a suitable option for microscopic diagnosis, allowing image capture and software identification of parasites. In addition, image analysis techniques could be a fast and optimal solution for the diagnosis of malaria, tuberculosis, or Neglected Tropical Diseases in endemic areas with low resources. The implementation of automated diagnosis by using smartphone applications and new digital imaging technologies in low-income areas is a challenge to achieve. Moreover, automating the movement of the microscope slide and image autofocusing of the samples by hardware implementation would systemize the procedure. These new diagnostic tools would join the global effort to fight against pandemic malaria and other infectious and poverty-related diseases.

[Comparison of dressings and devices to secure peripheral venous catheters in the emergency department: suitability according to patient profile]. / Idoneidad de los apósitos de fijación de la vía venosa periférica según el perfil del paciente en urgencias.

OBJECTIVES: To identify the most suitably designed dressings and devices to secure peripheral venous catheters (PVCs) in different types of patients. To evaluate the traction force the dressings could withstand and times they are able to keep the PVC in place in the emergency department. MATERIAL AND METHODS: Quasi-experimental descriptive observational study with inferential statistics to compare variables. We studied the designs of devices and dressings for securing PVCs in the emergency department (Omnifix, Tegaderm, Oper Dres, Steri-strip, and stopcocks) and special adaptations devised by the authors: A (Tegaderm), A1 (Tegaderm + Steristrip), A2 (Tegaderm + Oper Dres), B (Omnifix), C (Omnifix doubled). RESULTS: Participants carried out 520 tests on models of human patients to simulate standard, hairy, and hairy-sweaty skin. Costs were as follows: A, € 0.15; A1, € 0.35; A2, € 0.18; B, € 0.005; C, € 0.01. The times in seconds required to apply the dressings were as follows: (A, 15; A1, 25; A2, 20; B, 20; C, 35). The dressings withstood the following traction forces in grams: lengthwise, A, 760; B, 1694; C, 1530); perpendicular (A, 785; B, 1450; C, 3290), and transversal (A, 760; A1, 1220; A2, 1510; B, 1720; C, 2255). CONCLUSION: Design C was able to withstand greater forces in the traction tests. Extra surgical tape significantly improved resistance to traction when a stopcock was used. Using a Steri-strip with the Tegaderm device increased resistance to traction, although the improvement was less than that obtained with the Omnifix. The Tegaderm plus Omnifix design was significantly more resistant to traction than the Tegaderm by itself at only a slightly higher cost; the combination design, therefore, may be more recommendable. However, our results for resistance, cost, and application time showed that the Omnifix (desing B) is the best choice for securing a PVC.

OBJETIVO: Identificar los diseños de apósitos de fijación de catéter venoso periférico (CVP) más idóneos según el perfil del paciente en urgencias, y evaluar resistencias a la tracción y tiempos de colocación de los apósitos de fijación de CVP en urgencias. METODO: Estudio observacional descriptivo cuasiexperimental, con inferencias estadísticas entre las variables a estudio. Son objeto de investigación los diseños de apósitos de fijación de CVP con materiales habituales en urgencias (Omnifix ®, Tegaderm®, Operdres®, Steri-strip®, llave de 3 pasos) y los realizados por el equipo investigador: A (Tegaderm©), A1 (Tegaderm© + Steri-strip©), A2 (Tegaderm© + Operdress©), B (Omnifix©), C (Omnifix© doble). RESULTADOS: Se llevaron a cabo 520 pruebas sobre modelos humanos de pacientes simulados mediante colaboradores: estándar, velludo, velludo-diaforético. El coste en euros fue: (A:0,15; A1:0,35; A2:0,18; B:0,005; C:0,01). El tiempo de colocación en segundos: (A:15; A1:25; A2:20; B:20; C:35). Las resistencias a la tracción en gramos fueron: longitudinal (A:760; B:1.694; C:1.530); perpendicular (A:785; B:1.450; C:3.290) y transversal (A:760; A1:1.220; A2:1.510; B:1.720; C:2.255). CONCLUSIONES: El diseño C mostró la mayor resistencia en las pruebas de tracción. Las pruebas de resistencia con llave de tres pasos mejoraron significativamente al añadir una tira de esparadrapo suplementaria. El uso de Steri-strip® con Tegaderm© aumentó su resistencia, aunque fue menor que la obtenida por el diseño B. El diseño A2 mejoró significativamente la resistencia a la tracción sobre el A con mínimo coste, por lo que podría resultar más recomendable. Tras los resultados de resistencia, coste y tiempo de colocación, el diseño B resultó ser el apósito de fijación de CVP más eficiente en urgencias.