Freestanding and Scalable Force-Softness Bimodal Sensor Arrays for Haptic Body-Feature Identification.

Tactile technologies that can identify human body features are valuable in clinical diagnosis and human-machine interactions. Previously, cutting-edge tactile platforms have been able to identify structured non-living objects; however, identification of human body features remains challenging mainly because of the irregular contour and heterogeneous spatial distribution of softness. Here, freestanding and scalable tactile platforms of force-softness bimodal sensor arrays are developed, enabling tactile gloves to identify body features using machine-learning methods. The bimodal sensors are engineered by adding a protrusion on a piezoresistive pressure sensor, endowing the resistance signals with combined information of pressure and the softness of samples. The simple design enables 112 bimodal sensors to be integrated into a thin, conformal, and stretchable tactile glove, allowing the tactile information to be digitalized while hand skills are performed on the human body. The tactile glove shows high accuracy (98%) in identifying four body features of a real person, and four organ models (healthy and pathological) inside an abdominal simulator, demonstrating identification of body features of the bimodal tactile platforms and showing their potential use in future healthcare and robotics.

Neurophobia in medical students and junior doctors--blame the GIK.

INTRODUCTION: We aimed to create a definition of neurophobia, and determine its prevalence and educational risk factors amongst medical students and junior doctors in Singapore. MATERIALS AND METHODS: We surveyed medical students and junior doctors in a general hospital using electronic and paper questionnaires. We asked about knowledge, interest, perceived difficulty in neurology, and confidence in managing neurology patients compared to 7 other internal medicine specialties; quality and quantity of undergraduate and postgraduate neuroscience teaching, clinical neurology exposure, and postgraduate qualifications. Neurophobia was defined as ≤4 composite score of difficulty and confidence with neurology. RESULTS: One hundred and fifty-eight medical students (63.5%) and 131 junior doctors (73.2%) responded to the questionnaire. Neurophobia prevalence was 47.5% in medical students, highest amongst all medical subspecialties, and 36.6% in junior doctors. Multivariate analysis revealed that for medical students, female gender (OR 3.0, 95% CI, 1.3 to 6.7), low interest (OR 2.5, 95% CI, 1.0 to 6.2), low knowledge (OR 10.1, 95% CI, 4.5 to 22.8), and lack of clinical teaching by a neurologist (OR 2.8, 95% CI, 1.2 to 6.6) independently increased the risk of neurophobia. For doctors, low interest (OR 3.0, 95% CI, 1.3 to 7.0) and low knowledge (OR 2.7, 95% CI, 1.2 to 6.2) independently increased the risk of neurophobia, and female gender was of borderline significance (OR 2.0, 95% CI, 0.9 to 4.6). CONCLUSION: Neurophobia is highly prevalent amongst Singapore medical students and junior doctors. Low interest and knowledge are independent risk factors shared by both groups; female gender may also be a shared risk factor. The mnemonic GIK (Gender, Interest, Knowledge) identifies the risk factors to mitigate when planning teaching strategies to reduce neurophobia.

Recurrent episodic hypoxaemic respiratory failure following a stroke.

A 68-year-old man with no cardiovascular risk factors was admitted with a stroke because of multiple brain infarcts in different vascular territories. He required mechanical ventilation for hypoxia as a result of aspiration pneumonia. Subsequent recovery was hindered by episodic, unexplained hypoxia. Investigations excluded pulmonary embolism, pulmonary hypertension and severe lung diseases. Transthoracic echocardiography (TTE) with saline bubble contrast showed mild, delayed, right-to-left shunting, thought to represent an insignificant, intrapulmonary, non-cardiac shunt. Hypoxic episodes worsened, requiring admission from community rehabilitation hospital to our centre and another period of mechanical ventilation. Elevated alveolar-arterial gradients indicated a non-hypoventilatory cause. Repeat TTE bubble contrast study and transoesophageal echocardiography (TOE) demonstrated a patent foramen ovale (PFO) with large shunt potential, associated with an aneurysmal interatrial septum. This provided a unifying explanation for cryptogenic stroke and recurrent hypoxaemia. After percutaneous PFO closure hypoxic episodes ceased and he returned successfully to rehabilitation.

The challenge of providing holistic care in a viral epidemic: opportunities for palliative care.

OBJECTIVE: To determine, using the perspective of a hospital-based palliative care service (PCS), the spiritual and psychosocial impact of a novel and potentially fatal viral epidemic on patients, their families and health care workers. DESIGN: Qualitative study using semi-structured interviews. The data were analysed using the constant comparative method and were validated using respondent validation. PARTICIPANTS: Eight palliative care workers. SETTING: Tan Tock Seng Hospital (TTSH), the hospital designated to manage all cases of Severe Acute Respiratory Syndrome (SARS) in Singapore. RESULTS: Disease containment resulted in isolation, where isolation meant the disruption of connectedness. This disruption of connectedness took place at multiple levels: in the patient himself, between the patient and the family, within the family, between the patient and the health care worker, between the patient and society, and between health care workers. As the nature of the disease was uncertain, prognostication was inaccurate. This created difficulties in helping patients and their families prepare for death. The fear of facing the unknown led to safety-seeking behaviours, which could be overcome by repeated exposure to the feared situation. The process of bereavement was disturbed, as traditional death rituals could not be performed by the family. Informants perceived themselves to be suffering as they suffered the same anxieties, fears and grief as the patient. CONCLUSIONS: Dealing with a novel viral epidemic creates spiritual and psychosocial issues similar to those encountered in a palliative care practice. Palliative care workers would do well to be aware of such issues and act proactively when such epidemics arise.