Tecnologia gerencial para mediar a consulta de enfermagem a pessoas vivendo com doença de chagas / Management technology to mediate nursing consultation for people living with chagas disease

Objetivo: Construir e validar uma tecnologia gerencial, baseada no referencial teórico de Dorothea Orem, para mediar à consulta de enfermagem ao paciente com doença de chagas no Ambulatório de Cardiopatia Chagásica de uma instituição de ensino no município de Belém/Pa. Método: Pesquisa metodológica do tipo exploratória com abordagem quantitativa, realizada no período de maio a novembro de 2019, constituída em duas fases: elaboração do instrumento; submissão, avaliação e validação do instrumento por juízes especialistas. Resultados: Com exceção de um único item do instrumento, todo este foi validado com concordância de 95,12%. Conclusão: O instrumento validado contribuirá para a implementação da assistência a população. Os princípios da teoria do autocuidado são aplicáveis e pertinentes para planejar e avaliar a assistência aos pacientes que, neste estudo, especificamente, são os que vivem com doença de chagas, assim, este estudo proporciona aos enfermeiros um instrumento baseado em evidências científicas e validado por profissionais qualificados.(AU)

Objective: To construct and validate a management technology, based on Dorothea Orem's theoretical framework, to mediate the nursing consultation with patients with chagas disease at the Chagas Heart Disease Outpatient Clinic of an educational institution in the city of Belém/Pa. Method: Exploratory methodological research with quantitative approach, carried out from May to November 2019, consisting of two phases: elaboration of the instrument; submission, evaluation and validation of the instrument by expert judges. Results: With the exception of a single item of the instrument, the whole of this was validated with agreement of 95.12%. Conclusion: The validated instrument will contribute to the implementation of assistance to the population. The principles of the theory of self-care are applicable and pertinent to plan and evaluate care for patients who, in this study, specifically, are those living with Chagas disease, thus, this study provides nurses with an instrument based on scientific evidence and validated by qualified professionals.(AU)

Objetivo: Construir y validar una tecnología de manejo, basada en el marco teórico de Dorothea Orem, para mediar la consulta de enfermería con pacientes con enfermedad de Chagas en el Ambulatorio de Cardiopatías de Chagas de una institución educativa de la ciudad de Belém/Pa. Método: Investigación metodológica exploratoria con enfoque cuantitativo, realizada de mayo a noviembre de 2019, constituida en dos fases: elaboración del instrumento; presentación, evaluación y validación del instrumento por jueces expertos. Resultados: Con la excepción de un solo ítem del instrumento, el conjunto de este fue validado con concordancia de 95,12%. Conclusión: El instrumento validado contribuirá a la implementación de la asistencia a la población. Los principios de la teoría del autocuidado son aplicables y pertinentes para planificar y evaluar la atención de los pacientes que, en este estudio, específicamente, son los que viven con la enfermedad de Chagas, por lo que este estudio brinda al enfermero un instrumento basado en evidencia científica y validada. por profesionales calificados.(AU)

Review of current intracranial aneurysm flow diversion technology and clinical use.

Endovascular treatment of intracranial aneurysms (IAs) has evolved considerably over the past decades. The technological advances have been driven by the experience that coils fail to completely exclude all IAs from the blood circulation, the need to treat the diseased parent vessel segment leading to the aneurysm formation, and expansion of endovascular therapy to treat more complex IAs. Stents were initially developed to support the placement of coils inside wide neck aneurysms. However, early work on stent-like tubular braided structure led to a more sophisticated construct that then later was coined as a flow diverter (FD) and found its way into clinical application. Although FDs were initially used to treat wide-neck large and giant internal carotid artery aneurysms only amenable to surgical trap with or without a bypass or endovascular vessel sacrifice, its use in other types of IAs and cerebrovascular pathology promptly followed. Lately, we have witnessed an explosion in the application of FDs and subsequently their modifications leading to their ubiquitous use in endovascular therapy. In this review we aim to compile the available FD technology, evaluate the devices' peculiarities from the authors' perspective, and analyze the current literature to support initial and expanded indications, recognizing that this may be outdated soon.

Early experience treating intracranial aneurysms using Accero: a novel, fully visible, low profile braided stent with platinum-nitinol composite wire technology.

BACKGROUND: Accero is an innovative, fully visible, self-expanding braided stent with platinum-nitinol composite wire technology, produced by Acandis. OBJECTIVE: To assess the technical success and safety of this new stent by evaluating the intraprocedural behavior and complication rate, and the short-term follow-up results. METHODS: Forty-one consecutive patients suitable for stent-assisted coiling were selected for the use of Accero in an 11-month period. Clinical, procedural, and angiographic data, as well as 30-day morbidity, were recorded. The angiographic results, clinical follow-up at 30 days, and early imaging follow-up at 3 or 6 months were analyzed, when available. RESULTS: Forty-one aneurysms were treated with stent-assisted coiling. All cases were elective, of which 19 were previously untreated aneurysms and 22 were recurrent aneurysms. Aneurysm location was anterior communicating artery complex (16), basilar (12 cases), middle cerebral artery bifurcation (9 cases), and internal cerebral artery (4 cases). The stent was successfully deployed and aneurysm occlusion with coils achieved in 100% of our patients. One case of on table in-stent thrombosis occurred, which resolved after administration of glycoprotein IIB/IIIA inhibitor, with no clinical consequence, and one case of postoperative hematoma at the arteriotomy site, which was managed conservatively. On early follow-up, available for 37 patients, the complete occlusion rate was 76%, with only two recurrences needing further treatment. Satisfactory aneurysm occlusion was therefore achieved in 95% of cases. CONCLUSION: Stent-assisted coiling with the Accero braided stent proved safe and effective.

Aplicativos móveis sobre o HIV/aids: uma prospecção tecnológica / Mobile applications on hiv/aids: a technological prospection / Aplicaciones móviles sobre VIH/sida: una prospección tecnológica

Objetivo: identificar aplicativos, disponíveis para a cultura brasileira, que promovam conhecimentos ou informações acercas do HIV/Aids. Método: prospecção tecnológica realizada através de pesquisa documental com abordagem qualitativa. Foi realizada a busca por aplicativos através de acesso as lojas virtuais Apple Store e Google Play em janeiro de 2019. Na estratégia de busca utilizou-se os termos: HIV e aids. A organização dos dados foi realizada a partir de uma listagem com os aplicativos e suas características. Resultados: foram identificados 19 aplicativos na loja virtual Apple Store e 13 na Google Play. Em ambas as lojas virtuais foram identificados aplicativos voltados a população usuária dos sistemas de saúde, profissionais da saúde e população em geral, que promovem o acesso as informações relacionadas ao tema HIV/Aids. Conclusão: os aplicativos apresentam potencial para contribuir no controle no HIV/aids no país através da abordagem a prevenção combinada

Objective: to identify applications, available for brazilian culture, that promote knowledge or information about HIV/AIDS. Method:technological prospecting study carried out through documentary research with a qualitative approach. The search for applications was carried out through access to the Apple Store and Google Play virtual stores in January 2019. The search strategy used the terms: HIV and AIDS. The organization of the data was carried out from a list with the applications and their characteristics. Results: 19 applications were identified in the Apple Store and 13 in Google Play. In both virtual stores, applications were identified aimed at the population using health systems, health professionals and the general population, which promote access to information related to the HIV / AIDS theme. Conclusion: the applications have the potential to contribute to the control of HIV / AIDS in the country through the combined prevention approach

Objetivo: identificar aplicaciones, disponibles para la cultura brasileña, que promuevan el conocimiento o la información sobre el VIH / SIDA. Método:estudio de prospección tecnológica realizado mediante investigación documental con enfoque cualitativo. La búsqueda de aplicaciones se realizó a través del acceso a las tiendas virtuales Apple Store y Google Play en enero de 2019. La estrategia de búsqueda utilizó los términos: VIH y SIDA. La organización de los datos se realizó a partir de una lista con las aplicaciones y sus características. Resultados: se identificaron 19 aplicaciones en Apple Store y 13 en Google Play. En ambas tiendas virtuales, se identificaron aplicaciones dirigidas a la población utilizando sistemas de salud, profesionales de la salud y la población en general, que promueven el acceso a la información relacionada con el tema del VIH / SIDA. Conclusão: las aplicaciones tienen el potencial de contribuir al control del VIH / SIDA en el país a través del enfoque de prevención combinada

Effect of novel technology-enabled multidimensional physical activity feedback in primary care patients at risk of chronic disease - the MIPACT study: a randomised controlled trial.

BACKGROUND: Technological progress has enabled the provision of personalised feedback across multiple dimensions of physical activity that are important for health. Whether this multidimensional approach supports physical activity behaviour change has not yet been examined. Our objective was to examine the effectiveness of a novel digital system and app that provided multidimensional physical activity feedback combined with health trainer support in primary care patients identified as at risk of chronic disease. METHODS: MIPACT was a parallel-group, randomised controlled trial that recruited patients at medium (≥10 and < 20%) or high (≥20%) risk of cardiovascular disease and/or type II diabetes from six primary care practices in the United Kingdom. Intervention group participants (n = 120) received personal multidimensional physical activity feedback using a customised digital system and web-app for 3 months plus five health trainer-led sessions. All participants received standardised information regarding physical activity. Control group participants (n = 84) received no further intervention. The primary outcome was device-based assessment of physical activity at 12 months. RESULTS: Mean intervention effects were: moderate-vigorous physical activity: -1.1 (95% CI, - 17.9 to 15.7) min/day; moderate-vigorous physical activity in ≥10-min bouts: 0.2 (- 14.2 to 14.6) min/day; Physical Activity Level (PAL): 0.00 (- 0.036 to 0.054); vigorous physical activity: 1.8 (- 0.8 to 4.2) min/day; and sedentary time: 10 (- 19.3 to 39.3) min/day. For all of these outcomes, the results showed that the groups were practically equivalent and statistically ruled out meaningful positive or negative effects (>minimum clinically important difference, MCID). However, there was profound physical activity multidimensionality, and only a small proportion (5%) of patients had consistently low physical activity across all dimensions. CONCLUSION: In patients at risk of cardiovascular disease and/or type II diabetes, MIPACT did not increase mean physical activity. Using a sophisticated multidimensional digital approach revealed enormous heterogeneity in baseline physical activity in primary care patients, and practitioners may need to screen for low physical activity across dimensions rather than rely on disease-risk algorithms that are heavily influenced by age. TRIAL REGISTRATION: This trial is registered with the ISRCTN registry ( ISRCTN18008011 ; registration date 31 July 2013).

Heating/Solvent Responsive Shape-Memory Polymers for Implant Biomedical Devices in Minimally Invasive Surgery: Current Status and Challenge.

This review is about the fundamentals and practical issues in applying both heating and solvent responsive shape memory polymers (SMPs) for implant biomedical devices via minimally invasive surgery. After revealing the general requirements in the design of biomedical devices based on SMPs and the fundamentals for the shape-memory effect in SMPs, the underlying mechanisms, characterization methods, and several representative biomedical applications, including vascular stents, tissue scaffolds, occlusion devices, drug delivery systems, and the current R&D status of them, are discussed. The new opportunities arising from emerging technologies, such as 3D printing, and new materials, such as vitrimer, are also highlighted. Finally, the major challenge that limits the practical clinical applications of SMPs at present is addressed.

Triboelectric nanogenerators based on graphene oxide coated nanocomposite fibers for biomedical applications.

A high demand for green and eco-friendly triboelectric nanogenerators (TENGs) has multiplied the importance of their degradability for biomedical applications. However, the charge generation of current eco-friendly TENGs is generally limited. In this research, a flexible TENG based on a silk fibroin (SF) fibrous layer and a polycaprolactone (PCL)/graphene oxide (GO) fibrous layer was developed. Moreover, the PCL/GO layer was surface modified using various concentrations of GO (0, 1.5, 3, 6, and 9 wt%). We demonstrated that surface modification using GO nanosheets significantly improved the output of the TENG. Notably, the optimized GO modified layer resulted in a voltage of 100 V, a current of 3.15 mA [Formula: see text], and a power density of 72 mW[Formula: see text]. Moreover, a thin PCL layer applied as an encapsulation layer did not significantly modulate the performance of the TENG. Furthermore, during 28 d of soaking in a phosphate buffer solution, the proposed TENG was able to successfully generate electricity. The TENG was also proposed to be used for the electrical stimulation of PC12 cells. The results confirmed that this self-powered electrical stimulator could promote the attachment and proliferation of PC12 cells. Therefore, we have shown the potential for an eco-friendly and cost-effective TENG based on GO modified PCl/GO and silk fibrous layers to be used as a power source for biomedical applications.

Exploring non-assembly 3D printing for novel compliant surgical devices.

In minimally invasive surgery, maneuverability is usually limited and a large number of degrees of freedom (DOF) is highly demanded. However, increasing the DOF usually means increasing the complexity of the surgical instrument leading to long fabrication and assembly times. In this work, we propose the first fully 3D printed handheld, multi-steerable device. The proposed device is mechanically actuated, and possesses five serially controlled segments. We designed a new compliant segment providing high torsion and axial stiffness as well as a low bending stiffness by merging the functions of four helicoids and a continuum backbone. Compliant segments were combined to form the compliant shaft of the new device. In order to control this compliant shaft, a control handle was designed that mimics the shaft structure. A prototype called the HelicoFlex was built using only three 3D printed parts. HelicoFlex, with its 10 degrees of freedom, showed a fluid motion in performing single and multi-curved paths. The multi-steerable instrument was 3D printed without any support material in the compliant shaft itself. This work contributes to enlarge the body of knowledge regarding how additive manufacturing could be used in the production of multi-steerable surgical instruments for personalized medicine.

Ferramentas tecnológicas de interação em tablets no atendimento fonoaudiológico de crianças com transtorno dos sons da fala / Interactional technology tools in tablets phonological intervention in children with speech disorders / Herramientas tecnológicas de interacción en tabletas en la atención fonoaudiológica de niños con transtorno del habla

INTRODUÇÃO: Cada vez mais, proliferam-se ferramentas tecnológicas de comunicação. Nesse contexto, o tema desta pesquisa é a utilização dessas tecnologias nas intervenções fonoaudiológicas com crianças com transtorno dos sons da fala. OBJETIVO: Descrever a utilização de ferramentas tecnológicas de interação em tablets no atendimento fonoaudiológico de crianças com transtorno dos sons da fala. MÉTODO: Pesquisa descritiva com quatro crianças de ambos os sexos, na faixa etária de 5,3 a 5,11 anos. Foram realizadas avaliação e reavaliação individual dos sujeitos selecionados por meio das provas de fonologia do teste de linguagem infantil - ABFW. Os indivíduos foram atendidos semanalmente, com duração de 30 minutos. O tablet foi utilizado como dispositivo auxiliar. Foram coletados depoimentos livres (da professora e da coordenadora) sobre a evolução dos casos. Os dados foram analisados quantitativa e qualitativamente a partir de categorias definidas a posteriori. RESULTADOS: O tablet foi usado em 92,68% das sessões, e em média por 64,55% do tempo total das sessões. Prevaleceram os jogos interativos terapeuta/paciente (43,57%), seguidos por aplicativos de jogos individuais (33,12%) e uso da câmera em (23,29%). Analisando o conjunto dos casos estudados, verificou-se a seguinte tendência: o tablet funcionou como recurso motivador para o processo terapêutico, embora em diferentes graus e de maneira não decisiva para evolução dos casos. CONCLUSÃO: Nos sujeitos aqui estudados a utilização de ferramentas tecnológicas de interação favoreceu os processos terapêuticos, na medida em que intensificou a atividade dialógica entre paciente e terapeuta e configurou-se como recurso lúdico efetivo para a adesão dos pacientes ao tratamento.

INTRODUCTION: More and more, the use of technological communication tools is increasing. In this context, the theme of this research is the use of these technologies in speech therapy interventions in children with speech disorders (SD). OBJECTIVE: To describe the use of interactional technology tools with tablets in speech therapy of children with speech disorders. METHOD: Descriptive study with four children of both genders, aged 5.3 to 5.11 years old with SD. Individual assessment and reassessment were carried out through the ABFW test. Selected participants went to speech therapy weekly, for 30 minutes, in an adequate space. The tablet was used as an auxiliary tool. Statements were obtained from the teacher and the coordinator about the evolution of the cases. Data were analyzed quantitatively and qualitatively from categories defined later. RESULTS: The tablet was used in 92.68% of the sessions, and during 64.55% of the total time. Therapist / patient interaction games (43.57%) were the most used, followed by individual games (33.12%) and games with camera (23.29%). It was observed that the tablet worked as a motivating tool for the therapeutic process, although in different degrees and it was not overriding to the progress of the subjects. CONCLUSION: With the study the use of interactional technology tools improved the therapeutic process, as it intensified the dialogic activity between patient and therapist and was configured as an effective playful resource for patient adherence to the treatment.

INTRODUCCIÓN: Cada vez más, se proliferan herramientas tecnológicas de comunicación. El tema de esta investigación es la utilización de esas tecnologías en las intervenciones fonoaudiológicas con niños trastorno del habla. OBJETIVO: Describir la utilización de herramientas tecnológicas de interacción en tabletas en la atención fonoaudiológica de niños con trastorno del habla. MÉTODO: investigación descriptiva con cuatro niños de ambos sexos, en el grupo de edad de 5,3 a 5,11 años. Se realizó una evaluación y reavaloración individual de los sujetos por medio de la prueba de fonología del examen de lenguaje infantil - ABFW. Atendimiento semanal, durante 30 minutos. La tableta, se utilizó como dispositivo auxiliar. Fueron recolectados testimonios libres sobre la evolución de los casos. Los datos fueron analizados cuantitativa y cualitativamente a partir de categorías definidas a posteriori. RESULTADOS: La tableta fue utilizada en el 92,68% de las sesiones, y en promedio por el 64,55% del tiempo total. Se prevalecían los juegos de interacción terapeuta / paciente (43,57%), seguidos por aplicaciones de juegos individuales (33,12%) y cámara en (23,29%). Al analizar el conjunto de los casos estudiados, se verificó la siguiente tendencia: la tableta funcionó como recurso motivador para el proceso terapéutico, aunque en diferentes grados y de manera no decisiva para la evolución de los casos. CONCLUSIÓN: En los sujetos aquí estudiados la utilización de herramientas tecnológicas de interacción favoreció los procesos terapéuticos, en la medida en que intensificó la actividad dialógica entre paciente y terapeuta y se configuró como recurso lúdico efectivo para la adhesión de los pacientes al tratamiento.

Metal-Organic Frameworks for Biomedical Applications.

Metal-organic frameworks (MOFs) are an interesting and useful class of coordination polymers, constructed from metal ion/cluster nodes and functional organic ligands through coordination bonds, and have attracted extensive research interest during the past decades. Due to the unique features of diverse compositions, facile synthesis, easy surface functionalization, high surface areas, adjustable porosity, and tunable biocompatibility, MOFs have been widely used in hydrogen/methane storage, catalysis, biological imaging and sensing, drug delivery, desalination, gas separation, magnetic and electronic devices, nonlinear optics, water vapor capture, etc. Notably, with the rapid development of synthetic methods and surface functionalization strategies, smart MOF-based nanocomposites with advanced bio-related properties have been designed and fabricated to meet the growing demands of MOF materials for biomedical applications. This work outlines the synthesis and functionalization and the recent advances of MOFs in biomedical fields, including cargo (drugs, nucleic acids, proteins, and dyes) delivery for cancer therapy, bioimaging, antimicrobial, biosensing, and biocatalysis. The prospects and challenges in the field of MOF-based biomedical materials are also discussed.

Two-Photon Autofluorescence Imaging of Fixed Tissues: Feasibility and Potential Values for Biomedical Applications.

The value of optical redox imaging (ORI) of cells/tissues based on the intrinsic fluorescences of NADH (nicotinamide adenine dinucleotide) and oxidized flavoproteins (containing flavin adenine dinucleotide, i.e., FAD) has been demonstrated for potential biomedical applications including diagnosis, prognosis, and determining treatment response. However, the Chance redox scanner (a 3D cryogenic tissue imager) is limited by spatial resolution (~50 µm), and tissue ORI using fluorescence microscopy (single or multi-photon) is limited by the light penetration depth. Furthermore, viable or snap-frozen tissues are usually required. In this project, we aimed to study whether ORI may be achieved for unstained fixed tissue using a state-of-the-art modern Serial Two-Photon (STP) Tomography scanner that can rapidly acquire multi-plane images at micron resolution. Tissue specimens of mouse muscle, liver, and tumor xenografts were harvested and fixed in 4% paraformaldehyde (PFA) for 24 h. Tissue blocks were scanned by STP Tomography under room temperature to acquire the autofluorescence signals (NADH channel: excitation 750 nm, blue emission filter; FAD channel: excitation 860 nm, green emission filter). We observed remarkable signals with significant intra-tissue heterogeneity in images of NADH, FAD and redox ratio (FAD/(NADH+FAD)), which are worthy of further investigation for extracting biological information.

Very Preterm Infants with Technological Dependence at Home: Impact on Resource Use and Family.

OBJECTIVE: To examine the impact of medical complexity among very preterm infants on health care resource use, family, and neurodevelopmental outcomes at 18 months' corrected age. METHODS: This observational cohort study of Canadian infants born < 29 weeks' gestational age in 2009-2011 compared infants with and those without medical complexity defined as discharged home with assistive medical technology. Health care resource use and family outcomes were collected. Children were assessed for cerebral palsy, deafness, blindness, and developmental delay at 18 months. Logistic regression analysis was performed for group comparisons. RESULTS: Overall, 466/2,337 infants (20%) needed assistive medical technology at home including oxygen (79%), gavage feeding (21%), gastrostomy or ileostomy (20%), CPAP (5%), and tracheostomy (3%). Children with medical complexity were more likely to be re-hospitalized (OR 3.6, 95% CI 3.0-4.5) and to require ≥2 outpatient services (OR 4.4, 95% CI 3.5-5.6). Employment of both parents at 18 months was also less frequent in those with medical complexity compared to those without medical complexity (52 vs. 60%, p < 0.01). Thirty percent of children with medical complexity had significant neurodevelopmental impairment compared to 13% of those without medical complexity (p < 0.01). Lower gestational age, lower birth weight, bronchopulmonary dysplasia, sepsis, and surgical necrotizing enterocolitis were associated with a risk of medical complexity. CONCLUSION: Medical complexity is common following very preterm birth and has a significant impact on health care use as well as family employment and is more often associated with neurodevelopmental disabilities. Efforts should be deployed to facilitate care coordination upon hospital discharge and to support families of preterm children with medical complexity.

Wearable Potentiometric Sensors for Medical Applications.

Wearable potentiometric sensors have received considerable attention owing to their great potential in a wide range of physiological and clinical applications, particularly involving ion detection in sweat. Despite the significant progress in the manner that potentiometric sensors are integrated in wearable devices, in terms of materials and fabrication approaches, there is yet plenty of room for improvement in the strategy adopted for the sample collection. Essentially, this involves a fluidic sampling cell for continuous sweat analysis during sport performance or sweat accumulation via iontophoresis induction for one-spot measurements in medical settings. Even though the majority of the reported papers from the last five years describe on-body tests of wearable potentiometric sensors while the individual is practicing a physical activity, the medical utilization of these devices has been demonstrated on very few occasions and only in the context of cystic fibrosis diagnosis. In this sense, it may be important to explore the implementation of wearable potentiometric sensors into the analysis of other biofluids, such as saliva, tears and urine, as herein discussed. While the fabrication and uses of wearable potentiometric sensors vary widely, there are many common issues related to the analytical characterization of such devices that must be consciously addressed, especially in terms of sensor calibration and the validation of on-body measurements. After the assessment of key wearable potentiometric sensors reported over the last five years, with particular attention paid to those for medical applications, the present review offers tentative guidance regarding the characterization of analytical performance as well as analytical and clinical validations, thereby aiming at generating debate in the scientific community to allow for the establishment of well-conceived protocols.

Envisioning robotic surgery: Surgeons' needs and views on interacting with future technologies and interfaces.

BACKGROUND: The development of technology in robotic surgery is typically presented from a technical perspective. This study considers the user perspective as an input to the development of technology by exploring potential solutions within and beyond the field of robotic surgery. METHODS: Advanced technological solution concepts were selected based on a technology review and an ethnographic study. Using a future workshop method, these were rated and discussed by a group of surgeons from three perspectives: enhancing operation outcome, user experience and learning in the operating theatre. RESULTS: Diverse technologies were considered to offer potential for supporting the surgeons' work. User experience and learning could be improved especially via solutions novel to robotic surgery. Robotic surgery technologies currently under development were mainly considered to support a good operation outcome. Suitability for practical work was elaborated upon, and related concerns were identified. CONCLUSIONS: The results can support development of robotic surgery to enhance surgeons' work.

ZHAW Waedenswil: A new Approach in the Fight against Cancer.

A happy coincidence brought Dr Markus Rimann from ZHAW Waedenswil together with Dr Andreas Meyer from the start-up FGen and PD Dr Emanuela Felley-Bosco, Molecular Oncologist at Zurich University Hospital, to develop a technology platform for the manufacture and high throughput analysis of single mesothelioma spheroids. Armin Picenoni, former student in Chemistry for the Life Sciences at ZHAW, confirmed everything in writing his Master Thesis on this Innosuisse project.

New technologies improve adenoma detection rate, adenoma miss rate, and polyp detection rate: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The need to increase the adenoma detection rate (ADR) for colorectal cancer screening has ushered in devices that mechanically or optically improve conventional colonoscopy. Recently, new technology devices (NTDs) have become available. We aimed to compare the ADR, polyp detection rate (PDR), and adenoma miss rate (AMR) between NTDs and conventional colonoscopy and between mechanical and optical NTDs. METHODS: MEDLINE and Embase databases were searched from inception through September 2017 for articles or abstracts reporting ADR, PDR, and AMR with NTDs. Randomized controlled trials and case-control studies with >10 subjects were included. Primary outcomes included ADR, PDR, and AMR odds ratio (OR) between conventional colonoscopy and NTDs. Secondary outcomes included cecal intubation rates, adverse events, cecal intubation time, and total colonoscopy time. RESULTS: From 141 citations, 45 studies with 20,887 subjects were eligible for ≥1 analyses. Overall, the ORs for ADR (1.35; 95% confidence interval [CI] 1.24-1.47; P < .01) and PDR (1.51; 95% CI, 1.37-1.67; P < .01) were higher with NTDs. Higher ADR (OR, 1.52 vs 1.25; P = .035) and PDR (OR, 1.63 vs 1.10; P ≤ .01) were observed with mechanical NTDs. The overall AMR with NTDs was lower compared with conventional colonoscopy (OR, .19; 95% CI, .14-.26; P < .01). Mechanical NTDs had lower AMRs compared with optical NTDs (OR, .10 vs .33; P < .01). No differences in cecal intubation rates, cecal intubation time, or total colonoscopy time were found. CONCLUSIONS: Newer endoscopic technologies are an effective option to improve ADR and PDR and decrease AMR, particularly with mechanical NTDs. No differences in operability and safety were found.

Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care.

Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.

Promise of Mobile Health Technology to Reduce Disparities in Patients With Cancer and Survivors.

Despite recent advances in cancer control, numerous disparities exist in the areas of patient access to care, self-management, and quality of life. However, mobile health technology shows promise as a tool to reduce disparities among patients with cancer and cancer survivors by overcoming such barriers as limited access to providers, difficulty communicating with providers, and inadequate communication between patients and providers regarding symptoms. This narrative review draws on the literature in cancer and noncancer populations to identify factors that create or maintain disparities and to describe opportunities for mobile health technology to reduce disparities.

Digital Health for Geriatric Oncology.

In this review, we describe state-of-the-art digital health solutions for geriatric oncology and explore the potential application of emerging remote health-monitoring technologies in the context of cancer care. We also discuss the benefits and motivations behind adopting technology for symptom monitoring of older adults with cancer. We provide an overview of common symptoms and of the digital solutions-designed remote symptom assessment. We describe state-of-the-art systems for this purpose and highlight the limitations and challenges for the full-scale adoption of such solutions in geriatric oncology. With rapid advances in Internet-of-things technologies, many remote assessment systems have been developed in recent years. Despite showing potential in several health care domains and reliable functionality, few of these solutions have been designed for or tested in older patients with cancer. As a result, the geriatric oncology community lacks a consensus understanding of a possible correlation between remote digital assessments and health-related outcomes. Although the recent development of digital health solutions has been shown to be reliable and effective in many health-related applications, there exists an unmet need for development of systems and clinical trials specifically designed for remote cancer management of older adults with cancer, including developing advanced remote technologies for cancer-related symptom assessment and psychological behavior monitoring at home and developing outcome-oriented study protocols for accurate evaluation of existing or emerging systems. We conclude that perhaps the clearest path to future large-scale use of remote digital health technologies in cancer research is designing and conducting collaborative studies involving computer scientists, oncologists, and patient advocates.

Fabrication of Fine Electrodes on the Tip of Hypodermic Needle Using Photoresist Spray Coating and Flexible Photomask for Biomedical Applications.

We have introduced a fabrication method for electrical impedance spectroscopy (EIS)-on-a-needle (EoN: EIS-on-a-needle) to locate target tissues in the body by measuring and analyzing differences in the electrical impedance between dissimilar biotissues. This paper describes the fabrication method of fine interdigitated electrodes (IDEs) at the tip of a hypodermic needle using a photoresist spray coating and flexible film photomask in the photolithography process. A polyethylene terephthalate (PET) heat shrink tube (HST) with a wall thickness of 25 µm is employed as the insulation and passivation layer. The PET HST shows a higher mechanical durability compared with poly(p-xylylene) polymers, which have been widely used as a dielectric coating material. Furthermore, the HST shows good chemical resistance to most acids and bases, which is advantageous for limiting chemical damage to the EoN. The use of the EoN is especially preferred for the characterization of chemicals/biomaterials or fabrication using acidic/basic chemicals. The fabricated gap and width of the IDEs are as small as 20 µm, and the overall width and length of the IDEs are 400 µm and 860 µm, respectively. The fabrication margin from the tip (distance between the tip of hypodermic needle and starting point of the IDEs) of the hypodermic needle is as small as 680 µm, which indicates that unnecessarily excessive invasion into biotissues can be avoided during the electrical impedance measurement. The EoN has a high potential for clinical use, such as for thyroid biopsies and anesthesia drug delivery in a spinal space. Further, even in surgery that involves the partial resection of tumors, the EoN can be employed to preserve as much normal tissue as possible by detecting the surgical margin (normal tissue that is removed with the surgical excision of a tumor) between the normal and lesion tissues.