[Automatic Control System of Oxygen Concentration in Medical Hyperbaric Oxygen Chamber Based on ZigBee].

In order to effectively prevent the damage to the human body caused by abnormal oxygen concentration in the medical hyperbaric oxygen chamber, a ZigBee-based medical hyperbaric oxygen chamber oxygen concentration automatic control system is designed. The data acquisition module uses the microprocessor STM32F103C8T6 to receive the oxygen concentration data of each acquisition point, and the ZigBee of the data processing module transmits the processing results to the MSP430G2553 single-chip microcomputer at the receiving end of the slave. The MSP430G2553 single-chip microcomputer uses a self-organizing TS fuzzy neural network (SOTSFNN) and adds activation. The intensity concept realizes automatic control of the oxygen concentration in the hyperbaric oxygen chamber, and controls the buzzer to give an alarm when the oxygen concentration is lower than 19 mg/L and higher than 23 mg/L, and displays the current real-time oxygen concentration through LCD12864. The experimental results show that as the communication distance increases, the packet loss rate of the system is always lower than 5%, and the signal strength under the same communication distance is better; the system can effectively control the oxygen concentration value within the set range, and the oxygen concentration. The control accuracy is high and the stability is good.

Automatic Control System of Oxygen Concentration in Medical Hyperbaric Oxygen Chamber Based on ZigBee / 中国医疗器械杂志

In order to effectively prevent the damage to the human body caused by abnormal oxygen concentration in the medical hyperbaric oxygen chamber, a ZigBee-based medical hyperbaric oxygen chamber oxygen concentration automatic control system is designed. The data acquisition module uses the microprocessor STM32F103C8T6 to receive the oxygen concentration data of each acquisition point, and the ZigBee of the data processing module transmits the processing results to the MSP430G2553 single-chip microcomputer at the receiving end of the slave. The MSP430G2553 single-chip microcomputer uses a self-organizing TS fuzzy neural network (SOTSFNN) and adds activation. The intensity concept realizes automatic control of the oxygen concentration in the hyperbaric oxygen chamber, and controls the buzzer to give an alarm when the oxygen concentration is lower than 19 mg/L and higher than 23 mg/L, and displays the current real-time oxygen concentration through LCD12864. The experimental results show that as the communication distance increases, the packet loss rate of the system is always lower than 5%, and the signal strength under the same communication distance is better; the system can effectively control the oxygen concentration value within the set range, and the oxygen concentration. The control accuracy is high and the stability is good.

Electric acoustic stimulation (EAS) with the Naída CI Q90 sound processor in experienced cochlear implant users.

Objectives: The benefit of using the electroacoustic functionality was tested compared to electric stimulation alone. Two different cut-off frequencies between acoustic and electric stimulation were tried. Methods: Performance and subjective preference in 10 subjects was measured with electric only and electroacoustic stimulation with two settings: a cut-off for acoustic amplification at the frequency where thresholds exceeded 70 dB and 85 dB. An overlapping setting was also tried in five participants. Results: There was a non-significant trend with a median improvement in SRT of 1.3 dB (70 dB cut-off) and 0.8 dB (85 dB cut-off) compared to the electric only condition. From nine subjects who completed the study, one preferred the 85 dB cut-off frequency, with the others preferred either a 70 dB cut-off or an overlapping setting. Discussion: Nine subjects continued to use the EAS processor after study termination because of subjective benefits. The variability in speech outcomes and subjective preference is underlining the importance of being able to manually change acoustic and electric cut-off frequencies. Conclusion: There were non-significant median group benefits from use of the acoustic component for these existing CI users. A hearing loss of 70 dB HL is an appropriate default cut-off frequency in the fitting software.

Feasibility of an iPad to Facilitate Communication in Postoperative Patients With Head and Neck Cancer.

PURPOSE: To measure the feasibility of a communication application and an iPad to facilitate communication in postoperative patients with head and neck cancer. DESIGN: A prospective feasibility study. METHODS: This IRB-approved study was conducted in the postanesthesia care unit at an urban comprehensive cancer center. The participants included patients with head and neck cancer who underwent surgery that resulted in altered communication. Questionnaires were developed and administered to measure feasibility and patient satisfaction at different time points (preoperative, postoperative, and 1 to 4 days postoperatively). FINDINGS: Of 38 patients in the study, 25 (66%) were able to use the customized iPad. Of these 25 patients, 15 (60%) were satisfied or somewhat satisfied with it. 84% found the customized iPad to be very or somewhat helpful for communication after surgery. CONCLUSIONS: Patients were satisfied with the customized iPad, and the study found that using technology such as this was feasible in the immediate postoperative period.

[Design of warm-acupuncture technique training evaluation device].

To design a warm-acupuncture teaching instrument to train and evaluate its manipulation. We refer to the principle and technical operation characteristics of traditional warm-acupuncture, as well as the mechanical design and single-chip microcomputer technology. The device is consisted of device noumenon, universal acupoints simulator, vibration reset system and circuit control system, including frame, platform framework, the swing framework, universal acupoints simulator, vibration reset outfit, operation time circuit, acupuncture sensation display, and vibration control circuit, etc. It can be used to train needle inserting with different angles and moxa rubbing and loading. It displays whether a needle point meets the location required. We determine whether the moxa group on a needle handle is easy to fall off through vibration test, and operation time is showed. The device can objectively help warm-acupuncture training and evaluation so as to promote its clinical standardization manipulation.

Feasibility of Patient Reporting of Symptomatic Adverse Events via the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a Chemoradiotherapy Cooperative Group Multicenter Clinical Trial.

PURPOSE: To assess the feasibility of measuring symptomatic adverse events (AEs) in a multicenter clinical trial using the National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). METHODS AND MATERIALS: Patients enrolled in NRG Oncology's RTOG 1012 (Prophylactic Manuka Honey for Reduction of Chemoradiation Induced Esophagitis-Related Pain during Treatment of Lung Cancer) were asked to self-report 53 PRO-CTCAE items representing 30 symptomatic AEs at 6 time points (baseline; weekly ×4 during treatment; 12 weeks after treatment). Reporting was conducted via wireless tablet computers in clinic waiting areas. Compliance was defined as the proportion of visits when an expected PRO-CTCAE assessment was completed. RESULTS: Among 226 study sites participating in RTOG 1012, 100% completed 35-minute PRO-CTCAE training for clinical research associates (CRAs); 80 sites enrolled patients, of which 34 (43%) required tablet computers to be provided. All 152 patients in RTOG 1012 agreed to self-report using the PRO-CTCAE (median age 66 years; 47% female; 84% white). Median time for CRAs to learn the system was 60 minutes (range, 30-240 minutes), and median time for CRAs to teach a patient to self-report was 10 minutes (range, 2-60 minutes). Compliance was high, particularly during active treatment, when patients self-reported at 86% of expected time points, although compliance was lower after treatment (72%). Common reasons for noncompliance were institutional errors, such as forgetting to provide computers to participants; patients missing clinic visits; Internet connectivity; and patients feeling "too sick." CONCLUSIONS: Most patients enrolled in a multicenter chemoradiotherapy trial were willing and able to self-report symptomatic AEs at visits using tablet computers. Minimal effort was required by local site staff to support this system. The observed causes of missing data may be obviated by allowing patients to self-report electronically between visits, and by using central compliance monitoring. These approaches are being incorporated into ongoing studies.

[Can we do therapy without a therapist? Active components of computer-based CBT for depression]. / Peut-on faire une TCC sans thérapeute ? Composantes actives des TCC informatisées pour la dépression.

OBJECTIVES: Computer-delivered Cognitive Behavioral Therapies (C-CBT) are emerging as therapeutic techniques which contribute to overcome the barriers of health care access in adult populations with depression. The C-CBTs provide CBT techniques in a highly structured format comprising a number of educational lessons, homework, multimedia illustrations and supplementary materials via interactive computer interfaces. Programs are often administrated with a minimal or regular support provided by a clinician or a technician via email, telephone, online forums, or during face-to-face consultations. However, a lot of C-CBT is provided without any therapeutic support. Several reports showed that C-CBTs, both guided or unguided by a therapist, may be reliable and effective for patients with depression, and their use was recommended as part of the first step of the clinical care. The aim of the present qualitative review is to describe the operational format and functioning of five of the most cited unguided C-CBT programs for depression, to analyze their characteristics according to the CBT's principles, and to discuss the results of the randomized clinical trials (RCT) conducted to evaluate its effectiveness, adherence and user's experience. METHODS: We analyzed five C-CBTs: Beating The Blues (BTB), MoodGYM, Sadness, Deprexis and Overcoming Depression on the Internet (ODIN) and 22 randomized controlled studies according to 5 dimensions: General characteristics; Methodology, structure and organization; Specific modules, themes and techniques: Clinical indications, recruitment mode, type of users with depression, type and mode of therapist's support, overall therapeutic effects, adherence and user's experience. RESULTS: The C-CBT have a secured free or pay-to-use access in different languages (English, German, Dutch, and Chinese) but not in French. The programs may be accessed at a medical center or at home via a CD-ROM or via an Internet connection. Some C-CBTs are very close to textual self-helps provided via an E-learning mode (Sadness, MoodGYM, ODIN), others adopt interactive software technologies (Deprexis, BTB), but their interactivity and the possibility of personalization is low. The C-CBTs use similar principles and techniques as in face-to -face CBT (e.g. self-evaluation, psychoeducation, cognitive restructuring, cognitive restructuring of schema, behavioral activation and agenda setting, problem solving techniques, communication and crisis management techniques, relaxation, principles of positive psychology and relapse prevention, positive reinforcement methods, motivational feedbacks, social learning, homework assignments and progress monitoring). The results of the 22 RCSs showed that both the effectiveness and the adherence of the unguided C-CBT is high with self-referred active help-seekers with major depression, but the latter is low with users who are depressed out-patients referred by general practitioners or clinicians. The presence of therapist support improves the effectiveness and the adherence of the C-CBT, especially in clinical out-patients. CONCLUSIONS: In light of the existing insight of the advantages and the inconvenient of the C-CBT, the actual challenge is to find its optimal clinical indication and the modality of its effective use in clinical populations.

Chronic in vivo stability assessment of carbon fiber microelectrode arrays.

OBJECTIVE: Individual carbon fiber microelectrodes can record unit activity in both acute and semi-chronic (∼1 month) implants. Additionally, new methods have been developed to insert a 16 channel array of carbon fiber microelectrodes. Before assessing the in vivo long-term viability of these arrays, accelerated soak tests were carried out to determine the most stable site coating material. Next, a multi-animal, multi-month, chronic implantation study was carried out with carbon fiber microelectrode arrays and silicon electrodes. APPROACH: Carbon fibers were first functionalized with one of two different formulations of PEDOT and subjected to accelerated aging in a heated water bath. After determining the best PEDOT formula to use, carbon fiber arrays were chronically implanted in rat motor cortex. Some rodents were also implanted with a single silicon electrode, while others received both. At the end of the study a subset of animals were perfused and the brain tissue sliced. Tissue sections were stained for astrocytes, microglia, and neurons. The local reactive responses were assessed using qualitative and quantitative methods. MAIN RESULTS: Electrophysiology recordings showed the carbon fibers detecting unit activity for at least 3 months with average amplitudes of ∼200 µV. Histology analysis showed the carbon fiber arrays with a minimal to non-existent glial scarring response with no adverse effects on neuronal density. Silicon electrodes showed large glial scarring that impacted neuronal counts. SIGNIFICANCE: This study has validated the use of carbon fiber microelectrode arrays as a chronic neural recording technology. These electrodes have demonstrated the ability to detect single units with high amplitude over 3 months, and show the potential to record for even longer periods. In addition, the minimal reactive response should hold stable indefinitely, as any response by the immune system may reach a steady state after 12 weeks.

Comparative analysis of head-tilt and forward head position during laptop use between females with postural induced headache and healthy controls.

OBJECTIVES: To compare 1) maximum manually induced head-protraction, head-tilt and forward head position and 2) the evolution of head-tilt and forward head position during a laptop-task between a headache- and control-group. METHODS: Angles for maximum head-protraction, head-tilt and forward head position of 12 female students with postural induced headache and 12 female healthy controls were calculated at baseline and while performing a laptop-task. RESULTS: The headache-group demonstrated an increased passive head-protraction of 22.30% compared to the control-group. The ratio of forward head position during habitual sitting to the maximum head-protraction differed significantly (p = 0.046) between headache-group (1.4 ± 0.4) and the control-group (1.1 ± 0.2). The headache-group showed a biphasic forward head position and head-tilt profile. These profiles differed significantly (p < 0.05) between groups and were negatively correlated (rE = -0.927). CONCLUSION: The headache-group showed a larger passive head-protraction with a habitual forward head-position further located from the end-range. During the laptop-task forward head position and head-tilt behaved biphasically with a more static forward head position and a more dynamic head-tilt.

Assessing Child Nutrient Intakes Using a Tablet-Based 24-Hour Recall Tool in Rural Zambia.

BACKGROUND: Detailed dietary intake data in low-income populations are needed for research and program evaluation. However, collection of such data by paper-based 24-hour recall imposes substantial demands for staff time and expertise, training, materials, and data entry. OBJECTIVE: To describe our development and use of a tablet-based 24-hour recall tool for conducting dietary intake surveys in remote settings. METHODS: We designed a 24-hour recall tool using Open Data Kit software on an Android tablet platform. The tool contains a list of local foods, questions on portion size, cooking method, ingredients, and food source and prompts to guide interviewers. We used this tool to interview caregivers on dietary intakes of children participating in an efficacy trial of provitamin A-biofortified maize conducted in Mkushi, a rural district in central Zambia. Participants were children aged 4 to 8 years not yet enrolled in school (n = 938). Dietary intake data were converted to nutrient intakes using local food composition and recipe tables. RESULTS: We developed a tablet-based 24-hour recall tool and used it to collect dietary data among 928 children. The majority of foods consumed were maize, leafy vegetable, or small fish dishes. Median daily energy intake was 6416 kJ (1469 kcal). CONCLUSIONS: Food and nutrient intakes assessed using the tablet-based tool were consistent with those reported in prior research. The tool was easily used by interviewers without prior nutrition training or computing experience. Challenges remain to improve programming, but the tool is an innovation that enables efficient collection of 24-hour recall data in remote settings.

Design of a pulse-triggered four-channel functional electrical stimulator using complementary current source and time division multiplexing output method.

In this paper, a four-channel pulse-triggered functional electrical stimulator using complementary current source and time division output method is proposed for the research and application of functional electrical stimulation (FES). The high-voltage compliance and output impedance is increased by adopting the complementary current source, which can also realize the linear voltage-to-current conversion and high channel isolation. A high-voltage analog switch chip MAX14803, combined with a FIFO queue algorithm in the microprocessor, is used to setup the H-bridge and multiplexers for the four-channel time division multiplexing output. With this method, the size and cost of the key components are reduced greatly. The stimulating core circuit area is 30 × 50 mm(2). According to the experiments, the stimulator can achieve the four-channel charge-balanced biphasic stimulation with a current range between 0 and 60 mA and a single-phase pulse amplitude up to 60 V.

[Design of low-intermediate frequency electrotherapy and pain assessment system].

Aiming at the single treatment and the design separation between treatment and assessment in electrotherapy equipment, a kind of system including low-intermediate frequency treatment and efficacy evaluation was developed. With C8051F020 single-chip microcomputer as the core and the circuit design and software programming used, the system realized the random switch of therapeutic parameters, the collection, display and data storage of pressure pain threshold in the assessment. Experiment results showed that the stimulus waveform, current intensity, frequency, duty ratio of the system output were adjustable, accurate and reliable. The obtained pressure pain threshold had a higher accuracy (< 0.3 N) and better stability, guiding the parameter choice in the precise electrical stimulation. It, therefore, provides a reliable technical support for the treatment and curative effect assessment.

The application of participatory ergonomics in a healthcare setting in Hong Kong.

BACKGROUND: Work-related musculoskeletal disorders (WRMDs) are recognized as a major source of significant pain and disability in the healthcare sector. However, they are preventable if appropriate surveillance and intervention programs are implemented. OBJECTIVE: The purpose of this paper is to describe the holistic ergonomic approach that was used to address the multifactorial problems encountered by healthcare workers in their daily work. METHODS: Using participatory ergonomics, healthcare workers in this study teamed up with management and staff with expertise in ergonomic analysis, design, and implementation of remedies. Selected participatory ergonomic intervention programs targeted at an organizational level are elaborated. Interventions included pre-work stretching, workplace surveillance at a psychiatric department, on-site ergonomic teaching for community nurses, and display screen equipment consultancy. DISCUSSIONS: Changes in workplace design, equipment re-arrangement, awareness of proper posture, and adoption of good work practices all play important roles in reducing musculoskeletal disorders among healthcare workers. Prompt occupational medicine and rehabilitation services were also provided to complement the work disability prevention process. The impact of the various intervention programs on staff health, costs and productivity of the organization are simultaneously discussed.

Design of low-intermediate frequency electrotherapy and pain assessment system / 生物医学工程学杂志

Aiming at the single treatment and the design separation between treatment and assessment in electrotherapy equipment, a kind of system including low-intermediate frequency treatment and efficacy evaluation was developed. With C8051F020 single-chip microcomputer as the core and the circuit design and software programming used, the system realized the random switch of therapeutic parameters, the collection, display and data storage of pressure pain threshold in the assessment. Experiment results showed that the stimulus waveform, current intensity, frequency, duty ratio of the system output were adjustable, accurate and reliable. The obtained pressure pain threshold had a higher accuracy (< 0.3 N) and better stability, guiding the parameter choice in the precise electrical stimulation. It, therefore, provides a reliable technical support for the treatment and curative effect assessment.

The use of the mobile voice laboratory in the operating room during type I thyroplasty with Gore-Tex(®).

INTRODUCTION AND OBJECTIVE: The purposes of this study are to demonstrate the use of the mobile voice lab in type I thyroplasty with Gore-Tex(®) using analysis of spectrogram and fundamental frequency in the operating room, and also to show how to do this procedure. METHODS: Voice samples were recorded in the operating room immediately before and during type I thyroplasty. Six-week postoperative samples were also taken in the voice laboratory. Fundamental frequency and spectral analysis were analyzed. Spectrograms were evaluated by blind panel of 4 judges on a 100mm visual analogue scale. All three time points were compared and statistical analysis performed. Pre and postoperative V-RQOL scores were also compared. RESULTS: Significant improvement in spectrogram ratings were seen between before and during (P<.001), and before and after voice samples (P<.017). There was no significant difference between during and after scores, suggesting the persistence of the intraoperative improvement in this measure. Changes in fundamental frequency were not statistically significant, although fundamental frequency tended to increase in women and decrease in men after type I thyroplasty. Mean V-RQOL scores improved from 48.08 a 85.08 (P<.001). CONCLUSIONS: The mobile voice laboratory may be useful during type I thyroplasty with Gore-Tex(®). It offers an opportunity for the surgeon and voice pathologist to continue to collaborate in the treatment of patients with unilateral vocal fold paralysis.

A pilot health information management system for public health midwives serving in a remote area of Sri Lanka.

We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.

Low latency breathing frequency detection and monitoring on a personal computer.

We demonstrate a low latency respiratory/breathing frequency detection system that is fast (<5 ms), easy to operate, requires no batteries or external power supply and operates fully via computer-standard USB connection. Exercises in controlling ones breathing frequency, usually referred to as paced-breathing exercises, have shown positive effects in treating pulmonary diseases, cardiovascular diseases and stress/anxiety-related disorders. We developed a breathing frequency detection system which uses two pairs of microphones to detect exhalation activity, eliminate noise from the environment and stream the recording data via USB connection to a personal computer. It showed 97.1% reliability (10 subjects) when monitoring breathing activity in non-guided free breathing and 100% reliability (10 subjects) when monitoring breathing activity during interactive paced-breathing exercises. We also evaluated the breathing frequency detection systems noise elimination functionality which showed a reduction of 84.2 dB for stationary (white noise) and a reduction of 79.3 dB for non-stationary (hands clapping) noise.

SenseCam, imagery and bias in memory for wellbeing.

Identifying and modifying the negative interpretation bias that characterises depression is central to successful treatment. While accumulating evidence indicates that mental imagery is particularly effective in the modification of emotional bias, this research typically incorporates static and unrelated ambiguous stimuli. SenseCam technology, and the resulting video-like footage, offers an opportunity to produce training stimuli that are dynamic and self-relevant. Here participants experienced several ambiguous tasks and subsequently viewed SenseCam footage of the same tasks, paired with negative or positive captions. Participants were trained to use mental imagery to inter-relate SenseCam footage and captions. Participants reported increased levels of happy mood, reduced levels of sad mood, and increased task enjoyment following SenseCam review with positive versus negative captions. This shift in emotional bias was also evident at 24-hour follow-up, as participants recollected greater task enjoyment for those tasks previously paired with positive captions. Mental imagery appears to play an important role in this process. These preliminary results indicate that in healthy volunteers, SenseCam can be used within a bias modification paradigm to shift mood and memory for wellbeing associated with performing everyday activities. Further refinements are necessary before similar methods can be applied to individuals suffering from subclinical and clinical depression.