Towards optimal design of patient isolation units in emergency rooms to prevent airborne virus transmission: From computational fluid dynamics to data-driven modeling.

BACKGROUND: Patient isolation units (PIUs) can be an effective method for effective infection control. Computational fluid dynamics (CFD) is commonly used for PIU design; however, optimizing this design requires extensive computational resources. Our study aims to provide data-driven models to determine the PIU settings, thereby promoting a more rapid design process. METHOD: Using CFD simulations, we evaluated various PIU parameters and room conditions to assess the impact of PIU installation on ventilation and isolation. We investigated particle dispersion from coughing subjects and airflow patterns. Machine-learning models were trained using CFD simulation data to estimate the performance and identify significant parameters. RESULTS: Physical isolation alone was insufficient to prevent the dispersion of smaller particles. However, a properly installed fan filter unit (FFU) generally enhanced the effectiveness of physical isolation. Ventilation and isolation performance under various conditions were predicted with a mean absolute percentage error of within 13%. The position of the FFU was found to be the most important factor affecting the PIU performance. CONCLUSION: Data-driven modeling based on CFD simulations can expedite the PIU design process by offering predictive capabilities and clarifying important performance factors. Reducing the time required to design a PIU is critical when a rapid response is required.

Efficacy of 3D-printed eye model to enhance retinoscopy skills.

We conducted a prospective study to evaluate the efficacy of simulation-based education using a three-dimensional (3D)-printed schematic eye model in improving the retinoscopy refraction skills of medical students. A schematic eye model was printed using a fused deposition modeling-based 3D printer. Twenty medical students randomized into 3D (n = 10) and control (n = 10) groups received a 1-h lecture on the principles and methods of manifest refraction and were shown how to use the retinoscope and sciascope bars. The 3D group additionally attended a tutorial on the schematic eye. Both groups performed refractive examinations on four eyes of volunteer patients, and the results were recorded as a baseline. Instructor feedback and refraction practice was provided with the 3D group or with control group. To account for subject fatigue, patients spent no more than 8 min on the examination. After a 1-h break to allow for fatigue and familiarity, refraction tests were repeated on four randomly selected eyes of patients. Students' refraction readings were compared with the autorefractor values using a spherical equivalent value and blur strength. All participants measured the time required to complete the refraction test and reported their subjective confidence in the results of each refraction test. Refractive errors before and after training did not differ between the control and 3D groups, with a significant improvement in errors observed in both groups (p = 0.005 and 0.008, respectively). The time to complete refraction before and after training did not differ between the two groups, both of which showed a significant reduction in time (p = 0.005 and 0.028, respectively). Pre- and post-training confidence scores for the accuracy of each refraction on a 10-point Likert scale were not significantly different. However, when comparing score changes between pre- and post-training, only the control group showed a significant increase in confidence (p = 0.005). Tests for the non-inferiority of refractive errors after training indicated that the 3D group was non-inferior to the control group. In conclusion, training in retinoscopy refraction skills using a 3D-printed eye model resulted in significant improvement in accuracy and speed compared to practice with real patients. Except for better confidence in the control group, schematic eye model training was not inferior to practice with real patients.

Automated deep learning model for estimating intraoperative blood loss using gauze images.

The intraoperative estimated blood loss (EBL), an essential parameter for perioperative management, has been evaluated by manually weighing blood in gauze and suction bottles, a process both time-consuming and labor-intensive. As the novel EBL prediction platform, we developed an automated deep learning EBL prediction model, utilizing the patch-wise crumpled state (P-W CS) of gauze images with texture analysis. The proposed algorithm was developed using animal data obtained from a porcine experiment and validated on human intraoperative data prospectively collected from 102 laparoscopic gastric cancer surgeries. The EBL prediction model involves gauze area detection and subsequent EBL regression based on the detected areas, with each stage optimized through comparative model performance evaluations. The selected gauze detection model demonstrated a sensitivity of 96.5% and a specificity of 98.0%. Based on this detection model, the performance of EBL regression stage models was compared. Comparative evaluations revealed that our P-W CS-based model outperforms others, including one reliant on convolutional neural networks and another analyzing the gauze's overall crumpled state. The P-W CS-based model achieved a mean absolute error (MAE) of 0.25 g and a mean absolute percentage error (MAPE) of 7.26% in EBL regression. Additionally, per-patient assessment yielded an MAE of 0.58 g, indicating errors < 1 g/patient. In conclusion, our algorithm provides an objective standard and streamlined approach for EBL estimation during surgery without the need for perioperative approximation and additional tasks by humans. The robust performance of the model across varied surgical conditions emphasizes its clinical potential for real-world application.

Low dead space encapsulation and integration of circuits for retinal prosthesis based on cyclic olefin copolymer.

A retinal prosthesis is a device that can provide artificial vision to people who have lost their sight from certain retinal disorder. Because the device needs to be inserted into the body, high flexibility and reliability is required. Recently, devices using thermoplastic polymers such as LCP and COC as substrates have been studied. Being a highly functional integrated device, retinal prosthesis poses many design challenges. Among them, the stimulation chip embedding can be a particularly important task. Although it is common to use a wire bonding method for chip embedding, there are several limitations that are difficult to apply to implantable device. In this investigation, a novel approach is developed for high spaceefficient electrical connections and perform reliable encapsulation of integrated circuits to replace wire bonding. Since designing and manufacturing the stimulator chip used in retinal prosthesis requires non-negligible cost, a silicon die with the identical shape was selected as a substitute for testing purposes.

Quantum interference of multidimensional quantum states via space-division multiplexing of a long-coherent single photon from a warm 87Rb atomic ensemble.

The high-dimensional encoding of single photons can offer various possibilities for enhancing quantum information processing. This work experimentally demonstrates the quantum interference of an engineered multidimensional quantum state through the space-division multiplexing of a heralded single-photon state with a spatial light modulator (SLM) and spatial-mode mixing of a single photon through a long multimode fiber (MMF). In our experiment, the heralded single photon generated from a warm 87Rb atomic ensemble was bright, robust, and long-coherent. The multidimensional spatial quantum state of the long-coherent single photon was transported through a 4-m-long MMF and arbitrarily controlled using the SLM. We observed the quantum interference of a single-photon multidimensional spatial quantum state with a visibility of >95%. These results may have potential applications in quantum information processing, for example, in photonic variational quantum eigensolve with high-dimensional single photons and realizing high information capacity per photon for quantum communication.

Selective Edge Rounding of Cyclic Olefin Copolymer Film Using UV Laser for Implantable Electrode Package.

Cyclic Olefin Copolymer is emerging as a packaging material for implantable electrodes due to its physical properties such as low water absorption rate and low water vapor permeability. The electrode-tissue interface is often regarded as a major focus of implantable electrodes, but its packaging should also be considered thoroughly since it directly contacts the adjoining body cells. Therefore, eliminating any sharp boundaries or edges around the package would be beneficial to minimize potential inflammatory responses caused by physical/mechanical stresses. To smooth both inner/outer edges of a cyclic olefin copolymer packaging, an optimal UV laser condition was investigated by varying its marking speed and iterations. Clinical relevance - This establishes a method that can selectively smooth the edges around a cyclic olefin copolymer pack-aged implantable electrodes for reduced mechanical mismatch after insertion.

Low-cost, thermoplastic micro-lens array with a carbon black light screen for bio-mimetic vision.

Micro-lens array is a great example of bio-mimetic technology which was inspired by compound eyes found in insects and is used in lasers, optical communication, and 3D imaging. In this study, a micro-lens array was fabricated from cyclic olefin copolymer using a cost-effective method: compression molding and thermal reflow. Also, a light screen was installed between lenses to reduce the optical interference for clearer individual images. Cyclic olefin copolymer-based micro-lens array showed good optical results under a standard optical microscope. By placing the fabricated micro-lens array directly on an image sensor, it was observed that the light screen shows significant improvement in image quality. Also, the point spread function was analyzed to confirm the optical performance and the effectiveness of the micro-lens array with the light screen installed.

Fabrication of a light screen-aperture integrated flexible thin film micro-lens array for a biomimetic superposition compound eye.

Micro-lens array, an artificial compound eye vision system, provides a wide field of view and multi-perspective view. However, it has not been adopted as a computer vision application due to its limited visible range and high optical interference. In this research, a novel fabrication method for the flexible polydimethylsiloxane micro-lens array with a polytetrafluoroethylene light screen-aperture integrated layer was established by the simple protrusion method. The integrated layer provided longer visible range by one meter while maintaining the wide field-of-view of 100 °. The resulting images were used for obtaining depth information of a target as an example and for analyzing the rectangular and hexagonal arrangements of the micro-lenses for the future applications. With the improved visual range, wide field-of-view and flexibility, the fabricated micro-lens array can be applied to the small and curved CMOS image sensors in the future.

Current Stimulation of the Midbrain Nucleus in Pigeons for Avian Flight Control.

A number of research attempts to understand and modulate sensory and motor skills that are beyond the capability of humans have been underway. They have mainly been expounded in rodent models, where numerous reports of controlling movement to reach target locations by brain stimulation have been achieved. However, in the case of birds, although basic research on movement control has been conducted, the brain nuclei that are triggering these movements have yet to be established. In order to fully control flight navigation in birds, the basic central nervous system involved in flight behavior should be understood comprehensively, and functional maps of the birds' brains to study the possibility of flight control need to be clarified. Here, we established a stable stereotactic surgery to implant multi-wire electrode arrays and electrically stimulated several nuclei of the pigeon's brain. A multi-channel electrode array and a wireless stimulation system were implanted in thirteen pigeons. The pigeons' flight trajectories on electrical stimulation of the cerebral nuclei were monitored and analyzed by a 3D motion tracking program to evaluate the behavioral change, and the exact stimulation site in the brain was confirmed by the postmortem histological examination. Among them, five pigeons were able to induce right and left body turns by stimulating the nuclei of the tractus occipito-mesencephalicus (OM), nucleus taeniae (TN), or nucleus rotundus (RT); the nuclei of tractus septo-mesencephalicus (TSM) or archistriatum ventrale (AV) were stimulated to induce flight aviation for flapping and take-off with five pigeons.

Investigation of stereotactic surgery for avian brain stimulation by a fully implanted wireless system.

OBJECTIVE: The authors' goal was to study avian motor brain mapping via wireless stimulation to induce certain behaviors. In this paper, the authors propose an electrode design that is suitable for avian brain stimulation as well as a stereotactic implant procedure for the proposed electrode. METHODS: An appropriate breed for avian brain study was chosen. A fully implantable remote-controlled electrical stimulation system was inserted to minimize discomfort. A suitable electrode design and stereotactic surgery method based on the electrode design were investigated. RESULTS: Using a wireless stimulation system, flapping and rotation behaviors were induced by stimulating the ventral part of the nucleus intercollicularis and formatio reticularis medialis mesencephali both on the ground and during flight. CONCLUSIONS: The authors were able to implant the entire brain stimulation system inside the avian body without any surgical complications. Postoperative observations suggested that the bird did not find the implant uncomfortable.

Fabrication and Evaluation of Cyclic Olefin Copolymer Based Implantable Neural Electrode.

OBJECTIVE: The purpose of this paper is to establish fabrication method of cyclic olefin copolymer(COC)-based neural electrode. METHODS: The fabrication started with preparing COC pellets into COC films by compression molding. Metal layers were deposited on the COC film and attached to a silicon wafer. Laser ablation was used to cut the outer edges and mark alignment keys. The metal layers were patterned using standard photolithography procedures. Finally, the isolated electrodes were laminated. To ensure that the resulting electrode is safe and suitable for long-term implants, in vitro biocompatibility test, impedance evaluation, accelerated soak test, and repeated bend test were conducted. RESULTS: Cytotoxicity test and elution test confirmed the biocompatibility in vitro. The basic performance was not hindered compared to other polymer-based electrodes, and the longevity of the electrode was validated by accelerated soak test. However, repeated bend test revealed that the material might not be suitable for applications where constant bending is required. CONCLUSION: The COC-based neural electrode was successfully fabricated. The material showed several merits such as biocompatibility, thermoplasticity, low water absorption rate, and high transparency, but should be limited to applications where repeated bending is not required. SIGNIFICANCE: Electrical circuits in implantable prosthetic devices must be hermetically encapsulated for a long period of time. Material such as COC with extremely low water absorption rate could have a significant impact on the longevity of these devices.

A handheld neural stimulation controller for avian navigation guided by remote control.

BACKGROUND: Animal learning based on brain stimulation is an application in a brain-computer interface. Especially for birds, such a stimulation system should be sufficiently light without interfering with movements of wings. OBJECTIVE: We proposed a fully-implantable system for wirelessly navigating a pigeon. In this paper, we report a handheld neural stimulation controller for this avian navigation guided by remote control. METHODS: The handheld controller employs ZigBee to control pigeon's behaviors through brain stimulation. ZigBee can manipulate brain stimulation remotely while powered by batteries. Additionally, simple switches enable users to customize parameters of stimuli like a gamepad. These handheld and user-friendly interfaces make it easy to use the controller while a pigeon flies in open areas. RESULTS: An electrode was inserted into a nucleus (formatio reticularis medialis mesencephalic) of a pigeon and connected to a stimulator fully-implanted in the pigeon's back. Receiving signals sent from the controller, the stimulator supplied biphasic pulses with a duration of 0.080 ms and an amplitude of 0.400 mA to the nucleus. When the nucleus was stimulated, a 180-degree turning-left behavior of the pigeon was consistently observed. CONCLUSIONS: The feasibility of remote avian navigation using the controller was successfully verified.

Investigation of using Cyclic Olefin Copolymer as Neural Electrode.

Cyclic olefin copolymer (COC) is a polymer that has recently been attracting attention in optics and microfluidic applications due to its high solvent resistance, biocompatibility, thermoplasticity, and optical transparency. It also has very low water absorption rate, which makes COC a very good candidate for packaging material for implantable neural prosthetic devices. In this study, we investigated the possibilities of fabricating COC into a neural electrode. We started by heat-compressing COC pellets to form films. After oxygen plasma surface treatment, a thin layer of gold was deposited. Then, a standard photolithography technique was used to pattern the gold. Finally, the paths were insulated using an extra film of COC. The validity of the fabricated electrode was confirmed by metal contact test and soak testing in PBS solution for a week.

A Fully Implantable Wireless Stimulation System for Pigeon Navigation.

Navigation of freely moving animals has been studied for potential application to emergency situations and hazardous environments. A fully implantable stimulation system for remote animal navigation was proposed and applied to living pigeons. The animal navigation system, consisting of an external controller and a neural stimulator, was designed based on the anatomy of the pigeons. Depth electrodes were fabricated based on the anatomy of target pigeon brain regions. The fabricated neural stimulators received data wirelessly from the external controller and generated biphasic current pulses with preset parameters of amplitude, duration, and rate. The average impedance of the fabricated electrodes was 12.0∠-13.05° kΩ at 1 kHz. The neural stimulator was implanted on the dorsal side, and the depth electrodes were inserted into the formatio reticularis medialis mesencephali (FRM). When successive current pulses with an amplitude of 400 µA, a rate of 58 Hz, and a duration of 80 µs were applied to the target regions at 0.85 s intervals, turning/circling behaviors were induced for 6.2 s. The feasibility of the proposed wireless stimulation system was demonstrated in vivo.

Locomotion Control of Pigeons using Polymer-based Deep Brain Electrodes.

This paper describes the electrical modulation of locomotion in pigeons using deep brain electrodes. Polymer-based depth electrodes with four channels were fabricated. Based on the location of the nucleus intercollicularis (ICo), the shanks of the depth electrodes were designed to be a length of 11 mm. After the implantation of the depth electrode into the ICo region of the brain, it was connected by wires to a custom-made stimulator, and biphasic current pulses were delivered. Current pulses with an amplitude of 0.5 mA, a rate of 58.0 Hz, and a duration of $320\mu \mathrm{s} $s were applied for 0.5 s. When the ICo region was electrically stimulated, taking-off behavior was successfully induced for 0.4 s. Induction of taking-off behavior by electrical stimulation, when coupled to control of turning and running forward locomotions, may contribute to the development of remote flight-control system of freely moving pigeon.