Measuring continuing medical education conference impact and attendee experience: a scoping review.

Objectives: The aim was to comprehensively identify published research evaluating continuing medical education conferences, to search for validated tools and perform a content analysis to identify the relevant domains for conference evaluation. Methods: We used scoping review methodology and searched MEDLINE® for relevant English or French literature published between 2008 and 2022 (last search June 3, 2022). Original research (including randomized controlled trials, non-randomized studies, cohort, mixed-methods, qualitative studies, and editorial pieces) where investigators described impact, experience, or motivations related to conference attendance were eligible. Citations were assessed in triplicate, and data extracted in duplicate. Results: Eighty-three studies were included, 69 (83%) of which were surveys or interview based, with the majority conducted at the end of or following conference conclusion. Of the 74 tools identified, only one was validated and was narrowly focused on a specific conference component. A total of 620 items were extracted and categorized into 4 a priori suggested domains (engagement-networking, education-learning, impact, scholarship), and an additional 4 identified through content analysis (value-satisfaction, logistics, equity-diversity-inclusivity, career influences). Time trends were evident, including the absence of items related to equity-diversity-inclusivity prior to 2019, and a focus on logistics, particularly technology and virtual conferences, since 2020. Conclusions: This study identified 8 major domains relevant for continuing medical education conference evaluation. This work is of immediate value to individuals and organizations seeking to either design or evaluate a conference and represents a critical step in the development of a standardized tool for conference evaluation.

Human motor augmentation with an extra robotic arm without functional interference.

Extra robotic arms (XRAs) are gaining interest in neuroscience and robotics, offering potential tools for daily activities. However, this compelling opportunity poses new challenges for sensorimotor control strategies and human-machine interfaces (HMIs). A key unsolved challenge is allowing users to proficiently control XRAs without hindering their existing functions. To address this, we propose a pipeline to identify suitable HMIs given a defined task to accomplish with the XRA. Following such a scheme, we assessed a multimodal motor HMI based on gaze detection and diaphragmatic respiration in a purposely designed modular neurorobotic platform integrating virtual reality and a bilateral upper limb exoskeleton. Our results show that the proposed HMI does not interfere with speaking or visual exploration and that it can be used to control an extra virtual arm independently from the biological ones or in coordination with them. Participants showed significant improvements in performance with daily training and retention of learning, with no further improvements when artificial haptic feedback was provided. As a final proof of concept, naïve and experienced participants used a simplified version of the HMI to control a wearable XRA. Our analysis indicates how the presented HMI can be effectively used to control XRAs. The observation that experienced users achieved a success rate 22.2% higher than that of naïve users, combined with the result that naïve users showed average success rates of 74% when they first engaged with the system, endorses the viability of both the virtual reality-based testing and training and the proposed pipeline.

Effectiveness of Opuntia ficus indica (cactus) fruit juice for sludge conditioning.

The possibility of using Opuntia ficus indica fruit juice (OFIFJ) as a bioflocculant for conditioning the synthetic kaolin sludge and sewage sludge (region Oran, Algeria, and Pau, France) was studied. Turbidity of the supernatant, dryness of the sludge cake, and total time of filtration (TTF) were examined parameters. Using vacuum filtration, lime was also tested as a chemical conditioner and gives good results on Lescar (France) sewage sludge in terms of cake's dryness, filtrate quality, turbidity (13.54%), and total time of filtration (TTF = 85.29%), comparing to the industrial polymer (Sedifloc 408C; turbidity; 8.33% and TTF: 2.94%). For the sewage sludge of Oran (Algeria), the results obtained with OFIFJ were compared to those obtained with the cladodes juice of the same plant OFIC, and also with a cationic polymer (Superfloc 8396). For an optimum dosage, it showed that OFIFJ has a flocculation activity as same as the cladodes juice OFIC for sludge conditioning and gives better results in terms of turbidity (dosage of 22.4 g/kg DM: 3.7 NTU for OFIC, dosage of 8.36: 3.63 NTU for OFIFJ. Dryness was enhanced from 14.91 to 22.93% (OFIC 16 g/kg DM) and to 24.48% (OFIF 20.9 g/kg DM) but for TTF, we found the opposite. In fact, this plant showed to be an available, biodegradable, and non-toxic flocculant. For kaolin synthetic sludge (30%), the optimum dosages of those conditioners were found to be 0.066 g kg-1 for OFIC, comparing between vacuum filtration and filtration compression; turbidity was enhanced for both techniques, contrary to dryness. Concerning the Oran city sewage sludge, both turbidity and dryness were optimized. Same thing for the France sewage sludge, all the studied parameters were enhanced with the two studied bioflocculants.

A comparative study of electro-dewatering process performance for activated and digested wastewater sludge.

Electro-dewatering (EDW) is an alternative emerging and energy-efficient technology that provides improved liquid/solids separations in the dewatering of wastewater sludge. The EDW technology is not only an innovative dewatering method for significantly reducing the volume of wastewater sludge before re-utilization or disposal, but is also a promising emerging method which may potentially be used for decontamination purposes. In this study, the influence of the sludge properties (e.g. electrical conductivity, zeta potential, specific cake resistance, among others) on their mechanical and electrical behaviour in terms of dewaterability and electro-dewaterability, the applied current (current density from 20 to 80 A/m2), and filter cloth position relative to the electrode was investigated. A two-sided filter press at lab-scale with moving anode was used, and the treatment performance of the EDW process on two different types of wastewater sludge (activated and digested) was thoroughly assessed from both an electrochemical viewpoint and in terms of the dewatering rate. The results showed that the conditioned digested sludge was more easily dewatered by mechanical dewatering (MDW) with 34-35% (w%) of dry solids content compared to 19-20% (w%) for the activated sludge, thanks to the lower content of both the microbial extracellular polymeric substances (EPS) and the volatile suspended solids fraction. For the EDW results, the electrical conductivity of the sludge was pivotal to the dryness of the final solids and therefore also to the dewatering kinetics. The results demonstrated that the activated sludge arrived at an equilibrium much faster (after approximately 3600 s) compared with digested sludge, thanks to its lower electrical conductivity (0.8 mS/cm) providing a greater voltage drop across the cathode and therefore more repulsion of the solids from the cathode leading to continuously high filtrate flowrate. Also the EDW performance was analysed by comparing the ratio of the filtrate volume collected at the anode to the volume collected at the cathode side. For digested sludge at 5 bar, 40 A/m2 different positions of the filter cloth were tested but these configurations barely impacted the EDW performance, despite having a significant impact on the energy requirements. At industrial scale, it would be useful to position the filter cloths at some distance from the electrodes, but this study shows that this benefit may be quickly outweighed by the loss in EDW energy efficiency.

EXiO-A Brain-Controlled Lower Limb Exoskeleton for Rhesus Macaques.

Recent advances in the field of brain-machine interfaces (BMIs) have demonstrated enormous potential to shape the future of rehabilitation and prosthetic devices. Here, a lower-limb exoskeleton controlled by the intracortical activity of an awake behaving rhesus macaque is presented as a proof-of-concept for a locomotorBMI. A detailed description of the mechanical device, including its innovative features and first experimental results, is provided. During operation, BMI-decoded position and velocity are directly mapped onto the bipedal exoskeleton's motions, which then move the monkey's legs as the monkey remains physicallypassive. To meet the unique requirements of such an application, the exoskeleton's features include: high output torque with backdrivable actuation, size adjustability, and safe user-robot interface. In addition, a novel rope transmission is introduced and implemented. To test the performance of the exoskeleton, a mechanical assessment was conducted, which yielded quantifiable results for transparency, efficiency, stiffness, and tracking performance. Usage under both brain control and automated actuation demonstrates the device's capability to fulfill the demanding needs of this application. These results lay the groundwork for further advancement in BMI-controlled devices for primates including humans.

Influence of process operating parameters on dryness level and energy saving during wastewater sludge electro-dewatering.

Electrically assisted mechanical dewatering, known as electro-dewatering (EDW), is an alternative emerging technology for energy-efficient liquid/solids separation in the dewatering of wastewater sludge. In this study, the performance of the electro-dewatering (EDW) process for activated wastewater sludge was investigated. The influence of the operating modes; being the timing of voltage (U-EDW) or current (I-EDW) application to either or both the filtration and compression stages, and the influence of the applied pressure (in successive 30 min pressure steps) were studied. The results showed that by delaying the application of the electric field to the filter cake compression stage, there was a potential saving in power consumption of around 10-12% in the case of U-EDW and about 30-46% in the case of I-EDW. The increase of the applied pressure from 0.5 to 12 bar during the filter cake compression stage leads to an increase in electro-dewatering kinetics. The results also reveal that at a low electric field level the increase of the processing pressure has a relatively pronounced effect on the dewatering process. At high levels of the electric field, a minimum processing pressure (4-6 bar) is required to improve the electrical contact between the electrode and the sludge and thus lower the energy consumption.

Electro-dewatering of activated sludge: Electrical resistance analysis.

The significant risk of ohmic heating and the high electric energy consumption at terminal stages of the dewatering are two problems that hamper the development of the electro-dewatering (EDW) technology. In the future prospect of studying these two issues, it is important to provide and analyse quantitative data relative to the behavior of the electric resistance in EDW. It was the main goal of this study. It showed that the electric resistance of the complete system (cake + filter cloth) depended on the cake dryness. It increased sharply when the solids content exceeded around 45%.The solids loading also influenced the apparent resistance at the beginning of the process. The electric resistance of the filter cloth represented about 20% of the total resistance. It remained relatively constant over the process except at the terminal stage where it generally increased sharply. The use of conductive filter, such as metallic cloth, enabled to decrease the electric resistance and reduce the energy consumption of the process. The electric resistance decreased across the cake from the anode to the cathode. This behavior may be explained by several phenomena such as the ions migration and their interaction with the solid, the decrease of dry solids content from the anode to the cathode and the gas presence at the anode (due to electrolysis reaction).

Electro-dewatering of wastewater sludge: An investigation of the relationship between filtrate flow rate and electric current.

Compared to conventional dewatering techniques, electrical assisted mechanical dewatering, also called electro-dewatering (EDW) is an alternative and an effective technology for the dewatering of sewage sludge with low energy consumption. The objectives of this study were to evaluate the dewatering performance and to determine the influence of the process parameters (e.g. applied electric current, applied voltage, and the initial amount of dry solids) on the kinetics of EDW-process for activated urban sludge. Also significant efforts have been devoted herein to provide comprehensive information about the EDW mechanisms and to understand the relationship between these operating conditions with regards to develop a qualitative and quantitative understanding model of the electro-dewatering process and then produce a robust design methodology. The results showed a very strong correlation between the applied electric current and the filtrate flow rate and consequently the electro-dewatering kinetics. A higher applied electric current leads to faster EDW kinetics and a higher final dry solids content. In contrast, the results of this work showed a significant enhancement of the dewatering kinetics by decreasing the mass of the dry solids introduced into the cell (commonly known as the sludge loading).

Control strategies for active lower extremity prosthetics and orthotics: a review.

: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user.This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user's sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies.As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os--not as independent devices, but as actors within an ecosystem--is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers.Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use.The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user's neuromusculoskeletal system and are practical for use in locomotive ADL.

Development of an assistive motorized hip orthosis: kinematics analysis and mechanical design.

With the increase of life expectancy, a higher number of elderly need assistance to maintain their mobility and their independance. The hip joint is crucial for walking and is problematic for a large number of aged people. In this paper we present a novel design of a motorized hip orthosis to assist elderly people while walking, stair climbing and during the sit-to-stand transistions. The kinematics was developed based on biomechanics considerations. To be able to achieve a large assistance rate, velocity and torques of the hip joint were studied from the literature. In order to fit with these requirements, an amplification mechanism inspired by excavators was developed and implemented. Comfort considerations were also taken into account and a custom interface was designed with the collaboration of a professional orthopaedic technician. First tests with the prototype showed that the workspace is sufficient for walking, for stair climbing as well as for sit-to-stand transitions. The assistance rate can go up to 30% for a 70 kg subject during walking at a cadence of 100 steps/min. The comfort is guaranteed despite the important weight (4.3 kg) of this first prototype.

Compression dewatering of municipal activated sludge: effects of salt and pH.

Even after mechanical dewatering, activated sludge contains a large amount of water. Due to its composition and biological nature this material is usually highly compressible and known to be difficult to dewater. In the present work, two treatments (salt addition and pH modification) are proposed to highlight some aspects which could explain the poor dewaterability of activated sludge. Dewatering tests are carried out in a pressure-driven device in order to well examine both, filtration and compression stages. Physico-chemical parameters, such as surface charge, hydrophobicity, extracellular polymeric substances (EPS) content and filtrate turbidity are measured on the tested sludge, for a better analysis of dewatering results. The dewatering ability of the sludge is widely linked to the cohesion of the flocculated matrix and the presence of fine particles. Both treatments alter the flocculated matrix and release fine particles. The release of fine particles tends to clog both, the filter cake and the filter medium. Consequently, the filtration rate decreases due to higher resistances to the flow. On another hand, the polymeric matrix breakdown enables to release some water trapped within the floc to the bulk liquid phase and thus facilitates its removal, which tends to decrease the moisture content of the filter-cake. It also impacts the compression dewatering step. The more destroyed structures lead to less elastic cakes and thus a slower primary consolidation stage. At the opposite, the mobility of the broken aggregates within the filter-cake does not seem to be improved by size reduction (the kinetics of the secondary consolidation stage are not significantly modified).

Electro-dewatering of wastewater sludge: influence of the operating conditions and their interactions effects.

Electric field-assisted dewatering, also called electro-dewatering (EDW), is a technology in which a conventional dewatering mechanism such a pressure dewatering is combined with electrokinetic effects to realize an improved liquid/solids separation, to increase the final dry solids content and to accelerate the dewatering process with low energy consumption compared to thermal drying. The application of these additional fields can be applied to either or both dewatering stages (filtration and/or compression), or as a pre-or post-treatment of the dewatering process. In this study, the performance of the EDW on wastewater sludge was investigated. Experiments were carried out on a laboratory filtration/compression cell, provided with electrodes, in order to apply an electrical field. The chosen operating conditions pressure (200-1200 kPa) and voltage (10-50 V) are sufficient to remove a significant proportion of the water that cannot be removed using mechanical dewatering technologies alone. A response surface methodology (RSM) was used to evaluate the effects of the processing parameters of EDW on (i) the final dry solids content, which is a fundamental dewatering parameter and an excellent indicator of the extent of EDW and (ii) the energy consumption calculated for each additional mass of water removed. A two-factor central composite design was used to establish the optimum conditions for the EDW of wastewater sludge. Experiments showed that the use of an electric field combined with mechanical compression requires less than 10 and 25% of the theoretical thermal drying energy for the low and moderate voltages cases, respectively.

Electrical field: a historical review of its application and contributions in wastewater sludge dewatering.

Electric field-assisted dewatering, also called electro-dewatering, is a technology in which a conventional dewatering mechanism such a pressure dewatering is combined with electrokinetic effects to realize an improved liquid/solids separation, to increase the final dry solids content and to accelerate the dewatering process with low energy consumption compared to thermal drying. Electro-dewatering is not a new idea, but the practical industrial applications have been limited to niche areas in soil mechanics, civil engineering, and the ceramics industry. Recently, it has received great attention, specially, in the fields of fine-particle sludge, gelatinous sludge, sewage sludge, pharmaceutical industries, food waste and bull kelp, which could not be successfully dewatered with conventional mechanical methods. This review focuses on the scientific and practical aspects of the application of an electrical field in laboratory/industrial dewatering, and discusses this in relation to conventional dewatering techniques. A comprehensive bibliography of research in the electro-dewatering of wastewater sludges is included. As the fine-particle suspensions possess a surface charge, usually negative, they are surrounded by a layer with a higher density of positive charges, the electric double layer. When an electric field is applied, the usually negative charged particles move towards the electrode of the opposite charge. The water, commonly with cations, is driven towards the negative electrode. Electro-dewatering thus involves the well-known phenomena of electrophoresis, electro-osmosis, and electromigration. Following a detailed outline of the role of the electric double layer and electrokinetic phenomena, an analysis of the components of applied voltage and their significance is presented from an electrochemical viewpoint. The aim of this elementary analysis is to provide a fundamental understanding of the different process variables and configurations in order to identify potential improvements. Also discussed herein is the investigation of the electrical behaviour of a porous medium, with particular emphasis on porous medium conductivity determination.