Frontiers in Medical Technology最新文献

Introduction: The radio electric asymmetric conveyer (REAC) is a technology that has the purpose of restoring the cellular polarity triggering the rebalancing of the endogenous bioelectric field, which considering the neurological dysfunctions, affects the neural communication mechanisms. The studies published so far show that the REAC neuromodulation technology has positive effects in treating these dysfunctions, with the principles of endogenous bioelectricity as a basis to achieve these effects.

Objectives: This study aims to review the literature that explored the effects of REAC protocols on motor control and to identify which mechanisms would be involved.

Materials and methods: This integrative review considered studies that used REAC as a therapeutic intervention directed at human motor control and experimental research with animals that applied REAC to obtain effects related to motor behavior.

Results: Ten articles were included, eight clinical and two experimental studies. The clinical studies used the neuro postural optimization (NPO) protocol in 473 patients, of which 53 were healthy subjects, 91 were Alzheimer's disease patients, 128 were patients with atypical swallowing, 12 subjects with neurological diseases, and 189 were without the specification of disease. The experimental studies used the antalgic neuromodulation and neurodegeneration protocols in animal models.

Conclusion: The information integrated in this review made it possible to consider REAC technology a promising resource for treating motor control dysfunctions. It is possible to infer that the technology promotes functional optimization of neuronal circuits that may be related to more efficient strategies to perform motor tasks.

Background: There is increasing evidence that COVID-19 survivors are at increased risk of experiencing a wide range of cardiovascular complications post infection; however, there are no validated models or clear guidelines for remotely monitoring the cardiac health of COVID-19 survivors.

Objective: This study aims to test a virtual, in-home healthcare monitoring model of care for detection of clinical symptoms and impacts on COVID-19 survivors. It also aims to demonstrate system usability and feasibility.

Methods: This open label, prospective, descriptive study was conducted in South Western Sydney. Included in the study were patients admitted to the hospital with the diagnosis of COVID-19 between June 2021 and November 2021. Eligible participants after consent were provided with a pulse oximeter to measure oxygen saturation and a S-Patch EX to monitor their electrocardiogram (ECG) for a duration of 3 months. Data was transmitted in real-time to a mobile phone via Bluetooth technology and results were sent to the study team via a cloud-based platform. All the data was reviewed in a timely manner by the investigator team, for post COVID-19 related symptoms, such as reduction in oxygen saturation and arrhythmia.

Outcome measure: This study was designed for feasibility in real clinical setting implementation, enabling the study team to develop and utilise a virtual, in-home healthcare monitoring model of care to detect post COVID-19 clinical symptoms and impacts on COVID-19 survivors.

Results: During the study period, 23 patients provided consent for participation. Out of which 19 patients commenced monitoring. Sixteen patients with 81 (73.6%) valid tests were included in the analysis and amongst them seven patients were detected by artificial intelligence to have cardiac arrhythmias but not clinically symptomatic. The patients with arrhythmias had a higher occurrence of supraventricular ectopy, and most of them took at least 2 tests before detection. Notably, patients with arrhythmia had significantly more tests than those without [t-test, t (13) = 2.29, p < 0.05].

Conclusions: Preliminary observations have identified cardiac arrhythmias on prolonged cardiac monitoring in 7 out of the first 16 participants who completed their 3 months follow-up. This has allowed early escalation to their treating doctors for further investigations and early interventions.

Introduction: UK Built Environment is currently undergoing a digital transformation, as is happening in the National Health Service (NHS) of England. In this paper, the focus was on the intersection of the two sectors and specifically the potential digital transformation of the NHS Estate. The NHS has developed a strategy for its workforce, to improve staff health and wellbeing, and support equality, diversity, inclusion and the development of existing staff. Digital technologies (DTs) can relate to all Estates and Facilities Management priorities, as it cross-cuts all proposed actions. As opposed to most studies on the wellbeing of blue-collar workers, this article focuses on white-collar workers, specifically architects working in the NHS, especially since NHS at this stage is developing two important policies: the New Hospital Programme and the Workforce Action Plan. Therefore, it is important for the NHS to look at the digital transformation strategy in the prism of the other two. As architecture traditionally has low job satisfaction, it negatively impacts wellbeing. This study argues that this might have been accentuated during the pandemic for the architects working in the NHS and dealing with the added pressure from three new major tasks: adjusting the infrastructure capacity to fight Covid-19; and creating the infrastructure for the testing and vaccination programs. DTs in architecture potentially affect job satisfaction in terms of creativity, autonomy, time pressure, organisational commitment, and so on.

Methodology: The methodology comprises a literature review and a pilot of interviews with healthcare architects/designers working in the NHS or on NHS-related projects. The research context is informed by the COVID-19 crisis that brought healthcare architecture to the frontline of the pandemic, with NHS architects creating new wards and vaccination centers, while private healthcare architects designed new hospitals.

Results: In the niche area of healthcare architecture, architects were in their busiest year. Yet, the DTs available to them then could only support limited tasks and did not link well to operational data.

Discussion: To explore how DTs transform the wellbeing of healthcare architects, understanding wellbeing in healthcare architecture in light of digital transformation is crucial for creating the necessary leadership for the sector to grow.

Adenovirus based vectors are useful tools for vaccine development, gene therapy, and oncolytic virotherapy. Here we describe a novel approach for the genetic engineering of any portion of the adenovirus genome and the reconstruction of either fully replication competent or defective virions. This innovative strategy is rapid, effective and suitable for the manipulation of the entire genome broadening the spectrum of potential applications for the adenovirus system. Our strategy involved insertion of restriction enzyme recognition sequences absent in the native virus into the termini of the adenovirus genome in order to facilitate recovery. These restriction enzyme sites, together with the two inverted terminal repeats and packaging sequences, were synthesized and then subcloned into the pBR322 vector. The remaining internal portion of the adenovirus genome was separated and amplified via PCR into six segments, of which groups of two were joined together by PCR and then subcloned into pBR322 plasmids. During the PCR reaction, an overlap of 30-40 bp was added to the termini of the adjacent fragments, allowing for the subsequent isothermal assembly and correct orientation of all fragments. This approach allows for the genetic modification of each genomic fragment according to the specific research goals, (e.g., deletion, substitution, addition, etc.) To recreate the entire viral genome, the four engineered fragments (each comprised of two adenovirus genomic sections) as well as the pBR322 backbone, were reassembled into a single construct utilizing an isothermal assembly reaction. Finally, the reassembled plasmid containing the entire genome was linearized and transfected into HEK293 cells to recover the complete reconstructed adenoviral vector. Using this approach, we have successfully generated two recombinant reporter adenoviruses, one of human adenovirus serotype 14 and another of serotype 55. The E3 region was replaced by the reporter genes (GFP and Luciferase) to visualize and track the recovery process. Subsequent infection of A549 cells with these reconstructed adenovirus vectors demonstrated that they were replication competent. This method shortens the viral reconstruction process because the one-step isothermal assembly requires less than 4 days, and recombinant adenovirus recovery occurs within 10 days. This new method allows for single or multiple genetic modifications within any portion of the viral genome and can be used to construct or manipulate any adenovirus whose complete genome sequence is known.

Introduction: Despite routine implementation of cleaning and disinfection practices in clinical healthcare settings, high-touch environmental surfaces and contaminated equipment often serve as reservoirs for the transmission of pathogens associated with healthcare-associated infections (HAIs).

Methods: The current study involved the analysis of high-touch surface swabs using a metatranscriptomic sequencing workflow (CSI-Dx™) to assess the efficacy of cleanSURFACES® technology in decreasing microbial burden by limiting re-contamination. This is a non-human single center study conducted in the Emergency Department (ED) and on an inpatient Oncology Ward of Walter Reed National Military Medical Center that have followed hygienic practices during the COVID-19 pandemic environment.

Results: Although there was no difference in observed microbial richness (two-tailed Wilcoxon test with Holm correction, P > 0.05), beta diversity findings identified shifts in microbial community structure between surfaces from baseline and post-intervention timepoints (Day 1, Day 7, Day 14, and Day 28). Biomarker and regression analyses identified significant reductions in annotated transcripts for various clinically relevant microorganisms' post-intervention, coagulase-negative staphylococci and Malassezia restricta, at ED and Oncology ward, respectively. Additionally, post-intervention samples predominantly consisted of Proteobacteria and to a lesser extent skin commensals and endogenous environmental microorganisms in both departments.

Discussion: Findings support the value of cleanSURFACES®, when coupled with routine disinfection practices, to effectively impact on the composition of active microbial communities found on high-touch surfaces in two different patient care areas of the hospital (one outpatient and one inpatient) with unique demands and patient-centered practices.