Critical Reviews in Biomedical Engineering最新文献

Airway management has undergone dramatic transformation since the development of videolaryngoscopy (VL). VL improves glottic views when compared to direct laryngoscopy (DL). The image obtained is from a camera at the tip of the curved blade, and the view is not direct line of sight. Placement of the endotracheal tube (ETT) may therefore require the ETT to be manipulated in multiple planes to match the curvature of the VL blade. This placement of the ETT "around the corner" may be difficult without additional airway aids. The aim of this retrospective observational study was to determine whether endotracheal placement during VL in patients with a difficult airway required the use of an additional airway aid (bougie or fiberoptic scope). Difficult airway was defined as a Cormack and Lehane (C&L) grade 3 or 4 view obtained using DL prior to VL use. Data from 165 patients was included in the study. Simple ETT placement without an additional airway device was achieved in only 20.6% of cases (n = 34). The remaining 131 patients required a bougie or fiberscope to assist intubation. ETT placement was not possible with the bougie in 33 patients. These 33 patients were successfully intubated using a fiberscope-assisted VL (FAV) technique. VL improved C&L grade 3 views by at least one grade in 99.1% of cases, and grade 4 view to a grade 1 or 2 in 96.3% of cases. VL improves glottic view in patients with a difficult airway; but in nearly 80% of patients, a bougie or fiberscope is required to properly place the ETT. Practitioners should be aware that improved glottic views with VL may not translate into simple ETT placement, and additional airway aids need to be readily available.

Several researchers studied the health impacts of electromagnetic fields in work environment. However, the previous research focuses on the statistical analysis of past exposure. There are no studies that addressed prediction of health symptoms. Prediction and early diagnosis of occupational diseases of electric power workers with acceptable accuracy is needed. The objective of this study is to develop a data driven mathematical model for predicting and diagnosis of occupational diseases in workers in electric power industry. The complex nature of disease occurrence due to electromagnetic radiation is appropriate for the fuzzy rules set by medical experts which are analyzed and validated to produce hybrid fuzzy decision rules. The selected group of medical experts suggested using hormonal disorders, endocrine diseases, coffee abuse, chronic diseases of the internal organs, allergic diseases, cervical osteochondrosis, severe course of infectious diseases, intoxication, injury. The developed hybrid fuzzy logic model predicts high risk of developing nervous system diseases. The prediction accuracy exceeded 0.88, which is acceptable for supporting tool.

Hyperglycemia, which is associated with diabetes, increases the production of advanced glycation end products. Advanced glycation end products lead to the structural degradation of soft tissues. The structural degradation of diabetic soft tissues has been investigated in humans, rodents, and canines. Therefore, the objective of this review is to unify the various contributions to diabetes research through the mechanical properties and geometric characteristics of soft tissues. A systematic review was performed and identified the effects of diabetes on mechanical and geometric properties of soft tissues via experimental testing or in vivo - driven finite element analysis. The literature concludes that diabetes contributes to major structural changes in soft tissues but does not cause the same structural changes in all soft tissues (e.g., diabetic tendons are weaker and diabetic plantar tissues are tougher). Diabetes stiffens and toughens soft tissues, thus altering viscoelastic behavior (e.g., poor strain and stress response). However, diabetes management routines can prevent or minimize the effects of diabetes on the mechanical and geometric properties of soft tissues. Unification of the structural effects of diabetes on soft tissues will contribute to the pathophysiology of diabetes.

Since its conception as an applied biomedical technology nearly 30 years ago, nanopore is emerging as a promising, high-throughput, biomarker-targeted diagnostic tool for clinicians. The attraction of a nanopore-based detection system is its simple, inexpensive, robust, user-friendly, high-throughput blueprint with minimal sample preparation needed prior to analysis. The goal of clinical-based nanopore biosensing is to go from sample acquisition to a meaningful readout quickly. The most extensive work in nanopore applications has been targeted at DNA, RNA, and peptide identification. Although, biosensing of pathological biomarkers, which is covered in this review, is on the rise. This review is broken into two major sections: (i) the current state of existing biological, solid state, and hybrid nanopore systems and (ii) the applications of nanopore biosensors toward detecting neurodegenerative biomarkers.

Glaucoma is a heterogeneous group of diseases that are characterized by loss of retinal ganglion cells, which damages the optic nerve head (ONH) and visual field. If glaucoma, the most frequent cause of irretrievable vision loss, is detected at an initial stage, the rate of blindness may be reduced by nearly 50%-55%. Manual diagnosis is a laborious task; it is fairly time consuming and requires a skilled medical provider. With the lack of trained professionals in developing countries, automatic glaucoma diagnosis becomes an increasingly vital tool that aids in detection and disease risk analysis. Analyses of the optic disc (OD) and optic cup (OC) are normally performed to assess ONH damage. But of the numerous reported research reports that show results using machine-learning and image-processing approaches, major concern lies in the accuracy of segmenting and classifying OD and OC. The objective of the current study is to outline state-of-the-art image-processing techniques that are used to detect glaucoma early via segmenting and OD and OC classification. We also present research findings and limitations thereof that must be addressed to achieve higher accuracy to improve segmentation and classification quality.

Cutting efficiency of endodontic files (EFs) has been widely evaluated in the literature. However, its performance depends on the microgeometry of the cutting instrument itself, and this has not been studied in depth. The present review describes basic concepts of cutting instruments, including cutting-tool engineering, the EF relationship, and cutting efficiency among different EF geometric designs during primary treatment and nonsurgical endodontic retreatment.

There is an increased need of drugs with multifunctional properties for visualization of β-amyloid (Aβ) plaques for early diagnosis and treatment of Alzheimer's disease (AD). Curcumin (Cur) is a potent antiamyloid, antiinflammatory, and antiapoptotic natural product that has been used to treat several neurodegenerative diseases, including AD. Curcumin can reduce amyloid burden, rescue neuronal damage, and restore normal cognitive and sensory motor functions in AD. Curcumin is a promising natural product theranostic because it fluoresces and preferentially binds to misfolded Aβ. However, poor water solubility, limited bioavailability, and inability to cross the blood-brain barrier (BBB) limit curcumin use for biological applications. In this work, ultrasmall (~ 11 nm) curcumin encapsulated Pluronic F127 nanoparticles (FCur NPs) were developed and optimized to enhance bioavailability, facilitate circulation in the bloodstream, and improve BBB penetration. We compare BBB crossing ability of FCur NPs and free curcumin using an in vitro BBB model, and we demonstrate brain accumulation following intravenous administration to healthy mice. FCur NPs display 6.5-fold stronger fluorescent intensity in the brain than those from free curcumin. In addition, in vitro comparison with Congo red, a marker for Aβ plaques, revealed that encapsulated curcumin maintains its ability to bind to Aβ plaques. FCur NPs exhibited antioxidant and antiapoptotic activity when compared to free curcumin. The combination of in vitro and in vivo results suggest potential utility of the inexpensive FCur NPs as a theranostic agent for AD.