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This paper proposes a noninvasive dual optical photoplethysmography (PPG) sensor to classify the degree of arteriovenous fistula (AVF) stenosis in hemodialysis (HD) patients. Dual PPG measurement node (DPMN) becomes the primary tool in this work for detecting abnormal narrowing vessel simultaneously in multi-beds monitoring patients. The mean and variance of Rising Slope (RS) and Falling Slope (FS) values between before and after HD treatment was used as the major features to classify AVF stenosis. Multilayer perceptron neural networks (MLPN) training algorithms are implemented for this analysis, which are the Levenberg-Marquardt, Scaled Conjugate Gradient, and Resilient Back-propagation, to identify the degree of HD patient stenosis. Eleven patients were recruited with mean age of 77 ± 10.8 years for analysis. The experimental results indicated that the variance of RS in the HD hand between before and after treatment was significant difference statistically to stenosis (p < 0.05). Levenberg-Marquardt algorithm (LMA) was significantly outperforms the other training algorithm. The classification accuracy and precision reached 94.82% and 92.22% respectively, thus this technique has a potential contribution to the early identification of stenosis for a medical diagnostic support system.

Background Anatomy is one of the core subjects in medical education. Students spend considerable time and effort on learning the requisite anatomy knowledge. This study explored the effect of a multiple-player virtual reality (VR) gaming system on anatomy learning. Methods 18 participants were randomly assigned into 3 learning conditions: (1) a textbook reading control group (CG), (2) a single-player VR (SP) group; and (3) a multiple-player VR (MP) group. The participants studied anatomy for 5 days, and completed a multiple-choice test on Days 1, 5, and 12. In the VR environment, the participants used handheld controllers to move the simulated tissues. The mission of the game was to complete puzzles of a human body. The SP and MP groups filled out a motivation inventory on Day 5. The scores on the multiple-choice test, the correct assembly rates, and the motivation inventory scores were analyzed using the 2-way ANOVA or independent t -test to compare group differences. Results There was a significant interaction effect of group and timepoint ( p  = 0.003) in the multiple-choice test. In the CG, the scores on Day 1, Day 5, and Day 12 were significantly different ( p  < 0.001). The scores on Day 5 were significantly higher than those on Day 1 ( p  < 0.001). Although the scores declined slightly on Day 12, they were still significantly higher than those on Day 1 ( p  < 0.001). The SP and MP groups had similar results ( p  < 0.001, p  < 0.001). The differences between the groups were only significant on Day 12 ( p  = 0.003), not Day 5 ( p  = 0.06). On Day 12, the scores of the MP group were higher than those of the CG ( p  = 0.002). The SP group and MP group had high scores on the interest, competence, and importance subscales of the motivation inventory. Both VR groups considered the system to be fun and beneficial to their learning. However, the MP group reported higher stress levels than the SP group. Conclusion The results indicated that the proposed VR learning system had a positive impact on the anatomy learning. Although the between-player competition caused higher stress levels for the VR groups, the stress could have been a mediator of their learning outcomes. Trial registration ETRD, ETRD-D-19-00573. Registered 20 December 2018, http://www.edah.org.tw/irb/index.htm

Kretschmann-configuration has been used as a subwavelength framework to detect tiny ‎alterations of the refractive index of biomaterials. However, most of the theoretical assessment of such configuration ‎is usually based on the plane wave excitation transfer matrix method (TMM) of prism-‎coupled to thin metal film supporting plasmonic modes. Accordingly, a better theoretical framework ‎than the plane wave approximation is indispensable for reliable and accurate assessments and ‎simulations. A reformulated form of the traditional FFT-BPM has been adapted to evaluate the performance and characteristics of surface plasmonic waveguide biosensor. Surface plasmon mode is excited by a sub-wavelength narrow light beam. The highly confined optical energy of that plasmonic mode enables an ‎efficient means to detect tiny variations in the composition of ‎the analyte in contact with the metallic layer of the surface plasmon ‎guide. The plasmonic guided power is detected thereafter electronically via an optical MOS capacitor. the guided plasmonic power has been used to assess the fundamental characteristics and performance of the sensor, namely the linearity, sensitivity, and figure of merit as well as the full width at half maximum (FWHM). The proposed sensor could be integrated to a wide class of angular measurement system (for instance goniometer) or via electronic detection of the optical plasmonic guided power. we claim that this work is worthy of being shared with researchers and ‎developers interested in the experimentation and assessment of sensitive biosensors; especially in ‎case when complicated and sophisticated analysis tools represent an unpleasant burden.

An ultrasonic examination is a clinically universal and safe examination method, and with the development of telemedicine and precision medicine, the robotic ultrasound system (RUS) integrated with a robotic arm and ultrasound imaging system receives increasing attention. As the RUS requires precision and reproducibility, it is important to monitor the real-time calibration of the RUS during examination, especially the angle of the probe for image detection and its force on the surface. Additionally, to speed up the integration of the RUS and the current medical ultrasound system (US), the current RUSs mostly use a self-designed fixture to connect the probe to the arm. If the fixture has inconsistencies, it may cause an operating error. In order to improve its resilience, this study proposed an improved sensing method for real-time force and angle calibration. Based on multichannel pressure sensors, an inertial measurement unit (IMU), and a novel sensing structure, the ultrasonic probe and robotic arm could be simply and rapidly combined, which rendered real-time force and angle calibration at a low cost. The experimental results show that the average success rate of the downforce position identification achieved was 88.2%. The phantom experiment indicated that the method could assist the RUS in the real-time calibration of both force and angle during an examination.

Venous needle dislodgement (VND) is a major healthcare safety concern in patients undergoing hemodialysis. Although VND is uncommon, it can be life-threatening. The main objective of this study was to implement a real-time multi-bed monitoring system for VND by combining a novel leakage-detection device and IoMT (Internet of Medical Things) technology. The core of the system, the Acusense IoMT platform, consisted of a novel leakage-detection patch comprised of multiple concentric rings to detect blood leakage and quantify the leaked volume. The performance of the leakage-detection system was evaluated on a prosthetic arm and clinical study. Patients with a high risk of blood leakage were recruited as candidates. The system was set up in a hospital, and the subjects were monitored for 2 months. During the pre-clinical simulation experiment, the system could detect blood leakage volumes from 0.3 to 0.9 mL. During the test of the IoMT system, the overall success rate of tests was 100%, with no lost data packets. A total of 701 dialysis sessions were analyzed, and the accuracy and sensitivity were 99.7% and 90.9%, respectively. Evaluation questionnaires showed that the use of the system after training changed attitudes and reduced worry of the nursing staff. Our results show the feasibility of using a novel detector combined with an IoMT system to automatically monitor multi-bed blood leakage. The innovative concentric-circle design could more precisely control the warning blood-leakage threshold in any direction to achieve clinical cost-effectiveness. The system reduced the load on medical staff and improved patient safety. In the future, it could also be applied to home hemodialysis for telemedicine during the era of COVID-19.

In the context of assisted human, identifying and enhancing non-stationary speech targets speech in various noise environments, such as a cocktail party, is an important issue for real-time speech separation. Previous studies mostly used microphone signal processing to perform target speech separation and analysis, such as feature recognition through a large amount of training data and supervised machine learning. The method was suitable for stationary noise suppression, but relatively limited for non-stationary noise and difficult to meet the real-time processing requirement. In this study, we propose a real-time speech separation method based on an approach that combines an optical camera and a microphone array. The method was divided into two stages. Stage 1 used computer vision technology with the camera to detect and identify interest targets and evaluate source angles and distance. Stage 2 used beamforming technology with microphone array to enhance and separate the target speech sound. The asynchronous update function was utilized to integrate the beamforming control and speech processing to reduce the effect of the processing delay. The experimental results show that the noise reduction in various stationary and non-stationary noise environments were 6.1 dB and 5.2 dB respectively. The response time of speech processing was less than 10ms, which meets the requirements of a real-time system. The proposed method has high potential to be applied in auxiliary listening systems or machine language processing like intelligent personal assistant.

To assess the effects of virtual reality on patients with musculoskeletal disorders by means of a scoping review of randomized controlled trials (RCTs). The databases included PubMed, IEEE, and the MEDLINE database. Articles involving RCTs with higher than five points on the Physiotherapy Evidence Database (PEDro) scale were reviewed for suitability and inclusion. The methodological quality of the included RCT was evaluated using the PEDro scale. The three reviewers extracted relevant information from the included studies. Fourteen RCT articles were included. When compared with simple usual care or other forms of treatment, there was significant pain relief, increased functional capacity, reduced symptoms of the disorder, and increased joint angles for the virtual reality treatment of chronic musculoskeletal disorders. Furthermore, burn patients with acute pain were able to experience a significant therapeutic effect on pain relief. However, virtual reality treatment of patients with non-chronic pain such as total knee replacement, ankle sprains, as well as those who went through very short virtual reality treatments, did not show a significant difference in parameters, as compared with simple usual care and other forms of treatment. Current evidence supports VR treatment as having a significant effect on pain relief, increased joint mobility, or motor function of patients with chronic musculoskeletal disorders. VR seems quite effective in relieving the pain of patients with acute burns as well.

In this paper, we propose a novel fiber-optical dosimetry sensor for radiation measurement in biological applications. A two-dimensional (2D) fiber-optical dosimeter (FOD) for radiation measurement is considered. The sensors are arranged as a 2D array in a tailored holder. This FOD targets accurate industrial and medical applications which seek more tolerant radiation dosimeters. In this paper, the FOD sensors are subjected to gamma-ray radiation facilities from the 137Cs gamma-ray irradiator type for low doses and 60Co gamma-ray irradiator for high doses. For better evaluation of radiation effects on the FOD sample, the measurements are performed using eight sensors (hollow cylinder shape) with two samples in each dose. The sensors were measured before and after each irradiation. To the author’s knowledge, the measurements of FOD transplanted inside animals are presented for the first time in this paper. A 2D simulation program has been implemented for numerical simulation based on the attenuation factors from the absorbed dose inside the in vivo models. A comparison between the FOD and the standard thermo-luminescence detector is presented based on the test of in vivo animal models. The results indicate that the proposed FOD sensor is more stable and has higher sensitivity.

The most common treatment for end-stage renal disease (ESRD) patients is the hemodialysis (HD). For this kind of treatment, the functional vascular access that called arteriovenous fistula (AVF) is done by surgery to connect the vein and artery. Stenosis is considered the major cause of dysfunction of AVF. In this study, a noninvasive approach based on asynchronous analysis of bilateral photoplethysmography (PPG) with error correcting output coding support vector machine one versus rest (ESVM-OVR) for the degree of stenosis (DOS) evaluation is proposed. An artificial neural network (ANN) classifier is also applied to compare the performance with the proposed system. The testing data has been collected from 22 patients at the right and left thumb of the hand. The experimental results indicated that the proposed system could provide positive predictive value (PPV) reaching 91.67% and had higher noise tolerance. The system has the potential for providing diagnostic assistance in a wearable device for evaluation of AVF stenosis.

This study discusses whether the prism used in a Kretschmann-based surface plasmon sensor can be fabricated from a thermotropic liquid crystal (TLC) material. The refractive index of the TLC prism can be thermally tuned to match the excitation requirements for the surface plasmon modes along the metal–TLC interface of the proposed sensing platform. The TLC material was chemically prepared in vitro and was thermally and optically characterized. The measurements reported a wide mesophase temperature range ΔT (~35 °C) and a relatively high clearing temperature TC (~84 °C) which constitutes a stable thermal control for the TLC optical parameters. The experimentally measured refractive indices of the TLC material reflect a linear change in line with the temperatures at several selected wavelengths in the visible region. A design of the surface plasmon sensor was proposed, which provided a linear response to the investigated analytes refractive index. This work highlights the importance of employing TLC material in designs compatible with detecting refractive index changes by thermal tuning and presents refractive index interrogation as an alternative method for exciting surface plasmon modes.