(searched for: doi:(10.31354/*))
Published: 1 September 2020
Global Clinical Engineering Journal, Volume 3, pp 44-49; doi:10.31354/globalce.v3i1.57
Medical equipment that supports life, relieves diseases, and overcomes disabilities can also cause damage and death due to operational failures, user failures, and misuse. Hemodialysis machines include roller pumps that control the flow of blood, and these pumps have to be calibrated accurately to ensure they are working properly. This article describes the development of a low-cost, open source prototype that automates the flow analysis (measurement and recording) of the blood pumps in hemodialysis machines. Being able to accurately inspect the machine’s operation improves the quality and safety of its use. Through this technology (this process automation), it is believed equipment downtime and total tests cost will be reduced. This device has a system that collects data in real time, generated by the blood pump dialysis. Mathematical calculations are used to present flow information, including the standard deviation of the measurement, which is reported at the end of the test in an objective and simple way. Through a software and human machine interface (HMI), the test can be monitored and generate a report that contains the name and model of the equipment, the quantitative results of the flows, and the standard deviations of the measurements. The device can be used by clinical engineering teams in preventive maintenance and after corrective maintenance, as a control practice, making the calibration process easier and more cost-effective.
Published: 14 July 2020
Global Clinical Engineering Journal, Volume 3, pp 33-43; doi:10.31354/globalce.v3i1.102
This paper describes the guidelines for writing effective manuscript that complies with general scientific writing style and in particular with those that are incorporated by the editors and reviewers of the Global Clinical Engineering Journal (www.GlobalCE.org) when they evaluate submission of manuscripts. Readers of this paper will gain understandings of the manuscript preferred writing format and of the submission’s individual sections. Examples are provided for each of individual sections that further explain their purpose and contrast of their various styles. When the guidance provided in this paper is incorporated into a new submission, it is expected to elevate the quality of the writing as well as the desire of young clinical engineers to publish about their work and the interest of the scientific community to read it.
Published: 6 July 2020
Global Clinical Engineering Journal, Volume 3, pp 27-32; doi:10.31354/globalce.v3i1.104
Background and Objective: Venezuela presents a health, socio-economic crisis (minimum wage of 2.32 US dollars monthly), and a political one. Apart from having very poor quality public services and coverage, such as water, public transport, electricity, and the Internet. In this context, COVID-19 appears. This pathology quickly became a pandemic since its transmission occurs mainly through contact with the secretions of infected patients or with contaminated surfaces. Health workers face a higher risk of infection than the rest of the population. For this reason, the objective of the work was to reduce this threat while working with patients with COVID-19, redesigning the original "spray box". To carry out this work, the university, private health providers and private companies had to be united. Material and Methods: The following phases were carried out: a) A sketch is created; b) A 3D CD model is created; c) The prototype is manufactured; d) The prototype is improved; and e) The effectiveness and safety tests are carried out. Results: As a result, the medical team obtained a tool to limit the spread of COVID 19 and thereby improve the health of the health workers involved. This instrument is called "Cube de Vie" (CubeDV). Conclusions: to carry out a job in Venezuela is very complicated under the circumstances it presents, however, the joint work of three organizations such as the university, private health providers and private companies can generate solutions to the serious situation that the pandemic presents. .
Published: 30 June 2020
Global Clinical Engineering Journal, Volume 3, pp 10-26; doi:10.31354/globalce.v3i1.98
GLOBAL DISASTER UNPREPAREDNESS - The global COVID-19 crisis of 2020 has thrown a disturbing spotlight on the many ways in which healthcare systems, governments, medical industries, markets, and healthcare professions have been dangerously fragmented, unprepared, under-resourced, tragically slow and uncoordinated in responding to the most disruptive medical disaster of our times. Despite numerous threat-analysis studies, detailed pandemic scenarios and simulations by state and Federal agencies, despite billions of dollars spent on post-9/11 international disaster preparedness, and repeated top-levels warnings, the world’s governments, markets and healthcare systems have failed to prepare and prevent a health disaster from exploding into a multi-dimensional catastrophe. The fragmentation of plans and competencies across sectors, complicated by political decision-making, clearly demand mission-critical re-organization among the institutional players, with more coordinated, integrated, and systems-oriented professional approaches worldwide, and active cultivation of public health intelligence. For the reasons that follow, Clinical and Biomedical Engineers are among the best-suited health professionals to assume an expanded and comprehensive leadership role in this urgently needed transformation.
Published: 25 June 2020
Global Clinical Engineering Journal, Volume 3, pp 5-9; doi:10.31354/globalce.v3i1.59
In this study it is presented the implementation of a low-cost automated prototype, in an open code platform, that simulates maternal fetal signals, allowing test executions and fetal detectors. The goal is guaranteeing the use of these equipments in a safe, effective way in the monitoring of maternal fetal signals in hospital environments, since the simulator is used to evaluate the correct use of the equipment. Another possible application of the simulator is as a teaching tool. The results are demonstrated in a man-machine interface, the views of the measurements of fetal movement, uterine activity and fetal heart rate, generated by the simulator. The values demonstrated in the man-machine interface can be compared with the ones presented by the fetal monitor. With this comparison it is possible to check the correct functioning of the equipment tested.
Published: 22 June 2020
Global Clinical Engineering Journal, Volume 3, pp 1-2; doi:10.31354/globalce.v3i1.107
Published: 29 May 2020
Global Clinical Engineering Journal, Volume 2, pp 45-56; doi:10.31354/globalce.v2i3.86
Background and Objective. The deliberation n.7301 of 31/12/2001 provides for the inclusion of a call system with acoustic and luminous signalling within the minimum equipment of the recovery ward. However, traditional call systems are inefficient since they are based on the following incorrect assumptions: patients and staff are unmoving, information sources are static and assistance is unidirectional. Taking care of a patient involves different figures who should be dynamic and should be able to exchange information. Furthermore, the high number of clinical calls and alarms might be an issue, because on one hand they are essential to fulfil patients’ needs, but on the other hand they could cause stress and additional workload on medical staff. Indeed, they sometimes ignore some calls or waste a lot of time on non-urgent requests. In addition, the identification of an alarm and the prompt intervention seems to be more difficult during travelling. An ideal alarm system should have 100% sensitivity and specificity. Nevertheless, the alarms are designed to be extremely sensitive, at the expense of specificity. The alarm fatigue, that is the work overload due to an excessive alarms number exposition, is a critical problem in terms of safety in the current clinical practice because it involves desensitization and alarm loss, causing sometimes even the patient's death. Material and Methods. Therefore, appropriate approaches to notifications should be evaluated, including the effectiveness of mobile wireless technologies: linking patients, staff, data, services and medical devices simplifies communications and workflows. Several issues related to the communication among staff members, between patient and caregiver and to the alarms and vital parameters distribution in care-intensive environments have been analysed, focusing on the clinical effectiveness analysis of an innovative technology to support the Emergency Department of the Azienda Ospedaliera dei Colli activities. Afterwards, we have created a simulation model with Simul8, so that a digital twin reproduces direct and indirect activities in two cases: with and without (What If and As Is model) the aid of the technology. Results and conclusions. The model provides a set of Key Performance Indicators (number of performing activities, average alarm resolution time, waiting time) on which the compensatory aggregation method is applied to elaborate a single final score in both cases. This score is 52,5 in the As Is Model and 80 in the What If model. So, the clinical effectiveness has been demonstrated.
Published: 21 May 2020
Global Clinical Engineering Journal, Volume 2, pp 35-44; doi:10.31354/globalce.v2i3.89
This work investigates the validity and reliability of a novel biomechatronic device providing an interactive environment in Augmented Reality (AR) for neuromotor rehabilitation. A RGB-depth camera and telemonitoring/remote signaling module are the main components of the device, together with a PC-based interface. The interactive environment, which implements some optimized algorithms of body motion capture and novel methodologies for human body motion analysis, enables neuromotor rehabilitation treatments that are adaptable to the performance and individual characteristics of the patient. The RGB-Depth camera module is implemented through a Microsoft Kinect, ORBBEC ZED2K devices; the telemonitoring module for teleassistance and therapy supervision is implemented as a cloud service. Within the module of body motion tracking, the abduction and adduction movements of the limbs of the full-body structure are tracked and the joints angles are measured in real-time; the most distinctive feature of the tracking module is the control of the trunk and shoulder posture during the exercises performed by the patient. Indeed, the device recognizes an incorrect position of the patient's body that could affect the objective of the exercise to be performed. The recognition of an incorrect exercise is associated to the generation of an alert both to the patient and the physician, in order to maximize the effectiveness of the treatment based on the user's potential and to increase the chances of a better biofeedback. The experimental tests, which have been carried out by reproducing several neuromotor exercises on the interactive environment, show that the feature recognition and extraction of the joints and segments of the musculo-skeletal structure of the patient's, and of wrong posture during exercises, can achieve good performance in the different experimental conditions. The developed device is a valid tool for patients affected by chronic disability, but it could be extended to neurodegenerative diseases in the early stages of the disease. Thanks to the enhanced interactivity in augmented reality, the patient can overcome some difficulties in interaction with the most common IT tools and technologies; at the meanwhile she/he can perform rehabilitation at home. The physician can also check in real time the results and customize the care pathway. The enhanced interactivity provided by the device during rehabilitation session increases both the motivation by the patient and the continuity of the care, as well as it supports low-cost remote assistance and telemedicine by optimizing therapy costs. The key points are: i) making rehabilitation motivating for the patient, becoming a "player"; ii) optimize effectiveness and costs; iii) possibility of low-cost remote assistance and telemedicine.
Published: 19 May 2020
Global Clinical Engineering Journal, Volume 2, pp 24-34; doi:10.31354/globalce.v2i3.84
Health Technology Assessment focuses on equal appraisal of health technologies introduced into the market. This has made regulators and the governance of innovation reactive and dependent on the initiatives innovators take for technology development, thus making it supply driven. The policy makers’ role has become one of appraising technologies that are already developed rather than guiding the development agenda. This severely limits the possibility to ensure that health technologies sufficiently address major issues such as burden of disease, trade deficit and health inequalities. It places governments outside of the actor arena that co-shapes technologies in the early stages, restricting the involvement to facilitating scale up or not. It makes it hard to achieve health technology governance practices that maximally contribute to ensure technological developments that actually address public concerns. What is the potential of frameworks for changing this dynamics and how can evidence shape technology development agenda’s without falling into the traps of regulator lock-in or social engineering? The methodology presented in this study takes first but important steps towards an evidence based framework for priority setting to guide innovations, particularly in health and social sectors