Characterizing the acoustic environment in a Neonatal Intensive Care Unit

In this work, noise sources were studied in a Neonatal Intensive Care Unit (NICU) by evaluating the noise from various sources, including the influence of the work of the NICU staff. The objective was to evaluate the acoustic quality in the usual conditions in NICU rooms and inside incubators by monitoring the noise in both environments, and then data were processed using artificial neural networks. Although some types of noise were accurately classified in this way, the lack of uniformity of their sound spectra, their simultaneity, and concomitance hindered the unequivocal interpretation of some results with the classification models. After analyzing the results, it can be affirmed that the alarms of equipment had a remarkable influence on the acoustic environment. Other important influences also appeared due to the conversations of the staff, the use of the telephone, and the hauling of equipment and furniture

Internet of medical things – integrated, ultrasound-based respiration monitoring system for incubators

The study's aim was to develop a non-contact, ultrasound (US) based respiration rate and respiratory signal monitor suitable for babies in incubators. Respiration rate indicates average number of breaths per minute and is higher in young children than adults. It is an important indicator of health deterioration in critically ill patients. The current incubators do not have an integrated respiration monitor due to complexities in its adaptation. Monitoring respiratory signal assists in diagnosing respiration rated problems such as central Apnoea that can affect infants. US sensors are suitable for integration into incubators as US is a harmless and cost-effective technology. US beam is focused on the chest or abdomen. Chest or abdomen movements, caused by respiration process, result in variations in their distance to the US transceiver located at a distance of about 0.5 m. These variations are recorded by measuring the time of flight from transmitting the signal and its reflection from the monitored surface. Measurement of this delay over a time interval enables a respiration signal to be produced from which respiration rate and pauses in breathing are determined. To assess the accuracy of the developed device, a platform with a moving surface was devised. The magnitude and frequency of its surface movement were accurately controlled by its signal generator. The US sensor was mounted above this surface at a distance of 0.5 m. This US signal was wirelessly transmitted to a microprocessor board to digitise. The recorded signal that simulated a respiratory signal was subsequently stored and displayed on a computer or an LCD screen. The results showed that US could be used to measure respiration rate accurately. To cater for possible movement of the infant in the incubator, four US sensors were adapted. These monitored the movements from different angles. An algorithm to interpret the output from the four US sensors was devised and evaluated. The algorithm interpreted which US sensor best detected the chest movements. An IoMT system was devised that incorporated NodeMcu to capture signals from the US sensor. The detected data were transmitted to the ThingSpeak channel and processed in real-time by ThingSpeak’s add-on Matlab© feature. The data were processed on the cloud and then the results were displayed in real-time on a computer screen. The respiration rate and respiration signal could be observed remotely on portable devices e.g. mobile phones and tablets. These features allow caretakers to have access to the data at any time and be alerted to respiratory complications. A method to interpret the recorded US signals to determine respiration patterns, e.g. intermittent pauses, were implemented by utilising Matlab© and ThingSpeak Server. The method successfully detected respiratory pauses by identifying lack of chest movements. The approach can be useful in diagnosing central apnoea. In central apnoea, respiratory pauses are accompanied by cessation of chest or abdominal movements. The devised system will require clinical trials and integration into an incubator by conforming to the medical devices directives. The study demonstrated the integration of IoMT-US for measuring respiration rate and respiratory signal. The US produced respiration rate readings compared well with the actual signal generator's settings of the platform that simulated chest movements

In vitro neuronal cultures on MEA: an engineering approach to study physiological and pathological brain networks

Reti neuronali accoppiate a matrici di microelettrodi: un metodo ingegneristico per studiare reti cerebrali in situazioni fisiologiche e patologich

Modular Instrumentation for Controlling and Monitoring In-Vitro Cultivation Environment and Image-based Functionality Measurements of Human Stem Cells

Artificial animal cell culture was successfully developed by Ross Harrison in 1907. But it was not until the 1940’s and 1950’s that several developments occurred, which expedited the cell culturing in-vitro (C-Vitro) to be a consistent and reproducible technique to study isolated living-cells in a controlled environment. Currently, CVitro is one of the major tools in cellular and molecular biology both in the academia and industry. They are extensively utilised to study the cellular physiology/biochemistry, to screen drugs/therapeutic compounds, to understand the effects of drugs/toxic compounds and also to identify the pathways of carcinogenesis/mutagenesis. It is also used in large scale manufacturing of vaccines and therapeutic proteins. In any experimental setup, it is important that the C-Vitro model should represent the physiological phenomena of interest with reasonable accuracy so that all experimental results are statistically consistent and reproducible. In this direction, sensors and measurement systems play important roles in in-situ detection and/or control/manipulation of cells/tissues/environment. This thesis aimed to develop new technology for tailored cell culturing and integrated measurements. Firstly, design and assembly of a portable Invert-upright microscope interchangeable modular cell culturing platform (iuCMP) was envisioned. In contrast to conventional methods, micro-scaled systems mimic the cells' natural microenvironment more precisely, facilitating accurate and tractable models. The iuCMP integrates modular measurement schemes with a mini culture chamber using biocompatible cell-friendly materials, automated environment-control (temperature and gas concentrations), oxygen sensing and simultaneous functional measurements (electrophysiological and image-based). Time lapse microscopy is very useful in cell biology, but integration of advanced >i>in-vitro/device based biological systems (e.g. lab/organ/body-on-chips, or mini-bioreactors/microfluidic systems) into conventional microscopes can be challenging in several circumstances due to multiple reasons. But in iuCMP the main advantage is, the microscope can be switched either as an inverted or as an upright system and therefore can accommodate virtually any in-vitro device. It can capture images from regions that are otherwise inaccessible by conventional microscopes, for example, cells cultured on physical or biochemical sensor systems. The modular design also allows accommodating more sensor or measurement systems quite freely. We have demonstrated the system for video-based beating analysis of cardiomyocytes, cell orientation analysis on nanocellulose, and simultaneous long-term in-situ microscopy with oxygen and temperature sensing in hypoxia. In an example application, the system was utilised for long-term temperature stressing and simultaneous mechanobiological analysis of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). For this the iuCMP together with a temperature sensor plate (TSP) and a novel non-invasive beating analysis software (CMaN—cardiomyocyte function analysis tool, scripted as a subpart of this thesis), was applied for automated temperature response studies in hiPSC-CM cultures. In-situ temperature sensing is usually challenging with bulky external sensors, but TSPs solved this issue. In the temperature response study, we showed that the relationship between hiPSC-CM beating frequency and temperature is non-linear and measured the Q10 temperature coefficients. Moreover, we observed the hiPSC-CM contractile networking, including propagation of the action potential signal between dissociated clusters and their non-invasive measurements. It was the first case where these events were reported in hiPSC-CM clusters and their noninvasive measurements by image processing. The software CMaN comes with a user-friendly interface and, is equipped with features for batch processing, movement centre detection and cluster finding. It can extract six different signals of the contractile motion of cardiomyocytes (clusters or single cells) per processing. This ensures a minimum of one useful beating signal even in the cases of complex beating videos. On the processing end, compared to similar tools, CMaN is faster, more sensitive, and computationally less expensive and allows ROI based processing. In the case of healthy cells, the waveform of the signal from the CMaN resembles an ECG signal with positive and negative segments, allowing the computation of contraction and relaxation features separately. In addition to iuCMP, a Modular optical pH measurement system (MO-pH) for 24/7 non-contact cell culture measurements was also developed. The MO-pH incorporates modular sterilisable optical parts and is used in phenol-red medium cell cultures. The modular assembly of MO-pH cassettes is unique and reusable. Measurements are carried out in a closed flow system without wasting any culture medium and requires no special manual attention or recalibrations during culture. Furthermore, a new absorption correction model was put forward that minimised errors caused e.g. by biolayers in spectrometric pH measurement, which improved the pH measurement accuracy. MO-pH has been applied in long-term human adipose stem cells (hASC) expansion cultures in CO2 dependent and independent media. Additionally, the MO-pH was also utilised to comprehend the behaviour of pH, temperature and humidity in water jacked incubators as well as to record the pH response as a function of temperature in the presence and absence of CO2 in the context of stem cell cultures. The resulting plots clearly showed the interplay between measured parameters indicating a few stress sources present all through the culture. Additionally, it provided an overall picture of behaviour of critical control parameters in an incubator and pointed out the need for bioprocess systems with automatic process monitoring and smart control for maximum yield, optimal growth and maintenance of the cells. Besides, we also integrated MO-pH into flasks with reclosable lids (RL-F) and tested its applicability in stem cell cultures. A standalone system around an RL-F flask was built by combining the cell culture, medium perfusion and optical measurements. The developed RL-F system has been successfully tested in ASC-differentiation cultures. Finally, a few trial experiments for image-based pH estimation aimed for iuCMP have also been carried out. This includes tests with LCD illumination, optical projection tomography, and webcam systems. In reality, the pH is not distributed uniformly in tissues, and has shown a gradient of up to 1.0 pH unit within 1 cm distance. Therefore, producing reliable pH maps also in in-vitro can be important in understanding various common pathologies and location of lesions. A reliable and adequately developed long-term pH mapping method will be an important addition into the iuCMP

Parent-infant closeness and family-centered care in neonatal intensive care

Abstract Early interaction and closeness with a caregiver are important for the development of newborn infants. Postpartum separation between parent and newborn is still common in the hospital care of premature babies. Parent-infant closeness in neonatal units can be supported by a family-centered care culture, in which hospital care for the newborn is implemented in cooperation with parents. Measuring both parent-infant closeness and family-centered care culture is challenging, and hardly any prospective metrics reported by parents exists in the literature. The aim of this dissertation was to examine a) first the closeness between the infant and parent, b) second the parents’ participation in their infant’s care and how each are supported, and c) third how family-centered care practices are implemented in neonatal intensive care units (NICUs). New measures were developed and tested in order to obtain reliable information on the physical closeness between parent and infant and the perceived quality of family-centered care in NICUs. The results of the present study indicate that it is possible to modify care practices to better support parent-infant closeness and parents’ participation in their infant’s care without endangering the growth of the premature infant or lengthening hospitalization. In a prospective multi-center study including 11 NICUs in 6 European countries, differences among countries as well as among units within the same country were observed. The most significant factor explaining the observed differences was the possibility for parents to stay overnight in the unit. The new methods developed and validated in the present study can be used in the future, for example in studies exploring the effects of parent-infant closeness on short- and long-term outcomes of the hospitalized newborns. With these new tools, it is also possible to support the implementation of FCC practices.Tiivistelmä Varhainen vuorovaikutus ja läheisyys ovat tärkeä perusta vastasyntyneen kehitykselle. Vanhemman ja vastasyntyneen välistä läheisyyttä sairaaloissa voidaan tukea perhekeskeisellä hoitokulttuurilla (Family-centered care), jossa vastasyntyneen sairaalahoito toteutetaan yhteistyössä vanhempien kanssa. Läheisyyden ja perhekeskeisen hoitokulttuurin mittaaminen on haastavaa ja kirjallisuudesta ei juuri löydy prospektiivisia vanhempien raportoimia mittareita. Tämän väitöstutkimuksen tavoitteena oli selvittää, miten vanhemman ja lapsen välistä läheisyyttä ja vanhempien osallistumista keskosen hoitoon tuetaan ja miten perhekeskeisiä hoitokäytäntöjä toteutetaan vastasyntyneiden teho-osastoilla. Tutkimuksessa kehitettiin ja testattiin uusia mittareita, joilla voidaan saada luotettavaa tietoa vanhemman ja lapsen välisestä fyysisestä läheisyydestä ja perhekeskeisen hoidon laadusta vastasyntyneiden teho-osastoilla. Tutkimuksessa todettiin, että vastasyntyneiden teho-osaston hoitokäytäntöjä voidaan muokata läheisyyttä ja vanhempien osallistumista tukevampaan suuntaan vaarantamatta keskosen kasvua tai pidentämättä sairaalahoitoaikoja. Eurooppalaisessa monikeskustutkimuksessa osoitettiin eroja niin eri maiden välillä kuin myös saman maan sisällä eri yksiköiden välillä. Selkeimmin eroja selittävä tekijä oli vanhempien mahdollisuus yöpyä osastolla. Tutkimuksessa käytetyt prospektiiviset mittarit osoittautuivat helppokäyttöisiksi ja vähän kuormittaviksi, ja pystyivät osoittamaan merkittäviä yksiköiden välisiä eroja. Uusia menetelmiä voidaan tulevaisuudessa hyödyntää esimerkiksi selvitettäessä vanhemman ja lapsen välisen läheisyyden fysiologisia vaikutuksia ja vaikutuksia pitkäaikaiskehitykseen. Kehitettyjen mittareiden avulla voidaan myös tukea perhekeskeisten hoitokäytäntöjen käyttöönottoa

Collaborative Networks, Decision Systems, Web Applications and Services for Supporting Engineering and Production Management

This book focused on fundamental and applied research on collaborative and intelligent networks and decision systems and services for supporting engineering and production management, along with other kinds of problems and services. The development and application of innovative collaborative approaches and systems are of primer importance currently, in Industry 4.0. Special attention is given to flexible and cyber-physical systems, and advanced design, manufacturing and management, based on artificial intelligence approaches and practices, among others, including social systems and services