Investigation of photoplethysmographic signals and blood oxygen saturation values on healthy volunteers during cuff-induced hypoperfusion using a multimode PPG/SpO2 sensor

Photoplethysmography (PPG) is a technique widely used to monitor volumetric blood changes induced by cardiac pulsations. Pulse oximetry uses the technique of PPG to estimate arterial oxygen saturation values (SpO2). In poorly perfused tissues, SpO2 readings may be compromised due to the poor quality of the PPG signals. A multimode finger PPG probe that operates simultaneously in reflectance, transmittance and a combined mode called “transreflectance”’ was developed, in an effort to improve the quality of the PPG signals in states of hypoperfusion. Experiments on 20 volunteers were conducted to evaluate the performance of the multimode PPG sensor and compare the results with a commercial transmittance pulse oximeter. A brachial blood pressure cuff was used to induce artificial hypoperfusion. Results showed that the amplitude of the transreflectance AC PPG signals were significantly different (p\0.05) than the AC PPG signals obtained from the other two conventional PPG sensors (reflectance and transmittance). At induced brachial pressures between 90 and 135 mmHg, the reflectance finger pulse oximeter failed 25 times (failure rate 42.2 %) to estimate SpO2 values, whereas the transmittance pulse oximeter failed 8 times (failure rate 15.5 %). The transreflectance pulse oximeter failed only 3 times (failure rate 6.8 %) and the commercial pulse oximeter failed 17 times (failure rate 29.4 %)

Mechanics of fragmentation of crocodile skin and other thin films

Fragmentation of thin layers of materials is mediated by a network of cracks on its surface. It is commonly seen in dehydrated paintings or asphalt pavements and even in graphene or other two-dimensional materials, but is also observed in the characteristic polygonal pattern on a crocodile’s head. Here, we build a simple mechanical model of a thin film and investigate the generation and development of fragmentation patterns as the material is exposed to various modes of deformation. We find that the characteristic size of fragmentation, defined by the mean diameter of polygons, is strictly governed by mechanical properties of the film material. Our result demonstrates that skin fragmentation on the head of crocodiles is dominated by that it features a small ratio between the fracture energy and Young’s modulus, and the patterns agree well with experimental observations. Understanding this mechanics-driven process could be applied to improve the lifetime and reliability of thin film coatings by mimicking crocodile skin

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Soft Tissue Finite Element Modeling and Calibration of the Material Properties in the Context of Computer-Assisted Medical Interventions

International audienceThis chapter aims at illustrating how patient-specific models of human organs / soft tissues can be implemented into Finite Element (FE) packages. First is addressed the question of the generation of patient-specific FE models compatible with the clinical constraints. Then is discussed the calibration of the material properties, with choices that should be done between calibrations based on ex vivo or in vivo tissues loadings. The example of computer assisted maxillofacial surgery is addressed and results based on patients' data are provided