Medical device landscape for communicable and noncommunicable diseases in low-income countries

Abstract Background This study characterized the landscape of commercially available medical devices specifically designed for use in low-income countries (LICs). Methods A state-of-the-art review of peer-reviewed publications, patents, global health databases, and online resources was performed. The criteria established for a health technology’s inclusion in the study were: it met the definition of a medical device; it was designed and developed to address one of the top ten causes of death in LICs, Millennium Development Goal (MDG) 4, or MDG 5; and there was evidence of its commercialization. Results Analysis identified 134 commercialized devices exclusively designed for use in LICs. More than 85% of devices were designed to address infectious diseases or child or maternal health (MDG 4 or 5, respectively). None of the identified devices addressed prevention of noncommunicable diseases (NCDs). Only 8% of devices were designed for use in primary health facilities by non-physician health providers. Conclusion There is a significant mismatch between the projected global burden of disease due to NCDs and the relevant number of commercialized medical devices designed specifically for use in LICs. A limited number of commercialized devices were designed for use by non-physician health providers. These findings suggest the need for medical devices targeting NCDs in LICs and design processes that consider the broader context of design and engage stakeholders throughout all phases of design.https://deepblue.lib.umich.edu/bitstream/2027.42/144540/1/12992_2018_Article_355.pd

Does PRRT with standard activities of 177Lu-octreotate really achieve relevant somatostatin receptor saturation in target tumor lesions?: insights from intra-therapeutic receptor imaging in patients with metastatic gastroenteropancreatic neuroendocrine tumors

Twenty plantain crop fields were sampled to identify Meloidogyne spp. in Tierralta and Valencia municipalities. Ten soil and root samples per field were taken to obtain the nematodes. Meloidogyne species classification was based on the perineal pattern of the female, shape of the stylet in females, males and juveniles (J2), and shape and number of rings on the cephalic region in J2 and males. Stylet length and dorsal oesophageal gland (DOG) on males, females and J2, body length, tail and hyaline tail region in J2 were measured to identify the specie of root-knot nematode. Meloidogyne spp. were found in 80% of the fields in Valencia, and 60% of the field in Tierralta. M. incognita and M. arenaria were detected. M. incognita was the most frequent species throughout the sampled area. Mixtures of both species were found in both municipalities. This is the first report of mixed M. incognita and M. arenaria associated to plantain crop in Colombia.Veinte cultivos de plátano fueron muestreados en los municipios de Tierralta y Valencia para identificar las especies de Meloidogyne asociadas a este cultivo. Diez muestras de suelos y raíces fueron colectadas en cada de los lotes, las cuales fueron usadas para la obtención de los nemátodos. La clasificación de las especies se basó en las características morfológicas (patrón perineal de las hembras, forma del estilete de hembras, machos y juveniles (J2); forma y número de anillos de la región cefálica de J2 y machos) y morfométricas (longitud del estilete y la distancia de la base del estilete a la desembocadura de la glándula dorsal (D.G.O) de hembras, machos y J2; longitud del cuerpo, la cola y la región hialina de los J2. En el 80% de las fincas en Valencia se detectó la presencia de estos nematodos, mientras que el 60% de los predios en Tierralta fueron positivos para los mismos. Las especies encontradas fueron Meloidogyne incognita y M. arenaria. De estas, M. incognita fue la más frecuente detectada en la zona productora de plátano en los dos municipios. Mezcla de especies fueron detectadas en ambos municipios. Se reporta por primera vez en Colombia las especies M. incognita y M. arenaria, así como la mezcla de las mismas asociadas al cultivo de plátano

Predicting Factors for the Communication between hydatid Cyst and Biliary Tract

Background: Hydatid cyst communicated with biliary tract increases the morbidity and mortality rates. Therefore, early detection and treatment are vital.Methods: From 96 patients undergone hydatid cyst surgery, 12 were excluded. The specifications, size, location, and position of the cyst, the condition of the cyst wall thickness, the caught lobe, cyst rupture, liver abscess, and the size of the inside and outside liver bile ducts were identified through computed tomography scanning. Age, gender, icterus, white blood cell (WBC) count, the total, direct, and indirect bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase were identified.Results: In 21 patients (13 men and 8 women), there was communication between the hydatid cyst and biliary tract; from them, 14 patients had icterus. There were significant differences between the size of the cyst, the levels of liver enzymes, bilirubin, and alkaline phosphatase, and WBC count in communicated and non-communicated hydatid cysts (P = 0.001). There were no significant differences between the two groups in terms of age, gender, location of the cysts in the liver, and the thickness of the liver.Conclusions: Only the cyst size and the level of bilirubin were the predicting factor for the communication between hydatid cyst and biliary tract

Effect of low-temperature precipitates on microstructure and pseudoelasticity of an Fe–Mn–Si-based shape memory alloy

Fe–Mn–Si-based shape memory alloys (Fe-SMAs) have attracted much research attention due to their potential applications for vibration mitigation, energy dissipation, and re-centering in the construction sector. Because of the crucial impact of precipitation on the pseudoelasticity (PE) behavior of Fe-SMAs, the equilibrium phase diagram of an Fe–17Mn–5Si–10Cr–4Ni–1(V-C) (wt%) SMA was used in this study to identify a low-temperature precipitate and study its effect on the microstructure and PE of the alloy after a low-temperature aging process. Transmission electron microscopy (TEM) studies revealed that aging at 485 °C for 6 h after aging at 750 °C for 6 h led to the precipitation of fresh, parallelogram-shaped, (Cr–V–C)-rich precipitates along with elliptical-shaped, V-rich precipitates in the austenite grains of the recrystallized samples. Numerous parallel stacking faults (SFs) were formed due to the presence of the precipitates within the austenite grains. It is postulated that such an arrangement of SFs can further improve the PE by reducing the activation energy for the nucleation of ɛ-martensite laths and inhibiting them from colliding with each other and consequent formation of α'-martensite, resulting in a residual strain reduction to 2.7% after 4.0% tensile straining

An Evaluation and Comparison of Mechanical Properties of Phenolic-Glass Fabric Composites Prepared by Vacuum Bag-Only and Autoclave Processes

Hypothesis: The curing process for phenolic resin composites is always carried out under press or autoclave pressure, as water by-products are released during curing process. As a result, when phenolic composite parts are formed using the vacuum bag-only method, the costs of the mold and challenges of the pressure vessels would be eliminated, and a significant step is taken in easier manufacture of these parts.Methods: For the purpose of comparing the two methods, phenolic laminates were prepared using 3 bar pressure autoclave and vacuum bag-only methods. In order to investigate the effects of thickness on different properties, the samples were subjected to bending tests, short beam strength tests, void percentage tests, and fractured surface morphology tests.Findings: As the sample’s thickness increases, the flexural modulus increases while the flexural strength and short beam strength decrease. Furthermore, the modulus, bending strength, and strength of the short beam in the autoclave sample have increased by 27%, 17%, and 17%, respectively, compared to the vacuum bag-only sample. Morphological studies also showed that more void content was formed in the vacuum bag samples and the resin-fiber interaction was reduced compared to the autoclaved samples. A decrease in the bonding between resin and fibers and in the penetration of resin between fiber strands has also been observed with increasing thickness. Samples with a thickness of 1 mm had a void content of 3.5 ± 1% and in samples with a thickness of 9 mm, it was 15% ± 1%

Development of culturally appropriate pictorial cards to facilitate maternal health histories in rural Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135249/1/ijgo244.pd

Obstetrics‐based clinical immersion of a multinational team of biomedical engineering students in Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135577/1/ijgo218.pd

Prophylactic Peripheral Blood Stem Cell Collection in Patients with Extensive Bone-Marrow Infiltration of Neuroendocrine Tumours Prior to Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE

Peptide receptor radionuclide therapy (PRRT) of metastatic neuroendocrine tumors (NET) can be successfully repeated but may eventually be dose-limited. Since 177Lu-DOTATATE dose limitation may come from hematological rather than renal function, hematological peripheral blood stem cell backup might be desirable. Here, we report our initial experience of peripheral blood stem-cell collection (PBSC) in patients with treatment-related cytopenia and therefore high risk of bone-marrow failure. Five patients with diffuse bone-marrow infiltration of NET and relevant myelosuppression (≥grade 2) received PBSC before one PRRT cycle with 177Lu-DOTATATE (7.6 ± 0.8 GBq/cycle). Standard stem-cell mobilization with Granulocyte-colony stimulating factor (G-CSF) was applied, and successful PBSC was defined as a collection of >2 × 106/kg CD34+ cells. In case of initial failure, Plerixafor was administered in addition to G-CSF prior to apheresis. PBSC was successfully performed in all patients with no adverse events. Median cumulative activity was 44.8 GBq (range, 21.3–62.4). Three patients had been previously treated with PRRT, two of which needed the addition of Plerixafor for stem-cell mobilization. Only one of five patients required autologous peripheral blood stem-cell transplantation during the median follow up time of 28 months. PBSC collection seems to be feasible in NET with bone-marrow involvement and might be worth considering as a backup strategy prior to PRRT, in order to overcome dose-limiting bone-marrow toxicity