A nanocommunication system for endocrine diseases

Nanotechnology is a newand very promising area of research which will allow several new applications to be created in different fields, such as, biological, medical, environmental, military, agricultural, industrial and consumer goods. This paper focuses specifically on nanocommunications, which will allow interconnected devices, at the nano-scale, to achieve collaborative tasks, greatly changing the paradigm in the fields described. Molecular communication is a new communication paradigm which allows nanomachines to exchange information using molecules as carrier. This is the most promising nanocommunication method within nanonetworks, since it can use bio-inspired techniques, inherit from studied biological systems, which makes the connection of biologic and man-made systems a easier process. At this point, the biggest challenges in these type of nanocommunication are to establish feasible and reliable techniques that will allow information to be encoded, and mechanisms that ensure a molecular communication between different nodes. This paper focus on creating concepts and techniques to tackle these challenges, and establishing new foundations on which future work can be developed. The created concepts and techniques are then applied in an envisioned medical application, which is based on a molecular nanonetwork deployed inside the Human body. The goal of this medical application is to automatously monitor endocrine diseases using the benefits of nanonetworks, which in turn connects with the internet, thus creating a Internet of NanoThings system. The concepts and techniques developed are evaluated by performing several simulations and comparing with other researches, and the results and discussions are presented on the later sections of this paper

Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study

BACKGROUND: In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. METHODS: This case-control study took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a database of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, behavioural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach. RESULTS: Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6-75.6) compared to those without a head injury 90.3% (95% CI = 87.3-92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5-5.7)); the head injury rating was 1.9 (95% CI = 1.2-3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2-3.3) times higher in subjects with no medical history. CONCLUSION: Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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TELE-critical Care verSus usual Care on ICU PErformance (TELESCOPE): Protocol for a cluster-randomised clinical trial on adult general ICUs in Brazil

Introduction Daily multidisciplinary rounds (DMRs) consist of systematic patient-centred discussions aiming to establish joint therapeutic goals for the next 24 hours of intensive care unit (ICU) care. The aim of the present study protocol is to evaluate whether an intervention consisting of guided DMRs, supported by a remote specialist and audit/feedback on care performance will reduce ICU length of stay compared with a control group. Methods and analysis A multicentre, controlled, cluster-randomised superiority trial including 30 ICUs in Brazil (15 intervention and 15 control), from August 2019 to June 2021. In a parallel assignment, ICUs are randomised to a complex-intervention composed by daily rounds carried out through Tele-ICU by a remote ICU physician; development of local quality indicators dashboards coupled with monthly meetings with local leadership; and dissemination of evidence-based clinical protocols versus usual care. Primary outcome is ICU length of stay. Secondary outcomes include classification of the unit according to the profiles defined by the standardised resource use and the standardised mortality rate, hospital mortality, incidence of healthcare-associated infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation or alert and calm, rate of patients under normoxaemia. All adult patients admitted after the beginning of the study in each participant ICU will be enrolled. Inclusion criteria (clusters): public Brazilian ICUs with a minimum of 8 ICU beds interested/committed to participating in the study. Exclusion criteria (clusters): units with fully established DMRs by an intensivist, specialised or step-down units. Ethics and dissemination The study protocol was approved by the institutional review board (IRB) of the coordinator centre, and by IRBs of each enrolled hospital/ICU. Statistical analysis protocol is being prepared for submission before the end of patient's enrolment. Results will be disseminated through conferences, peer-reviewed journals and to each participating unit. Trial registration number NCT03920501; Pre-results