Landmine Neutralization: Air Excavation Unit

The Landmine Neutralization team’s poster will present our team’s progress towards designing and prototyping an air excavation unit. To accomplish this, the project team is working with the HALO Trust, the world’s largest demining NGO. The HALO Trust works in many countries to remove the remnants of war, including improvised explosive devices (IEDs) and unexploded ordnance (UXOs). This project seeks to help deminers by providing a device that blows air at high velocity to clear dust and other debris away from potential IEDs and UXOs in war-torn areas to help in their effort of demining. We have focused on designing our prototype to operate reliably in harsh environments while fulfilling our client’s specifications. Our client requested that we design our excavation unit to be easily installed onto their Volvo 220 backhoes and their custom-made backhoe attachments. The current design is modular and consists of a hydraulic motor powering a fan from a backpack leaf blower, all of which is assembled within a steel frame that attaches to the rake of the HALO excavators. Due to circumstances beyond our control, our project will be wrapping up at the end of this semester, which is sooner than anticipated. This means the goals of our project have been narrowed to having a functional prototype and relevant documentation that we can present to our client.https://mosaic.messiah.edu/engr2021/1008/thumbnail.jp

A Low-Cost Microprocessor-Controlled Stance-Control Knee Orthosis for Pediatric Mobility Impairments

Knee-ankle-foot orthoses (KAFOs) are commonly prescribed for individuals with knee instability or quadriceps weakness resulting from a variety of conditions such as spinal cord injury, stroke, spina bifida, and cerebral palsy. A locking KAFO fixes the leg fully straight and is the most prescribed orthotic intervention for these conditions. However, the functional benefits of lower extremity orthoses are maximally realized in stance-controlled knee-ankle-foot orthoses (SC-KAFOs) which allow free knee motion during swing but lock during stance. Existing SC-KAFO options are generally unreliable or expensive, and thus an unmet need exists for a reliable, versatile orthosis which can be manufactured at relatively low cost. The SC-KO team is working to meet this need by developing an intelligent stance-controlled knee orthotic with an any-angle locking mechanism controlled by a microprocessor based on information received from onboard inertial gait-phase sensing. The resulting device will allow for reliable knee locking for support during the stance phase, easy unlocking even under load for the free swing phase, and predictable, safe behavior on stairs and uneven terrain. The system is being developed as a knee-only orthosis but can be adapted for a full knee-ankle-foot orthosis, with ankle support being prescribed as needed. The first system developed will be configured for pediatric use to address mobility impairments arising from cerebral palsy and spina bifida with CURE Ethiopia serving as the clinical partner for the development and testing. Funding for this work provided by The Collaboratory for Strategic Partnerships and Applied Research.https://mosaic.messiah.edu/engr2022/1017/thumbnail.jp

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Marijuana Use Among Young Black Men Who Have Sex With Men and the HIV Care Continuum: Findings From the uConnect Cohort

<p><i>Background:</i> Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. <i>Objective:</i> Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. <i>Methods:</i> A cohort of YBMSM (<i>n</i> = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression models. <i>Results:</i> Study participants reported more intermittent marijuana use (<i>n</i> = 254, 56.2%) compared to heavy use (<i>n</i> = 198, 43.8%). Our sample contained 212 (34.3%) HIV seropositive participants of which 52 (24.5%) were unaware of their HIV positive status. Study participants who were heavy marijuana users were more likely to be unaware of their HIV seropositive status (AOR: 4.18; 95% CI 1.26, 13.89). All other stages in the care continuum demonstrated no significant differences between those who use marijuana intermittently or heavily or as a sex-drug and nonusers. <i>Conclusions:</i> YBMSM who used marijuana heavily were more likely to be HIV-positive unaware than those who never used marijuana. Findings were inconclusive regarding the relationships between marijuana use and other HIV care continuum metrics. However, knowledge of ones’ HIV status is a critical requirement for engaging in care and may have implications for onwards HIV transmission.</p