Tracheal intubation: improving first pass success with smart material solutions

Airway management and intubation procedures continue to challenge anaesthetists. With current equipment not always providing an optimum solution, this can lead to potential serious complications if an airway is not secured quickly. Improvements in airway devices need to be discussed, designed, tested, and implemented. The implementation of the appropriate smart technologies and materials present an opportunity to resolve key issues with bougie-guided intubation. It is suggested that the development of a novel steerable bougie could improve current tracheal intubation practice. This proposition is grounded on using the appropriate research and design development strategies combined with a structured methodological approach

Meaningful change: defining the interpretability of changes in endpoints derived from interactive and mHealth technologies in healthcare and clinical research

Immersive, interactive and mHealth technologies are increasingly being used in clinical research, healthcare and rehabilitation solutions. Leveraging technology solutions to derive new and novel clinical outcome measures is important to the ongoing assessment of clinical interventions. While demonstrating statistically significant changes is an important element of intervention assessment, understanding whether changes detected reflect changes of a magnitude that are considered meaningful to patients is equally important. We describe methodologies used to determine meaningful change and recommend that these techniques are routinely included in the development and testing of clinical assessment and rehabilitation technology solutions

The development of a novel steerable bougie to assist in airway management

Background: This paper describes the development of a new airway device that will improve the speed and safety of endotracheal intubation in anaesthesia and critical care. Case of need, design specification and fabrication of the steerable bougie mechanism is discussed. Aims: Identify the need for a novel steerable bougie whilst considering technology readiness levels associated with medical device design. Analyse and produce suitable mechanisms utilising smart materials to increase device functionality aiding successful patient intubation procedures. Methods: This work describes the total design activity that contributes to the successful development of medical devices, from case of need, to smart material actuation mechanisms. Research focuses on identifying a suitable control mechanism to allow a steerable tip to be integrated into a bougie with a control device attached to the laryngoscope. Results: Data collected from a user group survey supported the development of a novel bougie, with better shape retention, variable rigidity within the tip, and an integrated steerable function. Analysis of several mechanisms, artificial muscles, and smart materials identified a cost-effective steerable mechanism that can be incorporated into a bougie. Conclusion: Users have defined a need for an improved bougie. Controlling smart materials and mechanisms, within the predefined dimensions, identified strengths and weaknesses associated with steerable functions. The performance of the selected mechanism for incorporation requires a high level of control to accurately steer a device within the human airway

Radiation Testing of Electronics for the CMS Endcap Muon System

The electronics used in the data readout and triggering system for the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) particle accelerator at CERN are exposed to high radiation levels. This radiation can cause permanent damage to the electronic circuitry, as well as temporary effects such as data corruption induced by Single Event Upsets. Once the High Luminosity LHC (HL-LHC) accelerator upgrades are completed it will have five times higher instantaneous luminosity than LHC, allowing for detection of rare physics processes, new particles and interactions. Tests have been performed to determine the effects of radiation on the electronic components to be used for the Endcap Muon electronics project currently being designed for installation in the CMS experiment in 2013. During these tests the digital components on the test boards were operating with active data readout while being irradiated with 55 MeV protons. In reactor tests, components were exposed to 30 years equivalent levels of neutron radiation expected at the HL-LHC. The highest total ionizing dose (TID) for the muon system is expected at the inner-most portion of the CMS detector, with 8900 rad over ten years. Our results show that Commercial Off-The-Shelf (COTS) components selected for the new electronics will operate reliably in the CMS radiation environment

Performance analysis for difficult airway equipment: standardising for success

Equipment design and selection can contribute to the success or failure of difficult airway management. However, evaluative systems for providing the relative performance data for bougie introducers to help inform these choices do not exist outside of bespoke studies. This paper discusses the design development of an innovative tip pressure and shape retention testing system. Working with a design activity model, a set of stringent criteria to inform the manufacture of the testing systems were produced. Once implemented, this testing method can inform future equipment selection to improve procedure success rates and thereby reduce patient complications

Utilising object tracking for the performance analysis of difficult airway equipment - a Shape Retention Testing System (SRTS)

Failure to secure the airway on induction of anaesthesia can result in death and disability. Current equipment does not always provide an optimum solution. Most anaesthetists consider bougies essential equipment for safe anaesthesia. Evaluative systems providing accurate objective data assessing bougie introducer performance data do not exist. The Shape Retention Testing System (SRTS) utilises the Intel® RealSenseTM SR300 camera to create an accurate and repeatable testing environment. SRTS collected data will allow anaesthetists to compare device performance that will inform purchase and usage decisions of bougies, ensuring optimum benefit for safe practice

A wearable headset for monitoring electromyography responses within spinal surgery

Purpose: This research examines an approach for enhancing the efficiency of spinal surgery utilising the technological capabilities and design functionalities of wearable headsets, in this case Google Glass. The aim was to improve the efficiency of the selective dorsal rhizotomy neurosurgical procedure initially through the use of Glass via an innovative approach to information design for an intraoperative monitoring display. Methods Utilising primary and secondary research methods the development of a new electromyography response display for a wearable headset was undertaken. Results: Testing proved that Glass was fit for purpose and that the new intraoperative monitor design provided an example platform for the innovative intraoperative monitoring display; however, alternative wearable headsets such as the Microsoft HoloLens could also be equally viable. Conclusion: The new display design combined with the appropriate wearable technology could greatly benefit the selective dorsal rhizotomy procedure

Relations Between Timing Features and Colors in the X-Ray Binary 4U 0614+09

We study the correlations between timing and X-ray spectral properties in the low mass X-ray binary 4U 0614+09 using a large (265-ks) data set obtained with the Rossi X-ray Timing Explorer. We find strong quasi-periodic oscillations (QPOs) of the X-ray flux, like the kilohertz QPOs in many other X-ray binaries with accreting neutron stars, with frequencies ranging from 1329 Hz down to 418 Hz and, perhaps, as low as 153 Hz. We report the highest frequency QPO yet from any low mass X-ray binary at 1329+-4 Hz, which has implications for neutron star structure. This QPO has a 3.5-sigma single-trial significance, for an estimated 40 trials the significance is 2.4-sigma. Besides the kilohertz QPOs, the Fourier power spectra show four additional components: high frequency noise (HFN), described by a broken power-law with a break frequency between 0.7 and 45 Hz, very low frequency noise (VLFN), which is fitted as a power-law below 1 Hz, and two broad Lorentzians with centroid frequencies varying from 6 to 38 Hz and 97 to 158 Hz, respectively. We find strong correlations between the frequencies of the kilohertz QPOs, the frequency of the 6 to 38 Hz broad Lorentzian, the break frequency of the HFN, the strength of both the HFN and the VLFN and the position of the source in the hard X-ray color vs. intensity diagram. The frequency of the 97 to 158 Hz Lorentzian does not correlate with these parameters. We also find that the relation between power density and break frequency of the HFN is similar to that established for black hole candidates in the low state. We suggest that the changing mass accretion rate is responsible for the correlated changes in all these parameters.Comment: ApJ, referee

A feasibility and comparison study of Autonomous Robotic Vehicles for the FMCG manufacturing sector

As we are approaching the fourth industrial revolution of Industry 4.0, many companies including Original Equipment Manufacturers (OEM) and Fast-Moving Consumer Goods (FMCG) companies are currently conducting feasibility studies and researching the potentials of autonomous robots and vehicles in future massproduction processes. Compared to their Automated Guided Vehicle (AGV) predecessors, they are deemed to be far more economical to install and integrated into brownfield sites with more ease. This work presents a specification based comparison study of market leaders that evaluates the specifications given for 16 ARV technologies available globally and within the UK. From this comparison study a feasibility study of two similarly specified ARVs could be conducted, most notably the Omron LD-CT130 AIV. If Industry 4.0 is fully exploited, it has the opportunity to cause an increased efficiency and reduce overall costs within a company, and making processes lean. Failure to embrace ARV technology will result in the potential loss of jobs. There is of course resentment for change from modern Luddites. However, the 4th Industrial Revolution is inevitable and should be embraced. Wartzman (2015) suggested two approaches working hand in hand in for Industry 4.0: preparing for a future career, and encouraging continuous learning within industry with organisations retraining employees. Moreover, industries should train and educate themselves and employees regarding how to accommodate ARV technologies in order to retain jobs in the future