A Smart IoT-Based Prototype System for Rehabilitation Monitoring

Smart healthcare is growing significantly in the healthcare sector due to the Internet of Things. A remote monitoring system is one of the smart healthcare implementations for rehabilitating stroke patients. Nowadays, as the COVID-19 pandemic continues to spread, patients undergoing home rehabilitation have difficulty meeting with their physicians due to movement constraints. In addition, the healthcare facilities are devoted to treating patients with COVID-19. As a result, physicians and patients could not frequently meet to gather their rehabilitation progress. This study involves developing a prototype to monitor a post-stroke patient's rehabilitation process using the Arduino Nano 33 Bluetooth Low Energy (BLE) and force-sensing resistor (FSR). The prototype analyzes critical aspects of the rehabilitation process based on handgrip, heart rate, sleep, and step tracking measurements. The results of the handgrip, heart rate, sleep, and step tracking measurements are evaluated for various types of subjects and six testing approaches showed an accurate and consistent results. However, experiments partially success with a small error is detected while tracking the steps of each subject. Several recommendations are highlighted to improve the prototype using other sensors such as force sensing resistor and flex sensor for handgrip force transducer, electromyogram (EMG) sensor for stroke-patients rehabilitation, and others

A Smart IoT-Based Prototype System for Rehabilitation Monitoring

Smart healthcare is growing significantly in the healthcare sector due to the Internet of Things. A remote monitoring system is one of the smart healthcare implementations for rehabilitating stroke patients. Nowadays, as the COVID-19 pandemic continues to spread, patients undergoing home rehabilitation have difficulty meeting with their physicians due to movement constraints. In addition, the healthcare facilities are devoted to treating patients with COVID-19. As a result, physicians and patients could not frequently meet to gather their rehabilitation progress. This study involves developing a prototype to monitor a post-stroke patient's rehabilitation process using the Arduino Nano 33 Bluetooth Low Energy (BLE) and force-sensing resistor (FSR). The prototype analyzes critical aspects of the rehabilitation process based on handgrip, heart rate, sleep, and step tracking measurements. The results of the handgrip, heart rate, sleep, and step tracking measurements are evaluated for various types of subjects and six testing approaches showed an accurate and consistent results. However, experiments partially success with a small error is detected while tracking the steps of each subject. Several recommendations are highlighted to improve the prototype using other sensors such as force sensing resistor and flex sensor for handgrip force transducer, electromyogram (EMG) sensor for stroke-patients rehabilitation, and others

Knowledge, attitude, and practice towards COVID-19; A community survey in North-Borneo (Sabah), Malaysia

Aims: The COVID-19 pandemic has severely impacted the global economy as well as the healthcare delivery systems. Without effective treatment and vaccines in the earlier phase of the pandemic, the public needs to engage in precautionary behaviors and disease surveillance and response at the policy level. This study aimed to describe the knowledge, attitude, and practice toward COVID-19 among the residents in Sabah, Malaysia. Instruments & Methods: An online cross-sectional study was conducted using convenience sampling from March to April 2020. The chi-square test and multiple logistic regression were used to examine the association factors of knowledge, attitude, and practice towards the COVID-19 pandemic. Findings: A total of 536 participants completed the questionnaire. The mean knowledge score was 10.1±1.2, and 84.2% had a correct rate of knowledge. The attitude towards the final success in controlling COVID-19 was significantly different in age groups, marital status, and occupation types (p<0.05). Those with higher knowledge scores were more likely to agree with the confidence of the final success in controlling COVID-19. 94.4% were confident that Malaysia will win the battle against the COVID-19 pandemic. People in government sectors were 6.19 times more likely to wear masks than unemployed respondents. Conclusion: The level of knowledge of the residents in Sabah, Malaysia, about COVID-19 is quite satisfactory. Meanwhile, attitudes and practices towards COVID-19 differ according to the socio-demography of the population in Sabah.

The Effects Of Dry And Chilled Air On Tool Wear Behavior During Face Milling Of Inconel 718

Tool wear is one of the important criteria during the cutting process. It is mostly caused by the machining parameters, namely; cutting speed, feed rate, depth of cut, cooling condition, etc. This paper presents the behavior of cutting tool during dry and chilled air condition of face mill with the cutting speed of 20 to 40 m/min, the feed rate of 0.1 to 0.2 mm/tooth and axial depth of 0.1 mm. The analysis of variance (ANOVA) is applied to identify the significance of these factors effect on tool performance, later the mathematical model for the tool life prediction was developed. The investigation revealed that the cutting speed, feed rate dominating wear rate whilst the chilled air found to be marginally significant. Finally, the optimum condition for machining parameter for greater tool life can be obtained by the combination cutting speed of 20 m/min, the feed rate of 0.1 mm/tooth under chilled air condition. Implementation of chilled air contributed 7% improvement with 45 min compared to a dry condition. The study exhibited the round type insert of dry face milling is more prone to rapid flank wear than chilled air with no BUE appearance on the tool cutting edge

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Maximizing the Clinical Benefit of Radiotherapy in Solitary Plasmacytoma: An International Multicenter Analysis

Objective: Although local definitive radiotherapy (RT) is considered the standard of care for solitary plasmacytoma (SP), the optimal RT parameters for SP patients have not been defined. The aim of this retrospective study is to analyze the effectiveness of various RT doses, volumes, and techniques, as well as to define the relevant prognostic factors in SP. Methods: Between 2000 and 2019, 84 patients, including 54 with solitary bone plasmacytoma (SBP) and 30 with extramedullary plasmacytoma (EMP), underwent RT at six institutions. Results: The overall RT median dose was 42 Gy (range, 36.0–59.4). The median follow-up period was 46 months. Overall, the local control (LC) rate was 96%, while the complete remission (CR) rate was 46%. The 5-year local relapse-free survival (LRFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS), and overall survival (OS) rates were 89%, 71%, 55%, and 93%, respectively. Using an RT dose above 40 Gy was associated with a higher complete remission (CR) rate and a lower rate of local relapse. Modern irradiation techniques were associated with a trend toward a higher LC rate (98% vs. 87% for conventional, p = 0.09) and a significantly lower local relapse rate (6% vs. 25% for conventional, p = 0.04). However, RT dose escalation and technique did not lead to a significant effect on MMFS, PFS, and OS. Univariate analyses identified several patient characteristics as potentially relevant prognostic factors. In SBP patients, systemic therapy administration was associated significantly with MMFS and PFS rates. Conclusion: Using an RT dose >40 Gy and modern RT techniques may improve the local control and reduce the rate of relapse, without a significant impact on survival rates. The addition of systemic therapies may improve the MMFS and PFS rates of SBP patients