Pseudozyma aphidis bloodstream infection in a patient with aggressive lymphoma and a history of intravenous drug use: Case report and review of the literature

Pseudozyma aphidis is an environmental fungus which causes opportunistic infections in immunocompromised patients. Here we report the case of a 54-year-old, intravenous drug user woman, newly diagnosed to have an aggressive lymphoma, who developed a bloodstream infection caused by P. aphidis treated successfully with amphotericin-B therapy. The precise identification was assessed by sequencing. We propose to consider intravenous drug use as a risk factor for invasive infections due to this environmental yeast

Is medical device regulatory compliance growing as fast as extended reality to avoid misunderstandings in the future?

Purpose: European Extended Reality (XR) industry is expected to significantly increase by 2025 with an extreme impact on the Healthcare scenario. Considering that the transition period for the Medical Device Regulation 2017/745 (MDR 2017/745) will end in May 2024, purpose of this study is to assess whether the Medical Device Regulatory Compliance is ready to cope with the inclusion of XR and its possible social and economic impact in the world of medical device software (MDSW). Methods: XR publications patterns were evaluated since MDR 2017/745 release on different databases. European normative about MDSW are consulted, followed by the European Database of Medical Devices (EUDAMED). Results: The number of publications on XR have increased since 2017 and healthcare is the third highest-impacted subject area. Specific classes for software have been introduces in the European Nomenclature of Medical Devices (EMDN) and some XR applications have already been registered in EUDAMED classified as MDSW. Conclusions: XR will become intrinsic in everyday medical protocol and guidelines. The establishment of the IEEE Virtual Reality and Augmented Reality Working Group and the statement of VR for remoting surgery as a MDSW in MDCG 2019-11 are demonstration of the necessity of MD regulatory compliance in being able to keep up with the upcoming XR technologies. The Authors agree that the competent authorities should consider intervening in the European Regulative Compliance to cope with the revolution of Phygital in Healthcare and to regulate procedures involving the use of XR in medicine preventing future misunderstanding and criticalities especially for high risk situations

Ethics and biomedical engineering for well-being : a cocreation study of remote services for monitoring and support

The well-being of students and staff directly affects their output and efficiency. This study presents the results of two focus groups conducted in 2022 within a two-phase project led by the Applied Biomedical and Signal Processing Intelligent e-Health Lab, School of Engineering at the University of Warwick, and British Telecom within “The Connected Campus: University of Warwick case study” program. The first phase, by involving staff and students at the University of Warwick, aimed at collecting preliminary information for the subsequent second phase, about the feasibility of the use of Artificial Intelligence and Internet of Things for well-being support on Campus. The main findings of this first phase are interesting technological suggestions from real users. The users helped in the design of the scenarios and in the selection of the key enabling technologies which they considered as the most relevant, useful and acceptable to support and improve well-being on Campus. These results will inform future services to design and implement technologies for monitoring and supporting well-being, such as hybrid, minimal and even intrusive (implantable) solutions. The user-driven co-design of such services, leveraging the use of wearable devices and Artificial Intelligence deployment will increase their acceptability by the users

Prediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective study

Background: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients’ survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Methods: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. Results: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. Conclusions: We created a model able to predict CRE colonization at LT based on easy-to-obtain features that could guide antibiotic prophylaxis (Figure presented.)

The Impact of Covid-19 On Women Engineers In Sub-Saharan Africa

The Applied Biomedical Signal Processing Intelligent eHealth (ABSPIE) Lab performed 7 field studies in Sub-Saharan Africa, during which hospitals were visited. The multifaceted background of the lab members, including specialty areas such as biomedical engineering, health technology assessment, electrical engineering and bioethics, made possible a thorough analysis of the challenges faced in these low-resource settings. In particular, from these studies, it emerged that there is a limited number of available biomedical engineers and technicians (BMETs) in hospitals, as well as technicians skilled in the maintenance of medical devices. Moreover, the study highlighted how maintenance-related tasks are perceived as a degrading job for men as they are mainly performed daily life by women, whose number among BMETs in Africa is very low. Consequently, from our observations, it seems that the small number of BMETs and the gender-biased cultural perception of maintenance reduce the leadership of BMETs, thus resulting in incredibly low budgets, tools and training for maintenance tasks, which are vital for the safe and effective functioning of medical devices. Hence, we believe there is an urgent need to further study this phenomenon by leveraging local culture (i.e., matriarchal) to increase the leadership and numbers of BMETs in Sub-Saharan Africa, with a special focus on women in the profession. To validate our observations and hypotheses, we distributed questionnaires to African engineers (women and men. Armed with data gathered from this study, our major objective would then be to create in-loco awareness raising programs, in partnership with specific associations in order to increase the number of women accessing scientific studies in these settings, as well as to defeat gender bias, thus, increasing medical device maintenance practices in hospitals

A 3D-printed condom intrauterine balloon tamponade: Design, prototyping, and technical validation

: Post-partum haemorrhage is among the main causes of (preventable) mortality for women in low-resource settings (LRSs), where, in 2017, the mortality ratio was 462 out of every 100 000 live births, over 10 times higher than for high-resource settings. There are different treatments available for post-partum haemorrhage. The intrauterine balloon tamponade is a medical device that proved to be a simple and cost-effective approach. Currently, there are several balloon tamponades available, with different design and working principles. However, all these devices were designed for high-resource settings, presenting several aspects that could be inappropriate for many lower-income countries. This paper presents the results of a preclinical study aiming at informing the design, prototyping and validation of a 3D-printed intrauterine balloon tamponade concept, contributing towards the United Nation's Sustainable Development Goal 3: Good health and Well-being. Frugal engineering concepts and contextualised design techniques were applied throughout, to define the design requirements and specifications. The performance of the final prototype was validated against the requirements of the UK National Health System (NHS) technical guidelines and relevant literature, measuring the water leak and pressure drop over time, both open air and in a approximate uterus model. The resulting prototype is made up of six components, some of which are easy to retrieve, namely a water bottle, a silicone tube and an ordinary condom, while others can be manufactured locally using 3D printers, namely a modified bottle cap, a flow stopper and a valve for holding the condom in place. Validation testing bore promising results with no water or pressure leak open air, and minimal leaks in the approximate uterus model. This demonstrates that the 3D printed condom-based intrauterine balloon tamponade is performing well against the requirements and, when compared to the state of the art, it could be a more appropriate and more resilient solution to low-resource settings, as it bypasses the challenges in the supply of consumables and presents a greener option based on circular economy

The Ant Who Cried Wolf? Short-Term Repeated Exposure to Alarm Pheromone Reduces Behavioral Response in Argentine Ants

In this study we test whether Argentine ants (Linepithema humile) progressively reduce their response to a salient stimulus (alarm pheromone) with increased exposure over time. First, we used a two-chamber olfactometer to demonstrate three focal behaviors of Argentine ants that indicate an alarmed state in response to conspecific alarm pheromone and pure synthetic iridomyrmecin (a dominant component of L. humile alarm pheromone). We then measured how these behaviors changed after repeated exposure to conspecific alarm pheromone from live ants. In addition, we investigate whether there is a difference in the ants’ behavioral response after “short” (3 min) versus “long” (6 min) intervals between treatments. Our results show that Argentine ants do exhibit reduced responses to their own alarm pheromone, temporarily ceasing their response to it after four or five exposures, and this pattern holds whether exposure is repeated after “short” or “long” intervals. We suggest alarm pheromones may be perceived as false alarms unless threatening stimuli warrant a continued state of alarm. These results should be kept in mind while developing pheromone-based integrated pest management strategies