Development of a Modular Activity-Specific Upper Limb Prosthesis

The use of activity-specific upper-limb prosthesis helps children with upper-limb loss to engage in functional and recreational activities, such as music and sports. The purpose of this study was to develop a modular activity-specific prosthesis and develop a remote-fitting procedure. We evaluated patient satisfaction after using the device for 8 weeks and evaluated anthropometric and range of motion (ROM) measurements of the residual limb after use of the prosthesis. We enrolled 7 children with unilateral trans-radial amputations between 7 and 12 years of age. The modular activity- specific prosthesis was specifically designed for playing musical instruments and sports. A survey was performed to evaluate items such as assistive device satisfaction, wear, comfort and use. Descriptive statistics were performed to calculate the mean and standard deviation of the scores recorded in the patient satisfaction survey. The larger standard deviations showed that the observations were more spread out which represents that the patients were satisfied after using the prosthesis after using it for 8 weeks. A dependent T-test was performed between the anthropometric and ROM measurements after use of the prosthesis. The main findings of this study were that an effective modular activity-specific prosthesis can be developed at a low-cost. Additionally, remote fitting procedures were developed. The results also showed that participants were satisfied with the devices after 8 weeks of use. Furthermore, we observed that for strength of the affected limb there was a significant main effect for wrist motion

A Real-Time Programmable Pulsatile Flow Pump for In-Vitro Cardiovascular Experimentation

Benchtop In-vitro experiments are valuable tools for investigating the cardiovascular system and testing medical devices. Accurate reproduction of physiologic flow waveforms at various anatomic locations is an important component of these experimental methods. This study discusses the design, construction and testing of a low-cost and fully programmable pulsatile flow pump capable of continuously producing unlimited cycles of physiologic waveforms. Two prototypes with different designs were tested. The first one consisted of a stepper motor – piston pump combination and tests showed that it failed to satisfy the design requirements. The second, highly successful prototype consists of a gear pump actuated by an AC servo-motor and a feedback algorithm enabling high accuracy for flow rates up to 300ml/s across a range of loading conditions. The iterative feedback algorithm uses flow error values in one iteration to modify motor control waveform for the next iteration to better match desired flow. Within 4-7 iterations of feedback, the pump replicated physiologic flow waveforms to high levels of accuracy (normalized RMS error less than 2%) under varying downstream impedances. This device is significantly more affordable (~10% of the cost) than current commercial options. Furthermore, the pump can be controlled via common scientific software packages and thus can be implemented in large automation frameworks

RT-Link: A Time-Synchronized Link Protocol for Energy-Constrained Multi-hop Wireless Networks

We propose RT-Link, a time-synchronized link protocol for real-time wireless communication in industrial control, surveillance and inventory tracking. RT-Link provides predictable lifetime for battery-operated embedded nodes, bounded end-to-end delay across multiple hops, and collision-free operation. We investigate the use of hardwarebased time-synchronization for infrastructure nodes by using an AM carrier-current radio for indoors and atomic clock receivers for outdoors. Mobile nodes are synchronized via in-band software synchronization within the same framework. We identify three key observations in the design and deployment of RT-Link: (a) Hardware-based global-time synchronization is a robust and scalable option to in-band softwarebased techniques. (b) Achieving global time-synchronization is both economical and convenient for indoor and outdoor deployments. (c) RT-Link achieves a practical lifetime of over 2 years. Through analysis and simulation, we show that RTLink outperforms energy-efficient link protocols such as BMAC in terms of node lifetime and end-to-end latency. The protocol supports flexible services such as on-demand endto- end rate control and logical topology control. We implemented RT-Link on the CMU FireFly sensor platform and have integrated it within the nano-RK real-time sensor OS. A 42-node network with sub-20us synchronization accuracy has been deployed for 3 weeks in the NIOSH Mining Research Laboratory and within two 5-story campus buildings

Spontaneous Spinal Extradural Hematoma : A Rare Neurosurgical Emergency Reply

Non peer reviewe

Spontaneous Spinal Epidural Hematoma : A Surgical Case Series of Ten Patients

BACKGROUND: Spontaneous spinal epidural hematoma (SS-EDH) is a rare neurosurgical emergency. Little is known about predictive factors of outcome in patients with SS-EDH. Here, we present a case series of patients operated on for an SS-EDH. METHODS: We reviewed all cases of patients operated on for an SS-EDH between January 2009 and February 2016 in a large academic neurosurgical center. We recorded preadmission functional status, bleeding characteristics, and postsurgery outcome. Good outcome was defined, according to the Nurick score, as at least being able to walk in a way that did not prevent employment. Mean follow-up time was 19 months (standard deviation, 25 months). RESULTS: Ten patients, with a mean age of 70 years (standard deviation, 10), with SS-EDH were included. The location of SS-EDH was binomially distributed, with the highest frequencies in the upper thoracic region (Th3-5) and middle to low cervical region (C4-6). Five patients had a poor outcome. Of these, 3 remained chair bound or bedridden. No statistically significant association could be found between preoperative characteristics and outcome, but patients with poor preoperative motor function, thoracic hematoma, and more than 4 involved segments had a high rate of poor neurologic outcome. We could not establish any association between time delay from symptom onset to surgery and outcome. CONCLUSIONS: In our series, half of the patients with SS-EDH recovered well after surgery. Although no statistically significant association could be established, hematoma location, size, and preoperative motor function seem to be some of the most important predictive factors of postoperative recovery.Peer reviewe

INVESTIGATION OF POTENTIAL ETIOLOGICAL CONTRIBUTORS TO PATHOMORPHOLOGICAL ASPECTS OF RENAL DAMAGE IN COVID-19 PATIENTS: A CROSS-SECTIONAL STUDY.

Background: The COVID-19 pandemic extends beyond respiratory issues. It impacts various organs, including the kidneys, leading to complications such as acute kidney injury. Objectives: This study aimed to examine the histological characteristics of kidney damage among individuals who succumbed to COVID-19 and to elucidate underlying factors contributing to renal pathology in individuals with COVID-19. Methods: Utilizing a cross-sectional design, data were extracted from the medical records of 301 patients at Darbhanga Medical College and Hospital in Bihar, India. The primary focus was on individuals concurrently afflicted with SARS-CoV-2 infection and various kidney conditions, encompassing acute kidney injury (AKI), chronic kidney disease (CKD), nephritic syndrome, nephrotic syndrome, etc. Diverse data elements, including demographics, clinical outcomes, treatment durations, diagnoses, and laboratory test results, were collected. Results: Key findings from this investigation revealed a positive correlation between elevated creatinine levels and older age, as well as an association between higher initial creatinine levels and shorter treatment duration. Notably, patients who did not survive exhibited significantly higher initial creatinine levels compared to discharged patients. Patients diagnosed with COVID-19 and AKI experienced an extended hospital stay compared to those without AKI. Moreover, individuals with AKI complicating CKD experienced a significantly extended hospitalization period compared to those without AKI. Importantly, individuals with AKI faced a substantially higher risk of mortality compared to subjects who were diagnosed with CKD only. Furthermore, individuals suffering from AKI had a considerably elevated risk of mortality when compared to individuals without CKD or AKI. Conclusion: This study highlights its impact on clinical outcomes, the importance of early creatinine measurement, and the risk associated with advanced age and AKI complications. Recommendation: Consider closely monitoring elderly individuals with COVID-19, as advanced age is identified as a significant risk factor for the development of AKI as a complication of CKD

CARDIOVASCULAR AND RENAL OUTCOME OF LIVING KIDNEY DONORS ON A LONG TERM.

Background: Removal of one or more kidneys may result in reduced renal parenchyma and GFR. Hence it is essential to gain proper knowledge of clinical symptoms before donating the kidney. The main aim of this study is to analyze the long-term renal and cardiovascular outcomes in living kidney donors. Materials and methods: It was a retrospective, observational study in a single center. A total of 62 living kidney donors from Darbhanga Medical College and Hospital in Laheriasarai, Bihar, from September 2022 to August 2023 were selected for this study. Their initial data (visit 0) from the time of the study to their last nephrological data (visit 1) were obtained and compared. Results: There was a huge drop in glomerular filtration rate which was about 28mL/min in a phase of 82±60 months. One donor underwent chronic kidney failure according to his last nephrological checkup (visit 1). There was no association between the age group and reduced glomerular filtration rate. Conclusion: The decrease in glomerular filtration rate as a consequence of kidney donation may cause an adverse reaction in renal and cardiovascular outcomes. Recommendation: The age of the donor does not signify the occurring consequences so older and healthy donor individuals are also recommended