Digitizing tuberculosis treatment monitoring in Wuhan city, China, 2020–2021: Impact on medication adherence

IntroductionDigital technologies can improve adherence to tuberculosis (TB) treatment. We studied the impact of digitizing TB treatment monitoring on adherence among TB patients in Wuhan, China, during 2020-2021.MethodsWe compared an electronic system introduced to monitor TB medication adherence (e-Patient Service System; e-PSS) with the p paper-based standard of care (TB Control Information System; TCIS) in terms of prescribed TB treatment doses taken by patients and patient outcome after six months of follow up. We designed a cross sectional study using retrospective data for all drug susceptible pulmonary TB patients recorded on both systems. The main indicators were: compliant first follow up visit (within 3 days of start of treatment); medication adherence (80% or more of monthly doses taken); and end of treatment success ratio.ResultsA total of 1,576 TB patients were recorded in TCIS in July September, 2020 and 1,145 TB cases were included in e-PSS in January March, 2021. The distribution of patient demographic and clinical features was similar between the two groups. A larger proportion from the e-PSS group visited the community doctor in the first three days compared with the TCIS group (48.91 versus 29. 76 % respectively). Medication adherence was also higher in the e-PSS group during the 6 months of treatment than in the TCIS group (84. 28 versus 80.3 3 % respectively). Treatment success was 92.52% in the e-PSS group and 92.07% in the TCIS group. Multivariate logistic regress ion analysis demonstrated that adjusted odds ratios for compliant first follow up visit, medication adherence and favorable treatment outcome in the e-PSS versus TCIS groups were 2.94 (95% 2.47 3.50), 1.33 (95% 1.08 1.63), and 1. 12 (95% CL: 0.79 1.57) respectively.DiscussionThis study revealed improvements in TB care following an intervention to monitor treatment digitally in patients in Wuhan, China

Design of a Novel Haptic Joystick for the Teleoperation of Continuum-Mechanism-Based Medical Robots

Continuum robots are increasingly used in medical applications and the master–slave-based architectures are still the most important mode of operation in human–machine interaction. However, the existing master control devices are not fully suitable for either the mechanical mechanism or the control method. This study proposes a brand-new, four-degree-of-freedom haptic joystick whose main control stick could rotate around a fixed point. The rotational inertia is reduced by mounting all powertrain components on the base plane. Based on the design, kinematic and static models are proposed for position perception and force output analysis, while at the same time gravity compensation is also performed to calibrate the system. Using a continuum-mechanism-based trans-esophageal ultrasound robot as the test platform, a master–slave teleoperation scheme with position–velocity mapping and variable impedance control is proposed to integrate the speed regulation on the master side and the force perception on the slave side. The experimental results show that the main accuracy of the design is within 1.6°. The workspace of the control sticks is −60° to 110° in pitch angle, −40° to 40° in yaw angle, −180° to 180° in roll angle, and −90° to 90° in translation angle. The standard deviation of force output is within 8% of the full range, and the mean absolute error is 1.36°/s for speed control and 0.055 N for force feedback. Based on this evidence, it is believed that the proposed haptic joystick is a good addition to the existing work in the field with well-developed and effective features to enable the teleoperation of continuum robots for medical applications

Enhanced thermal conductivity of poly(vinylidene fluoride)/boron nitride nanosheet composites at low filler content

Due to the growing needs of thermal management in modern electronics, high thermal conductive polymer composites are increasingly demanded. Boron nitride nanosheet (BNNS) was prepared through molten hydroxide assisted liquid exfoliation of hexagonal boron nitride (h-BN) powder and used as thermally conductive filler. The poly(vinylidene fluoride) (PVDF)/BNNS films were obtained through solution blend and hot pressing. With only 4 wt% BNNS, the in-plane thermal conductivity of PVDF/BNNS composite achieved 4.69 W/mK, with a thermal conductivity enhancement of 2297% compared to neat PVDF. However, the through-plane thermal conductivity of the composites is only 0.23 W/mK, which shows a high thermal conductive anisotropy over 20. The thermal conductive anisotropy and the high in-plane thermal conductivity can be attributed to the formation of thermally conductive network in PVDF matrix. Thus, the BNNS reinforced PVDF films are promising for use as an efficient heat spreader for electronic cooling applications

Enhanced thermal conductivity of poly(vinylidene fluoride)/boron nitride nanosheet composites at low filler content

Due to the growing needs of thermal management in modern electronics, high thermal conductive polymer composites are increasingly demanded. Boron nitride nanosheet (BNNS) was prepared through molten hydroxide assisted liquid exfoliation of hexagonal boron nitride (h-BN) powder and used as thermally conductive filler. The poly(vinylidene fluoride) (PVDF)/BNNS films were obtained through solution blend and hot pressing. With only 4 wt% BNNS, the in-plane thermal conductivity of PVDF/BNNS composite achieved 4.69 W/mK, with a thermal conductivity enhancement of 2297% compared to neat PVDF. However, the through-plane thermal conductivity of the composites is only 0.23 W/mK, which shows a high thermal conductive anisotropy over 20. The thermal conductive anisotropy and the high in-plane thermal conductivity can be attributed to the formation of thermally conductive network in PVDF matrix. Thus, the BNNS reinforced PVDF films are promising for use as an efficient heat spreader for electronic cooling applications