Noninvasive Dynamic Characterization of Swallowing Kinematics and Impairments in High Resolution Cervical Auscultation via Deep Learning

Swallowing is a complex sensorimotor activity by which food and liquids are transferred from the oral cavity to the stomach. Swallowing requires the coordination between multiple subsystems which makes it subject to impairment secondary to a variety of medical or surgically related conditions. Dysphagia refers to any swallowing disorder and is common in patients with head and neck cancer and neurological conditions such as stroke. Dysphagia affects nearly 9 million adults and causes death for more than 60,000 yearly in the US. In this research, we utilize advanced signal processing techniques with sensor technology and deep learning methods to develop a noninvasive and widely available tool for the evaluation and diagnosis of swallowing problems. We investigate the use of modern spectral estimation methods in addition to convolutional recurrent neural networks to demarcate and localize the important swallowing physiological events that contribute to airway protection solely based on signals collected from non-invasive sensors attached to the anterior neck. These events include the full swallowing activity, upper esophageal sphincter opening duration and maximal opening diameter, and aspiration. We believe that combining sensor technology and state of the art deep learning architectures specialized in time series analysis, will help achieve great advances for dysphagia detection and management in terms of non-invasiveness, portability, and availability. Like never before, such advances will enable patients to get continuous feedback about their swallowing out of standard clinical care setting which will extremely facilitate their daily activities and enhance the quality of their lives

Structure analysis and enhancement of creep resistance and thermal properties of eutectic Sn-Ag lead free solder alloy by Ti and Cd - addition

Eutectic (Sn-3.5wt.%Ag) solder alloy is used in electronic circuits in which the creep property of the solder joints is essential for their applications. The study of creep, structure and thermal properties of three solder alloys (Sn-3.5wt.%Ag,Sn-3.5wt.%Ag-0.27wt.%Ti and Sn-3.5wt.Ag-0.27wt.%Cd) is characterized by the presence of (Ag3Sn-IMC) beside the phase (β-Sn). The microstructure parameters obtained from the X-ray analysis represented by, lattice parameters (a, c), the axial ratio (c/a), the residual strains (Δa/a0, Δc/c0) and peak height intensities (hkl) of some crystallographic planes are given. All parameters were found to be sensitive to the additions of (Ti or Cd), applied stresses and working temperatures in the range (298-373K).The crystallite size of the (211) reflection was found to increase from (61-132nm) with the additions and to decrease from (115-79nm) with the working temperatures. The morphological studies show a remarkable decrease in the size of (β-Sn) grains with the addition of (Cd) content which confirms the X-ray data. The obtained results show a decrease in melting temperature with the additions. The creep properties are notably improved by the addition of either (Ti) or (Cd). In order to reveal the creep characteristics such as stress exponent (n) and activation energy (Q), the tensile creep tests were performed within the temperature range (298-373K) at constant applied stress (17.27MPa). Based on the obtained stress exponents and activation energies, it is explained that the dominant deformation mechanism is dislocation climb over all temperature range. &nbsp

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

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

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

Abstract 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

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

Assessment of a combination between hard structures and sand nourishment eastern of Damietta harbor using numerical modeling

Damietta harbor was constructed in 1982 as an inland harbor with its 15 m depth navigation channel and two jetties acting like an obstacle to not allow sediment deposition in the harbor. On the other hand, they significantly affect the northern coast shoreline and hinder the sediment circulation in Damietta promontory. Satellite images show that new headlands are being implemented in the coastal shores of As-senaneyah. The proposed project consists of implementation of four headlands with length of 160 m, spacing of 400 m and using 150,000 m3 nourishment in those spacing between the hard structures only once during the construction time. Litpack 1D-model is used to predict shoreline responses to number of different five scenarios considered as combination between hard structures such as headlands and sand nourishment. A total number of 32 profiles were used to assess the shoreline changes along Gamasa, Damietta and Ras El-bar resort from 2010 to 2015. This study prevails a high erosion rate of the eastern and western shorelines of the proposed headlands. Nourishment of 200,000 m3/year is found to be a reasonable solution due to simplicity of being attained from Damietta harborâs annual dredged materials which was reported to be average of 1 million m3/year. Keywords: Numerical modeling, Damietta harbor, Egyptian shoreline changes, Inland harbo