micromachined flow sensors in biomedical applications

Application fields of micromachined devices are growing very rapidly due to the continuous improvement of three dimensional technologies of micro-fabrication. In particular, applications of micromachined sensors to monitor gas and liquid flows hold immense potential because of their valuable characteristics (e.g., low energy consumption, relatively good accuracy, the ability to measure very small flow, and small size). Moreover, the feedback provided by integrating microflow sensors to micro mass flow controllers is essential to deliver accurately set target small flows. This paper is a review of some application areas in the biomedical field of micromachined flow sensors, such as blood flow, respiratory monitoring, and drug delivery among others. Particular attention is dedicated to the description of the measurement principles utilized in early and current research. Finally, some observations about characteristics and issues of these devices are also reported

Prompt Application-Transparent Transaction Revalidation in Software Transactional Memory

Software Transactional Memory (STM) allows encapsulating shared-data accesses within transactions, executed with atomicity and isolation guarantees. The assessment of the consistency of a running transaction is performed by the STM layer at specific points of its execution, such as when a read or write access to a shared object occurs, or upon a commit attempt. However, performance and energy efficiency issues may arise when no shared-data read/write operation occurs for a while along a thread running a transaction. In this scenario, the STM layer may not regain control for a considerable amount of time, thus not being able to early detect if such transaction has become inconsistent in the meantime. To tackle this problem we present an STM architecture that, thanks to a lightweight operating system support, is able to perform a fine-grain periodic (hence prompt) revalidation of running transactions. Our proposal targets Linux and x86 systems and has been integrated with the open source TinySTM package. Experimental results with a port of the TPC-C benchmark to STM environments show the effectiveness of our solution

Preemptive Software Transactional Memory

In state-of-the-art Software Transactional Memory (STM) systems, threads carry out the execution of transactions as non-interruptible tasks. Hence, a thread can react to the injection of a higher priority transactional task and take care of its processing only at the end of the currently executed transaction. In this article we pursue a paradigm shift where the execution of an in-memory transaction is carried out as a preemptable task, so that a thread can start processing a higher priority transactional task before finalizing its current transaction. We achieve this goal in an application-transparent manner, by only relying on Operating System facilities we include in our preemptive STM architecture. With our approach we are able to re-evaluate CPU assignment across transactions along a same thread every few tens of microseconds. This is mandatory for an effective priority-aware architecture given the typically finer-grain nature of in-memory transactions compared to their counterpart in database systems. We integrated our preemptive STM architecture with the TinySTM package, and released it as open source. We also provide the results of an experimental assessment of our proposal based on running a port of the TPC-C benchmark to the STM environment

Model-Based Proactive Read-Validation in Transaction Processing Systems

Concurrency control protocols based on read-validation schemes allow transactions which are doomed to abort to still run until a subsequent validation check reveals them as invalid. These late aborts do not favor the reduction of wasted computation and can penalize performance. To counteract this problem, we present an analytical model that predicts the abort probability of transactions handled via read-validation schemes. Our goal is to determine what are the suited points-along a transaction lifetime-to carry out a validation check. This may lead to early aborting doomed transactions, thus saving CPU time. We show how to exploit the abort probability predictions returned by the model in combination with a threshold-based scheme to trigger read-validations. We also show how this approach can definitely improve performance-leading up to 14 % better turnaround-as demonstrated by some experiments carried out with a port of the TPC-C benchmark to Software Transactional Memory

Contactless Monitoring of Breathing Patterns and Respiratory Rate at the Pit of the Neck: A Single Camera Approach

Vital signs monitoring is pivotal not only in clinical settings but also in home environments. Remote monitoring devices, systems, and services are emerging as tracking vital signs must be performed on a daily basis. Different types of sensors can be used to monitor breathing patterns and respiratory rate. However, the latter remains the least measured vital sign in several scenarios due to the intrusiveness of most adopted sensors. In this paper, we propose an inexpensive, off-the-shelf, and contactless measuring system for respiration signals taking as region of interest the pit of the neck. The system analyses video recorded by a single RGB camera and extracts the respiratory pattern from intensity variations of reflected light at the level of the collar bones and above the sternum. Breath-by-breath respiratory rate is then estimated from the processed breathing pattern. In addition, the effect of image resolution on monitoring breathing patterns and respiratory rate has been investigated. The proposed system was tested on twelve healthy volunteers (males and females) during quiet breathing at different sensor resolution (i.e., HD 720, PAL, WVGA, VGA, SVGA, and NTSC). Signals collected with the proposed system have been compared against a reference signal in both the frequency domain and time domain. By using the HD 720 resolution, frequency domain analysis showed perfect agreement between average breathing frequency values gathered by the proposed measuring system and reference instrument. An average mean absolute error (MAE) of 0.55 breaths/min was assessed in breath-by-breath monitoring in the time domain, while Bland-Altman showed a bias of −0.03 ± 1.78 breaths/min. Even in the case of lower camera resolution setting (i.e., NTSC), the system demonstrated good performances (MAE of 1.53 breaths/min, bias of −0.06 ± 2.08 breaths/min) for contactless monitoring of both breathing pattern and breath-by-breath respiratory rate over time

Microfabricated tactile sensors for biomedical applications: a review

During the last decades, tactile sensors based on different sensing principles have been developed due to the growing interest in robotics and, mainly, in medical applications. Several technological solutions have been employed to design tactile sensors; in particular, solutions based on microfabrication present several attractive features. Microfabrication technologies allow for developing miniaturized sensors with good performance in terms of metrological properties (e.g., accuracy, sensitivity, low power consumption, and frequency response). Small size and good metrological properties heighten the potential role of tactile sensors in medicine, making them especially attractive to be integrated in smart interfaces and microsurgical tools. This paper provides an overview of microfabricated tactile sensors, focusing on the mean principles of sensing, i.e., piezoresistive, piezoelectric and capacitive sensors. These sensors are employed for measuring contact properties, in particular force and pressure, in three main medical fields, i.e., prosthetics and artificial skin, minimal access surgery and smart interfaces for biomechanical analysis. The working principles and the metrological properties of the most promising tactile, microfabricated sensors are analyzed, together with their application in medicine. Finally, the new emerging technologies in these fields are briefly described

Optoelectronic plethysmography in clinical practice and research: a review

Background: Optoelectronic plethysmography (OEP) is a non-invasive motion capture method to measure chest wall movements and estimate lung volumes. Objectives: To provide an overview of the clinical findings and research applications of OEP in the assessment of breathing mechanics across populations of healthy and diseased individuals. Methods: A bibliographic research was performed with the terms “opto-electronic plethysmography,” “optoelectronic plethysmography,” and “optoelectronic plethysmograph” in 50 digital library and bibliographic search databases resulting in the selection of 170 studies. Results: OEP has been extensively employed in studies looking at chest wall kinematics and volume changes in chest wall compartments in healthy subjects in relation to age, gender, weight, posture, and different physiological conditions. In infants, OEP has been demonstrated to be a tool to assess disease severity and the response to pharmacological interventions. In chronic obstructive pulmonary disease patients, OEP has been used to test if patients can dynamically hyperinflate or deflate their lungs during exercise. In neuromuscular patients, respiratory muscle strength and chest kinematics have been analyzed. A widespread application of OEP is in tailoring post-operative pulmonary rehabilitation as well as in monitoring volume increases and muscle contributions during exercise. Conclusions: OEP is an accurate and validated method of measuring lung volumes and chest wall movements. OEP is an appropriate alternative method to monitor and analyze respiratory patterns in children, adults, and patients with respiratory diseases. OEP may be used in the future to contribute to improvements in the therapeutic strategies for respiratory conditions

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