bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial and ethnic differences in unmet needs among older adults receiving publicly‐funded home and community‐based services
Authors: Fabius Chanee D. , Parikh Romil , Wolf Jack M. , Giordano Stephanie , Fashaw‐Walters Shekinah , Jutkowitz Eric , Shippee Tetyana
Published: August 2024

Background

Unmet need for home and community‐based services (HCBS) may disparately impact older adults from racial and ethnic minoritized groups. We examined racial and ethnic differences in unmet need for HCBS among consumers ≥65 years using publicly funded HCBS.

Methods

We analyzed the National Core Indicators‐Aging and Disability survey data (2015–2019) from 21,739 community‐dwelling HCBS consumers aged ≥65 years in 23 participating states. Outcome measures included self‐reported unmet need in six service types (i.e., personal care, homemaker/chore, delivered meals, adult day services, transportation, and caregiver support). Racial and ethnic groups included non‐Hispanic Black, Asian, non‐Hispanic White, Hispanic, and multiracial groups. Logistic regression models examined associations between race and ethnicity and unmet need, adjusting for sociodemographic, health, and HCBS program (i.e., Medicaid, Older Americans Act [OAA], Program for All‐Inclusive Care for the Elderly [PACE]) characteristics, and use of specific service types.

Results

Among 21,739 respondents, 23.3% were Black, 3.4% were Asian, 10.8% were Hispanic, 58.8% were non‐Hispanic White, and 3.7% were multiracial or identified with other races/ethnicities. Asian and Black consumers had higher odds of reporting unmet need in personal care than White consumers (adjusted odds ratio [aOR], 1.45, p value < 0.01; and aOR, 1.25, p < 0.001, respectively). Asian and Black consumers had significantly higher odds of unmet need in adult day services versus White consumers (aOR, 1.94, p < 0.001 and aOR, 1.39, p < 0.001, respectively). Black consumers had higher odds of unmet need versus non‐Hispanic White consumers in meal delivery and caregiver support services (aOR, 1.29; p < 0.01; and aOR 1.26, p < 0.05, respectively). Race and ethnicity were not significantly associated with experiencing unmet need for homemaker/chore or transportation services.

Conclusions

Future research should identify driving forces in disparities in unmet need to develop culturally appropriate solutions.
Qualitative evaluation of the SHARING Choices trial of primary care advance care planning for adults with and without dementia
Authors: Dy Sydney M. , Scerpella Daniel L. , Hanna Valecia , Walker Kathryn A. , Sloan Danetta H. , Green Chase Mulholland , Cotter Valerie , Wolff Jennifer L. , Giovannetti Erin Rand , McGuire Maura , Hussain Naaz , Smith Kelly M. , Saylor Martha Abshire
Published: August 2024

Background

Primary care can be an important setting for communication and advance care planning (ACP), including for those with dementia and their families. The study objective was to explore experiences with a pragmatic trial of a communication and ACP intervention, SHARING Choices, in primary care for older adults with and without dementia.

Methods

We conducted qualitative interviews using tailored semi‐structured guides with three groups: ACP facilitators who conducted the intervention; clinicians, managers, and administrators from sites randomized to the intervention; and patients and families who met with ACP facilitators. We used thematic analysis to identify and synthesize emergent themes based on key Consolidated Framework for Implementation Research concepts and Proctor's Implementation Outcomes, triangulating the three groups' perspectives.

Results

We identified five key themes. For acceptability, perceptions of the intervention were mostly positive, although some components were not generally implemented. For adoption, respondents perceived that ACP facilitators mainly focused on conducting ACP, although facilitators often did not implement the ADRD and family engagement aspects with the ACP. For relational connections, ACP facilitator—practice and clinician communication and engagement were key to how the intervention was implemented. For adaptability, ACP facilitators and health systems adapted how the ACP facilitation component was implemented to local preferences and over time, given the pragmatic nature of the trial. And, for sustainability, ACP facilitators and clinicians/managers/facilitators were positive that the intervention should be continued but noted barriers to its sustainability. Patients and families generally did not recall the intervention.

Conclusions

ACP facilitators and clinicians, managers, and administrators had positive perceptions of the ACP facilitator component of the intervention in this pragmatic trial with adaptation to local preferences. However, engaging those with dementia and families was more challenging in the implementation of this intervention.
Poration of mitochondrial membranes by amyloidogenic peptides and other biological toxins
Authors: Vassallo Neville
Published: August 2024

Mitochondria are essential organelles known to serve broad functions, including in cellular metabolism, calcium buffering, signaling pathways and the regulation of apoptotic cell death. Maintaining the integrity of the outer (OMM) and inner mitochondrial membranes (IMM) is vital for mitochondrial health. Cardiolipin (CL), a unique dimeric glycerophospholipid, is the signature lipid of energy‐converting membranes. It plays a significant role in maintaining mitochondrial architecture and function, stabilizing protein complexes and facilitating efficient oxidative phosphorylation (OXPHOS) whilst regulating cytochrome c release from mitochondria. CL is especially enriched in the IMM and at sites of contact between the OMM and IMM. Disorders of protein misfolding, such as Alzheimer's and Parkinson's diseases, involve amyloidogenic peptides like amyloid‐β, tau and α‐synuclein, which form metastable toxic oligomeric species that interact with biological membranes. Electrophysiological studies have shown that these oligomers form ion‐conducting nanopores in membranes mimicking the IMM's phospholipid composition. Poration of mitochondrial membranes disrupts the ionic balance, causing osmotic swelling, loss of the voltage potential across the IMM, release of pro‐apoptogenic factors, and leads to cell death. The interaction between CL and amyloid oligomers appears to favour their membrane insertion and pore formation, directly implicating CL in amyloid toxicity. Additionally, pore formation in mitochondrial membranes is not limited to amyloid proteins and peptides; other biological peptides, as diverse as the pro‐apoptotic Bcl‐2 family members, gasdermin proteins, cobra venom cardiotoxins and bacterial pathogenic toxins, have all been described to punch holes in mitochondria, contributing to cell death processes. Collectively, these findings underscore the vulnerability of mitochondria and the involvement of CL in various pathogenic mechanisms, emphasizing the need for further research on targeting CL‐amyloid interactions to mitigate mitochondrial dysfunction.

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Efficacy of hyaluronic acid in temporomandibular disorders evaluated with diagnostic criteria for temporomandibular disorders (DC/TMD)
Authors: Kukreja Pankaj , Kukreja Bhavna Jha , Marrapodi Maria Maddalena , Ronsivalle Vincenzo , Cicciù Marco , Minervini Giuseppe
Published: August 2024

Background

The study aimed to retrospectively assess the efficacy of hyaluronic acid (HA) in managing temporomandibular disorders (TMD) using the diagnostic criteria for temporomandibular disorders (DC/TMD). There has been an ongoing debate regarding the effectiveness of HA as a treatment option for TMD, which necessitated a thorough evaluation.

Methods

The review adhered to PRISMA guidelines conducted across eight different databases, including PubMed, Embase, Web of Science, Cochrane Library, Scopus, ScienceDirect, PsycINFO and CINAHL. The selection criteria included studies that evaluated the efficacy of HA in TMD patients, utilised DC/TMD, and were published in English. Data extraction and quality assessment were performed independently by two reviewers. ROB–2 tool was employed to assess methodological quality of the assessed studies.

Results

A total of 10 studies met the inclusion criteria. They demonstrated that HA was effective in improving various symptoms of TMD, such as pain, mouth opening and joint sounds over control group. But on the other end, platelet‐rich plasma (PRP) was found to be better than HA intervention in alleviation of TMD symptoms. However, the degree of improvement varied across the studies. Some studies reported adverse effects, but these were typically minor and transient. Risk of bias assessment was low in all the included studies.

Conclusion

The findings suggest that HA can be an effective treatment for TMD when evaluated with DC/TMD. However, the variation in effectiveness across studies indicates the need for individualised treatment planning and careful monitoring of adverse effects. Further research is needed to refine the treatment protocols and understand the long‐term effectiveness and safety of HA in TMD management.
Changes in Craniofacial Morphology Induced by Unilateral Nasal Obstruction in Mice of Different Ages
Authors: Hu Yun , Li Hegang
Published: August 2024

Background

Nasal obstruction in humans leads to mouth breathing and subsequent hypoxia in the entire body. Furthermore, nasal obstruction in growing children affects craniofacial growth and development.

Objective

To investigate the effects of unilateral nasal obstruction (UNO) on craniofacial growth in mice of different ages, particularly on the morphology of the nasomaxillary complex and mandible.

Methods

Mice aged 3, 6 and 12 weeks were selected as representatives of juvenile, adolescent and adult stages, respectively. A total of 30 male C57BL/6J mice (10 mice each at the ages of 3, 6 and 12 weeks) were used in this study for a 3‐week experiment. The mice in each age stage were randomly and evenly assigned to either the control group (C3+3, C6+3 and C12+3) or the experimental group (E3+3, E6+3 and E12+3). The UNO model in experimental group was constructed by plugging the mouse's left nostril, thereby disrupting its normal nasal breathing pattern and inducing hypoxia. The control group underwent the sham procedure. After 3 weeks, the length, width and height of the cranium, nasomaxillary complex and mandible of each group were measured on two‐dimensional images constructed by micro‐computed tomography. Furthermore, the impact of UNO on mouse growth was evaluated through the measurement of femoral length.

Results

In juvenile mice, UNO inhibited the growth of cranial width, cranial height and mandibular length. In adolescent mice, UNO impeded the growth of the femoral length, cranial length, nasomaxillary length and mandibular length. In adult mice, no significant negative effects of UNO on craniofacial growth were found.

Conclusion

Referring to the experimental results, in addition to actively treating nasal obstruction in patients, it is important to monitor the growth of the mandible in juveniles, as well as the nasomaxillary and mandibular growth in adolescents during orthodontic clinical practice.
Self‐efficacy and home dialysis: An integrative review
Authors: D'Souza Nicola A. , Abu‐Qamar Ma'en Zaid , Whitehead Lisa
Published: August 2024

Background

Enhancing patient confidence in their ability (self‐efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self‐efficacy in patients managing home dialysis.

Objectives

To identify self‐reported levels of self‐efficacy, the measurements used to assess self‐efficacy and the effectiveness of interventions to enhance self‐efficacy in patients undergoing home dialysis.

Design

An integrative review approach was employed using Whittemore and Knafl's methodology.

Methods

A comprehensive search was conducted to identify literature on self‐efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and Scopus databases without a date limit. The included literature was critically appraised for methodological quality. Data extraction was conducted to report the study characteristics, measurement tools used and interventions conducted along with the synthesis of findings in a narrative format.

Results

Fifteen studies were included in the review were predominantly quantitative examining training programmes promoting self‐efficacy in adults conducting home dialysis. The finding that self‐efficacy builds over time was structured into two themes; gaining skills to develop self‐efficacy and building and maintaining knowledge of self‐efficacy.

Conclusion

The findings highlighted the importance of employing multifaceted strategies with support from health professionals including nurses, families and peer support to develop self‐efficacy in patients undergoing home dialysis.
Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results
Authors: Zhang Rui , Wang Xiaoyu , Liu Shenghe , Qiu Shuo , Ruan Hongjiang , Kang Qinglin
Published: August 2024

Objectives

To introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes.

Methods

From January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist‐90‐Revised questionnaire. Paired two‐group t‐test was applied to compare the parameters.

Results

The mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74–83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117–134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow‐up plan with an average follow‐up time of 29.7 ± 3.4 months (range, 24–35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist‐90‐Revised questionnaire of each patient were improved after the whole procedure.

Conclusion

We demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure.
Efficacy and safety of intravenous ketamine treatment in Japanese patients with treatment‐resistant depression: A double‐blind, randomized, placebo‐controlled trial
Authors: Ohtani Yohei , Tani Hideaki , Nomoto‐Takahashi Kie , Yatomi Taisuke , Yonezawa Kengo , Tomiyama Sota , Nagai Nobuhiro , Kusudo Keisuke , Honda Shiori , Moriyama Sotaro , Nakajima Shinichiro , Yamada Takashige , Morisaki Hiroshi , Iwabuchi Yu , Jinzaki Masahiro , Yoshimura Kimio , Eiro Tsuyoshi , Tsugawa Sakiko , Ichijo Sadamitsu , Fujimoto Yu , Miyazaki Tomoyuki , Takahashi Takuya , Uchida Hiroyuki
Published: August 2024

Aim

Although the antidepressant effect of ketamine on treatment‐resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD.

Methods

In this double‐blind randomized placebo‐controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post‐treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score.

Results

Intention‐to‐treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (−8.1 ± 10.0 vs −2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per‐protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (−9.1 ± 10.2 vs −2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score.

Conclusion

Intravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations.
Risk management during times of health uncertainty in Spain: A qualitative analysis of ethical challenges
Authors: Macpherson Ignacio , Guardia Juan J. , Morales Isabel , Zárate Belén , Belda Ignasi , Simon Wendy R.
Published: August 2024

The study examines the reflections of various experts in risk management when asked about uncertainty generated by a health threat and the response to such a threat: what criteria should guide action when potential harm is anticipated, but not known with certainty? The objective of the research is to obtain a holistic perspective of ethical conflicts in risk management, based on experts’ accounts within the Spanish territory. A qualitative study was conducted through semi‐structured interviews with 27 experts from various fields related to health risk management and its ethical implications, following the grounded theory method. The method includes theory generation through an inductive approach, based on the identified categories. The 27 narratives obtained revealed a variety of fundamental issues grouped into 8 subcategories and subsequently grouped into three main categories. The first category focuses on human vulnerability in health matters. The second category explores the agents and instruments for decision‐making that arise from uncertain or traumatic social events. The third category refers to the need for common ethical paradigms for all humanity that implement justice over universal values. A main theory was suggested on the concept of responsibility in a global common good. There is an urgent need to assume this integrative responsibility as an inherent strategy in decision‐making. To achieve this, the involved actors must acquire specific humanistic training, conceptualizing fundamental ethical principles, and emphasizing skills more related to humanistic virtues than technical knowledge.
Hypothermic Peritoneal Perfusion of Cold Oxygenated Perfluorocarbon May Improve the Efficacy of Extracorporeal Oxygenation: A Mathematical Model-Based Analysis
Authors: Rezaei Parham , Leibowitz Joshua L. , KadkhodaeiElyaderani Behzad , Moon Yejin , Awad Morcos , Stachnik Stephen , Sarkar Grace , Shaw Anna E. , Naselsky Warren , Enofe Nosayaba , Stewart Shelby , Culligan Melissa J. , Friedberg Joseph S. , Yu Miao , Hahn Jin-Oh
Published: August 2024

Circulation of perfluorocarbon (PFC) through corporeal cavities has received interest by virtue of its potential to supplement oxygenation via mechanical ventilation. However, the technology is not mature enough for clinical application, due to the knowledge gaps regarding the limiting factors hampering oxygen transport from PFC to blood. In this paper, we investigate a novel hypothesis that hypothermic peritoneal perfusion of cold oxygenated PFC may improve oxygenation of blood by facilitating the diffusion of oxygen from PFC to blood. Our hypothesis originates from physics-inspired insights that both hypothermia and PFC cooling may increase PFC-to-blood oxygen tension gradient: (i) hypothermia may decrease venous oxygen tension while (ii) cooling PFC may increase oxygen tension therein by increasing its oxygen solubility. Using a physics-based mathematical model capable of simulating oxygen tension responses to mechanical ventilation and peritoneal PFC perfusion under normothermic and hypothermic conditions, we analyzed the effect of hypothermic peritoneal cold PFC perfusion on blood oxygenation. The results predicted that peripheral oxygen saturation may be improved by 5–10% by peritoneal perfusion of oxygenated 15 °C PFC at 32 °C body temperature compared with peritoneal perfusion of oxygenated 37.5 °C PFC at 37.5 °C body temperature. The results also predicted that cooling PFC may play a more meaningful role than hypothermia. Pending the investigation of adverse impact of hypothermia and cold PFC on homeostasis, hypothermic cold PFC perfusion may improve peritoneal oxygenation by facilitating diffusion.
Noninvasive Patient Monitoring with Ambient Sensors to Monitor Physical and Cognitive Health for Individuals Living with Alzheimer’s Disease
Authors: Johnson Brian Bradley
Published: August 2024

An estimated 6.2 million Americans aged 65 or older live with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias in the United States, and 55 million globally. Fall detection, prediction, and prevention patient monitoring technology for this population has not been widely adopted as the standard of care because of privacy concerns with artificial intelligent video surveillance and problematic user experience design with wearables. The current standard of care for falls is eyewitness or self-report and therefore highly susceptible to human error. Therefore, solutions need to be scalable, affordable, and clinically effective with broad technology user acceptance.

Despite many prevention and intervention methods that have been tried in past decades, falls remain the number one concern in aging care. The Centers for Medicare and Medicaid Services pay an enormous cost estimated at $50B per year on falls and fall related injuries. Human activity recognition with noninvasive ambient sensors is a versatile approach to patient monitoring as human movement can be translated into activities of daily living with sophisticated algorithms. This method does not use cameras and requires no contact with the body and thus it could be accepted at a higher rate than previous technologies and could therefore be adopted as the standard of care across the continuum.
A Benefit of Late Phase Design Studies: Design Verification Data Lensing
Authors: McLauchlan Arric E. , Patel Rakesh , Hayden David , Gokhale Apurva , Raghupathy Ramesh , Hario Neal , Falk Jeff
Published: August 2024

Process Integration and Design Optimization (PIDO) tools, which can connect and automate a series of computational processes forming an executable workflow with automated data input, analysis execution, and output collection, have an abundance of potential early in the life cycle of a product, but the utilization of these tools and approaches in late-phase programs can be every bit as valuable. One could even argue that the use of these tools to quickly find root causes and optimize final solutions is even more important in the late phases of a program, as the costs at these phases are much higher. PIDO tools and approaches can automate design iterations, allowing more designs to be tested in a shorter amount of time, which can help form a better understanding of the response space, and can in turn help determine the critical parameters of the system. These critical parameters can then be used to lens design verification (DV) data by drawing engineers' focus to the critical relationships of the DV data in order to make statistical observation about these influential factors controlling the system’s response. Potentially, this could be used to find process solutions to product issues without requiring expensive late-phase design changes. This article shows how this very approach was used on a prototype catheter’s hemostasis assembly to troubleshoot a leakage issue prior to locking-in the production tooling design.
Modeling and Simulation of Two Patient Single Ventilator Systemwith Simcenter Amesim
Authors: Wang Jing , Sivashankar Shiva , Arvanitis Elena , Reed Daniel
Published: August 2024

In this paper, we propose a simulation model using Simcenter Amesim for the two patient single ventilator setup. The model captures the connections and control of the mechanical components to ensure the proper ventilating function for pressure control mode. Using multiple model simulations with different lung parameter values, we demonstrate that two patients can be safely paired together on one ventilator if their lung compliances are similar. The modeling approach demonstrated herein can be used to quantify the impact of varying different parameters on the overall system performance and to accelerate the development of mechatronic medical devices.
Use of a Priming Package to Aid in Overcoming an Experiential Gap Resulting from the Differences in Functional Ability of Student Designers Versus Users
Authors: Sprigle Stephen , Drawdy Morgan
Published: August 2024

In the context of design, an experiential gap occurs when a disparity exists between the experiences of the target user and that of the designer. When designing for persons with disabilities, an experiential gap presents a challenge in addressing usability during the conceptual design process. In other words, the designer cannot grasp the differences in functional ability or the complexities of disability. This can hinder the design process as conceptual designs are developed and evaluated. This project used a priming package to better orient student designers to their project and unfamiliar target users. Using interviews with the design teams, guidelines for developing priming packages are proposed. The priming package should include a project brief and objective, desirable features list, background information, predicate technology, and stakeholder contact information. The purpose of the priming package was to allow the design team to kickstart design activities and to better prepare students to engage users and stakeholders. Student interviews confirmed that a benefit of the priming package was to improve early communication.
Design of a Newpleural Biopsy Device for Improved Procedural Efficacy
Authors: Bradshaw Catherine , Dheda Keertan , Esmail Aliasgar , Sivarasu Sudesh
Published: August 2024

Pleural biopsies are challenging procedures that rely heavily on the skill of the performing clinician as there is little to guide them other than the feel of the needle within the patient. This is especially true in resource-poor settings as the cost and availability of external imaging equipment (such as computed tomography, ultrasound scanners, or thoracoscopes), and the increased skill needed to use the equipment prohibits their regular usage during these procedures. As a result, basic cutting needle biopsies have high risks of causing damage to the lung when the needle is inserted past the pleural space, or low diagnostic rates as pleural tissue is often not included in the biopsies. However, despite these drawbacks, pleural biopsies are performed regularly, most notably for diagnosing tuberculous pleurisy in low- or middle-income countries. This paper proposes a new cutting needle design to firstly improve the yield of pleural tissue in the biopsies, and secondly, allow for multiple biopsies to be collected with a single insertion, minimising the risks usually associated with each needle insertion. Preliminary verification of the biopsy mechanism shows that multiple, separate, adequately sized biopsies are possible with this design.
Robotic Ultrasound for Remote Diagnostics: Design and Prototyping
Authors: Scholnik Lily , Nelson Carl A. , Christensen Jason
Published: August 2024

Ultrasound is a relatively low-cost, high-value imaging modality used in a variety of medical specialties. One of the challenges of deploying ultrasound more widely, especially in low-resource settings, pertains to the availability of the specific expertise needed. The premise of this research is that a telepresence approach may reduce this barrier and facilitate increased impact of ultrasound technology. In this paper, we present progress toward developing a robot for remote ultrasound diagnosis, with a focus on requirements specific to pediatric cardiology. Design objectives, constraints, and rationale are explained, and modeling and prototyping results are presented.
How to Design Wearable Devices to be Waterproof: Hearing Aid Engineered from the Inside Out to be Waterproof and Weatherproof
Authors: Borra Ganesh , Standish Craig
Published: August 2024

Hearing aids are medical-grade hearing healthcare devices that are built for superior sound quality and to encourage hearing aid wearers to live a more active lifestyle. With the introduction of on-ear sensor and rechargeable batteries, coupled with health and wellness features inspired an evolution in the benefit hearing aids could provide beyond aural rehabilitation. The ability to track physical activity came with the responsibility to ensure the hearing aids can withstand the heat, sweat, and varied environments they are subjected to. While most hearing aids today are designed to withstand wear and tear associated with being in constant contact with the wearer’s skin, in or around the ear, hearing aids continue to push the limits of the lifestyles the wearers maintain. The unique challenge with hearing aids is the use of glue is not allowed to seal the interfaces due to the increased sustainability and repairability emphasis. Further these devices have atmospheric acoustic openings to allow input sound to the mics. Since its introduction close to two decades ago, nanocoating technology has become a hearing aid industry standard that protects the device by acting as a first layer of defense from liquids, oils, and solids that may degrade the components of the hearing aids over time. The latest hearing aid design presented in this paper is engineered inside out, with multiple ingress protection barriers to ensure reliability of the product throughout its lifespan and to make it waterproof and weatherproof. A novel set of tests are designed and developed specifically to replicate the harshest conditions and use cases these wearable devices will come across in the real world application and the results show how the new design elements helped achieve successfully passing those tests.
Pneumatic Soft Robot Extensor for Hand Rehabilitation
Authors: Walters Brittany Heintz , Young Jhet Cooperrider , Muñoz Alissa , Han Yen-Lin
Published: August 2024

Impaired hand function, commonly presenting as impaired finger extension, is one of the most common motor deficits after stroke, and an affordable, accessible device for hand rehabilitation is needed. This paper discusses a soft robotic extensor designed to address finger extension deficits in stroke survivors. Intentionally diverging from glove-based concepts while focusing on enhancing patient accessibility, the soft robot extensor is a stand-alone device designed to fit under the flexed fingers of a patient with limited finger extension. When actuated with pressurized air, its elastomer structure straightens and extends the fingers. Preliminary evaluation of the device in 5 healthy adults (age, 21.00 ± 2.92 years; 3 females, 2 males) demonstrated finger range of motion with device actuation sufficient to perform 90% of functional hand tasks. Electromyography of the finger extensors revealed no significant muscle activity during device actuation, demonstrating that range of motion occurred from soft robot actuation versus voluntary muscle activation. Results from an adapted System Usability Scale demonstrated positive feedback from participants regarding usability. Results highlight the soft robot extensor’s potential as an accessible device for improving hand function and support continued device development.
An Innovative Needle Template for Initial Angulation in Needle-Based Procedures
Authors: Imanaka Rex , Padasdao Blayton , Konh Bardia
Published: August 2024

Needle angulation is often desired in needle-based procedures for precise targeting inside tissue and/or to avoid obstacles. It has been shown that needle-based procedures such as prostate brachytherapy could benefit from angular needle insertion, e.g., reaching targets that are not accessible via a straight shot or to bypass pubic arch interface. Recent research has also shown that angular needle insertions as well as needle bending could improve catheter implantation in high-dose-rate brachytherapy conformal to the prostate boundaries, and consequently improve the outcome of the procedure via improved dosimetric constraints. This work presents a novel needle guide template to facilitate needle’s initial angulation prior to puncture. The needle guide is designed with two parallel templates featuring similar grid patterns. The distance between the templates is adjustable, and the template proximal to the patient can rotate to achieve a desired needle angulation. The needle guide is primarily tested, and the access region is estimated.
Measuring Heart Rate Synchrony for a Patient-Music Therapist Dyad
Authors: Pemble Faith , Yarlagadda Harika , Clarke-Sather Abigail , Cevasco-Trotter Andrea , Sandbulte Jomara , Zhao T. Christina , Silverman Michael , Wang Sonya
Published: August 2024

Caregivers are essential to patient health and wellness, especially regarding infant patients. Stress on parent caregivers can impact parent-infant bonding and ultimately infant health. Music therapy has been shown to decrease stress for mothers of hospitalized infants. Implementing music therapy as an approach to decrease parent-caregiver stress may help reduce physiological signs of stress e.g. heart rate. Coordinated heart rate, or heart rate synchrony, may reflect trust building, therapeutic calming of the body, and stress reaction through participant-therapist interactions. This study investigates the feasibility of data collection and analysis as indicated by heart rate synchrony between an adult and a music therapist before, during, and after therapy sessions as a hypothesis for the translation of heart rate synchrony between parent-infant dyads.

Utilizing Garmin smartwatches and a secure data transfer system, vital signs data was collected and analyzed with MATLAB. Preliminary results reveal a pronounced synchrony between participant and music therapist during specific interaction phases. The study contributes to the evolving understanding of the complex physiological dynamics between dyads, particularly within the realm of music therapy. The identified synchrony underscores the potential significance of music therapy in fostering physiological alignment between participants, laying the foundation for future research in support of caregiver health and wellbeing.
Improved Portable Instrument Tracking System for Surgical Training
Authors: Nelson Victoria , Ang Han Wei (Kelvin) , Thengvall Simon , Nelson Carl A. , Li Hong , Suh Irene , Siu Ka-Chun
Published: August 2024

Surgeons in training have a limited opportunity to practice their skills in a realistic surgical environment. Surgical training models are expensive and are often single-use exercises involving consumable supplies. The goal of the work presented in this paper is to increase surgeon training time by developing a surgical training simulator that is portable, inexpensive, and offers a realistic surgical environment. To achieve this goal, the device must be easily assembled, compact, durable, resistant to loads experienced during transport, and can be integrated with virtual reality training modules. This device must also work with a variety of surgical instruments, since the surgeons will be supplying their own instruments for training. The simulation environment for this project is developed with the focus of simulating laparoscopic gallbladder surgery, with the potential of extending the simulation environment for other surgeries. This paper will outline the current state of the prototype and the design process for creating the prototype.
Compression Plating of Long Bone Fractures with Flexure-Based Compliant Locking Plates
Authors: Huxman Connor , Armstrong April , Updegrove Gary , Lewis Gregory , Butler Jared
Published: August 2024

A novel flexure-based compliant bone plate is proposed for long bone fracture compression. Locking screws can be used in all screw holes while compression is generated through pretensioning of flexible elements in the plate. Performance differences are characterized for the use of both titanium alloy and stainless steel in the proposed plate. Biomechanical simulations are performed with finite element analysis to determine the fracture surface compression characteristics. The proposed compliant plating technology may offer unique benefits of both locked and compression plating.
Cadaveric Evaluation of a Novel Convection-Enhanced Therapy Catheter System
Authors: Morales Brianna , Rossmeisl John , Rylander Chris
Published: August 2024

Convection-enhanced delivery is an experimental method for glioblastoma treatment. This work evaluates the Convection-Enhanced Therapy Catheter System (CETCS) by subjecting it to several cadaveric fetal bovine and porcine brain tests that replicate the anticipated future clinical use of the device.

CETCS includes a cannula containing six microneedles. First, the CETCS cannula and microneedle visibility were evaluated with CT imaging in cadaveric tissue. Second, the cannula and microneedles were subjected to a cadaveric tissue insertion test and evaluated for tissue accumulation postinsertion. This test was also performed with a silicone elastomer material similar to a predicate device. A third test evaluated the microneedle's ability to undergo a syringe drop test with 3, 10, and 20 mL water-filled syringes.

The results of this study prove that the CETCS cannula and microneedles are visible with CT imaging. CETCS and the predicate device material for the tissue insertion tests behave similarly, with an average tissue accumulation mass of 16.4 ± 3.6 mg and 21.4 ± 4.0 mg, respectively. The microneedles did not experience function-limiting damage with any attached syringes in the syringe drop test. The passing of all tests suggests that CETCS will satisfactorily meet regulatory testing milestones required for future clinical use.
Development of high on/off current ratio in p-type copper oxide thin-film transistors with a back-end-of-line compatible process
Authors: Kuo Chi-Yuan , Lin Wei-Chen , Lo Tsung-Tien , Shen Ching-Hsuan , Shen Ming-Yu , Lee Chia-Chan , Lin Chi-Ping , Lin Yuang-Ming , Huang Haw-Tyng , Yeh Po-Chun , Chen Hsin-Chu , Wu Chih-I
Published: August 2024

The objective of this study is to develop an efficient process to synthesize wafer scale p-type cuprous oxide (Cu2O) with the back-end-of-line (BEOL) compatible process (<400 °C). Metallic copper is deposited on SiO2/Si substrates followed by rapid thermal oxidation to oxidize it into large-area, uniform Cu2O. Bottom-gate Cu2O thin-film transistors (TFTs) were fabricated as gate dielectric on 100 nm thermal oxide. The results of the ID-VG curve demonstrate that we have successfully fabricated BEOL-compatible p-type Cu2O TFTs. The drain-off current can be achieved to 0.1 pA, with the highest on/off ratio reaching up to 6 orders. Significantly, the TFT with an on/off ratio of 106 is sufficient to meet the requirements for digital circuit applications, including logic circuits, and the BEOL-compatible process (<400 °C) can fulfill the demands of monolithic 3D integrated circuits, expanding the scope of functional integration applications. Additionally, positive bias stress reliability testing indicated a high-quality passivation layer. These findings suggest that material improvements have significantly enhanced the performance of Cu2O TFTs.
Large-field and high-resolution low-voltage scanning electron microscopy with correction of beam-image-shift-induced chromatic deflection aberration
Authors: Kizawa S. , Bizen D. , Suzuki K. , Mizutani S. , Watanabe R. , Kasai Y. , Mizuhara Y.
Published: August 2024

We present a chromatic deflection aberration-free beam-image-shifting technique for low-voltage scanning electron microscopy. The technique utilizes a Wien filter to correct the chromatic deflection aberration induced by the beam-image shift. Experimental results demonstrated that this method significantly improves spatial resolution across a large field of view (FOV) of 28 × 28 μm2, covered by the beam-image shift. By correcting the chromatic deflection aberration, the degradation rate of the spatial resolution at the corner of the FOV relative to its center reduced from a maximum of 16% to 8%. The developed Wien filter responded 60% faster than the beam-image shift, eliminating the need for additional settling time for correction. Furthermore, we applied the presented technique to semiconductor pattern measurement and showed significant potential to improve the critical dimension uniformity in the FOV covered by the beam-image shift. We believe that the proposed method provides a practical and cost-effective amelioration as a beam-image-shifting technique.
Evaluation of a novel multimode interfacial rheometer
Authors: Ashkenazi Daniel , Pham Kiet , Vermant Jan , Wagner Norman J. , Gottlieb Moshe
Published: August 2024

Determination of the rheological properties and the interfacial structure–property relationships for complex fluid–fluid interfaces can be of crucial importance for the understanding of physiological and biomedical systems, designing and engineering industrial processes, and developing environmental remediation technologies. For the measurement of interfacial shear rheological material functions, it has been determined that the control of the surface pressure during the application of deformation is essential for obtaining reproducible data especially when measuring complex interfaces, such as particle- and polymer-laden interfaces. Moreover, the study of complex fluid interfaces is complicated by kinematically mixed interfacial flow fields, which include both shear and dilatation (shape and area changes), leading to a possible complex flow history. To address this, specialized rheometers have been developed to provide clear kinematic conditions. For instance, a radial trough has been introduced to enhance the study of dilatational interfacial rheology, effectively solving the challenges posed by the mixed flow fields typical in standard rectangular Langmuir–Pockels (LP) troughs or pendant drops. In the present work, we utilize a new trough instrument, the Quadrotrough (QT), capable of performing on the same device (and sample) independent dilatational and shear deformations at the air/liquid interface under strain and surface pressure control. Brewster angle microscopy (BAM) imaging is carried out in situ simultaneously with rheological measurements. Thus, the QT embodies the combined advantages of the circular trough and the controlled surface pressure shear interfacial rheometer. The interfacial rheology of poly(tert-butyl methacrylate) at the air/water interface was measured for both pure dilatation and pure shear in steady and small amplitude oscillatory (SAO) dilatation (D) and shear (S) modes on the same interface. BAM images were obtained during shear and compression. The results obtained by the QT were highly reproducible and in good agreement with measurements performed previously using the LP trough-mounted double wall ring rheometer and the radial trough. The Hencky strain model was employed to derive steady shear and dilatational interfacial moduli. Very good agreement was observed between the steady and complex shear moduli. However, the dilatational moduli measured under steady compression were markedly smaller than those measured by small amplitude oscillatory dilatational at fixed molecular areas, further highlighting the complicating factor of deformation history on material properties for complex interfaces. In summary, the QT has been shown to be a valuable tool for exploring interfacial rheology and providing insights into complex interfacial systems.
Advanced multiparametric image spectroscopy and super-resolution microscopy reveal a minimal model of CD95 signal initiation
Authors: Bartels Nina , van der Voort Nicolaas T. M. , Opanasyuk Oleg , Felekyan Suren , Greife Annemarie , Shang Xiaoyue , Bister Arthur , Wiek Constanze , Seidel Claus A. M. , Monzel Cornelia
Published: August 2024

Unraveling the concentration-dependent spatiotemporal organization of receptors in the plasma membrane is crucial to understand cell signal initiation. A paradigm of this process is the oligomerization of CD95 during apoptosis signaling, with different oligomerization models being discussed. Here, we establish the molecular-sensitive approach cell lifetime Förster resonance energy transfer image spectroscopy to determine CD95 configurations in live cells. These data are corroborated by stimulated emission depletion microscopy, confocal photobleaching step analysis, and fluorescence correlation spectroscopy. We probed CD95 interactions for concentrations of ~10 to 1000 molecules per square micrometer, over nanoseconds to hours, and molecular to cellular scales. Quantitative benchmarking was achieved establishing high-fidelity monomer and dimer controls. While CD95 alone is primarily monomeric (~96%) and dimeric (4%), the addition of ligand induces oligomerization to dimers/trimers (~15%) leading to cell death. This study highlights molecular concentration effects and oligomerization dynamics. It reveals a minimal model, where small CD95 oligomers suffice to efficiently initiate signaling.