Cautiously optimistic: paediatric critical care nurses' perspectives on data-driven algorithms in low-resource settings-a human-centred design study in Malawi.

Background: Paediatric critical care nurses face challenges in promptly detecting patient deterioration and delivering high-quality care, especially in low-resource settings (LRS). Patient monitors equipped with data-driven algorithms that monitor and integrate clinical data can optimise scarce resources (e.g.

A U - Net Deep Learning Model for Infant Heart Rate Estimation from Ballistography.

Ballistography(BSG) is a non-intrusive and low- cost alternative to electrocardiography (ECG) for heart rate (HR) monitoring in infants. Due to the inter-patient variance and susceptibility to noise, heartbeat detection in the BSG waveform remains a challenge. The aim of this study was to estimate HR from a bed-based pressure mat BSG signal using a deep learning approach.

Exploration of using a pressure sensitive mat for respiration rate and heart rate estimation.

Measuring the respiration and heart rate unobtrusively in home settings is an important goal for health monitoring. In this work, use of a pressure sensitive mat was explored. Two methods using body morphology information, based on shoulder blades and weighted centroid, were developed for respiration rate (RR) calculation.

Intelligent checklists improve checklist compliance in the intensive care unit: a prospective before-and-after mixed-method study.

Background: We examined whether a context and process-sensitive 'intelligent' checklist increases compliance with best practice compared with a paper checklist during intensive care ward rounds.

Methods: We conducted a single-centre prospective before-and-after mixed-method trial in a 35 bed medical and surgical ICU. Daily ICU ward rounds were observed during two periods of 8 weeks.

Investigation of a Ballistocardiogram-Based Technique for Unobtrusive Monitoring of Fluid Accumulation in the Body.

We introduce a novel monitoring solution for fluid accumulation in the human body (e.g. internal bleeding), based on observation of a selected energy-describing feature of the Ballistocardiogram (BCG) signal.

Evaluating the Performance of Cardiac Pulse Duplicators Through the Concept of Fidelity.

Introduction: The advanced design techniques used in modern prosthetic heart valve (PHV) development require accurate replication of the entire cardiac cycle. While cardiac pulse duplicator (CPD) design has a direct impact on the PHV test data generated, no clear guidelines exist to evaluate the CPD's performance. In response to this, we present a method to quantitatively assess CPD performance.

Development of a gesture and voice controlled system for burn injury prevention in individuals with disabilities.

Burn injury is a major public health issue in developing countries, with most injuries being largely associated with the use of kitchen stoves. This study details the development of a cost-effective gesture and voice recognition controlled (GVC) system to be used by individuals with disabilities to reduce the likelihood of burn injury and improve their quality of life. The device replaces conventional dial controls with voice and hand gesture recognition sensors and software which are designed to be easily implemented into a household kitchen.

Implementation of a manually operated blood pressure monitor based on energy harvesting for use in resource-constrained settings.

Health workers who screen for hypertension in rural and resource-constrained settings face many challenges including limited training, difficulties in correctly performing blood pressure (BP) measurements, and electrical grid unreliability. The aim of this study is to present the implementation of a manually operated BP monitor which assists health workers in overcoming some of these challenges by harvesting energy during manual cuff inflation and then discharging it in a controlled manner to power BP data acquisition, storage and wireless transmission. A prototype device was fabricated using a rotary alternator, flywheel and capacitor which harvests and stores energy when the bulb is squeezed during cuff inflation.

Development of a wearable support system to aid the visually impaired in independent mobilization and navigation.

Visually impaired individuals have great difficulty in navigating unfamiliar environments. Conventional methods of obstacle detection are not always sufficient, thus a need exists for a low-cost device which could aid the visually impaired in navigating indoor environments. The aim of this study is to develop a wearable prototype support system which aids the visually impaired in independent navigation and mobilization.

Investigation of the feasibility of non-invasive optical sensors for the quantitative assessment of dehydration.

This study explores the feasibility of prospectively assessing infant dehydration using four non-invasive, optical sensors based on the quantitative and objective measurement of various clinical markers of dehydration. The sensors were investigated to objectively and unobtrusively assess the hydration state of an infant based on the quantification of capillary refill time (CRT), skin recoil time (SRT), skin temperature profile (STP) and skin tissue hydration by means of infrared spectrometry (ISP). To evaluate the performance of the sensors a clinical study was conducted on a cohort of 10 infants (aged 6-36 months) with acute gastroenteritis.

Development of a diagnostic feedback device to assess neonatal cardiopulmonary resuscitation chest compression performance.

Neonatal cardiopulmonary resuscitation (NCPR) is an important intervention to save the lives of newborns who suffer from cardiac and respiratory arrest. Despite its importance there is a dearth of NCPR research and no commercially available feedback device suitable for use during NCPR. The aim of this study is to develop a diagnostic feedback device in the form of a patch placed on the infant's chest.

Towards an algorithm for automatic accelerometer-based pulse presence detection during cardiopulmonary resuscitation.

Manual palpation is still the gold standard for assessment of pulse presence during cardiopulmonary resuscitation (CPR) for professional rescuers. However, this method is unreliable, time-consuming and subjective. Therefore, reliable, quick and objectified assessment of pulse presence in cardiac arrest situations to assist professional rescuers is still an unmet need.

Evaluating the influence of ventilation and ventilation-compression synchronization on chest compression force and depth during simulated neonatal resuscitation.

Objectives: To investigate the influence of ventilation and ventilation-compression synchronization on compression force and sternal displacement during simulated neonatal cardiopulmonary resuscitation (NCPR) on an infant manikin.

Methods: Five Neonatal Resuscitation Program trained clinicians were recruited to perform simulated NCPR on an infant manikin using two-finger (TF) and two-thumb (TT) compression, with synchronous and asynchronous ventilation, as well as without ventilation. The sternal displacement and force were recorded and analyzed.

Development of diagnostic sensors for infant dehydration assessment using optical methods.

Dehydration resulting from acute diarrhea is one of the leading causes of infant mortality in the developing world. Safe assessment of an infant's hydration level is essential to determine appropriate clinical intervention strategies. However, clinical hydration scales, which are the current gold standard for non-invasive hydration assessment, are often unreliable in lower resource settings.

Development of a diagnostic dehydration screening sensor based on infrared spectrometry.

The clinical assessment of dehydration is highly subjective and requires experienced and highly trained clinical personnel. At present no objective method for quantitatively determining an individual's dehydration status exists. The aim of this study is to address this deficiency by presenting the development and testing of a novel diagnostic tool for dehydration detection based on infrared spectrometry.

Pulse detection with a single accelerometer placed at the carotid artery: Performance in a real-life diagnostic test during acute hypotension.

Pulse detection via palpation is a basic and essential procedure in daily medical practice. We have been investigating the performance of a single accelerometer placed above the carotid artery, which is one of the recommended locations for manual palpation. A low-cost sensor attached by an adhesive measures accelerations due to carotid dilatations and whole body vibrations.

Evaluation of the use of frequency response in the diagnosis of pleural effusion on a phantom model of the human lungs.

Pleural effusion is one of the most widespread respiratory diseases in the world. Current diagnostic techniques include a combination of medical history and x-ray or CT scan imaging of the chest. However, these techniques are expensive and impractical in resource limited settings.

Development of a real-time feedback algorithm for chest compression during CPR without assuming full chest decompression.

Objectives: To evaluate the performance of a real-time feedback algorithm for chest compression (CC) during cardiopulmonary resuscitation (CPR), which provides accurate estimation of the CC depth based on dual accelerometer signal processing, without assuming full CDC. Also, to explore the influence of incomplete chest decompression (CDC) on the CC depth estimation performance.

Methods: The performance of a real-time feedback algorithm for CC during CPR was evaluated by comparison with an offline algorithm using adult CPR manikin CC data obtained under various conditions.

The influence of leaflet skin friction and stiffness on the performance of bioprosthetic aortic valves.

Leaflet skin friction and stiffness were found to have a significant influence on the systolic performance of a 19 mm diameter bioprosthetic aortic valve based on fluid-structure interaction simulations at a heart rate of 72 bpm. Four different leaflet skin friction coefficients (0.0, 9.

Development of a diagnostic glove for unobtrusive measurement of chest compression force and depth during neonatal CPR.

Optimizing chest compression (CC) performance during neonatal cardiopulmonary resuscitation (CPR) is critical to improving survival outcomes since current clinical protocols often achieve only a fraction of the native cardiovascular perfusion. This study presents the development of a diagnostic tool to unobtrusively measure the CC depth and force during neonatal CPR using sensors mounted on a glove platform. The performance of the glove was evaluated by infant manikin tests using the two-thumb (TT) and two-finger (TF) methods of CC during simulated, unventilated neonatal CPR.

Development of a smart backboard system for real-time feedback during CPR chest compression on a soft back support surface.

The quality of cardiopulmonary resuscitation (CPR) is often inconsistent and frequently fails to meet recommended guidelines. One promising approach to address this problem is for clinicians to use an active feedback device during CPR. However, one major deficiency of existing feedback systems is that they fail to account for the displacement of the back support surface during chest compression (CC), which can be important when CPR is performed on a soft surface.

Experimental validation of the fluid-structure interaction simulation of a bioprosthetic aortic heart valve.

Experiments performed on a 19 mm diameter bioprosthetic valve were used to successfully validate the fluid-structure interaction (FSI) simulation of an aortic valve at 72 bpm. The FSI simulation was initialized via a novel approach utilizing a Doppler sonogram of the experimentally tested valve. Using this approach very close quantitative agreement (≤12.

A scoping review of important urinary catheter induced complications.

This study presents a scoping review of the literature on the morbidity and mortality associated with several common complications of urinary catheterization. Data gathered from the open literature were analyzed graphically to gain insights into the most important urinary catheter induced complications. The results reveal that the most significant catheter complications are severe mechanical trauma (perforation, partial urethral damage and urinary leakage), symptomatic bacterial infection, and anaphylaxis, catheter toxicity and hypersensitivity.

In vitro characterization of an aortic bioprosthetic valve using Doppler echocardiography and qualitative flow visualization.

A 19 mm diameter prototype bioprosthetic valve mounted in a cardiac pulse duplicator was characterized using Doppler echocardiography and qualitative flow visualization at a heart rate of 72 bpm. Analysis of the flow visualization images revealed that the prototype and control valve leaflets open symmetrically but close asymmetrically. The asymmetry in the closing of the valves is likely due to the large pressure gradients across the valves and may have implications for the long term mechanical failure of the valves.