Search Results (6)

Robotic ultrasound scanning has excellent potential to reduce physician workload, obtain higher-quality imaging, and reduce costs. However, the traditional admittance control strategy for robotics cannot meet the high-precision force control requirements for robots, which are critical for improving image quality and ensuring patient safety. In this study, an integral adaptive admittance control strategy is proposed for contact force control between an ultrasound probe and human skin to enhance the accuracy of force tracking. First, a robotic ultrasound scanning system is proposed, and the system’s overall workflow is introduced. Second, an adaptive admittance control strategy is designed to estimate the uncertain environmental information online, and the estimated parameters are used to modify the reference trajectory. On the basis of ensuring the stability of the system, an integral controller is then introduced to improve the steady-state response. Subsequently, the stability of the proposed strategy is analysed. In addition, a gravity compensation process is proposed to obtain the actual contact force. Finally, through a simulation analysis, the effectiveness of the strategy is discussed. Simultaneously, a series of experiments are carried out on the robotic ultrasound scanning system, and the results show that the strategy can successfully maintain a constant contact force under soft uncertain environments, which effectively improves the efficiency of scanning. Full article

Sweat-rate measurement has received more and more attention, especially for specific groups, such as athletes, soldiers and manual workers, due to their excessive sweat loss under prolonged intense heat stress, which increases the risk of dehydration and electrolyte imbalance. The highly effective manufacture of a sweat-sensing device is essential to its wide range of applications in perspiration-related physiological information detection. In this work, we propose a simple and cost-effective strategy for the manufacture of a microfluidic sweat-rate-sensing patch via laser cutting and transfer printing technology. A copper foil tape is used as the electrode for in situ admittance based sweat-rate-sensing. The detection circuits and measurement conditions are optimized to prevent the negative effect of an electrochemical reaction between a copper electrode and sweat for precise admittance measurement. In vitro and on-body experiments demonstrate that the copper electrode is applicable for admittance-based sweat sensing and is capable of achieving equivalent sensing accuracy as a gold electrode and that the proposed sensor structure can perform consecutive and accurate sweat-rate-sensing and facilitates a significant increase in manufacturing efficiency. Full article

Acute chemical intoxication represents one of the major causes of Emergency Room admittance, and possible errors in diagnosis are extremely frequent, especially when patients present generic and non-specific symptoms. Diquat, a bipyridyl class of herbicides, exerts high intrinsic toxicity as a consequence of free oxygen radicals, leading to cellular death and organ dysfunctions. Following ingestion, with the major source of absorption for suicidal purposes, the chemical induces local irritating effects; systemic symptoms appear later, while specific symptoms can occur in the following 48 h. A smoker and hypertensive 50-year-old man arrives at the E.R., reporting that an episode of herbicide inhalation occurred few hours earlier. Physical examination evidenced alkalosis with hypoxemia, leucocytosis, mild hyperglycaemia and moderate increase in creatine kinase and myoglobin. Despite blood creatine kinase and myoglobin values that were higher than normal, he was prescribed with hydration and anti-pain therapy. During the night, the man left the hospital; he returned the next morning at 8:45 a.m., with cardiorespiratory arrest, medium fixed non-reactive mydriasis, diffused cyanosis of the skin and of the mucous membranes, as well as imperceptible pulse and peripheral pressure. Despite resuscitation attempts, the patient died at 9:30 a.m.; the body was immediately transferred to the morgue. Autopsy and toxicological analyses were carried out nine days later, evidencing paraquat ingestion for suicidal purposes. GC/MS analyses to verify the presence of diquat were performed on body fluids and gastric and colon contents; all specimens resulted positive, thus confirming the cause of death as herbicide ingestion (blood diquat concentration of 1.2 mg/L; more than twice the minimum to observe a systemic poisoning). The procedure followed for patient management resulted to be not in line with the provisions of both guidelines and good clinical practices. Staff did not perform clinical-diagnostical monitoring of the patient’s condition or ask for more specific analyses (i.e., serum creatine phosphokinase monitoring). This misconduct led to a decrease in the patient’s chances to survive. Full article

Staphylococcus epidermidis, ubiquitous in the human nasal and skin microbiota, is a common causative microorganism in prosthetic joint infections (PJIs). A high proportion of PJI isolates have been shown to harbor genetic traits associated with resistance to/tolerance of agents used for antimicrobial prophylaxis in joint arthroplasties. These traits were found within multidrug-resistant S. epidermidis (MDRSE) lineages of multiple genetic backgrounds. In this study, the aim was to study whether MDRSE lineages previously associated with PJIs are present in the nasal and skin microbiota of patients planned for arthroplasty surgery but before hospitalization. We cultured samples from nares, inguinal creases, and skin over the hip or knee (dependent on the planned procedure) taken two weeks (median) prior to admittance to the hospital for total joint arthroplasty from 66 patients on agar plates selecting for methicillin resistance. S. epidermidis colonies were identified and tested for the presence of mecA. Methicillin-resistant S. epidermidis (MRSE) were characterized by Illumina-based whole-genome sequencing. Using this method, we found that 30/66 (45%) of patients were colonized with MRSE at 1–3 body sites. A subset of patients, 10/66 (15%), were colonized with MDRSE lineages associated with PJIs. The qacA gene was identified in MRSE isolates from 19/30 (63%) of MRSE colonized patients, whereas genes associated with aminoglycoside resistance were less common, found in 11/30 (37%). We found that MDRSE lineages previously associated with PJIs were present in a subset of patients’ pre-admission microbiota, plausibly in low relative abundance, and may be selected for by the current prophylaxis regimen comprising whole-body cleansing with chlorhexidine-gluconate containing soap. To further lower the rate of S. epidermidis PJIs, the current prophylaxis may need to be modified, but it is important for possible perioperative MDRSE transmission events and specific risk factors for MDRSE PJIs to be investigated before reevaluating antimicrobial prophylaxis. Full article

In this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th–7th decades, with mortality rates that reach 70%. The infection usually advances through the superficial fascial layers of the perineum and abdomen and affects the skin. In our case the infection also affected the spermatic fasciae and advanced in the abdominal and pelvic cavities, abdominal muscles, and surrounding soft tissues. Subsequent debridement left the patient with large soft tissue and muscle defects and an open abdominal cavity that needed reconstruction. We designed two pedicled tensor fascia lata flaps with extra fascia for abdominal support. Healing was marked by a pseudomonas aeruginosa infection that led to skin graft sloughing and marginal wound breakdown, which was treated with antibiotics and local wound care. Eventually the wounds healed, and the patient left the hospital 11 weeks after admittance. The outcome of the case was good considering the initial extent of the infection. The cosmetic shortcomings were not shared by the patient and future scar corrections are planned. Full article

The electrodermal activity (EDA) is a reliable physiological signal for monitoring the sympathetic nervous system. Several studies have demonstrated that EDA can be a source of effective markers for the assessment of emotional states in humans. There are two main methods for measuring EDA: endosomatic (internal electrical source) and exosomatic (external electrical source). Even though the exosomatic approach is the most widely used, differences between alternating current (AC) and direct current (DC) methods and their implication in the emotional assessment field have not yet been deeply investigated. This paper aims at investigating how the admittance contribution of EDA, studied at different frequency sources, affects the EDA statistical power in inferring on the subject’s arousing level (neutral or aroused). To this extent, 40 healthy subjects underwent visual affective elicitations, including neutral and arousing levels, while EDA was gathered through DC and AC sources from 0 to 1 kHz. Results concern the accuracy of an automatic, EDA feature-based arousal recognition system for each frequency source. We show how the frequency of the external electrical source affects the accuracy of arousal recognition. This suggests a role of skin susceptance in the study of affective stimuli through electrodermal response. Full article