A feasible route for the design and manufacture of customised respiratory protection through digital facial capture

AbstractThe World Health Organisation has called for a 40% increase in personal protective equipment manufacturing worldwide, recognising that frontline workers need effective protection during the COVID-19 pandemic. Current devices suffer from high fit-failure rates leaving significant proportions of users exposed to risk of viral infection. Driven by non-contact, portable, and widely available 3D scanning technologies, a workflow is presented whereby a user’s face is rapidly categorised using relevant facial parameters. Device design is then directed down either a semi-customised or fully-customised route. Semi-customised designs use the extracted eye-to-chin distance to categorise users in to pre-determined size brackets established via a cohort of 200 participants encompassing 87.5% of the cohort. The user’s nasal profile is approximated to a Gaussian curve to further refine the selection in to one of three subsets. Flexible silicone provides the facial interface accommodating minor mismatches between true nasal profile and the approximation, maintaining a good seal in this challenging region. Critically, users with outlying facial parameters are flagged for the fully-customised route whereby the silicone interface is mapped to 3D scan data. These two approaches allow for large scale manufacture of a limited number of design variations, currently nine through the semi-customised approach, whilst ensuring effective device fit. Furthermore, labour-intensive fully-customised designs are targeted as those users who will most greatly benefit. By encompassing both approaches, the presented workflow balances manufacturing scale-up feasibility with the diverse range of users to provide well-fitting devices as widely as possible. Novel flow visualisation on a model face is presented alongside qualitative fit-testing of prototype devices to support the workflow methodology.

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Respiratory Protection by Respirators: The Predictive Value of User Seal Check for the Fit Determination in Healthcare Settings

Infection Control and Hospital Epidemiology ◽

10.1086/659151 ◽

2011 ◽

Vol 32 (4) ◽

pp. 402-403 ◽

Cited By ~ 5

Author(s):

Simon Ching Lam ◽

Joseph Kok Long Lee ◽

Linda Yin King Lee ◽

Ka Fai Wong ◽

Cathy Nga Yan Lee

Keyword(s):

Electronic Device ◽

World Health ◽

Respiratory Pathogens ◽

Respiratory Protection ◽

Healthcare Settings ◽

The World ◽

Fit Testing ◽

Control And Prevention ◽

Health Organization ◽

N95 Respirators

The N95 respirator is one type that is recommended by the World Health Organization and the Centers for Disease Control and Prevention (CDC) to prevent inhalation of droplets that may act to transmit respiratory pathogens. However, the reliability of this respirator to prevent transmission is dependent on how well it is fitted to the wearer. For ill-fitting respirators, the average penetration by ambient aerosol was found to be 33%, compared with 4% for well-fitting respirators. Such penetration or leakage may be caused by the gap between the respirator and the wearer's face. Therefore, formal fit testing should be carried out prior to the use of N95 respirators. Quantitative fit testing measures “the adequacy of respirator fit by numerically measuring the amount of leakage into the respirator” using an electronic device.

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Electronic Data Management for Vaccine Trials in Low Resource Settings: Upgrades, Scalability, and Impact of ODK

Frontiers in Public Health ◽

10.3389/fpubh.2021.665584 ◽

2021 ◽

Vol 9 ◽

Author(s):

Michael Marks ◽

Sham Lal ◽

Hannah Brindle ◽

Pierre-Stéphane Gsell ◽

Matthew MacGregor ◽

...

Keyword(s):

Data Collection ◽

Clinical Research ◽

Data Management ◽

Open Source ◽

Large Scale ◽

Democratic Republic Of Congo ◽

World Health ◽

Electronic Data ◽

Diverse Range ◽

Electronic Data Collection

Background: ODK provides software and standards that are popular solutions for off-grid electronic data collection and has substantial code overlap and interoperability with a number of related software products including CommCare, Enketo, Ona, SurveyCTO, and KoBoToolbox. These tools provide open-source options for off-grid use in public health data collection, management, analysis, and reporting. During the 2018–2020 Ebola epidemic in the North Kivu and Ituri regions of Democratic Republic of Congo, we used these tools to support the DRC Ministère de la Santé RDC and World Health Organization in their efforts to administer an experimental vaccine (VSV-Zebov-GP) as part of their strategy to control the transmission of infection.Method: New functions were developed to facilitate the use of ODK, Enketo and R in large scale data collection, aggregation, monitoring, and near-real-time analysis during clinical research in health emergencies. We present enhancements to ODK that include a built-in audit-trail, a framework and companion app for biometric registration of ISO/IEC 19794-2 fingerprint templates, enhanced performance features, better scalability for studies featuring millions of data form submissions, increased options for parallelization of research projects, and pipelines for automated management and analysis of data. We also developed novel encryption protocols for enhanced web-form security in Enketo.Results: Against the backdrop of a complex and challenging epidemic response, our enhanced platform of open tools was used to collect and manage data from more than 280,000 eligible study participants who received VSV-Zebov-GP under informed consent. These data were used to determine whether the VSV-Zebov-GP was safe and effective and to guide daily field operations.Conclusions: We present open-source developments that make electronic data management during clinical research and health emergencies more viable and robust. These developments will also enhance and expand the functionality of a diverse range of data collection platforms that are based on the ODK software and standards.

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Sociodemographic Determinants of Physical Inactivity of People Aged 60 Years and Older: A Cross-Sectional Study in Poland

BioMed Research International ◽

10.1155/2020/7469021 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Elżbieta Biernat ◽

Monika Piątkowska

Keyword(s):

Physical Activity ◽

Physical Inactivity ◽

Large Scale ◽

Average Energy ◽

World Health Organisation ◽

Sociodemographic Factors ◽

Small Towns ◽

World Health ◽

Place Of Residence ◽

Cross Sectional

Purpose. The aim of the study was to evaluate general physical activity (PA) level on the basis of leisure time and transportation physical activity (LTPA and TPA), assess the percentage of persons not meeting PA recommendations by the World Health Organisation (WHO), and evaluate the relationship between selected sociodemographic factors and physical inactivity. Methods. The paper is based on data ( n = 7,347 ) retrieved from five large-scale surveys (2014-2018) used to collect information on the PA of Polish society. In order to meet the aim of the paper, we selected a sample of 2,023 Poles aged ≥ 60 years old. In each wave, the Polish long version of the International Physical Activity Questionnaire was used. Mann–Whitney U and Kruskal-Wallis tests were used to investigate the differences between the types and volume of PA and sociodemographic variables. Relationships between physical inactivity and analysed variables were evaluated using log-linear analysis. To capture relationships between physical inactivity and a set of explanatory variables, a predictive model was built. Results. The total average energy expenditure amounted to 1879.5 ± 2352.5 MET-min/week, including LTPA ( 938.5 ± 1491.9 MET-min/week) and TPA ( 944.8 ± 1322.4 MET-min/week). Over the course of the last two years of the study, the average value of MET-min/week increased significantly ( p < 0.05 ); however, prohealth WHO norms are not met by nearly 40% of Poles. Sex determines the volume of LTPA and TPA ( p < 0.05 ) but does not determine the inactivity of seniors. Place of residence and education differentiate participation in LTPA and TPA. The lower the education level and the smaller the place of residence, the greater the inactivity. Conclusions. The target for future interventions should be people aged 60+ living in villages and small towns (especially those with primary education). It is necessary to undertake educational and motivational programmes promoting PA. It is essential to develop detailed recommendations and to create a friendly and supportive environment.

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Is scaling-up COVID-19 testing cost-saving?

10.1101/2020.03.22.20041137 ◽

2020 ◽

Author(s):

Bernardo Sousa-Pinto ◽

João Almeida Fonseca ◽

Altamiro Costa-Pereira ◽

Francisco Nuno Rocha-Gonçalves

Keyword(s):

Cost Saving ◽

Large Scale ◽

Scale Up ◽

Scaling Up ◽

World Health ◽

Hospitalization Costs ◽

Testing Cost ◽

Additional Costs ◽

Economic Analyses ◽

Health Organization

The World Health Organization currently recommends that governments scale up testing for COVID-19 infection. We performed health economic analyses projecting whether the additional costs from screening would be offset by the avoided costs with hospitalizations. We analysed Portuguese COVID-19 data up until the 22nd March 2020, and estimated the additional number of cases that would be detected if different testing rates and frequencies of positive results would have been observed. We projected that, in most scenarios, the costs with scaling up COVID-19 tests would be lower than savings with hospitalization costs, rendering large scale testing cost-saving.

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The occupational effects of unconventional (custom-made) hearing protection for platinum mine workers

SA Journal of Industrial Psychology ◽

10.4102/sajip.v29i2.105 ◽

2003 ◽

Vol 29 (2) ◽

Cited By ~ 1

Author(s):

R. J. Steenkamp

Keyword(s):

Hearing Loss ◽

Large Scale ◽

Noise Exposure ◽

World Health Organisation ◽

World Health ◽

Hearing Protection ◽

Priority List ◽

Custom Made ◽

Hearing Protectors ◽

Mine Workers

Noise-induced hearing loss (NIHL) is on the priority list of the World Health Organisation (WHO). Hearing loss due to industrial noise exposure is the most prevalent industrial disease. Noise (above 85 dB) is not only a physical hazard, but also a psychological hazard that may create or exacerbate ergonomic or mechanical hazards. Conventional hearing protection devices (HPDs) are widely applied but also misused in the mining sector. In this investigation ownership and general attitudes were measured by determining how unconventional hearing protectors (custom-made hearing protectors) (CHPDs) is experienced by the mine- workers. The results could indicate whether these protectors, which is perceived by management to be costly, sophisticated and difficult to implement on a large scale, are a viable alternative to conventional hearing protectors. The results indicated certain positive directions in terms of quality hearing conservation and confirmed that CHPDs (with its unique features) do not only protect hearing but has several other occupational benefits. Opsomming Geraasdoofheid is op die prioriteitslys van die Wêreld Gesondheidsorganisasie (WHO). Gehoorverlies wat deur industriële geraasblootstelling veroorsaak word, word as die mees prominente beroepgesondheidsiekte beskou. Geraas (bo 85 dB) is nie net ’n fisiese risiko nie, maar hou ook ook psigologiese gevare in, wat ander meganiese en ergonomiese risiko’s kan veroorsaak of vererger. Konvensionele geraasdempers word op grootskaal in die mynsektor gebruik, maar ook wanaangewend. In hierdie ondersoek is eienaarskap en die algemene gesindhede van gebruikers gemeet deur te bepaal hoe onkonvensionele gehoorbeskermers (doelgemaakte gehoorbeskermers) deur die mynwerkers self ervaar word. Die resultate kan as ‘n aanduiding dien of hierdie beskermers, wat dikwels deur bestuur as duur, gesofistikeerd en moeilik op ‘n grootskaal implementeerbaar is, as ’n lewensvatbare alternatief tot konvensionele gehoorbeskermers oorweeg moet word. Die resultate toon sekere positiewe aspekte ten opsigte van gehalte gehoorkonservering en het bevestig dat doelgemaakte gehoorbeskermers (met hul unieke eienskappe) nie slegs gehoor beskerm nie, maar verskeie ander beroepsverwante voordele inhou.

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Meso/macroscopically multifunctional surface interfaces, ridges, and vortex-modified anode/cathode cuticles as force-driven modulation of high-energy density of LIB electric vehicles

Scientific Reports ◽

10.1038/s41598-019-51345-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 9

Author(s):

H. Khalifa ◽

S. A. El-Safty ◽

A. Reda ◽

M. A. Shenashen ◽

M. M. Selim ◽

...

Keyword(s):

Energy Density ◽

High Speed ◽

Large Scale ◽

Coulombic Efficiency ◽

Scale Up ◽

Lithium Ion ◽

High Energy ◽

High Energy Density ◽

Diverse Range

Abstract Modulation of lithium-ion battery (LIB) anodes/cathodes with three-dimensional (3D) topographical hierarchy ridges, surface interfaces, and vortices promotes the power tendency of LIBs in terms of high-energy density and power density. Large-scale meso-geodesics offer a diverse range of spatial LIB models along the geodetically shaped downward/upward curvature, leading to open-ended movement gate options, and diffusible space orientations. Along with the primary 3D super-scalable hierarchy, the formation of structural features of building block egress/ingress, curvature cargo-like sphere vehicles, irregularly located serrated cuticles with abundant V-undulated rigidness, feathery tube pipe conifers, and a band of dagger-shaped needle sticks on anode/cathode electrode surfaces provides high performance LIB modules. The geodetically-shaped anode/cathode design enables the uniqueness of all LIB module configurations in terms of powerful lithium ion (Li+) movement revolving in out-/in- and up-/downward diffusion regimes and in hovering electron density for high-speed discharge rates. The stability of built-in anode//cathode full-scale LIB-model meso-geodesics affords an outstanding long-term cycling performance. The full-cell LIB meso-geodesics offered 91.5% retention of the first discharge capacity of 165.8 mAhg−1 after 2000 cycles, Coulombic efficiency of ~99.6% at the rate of 1 C and room temperature, and high specific energy density of ≈119 Wh kg−1. This LIB meso-geodesic module configuration may align perfectly with the requirements of the energy density limit mandatory for long-term EV driving range and the scale-up commercial manufactures.

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Telehealth Demand Trends in COVID-19: An Infodemiological Evaluation of the Top 50 Most Affected Countries (Preprint)

10.2196/preprints.24445 ◽

2020 ◽

Author(s):

Mark Yu Zheng Wong ◽

Dinesh Visva Gunasekaran ◽

Simon Nusinovici ◽

Charumathi Sabanayagam ◽

Khung Keong Yeo ◽

...

Keyword(s):

Latin American ◽

Scale Up ◽

World Health Organisation ◽

The United States ◽

World Health ◽

Information Communications Technology ◽

The World ◽

The Mean ◽

Ict Infrastructure ◽

June July

BACKGROUND The COVID-19 pandemic has led to urgent calls for the adoption of telehealth solutions. However, public interest and demand for telehealth during the pandemic remains unknown. OBJECTIVE We used an infodemiological approach to estimate the demand for telehealth services during COVID-19 globally, focusing on the 50 most-affected countries and comparing the demand for such services with the level of information-communications technology (ICT) infrastructure available. METHODS We used Google Trends, the Baidu Index (China), and the Yandex Keyword Statistics (Russia) to extract data on worldwide and individual countries’ telehealth-related internet searches from 1st January to 7th July, 2020, presented as “Relative Search Volumes” (RSV, ranging 0-100). Daily COVID-19 cases and deaths were retrieved from the World Health Organisation. Individual countries’ ICT infrastructure profile were retrieved from the World Economic Forum Report. RESULTS Across the 50 countries, the mean±SD RSV was 18.5±23.2, and the mean ICT index was 62.1±15.0. An overall spike in worldwide telehealth-related RSVs was observed from 11th March 2020 (RSV peaked to 76.0), which then tailed off in June-July 2020 (mean RSV for period=25.8), but remained higher than pre-March RSVs (mean=7.29). By country, 42 (84%) manifested increased RSVs over the evaluation period, with the highest observed in Canada (RSV=100) and the United States (RSV=96). When evaluating associations between RSV and ICT index, the US and Canada demonstrated both high RSVs and ICTs (≥70.3). In contrast, European countries had relatively lower RSVs (ranging 3.4-19.5) despite high ICTs (mean=70.3). Several Latin-American (Brazil, Chile, Colombia), and South-Asian (India, Bangladesh, Pakistan) countries demonstrated relatively higher RSVs (ranging 13.8-73.3) but low ICTs (mean=44.6), indicating that the telehealth demand outstrips the current ICT infrastructure. CONCLUSIONS There is generally increased interest and demand for telehealth services across the 50 countries most affected by COVID-19, highlighting the need to scale up telehealth capabilities, during and beyond COVID-19. CLINICALTRIAL

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Electronic Data Management in Public Health and Humanitarian Crises. Upgrades, Scalability and Impact of ODK

10.21203/rs.3.rs-52854/v1 ◽

2020 ◽

Author(s):

Michael Marks ◽

Sham Lal ◽

Hannah Brindle ◽

Pierre-Stéphane Gsell ◽

Matthew MacGregor ◽

...

Keyword(s):

Public Health ◽

Data Collection ◽

Clinical Research ◽

Data Management ◽

Open Source ◽

Large Scale ◽

World Health ◽

Electronic Data ◽

Diverse Range ◽

Health And Social Care

Abstract BackgroundODK provides software and standards that are popular solutions for off-grid electronic data collection and are the basis of related products like CommCare, Enketo, Ona, SurveyCTO and KoBoToolbox. In combination with the use of statistical analysis software such as R, these tools provide fully open-source options for off-grid use in public health data collection, management, analysis and reporting.ResultsNew functions were developed to facilitate the use of ODK, Enketo and R in large scale data collection, aggregation, monitoring and near-real-time analysis during clinical research in health emergencies. We present open-source enhancements to ODK that include a built-in audit-trail, a framework and companion app for biometric registration of ISO/IEC 19794-2 fingerprint templates, enhanced performance features, better scalability for studies featuring millions of data form submissions, increased options for parallelisation of research projects, and pipelines for automated management and analysis of data. We also developed novel encryption protocols for enhanced web-form security in Enketo. During the 2018-2020 Ebola epidemic in the North Kivu & Ituri regions of Democratic Republic of Congo, ODK, Enketo and R were leveraged to support the DRC Ministère de la Santé RDC and World Health Organization in their efforts to administer an experimental vaccine (VSV-Zebov-GP) as part of their strategy to control the transmission of infection. Against the backdrop of a complex and challenging epidemic response, our enhanced platform of open tools was used to collect and manage data from more than 280,000 eligible study participants who received VSV under informed consent. These data were used to determine whether the VSV-Zebov-GP was safe and effective and to guide daily field operations.ConclusionsWe present open source developments that make electronic data management during clinical research and health emergencies more viable and robust. These developments will also enhance and expand the functionality of a diverse range of data collection platforms (Ona, KoBoToolbox etc.) that are based on the ODK software and standards.FundingThis research is funded by the Department of Health and Social Care using UK Aid funding and is managed by the NIHR (PR-OD-1017-20001).

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Analysis of Serological Biomarkers of SARS-CoV-2 Infection in Convalescent Samples From Severe, Moderate and Mild COVID-19 Cases

Frontiers in Immunology ◽

10.3389/fimmu.2021.748291 ◽

2021 ◽

Vol 12 ◽

Author(s):

Javier Castillo-Olivares ◽

David A. Wells ◽

Matteo Ferrari ◽

Andrew C. Y. Chan ◽

Peter Smith ◽

...

Keyword(s):

Large Scale ◽

World Health Organisation ◽

Epidemiological Studies ◽

Antibody Responses ◽

Clinical Severity ◽

World Health ◽

Binding Assays ◽

Neutralising Antibodies ◽

Antibody Assays ◽

Binding Antibody

Precision monitoring of antibody responses during the COVID-19 pandemic is increasingly important during large scale vaccine rollout and rise in prevalence of Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV-2) variants of concern (VOC). Equally important is defining Correlates of Protection (CoP) for SARS-CoV-2 infection and COVID-19 disease. Data from epidemiological studies and vaccine trials identified virus neutralising antibodies (Nab) and SARS-CoV-2 antigen-specific (notably RBD and S) binding antibodies as candidate CoP. In this study, we used the World Health Organisation (WHO) international standard to benchmark neutralising antibody responses and a large panel of binding antibody assays to compare convalescent sera obtained from: a) COVID-19 patients; b) SARS-CoV-2 seropositive healthcare workers (HCW) and c) seronegative HCW. The ultimate aim of this study is to identify biomarkers of humoral immunity that could be used to differentiate severe from mild or asymptomatic SARS-CoV-2 infections. Some of these biomarkers could be used to define CoP in further serological studies using samples from vaccination breakthrough and/or re-infection cases. Whenever suitable, the antibody levels of the samples studied were expressed in International Units (IU) for virus neutralisation assays or in Binding Antibody Units (BAU) for ELISA tests. In this work we used commercial and non-commercial antibody binding assays; a lateral flow test for detection of SARS-CoV-2-specific IgG/IgM; a high throughput multiplexed particle flow cytometry assay for SARS-CoV-2 Spike (S), Nucleocapsid (N) and Receptor Binding Domain (RBD) proteins); a multiplex antigen semi-automated immuno-blotting assay measuring IgM, IgA and IgG; a pseudotyped microneutralisation test (pMN) and an electroporation-dependent neutralisation assay (EDNA). Our results indicate that overall, severe COVID-19 patients showed statistically significantly higher levels of SARS-CoV-2-specific neutralising antibodies (average 1029 IU/ml) than those observed in seropositive HCW with mild or asymptomatic infections (379 IU/ml) and that clinical severity scoring, based on WHO guidelines was tightly correlated with neutralisation and RBD/S antibodies. In addition, there was a positive correlation between severity, N-antibody assays and intracellular virus neutralisation.

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Implementing a Two-Tiered Model of Optometry Training in Mozambique as an Eye Health Development Strategy

Global Journal of Health Science ◽

10.5539/gjhs.v11n9p13 ◽

2019 ◽

Vol 11 (9) ◽

pp. 13

Author(s):

Diane van Staden ◽

James Loughman ◽

Kovin Naidoo

Keyword(s):

Development Strategy ◽

Scale Up ◽

Training Model ◽

World Health Organisation ◽

World Health ◽

Comparative Approach ◽

Situational Analysis ◽

Eye Health ◽

Health Strategy

BACKGROUND: The global burden of vision impairment has been acknowledged by the World Health Organisation as a public health challenge. In order to scale up the production of eye health personnel in developing countries, a tiered model of optometry training was explored in Mozambique. OBJECTIVES: The Mozambique case study was evaluated to assess the feasibility of a tiered model of optometry training as a developmental eye health strategy. METHODS: A qualitative, case study approach was used. Semi-structured key informant interviews were conducted and project documents were reviewed in the data collection phase. Data underwent a process of content analysis, using a constant comparative approach across sources, and was analysed thematically using inductive reasoning. RESULTS: Three key themes which emerged were Rationale for a training model, Implementation considerations and Development practice considerations. Results demonstrated that while tiered models of training may have developmental rationale, awareness of the profession and its place in addressing health needs, intensive consultation with local stakeholders and a thorough situational analysis are required for this strategy to be feasible. CONCLUSIONS: A tiered model of training appears to have theoretical basis as a developmental eye health strategy. However, local applicability and legislative alignment is required in order for these training initiatives to be sustainably implemented.

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