Testing of mechanical ventilators and infant incubators in healthcare institutions

Abstract Objectives: To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen. Methods: The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020. Results: A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61). Conclusions: Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.

Download Full-text

COVID-19 in conflict border regions: a case of South Kordofan, Sudan

Conflict and Health ◽

10.1186/s13031-021-00370-9 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Quraish Sserwanja ◽

Mohammed Bashir Adam ◽

Joseph Kawuki ◽

Emmanuel Olal

Keyword(s):

Case Fatality ◽

Mechanical Ventilators ◽

Governmental Organizations ◽

Non Governmental Organizations ◽

Bed Capacity ◽

Displaced People ◽

Set Up ◽

One Year ◽

Novel Coronavirus ◽

South Kordofan

AbstractThe novel coronavirus disease (COVID-19) was first reported in Sudan on 13 March 2020. Since then, Sudan has experienced one of the highest rates of COVID-19 spread and fatalities in Africa. One year later, as per 22 March 2021, Sudan had registered 29,661 confirmed cases and 2,028 deaths with a case fatality rate (CFR) of 6.8 %. By 12 December 2020, of the 18 states in Sudan, South Kordofan had the fifth highest CFR of 17.4 %, only surpassed by the other conflict affected North (57.5 %), Central (50.0 %) and East (31.8 %) Darfur States. By late March 2021, just three months from December 2020, the number of cases in South Kordofan increased by 100 %, but with a significant decline in the CFR from 17.4 to 8.5 %. South Kordofan is home to over 200,000 poor and displaced people from years of destructive civil unrests. To date, several localities such as the Nubba mountains region remain under rebel control and are not accessible. South Kordofan State Ministry of Health in collaboration with the federal government and non-governmental organizations set up four isolation centres with 40 total bed capacity, but with only two mechanical ventilators and no testing centre. There is still need for further multi-sectoral coalition and equitable allocation of resources to strengthen the health systems of rural and conflict affected regions. This article aims at providing insight into the current state of COVID-19 in South Kordofan amidst the second wave to address the dearth of COVID-19 information in rural and conflict affected regions.

Download Full-text

Low cost volume sensors for mechanical ventilators

IEEE Latin America Transactions ◽

10.1109/tla.2021.9451255 ◽

2021 ◽

Vol 19 (6) ◽

pp. 1083-1089

Author(s):

CAIO ARAUJO DAMASCENO ◽

AYLSON LOPES LEAL ◽

GABRYEL FIGUEIREDO SOARES ◽

GUSTAVO RETUCI PINHEIRO ◽

LUAN DA SILVA BEZERRA ◽

...

Keyword(s):

Low Cost ◽

Mechanical Ventilators

Download Full-text

Candida auris and Carbapenemase-Producing Organism Prevalence in an Extended Stay Pediatric Hospital, Chicago, Illinois, 2019

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.662 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s145-s146

Author(s):

Kelly Walblay ◽

Tristan McPherson ◽

Elissa Roop ◽

David Soglin ◽

Ann Valley ◽

...

Keyword(s):

The United States ◽

Multidrug Resistant ◽

Pediatric Hospital ◽

Mechanical Ventilators ◽

Candida Auris ◽

Term Care ◽

Healthcare Settings ◽

High Acuity ◽

Gastrostomy Tubes

Background:Candida auris and carbapenemase-producing organisms (CPO) are multidrug-resistant organisms that can colonize people for prolonged periods and can cause invasive infections and spread in healthcare settings, particularly in high-acuity long-term care facilities. Point-prevalence surveys (PPSs) conducted in long-term acute-care hospitals in the Chicago region identified median prevalence of colonization to be 31% for C. auris and 24% for CPO. Prevalence of C. auris colonization has not been described in pediatric populations in the United States, and limited data exist on CPO colonization in children outside intensive care units. The Chicago Department of Public Health (CDPH) conducted a PPS to assess C. auris and CPO colonization in a pediatric hospital serving high-acuity patients with extended lengths of stay (LOS). Methods: CDPH conducted a PPS in August 2019 in a pediatric hospital with extended LOS to screen for C. auris and CPO colonization. Medical devices (ie, gastrostomy tubes, tracheostomies, mechanical ventilators, and central venous catheters [CVC]) and LOS were documented. Screening specimens consisted of composite bilateral axillae and groin swabs for C. auris and rectal swabs for CPO testing. The Wisconsin State Laboratory of Hygiene tested all specimens. Real-time polymerase chain reaction (PCR) assays were used to detect C. auris DNA and carbapenemase genes: blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP (Xpert Carba-R Assay, Cepheid, Sunnyvale, CA). All axillae and groin swabs were processed by PCR and culture to identify C. auris. For CPO, culture was only performed on PCR-positive specimens. Results: Of the 29 patients hospitalized, 26 (90%) had gastrostomy tubes, 24 (83%) had tracheostomies, 20 (69%) required mechanical ventilation, and 3 (10%) had CVCs. Also, 25 (86%) were screened for C. auris and CPO; 4 (14%) lacked parental consent and were not swabbed. Two rectal specimens were unsatisfactory, producing invalid CPO test results. Median LOS was 35 days (range, 1–300 days). No patients were positive for C. auris. From CPO screening, blaOXA-48 was detected in 1 patient sample, yielding a CPO prevalence of 3.4% (1 of 29). No organism was recovered from the blaOXA-48 positive specimen. Conclusions: This is the first documented screening of C. auris colonization in a pediatric hospital with extended LOS. Despite a high prevalence of C. auris and CPOs in adult healthcare settings of similar acuity in the region, C. auris was not identified and CPOs were rare at this pediatric facility. Additional evaluations in pediatric hospitals should be conducted to further understand C. auris and CPO prevalence in this population.Funding: NoneDisclosures: None

Download Full-text

Extensive Countrywide Field Investigation of Somatic Cell Counts and Total Bacterial Counts in Bulk-Tank Raw Milk in Sheep Flocks in Greece

Foods ◽

10.3390/foods10020268 ◽

2021 ◽

Vol 10 (2) ◽

pp. 268

Author(s):

Daphne T. Lianou ◽

Charalambia K. Michael ◽

Natalia G. C. Vasileiou ◽

Efthymia Petinaki ◽

Peter J. Cripps ◽

...

Keyword(s):

Somatic Cell ◽

Geometric Mean ◽

Cell Counting ◽

Lactation Period ◽

Mechanical Ventilators ◽

Bulk Tank Milk ◽

Bacterial Counts ◽

Somatic Cell Counts ◽

Cell Counts ◽

Bulk Tank

Objectives were to investigate somatic cell counts (SCC) and total bacterial counts (TBC) in the raw bulk-tank milk of sheep flocks in Greece, to study factors potentially influencing increased SCC and TBC in the bulk-tank milk of sheep and to evaluate possible associations of SCC and TBC with milk content. Throughout Greece, 325 dairy sheep flocks were visited for collection of milk sampling for somatic cell counting, microbiological examination and composition measurement. Geometric mean SCC were 0.488 × 106 cells mL−1; geometric mean TBC were 398 × 103 cfu mL−1; 228 staphylococcal isolates were recovered form 206 flocks (63.4%). Multivariable analyses revealed annual incidence risk of clinical mastitis, age of the farmer and month into lactation period (among 53 variables) to be significant for SCC > 1.0 × 106 cells mL−1 and month into lactation period at sampling and availability of mechanical ventilators (among 58 variables) to be significant for TBC > 1500 × 103 cfu mL−1. Negative correlation of SCC with fat, total protein and lactose and positive correlation of SCC with added water were found. With SCC > 1.0 × 106 cells mL−1, significant reduction of protein content (2%) was observed, whilst in flocks with SCC > 1.5 × 106 cells mL−1, significantly lower annual milk production per ewe (42.9%) was recorded.

Download Full-text

Development of a Pulmonary Workshop for Organ Recovery Coordinators’ Continuing Medical Education

Progress in Transplantation ◽

10.1177/1526924820958113 ◽

2020 ◽

Vol 30 (4) ◽

pp. 372-375

Author(s):

Nicholas R. Henry ◽

Donna D. Gardner ◽

Nathan Rodrigues

Keyword(s):

Continuing Education ◽

Professional Education ◽

Organ Procurement ◽

Program Assessment ◽

Management Skills ◽

Mechanical Ventilators ◽

Hands On ◽

Before And After ◽

Specialized Education ◽

Organ Recovery

Organ recovery coordinators (ORCs) have varied professional education backgrounds; however, based on their specialized education, their training may not have included in-depth mechanical ventilation and pulmonary management. An 8-hour pulmonary workshop was developed in collaboration between an organ procurement organization and a university-based respiratory care department. The workshop focused on pulmonary management and hands-on laboratory exercises using mechanical ventilators. A program assessment questionnaire was completed by participants following the workshop, which requested their self-reported comfort/familiarity with pulmonary management skills before and after the workshop on a 5-point Likert scale. Following the pulmonary workshop, the mean ORC comfort/familiarity for all pulmonary management skills increased significantly ( P < .01). This program suggests ORCs can develop a greater awareness and comfort with pulmonary management by participating in a continuing education pulmonary workshop. Continuing education initiatives focused on pulmonary management of donor patients using hands-on competencies should be part of the ORCs practice improvement efforts.

Download Full-text

An Adaptive Neuro-Fuzzy Control of Pneumatic Mechanical Ventilator

Actuators ◽

10.3390/act10030051 ◽

2021 ◽

Vol 10 (3) ◽

pp. 51

Author(s):

Jozef Živčák ◽

Michal Kelemen ◽

Ivan Virgala ◽

Peter Marcinko ◽

Peter Tuleja ◽

...

Keyword(s):

Control System ◽

Control Algorithm ◽

Fuzzy Inference ◽

Fuzzy Controller ◽

Mechanical Design ◽

Mechanical Ventilator ◽

Mechanical Ventilators ◽

Inference System ◽

Control Approach ◽

Neuro Fuzzy

COVID-19 was first identified in December 2019 in Wuhan, China. It mainly affects the respiratory system and can lead to the death of the patient. The motivation for this study was the current pandemic situation and general deficiency of emergency mechanical ventilators. The paper presents the development of a mechanical ventilator and its control algorithm. The main feature of the developed mechanical ventilator is AmbuBag compressed by a pneumatic actuator. The control algorithm is based on an adaptive neuro-fuzzy inference system (ANFIS), which integrates both neural networks and fuzzy logic principles. Mechanical design and hardware design are presented in the paper. Subsequently, there is a description of the process of data collecting and training of the fuzzy controller. The paper also presents a simulation model for verification of the designed control approach. The experimental results provide the verification of the designed control system. The novelty of the paper is, on the one hand, an implementation of the ANFIS controller for AmbuBag pressure control, with a description of training process. On other hand, the paper presents a novel design of a mechanical ventilator, with a detailed description of the hardware and control system. The last contribution of the paper lies in the mathematical and experimental description of AmbuBag for ventilation purposes.

Download Full-text

Wireless communication integrated active noise control system for infant incubators

2013 IEEE International Conference on Acoustics, Speech and Signal Processing ◽

10.1109/icassp.2013.6637672 ◽

2013 ◽

Cited By ~ 3

Author(s):

Lichuan Liu ◽

Sen M. Kuo

Keyword(s):

Control System ◽

Wireless Communication ◽

Noise Control ◽

Active Noise Control ◽

Active Noise ◽

Infant Incubators

Download Full-text

Neonatal Mercury Vapor Exposure in an Infant Incubator

PEDIATRICS ◽

10.1542/peds.66.6.988 ◽

1980 ◽

Vol 66 (6) ◽

pp. 988-990

Author(s):

John F. McLaughlin ◽

Robert W. Telzrow ◽

Celia Mae Scott

Keyword(s):

Newborn Infant ◽

Body Burden ◽

Mercury Vapor ◽

Metallic Mercury ◽

Heating Unit ◽

Substantial Body ◽

Healthy Newborn ◽

Infant Incubator ◽

Infant Incubators

A healthy newborn infant acquired a substantial body burden of mercury by inhaling mercury vapor originating from a broken mercury expansion switch in the heating unit of an infant incubator. Highly toxic mercury vapor is produced in quantity by heating otherwise harmless metallic mercury. Switches and thermometers that contain mercury should be removed from infant incubators.

Download Full-text