Low-Cost and Easily Fabricated Ultrasound-Guided Breast Phantom for Breast Biopsy Training

We aimed to develop an inexpensive and easy-to-fabricate gelatin-based training phantom for improving the breast biopsy skill and confidence level of residents. Young’s modulus and acoustic properties of the gelatin tissue phantom and simulated tumors were investigated. Six residents were requested to evaluate the effectiveness of the breast phantom. The results showed that 83% (n = 5) of the participants agreed that the ultrasound image quality produced by the breast phantom was excellent or good. Only 17% (n = 1) of the participants claimed that there was room for improvement for the haptic feedback they received during the placement of the core needle into the breast phantom. The mean pre-instructional score was 17% (SD 17%) for all participants. The mean post-instructional score was 83% (SD 17%), giving an overall improvement of 67%. In conclusion, the mean needle biopsy skill and confidence levels of the participants substantially increased through simulation training on our breast phantom. The participants’ feedback showed the phantom is sufficiently realistic in terms of ultrasound imaging and haptic feedback during needle insertion; thus, the training outcome can be linked to the performance of residents when they perform a live biopsy.

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Low-cost and easily fabricated ultrasound-guided breast phantom for breast biopsy training

10.21203/rs.2.19957/v1 ◽

2020 ◽

Author(s):

Si Yen Ng ◽

Yao-Lung Kuo ◽

Chi-Lun Lin

Keyword(s):

Simulation Training ◽

Haptic Feedback ◽

Breast Biopsy ◽

Low Cost ◽

Ultrasound Image ◽

Acoustic Properties ◽

Benign Tumors ◽

Ultrasound Guided ◽

Breast Phantom ◽

The Mean

Abstract Background: We developed an inexpensive and easy-to-fabricate gelatin-based breast biopsy training phantom and evaluated its effectiveness in improving the biopsy skill level and confidence level of residents.Methods: Six residents were requested to evaluate the effectiveness of the double-layered breast phantom, which contained a malignant tumor, two benign tumors, and a cyst. The Young’s modulus and acoustic properties of the gelatin tissue phantom and simulated tumors were investigated.Results: The result showed that 83% (n=5) of the participants agreed that the ultrasound image quality produced by the breast phantom was excellent or good. However, only 17% (n=1) of the participants claimed that there was room of improvement for the haptic feedback they received during the placement of core needle into the breast phantom. The mean pre-instructional score was 17% (SD 33%) for all participants. The mean post-instructional score was 83% (SD 33%), giving an overall improvement of 1.32/2 mean scores. The mean needle biopsy skill and confidence levels of the participants substantially increased through simulation training on our breast phantom.Conclusions: The proposed breast phantom can be easily fabricated by a resident for breast biopsy training. Simulation training using our breast phantom can improve a resident's confidence when performing challenging ultrasound-guided breast biopsy. According to the participants’ feedback, our breast phantom is sufficiently realistic in terms of ultrasound imaging and haptic feedback during needle insertion; thus, the training outcome can be linked to the performance of residents when they perform a live biopsy.

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A gaming system with haptic feedback to improve upper extremity function: A prospective case series

Technology and Disability ◽

10.3233/tad-200319 ◽

2021 ◽

pp. 1-12

Author(s):

Hamilton Hernandez ◽

Isabelle Poitras ◽

Linda Fay ◽

Ajmal Khan ◽

Jean-Sébastien Roy ◽

...

Keyword(s):

Upper Extremity ◽

Haptic Feedback ◽

Low Cost ◽

Case Series ◽

Performance Measure ◽

Occupational Performance ◽

Canadian Occupational Performance Measure ◽

Prospective Case Series ◽

Paediatric Rehabilitation ◽

Therapeutic Settings

BACKGROUND: Video games can be used to motivate repetitive movements in paediatric rehabilitation. Most upper limb videogaming therapies do not however include haptic feedback which can limit their impact. OBJECTIVE: To explore the effectiveness of interactive computer play with haptic feedback for improving arm function in children with cerebral palsy (CP). METHODS: Eleven children with hemiplegic CP attended 12 therapist-guided sessions in which they used a gaming station composed of the Novint Falcon, custom-built handles, physical supports for the child’s arm, games, and an application to manage and calibrate therapeutic settings. Outcome measures included Quality of Upper Extremity Skills Test (QUEST) and Canadian Occupational Performance Measure (COPM). The study protocol is registered on clinicaltrials.gov (NCT04298411). RESULTS: Participants completed a mean of 3858 wrist extensions and 6665 elbow/shoulder movements during the therapist-guided sessions. Clinically important improvements were observed on the dissociated and grasp dimensions on the QUEST and the performance and satisfaction scales of the COPM (all p< 0.05). CONCLUSION: This study suggests that computer play with haptic feedback could be a useful and playful option to help improve the hand/arm capacities of children with CP and warrants further study. The opportunities and challenges of using low-cost, mainstream gaming software and hardware for therapeutic applications are discussed.

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Utility-Scale PV-Battery versus CSP-Thermal Storage in Morocco: Storage and Cost Effect under Penetration Scenarios

Energies ◽

10.3390/en14154675 ◽

2021 ◽

Vol 14 (15) ◽

pp. 4675

Author(s):

Ayat-allah Bouramdane ◽

Alexis Tantet ◽

Philippe Drobinski

Keyword(s):

Storage Capacity ◽

Low Cost ◽

Thermal Storage ◽

Solar Pv ◽

Storage Duration ◽

Maximum Cost ◽

Pv Inverter ◽

The Mean ◽

Mean Variance Portfolio ◽

Utility Scale

In this study, we examine how Battery Storage (BES) and Thermal Storage (TES) combined with solar Photovoltaic (PV) and Concentrated Solar Power (CSP) technologies with an increased storage duration and rental cost together with diversification would influence the Moroccan mix and to what extent the variability (i.e., adequacy risk) can be reduced; this is done using recent (2013) cost data and under various penetration scenarios. To do this, we use MERRA-2 climate reanalysis to simulate hourly demand and capacity factors (CFs) of wind, solar PV and CSP without and with increasing storage capabilities—as defined by the CSP Solar Multiple (SM) and PV Inverter Loading Ratio (ILR). We adjust these time series to observations for the four Moroccan electrical zones over the year 2018. Our objective is to maximize the renewable (RE) penetration and minimize the imbalances between RE production and consumption considering three optimization strategies. We analyze mixes along Pareto fronts using the Mean-Variance Portfolio approach—implemented in the E4CLIM model—in which we add a maximum-cost constraint to take into account the different rental costs of wind, PV and CSP. We propose a method to calculate the rental cost of storage and production technologies taking into account the constraints on storage associated with the increase of SM and ILR in the added PV-BES and CSP-TES modules, keeping the mean solar CFs fixed. We perform some load bands-reduction diagnostics to assess the reliability benefits provided by each RE technology. We find that, at low penetrations, the maximum-cost budget is not reached because a small capacity is needed. The higher the ILR for PV, the larger the share of PV in the mix compared to wind and CSP without storage is removed completely. Between PV-BES and CSP-TES, the latter is preferred as it has larger storage capacity and thus stronger impact in reducing the adequacy risk. As additional BES are installed, more than TES, PV-BES is favored. At high penetrations, optimal mixes are impacted by cost, the more so as CSP (resp., PV) with high SM (resp., ILR) are installed. Wind is preferably installed due to its high mean CF compared to cost, followed by either PV-BES or CSP/CSP-TES. Scenarios without or with medium storage capacity favor CSP/CSP-TES, while high storage duration scenarios are dominated by low-cost PV-BES. However, scenarios ignoring the storage cost and constraints provide more weight to PV-BES whatever the penetration level. We also show that significant reduction of RE variability can only be achieved through geographical diversification. Technological complementarity may only help to reduce the variance when PV and CSP are both installed without or with a small amount of storage. However, the diversification effect is slightly smaller when the SM and ILR are increased and the covariances are reduced as well since mixes become less diversified.

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Economic Burden of Colorectal Cancer: A Case of Fars, Iran

Cancer Control ◽

10.1177/10732748211009952 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110099

Author(s):

Abdosaleh Jafari ◽

Peyman Mehdi Alamdarloo ◽

Mehdi Dehghani ◽

Peivand Bastani ◽

Ramin Ravangard

Keyword(s):

Colorectal Cancer ◽

Economic Burden ◽

Purchasing Power Parity ◽

Annual Cost ◽

Low Cost ◽

Direct Costs ◽

Fars Province ◽

Power Parity ◽

Medical Sciences ◽

The Mean

Among cancers, colorectal cancer is the third most common cancer in the world and the fourth leading cause of cancer deaths worldwide. Some studies have shown that the incidence of colorectal cancer is increasing in Iran and in Fars province. The present study aimed to determine the economic burden of colorectal cancer in patients referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences in 2019 from the patients’ perspective. This is a partial economic evaluation and a cost-of-illness study conducted cross-sectionally in 2019. All the patients with colorectal cancer who had been referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences, and had medical records were studied through the census method (N = 96). A researcher-made data collection form was used to collect the cost data. The prevalence-based and bottom-up approaches were also used in this study. The human capital approach was applied to calculate indirect costs. The mean annual cost per patient with colorectal cancer in the present study was $10930.98 purchasing power parity (PPP) (equivalent to 5745.29 USD), the main part of which was the medical direct costs (74.86%). Also, among the medical direct costs per patient, the highest were those of surgeries (41.7%). In addition, the mean annual cost per patient with colorectal cancer in the country was $ 116917762 PPP (equivalent to 61451621.84 USD) in 2019. Regarding the considerable economic burden of colorectal cancer and in order to reduce the costs, these suggestions can be made: increasing the number of specialized beds through the cooperation of health donors, establishing free or low-cost accommodation centers for patients and their companions near the medical centers, using the Internet and cyberspace technologies to follow up the treatment of patients, and increasing insurance coverage and government drug subsidies on drug purchase.

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Evaluating the Effect of Three-Dimensional Visualization on Force Application and Performance Time during Robotics-Assisted Mitral Valve Repair

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3182a3200e ◽

2013 ◽

Vol 8 (3) ◽

pp. 199-205 ◽

Cited By ~ 2

Author(s):

Maria E. Currie ◽

Ana Luisa Trejos ◽

Reiza Rayman ◽

Michael W.A. Chu ◽

Rajni Patel ◽

...

Keyword(s):

Cardiac Surgery ◽

Mitral Valve ◽

Haptic Feedback ◽

3D Visualization ◽

Three Dimensional ◽

Test Bed ◽

Mitral Valve Annuloplasty ◽

Significant Difference ◽

The Mean ◽

Mean Time

Objective The purpose of this study was to determine the effect of three-dimensional (3D) binocular, stereoscopic, and two-dimensional (2D) monocular visualization on robotics-assisted mitral valve annuloplasty versus conventional techniques in an ex vivo animal model. In addition, we sought to determine whether these effects were consistent between novices and experts in robotics-assisted cardiac surgery. Methods A cardiac surgery test-bed was constructed to measure forces applied during mitral valve annuloplasty. Sutures were passed through the porcine mitral valve annulus by the participants with different levels of experience in robotics-assisted surgery and tied in place using both robotics-assisted and conventional surgery techniques. Results The mean time for both the experts and the novices using 3D visualization was significantly less than that required using 2D vision (P < 0.001). However, there was no significant difference in the maximum force applied by the novices to the mitral valve during suturing (P = 0.7) and suture tying (P = 0.6) using either 2D or 3D visualization. The mean time required and forces applied by both the experts and the novices were significantly less using the conventional surgical technique than when using the robotic system with either 2D or 3D vision (P < 0.001). Conclusions Despite high-quality binocular images, both the experts and the novices applied significantly more force to the cardiac tissue during 3D robotics-assisted mitral valve annuloplasty than during conventional open mitral valve annuloplasty. This finding suggests that 3D visualization does not fully compensate for the absence of haptic feedback in robotics-assisted cardiac surgery.

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Low-Cost Customized Cranioplasty with Polymethyl Methacrylate Using 3D Printer Generated Mold: An Institutional Experience and Review of Literature

Indian Journal of Neurotrauma ◽

10.1055/s-0041-1729679 ◽

2021 ◽

Author(s):

Ankit Chaudhary ◽

Virendra Deo Sinha ◽

Sanjeev Chopra ◽

Jitendra Shekhawat ◽

Gaurav Jain

Keyword(s):

Polymethyl Methacrylate ◽

Bone Fractures ◽

Low Cost ◽

Operating Time ◽

Three Dimensional ◽

Wound Dehiscence ◽

3D Printer ◽

Skull Defects ◽

Aesthetic Appearance ◽

The Mean

Abstract Background Cranioplasty is performed to repair skull defects and to restore normal skull anatomy. Optimal reconstruction remains a topic of debate. Autologous bone flap is the standard option but it may not be available due to traumatic bone fractures, bone infection, and resorption. The authors present their experience with prefabrication of precise and low-cost polymethyl methacrylate (PMMA) mold using three-dimensional (3D) digital printing. Methods A total of 30 patients underwent cranioplasty between March 2017 and September 2019 at Sawai Man Singh Medical College Jaipur, India. Preoperative data included diagnosis for which decompressive craniectomy was done and Glasgow coma scale score. Intraoperative data included operating time. Postoperative data included cosmetic outcome in the form of cranial contour and margins, complications such as infection, seroma, implant failure, wound dehiscence, and hematoma. Results Patient age at cranioplasty ranged from 12 to 63 years with a mean age of 36.7 years. The mean operating time was 151.6 minutes (range 130–190 minutes). The mean follow-up period was 8 months (range 6–13 months). Postoperative wound dehiscence developed in one case (3.3%). Cranial contour and approximation of the margins were excellent and aesthetic appearance improved in all patients. Conclusion Low-cost PMMA implant made by digital 3D printer mold is associated with reconstruction of the deformed skull contour giving satisfactory results to the patient and his family members, at a low cost compared with other commercially available implants. This technique could be a breakthrough in cranioplasty.

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Development of oil-in-water microemulsion encapsulating Vitamin E for thermal and hydrolysis degradation study

Malaysian Journal of Fundamental and Applied Sciences ◽

10.11113/mjfas.v16n3.1517 ◽

2020 ◽

Vol 16 (3) ◽

pp. 277-280

Author(s):

Khairun Nisa Abdul Rahman ◽

Vicit Rizal Eh Suk ◽

Khalisanni Khalid ◽

Nurhazirah Mohd Ihsan ◽

Zainurin Md Dom ◽

...

Keyword(s):

Particle Size ◽

Vitamin E ◽

Encapsulation Efficiency ◽

Low Cost ◽

Bioactive Compound ◽

Small Particle Size ◽

Degradation Study ◽

Oil In Water ◽

The Mean ◽

Vitamin E Homologs

Vitamin E is widely used for medicinal and cosmeceuticals purposes. However, it is easy to degrade by the environment. In this study, the degradation of Gold Tri.E™ was studied and determined. Gold Tri.E™ is a mixture of Vitamin E homologs (tocotrienol and tocopherol) extracted from palm oil (Elais Guineensis). A nanocarrier system has been optimized to encapsulate Gold Tri.E™ from degrading and increasing its stability as a bioactive compound. An oil-in-water (o/w) microemulsion was formulated and optimized as the best carrier to encapsulate Gold Tri.E™ with the mean particle size of 32.60±3.60 nm and 99.99±0.01% encapsulation efficiency (EE). Degradation of the Gold Tri.E™ in o/w microemulsion was significantly reduced as compared to the bare Gold Tri.ETM. This suggested that the system could protect Gold Tri.E™ from thermal and hydrolysis degradation. Thus, the ease of preparation, low-cost production, and small particle size obtained when Gold Tri.E™ encapsulated in this system give promising drug delivery system to encapsulate, protect, and increase the shelf life of Gold Tri.E™.

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Comparative study of colour Doppler vs. FNNAC findings in WHO grade II thyroid enlargement in adult females

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192724 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1025

Author(s):

Sudhakar Rao M. S. ◽

Navneeth T. P. ◽

John C. J.

Keyword(s):

Pulsatility Index ◽

Low Cost ◽

Resistive Index ◽

Colour Doppler ◽

Who Grade ◽

Predictive Values ◽

Non Invasive ◽

Adult Females ◽

The Mean ◽

Sensitivity Specificity

Background: Thyroid gland disorders form one of the most common endocrinal and surgical problems encountered in clinical practice. FNNAC is widely accepted as the primary and better method than FNAC for investigation but has its disadvantages. Colour Doppler is a non-invasive, low cost, easily available and repeatable investigation with least patient discomfort and can be valuable in detection of benign and malignant thyroid enlargements.Methods: Forty cases of adult females with WHO grade 2 thyroid enlargement attending the department of otorhinolaryngology selected on simple random basis were included in this study. Following written consent, Colour Doppler scanning and FNNAC test were done on the thyroid swelling and the results were analysed. Results: The mean age of patients was 32.44 years. The mean age of malignancy was 44.66 years and showed statistically significant association. The Resistive and Pulsatility index and combination of both were found to have statistically significant results in detecting malignant and benign lesions The sensitivity, specificity, positive and negative predictive values of RI and PI were 83.33%, 94.12%, 71.43%, 96.97% and 50%, 94.12%, 60% and 91.43% respectively. On combining both the indices, the sensitivity was 91.67% and the positive predictive value was 97.06%.Conclusions: Colour Doppler can differentiate between benign and malignant thyroid enlargements using Resistive index (of>0.75) and Pulsatility Index (of>1.5) and can be a complementary diagnostic tool in the thyroid enlargement lesions, considering its accuracy, cost-effectiveness, easy availability and non-invasive repeatable nature.

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Low-Cost Open Source Ultrasound-Sensing Based Navigational Support for the Visually Impaired

Sensors ◽

10.3390/s19173783 ◽

2019 ◽

Vol 19 (17) ◽

pp. 3783 ◽

Cited By ~ 3

Author(s):

Petsiuk ◽

Pearce

Keyword(s):

Open Source ◽

Visually Impaired ◽

Vision Loss ◽

Haptic Feedback ◽

Low Cost ◽

Poverty Line ◽

Full Time ◽

Distance Information ◽

Point Distance ◽

Navigational Support

Nineteen million Americans have significant vision loss. Over 70% of these are not employed full-time, and more than a quarter live below the poverty line. Globally, there are 36 million blind people, but less than half use white canes or more costly commercial sensory substitutions. The quality of life for visually impaired people is hampered by the resultant lack of independence. To help alleviate these challenges this study reports on the development of a low-cost, open-source ultrasound-based navigational support system in the form of a wearable bracelet to allow people with the lost vision to navigate, orient themselves in their surroundings and avoid obstacles when moving. The system can be largely made with digitally distributed manufacturing using low-cost 3-D printing/milling. It conveys point-distance information by utilizing the natural active sensing approach and modulates measurements into haptic feedback with various vibration patterns within the four-meter range. It does not require complex calibrations and training, consists of the small number of available and inexpensive components, and can be used as an independent addition to traditional tools. Sighted blindfolded participants successfully demonstrated the device for nine primary everyday navigation and guidance tasks including indoor and outdoor navigation and avoiding collisions with other pedestrians.

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Lesões Músculo-Esqueléticas em Remadores de Competição

Acta Médica Portuguesa ◽

10.20344/amp.6364 ◽

2015 ◽

Vol 28 (4) ◽

pp. 427 ◽

Cited By ~ 1

Author(s):

Francisco Bernardes ◽

Alfredo Mendes-Castro ◽

José Ramos ◽

Ovídio Costa

Keyword(s):

Statistical Analysis ◽

Anatomical Location ◽

Lumbar Region ◽

Confidence Levels ◽

Injury Occurrence ◽

Parametric Statistics ◽

The Mean ◽

Occurrence Type ◽

Location Type ◽

Type Of Injury

Introduction: The objective of this study was the assessment of the injuries occurred over the competitive rowing lifetime of Portuguese senior rowers. Material and Methods: We sent a questionnaire to all Portuguese senior rowers medalled in the national championships during the 2013-2014 season. We analysed biometric variables, anatomic location, type and circumstances of injury occurrence, type of treatment provided and time of inactivity. For statistical analysis we used parametric and non-parametric statistics with 95% confidence levels (p < 0.05). Results: The questionnaire was answered by 18 of the 18 female and 74 of the 77 male rowers. Females had significantly lower ages, heights and weights and rowed more often sculling boats (p < 0.05). The number of years of practice, as well as the number of injuries per rower was similar, for both females and males. The mean age at the first injury was significantly lower in females (p < 0.001), who also had more progressive lesions than acute ones, although not significantly. In both, the most frequent anatomical location and type of injury were the lumbar region and muscular pathology, with a higher occurrence in winter and spring, during land training. Females sustained longer periods of inactivity, but not significantly. Discussion: The results that were different from those reported by other authors may be related with differences in the studied populations or with other factors that need to be clarified. Conclusion: The injuries sustained by the Portuguese competitive rowers, probably associated with a lower competitive exposure of our athletes, were less severe than those generally reported in the literature.

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