Usability of an Automated System for Real-Time Monitoring of Shared Decision-Making for Surgery: Mixed Methods Evaluation

BACKGROUND

Improving shared decision-making (SDM) for patients has become a health policy priority in many countries. Achieving high-quality SDM is particularly important for approximately 313 million surgical treatment decisions patients make globally every year. Large-scale monitoring of surgical patients' experience of SDM in real time is needed to identify the failings of SDM before surgery is performed. We developed a novel approach to automating real-time data collection using an electronic measurement system to address this. Examining usability will facilitate its optimization and wider implementation to inform interventions aimed at improving SDM.

OBJECTIVE

This study examined the usability of an electronic real-time measurement system to monitor surgical patients' experience of SDM. We aimed to evaluate the metrics and indicators relevant to system effectiveness, system efficiency, and user satisfaction.

METHODS

We performed a mixed methods usability evaluation using multiple participant cohorts. The measurement system was implemented in a large UK hospital to measure patients' experience of SDM electronically before surgery using 2 validated measures (CollaboRATE and SDM-Q-9). Quantitative data (collected between April 1 and December 31, 2021) provided measurement system metrics to assess system effectiveness and efficiency. We included adult patients booked for urgent and elective surgery across 7 specialties and excluded patients without the capacity to consent for medical procedures, those without access to an internet-enabled device, and those undergoing emergency or endoscopic procedures. Additional groups of service users (group 1: public members who had not engaged with the system; group 2: a subset of patients who completed the measurement system) completed user-testing sessions and semistructured interviews to assess system effectiveness and user satisfaction. We conducted quantitative data analysis using descriptive statistics and calculated the task completion rate and survey response rate (system effectiveness) as well as the task completion time, task efficiency, and relative efficiency (system efficiency). Qualitative thematic analysis identified indicators of and barriers to good usability (user satisfaction).

RESULTS

A total of 2254 completed surveys were returned to the measurement system. A total of 25 service users (group 1: n=9; group 2: n=16) participated in user-testing sessions and interviews. The task completion rate was high (169/171, 98.8%) and the survey response rate was good (2254/5794, 38.9%). The median task completion time was 3 (IQR 2-13) minutes, suggesting good system efficiency and effectiveness. The qualitative findings emphasized good user satisfaction. The identified themes suggested that the measurement system is acceptable, easy to use, and easy to access. Service users identified potential barriers and solutions to acceptability and ease of access.

CONCLUSIONS

A mixed methods evaluation of an electronic measurement system for automated, real-time monitoring of patients' experience of SDM showed that usability among patients was high. Future pilot work will optimize the system for wider implementation to ultimately inform intervention development to improve SDM.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2023-079155.

Real-Time Measurement and Uncertainty Evaluation of Optical Path Difference in Fiber Optic Interferometer Based on Auxiliary Interferometer

Optical interferometers are the main elements of interferometric sensing and measurement systems. Measuring their optical path difference (OPD) in real time and evaluating the measurement uncertainty are key to optimizing system noise and ensuring system consistency. With the continuous sinusoidal wavelength modulation of the laser, real-time OPD measurement of the main interferometer is achieved through phase comparison of the main and auxiliary interferometers. The measurement uncertainty of the main interferometer OPD is evaluated. It is the first evaluation of the impact of different auxiliary interferometer calibration methods on OPD measurements. A homodyne quadrature laser interferometer (HQLI) is used as the main interferometer, and a 3 × 3 interferometer is used as the auxiliary interferometer. The calibration of the auxiliary interferometer using optical spectrum analyzer scanning and ruler measurement is compared. The evaluation shows that the auxiliary interferometer is the most significant source of uncertainty and causes the total uncertainty to increase linearly with increasing OPD. It is proven that a high-precision calibration and large-OPD auxiliary interferometer can improve the real-time accuracy of OPD measurements based on the auxiliary interferometer. The scheme can determine the minimum uncertainty to optimize the system noise and consistency for vibration, hydroacoustic, and magnetic field measurements with OPDs of the ~m level.

Quantifying the Chemical Composition and Real-Time Mass Loading of Nanoplastic Particles in the Atmosphere Using Aerosol Mass Spectrometry

Plastic debris, including nanoplastic particles (NPPs), has emerged as an important global environmental issue due to its detrimental effects on human health, ecosystems, and climate. Atmospheric processes play an important role in the transportation and fate of plastic particles in the environment. In this study, a high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS) was employed to establish the first online approach for identification and quantification of airborne submicrometer polystyrene (PS) NPPs from laboratory-generated and ambient aerosols. The fragmentation ion C8H8+ is identified as the major tracer ion for PS nanoplastic particles, achieving an 1-h detection limit of 4.96 ng/m3. Ambient PS NPPs measured at an urban location in Texas are quantified to be 30 ± 20 ng/m3 by applying the AMS data with a constrained positive matrix factorization (PMF) method using the multilinear engine (ME-2). Careful analysis of ambient data reveals that atmospheric PS NPPs were enhanced as air mass passed through a waste incinerator plant, suggesting that incineration of waste may serve as a source of ambient NPPs. The online quantification of NPPs achieved through this study can significantly improve our understanding of the source, transport, fate, and climate effects of atmospheric NPPs to mitigate this emerging global environmental issue.

Facilitating the Work of Unmanned Aerial Vehicle Operators Using Artificial Intelligence: An Intelligent Filter for Command-and-Control Maps to Reduce Cognitive Workload

OBJECTIVE

Evaluating the ability of a Gibsonian-inspired artificial intelligence (AI) algorithm to reduce the cognitive workloads of military Unmanned Aerial Vehicle (UAV) operators.

BACKGROUND

Military UAV operators use the command-and-control (C2) map for developing mission-relevant situation awareness (SA). Yet C2 maps are overloaded with information, mostly irrelevant to the mission, causing operators to neglect the map altogether. To reduce irrelevant information, an intelligent filtering algorithm was developed. Here we evaluate its effectiveness in reducing operators' cognitive workloads.

METHOD

Two-stage operational scenarios were conducted with professional ex-military UAV operators, using two filter protocols and a no-filter control. High-end real-time techniques were used to continuously assess workload from muscle behavior and machine learning models.

RESULTS

Lower cognitive workload was found when applying the algorithm's protocols, especially when fatigue started to accumulate (Stage II). However, concerns about the quality of SA arose.

CONCLUSION

The algorithm was positively evaluated for its ability to reduce operators' cognitive workloads. More evaluations of operators' SA are required.

APPLICATION

The algorithm demonstrates the possibility of integrating AI to improve human performance in complex systems, and can be applied to other domains where spatial-temporal information needs to be contextually filtered in real time.

Buildings' Biaxial Tilt Assessment Using Inertial Wireless Sensors and a Parallel Training Model

Applications of MEMS-based sensing technology are beneficial and versatile. If these electronic sensors integrate efficient processing methods, and if supervisory control and data acquisition (SCADA) software is also required, then mass networked real-time monitoring will be limited by cost, revealing a research gap related to the specific processing of signals. Static and dynamic accelerations are very noisy, and small variations of correctly processed static accelerations can be used as measurements and patterns of the biaxial inclination of many structures. This paper presents a biaxial tilt assessment for buildings based on a parallel training model and real-time measurements using inertial sensors, Wi-Fi Xbee, and Internet connectivity. The specific structural inclinations of the four exterior walls and their severity of rectangular buildings in urban areas with differential soil settlements can be supervised simultaneously in a control center. Two algorithms, combined with a new procedure using successive numeric repetitions designed especially for this work, process the gravitational acceleration signals, improving the final result remarkably. Subsequently, the inclination patterns based on biaxial angles are generated computationally, considering differential settlements and seismic events. The two neural models recognize 18 inclination patterns and their severity using an approach in cascade with a parallel training model for the severity classification. Lastly, the algorithms are integrated into monitoring software with 0.1° resolution, and their performance is verified on a small-scale physical model for laboratory tests. The classifiers had a precision, recall, F1-score, and accuracy greater than 95%.

Rapid Manufacturing Approach of an Ultrathin Moisture Sensor for Health Monitoring

This study developed a rapid manufacturing approach for a moisture sensor based on contactless jet printing technology. A compact measurement system with ultrathin and flexure sensor electrodes was fabricated. The proposed sensor system focuses on continuous urine measurement, which can provide timely information on subjects to ensure efficient diagnosis and treatment. The obtained results verify that the proposed sensor system can exhibit a typical responsivity of up to -7.76 mV/%RH in the high-sensitivity range of 50-80 %RH. A preliminary field experiment was conducted on a hairless rat, and the effectiveness of the proposed ultrathin moisture sensor was verified. This ultrathin sensor electrode can be fabricated in the micrometer range, and its application does not affect the comfort of the user. The ultrathin electrode sensors can be printed directly on the diaper or undergarment of the user for in situ urine health monitoring, particularly of infants and the elderly.

Development of a real-time in vivo dosimetry tool for electron beam therapy using a flexible thin film solar cell coated with scintillator powder

PURPOSE

A real-time solar cell based in vivo dosimetry system (SC-IVD) was developed using a flexible thin film solar cell and scintillating powder. The present study evaluated the clinical feasibility of the SC-IVD in electron beam therapy.

METHODS

A thin film solar cell was coated with 100 mg of scintillating powder using an optical adhesive to enhance the sensitivity of the SC-IVD. Calibration factors were obtained by dividing the dose, measured at a reference depth for 6-20 MeV electron beam energy, by the signal obtained using the SC-IVD. Dosimetric characteristics of SC-IVDs containing variable quantities of scintillating powder (0-500 mg) were evaluated, including energy, dose rate, and beam angle dependencies, as well as dose linearity. To determine the extent to which the SC-IVD affected the dose to the medium, doses at R90 were compared depending on whether the SC-IVD was on the surface. Finally, the accuracy of surface doses measured using the SC-IVD was evaluated by comparison with surface doses measured using a Markus chamber.

RESULTS

Charge measured using the SC-IVD increased linearly with dose and was within 1% of the average signal according to the dose rate. The signal generated by the SC-IVD increased as the beam angle increased. The presence of the SC-IVD on the surface of a phantom resulted in a 0.5%-2.2% reduction in dose at R90 for 6-20 MeV electron beams compared with the bare phantom. Surface doses measured using the SC-IVD system and Markus chamber differed by less than 5%.

CONCLUSIONS

The dosimetric characteristics of the SC-IVD were evaluated in this study. The results showed that it accurately measured the surface dose without a significant difference of dose in the medium when compared with the Markus chamber. The flexibility of the SC-IVD allows it to be attached to a patient's skin, enabling real-time and cost-effective measurement.

Real-Time Measurement of Refractive Index Using 3D-Printed Optofluidic Fiber Sensor

This work describes a 3D-printed optofluidic fiber sensor to measure refractive index in real time, combining a microfluidic system with an optical fiber extrinsic Fabry-Perot interferometer. The microfluidic chip platform was developed for this purpose through 3D printing. The Fabry-Perot cavity was incorporated in the microfluidic chip perpendicularly to the sample flow, which was of approximately 3.7 µL/s. The optofluidic fiber sensor platform coupled with a low-cost optical power meter detector was characterized using different concentrations of glucose solutions. In the linear regression analysis, the optical power shift was correlated with the refractive index and a sensitivity of -86.6 dB/RIU (r² = 0.996) was obtained. Good results were obtained in terms of stability with a maximum standard deviation of 0.03 dB and a sensor resolution of 5.2 × 10^-4 RIU. The feasibility of the optofluidic fiber sensor for dynamic analyses of refractive index with low sample usage was confirmed through real-time measurements.

Application of measurable surgical guides in immediate implant placement and immediate restoration

This article reports a case of using immediate implant placement and immediate restoration combined with measurable implant surgical guides to restore compromised maxillary incisors caused by dental trauma. Target restoration was designed in the exoCAD software preoperatively, intraoral measurements were obtained in three directions, and the correct position of virtual implants was determined in BlueSky Plan 4. Afterward, measurable implant guides were designed and fabricated by 3D printing. Under the guidance of the measurable implant surgical guides and intraoperative measurement, the entry point was determined, the axial direction was verified when drilling to half the depth, and the 3D position was verified when drilling to total depth. Implants were inserted followed by verification once again. The temporary restoration, which was designed based on the target restoration and emergence profile of the original teeth and milled preoperatively, was connected to the implant immediately after surgery. Postoperative accuracy analysis showed that the mean linear deviations between the actual implant position and the pre-planned position were (0.57±0.17) mm at the entry point and (0.82±0.27) mm at the apex, and the mean angular deviation was (1.86±0.89) °, demonstrating that precise implant placement and immediate restoration were implemented.

A Comprehensive Review of the Recent Developments in Wearable Sweat-Sensing Devices

Sweat analysis offers non-invasive real-time on-body measurement for wearable sensors. However, there are still gaps in current developed sweat-sensing devices (SSDs) regarding the concerns of mixing fresh and old sweat and real-time measurement, which are the requirements to ensure accurate the measurement of wearable devices. This review paper discusses these limitations by aiding model designs, features, performance, and the device operation for exploring the SSDs used in different sweat collection tools, focusing on continuous and non-continuous flow sweat analysis. In addition, the paper also comprehensively presents various sweat biomarkers that have been explored by earlier works in order to broaden the use of non-invasive sweat samples in healthcare and related applications. This work also discusses the target analyte's response mechanism for different sweat compositions, categories of sweat collection devices, and recent advances in SSDs regarding optimal design, functionality, and performance.

Optimizing Calibration for a Capacitance-Based Void Fraction Sensor with Asymmetric Electrodes under Horizontal Flow in a Smoothed Circular Macro-Tube

In this study, a technique that uses a capacitance sensor with an asymmetric electrode to measure the void fraction of a refrigerant was developed. It is known that the void fraction and flow pattern affect the measured capacitance. Therefore, the relationship between the void fraction and capacitance is not linear; hence, a calibration method for obtaining accurate measurements is necessary. A calibration method was designed in this study based on repeated capacitance measurements and the bimodal temporal distribution to calibrate the atypical and repetitive flow patterns of slug flow and its transition to the intermittent flow regime. The calibration method also considers the weighted-average relation for the gradual transition of the intermittent to annular flow pattern according to the change from low to high quality. The proposed method was experimentally analyzed under the conditions of R32 refrigerant, a tube inner diameter of 7.1 mm, saturation temperature of 25 °C, mass flux of 100-400 kg m^-2 s^-1, and vapor quality of 0.025-0.900, and it was validated using a quick-closing valve (QCV) system under identical conditions. A relative error of 2.99% was obtained for the entire system, indicating good agreement between the proposed and QCV-based methods.

Small-Angle Particle Counting Coupled Photometry for Real-Time Detection of Respirable Particle Size Segmentation Mass Concentration

Respirable particulate matter air pollution is positively associated with SARS-CoV-2 mortality. Real-time and accurate monitoring of particle concentration changes is the first step to prevent and control air pollution from inhalable particles. In this research, a new light scattering instrument has been developed to detect the mass concentration of inhalable particles. This instrument couples the forward small-angle single particle counting method with the lateral group particle photometry method in a single device. The mass concentration of four sizes of inhalable particles in the environment can be detected simultaneously in a large area in real-time without using a particle impactor. Different from the traditional light scattering instrument, this new optical instrument can detect darker particles with strong light absorption, and the measurement results mainly depend on the particle size and ignore the properties of the particles. Comparative experiments have shown that the instrument can detect particles with different properties by simply calibrating the environmental density parameters, and the measurement results have good stability and accuracy.

Real-Time Measurement of Drilling Fluid Rheological Properties: A Review

The accurate and frequent measurement of the drilling fluid’s rheological properties is essential for proper hydraulic management. It is also important for intelligent drilling, providing drilling fluid data to establish the optimization model of the rate of penetration. Appropriate drilling fluid properties can improve drilling efficiency and prevent accidents. However, the drilling fluid properties are mainly measured in the laboratory. This hinders the real-time optimization of drilling fluid performance and the decision-making process. If the drilling fluid’s properties cannot be detected and the decision-making process does not respond in time, the rate of penetration will slow, potentially causing accidents and serious economic losses. Therefore, it is important to measure the drilling fluid’s properties for drilling engineering in real time. This paper summarizes the real-time measurement methods for rheological properties. The main methods include the following four types: an online rotational Couette viscometer, pipe viscometer, mathematical and physical model or artificial intelligence model based on a Marsh funnel, and acoustic technology. This paper elaborates on the principle, advantages, limitations, and usage of each method. It prospects the real-time measurement of drilling fluid rheological properties and promotes the development of the real-time measurement of drilling rheological properties.

Breath-Triggered Drug Release System for Preterm Neonates

A major disadvantage of inhalation therapy with continuous drug delivery is the loss of medication during expiration. Developing a breath-triggered drug release system can highly decrease this loss. However, there is currently no breath-triggered drug release directly inside the patient interface (nasal prong) for preterm neonates available due to their high breathing frequency, short inspiration time and low tidal volume. Therefore, a nasal prong with an integrated valve releasing aerosol directly inside the patient interface increasing inhaled aerosol efficiency is desirable. We integrated a miniaturized aerosol valve into a nasal prong, controlled by a double-stroke cylinder. Breathing was simulated using a test lung for preterm neonates on CPAP respiratory support. The inhalation flow served as a trigger signal for the valve, releasing humidified surfactant. Particle detection was performed gravimetrically (filter) and optically (light extinction). The integrated miniaturized aerosol valve enabled breath-triggered drug release inside the patient interface with an aerosol valve response time of <25 ms. By breath-triggered release of the pharmaceutical aerosol as a bolus during inhalation, the inhaled aerosol efficiency was increased by a factor of >4 compared to non-triggered release. This novel nasal prong with integrated valve allows breath-triggered drug release directly inside the nasal prong with short response time.

Analysis of Pharmacokinetics in the Cochlea of the Inner Ear

Hearing loss affects >5% of the global population and therefore, has a great social and clinical impact. Sensorineural hearing loss, which can be caused by different factors, such as acoustic trauma, aging, and administration of certain classes of drugs, stems primarily from a dysfunction of the cochlea in the inner ear. Few therapeutic strategies against sensorineural hearing loss are available. To develop effective treatments for this disease, it is crucial to precisely determine the behavior of ototoxic and therapeutic agents in the microenvironment of the cochlea in live animals. Since the 1980s, a number of studies have addressed this issue by different methodologies. However, there is much less information on pharmacokinetics in the cochlea than that in other organs; the delay in ontological pharmacology is likely due to technical difficulties with accessing the cochlea, a tiny organ that is encased with a bony wall and has a fine and complicated internal structure. In this review, we not only summarize the observations and insights obtained in classic and recent studies on pharmacokinetics in the cochlea but also describe relevant analytical techniques, with their strengths, limitations, and prospects.

Face Alignment in Thermal Infrared Images Using Cascaded Shape Regression

The evaluation of physiological and psychological states using thermal infrared images is based on the skin temperature of specific regions of interest, such as the nose, mouth, and cheeks. To extract the skin temperature of the region of interest, face alignment in thermal infrared images is necessary. To date, the Active Appearance Model (AAM) has been used for face alignment in thermal infrared images. However, computation using this method is costly, and it has a low real-time performance. Conversely, face alignment of visible images using Cascaded Shape Regression (CSR) has been reported to have high real-time performance. However, no studies have been reported on face alignment in thermal infrared images using CSR. Therefore, the objective of this study was to verify the speed and robustness of face alignment in thermal infrared images using CSR. The results suggest that face alignment using CSR is more robust and computationally faster than AAM.

Comparing respirator laboratory protection factors measured with novel personal instruments to those from the PortaCount

A quantitative fit test is performed using a benchtop instrument (e.g., TSI PortaCount) to assess the fit factor provided by a respirator when assigned to a worker. There are no wearable instruments on the market to measure protection factors while the respirator is in use. The aim of this study is to evaluate two new, wearable, quantitative instruments-a dual-channel optical particle counter (DC OPC) and a dual-channel condensation particle counter (DC CPC)-that would enable in-situ, real-time measurement of respirator workplace protection factor. Respirator laboratory protection factors measured by the new instruments were compared to those measured with the TSI PortaCount on one test subject for three test aerosols (sodium chloride, incense, ambient) at target laboratory protection factors of 100, 300, and 1,000 for sodium chloride and ambient, and 75 and 500 for incense. Three replicates were performed for each test condition. Data were analyzed with a two-sided paired t-test at a significance level of 0.05. Laboratory protection factors measured with the DC CPC agree with those measured with the PortaCount whereas those from the DC OPC generally do not. Mean laboratory protection factors derived from the DC CPC are only statistically significantly different for mean values of a laboratory protection factor at ambient conditions for a target laboratory protection factor of 300 (p = 0.02) and for incense at a target laboratory protection factor of 75 (p = 0.03). Although statistically significant, the difference in laboratory protection factors derived from the DC CPC are not substantial in practice and may be explained by systematic uncertainty. In contrast, the DC OPC reports substantially larger mean laboratory protection factors, differing by about half an order of magnitude in extreme cases, and statistically significantly different mean laboratory protection factors for the sodium chloride aerosol for target laboratory protection factors of 100 and 300 (p = 0.01 and p = 0.01).

Wearable Devices for Ergonomics: A Systematic Literature Review

Wearable devices are pervasive solutions for increasing work efficiency, improving workers' well-being, and creating interactions between users and the environment anytime and anywhere. Although several studies on their use in various fields have been performed, there are no systematic reviews on their utilisation in ergonomics. Therefore, we conducted a systematic review to identify wearable devices proposed in the scientific literature for ergonomic purposes and analyse how they can support the improvement of ergonomic conditions. Twenty-eight papers were retrieved and analysed thanks to eleven comparison dimensions related to ergonomic factors, purposes, and criteria, populations, application and validation. The majority of the available devices are sensor systems composed of different types and numbers of sensors located in diverse body parts. These solutions also represent the technology most frequently employed for monitoring and reducing the risk of awkward postures. In addition, smartwatches, body-mounted smartphones, insole pressure systems, and vibrotactile feedback interfaces have been developed for evaluating and/or controlling physical loads or postures. The main results and the defined framework of analysis provide an overview of the state of the art of smart wearables in ergonomics, support the selection of the most suitable ones in industrial and non-industrial settings, and suggest future research directions.

Minimally Invasive Electrochemical Patch-Based Sensor System for Monitoring Glucose and Lactate in the Human Body-A Survey-Based Analysis of the End-User's Perspective

Background: Wearable electrochemical sensors that detect human biomarkers allow a comprehensive analysis of a person’s health condition. The “electronic smart patch system for wireless monitoring of molecular biomarkers for health care and well-being” (ELSAH) project aims to develop a minimally invasive sensor system that is capable of continuously monitoring glucose and lactate in the dermal interstitial fluid in real time. It is the objective of the present study to compare the intended ELSAH-patch specifications with the expectations and requirements of potential end-users at an early stage during the development phase. Methods: A questionnaire addressing different aspects of the ELSAH-patch was filled out by 383 respondents. Results: The participants stated a high general demand for such a system, and they would use the ELSAH-patch in different health care and physical fitness applications. The preferred terminal device for communication with the sensor would be the smartphone. An operating time of 24 hours would be sufficient for 55.8% of the users (95%-CI: 50.3–61.3%), while 43.5% of them (95%-CI: 38.0–48.9%) would prefer a lifetime of several days or more. The software should have a warning function, especially for critical health conditions. Since the measured personal data would be highly sensitive, the participants called for high standards for data security and privacy. Conclusion: In general, the participants’ responses on their expectations and requirements were well in line with the intended specifications of the ELSAH-patch system. However, certain technical aspects such as the lifetime, data security and accuracy require special attention during its development.

Real-time in vivo dosimetry system based on an optical fiber-coupled microsized photostimulable phosphor for stereotactic body radiation therapy

PURPOSE

To develop an in vivo dosimeter system for stereotactic body radiation therapy (SBRT) that can perform accurate and precise real-time measurements, using a microsized amount of a photostimulable phosphor (PSP), BaFBr:Eu²⁺ .

METHODS

The sensitive volume of the PSP was 1.26 × 10^-5  cm³ . The dosimeter system was designed to apply photostimulation to the PSP after the decay of noise signals, in synchronization with the photon beam pulse of a linear accelerator (LINAC), to eliminate the noise signals completely using a time separation technique. The noise signals included stem signals, and radioluminescence signals generated by the PSP. In addition, the dosimeter system was built on a storage-type dosimeter that could read out a signal after an arbitrary preset number of photon beam pulses were incident. First, the noise and photostimulated luminescence (PSL) signal decay times were measured. Subsequently, we confirmed that the PSL signals could be exclusively read out within the photon beam pulse interval. Finally, using a water phantom, the basic characteristics of the dosimeter system were demonstrated under SBRT conditions, and the feasibility for clinical application was investigated. The reproducibility, dose linearity, dose-rate dependence, temperature dependence, and angular dependence were evaluated. The feasibility was confirmed by measurements at various dose gradients and using a representative treatment plan for a metastatic liver tumor. A clinical plan was created with a two-arc beam volumetric modulated arc therapy using a 10 MV flattening filter-free photon beam. For the water phantom measurements, the clinical plan was compiled into a plan with a fixed gantry angle of 0°. To evaluate the energy dependence during SBRT, the percent depth dose (PDD) was measured and compared with those calculated via Monte Carlo (MC) simulations.

RESULTS

All the PSL signals could be read out while eliminating the noise signals within the minimum pulse interval of the LINAC. Stable real-time measurements could be performed with a time resolution of 56 ms (i.e., number of pulses = 20). The dose linearity was good in the dose range of 0.01-100 Gy. The measurements agreed within 1% at dose rates of 40-2400 cGy/min. The temperature and angular dependence were also acceptable since these dependencies had only a negligible effect on the measurements in SBRT. At a dose gradient of 2.21 Gy/mm, the measured dose agreed with that calculated using a treatment planning system (TPS) within the measurement uncertainties due to the probe position. For measurements using a representative treatment plan, the measured dose agreed with that calculated using the TPS within 0.5% at the center of the beam axis. The PDD measurements agreed with the MC calculations to within 1% for field sizes <5 × 5 cm² .

CONCLUSION

The in vivo dosimeter system developed using BaFBr:Eu²⁺ is capable of real-time, accurate, and precise measurement under SBRT conditions. The probe is smaller than a conventional dosimeter, has excellent spatial resolution, and can be valuable in SBRT with a steep dose distribution over a small field. The developed PSP dosimeter system appears to be suitable for in vivo SBRT dosimetry.

Novel Test Bench for Inhaler Characterization Including Real-Time Determination of Output, Output Rate, and Liquid Water Content of Delivered Aerosols

Background: Developing new (triggered) or improving existing inhaler systems for (preterm) neonates and adults requires test benches for the determination of aerosol output and aerosol output rate. Furthermore, real-time measurement of aerosol output and output rate is advantageous with respect to both development costs and development time, especially when using liquid or humidified dry aerosols. The current standard test procedures following ISO 27427, however, are time-consuming. Moreover, these procedures are not applicable to inhalers for preterm neonates, due to their high breathing frequency, low tidal volume, and the dead space in commercially available test benches. We are describing a novel test bench approach combining gravimetric and optical detection to facilitate real-time measurement of aerosol output, aerosol output rate, and aerosol liquid water content in inhalation systems for (preterm) neonates and adults. Methods: We integrated a laser-based optical measurement unit into test benches for inhalers for adults and preterm neonates, based on ISO 27427. Breathing was simulated by a sine pump for adults and by a test lung for preterm neonates on continuous positive airway pressure respiratory support. Dry or humidified aerosol was released by a continuous powder aerosolizer system. Simultaneous particle measurement by gravimetry (filter) and light extinction (laser system) was performed using the novel test benches. Results: We developed test benches for inhalers for (preterm) neonates and adults in accordance with ISO 27427, combining optical and gravimetric particle detection. Optical and gravimetric measurements conducted with these test benches were highly correlated, thus enabling real-time measurement of aerosol output and output rate. In addition, our test benches are suitable to determine the aerosol water content in situ directly at the patient interface. Conclusion: This novel test bench allows characterization of inhalation devices in real time and therefore will accelerate optimization and development cycles. Conformity with ISO 27427 allows its use in various applications.

[Development of a New Type of Atherosclerosis Detection Device]

This paper describes how to develop a practical new type of atherosclerosis detection device, which can realize real-time measurement and analysis of human atherosclerosis. According to the mechanism of human atherosclerosis, the design objectives of the system are formulated to determine the construction of the platform. The system calculates the pulse wave velocity by measuring the pulse wave of human fingers and toes, adds four blood pressure measurements to the system design, calculates the ankle-brachial index, and comprehensively measures and analyses the degree of human arteriosclerosis.

Real-Time Measurement of the Liquid Amount in Cryo-Electron Microscopy Grids Using Laser Diffraction of Regular 2-D Holes of the Grids

Cryo-electron microscopy (cryo-EM) is now the first choice to determine the high-resolution structures of huge protein complexes. Grids with two-dimensional arrays of holes covered with a carbon film are typically used in cryo-EM. Although semi-automatic plungers are available, notable trial-and-error is still required to obtain a suitable grid specimen. Herein, we introduce a new method to obtain thin ice specimens using real-time measurement of the liquid amounts in cryo-EM grids. The grids for cryo-EM strongly diffracted laser light, and the diffraction intensity of each spot was measurable in real-time. The measured diffraction patterns represented the states of the liquid in the holes due to the curvature of the liquid around them. Using the diffraction patterns, the optimal time point for freezing the grids for cryo-EM was obtained in real-time. This development will help researchers rapidly determine highresolution protein structures using the limited resource of cryo-EM instrument access.

Real-Time Humidity Measurement during Sports Activity using Optical Fibre Sensing

An optical fibre sensor for monitoring relative humidity (RH) changes during exercise is demonstrated. The humidity sensor comprises a tip coating of poly (allylamine hydrochloride) (PAH)/silica nanoparticles (SiO₂ NPs) deposited using the layer-by-layer technique. An uncoated fibre is employed to compensate for bending losses that are likely to occur during movement. A linear fit to the response of the sensing system to RH demonstrates a sensitivity of 3.02 mV/% (R² = 0.96), hysteresis ± 1.17% RH when 11 bilayers of PAH/SiO₂ NPs are coated on the tip of the fibre. The performance of two different textiles (100% cotton and 100% polyester) were tested in real-time relative humidity measurement for 10 healthy volunteers. The results demonstrate the moisture wicking properties of polyester in that the relative humidity dropped more rapidly after cessation of exercise compared to cotton. The approach has the potential to be used to monitor sports performance and by clothing developers for characterising different garment designs.

Real-Time Electrical Resistivity Measurement and Mapping Platform of the Soils with an Autonomous Robot for Precision Farming Applications

Soil electrical resistivity (ER) is an important indicator to indirectly determine soil physical and chemical properties such as moisture, salinity, porosity, organic matter level, bulk density, and soil texture. In this study, real-time ER measurement system has been developed with the help of an autonomous robot. The aim of this study is to provide rapid measurement of the ER in large areas using the Wenner four-probe measurement method for precision farming applications. The ER measurement platform consists of the Wenner probes, a y-axis shifter driven by a DC motor through a gear reducer, all installed on a steel-frame that mount to an autonomous robot. An embedded industrial computer and differential global positioning system (DGPS) were used to assist in real-time measuring, recording, mapping, and displaying the ER and the robot position during the field operation. The data acquisition software was codded in Microsoft Visual Basic.NET. Field experiments were carried out in a 1.2 ha farmland soil. ER and DGPS values were stored in Microsoft SQL Server 2005 database, an ordinary Kriging interpolation technique by ArcGIS was used and the average ER values were mapped for the soil depth between 0 and 50 cm. As a result, ER values were observed to be between 30.757 and 70.732 ohm-m. In conclusion, the experimental results showed that the designed system works quite well in the field and the ER measurement platform is a practical tool for providing real-time soil ER measurements.

An Embedded Sensor System for Real-Time Detecting 5-DOF Error Motions of Rotary Stages

The geometric error motions of rotary stages greatly affect the accuracy of constructed machines such as machine tools, measuring instruments, and robots. In this paper, an embedded sensor system for real-time measurement of two radial and three angular error motions of a rotary stage is proposed, which makes use of a rotary encoder with multiple scanning heads to measure the rotational angle and two radial error motions and a miniature autocollimator to measure two tilt angular errors of the axis of rotation. The assembly errors of the grid disc of the encoder and the mirror for autocollimator are also evaluated and compensated. The developed measuring device can be fixed inside the rotary stage. In the experiments, radial error motions of two points on the axis (h = 5 mm and 60 mm) were measured and calibrated with LVDTs, and the data showed that the radial error motions of the axis were less than 20 μm, and the calibration residual errors were less than 2 μm. When intermittent external forces were applied to the stage, the change of the stage’s error motion could also be monitored accurately.

A New Angular Light Scattering Measurement of Particulate Matter Mass Concentration for Homogeneous Spherical Particles

Under the condition of ultra-low emission for power plants, the particulate matter concentration is significantly lower than that of typical power plants a decade ago, which posed new challenges for the particulate matter monitoring of stationary emission. The monitoring of particulate matter mass concentration based on ensemble light scattering has been found affected by particle size. Thus, this study develops a method of using the scattering angular distribution to obtain the real-time particle size, and then correct the particulate matter concentration with the real-time measured particle size. In this study, a real-time aerosol concentration and particle size measurement setup is constructed with a fixed detector at the forward direction and a rotating detector. The mass concentration is measured by the fixed detector, and the particle size is measured from the intensity ratio of the two detectors. The simulations show that the particle size has power law functionality with the angular spacing of the ripple structure according to Mie theory. Four quartz aerosols with different particle size are tested during the experiment, and the particle size measured from the ripple width is compared with the mass median size measured by an electrical low pressure impactor (ELPI). Both techniques have the same measurement tendency, and the measurement deviation by the ripple width method compared with ELPI is less than 15%. Finally, the measurement error of the real-time mass concentration is reduced from 38% to 18% with correction of the simultaneously measured particle size when particle size has changed.

Design of UAV-Embedded Microphone Array System for Sound Source Localization in Outdoor Environments

In search and rescue activities, unmanned aerial vehicles (UAV) should exploit sound information to compensate for poor visual information. This paper describes the design and implementation of a UAV-embedded microphone array system for sound source localization in outdoor environments. Four critical development problems included water-resistance of the microphone array, efficiency in assembling, reliability of wireless communication, and sufficiency of visualization tools for operators. To solve these problems, we developed a spherical microphone array system (SMAS) consisting of a microphone array, a stable wireless network communication system, and intuitive visualization tools. The performance of SMAS was evaluated with simulated data and a demonstration in the field. Results confirmed that the SMAS provides highly accurate localization, water resistance, prompt assembly, stable wireless communication, and intuitive information for observers and operators.

Current Trends in Ligand Binding Real-Time Measurement Technologies

Numerous advances in ligand binding assay (LBA) real-time measurement technologies have been made within the last several years, ranging from the development of novel platforms to drive technology expansion to the adaptation of existing platforms to optimize performance and throughput. In this review, we have chosen to focus on technologies that provide increased value to two distinct segments of the LBA community. First, experimentally, by measuring real-time binding events, these technologies provide data that can be used to interrogate receptor/ligand binding interactions. While overall the platforms are not new, they have made significant advances in throughput, multiplexing, and/or sensitivity. Second, clinically, these point-of-care (POC) technologies provide instantaneous information which facilitates rapid treatment decisions.

Proper Orthogonal Decomposition Methods for the Analysis of Real-Time Data: Exploring Peak Clustering in a Secondhand Smoke Exposure Intervention

This work explores a method for classifying peaks appearing within a data-intensive time-series. We summarize a case study from a clinical trial aimed at reducing secondhand smoke exposure via the installation of air particle monitors in households. Proper orthogonal decomposition (POD) in conjunction with a k-means clustering algorithm assigns each data peak to one of two clusters. Aversive feedback from the monitors increased the proportion of short-duration, attenuated peaks from 38.8% to 96.6%. For each cluster, a distribution of parameters from a physics-based model of airborne particles is estimated. Peaks generated from these distributions are correctly identified by POD/clustering with >60% accuracy.

Studying learning in the healthcare setting: the potential of quantitative diary methods

Quantitative diary methods are longitudinal approaches that involve the repeated measurement of aspects of peoples' experience of daily life. In this article, we outline the main characteristics and applications of quantitative diary methods and discuss how their use may further research in the field of medical education. Quantitative diary methods offer several methodological advantages, such as measuring aspects of learning with great detail, accuracy and authenticity. Moreover, they enable researchers to study how and under which conditions learning in the health care setting occurs and in which way learning can be promoted. Hence, quantitative diary methods may contribute to theory development and the optimization of teaching methods in medical education.

Real time voltage and current phase shift analyzer for power saving applications

Nowadays, high importance is given to low energy devices (such as refrigerators, deep-freezers, washing machines, pumps, etc.) that are able to produce reactive power in power lines which can be optimized (reduced). Reactive power is the main component which overloads power lines and brings excessive thermal stress to conductors. If the reactive power is optimized, it can significantly lower the electricity consumption (from 10 to 30%—varies between countries). This paper will examine and discuss the development of a measuring device for analyzing reactive power. However, the main problem is the precise real time measurement of the input and output voltage and current. Such quality measurement is needed to allow adequate action intervention (feedback which reduces or fully compensates reactive power). Several other issues, such as the accuracy and measurement speed, must be examined while designing this device. The price and the size of the final product need to remain low as they are the two important parameters of this solution.