Performance assessment of a ventilator developed for emergency use in a resource-constrained ICU setting during the COVID-19 pandemic.

Background: The Masi mechanical ventilator was developed in Peru, designed and manufactured as a rapid-response to the healthcare emergency. Its promising pre-clinical and clinical results allowed it to be approved by the national regulatory authority to be used during the emergency. The key features of Masi are its low manufacturing cost, low dependence on a supply of high volumes of oxygen, low oxygen consumption, and flexibility between non-invasive and invasive ventilation.

Diagnosis of Pneumoconiosis with Machine Learning.

Pneumoconiosis encompasses a group of lung diseases caused by inhaling dust particles. Frequently recognized as an occupational disease, it primarily affects workers in the mining industry. This paper details the use of machine learning algorithms to automate the diagnostic process in two distinct stages: Stage 1 involves lung segmentation, and Stage 2 focuses on classifying X-rays to determine the presence or absence of pneumoconiosis.

Monitoring of Lung Ultrasound Acquisition using Infrared Sensors and Artificial Intelligence.

Lung diseases contribute significantly to global mortality rates. The conventional diagnostic techniques based on medical imaging used for lung disease diagnosis normally require specialized personnel and complex infrastructure, posing challenges in rural areas. In response to these challenges, Volume Sweep Imaging in the lung (VSI-L) is an ultrasound-based acquisition protocol designed to empower non-specialized healthcare providers by following the movement of the transducer when performing a set of ultrasound scans along the chest.

Proposal and comparison of quality measures in Crawling Waves Sonoelastography.

Ultrasound shear-wave elastography has emerged as a promising non-invasive technique for assessing tissue stiffness and elasticity, enabling the detection and monitoring of pathological changes for disease diagnosis, treatment and monitoring. Crawling Waves Sonoelastography (CWS) is an elastography approach that generates mechanical waves to measure Shear Wave Speed (SWS). However, current estimation techniques for CWS present important limitations such as the presence of artifacts leading to potential diagnostic inaccuracies.

A comparison between Deep Learning architectures for the assessment of breast tumor segmentation using VSI ultrasound protocol.

Automatic breast tumor ultrasound segmentation is one of the most critical components in the development of tools for breast cancer diagnosis. Several deep learning algorithms have been tested with public and private datasets but none of them has been designed for asynchronous protocol ultrasound acquisition. In this work, a dataset collected through the Volume Sweep Imaging protocol for breast ultrasound (VSI-B) was used.

Performance of emergency mechanical ventilators in response to the covid-19 pandemic: an intercomparison study.

Emergency mechanical ventilators developed during the pandemic were used to meet the high demand in intensive care units to care for COVID-19 patients. An example of such ventilators is Masi, developed in Peru and installed in more than 15 hospitals around the country. This study aimed to compare Masi's performance with other emergency mechanical ventilators manufactured during the covid-19 pandemic such as Neyün, Spiro Wave and a prototype developed by the Faculty of Engineering of the National University of Asuncion (FIUNA).

A pilot study for testing a low-cost 3D design with an inertial sensor for the quantitative assessment of finger tapping in patients with Parkinson's Disease.

Parkinson's disease (PD) is one of the most common neurodegenerative disorders worldwide. Current identification and monitoring of its motor symptoms depends on the clinical expertise. Repetitive finger tapping is one of the most common clinical maneuvers to assess for bradykinesia.

Enablers and barriers to adopt the locally developed Masi mechanical ventilator amid COVID-19 pandemic in Peru.

Background: Limited supply of resources during the COVID-19 emergency encouraged the local development of the Masi mechanical ventilator (MV). Despite the efforts to promote Masi, adopting this innovation faced multiple obstacles, regardless of its performance. We explored the perceptions among healthcare personnel towards incorporating Masi to provide ventilatory support to COVID-19 patients during the second wave in Peru (January to June 2021).

Temporal Evaluation of the Surface Area of Treated Skin Ulcers Caused by Cutaneous Leishmaniasis and Relation with Optical Parameters in an Animal Model: A Proof of Concept.

Cutaneous leishmaniasis (CL) is a neglected disease caused by an intracellular parasite of the genus. CL lacks tools that allow its understanding and treatment follow-up. This article presents the use of metrical and optical tools for the analysis of the temporal evolution of treated skin ulcers caused by CL in an animal model.

Diagnosis of Pregnancy Complications Using Blind Ultrasound Sweeps Performed by Individuals Without Prior Formal Ultrasound Training.

Objective: To estimate the diagnostic accuracy of blind ultrasound sweeps performed with a low-cost, portable ultrasound system by individuals with no prior formal ultrasound training to diagnose common pregnancy complications.

Methods: This is a single-center, prospective cohort study conducted from October 2020 to January 2022 among people with second- and third-trimester pregnancies. Nonspecialists with no prior formal ultrasound training underwent a brief training on a simple eight-step approach to performing a limited obstetric ultrasound examination that uses blind sweeps of a portable ultrasound probe based on external body landmarks.

Sustainable volume sweep imaging lung teleultrasound in Peru: Public health perspectives from a new frontier in expanding access to imaging.

Background: Pulmonary disease is a common cause of morbidity and mortality, but the majority of the people in the world lack access to diagnostic imaging for its assessment. We conducted an implementation assessment of a potentially sustainable and cost-effective model for delivery of volume sweep imaging (VSI) lung teleultrasound in Peru. This model allows image acquisition by individuals without prior ultrasound experience after only a few hours of training.

Characterisation of the soft tissue viscous and elastic properties using ultrasound elastography and rheological models: validation and applications in plantar soft tissue assessment.

. The mechanical behaviour of soft tissue is influenced by its elastic and viscous characteristics. Therefore, the aim of this study was to develop a validated method to characterise the viscoelastic properties of soft tissues based on ultrasound elastography data.

No sonographer, no radiologist: Assessing accuracy of artificial intelligence on breast ultrasound volume sweep imaging scans.

Breast ultrasound provides a first-line evaluation for breast masses, but the majority of the world lacks access to any form of diagnostic imaging. In this pilot study, we assessed the combination of artificial intelligence (Samsung S-Detect for Breast) with volume sweep imaging (VSI) ultrasound scans to evaluate the possibility of inexpensive, fully automated breast ultrasound acquisition and preliminary interpretation without an experienced sonographer or radiologist. This study was conducted using examinations from a curated data set from a previously published clinical study of breast VSI.

COVOX: Providing oxygen during the COVID-19 health emergency.

We introduce an autonomous oxygen concentrator that was designed in Peru to fight the oxygen shortage produced worldwide as a consequence of the COVID-19 pandemic. Oxygen concentrators represent a suitable and favorable option for administering this gas at the patient's bedside in developing countries, especially when cylinders and tubed systems are unavailable or when access to them is restricted by lack of accessories, inadequate power supply, or shortage of qualified personnel. Our system uses a pressure swing adsorption technique to provide oxygen to patients at a flow rate of up to 15 l/min ± 1,5 l/min and a concentration of 93 % ± 3 %, offering robustness, safety and functionality.

Assessment of a Brief Standardized Obstetric Ultrasound Training Program for Individuals Without Prior Ultrasound Experience.

Obstetric volume sweep imaging (OB VSI) is a simple set of transducer movements guided by external body landmarks that can be taught to ultrasound-naive non-experts. This approach can increase access to ultrasound in rural/low-resources settings lacking trained sonographers. This study presents and evaluates a training program for OB VSI.

Volume sweep imaging lung teleultrasound for detection of COVID-19 in Peru: a multicentre pilot study.

Objectives: Pulmonary disease is a significant cause of morbidity and mortality in adults and children, but most of the world lacks diagnostic imaging for its assessment. Lung ultrasound is a portable, low-cost, and highly accurate imaging modality for assessment of pulmonary pathology including pneumonia, but its deployment is limited secondary to a lack of trained sonographers. In this study, we piloted a low-cost lung teleultrasound system in rural Peru during the COVID-19 pandemic using lung ultrasound volume sweep imaging (VSI) that can be operated by an individual without prior ultrasound training circumventing many obstacles to ultrasound deployment.

Mechanical validation of viscoelastic parameters for different interface pressures using the Kelvin-Voigt fractional derivative model.

The knowledge of the biomechanical properties of tissues is useful for different applications such as disease diagnosis and treatment monitoring. Reverberant Shear Wave Elastography (RSWE) is an approach that has reduced the restrictions on wave generation to characterize the shear wave velocity over a range of frequencies. This approach is based on the generation of a reverberant field that is generated by the reflections of waves from inhomogeneities and tissue boundaries that exist in the tissue.

Feasibility of a Deep Learning approach to estimate Shear Wave Speed using the framework of Reverberant Shear Wave Elastography: A numerical simulation study.

Reverberant Shear Wave Elastography (RSWE) is an ultrasound elastography technique that offers great advantages, however, current estimators generate underestimations and time-consuming issues. As well, the involvement of Deep Learning into the medical imaging field with new tools to assess complex problems, makes it a great candidate to serve as a new approach for a RSWE estimator. This work addresses the application of a Deep Neural Network (DNN) for the estimation of Shear Wave Speed (SWS) maps from particle velocity using numerically simulated data.

Panoramic Reconstruction of B-mode Lung Ultrasound Images Acquired using a Longitudinal Volume Sweep Imaging Protocol.

The ongoing COVID-19 pandemic has already affected more than 300 million people worldwide. Medical imaging shortage affects an estimated of 4 billion people, especially in rural and remote areas (RAs), limiting diagnostic assessment of respiratory illness. Lung ultrasound imaging (LUS) together with volume sweep imaging (VSI) acquisition protocols have been successfully piloted as a solution for lung screening in RAs eliminating the need for trained operators and on-site radiologists.

Extension of Non-invasive Ventilation Capabilities of MASI for the Care of Patients Affected by COVID-19.

The MASI mechanical ventilator was developed in a state of emergency to meet the demand for ventilators caused by COVID-19. Although it has obtained positive results in its use with patients in intensive care units, not having an optimal quality non-invasive ventilation (NIV) modality prevents it from being used in the early treatment of patients, which has been shown to prevent admission to the ICU and reduce mortality. Therefore, the following study focuses on evaluating MASI's ability to provide NIV using different accessories in order to compare their performance and determine which one would work best with MASI, and under which conditions.

Breast Ultrasound Volume Sweep Imaging: A New Horizon in Expanding Imaging Access for Breast Cancer Detection.

Objective: The majority of people in the world lack basic access to breast diagnostic imaging resulting in delay to diagnosis of breast cancer. In this study, we tested a volume sweep imaging (VSI) ultrasound protocol for evaluation of palpable breast lumps that can be performed by operators after minimal training without prior ultrasound experience as a means to increase accessibility to breast ultrasound.

Methods: Medical students without prior ultrasound experience were trained for less than 2 hours on the VSI breast ultrasound protocol.

Biological evaluation of a mechanical ventilator that operates by controlling an automated manual resuscitator. A descriptive study in swine.

The Covid-19 outbreak challenged health systems around the world to design and implement cost-effective devices produced locally to meet the increased demand of mechanical ventilators worldwide. This study evaluates the physiological responses of healthy swine maintained under volume- or pressure-controlled mechanical ventilation by a mechanical ventilator implemented to bring life-support by automating a resuscitation bag and closely controlling ventilatory parameters. Physiological parameters were monitored in eight sedated animals (t0) prior to inducing deep anaesthesia, and during the next six hours of mechanical ventilation (t1-7).

No sonographer, no radiologist: New system for automatic prenatal detection of fetal biometry, fetal presentation, and placental location.

Ultrasound imaging is a vital component of high-quality Obstetric care. In rural and under-resourced communities, the scarcity of ultrasound imaging results in a considerable gap in the healthcare of pregnant mothers. To increase access to ultrasound in these communities, we developed a new automated diagnostic framework operated without an experienced sonographer or interpreting provider for assessment of fetal biometric measurements, fetal presentation, and placental position.

Performance of the Masi Peruvian ventilator at high altitude.

In response to Covid-19 crisis, 310 Masi ventilators were produced and validated in Lima, Peru, according to applicable standards. Four of them, were transported to Puno, in order to strengthen ICU Services there, but this set a major challenge to Masi team as effects of altitude on ventilators were unknown. Once there, ventilators were acclimated and calibrated.

Shear Wave Speed estimator using Continuous Wavelet Transform for Crawling Wave Sonoelastography.

Crawling Wave Sonoelastography (CWS) is an elastography ultrasound-based imaging approach that provides tissue stiffness information through the calculation of Shear Wave Speed (SWS). Many SWS estimators have been developed; however, they report important limitations such as the presence of artifacts, border effects or high computational cost. In addition, these techniques require a moving interference pattern which could be challenging for in vivo applications.