Robust collagen texture quantification in nonlinear microscopy by combining the gradient structure tensor with a mixed noise model.

Collagen structure derangement is a hallmark of several diseases in different types of tissue. Extraction of quantitative markers of collagen organization from nonlinear microscopy images can help early disease detection, but it can be affected by the presence of image noise. This study introduced and validated a novel methodology for a robust quantification of collagen fiber direction, dispersion, and degree of anisotropy (DA) from collagen images, based on the reinforcement of the gradient structure tensor computation with a mixed noise model.

Field assessment of a novel sensor for measuring noncondensable gases in steam sterilizers.

Steam sterilization is widely used to process heat-resistant instruments in hospital settings. The presence of non-condensing gases (NCGs) in the steam may severely impact heat transfer and process efficacy. However, the current practice does not include routine NCG monitoring in the sterilizer chamber.

Vital parameter monitoring in harsh environment by the MedSENS in-ear multisensor device.

Accurate assessment of vital parameters is essential for diagnosis and triage of critically ill patients, but not always feasible in out-of-hospital settings due to the lack of suitable devices. We performed an extensive validation of a novel prototype in-ear device, which was proposed for the non-invasive, combined measurement of core body temperature (Tc), oxygen saturation (SpO), and heart rate (HR) in harsh environments. A pilot study with randomized controlled design was conducted in the terraXcube environmental chamber.

Effect of oxygen supplementation on cognitive performance among HEMS providers after acute exposure to altitude: the HEMS II randomized clinical trial.

Importance: Emergency medical services (EMS) providers transiently ascend to high altitude for primary missions and secondary transports in mountainous areas in helicopters that are unpressurised and do not have facilities for oxygen supplementation. The decrease in cerebral oxygen saturation can lead to impairment in attention and reaction time as well as in quality of care during acute exposure to altitude.

Objective: The primary aim of the current study was to investigate the effect of oxygen supplementation on cognitive performance in Helicopter EMS (HEMS) providers during acute exposure to altitude.

Systematic in-silico evaluation of fibrosis effects on re-entrant wave dynamics in atrial tissue.

Despite the key role of fibrosis in atrial fibrillation (AF), the effects of different spatial distributions and textures of fibrosis on wave propagation mechanisms in AF are not fully understood. To clarify these aspects, we performed a systematic computational study to assess fibrosis effects on the characteristics and stability of re-entrant waves in electrically-remodelled atrial tissues. A stochastic algorithm, which generated fibrotic distributions with controlled overall amount, average size, and orientation of fibrosis elements, was implemented on a monolayer spheric atrial model.

Auditory function in humans at high altitude. A scoping review.

Purpose: High-altitude (HA) affects sensory organ response, but its effects on the inner ear are not fully understood. The present scoping review aimed to collect the available evidence about HA effects on the inner ear with focus on auditory function.

Methods: The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon.

Drones reduce the treatment-free interval in search and rescue operations with telemedical support - A randomized controlled trial.

Introduction: Response to medical incidents in mountainous areas is delayed due to the remote and challenging terrain. Drones could assist in a quicker search for patients and can facilitate earlier treatment through delivery of medical equipment. We aim to assess the effects of using drones in search and rescue (SAR) operations in challenging terrain.

Quantitative assessment of transmural fibrosis profile in the human atrium: evidence for a three-dimensional arrhythmic substrate by slice-to-slice histology.

Aims: Intramural fibrosis represents a crucial factor in the formation of a three-dimensional (3D) substrate for atrial fibrillation (AF). However, the transmural distribution of fibrosis and its relationship with atrial overload remain largely unknown. The aim of this study is to quantify the transmural profile of atrial fibrosis in patients with different degrees of atrial dilatation and arrhythmic profiles by a high-resolution 3D histology method.

Low Ambient Temperature Exposition Impairs the Accuracy of a Non-invasive Heat-Flux Thermometer.

Background: Indirect core body temperature (CBT) monitoring from skin sensors is gaining attention for in-field applications thanks to non-invasivity, portability, and easy probe positioning. Among skin sensors, heat-flux devices, such as the so-called Double Sensor (DS), have demonstrated reliability under various experimental and clinical conditions. Still, their accuracy at low ambient temperatures is unknown.

A Divergence-Based Approach for the Identification of Atrial Fibrillation Focal Drivers From Multipolar Mapping: A Computational Study.

The expanding role of catheter ablation of atrial fibrillation (AF) has stimulated the development of novel mapping strategies to guide the procedure. We introduce a novel approach to characterize wave propagation and identify AF focal drivers from multipolar mapping data. The method reconstructs continuous activation patterns in the mapping area by a radial basis function (RBF) interpolation of multisite activation time series.

Insight into the use of tympanic temperature during target temperature management in emergency and critical care: a scoping review.

Background: Target temperature management (TTM) is suggested to reduce brain damage in the presence of global or local ischemia. Prompt TTM application may help to improve outcomes, but it is often hindered by technical problems, mainly related to the portability of cooling devices and temperature monitoring systems. Tympanic temperature (T) measurement may represent a practical, non-invasive approach for core temperature monitoring in emergency settings, but its accuracy under different TTM protocols is poorly characterized.

Monitoring Steam Penetration in Channeled Instruments: An Evidence-Based Worst-Case for Practical Situations.

Steam sterilization of channeled medical devices requires steam penetration into narrow channels. However, a quantitative characterization of this phenomenon in practical situations is lacking. This study evaluates the effect of load, loading pattern, and wrapping system on steam penetration into channels.

Hearables: New Perspectives and Pitfalls of In-Ear Devices for Physiological Monitoring. A Scoping Review.

Technological advancements are opening the possibility of prolonged monitoring of physiological parameters under daily-life conditions, with potential applications in sport science and medicine, and in extreme environments. Among emerging wearable technologies, in-ear devices or hearables possess technical advantages for long-term monitoring, such as non-invasivity, unobtrusivity, good fixing, and reduced motion artifacts, as well as physiological advantages related to the proximity of the ear to the body trunk and the shared vasculature between the ear and the brain. The present scoping review was aimed at identifying and synthesizing the available evidence on the use and performance of in-ear monitoring of physiological parameters, with focus on applications in sport science, sport medicine, occupational medicine, and extreme environment settings.

MicroRNAs: New contributors to mechano-electric coupling and atrial fibrillation.

Atrial fibrillation (AF) is a multifactorial disease, which often occurs in the presence of underlying cardiac abnormalities and is supported by electrophysiological and structural alterations, generally referred to as atrial remodeling. Abnormal substrates are commonly encountered in various conditions that predispose to AF, such as hypertension, heart failure, obesity, and sleep apnea, in which atrial stretch plays a key mechanistic role. Emerging evidence suggests a role for microRNAs (small non-coding RNAs) in the pathogenesis of AF, where they can act as post-transcriptional regulators of the genes involved in atrial remodeling.

Unsupervised Classification of Atrial Electrograms for Electroanatomic Mapping of Human Persistent Atrial Fibrillation.

Objective: Ablation treatment for persistent atrial fibrillation (persAF) remains challenging due to the absence of a 'ground truth' for atrial substrate characterization and the presence of multiple mechanisms driving the arrhythmia. We implemented an unsupervised classification to identify clusters of atrial electrograms (AEGs) with similar patterns, which were then validated by AEG-derived markers.

Methods: 956 bipolar AEGs were collected from 11 persAF patients.

Morphological MRI of knee cartilage: repeatability and reproducibility of damage evaluation and correlation with gross pathology examination.

Objective: To assess the performance of a morphological evaluation, based on a clinically relevant magnetic resonance imaging (MRI) protocol, in scoring the severity of knee cartilage damage. Specifically, to evaluate the reproducibility, repeatability, and agreement of MRI evaluation with the gross pathology examination (GPE) of the tissue.

Methods: MRI of the knee was performed the day before surgery in 23 patients undergoing total knee arthroplasty.

Implementation and validation of real-time algorithms for atrial fibrillation detection on a wearable ECG device.

Background: Due to the growing epidemic of atrial fibrillation (AF), new strategies for AF screening, diagnosis, and monitoring are required. Wearable devices with on-board AF detection algorithms may improve early diagnosis and therapy outcomes. In this work, we implemented optimized algorithms for AF detection on a wearable ECG monitoring device and assessed their performance.