Electronic Medical Devices Research Articles

Experience of the organization in Ukraine of the system of training of specialists for prosthetic industry according to international standards

At the present stage, the problem of training for related industries in the system of production, operation of products and provision of services is especially relevant. To a large extent, this is typical of medicine and related industries that are engaged in the production and operation of biotechnological devices and systems, electronic medical devices and the provision of rehabilitation services in health and social protection systems.
 Training of specialists in the field of prosthetics and orthoses for the manufacture of means for the rehabilitation of patients with musculoskeletal disorders. The aim of the work is to highlight the experience of the main stages of training of modern specialists for the prosthetic industry according to international standards. To do this, it is necessary to consider the main approaches to the formation of curricula, the organization of practical training and the scientific component of the training program for prosthetics and orthoses. From 2001 to 2012 according with cooperation program between KNURE and the Ukrainian Research Institute of Prosthetics 5 groups of bachelors and specialists with a total of 72 graduates underwent training under this program, 4 groups with a total of 65 graduates underwent retraining. In order to implement the project "Creation of prosthetic and orthopedic education in Ukraine", based on an international agreement between the Ukrainian Research Institute of Prosthetics, Kharkiv National University of Radio Electronics and the School of Rehabilitation Sciences (NS) began in January 2018 a training program for teachers-trainers for prosthetics and orthoses according to the educational program "Orthopedic Technologies and Engineering", developed in accordance with the international standard ISPO category II. The main stages of cooperation, practical and scientific parts for master's training in the specialty "Orthopedic Technologies and Engineering" in the specialty 163 – "Biomedical Engineering" are considered. In accordance with the international standard ISPO, a program for training specialists in prosthetics and orthoses according to the scientific plan "Orthopedic Technologies and Engineering" has been created and started to operate. The perspective of the work is the development of modern educational content for the training of highly qualified specialists of different levels of education in "Orthopedic Technologies and Engineering" in accordance with modern world standards.

Smartphone-based Identification of Critical Levels of Glycated Hemoglobin A1c using Transdermal Optical Imaging

Abstract: Worldwide, the prevalence of diabetes has continued to increase rapidly. This gives rise to concerns regarding appropriate diabetes management to ensure optimal glycemic control. Untreated or uncontrolled diabetes can lead to a host of complications, such as cardiovascular diseases, an increased likelihood of morbidity and mortality (Deshpande, Harris-Hayes, & Schootman, 2008). A challenging problem which arises in diabetes management is the limitations of current blood glucose monitoring techniques. Electronic medical devices can potentially overcome the persistent problems in the healthcare industry. Thus, for this study, it was of interest to investigate whether advanced machine learning methods and Anura, a smartphone-based transdermal optical imaging technology (TOI) that assess health markers, can be a viable solution for diabetes management. Objectives: To examine the validity of TOI and a novel machine algorithm for diabetes prediction (i.e diabetes and non-diabetes). We compared the diabetes classification from TOI’s obtained glycated hemoglobin A1c (HbA1c) concentrations against data obtained from FDA approved blood immunoassay. Methods: In the present study, we used a kitchen sink random forest machine algorithm for diabetes prediction. The data set was obtained from 513 participants recruited during their annual physical examination at the Health Management Center of The Affiliated Hospital of Hangzhou Normal University, China. This included participant’s TOI and blood immunoassay determined HbA1c concentrations. To validate the model, pristine testing was done on 400 pristine participants pseudo randomly selected during 20 trials of training/testing. Results: The confusion matrix found TOI to have a classification accuracy of 66%, and the ROC curve of the RF classifier found TOI to have a ROC AUC of 0.69. Conclusions: The present study provides evidence for the potential use of the TOI technology, Anura, for contactless, non-invasive, and inexpensive assessments of diabetes.

Self-powered pulsed direct current stimulation system for enhancing osteogenesis in MC3T3-E1

Abstract Promoting the differentiation of osteoblasts is critical to maintain bone homeostasis for treatment osteoporosis and fracture healing. For these orthopedic diseases, a portable, highly patient compliance therapy device remains a great challenge. Here, we proposed a biomechanical-energy-driven shape memory piezoelectric nanogenerator (sm-PENG) that integrated with fixation splint to promote osteogenic differentiation. The pulsed direct current (DC) generated from the sm-PENG effectively promote MC3T3-E1 preosteoblast cell proliferation, orientation and increase intracellular calcium ion. At the same time, the ALP activity of cells is also improved by pulsed-DC under long-term culture conditions. Ultimately, increasing calcium deposition, extracellular matrix mineralization and osteogenesis. Our work demonstrates the potential of sm-PENG as a power source for pulsed-DC stimulation of bone repair, and shows great prospect self-powered and portable electronic medical device.

Wearable pressure sensor based on MXene/single-wall carbon nanotube film with crumpled structure for broad-range measurements

High-performance flexible pressure sensors are attracting great interest owing to their potential applications for electronic skins, human–machine interfaces, and biomedical diagnostics. However, there remain significant challenges for the fabrication of low-cost and high-sensitivity sensors. Here, we report the preparation of Ti3C2T x MXene/single-wall carbon nanotube (SWNT) composite films through vacuum-assisted filtration followed by thermal shrinkage. SWNTs can effectively prevent MXenes from stacking and improve the electrical performance of the films. The films are used as a flexible piezoresistive sensor for pressures ranging from 33 Pa to 130 kPa. And experimental test results indicate that the fabricated pressure sensors have high sensitivity (116.15 kPa−1 below 40 kPa and 12.7 kPa−1 at 40–130 kPa), a fast response time of 13 ms, and long-term stability over 6000 periods. The sensor can be used to monitor human physiological signals, such as finger movements, voice detection, and wrist pulse in real-time. Moreover, a 4 × 4 sensor array was successfully applied in the pressure distribution mapping of different objects, indicating that the pressure sensor can be applied in electronic skin, medical devices, and other wearable devices.

Sociodemographic disparities in energy insecurity among low-income households before and during the COVID-19 pandemic

Energy insecurity is a growing public health threat among low-income populations in the United States. Prior research has shown that energy insecurity is associated with adverse health effects and can lead people to engage in risky coping strategies. Here we evaluate rates of energy insecurity, which factors contribute to it, and how the early months of the COVID-19 pandemic exacerbated the problem. We show that energy insecurity is highly prevalent among households at or below 200% of the federal poverty line. We further show that Black and Hispanic households are more likely to experience energy insecurity and face utility disconnection, as are households with young children, individuals that require electronic medical devices and those in dwellings with inefficient or poor conditions. These conditions exist under normal circumstances, and the COVID-19 pandemic seems to have exacerbated the overall incidence of energy insecurity. The inability of a household to meet basic energy needs is associated with adverse health consequences. This study finds that the COVID-19 pandemic increased the prevalence of energy insecurity, and may have widened pre-existing racial disparities in the likelihood of being energy insecure.

МАТЕМАТИЧЕСКОЕ ОБЕСПЕЧЕНИЕ ЭЛЕКТРОННОЙ АППАРАТУРЫ ДЛЯ ОБРАБОТКИ БИОМЕДИЦИНСКИХ СИГНАЛОВ

The authors analyze certain aspects that are common to many medical electronic devices and indicate the main tasks and problems that arise in the design of electronic devices. The issue of improving the efficiency of biomedical signal transducers has been resolved by improving existing transducers taking into account mathematical support and design process algorithms for the implementation of various functions of medical devices. The electrical circuit of an adaptive low-pass filter with real measurement parameters has been modeled using the Electronic Workbench program.

Impact of Health Information Technologies on the Quality of Healthcare Deliveries

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

Keeping it Clean

When it comes to designing wearable medical electronic devices it’s critical to ensure PCBs are clear of contamination,

Impact of the COVID-19 pandemic on medical education: Medical students' knowledge, attitudes, and practices regarding electronic learning.

The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education. A cross-sectional survey was conducted with medical students from more than 13 medical schools in Libya. A paper-based and online survey was conducted using email and social media. The survey requested demographic and socioeconomic information, as well as information related to medical online learning and electronic devices; medical education status during the COVID-19 pandemic; mental health assessments; and e-learning knowledge, attitudes, and practices. A total of 3,348 valid questionnaires were retrieved. Most respondents (64.7%) disagreed that e-learning could be implemented easily in Libya. While 54.1% of the respondents agreed that interactive discussion is achievable by means of e-learning. However, only 21.1% agreed that e-learning could be used for clinical aspects, as compared with 54.8% who disagreed with this statement and 24% who were neutral. Only 27.7% of the respondents had participated in online medical educational programs during the COVID-19 pandemic, while 65% reported using the internet for participating in study groups and discussions. There is no vaccine for COVID-19 yet. As such, the pandemic will undeniably continue to disrupt medical education and training. As we face the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of the COVID-19 outbreak on medical education and on the progression of training. The time for change is now, and there should be support and enthusiasm for providing valid solutions to reduce this disruption, such as online training and virtual clinical experience. These measures could then be followed by hands-on experience that is provided in a safe environment.

Unique antimicrobial/thermally conductive polymer composites for use in medical electronic devices

AbstractThe common neglect of the prominent bacterial growth and accumulation on polymer‐based thermal conductive materials used in medical electronic devices will hurt the functionality and lifetime of medical devices, and sometimes even lead to medical accidents. In this study, we developed a novel ternary composite with excellent antimicrobial and thermal conductive properties to solve this problem. This composite was composed of antimicrobial functionalized hexagonal boron nitride (AB@h‐BN) nanoplatelets, low melt alloys (LMAs), and epoxy. Antimicrobial testing showed that the AB@h‐BN/LMAs/epoxy composites were 100% against both Escherichia coli and Staphylococcus aureus; their antibacterial mechanism was contact killing and was harmless to the environment. Besides enhancing the antimicrobial property, the AB@h‐BN nanoplatelets connected the mutually independent LMAs, forming the continuous network for heat conduction in the epoxy. Benefited from this distinctive structure, the thermal conductivity of AB@h‐BN/LMAs/epoxy can reach 2.66 Wm−1 k−1, which represented an enhancement of about 1141% over the pure epoxy.

Applications of two-dimensional material-functional separator in lithium battery

In recent years, people’s continuous attention to energy crisis and environmental problems has promoted the development of electric energy storage technology. The emergence of lithium-ion battery (LIB) has profoundly impacted on society by providing energy storage for portable electronic devices, medical devices and electric vehicles. However, the electrode materials can only contribute a low capacity due to the intercalation reaction chemistry, specific capacity of Li-ion batteries cannot be further improved. Therefore, lithium secondary battery systems with higher energy and power density need to be developed for the next generation of electric vehicles.The lithium metal has an extremely high theoretical specific capacity (3860 mAh/g) and low redox potential (–3.04 V vs. standard hydrogen electrode), giving the lithium battery a high energy density when used as a anode material. And when sulfur used as a cathode material, its theoretical specific capacity reaches 1672 mAh/g, thus the theoretical energy density of the lithium sulfur (Li-S) battery system is as high as 2600 Wh/kg. However, the polysulfides in Li-S battery seriously affect the safety and electrochemical performance of the cell. When lithium metal used as anode materials, the uncontrolled dendrite growth also brings serious safety risks to users. Therefore, all the basic components of lithium batteries, including the anode, cathode, separator and electrolyte, need to be optimized. Most of the current research has focused on the development of high-capacity anode and cathode materials. In fact, functional separators have an important impact on the safety and electrochemical performance of lithium secondary batteries. Compared with other materials that modified commercial polyolefin membranes, two-dimensional materials offer the advantages of ultra-thin laminate structure, high mechanical strength, high specific area, and adjustable surface chemical properties. Therefore, in Li-S batteries, two-dimensional material-functionalized separators can inhibit the shuttle effect of polysulfides through chemical adsorption and confined pore channels. In Li-metal batteries, the inhibition of dendritic growth by two-dimensional functional membranes is mainly due to its high mechanical strength, thermal conductivity and the ability to regulate ion transport flux through defect sites. And in Li-ion batteries, the two-dimensional functional separator mainly improves the wettability and poor thermal stability of routine polyolefin membrane, thus it greatly enhances the electrochemical performance and safety performance of lithium cells. This review first introduces the unique advantages of two-dimensional materials in the membrane, including parallel self-assembly feature, excellent mechanical strength and flexibility, ultrahigh specific surface area, surfaces are easily modified and element doped and ultrathin laminar structure. Then the review briefly describes the method of constructing two-dimensional materials separators and its characterization. Subsequently, this paper focuses on the application of different types of two-dimensional materials functional membranes in solving polysulfide shuttle effect in Li-S batteries, dendrite growth of anode in Li-metal batteries, as well as poor wettability and thermal stability of commercial separator in Li-ion batteries. Finally, the remaining opportunities and challenges of two-dimensional materials in Li battery separator materials are briefly discussed.

Unfolding the future: Self-controlled catalytic nanomotor in healthcare system.

Nanomotors, multimetallic systems are biologically inspired self-propelled tiny engines able to perform difficult tasks of transporting cargos from one end to another in presence of hydrogen peroxide fuel. Nanomotors can revolutionize the drug delivery system at the desired target by converting chemical energy into mechanical energy. Nanomotors exhibit unique properties like moving at higher speed, self-propulsion and drilling into the complex cellular environment. The review focuses on fuel dependent and fuel-free nanomotors with their propulsion mechanism. Further, the review highlights the method of fabrication, biohybrid nanomotors, toxicities along with their application in the field of active drug delivery, diabetes, precise surgery, ischemic stroke therapy, diagnosis and treatment of coronavirus, microwave hyperthermia, zika virus detection, anti-bacterial activity, water treatment and sensing and challenges lying at the forefront in the development of these tiny nanomachines. Hydrogen peroxide is toxic to mankind; biohybrid motors give an extra edge of eliminating hydrogen peroxide as fuel for self-propulsion, this can be used for smart drug delivery by reducing toxicities as compared to artificial nanomotors. Cost-effective fabrication of nanomotors will extend their applications in commercial sector overcoming limitations like scale-up and regulatory approval. In near future, nanomotors will diversify in fields of restoring conductivity of electronic medical devices, 3D printing and theranostics.

RETRACTED ARTICLE: Ontology-based prediction of cochlear implantation outcome using cross-modal plasticity analysis

Cochlear implantation is a surgical procedure by which an electronic medical device, namely a cochlear implant, is fitted to the individual who has the challenge of hearing. It takes the function of the damaged inner ear, the cochlea. The hearing impaired may not benefit from this procedure because of cross-modal plasticity. This work aims to study the implantee’s visual modal adaptation by analyzing the visual evoked potential. The proposed methodology analyses the existence of cross-modal reorganization in the auditory cortex of bilateral prelingually deaf children after cochlear implantation using visual evoked potential. Fifty healthy, 50 prelingually, deaf children 50 cochlear implanted were considered as a cohort of the Visual evoked potential. The evoked potential recorded using pattern reversal stimulation. The amplitude and latency of N75, P100, and N145 components show a significant difference in normal, cochlear, and deaf. The early diagnosis of hearing impairment demands the patients and doctors to make a series of decisions for the betterment of the implantee in an accelerated manner through traditional database methodology implemented for making decisions, analyzing, interpreting, processing of data is so difficult in the conventional system. Medical knowledge represented for the computers to analyze the inferred data and to make the decisions. Ontology is the most potent tool to encode medical data semantically. A fuzzy ontology-based decision support system built to predict the cochlear implantation outcome. The ontology created using Protege software tool and the decision taken using Jena and pellet reasoner. A fuzzy-based prediction model designed using a fuzzy interface system to estimate the categories of auditory performance (CAP) test reliable indicators of cochlear implantation success.

Highly Sensitive, Breathable, and Flexible Pressure Sensor Based on Electrospun Membrane with Assistance of AgNW/TPU as Composite Dielectric Layer

Pressure sensors have been widely used in electronic wearable devices and medical devices to detect tiny physical movements and mechanical deformation. However, it remains a challenge to fabricate desirable, comfortable wearing, and highly sensitive as well as fast responsive sensors to capture human body physiological signs. Here, a new capacitive flexible pressure sensor that is likely to solve this problem was constructed using thermoplastic polyurethane elastomer rubber (TPU) electrospinning nanofiber membranes as a stretchable substrate with the incorporation of silver nanowires (AgNWs) to build a composite dielectric layer. In addition, carbon nanotubes (CNTs) were painted on the TPU membranes as flexible electrodes by screen printing to maintain the flexibility and breathability of the sensors. The flexible pressure sensor could detect tiny body signs; fairly small physical presses and mechanical deformation based on the variation in capacitance due to the synergistic effects of microstructure and easily altered composite permittivity of AgNW/TPU composite dielectric layers. The resultant sensors exhibited high sensitivity (7.24 kPa−1 within the range of 9.0 × 10−3 ~ 0.98 kPa), low detection limit (9.24 Pa), and remarkable breathability as well as fast responsiveness (<55 ms). Moreover, both continuously pressing/releasing cycle over 1000 s and bending over 1000 times did not impair the sensitivity, stability, and durability of this flexible pressure sensor. This proposed strategy combining the elastomer nanofiber membrane and AgNW dopant demonstrates a cost-effective and scalable fabrication of capacitive pressure sensors as a promising application in electronic skins and wearable devices.

Preliminary Effects of a Mobile Interactive Supervised Therapy Intervention on People Living With HIV: Pilot Randomized Controlled Trial.

BackgroundAs people living with HIV infection require lifelong treatment, nonadherence to medication will reduce their chance of maintaining viral suppression and increase the risk of developing drug resistance and HIV transmission.ObjectiveThis study aimed to evaluate the efficacy of a mobile app, Mobile Interactive Supervised Therapy (MIST), for improving adherence to oral HIV medications among HIV-infected adults in Singapore.MethodsWe conducted a two-group pilot randomized controlled trial (RCT) with a process evaluation, in which 40 HIV-infected participants with once-daily medication regimes were recruited from a public tertiary hospital in Singapore and randomly assigned equally to either the intervention (receiving MIST and routine care) or control (receiving routine care only) groups. The intervention lasted for 2 months. The outcome of antiretroviral therapy (ART) adherence was measured by a 7-day recall self-report (SR), pill count (PC), an electronic medical device—Medication Event Monitoring System (MEMS)—and a mobile app—MIST (for the intervention group only). In total, 20 participants from the intervention group were interviewed at the end of the intervention to assess the acceptability of MIST. Data were collected at baseline and at 1-month and 2-month postintervention.ResultsAll participants had excellent medication adherence at baseline (median 100, IQR 100-100). The use of MIST did not result in a significant improvement in ART adherence when measured by the SR, PC, and MEMS, as compared with the control group at 1-month (P values >.99, .86, and .74, respectively) and 2-month (P values=.80, .84, and .82, respectively) postintervention. ART adherence also did not improve in each group over the same period. MIST was perceived to be a beneficial tool based on the process evaluation results.ConclusionsAlthough MIST did not enhance medication adherence to HIV treatments, mainly owing to the ceiling effect, it was perceived to be beneficial among the participants of this study. Our process evaluation provided useful data to further develop MIST for bigger and long-term mobile phone app–assisted intervention RCTs in the future.Trial RegistrationClinicalTrials.gov NCT03794648; https://clinicaltrials.gov/ct2/show/NCT03794648

Energy Band Gap Investigation of Biomaterials: A Comprehensive Material Approach for Biocompatibility of Medical Electronic Devices.

Over the past ten years, tissue engineering has witnessed significant technological and scientific advancements. Progress in both stem cell science and additive manufacturing have established new horizons in research and are poised to bring improvements in healthcare closer to reality. However, more sophisticated indications such as the scale-up fabrication of biological structures (e.g., human tissues and organs) still require standardization. To that end, biocompatible electronics may be helpful in the biofabrication process. Here, we report the results of our systematic exploration to seek biocompatible/degradable functional electronic materials that could be used for electronic device fabrications. We investigated the electronic properties of various biomaterials in terms of energy diagrams, and the energy band gaps of such materials were obtained using optical absorption spectroscopy. The main component of an electronic device is manufactured with semiconductor materials (i.e., Eg between 1 to 2.5 eV). Most biomaterials showed an optical absorption edge greater than 2.5 eV. For example, fibrinogen, glycerol, and gelatin showed values of 3.54, 3.02, and 3.0 eV, respectively. Meanwhile, a few materials used in the tissue engineering field were found to be semiconductors, such as the phenol red in cell culture media (1.96 eV energy band gap). The data from this research may be used to fabricate biocompatible/degradable electronic devices for medical applications.

A Review of Methods and Challenges for Improvement in Efficiency and Distance for Wireless Power Transfer Applications

Abstract Over the past few years, interest and research in wireless power transfer (WPT) have been rapidly incrementing, and as an effect, this is a remarkable technology in many electronic devices, electric vehicles and medical devices. However, most of the applications have been limited to very close distances because of efficiency concerns. Even though the inductive power transfer technique is becoming relatively mature, it has not shown near-field results more than a few metres away transmission. This review is focused on two fundamental aspects: the power efficiency and the transmission distance in WPT systems. Introducing the principles and the boundaries, scientific articles will be reviewed and discussed in terms of their methods and respective challenges. This paper also shows more important results in efficiency and distance obtained, clearly explaining the theory behind and obstacles to overcome. Furthermore, an overlook in other aspects and the latest research studies for this technology will be given. Moreover, new issues have been raised including safety and security.

Progress in self-powered health monitoring and physiological function regulation devices

Nanogenerator (triboelectric nanogenerator and piezoelectric nanogenerator) has experienced a rapid development since it was proposed. This technique can covert various mechanical energies into electric energy, including human motion energy, wind energy, acoustic energy and ocean energy. The converted electricity can be used for health monitoring and physiological function regulation, such as pulse detection, bioelectrical stimulation and cardiac pacing. This review summarizes the structure, working mechanism, output performance of nanogenerator and its latest progress in circulatory system, nervous system, biological tissue, sleep and rescue system. Additionally, a further analysis was also made on the application challenge of nanogenerator in clinical treatment. In the future, nanogenerator is expected to be an auxiliary power source, or even to replace battery to power medical electronic device and realize the self-powered health monitoring and physiological function regulation of human body.

Embedded memory options for ultra-low power IoT devices

The Internet of Things (IoT) connects everyday devices to the internet to gather information using sensors and embedded systems. Emerging low power for Internet of Things wearables, and medical electronic devices has an ultimate goal to reduce overall system power and increase battery life. These applications require efficient memory solutions. Ultra-low energy dissipation for Internet of things devices enables prolonged battery life. Minimizing energy consumption requires correct architectural choice. This paper presents the selection of memory options for Ultra-low power IoT devices. Three type of memories which are flip-flop base memory, latch-based memory and SRAM based memory has been evaluated for 65 nm low power foundry technology. The result of the study shown that latch based memory has better resource utilization in terms of power−area product. The latch based RAM saved 60% in power-area product, relative to an SRAM based memory and more than 90% relative to a flip-flop based RAM. The study is targeting wearable electronics for ECG monitoring which requires 2 KB of RAM.

Abstract CT173: Tumor Treating Fields (150 kHz) concurrent with standard of care treatment for stage 4 non-small cell lung cancer (NSCLC) following platinum failure: The Phase III LUNAR study

Abstract Background Tumor Treating Fields (TTFields) is a non-invasive, anti-mitotic treatment that disrupts the formation of the mitotic spindle and dislocation of intracellular constituents. TTFields plus temozolomide significantly extended survival in newly diagnosed glioblastoma. Efficacy of TTFields in NSCLC has been shown in preclinical in vitro and in vivo models. In a Phase I/II pilot study [NCT00749346} of advanced NSCLC, TTFields in combination with pemetrexed detected no serious adverse events and median overall survival (OS) was 13.8 months. In the Phase III LUNAR study [NCT02973789], we investigated if the addition of TTFields to immune checkpoint inhibitors or docetaxel following platinum doublet failure will increase overall survival (OS). Methods Patients (N=534), with squamous or non-squamous NSCLC, are stratified by their selected standard therapy (immune checkpoint inhibitors or docetaxel), histology (squamous vs. non-squamous) and geographical region. Key inclusion criteria are disease progression while on or after platinum-based therapy, ECOG 0-2, no electronic medical devices in the upper torso, and absence of brain metastasis. Docetaxel or immune checkpoint inhibitors are given at standard doses. TTFields (150 kHz) are applied to the upper torso for at &amp;gt;18 hours/day, allowing patients to maintain daily activities. TTFields are continued until progression in the thorax and/or liver. Follow up is performed once q6 weeks, including CT scans of the chest and abdomen. On progression in the thorax and/or liver, patients have 3 post-progression follow up visits and are then followed monthly for survival. The primary endpoint is superiority in OS between patients treated with TTFields in combination with the standard of care treatments versus standard of care treatments alone. Key secondary endpoints compare the OS in patients treated with TTFields and docetaxel versus docetaxel alone, and patients treated with TTFields and immune checkpoint inhibitors vs those treated with immune checkpoint inhibitors alone. An exploratory analysis will test non-inferiority of TTFields with docetaxel compared to checkpoint inhibitors alone. Secondary endpoints include progression-free survival, radiological response rate, quality of life based on the EORTC QLQ C30 questionnaire and severity and frequency of adverse events. The sample size is powered to detect a HR of 0.75 in TTFields-treated patients versus control group. Citation Format: Uri Weinberg, Ori Farber, Moshe Giladi, Zeev Bomzon, Eilon Kirson. Tumor Treating Fields (150 kHz) concurrent with standard of care treatment for stage 4 non-small cell lung cancer (NSCLC) following platinum failure: The Phase III LUNAR study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT173.