Increase Patient Comfort Research Articles

P278 Pan-enteric capsule to assess treatment effects of vedolizumab in IBD patients: A 1 year proof of concept study

Abstract Background Pan-enteric capsule (PEC) endoscopy may be an acceptable alternative to more invasive endoscopy in the assessment of patients with IBD. These patients require endoscopic assessment of disease extent and severity to guide both initiation and continuation of biological therapy. There are many potential benefits including: increased patient comfort, lower complication risk, no sedation related risks and greater convenience for the patient. Vedolizumab is an effective biological agent for both UC and Crohn’s disease. Previous studies largely concentrated their endoscopic analysis on improvements seen within the colonic mucosa. However, less is known about the effects of Vedolizumab on the small bowel Crohn’s disease. Using a pan-enteric capsule (PillCam Crohn’s Capsule, Medtronic, USA), we evaluated the symptomatic, clinical and endoscopic improvements seen in a group of IBD patients over a 1 year treatment course of Vedolizumab. We also assessed any patient preference for PEC as opposed to colonoscopy. Methods A group of 10 patients starting Vedolizumab were evaluated at 0, 6 and 12 months via PEC, rather than colonoscopy +/- small bowel capsule/MRI. Biochemical and clinical evaluation used ESR, Calprotectin and symptomatic scores (HBI or mUCDAI). The extent and severity of the underlying Crohn’s disease was assessed using the Eliakim score, which has shown strong inter-reader reliability and moderate-to-strong correlation with the Lewis score. Questionnaires were completed post procedure to determine patient acceptability. Results We found the average ESR reduced from 30 (range 7–81) to 12.1 (2–31) after 1 year of Vedolizumab. Likewise, the average faecal calprotectin dropped from 1263.6 (189->1800) to 440.1 (30–1460). The modified UCDI score and modified HBI reduced from 5 to 0, and 7.5 to 3.5, respectively. The average small bowel PillCam Crohn’s Capsule Score reduced from 5 to 2.8, whilst the Eliakim Score dropped from 13.6 (6–30) to 5.2 (0–22). The comfort score for PEC was on average 9.5/10, with all 10 patients reporting a preference to continue with PEC evaluation in the future. Conclusion PEC provides an excellent evaluation of the pan-intestinal extent and severity of IBD, and the effects of a treatment regime. We feel PEC should be considered as a 1st line assessment tool when evaluating the effectiveness of biological therapy in IBD patients, especially those with small bowel Crohn’s disease. Whilst Vedolizumab has already been shown to be beneficial in the treatment of colonic inflammation, this proof of concept study also demonstrated its beneficial effect in reducing inflammation across all 3 segments of the small bowel in those with Crohn’s disease.

Diode Laser in the Management of Leukoplakia - A Retrospective Study.

Leukoplakia is among the most common potentially malignant disorders encountered in clinical dental practice. The treatment of leukoplakia includes nonsurgical and surgical management. The surgical treatment includes excision, electrocauterisation, laser surgery or cryosurgery. This retrospective study aimed to analyse the efficacy of diode lasers in the management of leukoplakia. The sample consists of 56 cases with 77 leukoplakia sites treated with diode laser between January 2018 and December 2020 with a minimum of six months follow-up. For each patient, personal data was collected along with site of lesions, leukoplakia phase, type of treatment performed (laser ablation or laser excision), side effects, recurrences and malignant transformation. Inferential statistical analysis was then conducted. After applying exclusion criteria, 56 cases with 77 leukoplakia sites were included in this study. Males aged >45 years were predominantly affected. Homogeneous leukoplakia (48.1%) was the most common phase. Recurrences were noted in 19.48% of the cases. Compared to laser excision, laser ablation had more recurrences. Gingival lesions showed a higher recurrence rate than other sites in the oral cavity. None of the cases showed malignant transformation. Laser offers many advantages over other conventional methods including lesser postoperative pain and swelling, bloodless dry operating field and increased patient comfort and requires minimal local anaesthesia. The study concluded that diode laser is an effective surgical treatment modality for treating leukoplakia. Furthermore, the laser excision technique was found to be superior to laser ablation due to lesser recurrence.

Effect of Kegel Pelvic Floor Muscle Exercise Combined with Clean Intermittent Self-catheterization on urinary retention after radical hysterectomy for cervical cancer.

Objectives:To investigate the effect of Kegel pelvic floor muscle training combined with clean intermittent self-catheterization on patients with cervical cancer, and to analyze the risk factors affecting urinary retention.Methods:A total of 166 patients with cervical cancer admitted to our hospital from October 2016 to December 2019, all of whom received radical resection of cervical cancer, were divided into two groups according to the random number table method: the observation group and the control group, with 83 cases in each group. The control group underwent clean intermittent self-catheterization, while the observation group underwent Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization. The catheter replacement rate, bladder residual urine volume, self-perceived burden scale (SPB), Kolcaba general comfort questionnaire (GCQ), incidence of urinary tract infection, and urinary retention after catheter removal were compared between the two groups. Logistics regression analysis was utilized to analyze the risk factors affecting urinary retention.Results:The incidence of catheter replacement, urinary retention, dysuria and bladder residual urine volume in the observation group were significantly lower than those in the control group (P<0.05). Postoperative SPB score of the two groups decreased significantly, while the GCQ score increased significantly. Postoperative SPB score of the observation group was significantly lower than that of the control group, while the GCQ score was significantly higher than that of the control group (P<0.05). Statistically significant differences can be observed in the comparison of catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin between the two groups (P<0.05). Logistic regression analysis showed that catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin were independent risk factors affecting urinary retention (P<0.05).Conclusions:Catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin are the risk factors for postoperative urinary retention in patients with cervical cancer. With Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization, a variety of benefits can be realized, such as improved bladder function, reduced incidence of urinary tract infections and urinary retention, as well as increased patient comfort.

Changing trends in orthodontic arch wire

Orthodontic wires are integral part of fixed mechanotherapy in orthodontics which are used to facilitate tooth movement. A wide range of materials available that are used to manufacture orthodontic archwires. Selection of suitable wire material increase patient comfort, efficiency of orthodontic mechanics and reduce chair side time. Nowadays esthetic wire materials are available that can be used in esthetically conscious patients. This article discusses the changing trend in wire materials.

Aromatherapy in Stroke Patients: Is it Time to Begin?

Stroke is the second largest cause of death worldwide, causing disease with long-term consequences and considerable healthcare costs. The application of new nursing interventions aimed at reducing distressing behaviors and at increasing patient comfort is an important part of the care and, until now, there are no defined guidelines. Aromatherapy has been demonstrated to be efficient in several other neurological disorders for the treatment of somatic and emotional diseases and to promote patient health. In the management of stroke patients, aromatherapy is still in its infancy. The first evidence coming from animal models demonstrated a consistent and reliable neuroprotective effect in reducing cerebral ischemia–reperfusion injury. In the last few years, some preliminary data being to be collected in humans revealed significant influence in reducing patients’ pain and emotional distress. In this perspective study, we sought to summarize, for the first time, the main findings emerging from this new field of study, discussing the future opportunities to be translated into primary care practice.

"It was surprisingly equivalent to the appointment I had in person": Advantages and disadvantages of synchronous telehealth for delivering primary care for autistic adults.

Autistic adults face many barriers to receiving quality primary health care like clinics that are far away and sensory sensitivities. Real-time telehealth visits, called "virtual visits," are live video chats between the patient and provider. Virtual visits may minimize barriers to care for autistic adults. We wanted to describe advantages and disadvantages of using virtual visits for delivering primary health care for autistic adults. We interviewed 7 autistic adults and 12 caregivers of autistic adults who receive primary care through one clinic. Autistic adults and caregivers said advantages to virtual visits were that (1) patients were more comfortable at home, (2) patients could get health care while avoiding physical contact with other people during the pandemic, and (3) virtual visits were similar to or better than in-person visits. The disadvantages included that (1) there could be technology problems like grainy video, (2) the doctor could not physically examine the patient (e.g. look in ears), and (3) patients sometimes participated less in the virtual visit than they would in person. Virtual visits may be beneficial for autistic adults by eliminating travel to the clinic and avoiding stressful sensory stimuli. We recognize that virtual visits may not work for all patients or in all situations. However, our study shows that primary care virtual visits may be beneficial for autistic adults during and beyond the pandemic.

Usefulness of SARS-CoV-2 antigen test sample as input for SARS-CoV-2 RT-PCR analysis.

SARS‐CoV‐2 rapid detection is of great interest to prevent viral dissemination. In that sense, antigen tests appeared as a very valuable tool to reach this goal. However, it is possible to obtain a negative result in those patients with low viral loads, and consequently, reverse transcription‐polymerase chain reaction (RT‐PCR) should be performed on samples from patients with a negative antigen test in which there is a strong suspicion of COVID infection. The common diagnostic algorithm involves taking a second sample for RT‐PCR testing. This study evaluates the usefulness of the antigen test sample for carrying out RT‐PCR analysis when necessary. Results obtained indicate that can be used a unique sample for both antigen test and RT‐PCR. This data showed that it is possible to reduce excessive suspected individuals managing and so on increase staff security and patient comfort.

Potential of spiral breast computed tomography to increase patient comfort compared to DM

PurposeTo intra-individually compare patient comfort of spiral breast computed tomography (SBCT) versus digital mammography (DM). MethodThis prospective IRB approved study included 79 patients undergoing both SBCT and DM for the assessment of BI-RADS 4 – 6 lesions.Following SBCT and DM patients answered a standardized questionnaire regarding “Overall patient comfort” and “Pain” on a 5-point Likert Scale.On the same Likert Scale, experienced radiologic technicians rated the workflow of the SBCT regarding patients’ “Mobility”, ease of patient “Positioning”, patients’ adherence to the examination (“Compliance”) and expected image quality.Visibility of fibroglandular tissue in SBCT was independently rated by two breast radiologists on a 10-point Likert Scale.Subgroups stratified by menopausal status and body mass index (BMI) were analyzed. ResultsPatients reported significantly lower pain during SBCT (4.73 ± 0.57) compared to DM (4.09 ± 0.90; P < 0.01). This effect was independent from BMI. However, pain reduction by SBCT was most pronounced in premenopausal (SBCT vs. DM: 4.79 ± 0.50 vs. 3.89 ± 0.99) compared to postmenopausal patients (4.71 ± 0.77 vs. 4.20 ± 0.89). Overall patient comfort in premenopausal patients tended to be higher in SBCT compared to DM (P = 0.08).Radiologic technicians rated the SBCT procedure generally as positive (average: 4.62 ± 0.56). Coverage of fibroglandular tissue in SBCT was generally high (9.82 ± 0.43) and interrater agreement was good (κ = 0.77). ConclusionsPatients experience less pain during spiral breast computed tomography compared to DM, especially in premenopausal women. Imaging is feasible at a high level of anatomical breast coverage and without problems with the clinical workflow.

DIAGNOSTICS AND INTENSIVE CARE OF HEART FAILURE IN PATIENTS WHO UNDERWENT CORONARY ARTERY BYPASS GRAFT SURGERY WITH ARTIFICIAL CIRCULATION

Abstract. Introduction. Coronary heart disease, the complexity of the surgery conducted, inflammatory reaction to extracorporeal circulation and the need for perioperative anticoagulation influence perioperative state of hemodynamics during the surgical revascularization of a myocardium in patients with coronary heart disease.&#x0D; The aim. To improve the results of treatment of cardiac surgery patients with heart failure who underwent surgery, namely, coronary artery bypass grafting using extracorporeal circulation by improving methods of diagnosing heart failure.&#x0D; Materials and methods. 100 cardiac surgery patients with coronary heart disease were operated on at State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. In all the cases, coronary artery bypass grafting was performed using artificial circulation. In patients of group 1 (40 patients) in the postoperative period, the correction of hemodynamic disorders was performed according to the standard protocol. In group 2 (60 patients) - a differentiated approach to the correction of hemodynamic disorders was used.&#x0D; Results. It was found that in group 2 for stabilization of hemodynamics, oxygen status, microcirculation, smaller doses of sympathomimetics and shorter duration of their use, P &lt;0.05 than in 1 were applied.&#x0D; Conclusions. The results of the studies indicate the possibility of using the method of phasography, in particular, the analysis of symmetry of the T wave, as a marker of ischemic changes in the myocardium in cardiac patients who underwent coronary artery bypass grafting using artificial circulation. The obtained data show that the developed algorithm of perioperative management of cardiac surgery patients with heart failure makes it possible to significantly accelerate the rehabilitation of cardiac surgery patients, increase patient comfort and reduce the length of their hospitalization. The possibility of using phasography for monitoring of myocardial condition in patients undergoing coronary artery bypass surgery has been investigated.

Comparison of high-flow and conventional nasal cannula oxygen in patients undergoing endobronchial ultrasonography.

Oxygen therapy is required to prevent hypoxaemia during the endobronchial ultrasonography (EBUS) procedure. To compare the effectiveness of oxygen therapy delivered through high-flow nasal cannula (HFNC) and conventional nasal cannula (CNC) in patients undergoing EBUS. The primary outcome was the proportion of patients who desaturated. Patient compliance and satisfaction were also evaluated. This single-centre prospective interventional study was conducted in a tertiary hospital among patients who presented to the EBUS unit in 2018 and 2019. Patients were randomly assigned to the HFNC group or the CNC group. The study included 170 patients (111 men and 59 women) with a mean age of 58 ± 14 years. The number of patients experiencing desaturation while receiving oxygen was statistically significantly lower (P < 0.001) in the HFNC group (n = 5) compared with the CNC group (n = 26). Oxygen therapy was adjusted in two patients in the CNC group due to desaturation. Saturation was significantly higher in the HFNC group (P < 0.0001) at the end of the EBUS procedure. Heart rate at the end of EBUS was lower in the HFNC group, but this difference was not statistically significant (96 ± 16 vs 101 ± 19, P = 0.13). Five patients in the HFNC group and 18 patients in the CNC group reported discomfort during the procedure (P = 0.006). Oxygen therapy delivered by HFNC seems to be safer and more effective than by CNC in patients undergoing EBUS. Oxygen therapy with HFNC may be considered as an alternative to CNC because it may increase patient comfort and thereby improve compliance.

Identifying Barriers to Effective Patient-Provider Communication About Food Insecurity Screenings in Outpatient Clinical Settings in Central Florida: A Mixed-Methods Study.

Screening for food insecurity in health care settings is inconsistently performed among health care providers. This study examined how patient-provider interactions influenced patient comfort discussing food insecurity, an important social determinant of health. We conducted a convergent mixed-methods study and surveyed patients on their experiences with patient-centered care when communicating and interacting with their providers, and their comfort level being screened for food insecurity. Telephone interviews were also conducted to better understand the concepts in the survey. Various clinical organizations in Central Florida, as well as food pantries affiliated with Second Harvest Food Bank. Forty-six patients in Central Florida completed the survey, 12 of whom completed qualitative portions of the study (7 completing the qualitative survey questions and 5 completing a telephone interview). Patient comfort discussing food insecurity with their health care providers. Quantitative findings show that patient involvement in care planning and cultural sensitivity of health care providers were 2 important factors associated with patient comfort being screened for food insecurity. Qualitative findings suggest that providers' effective communication and empathy are other factors that can influence patient comfort. To effectively address food insecurity of vulnerable patients and communities, it is important that providers conduct screenings within their practice. This study points to specific actions that providers may employ to increase patient comfort discussing this topic. Efficiently identifying food-insecure patients and connecting them to appropriate community resources would improve patient health and aid in efforts to eliminate health disparities.

25-Gauge vitrectomy; Up-to-date Indications and Applications

Reduction of surgical time, increased patient comfort by decreased postoperative inflammation and fast postoperative recovery time are the main benefits of 25-G vitrectomy. Recently, with the advent of new microsurgical instrumentation and the improvement of surgical skills, we can use 25-G vitrectomy in a wide spectrum of vitreoretinal pathology. In this review, we aimed to summarize the surgical advances and evolution of 25-Gauge vitrectomy and discuss its advantages and application in vitreoretinal surgery.

The Correlation between Marketing Mix and Customer Satisfaction in the General Poly Unit at Bhayangkara Hospital, Kupang

Patient satisfaction is one of the important things in reviewing the quality of service of a health agency. The marketing mix is ​​a set of tools that play an important role as a company strategy and policy to achieve customer satisfaction. Bhayangkara Hospital is a type C hospital that provides individual health services with inpatient and outpatient treatment, and emergency services. The purpose of this study was to determine the relationship between marketing mix and customer satisfaction in the general poly unit of Bhayangkara Hospital. The research design was an analytic survey with a cross sectional design. The research sample consisted of 90 respondents who were selected using accidental sampling technique. The results of the study found that there was a relationship between product mix (p = 0.003), place (p = 0.037), promotion (p = 0.037), people (p = 0.046), process (p = 0.050) and physical evidence (p = 0.037) with customer satisfaction. And there is no relationship between price mix (p = 0.228) with customer satisfaction. The hospital should pay more attention to the supporting facilities and infrastructure to increase patient comfort in the general poly unit of Bhayangkara Hospital.

Patient Perception Regarding the Safety of Elective Joint Arthroplasty Surgery During the COVID-19 Pandemic.

BackgroundTotal joint arthroplasty (TJA) practices have been dramatically impacted by the COVID-19 pandemic. To date, no study has assessed trends in patient perceptions regarding the safety of elective TJA.MethodsA single-institution, prospective cohort study was conducted between May 11th and August 10th, 2020. All patients who underwent elective hip and knee arthroplasty were contacted via telephone or emailed surveys. Two-hundred and thirty-five consecutive patients were screened, and 158 agreed to participate. The average age was 65.9 ± 11.5 years, with 51.0% of patients being female. The percentage of participants who underwent total knee, total hip, and unicompartmental knee arthroplasty was 41.4%, 37.6%, and 21.0%, respectively. Survey components assessed demographic data, level of concern and specific concerns about the pandemic, and factors increasing patient comfort in proceeding with surgery.ResultsOlder age (P = .029) and female sex (P = .004) independently predicted higher concern on multivariate analysis. Race (P = .343), surgical site (knee vs hip, P = .58), and procedure type (primary vs revision, P = .26) were not significantly related to degree of concern. Most participants (71.5%) disagreed that the pandemic would negatively affect the outcome of their surgery. Patient concern mirrored statewide COVID-19 cases and deaths, rather than local municipal trends. The most cited reassuring factors were preoperative COVID-19 testing, personal protective equipment usage by hospital staff, and surgeon support.ConclusionsPatient concern regarding the safety of elective TJA may follow broader policy-level events rather than local trends. Surgeons should note that universal preoperative COVID-19 testing, adequate personal protective equipment, and surgeon support were reassuring to patients.Level of EvidenceLevel IV Therapeutic.

Patient Satisfaction with Telehealth During the COVID-19 Pandemic in a Pediatric Pulmonary Clinic.

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has drastically impacted health care delivery systems and has resulted in the rapid implementation of telehealth services across many health care specialties. As the COVID-19 pandemic highlighted the need to leverage digital mediums to increase patient access to health care, our pediatric pulmonary division sought to measure patient satisfaction with a new telehealth platform.MethodA survey was sent to 281 pediatric pulmonary patients from March 2020 to April 2020. Parents were asked to rate their overall experience with telemedicine.ResultsFifty surveys were completed, and results indicated that overall initial satisfaction with care was high. Eighty-two percent of participants either strongly agreed or agreed that they would use telehealth services again.DiscussionThe positive outcome measures may reflect increased patient comfort with integrating telehealth into routine pediatric pulmonary care services. Given high patient satisfaction ratings, we believe that the telehealth platform should be considered for use in routine practice after the COVID-19 pandemic has resolved.

Could the Valsalva manoeuvre be an alternative to the tenaculum for intrauterine device insertion?

Objectives This study investigated whether the Valsalva manoeuvre (VM) could be an alternative to use of the tenaculum for intrauterine device (IUD) insertion. The aims were to establish whether VM could provide good patient comfort and enable the insertion to be performed successfully with adequate pain control in cases where the cervix could not be passed spontaneously. Methods Women who attended the outpatient clinic of Alanya Education and Research Hospital between November 2017 and December 2020 for IUD insertion were randomly assigned to the VM (n = 52) or tenaculum (n = 55) group. Insertion in the latter group was carried out by grasping the cervix with a single-toothed tenaculum. In the VM group, no tenaculum was used to grasp the cervix; instead, the woman was asked to perform VM during insertion. Results IUD insertion success rates were similar between the groups. Procedural anxiety scores were slightly higher in the tenaculum group. Pain scores measured during the procedure were significantly higher in the tenaculum group compared with the VM group. Severe pain was reported by 58.2% of women in the tenaculum group, whereas 57.7% of women in the VM group reported no pain. Conclusion In cases where an IUD cannot be passed through the cervical canal spontaneously, the procedure should be attempted using VM before using a tenaculum. The use of VM may lead to lower pain and anxiety levels as well as increased patient comfort.

A dual-time-window protocol to reduce acquisition time of dynamic tau PET imaging using [18F]MK-6240

Background[18F]MK-6240 is a PET tracer with sub-nanomolar affinity for neurofibrillary tangles. Therefore, tau quantification is possible with [18F]MK-6240 PET/CT scans, and it can be used for assessment of Alzheimer’s disease. However, long acquisition scans are required to provide fully quantitative estimates of pharmacokinetic parameters. Therefore, on the present study, dual-time-window (DTW) acquisitions was simulated to reduce PET/CT acquisition time, while taking into consideration perfusion changes and possible scanning protocol non-compliance. To that end, time activity curves (TACs) representing a 120-min acquisition (TAC120) were simulated using a two-tissue compartment model with metabolite corrected arterial input function from 90-min dynamic [18F]MK-6240 PET scans of three healthy control subjects and five subjects with mild cognitive impairment or Alzheimer’s disease. Therefore, TACs corresponding to different levels of specific binding were generated and then various perfusion changes were simulated. Next, DTW acquisitions were simulated consisting of an acquisition starting at tracer injection, a break and a second acquisition starting at 90 min post-injection. Finally, non-compliance with the PET/CT scanning protocol were simulated to assess its impact on quantification. All TACs were quantified using reference Logan’s distribution volume ratio (DVR) and standardized uptake value ratio (SUVR90) using the cerebellar cortex as reference region.ResultsIt was found that DVR from a DTW protocol with a 60-min break between two 30-min dynamic scans closely approximates the DVR from the uninterrupted TAC120, with a regional bias smaller than 2.5%. Moreover, SUVR90 estimates were more susceptible (regional bias ≤ 19%) to changes in perfusion compared to DVR from a DTW TAC (regional bias ≤ 10%). Similarly, SUVR90 was affected by late-time scanning protocol delays reaching an increase of 8% for a 20-min delay, while DVR was not affected (regional bias < 1.5%) by DTW protocol non-compliance.ConclusionsTherefore, such DTW protocol has the potential to increase patient comfort and throughput without compromising quantitative accuracy and is more reliable against SUVR in terms of perfusion changes and protocol deviations, which could prove beneficial for drug effect assessment and patient follow-up using longitudinal [18F]MK-6240 PET imaging.

Direct Digitalization Devices in Today’s Dental Practice: Intra Oral Scanners

Rapidly developing technologies and new changes in modern dentistry have led to more effective solutions to be used in our clinical practice. The digital workflow includes some steps, such as data acquisition, digitalization, designing, and subsequently manufacturing by using digital devices. In this process, acquiring the images from patients mouth, which is named computer-aided impression (CAI), is the first step of the digital workflow and named as digitalization. The need to skip many time-consuming intermediate steps and reduce the possibility of fabrication errors has made the digital workflow a popular choice for dentists and dental technicians. The popularity of intraoral scanners has increased rapidly since the 1980s. With the development of camera systems and software engineering, many companies have presented many different IOS devices, which are based on different software systems. This situation causes dentists to get confused due to the formation of a very large data cluster. IOS devices are used to capture the digital data and they are an effective alternative to conventional impressions in many ways, such as increased patient comfort, time efficiency, hygiene, predictability, and precise results. Clinicians should have enough technical information about the IOS they use to obtain optimal results in fabricated restorations. The aim of this review is to evaluate the scanning technologies of intraoral scanners, their advantages and disadvantages in clinical practice, scanning strategies, accuracy of scanning processes, and software protocols.

A Deep Learning Strategy for Automatic Sleep Staging Based on Two-Channel EEG Headband Data.

Sleep disturbances are common in Alzheimer’s disease and other neurodegenerative disorders, and together represent a potential therapeutic target for disease modification. A major barrier for studying sleep in patients with dementia is the requirement for overnight polysomnography (PSG) to achieve formal sleep staging. This is not only costly, but also spending a night in a hospital setting is not always advisable in this patient group. As an alternative to PSG, portable electroencephalography (EEG) headbands (HB) have been developed, which reduce cost, increase patient comfort, and allow sleep recordings in a person’s home environment. However, naïve applications of current automated sleep staging systems tend to perform inadequately with HB data, due to their relatively lower quality. Here we present a deep learning (DL) model for automated sleep staging of HB EEG data to overcome these critical limitations. The solution includes a simple band-pass filtering, a data augmentation step, and a model using convolutional (CNN) and long short-term memory (LSTM) layers. With this model, we have achieved 74% (±10%) validation accuracy on low-quality two-channel EEG headband data and 77% (±10%) on gold-standard PSG. Our results suggest that DL approaches achieve robust sleep staging of both portable and in-hospital EEG recordings, and may allow for more widespread use of ambulatory sleep assessments across clinical conditions, including neurodegenerative disorders.

Multi-Capsule Endoscopy: An initial study on modeling and phantom experimentation of a magnetic capsule train

Capsule endoscopy offers increased patient comfort and improved visibility of the entire gastrointestinal (GI) tract. Besides imaging, numerous literary studies on capsule endoscopy have demonstrated drug delivery, navigation strategies, tactile sensing for tumor diagnosis, and biopsy. Yet, the size limitation hampers the availability of multiple features within a single capsule. In an effort to increase the space and functionality, we propose the use of multiple capsules. All capsules together form a capsule-train, whose wagons are connected with magnetic push/pull forces. Magnets located on each capsule form the virtual magnetic spring. The presence of a preset gap allows for joint tasks on the targeted tissue. The gap in-between capsules also ensures ease of motion throughout the GI, while negating the risk of clinching of tissue parts in between the capsules. Designed capsule train with two capsules successfully traveled through straight phantom without breaking connection for typical bowel speed. Also, same experiment is repeated with higher (2 × to 16 × of expected) speeds to inspect possible abrupt conditions, where capsules traveled together without any disconnection while maintaining constant distance in-between. Experiment results successfully imitate the developed magnet spring model (10–30% mismatch) even with ignored friction forces and camera pixilation errors. As future work, we will be working on adapting the capsule train for curved trajectories and perform demonstrations on ex-vivo animal bowel models. With further development, magnetically connected multi-capsule train can be adapted to clinic for improved functionality and multitasking through the GI tract.