Respiratory Devices Research Articles

Influence of Acid Modification of Natural Phlogopite on Catalytic Activity of Supported Pd(II)-Cu(II) Complexes in the Reaction of Oxidation of Carbon Monoxide by Atmospheric Oxygen

The paper presents original results on the of nitric acid concentrations effect on structure, morphology, protolytic properties and the activity of low-temperature carbon monoxide oxidation catalysts based on acid-modified phlogopite (Н-Phl-1) and K2PdCl4, Cu(NO3)2, KBr base components. The obtained samples were characterized by XRD, SEM, FT-IR spectroscopy and pH metric method. The obtained catalyst Pd(II)-Cu(II)/8H-Phl-1 can be recommended for use in respiratory devices.

Phantom study of an in-house amplitude-gating respiratory method with silicon photomultiplier technology positron emission tomography/computed tomography

PurposeThe objective of this phantom study was to determine whether breathing-synchronized, silicon photomultiplier (SiPM)-based PET/CT has a suitable acquisition time for routine clinical use. MethodsAcquisitions were performed in list mode on a 4-ring SiPM-based PET/CT system. The experimental setup consisted of an external respiratory tracking device placed on a commercial dynamic thorax phantom containing a sphere filled with [F-18]-fluorodeoxyglucose. Three-dimensional sinusoidal motion was imposed on the sphere. Data were processed using frequency binning and amplitude binning (the "DMI” and “OFFLINE” methods, respectively). PET sinograms were reconstructed with a Bayesian penalized likelihood algorithm. ResultsRespiratory gating from a 150‑sec acquisition was successful. The DMI and OFFLINE methods gave similar activity profiles but both were slightly shifted in space; the latter profile was closest to the reference acquisition. ConclusionWith SiPM PET/CT systems, the amplitude-based processing of breathing-synchronized data is likely to be feasible in routine clinical practice.

Frequency and Correlates of Pediatric High-Flow Nasal Cannula Use for Bronchiolitis, Asthma, and Pneumonia.

Heated humidified high-flow nasal cannula (HFNC) is a respiratory support device historically used in pediatrics for infants with bronchiolitis. No large-scale analysis has determined the current frequency or demographic distribution of HFNC use in children. The objective of this study was to determine the frequency and correlates of HFNC use in children presenting to the hospital for asthma, bronchiolitis, or pneumonia. This longitudinal observational study was based on electronic health record data from a large regional health information exchange, the Indiana Network for Patient Care (INPC). Subjects were age 0-18 y with recorded hospital encounters at an INPC hospital between 2010-2019 with International Classification of Diseases codes for bronchiolitis, asthma, or pneumonia. Annual proportions of HFNC use among all hospital encounters were assessed using generalized additive models. Log-binomial regression models were used to identify correlates of incident HFNC use and determine risk ratios of specific subjects receiving HFNC. The study sample included 242,381 unique subjects with 412,712 hospital encounters between 2010-2019. The 10-y period prevalence of HFNC use was 2.54% (6,155/242,381) involving 7,974 encounters. Hospital encounters utilizing HFNC increased by 400%, from 326 in 2010 to 1,310 in 2019. This increase was evenly distributed across all 3 diagnostic categories (bronchiolitis, asthma, and pneumonia). Sex, race, age, and ethnicity all significantly influenced the risk of HFNC use. Over the 10-y period, the percentage of all hospital encounters using HFNC increased from 1.11% in 2010 to 3.15% in 2018. Subjects with multiple diagnoses had significantly higher risk of receiving HFNC. The use of HFNC in children presenting to the hospital with common respiratory diseases has increased substantially over the past decade and is no longer confined to treating infants with bronchiolitis. Demographic and diagnostic factors significantly influenced the frequency of HFNC use.

Carbapenem-resistant Acinetobacter baumannii at a tertiary-care hospital in Botswana: Focus on perinatal environmental exposures

Background: Bloodstream infections (BSIs) due to carbapenem-resistant Acinetobacter baumannii (CRAB) are difficult to treat and are associated with high mortality, particularly in neonates. Healthcare-associated CRAB infections have been linked to environmental reservoirs and are associated with seasonal clustering. CRAB outbreaks are being reported more frequently in sub-Saharan Africa, but published reports from this region that incorporate comprehensive surveillance data and environmental investigations are rare. Methods: We reviewed microbiology surveillance records at a 530-bed, public, tertiary-care hospital in Botswana from January 1 to December 13, 2021, and we collected data regarding age, specimen type, and onset date for all cultures from unique patients growing Acinetobacter spp. An automated blood-culture system was used for organism detection, manual biochemical tests were used for identification, and disc and agar diffusion methods were used for antimicrobial sensitivity testing. During this time, we conducted 4 point-prevalence environmental sampling surveys at this hospital’s 36-bed neonatal unit from January through June 2021 in addition to 3 neonatal CRAB cluster investigations. Environmental samples from surfaces, hands of caregivers and healthcare workers, and equipment were collected using flocked swabs. Extended-spectrum β-lactamase–producing organisms from environmental samples were identified using selective and differential chromogenic media (CHROMagarTM ESBL). Results: Overall, 48 Acinetobacter infections were identified, including 28 BSIs (among 3,699 blood cultures processed, approximately one-third of which were from neonates). More than half of cases were perinatal, which included 16 neonatal BSIs (median age, 4 days; case fatality rate, 56%), and 1 fatal case of postpartum sepsis in a 37-year-old mother. Among isolates tested, 35 (92%) of 38 demonstrated carbapenem resistance. Treatment information was not available for all neonatal patients, but delays in appropriate antimicrobial therapy were cited in all fatal cases. Most neonatal CRAB cases clustered in time and space (Fig. 1). For example, 15 (71%) of 21 neonatal cases occurred in the same unit and same week as another case. In the neonatal unit, CRAB clusters were associated with increased Acinetobacter recovery during environmental point-prevalence surveys (Fig. 1). Acinetobacter contamination was identified on feeding equipment (breast pumps, feeding tubes), respiratory equipment (suction machines or catheters, ventilator humidifiers), and hands of caregivers and healthcare workers. Conclusions: We report hyperendemic rates of CRAB infections with evidence of spatotemporal clustering, especially among neonates. Higher CRAB incidence coincided with increased Acinetobacter recovery during environmental sampling. We identified plausible transmission vehicles (respiratory or feeding devices, hands) in the neonatal care environment highlighting the value of environmental sampling to support CRAB investigations and reinforcing the importance of comprehensive and consistent disinfection practices, especially in resource-limited settings where equipment is shared or reused.Funding: NoneDisclosures: None

Phrenic nerve stimulation experiences. A single centre, controlled, prospective study

Patients with central apnoea may use electro ventilation, provided their phrenic nerves and diaphragm muscles are normal. A tendency towards better survival has been found, and both an improved quality of life and facilitated nursing have been claimed with electro ventilation compared to mechanical ventilation. The high investment for the device may form a hurdle for fund providers like our hospital administration board. We, therefore, from our first patient onwards, collected clinically meaningful data in a special register of all patients using electro ventilation and their controls on mechanical ventilation. Since 1988 172 patients left our institution dependent on a respiratory device. Of these, all 48 patients with preserved phrenic nerves chose phrenic nerve stimulation. A patient on mechanical ventilation who agreed to participate was chosen as a control (n = 44). All patients were seen at least once a year. 90 patients suffered high tetraplegia, and 2 suffered central apnoea for other reasons. There is a tendency towards better survival, and there is a lower frequency of decubital ulcers (0.02) and respiratory tract infections (p0.000) with electro than with mechanical ventilation. The frequency of respiratory infections turned out to be a better measure of the quality of respiratory care than survival. The resulting decrease in the need for airway nursing, and the reduced incidence of respiratory infections repaid the high investment in electro ventilation within one year in our setting. Informed patients prefer electro to mechanical ventilation; fund providers might also agree with this preference.

Role of helmet ventilation during the 2019 coronavirus disease pandemic.

Coronavirus disease 2019 (COVID-19) has been declared a pandemic by the World Health Organization; it has affected millions of people and caused hundreds of thousands of deaths. Patients with COVID-19 pneumonia may develop acute hypoxia respiratory failure and require noninvasive respiratory support or invasive respiratory management. Healthcare workers have a high risk of contracting COVID-19 while fitting respiratory devices. Recently, European experts have suggested that the use of helmet continuous positive airway pressure should be the first choice for acute hypoxia respiratory failure caused by COVID-19 because it reduces the spread of the virus in the ambient air. By contrast, in the United States, helmets were restricted for respiratory care before the COVID-19 pandemic until the Food and Drug Administration provided the ‘Umbrella Emergency Use Authorization for Ventilators and Ventilator Accessories’. This narrative review provides an evidence-based overview of the use of helmet ventilation for patients with respiratory failure.

Effectiveness of Face Masks and Respiratory Aid Devices for Prophylaxis against COVID-19

The COVID-19 epidemic was spread rapidly around the world in 2019, and has greatly affected people’s general interaction, their work habits, dailylives and businesses. A personnel protection against the spread of COVID-19 is not only beneficial but is critically important especially for those working in medical fields. Current studies were performed to review the use and benefits of face mask and respiratory aid devices in order to control the spread of COVID-19. The respiratory aids devices (RADs) may be recommended as anti-COVID-19 masks rather than surgical masks. However, RADs having P and R series filters do not prevent the infiltration of coronavirus due to its smaller size as compared to the filtration capacity of filters. The N99 and N100 filters cause a difficulty inbreathing; it is difficult to wear such sort of respirators for a longer time. N95 respirators are recommended by medical professionals as they provide lesser(almost half) respiratory resistance. However, wearing of face masks is also involved some risks and side effects which may include physiological and disturbing effects, difficulty in breathing, affecting the volume and quality of sound, decrease of innate immunity, cardiopulmonary overload and increase in contamination chances due to development of humid habitat inside the mask.

Integrating Pharmacy and Registry Data Strengthens Clinical Assessments of Patient Adherence.

Background: Accurate clinical assessment of patient adherence using reliable and valid measures is essential in establishing the presence of adherence issues and support practices for pharmacists. Objective: This investigation aims to conduct a novel assessment of patient adherence to asthma controller therapy by combining 1) patient-specific dosage data found in pharmacy dispensing data with 2) centrally collected administrative claims records, to determine the added value of using both sources of data. Methods: A total of 381 clinically uncontrolled asthma patients, from 95 community pharmacies across three Australian States were recruited and provided consent for the retrieval of their claims records and pharmacy dispensing data. Patients were stratified as multiple or single pharmacy users and adherence scores were calculated via the proportion of days covered (PDC) method using 1) patient claims records, 2) patient pharmacy dispensing data, and 3) combined claims records and pharmacy dispensing data. Cohort and subgroup adherence estimates were then compared. Results: Low levels of adherence were evident amongst the cohort irrespective of the data source used. PDC estimates based on claims records alone or combined claims records and pharmacy dispensing data were significantly higher than estimates based on pharmacy dispensing data for the total cohort (56%, 52%, 42% respectively, p < 0.001) and more noticeably for multiple pharmacy users (67%, 64%, 35% respectively, p < 0.001). PDC estimates based on combined claims records and pharmacy dispensing data were significantly lower than estimates based on claims records alone, indicating that perhaps standard daily dose is not a robust proxy for prescribed dosage to inhaled respiratory devices in adherence approximations. Poorer adherence was found amongst single pharmacy users than multiple pharmacy users when combined claims records and pharmacy dispensing data (46% compared to 64% respectively, p < 0.001) or claims records alone (51% compared to 67% respectively, p < 0.001) were compared. Conclusion: Access to routine collected data increases clinical acuity over patient adherence to asthma controller medications and is a valuable resource for health care professionals. A policy of secure accessibility of such data at the patient-pharmacist or patient-GP interface may allow real-time intervention and assist in decision making across numerous therapeutic areas.

Current and Future Perspective of Devices and Diagnostics for Opioid and OIRD.

OIRD (opioid-induced respiratory depression) remains a significant public health concern due to clinically indicated and illicit opioid use. Respiratory depression is the sine qua non of opioid toxicity, and early detection is critical for reversal using pharmacologic and non-pharmacologic interventions. In addition to respiratory monitoring devices such as pulse oximetry, capnography, and contactless monitoring systems, novel implantable sensors and detection systems such as optical detection and electrochemical detection techniques are being developed to identify the presence of opioids both in vivo and within the environment. These new technologies will not only monitor for signs and symptoms of OIRD but also serve as a mechanism to alert and assist first responders and lay rescuers. The current opioid epidemic brings to the forefront the need for additional accessible means of detection and diagnosis. Rigorous evaluation of safety, efficacy, and acceptability will be necessary for both new and established technologies to have an impact on morbidity and mortality associated with opioid toxicity. Here, we summarized existing and advanced technologies for opioid detection and OIRD management with a focus on recent advancements in wearable and implantable opioid detection. We expect that this review will serve as a complete informative reference for the researchers and healthcare professionals working on the subject and allied fields.

Effects of a new respiratory muscle training device in community-dwelling elderly men: an open-label, randomized, non-inferiority trial

BackgroundRespiratory muscle training (RMT) has various clinical benefits in older adults; however, the low adherence to training remains a challenging issue. The present study aimed to confirm the efficacy of a new device that combines inspiratory muscle training and a positive expiratory pressure (IMT/PEP) compared to that of a Threshold IMT device (Philips Respironics Inc), and to determine whether home-based training differed from rehabilitation center training.MethodsThis four-arm, multicenter, parallel, non-inferiority trial randomized 80 active community-dwelling older men (mean age = 72.93 ± 5.02 years) to center-based groups (new IMT/PEP device or Threshold IMT device; 16 supervised sessions) or home-based groups (new IMT/PEP device or Threshold IMT device; 2 supervised sessions and individual sessions). Participants in all groups performed RMT twice a day for 8 weeks. Assessments were performed at baseline and post-training. The primary outcomes were maximum inspiratory pressure and maximal expiratory pressure. The secondary outcomes included forced vital capacity and forced expiratory volume in the first second, peak cough flow, diaphragm thickness, VO2 peak, the International Physical Activity Questionnaire score, electromyographic activities of the sternocleidomastoid muscle, and skeletal muscle mass and phase angle as measured by bioimpedance analysis. In addition, rates of adherence to each protocol were also compared.ResultsAmong all groups, the maximal inspiratory pressure was improved post-training, while the maximal expiratory pressure showed improvement only in the IMT/PEP groups. The overall non-inferiority of the IMT/PEP device was thus validated. A statistically significant improvement in diaphragm thickness was found. However, no consistent improvement was shown in other secondary outcomes. No significant difference in training adherence rate between protocols was observed (mean adherence rate of 91–99%).ConclusionCompared to the Threshold IMT, the new IMT/PEP device did not result in a significant difference in maximal inspiratory pressure but did improve maximal expiratory pressure in older men. The IMT/PEP device’s improved usability, which is associated with exercise adherence, provided distinct advantages in this cohort. If proper education is first provided, home-based RMT alone may provide sufficient effects in older individuals.Trial registrationThis trial was registered in the database cris.nih.go.kr (registration number KCT0003901) on 10/05/2019.

Sleep Disorders in Patients With Craniopharyngioma: A Physiopathological and Practical Update

Sleep disorders (SDs) represent an important issue in patients with craniopharyngioma (CP). Nearly 70% of these patients complain of sleep-wake cycle alterations and/or excessive diurnal somnolence due to sleep-related breathing disorders, such as obstructive sleep apnea (OSA) and/or central hypersomnia, including secondary narcolepsy. SDs may severely reduce quality of life, increase disease-related cardiorespiratory and cardiovascular morbidity, and finally play a major role in increased long-term mortality reported on patients with CP. A major risk factor for SDs is represented by the hypothalamic syndrome, which may develop because of direct hypothalamic damage by the tumor itself and/or complications of the treatments, neurosurgery and/or radiotherapy, and typically includes permanent neuroendocrine dysfunctions, morbid obesity, and secondary metabolic disorders. Despite increasing attention to SDs in the general population, and in particular to OSA as a risk factor for cardio-metabolic diseases and excessive daytime somnolence, sleep evaluation is still not routinely proposed to patients with CP. Hence, SDs are often underdiagnosed and undertreated. The aim of this paper is to update current knowledge of the pathogenesis and prevalence of SDs in patients with CP and propose practical algorithms for their evaluation and management in clinical practice. Particular attention is paid to screening and diagnostic tools for appropriate characterization of SDs, identification of risk factors, and potential role of hypothalamic sparing surgery in the prevention of morbid obesity and SDs. Available tools in sleep medicine, including lifestyle interventions, drugs, and respiratory devices, are discussed, as well as the importance of optimal hormone replacement and metabolic interventions. Current limits in the diagnosis and treatment of SDs in patients with CP and possible future avenues for research agenda are also considered.

A novel approach to combat the spread of coronavirus and other respiratory infections with the aid of a smart sanitizing respirator

A novel approach to combat the spread of coronavirus and other respiratory infections with the aid of a smart sanitizing respirator

Ocular Surface Infection by SARS-CoV-2 in COVID-19 Pneumonia Patients Admitted to Sub-Intensive Unit: Preliminary Results.

The aim of the present study is to check the relationship between virus detection on the conjunctival swabs by RT-PCR and the systemic and ocular clinical data, treatments, and to the modalities of administration of supplemental oxygen. The SARS-CoV-2 RNA reverse-transcriptase PCR assay of conjunctival brushing samples and the corneal/conjunctival clinical findings were evaluated in 18 eyes of 9 consecutive patients admitted to the COVID-19 Sub-intensive Unit of Salerno Hospital University, Italy. Conjunctival swabs were positive for SARS-CoV-2 in 13 eyes of 7 patients; corneal epithelial defects were detected in 9 eyes. The seven patients with ocular involvement from SARS-CoV-2 had undergone treatment with a full-face mask or oxygen helmet in the last week, while the two subjects with negative conjunctival swabs had been treated with high flow nasal cannula. The positivity to the conjunctival test for SARS-CoV-2 was higher (72%) than that reported in the literature (10–15%) and related in all cases to the use of facial respiratory devices. These results suggest that exposure of unprotected eyes to aerosols containing high concentrations of SARS-CoV-2 could cause a keratoconjunctival viral infection. Further studies are needed to verify the causal link with the use of respiratory facial devices in patients suffering from COVID-19 pneumonia.

Engineering of Materials for Respiratory Protection: Salt-Coated Antimicrobial Fabrics for Their Application in Respiratory Devices

ConspectusThe development of a highly effective, low-cost method for protection against direct transmission through infectious media associated with respiratory diseases has been considered to be a major challenge in the management of the pandemic outbreak. Currently, filtration in respirators and masks depends on the mesh size, raising safety concerns about direct contact with the virus-laden layers of masks and respirators during use and disposal. Also, conventional medical face masks and respirators are recommended for single use only because long-term use and reuse of masks increase the risk of contact transmission of pathogens. As a result, mask reusability has gained much attention in addressing the global problem of respirator and mask shortages during the COVID-19 pandemic. Furthermore, coinfection by influenza, SARS-CoV-2, and bacteria has been an ongoing issue in the current COVID-19 pandemic. In our response to the increasing demand for more convenient forms of disease control, our group has investigated antimicrobial technologies for respiratory devices against pandemic/epidemic diseases and developed two universal antimicrobial coating technologies: (1) nonwashable, reusable salt-coated fabrics and (2) washable, photopolymerizable polymer-coated fabrics which efficiently inactivate infectious viruses by contact with the filter. This is an opportune time to assess research efforts toward antimicrobial face mask technology for its expected impact on society and the economy.In this Account, we introduce the importance of respiratory devices for protection against respiratory diseases, decontamination methods, technical challenges for reuse and extended use, antimicrobial substances used in masks, antimicrobial functionalization strategies for mask fibers, and the characterization of antimicrobial performance and the limitations of the current procedure. Then, the major focus will be directed to discussing the continued efforts of our group to develop antimicrobial fabrics for face mask covers and face masks/respirators based on salt-coated polypropylene (PP) fibers. In the following sections of this Account, we will first discuss salt coating methods and pathogen inactivation mechanisms in salt-coated filters. Then, an overview of our recent progress in evaluating the antimicrobial performance of salt-coated PP fabrics against five different bacterial species, influenza viruses, and human coronaviruses will be presented. The technical challenges in the implementation of the technology will be highlighted in the last section. We believe that easy-to-implement antimicrobial respiratory devices would guarantee improved protection without decontamination processes and enable rapid responses to future pandemic/epidemic outbreaks.

Reproducibility of deep inspiration breath-hold technique for left-side breast cancer with respiratory monitoring device, Abches.

PurposeThis study aimed to evaluate the reproducibility of deep inspiration breath‐hold (DIBH) using a respiratory control device, Abches, in patients with left‐sided breast cancer.Material and methodsAbches comprises a main body, an indicator panel, and two fulcrums, one each on the chest and abdomen. Forty left side breast cancer patients treated with DIBH using abches were enrolled in this study. For all patients, CT images were taken three times to confirm the target position inside the body and to check the breath‐hold reproducibility. Three anatomical points on the nipple, sternum, and heart were selected as measurement points on CT images. After measuring the coordinates, breath‐hold reproducibility was defined as the mean of the absolute difference in the coordinates between the three CT images. The maximum differences were also investigated. In addition, the dice similarity coefficient (DSC) was calculated to examine the displacement of the heart volume in detail. Moreover, digitally reconstructed radiographs (DRRs) and linac graphs (LGs) were used to measure the positional accuracy of the chest and heart.ResultsThe reproducibility in all patients was within 0.75 mm for the nipple, 0.78 mm for the sternum, and 2.18 mm for the heart in each direction. Similarly, the maximum displacements for all patients were within 1.90 mm, 1.69 mm, and 4.75 mm, respectively, in each direction. For heart volume, the average DSC for all cases was 0.93 ± 0.01. The differences between the DRR and LG images were 1.70 ± 1.10 mm and 2.10 ± 1.60 mm, for the chest and heart, respectively.ConclusionOur study showed that DIBH using Abches can be performed with good target reproducibility of less than 3 mm with proper breath‐hold practice, whereas the heartbeat‐derived reproducibility of the cardiac position is poor and needs to be monitored carefully during treatment simulation

Airofit How a new respiratory device is strengthening anaerobic capacity

Airofit How a new respiratory device is strengthening anaerobic capacity

Respiratory ECMO Device Played a Roll as the Last Stronghold for Severe Respiratory Failure

Respiratory ECMO Device Played a Roll as the Last Stronghold for Severe Respiratory Failure

Pitfall of Respiratory Assist Devices in Pre-hospital Care〜A Comparison between Bag Valve Masks（BVM）, BVM with gas supply valve, and Jackson Rees〜

Pitfall of Respiratory Assist Devices in Pre-hospital Care〜A Comparison between Bag Valve Masks（BVM）, BVM with gas supply valve, and Jackson Rees〜

Accuracy of Heart Rate and Respiratory Rate Measurements Using Two Types of Wearable Devices.

ABSTRACTObjectives:Wearable devices such as fitness trackers have become popular in the healthcare field. Tracking heart rate and respiratory rate, in addition to physical activity, may provide an accurate picture of daily health. We believe that a combination of two types of devices can simultaneously measure and record physical activity, heart rate, and respiratory rate. However, the measurement accuracies of these two types of devices are not clear. This study aimed to determine the measurement accuracies of two wearable devices for heart and respiratory rate measurements.Methods:Ten healthy men performed incremental load tests (ILTs) and constant load tests (CLTs) on a cycle ergometer. The heart and respiratory rates were measured using wrist-worn (Silmee W22, TDK, Japan, Tokyo) and respiratory tracking devices (Spire Stone, Spire Health, San Francisco, CA, USA), respectively. A 12-lead electrocardiograph and the breath-by-breath method were used as external standards for heart and respiratory rates, respectively.Results:Bland–Altman analysis showed that heart rate had a fixed bias at rest and during ILT and CLT and had a proportional bias during CLT. The standard error values of the regression at rest and during CLT were less than 10 bpm for heart rate and less than 5.0 /min for respiratory rate. During ILT, the standard error was greater than 10 bpm for heart rate and approximately 5.0 /min for respiratory rate.Conclusions:The heart and respiratory rate measurements obtained using wearable devices were accurate within the practical margin of error.

Additive Manufacturing Interventions during the COVID-19 Pandemic: South Africa

Additive manufacturing (AM), also known as 3D printing, is considered a renaissance of the manufacturing industry. Its unique capability of manufacturing 3D objects with intricate geometrical configurations has been used to produce hospital equipment and personal protective equipment (PPE) in an attempt to curb the spread of the COVID-19 pandemic in South Africa. The technology has been used by different research units to produce ventilators, respirator face masks, oscillating respiratory devices, oxygen connectors, oxygen splitters, non-invasive ventilation helmets, reusable clinician PPE, visor frames for face shields, etc. Despite the efforts of the AM community in South Africa, COVID-19 infections have continued to increase in the country. It came to light that technological interventions (including AM) alone cannot prevent the spread of the virus without the corresponding adaptive behavioural changes, such as adhering to COVID-19 prevention protocols (washing of hands, social distancing, etc.). It could be postulated that the spread of COVID-19 can only be prevented by inter-marrying the technological interventions (AM) with adaptive behavioural changes.