1
|
Nilasaroya A, Kop AM, Collier RC, Kennedy B, Kelsey LJ, Pollard F, Ha JF, Morrison DA. Establishing local manufacture of PPE for healthcare workers in the time of a global pandemic. Heliyon 2023; 9:e13349. [PMID: 36816240 PMCID: PMC9922675 DOI: 10.1016/j.heliyon.2023.e13349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 01/10/2023] [Accepted: 01/25/2023] [Indexed: 02/16/2023] Open
Abstract
A face shield is a secondary personal protective equipment (PPE) for healthcare workers (HCW). Worn with the appropriate face masks/respirators, it provides short term barrier protection against potentially infectious droplet particles. Coronavirus disease 2019 (COVID-19) caused a spike in demand for PPE, leading to a shortage and risking the safety of HCW. Transport restrictions further challenged the existing PPE supply chain which has been reliant on overseas-based manufacturers. Despite the urgency in demand, PPE must be properly tested for functionality and quality. We describe the establishment of local face shields manufacture in Western Australia to ensure adequate PPE for HCW. Ten thousand face shields for general use (standard) and for ear, nose and throat (ENT) specialist use were produced. Materials and design considerations are described, and the face shields were vigorously tested to the relevant Standards to ensure their effectiveness as a protective barrier, including splash and impact resistance. Comparative testing with traditional and other novel face shields was also undertaken. Therapeutic Goods Administration (TGA) licence was obtained to manufacture and supply the face shields as a Class I medical device. The swiftness of process is a credit to collaboration from industry, academia and healthcare.
Collapse
Affiliation(s)
- Anastasia Nilasaroya
- Centre for Implant Technology and Retrievals Analysis (CITRA), Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Western Australia, 6000, Australia
| | - Alan Matthew Kop
- Centre for Implant Technology and Retrievals Analysis (CITRA), Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Western Australia, 6000, Australia
| | - Ryan Christopher Collier
- Centre for Implant Technology and Retrievals Analysis (CITRA), Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Western Australia, 6000, Australia
| | - Brendan Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, 6009, Australia and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia,Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia,Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
| | - Lachlan James Kelsey
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia, 6009, Australia,Department of Mechanical Engineering, School of Engineering, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Faz Pollard
- Adarsh Australia, 6 Crocker Drive, Malaga, Western Australia, 6090, Australia
| | - Jennifer Fong Ha
- Department of Paediatrics Otolaryngology Head & Neck Surgery, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Western Australia, 6009, Australia,Murdoch ENT, Wexford Medical Centre, Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch, Western Australia, 6150, Australia,Department of Surgery, The University of Western Australia, Stirling Highway, Nedlands, Western Australia, 6009, Australia
| | - David Anthony Morrison
- Centre for Implant Technology and Retrievals Analysis (CITRA), Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Western Australia, 6000, Australia,Corresponding author.
| |
Collapse
|
2
|
Hofmeier B, Wolpert S, Aldamer ES, Walter M, Thiericke J, Braun C, Zelle D, Rüttiger L, Klose U, Knipper M. Reduced sound-evoked and resting-state BOLD fMRI connectivity in tinnitus. Neuroimage Clin 2018; 20:637-649. [PMID: 30202725 PMCID: PMC6128096 DOI: 10.1016/j.nicl.2018.08.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/02/2023]
Abstract
The exact neurophysiological basis of chronic tinnitus, which affects 10-15% of the population, remains unknown and is controversial at many levels. It is an open question whether phantom sound perception results from increased central neural gain or not, a crucial question for any future therapeutic intervention strategies for tinnitus. We performed a comprehensive study of mild hearing-impaired participants with and without tinnitus, excluding participants with co-occurrences of hyperacusis. A right-hemisphere correlation between tinnitus loudness and auditory perceptual difficulty was observed in the tinnitus group, independent of differences in hearing thresholds. This correlation was linked to reduced and delayed sound-induced suprathreshold auditory brain responses (ABR wave V) in the tinnitus group, suggesting subsided rather than exaggerated central neural responsiveness. When anatomically predefined auditory regions of interest were analysed for altered sound-evoked BOLD fMRI activity, it became evident that subcortical and cortical auditory regions and regions involved in sound detection (posterior insula, hippocampus), responded with reduced BOLD activity in the tinnitus group, emphasizing reduced, rather than increased, central neural gain. Regarding previous findings of evoked BOLD activity being linked to positive connectivities at rest, we additionally analysed r-fcMRI responses in anatomically predefined auditory regions and regions associated with sound detection. A profound reduction in positive interhemispheric connections of homologous auditory brain regions and a decline in the positive connectivities between lower auditory brainstem regions and regions involved in sound detection (hippocampus, posterior insula) were observed in the tinnitus group. The finding went hand-in-hand with the emotional (amygdala, anterior insula) and temporofrontal/stress-regulating regions (prefrontal cortex, inferior frontal gyrus) that were no longer positively connected with auditory cortex regions in the tinnitus group but were instead positively connected to lower-level auditory brainstem regions. Delayed sound processing, reduced sound-evoked BOLD fMRI activity and altered r-fcMRI in the auditory midbrain correlated in the tinnitus group and showed right hemisphere dominance as did tinnitus loudness and perceptual difficulty. The findings suggest that reduced central neural gain in the auditory stream may lead to phantom perception through a failure to energize attentional/stress-regulating networks for contextualization of auditory-specific information. Reduced auditory-specific information flow in tinnitus has until now escaped detection in humans, as low-level auditory brain regions were previously omitted from neuroimaging studies. TRIAL REGISTRATION German Clinical Trials Register DRKS0006332.
Collapse
Key Words
- ABR wave
- ABR, auditory brainstem response
- BA, Brodmann area
- BA13A, anterior insula
- BA13P, posterior insula
- BA28, entorhinal cortex
- BB-chirp, broadband chirp
- BERA, brainstem-evoked response audiometry
- CN, cochlear nucleus
- CSF, cerebrospinal fluid
- Cortisol
- DL, dorsolateral
- EFR, envelope-followed responses
- ENT, ear, nose and throat
- FA, flip angle
- FDR, false discovery rate
- FOV, field of view
- FWHM, full width at half maximum
- G-H-S, Goebel-Hiller-Score
- HF-chirp, high-frequency chirp
- HPA, hypothalamic-pituitary-adrenal
- High-SR AF, high-spontaneous firing rates auditory fibers
- IC, inferior colliculus
- L, left
- LF-chirp, low-frequency chirp
- Low-SR AF, low-spontaneous firing rates auditory fibers
- M, medial
- MGB, medial geniculate body
- MNI, Montreal Neurological Institute
- PFC, prefrontal cortex
- PTA, pure tone audiogram
- R, right
- ROI, region of interest
- SD, standard deviation
- SOC, superior olivary complex
- SPL, sound pressure level
- SPM, Statistical Parametric Mapping
- TA, acquisition time
- TE, echo time
- TR, repetition time
- Tinnitus
- VBM, voxel-based morphometry
- fMRI
- r-fcMRI
- rCBF, resting-state cerebral blood flow
- rCBV, resting-state cerebral blood volume
- zFC, z-values functional connectivity
Collapse
Affiliation(s)
- Benedikt Hofmeier
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Ebrahim Saad Aldamer
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Moritz Walter
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - John Thiericke
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany/HNO Ärzte Praxis Part GmbB, Aschaffenburg, Germany
| | - Christoph Braun
- MEG Center, University Hospital Tübingen, Otfried-Müller-Str. 47, D-72076 Tübingen, Germany
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, D-73076 Tübingen, Germany.
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany.
| |
Collapse
|
3
|
El Howairis M, Buchholz N. A naked-eye comparison of image quality between a portable versus a fixed camera system for digital flexible ureterorenoscopy - A single centre experience. Arab J Urol 2017; 15:211-5. [PMID: 29071154 DOI: 10.1016/j.aju.2017.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 11/20/2022] Open
Abstract
Objective To assess the image quality using the portable OTV-SI (Olympus, Southend, UK) light source system compared to a dedicated fixed standard stack system for flexible ureterorenoscopy (URS) as judged by the human eye. Methods We compared two differing flexible URS set-ups. The first was our normal completely digital fixed set-up, comprising a flexible ureteroscope and matching digital stack system (CLV-S40 PRO-6E, Olympus). The second set-up comprised the same digital ureteroscope but with a conventional non-digital stack system and the OTV-SI portable light source. Seven experienced urologists were asked to subjectively assess the quality of the video sequences with the naked eye. The image qualities assessed were as follows: colour, distortion, graininess, depth perception, contrast, and glare. Finally, they were asked to guess whether they were observing images from the normal fixed set-up or the portable set-up. Fisher’s exact test was used to compare the two sets of nominal variables. Results There were no significant differences in the observation ratings between the fixed and portable systems, independent of observer or image settings. Also, the surgeons were not able to correctly guess which stack system had been used. Conclusion For flexible URS imaging, the combination of a digital ureteroscope with a conventional non-digital stack system together with the OTV-SI portable light source was subjectively found not to be inferior to the completely digital fixed set-up. Thus, the cheaper and smaller portable system could be considered as an economical option without substantial loss of image quality, especially useful in developing countries.
Collapse
|