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Extracorporeal membrane oxygenation versus conventional therapy in patients with acute respiratory failure: systematic review with meta-analysis

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Research on biomedical engineering 2024年第3-4期40卷 835-849页

作者： de Souza, Daniel Baldoino Barreto, Cassiana Gabriela Lima Milagre, Selma Terezinha Pereira, Adriano Alves University Hospital of the Federal University of Santa Catarina Florianópolis Brazil Centre for Innovation and Technology Assessment in Health Faculty of Electrical Engineering Postgraduate Program in Electrical and Biomedical Engineering Federal University of Uberlândia Uberlândia Brazil

Background: Acute respiratory distress syndrome (ARDS) is a severe condition where lung alveoli fill with fluid, depriving organs of oxygen and risking death. Mechanical ventilation is conventional for oxygen therapy, but extracorporeal membrane oxygenation (ECMO) may be needed for refractory ARDS cases. This study aims to compare ECMO's impact on mortality and hospital stay versus conventional treatment for patients aged 12 or older with moderate or severe ARDS in intensive care units (ICUs). Methodology: Four independent reviewers followed the PRISMA-P method for the review. The key question used the PICOS tool. Databases searched included Cochrane Library, Bireme, MEDLINE, EMBASE, Web of Science, Scielo, LILACS, and grey literature to minimize publication bias. Selected papers were randomized controlled trials (RCTs) without language restrictions, meeting predefined inclusion and exclusion criteria. RoB-2 assessed bias risk, and GRADE evaluated evidence quality. Mortality was analyzed using a fixed-effect PETO method (odds ratio), and hospital stay was treated as a continuous variable using inverse variance and standardized mean difference (SMD). Results: We found 3,774 articles and selected 6 studies with 1,050 participants. Of these, 519 were allocated to the intervention group (ECMO) and 531 to the conventional treatment group (MV). The risk of bias for 3 studies was "some concerns," and 3 were "high risk of bias," mainly due to "deviations from intended/planned interventions" and "selection of reported outcomes." The primary outcomes for 30-day, 60-day, 90-day, and 180-day mortality showed odds ratios of 0.90 (95% CI: 0.66–1.21), 0.78 (95% CI: 0.50–1.21), 0.90 (95% CI: 0.66–1.21), and 0.62 (95% CI: 0.36–1.06) respectively, with low heterogeneity (I2 0.10). The secondary outcomes for a total length of stay and ICU stay showed standardized mean differences of 0.39 (95% CI: 0.13–0.65) and 0.33 (95% CI: 0.05–0.60) respectively, with substantial heterogeneity (I2

关键词： Risk assessment

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Micro-electrode array (MEA) electrophysiological signal analysis by descriptive stochastic tests of the probability density structure

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Research on biomedical engineering 2025年第2期41卷 1-13页

作者： Faria, Vinícius Naves Rezende Ramos, Marina Abadia Martinoia, Sérgio Destro-Filho, João-Batista Postgraduate Program in Electrical Engineering Universidade Federal de MG Uberlândia Brazil Postgraduate Program in Biomedical Sciences Universidade Federal de MG Uberlândia Brazil Division of Informatics Bioengineering Robotics and System Engineering Università Degli Studi Di Genova Genova Italy

Purpose: The primary objective of this study is to present, analyze, and quantitatively characterize the electrical signals obtained from neuronal cultures coupled to micro-electrode arrays (MEAs). Special attention is given to the temporal evolution of electrical activity across distinct geometric regions of the MEA devices. Methods: The proposed methodology involves signal acquisition, classical analysis based on spike and burst detection, and, critically, the characterization of the probability density structure of the signals. This is achieved through the quantification of Gaussianity—expressed as the percentage of segments non-Gaussian (PSNG)—and stationarity— expressed as the percentage of segments non-stationary (PSNE). Results: Initial analyses showed that first-order power spectral density quantifiers lacked the statistical robustness required to effectively describe the complex components of MEA signals. In contrast, PSNG and PSNE demonstrated strong potential in capturing the different stages of neuronal culture development. Cluster analysis further supported the discriminative capacity of these quantifiers. Conclusion: The phase corresponding to decreased neuronal activity and onset of cell death—a biologically critical stage—exhibited the strongest correlation among the studied variables. These results suggest a discernible biological organization and highlight the relevance of PSNG and PSNE as promising tools for assessing neuronal culture dynamics. © The Author(s), under exclusive licence to The Brazilian Society of biomedical engineering 2025.

关键词： Cell death

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Usability evaluation of high-fidelity simulation manikin for cardiopulmonary resuscitation training for medical students

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Research on biomedical engineering 2024年第1期40卷 253-264页

作者： Silva, Lucas de Brito Gonçalves, Fabrícia Torres Arantes, Henrique Pierotti Garcia, Rodrigo Alves Gasparin, Maria Regina Franco Ribeiro dos Reis, Melissa Mariane Andrade, Adriano de Oliveira Pereira, Adriano Alves Milagre, Selma Terezinha Santos, Fernando Pasquini Faculty of Electrical Engineering Graduate Program in Biomedical Engineering Federal University of Uberlândia Campus Santa Mônica Bloco 1E MG Uberlândia38400-902 Brazil Instituto Master de Ensino Presidente Antônio Carlos MG Araguari Brazil

Purpose: With the increasing incidence of cardiac arrests in non-critical areas, it is crucial to provide comprehensive training to healthcare professionals. Simulation-based training using manikins offers a morally sound alternative to traditional methods and allows students to apply clinical skills in realistic scenarios. Usability evaluation, including assessment of efficiency, effectiveness, and user satisfaction, is essential for ensuring the effectiveness of the training. This research focuses on evaluating the usability of the simulation manikin for teaching cardiopulmonary resuscitation to medical students. Methods: Twenty-one volunteers participated in the experiments: 18 students and three teaching doctors (one instructor professor and two evaluator professors). The instructor professor was instructed to follow the same procedure used in the classroom setting. The evaluating professors were provided with appropriately labeled data collection instruments to evaluate the usability of manikins. The student performed the tasks as instructed, and after completion, they were directed to the debriefing room, where they filled out the feedback form. Results: The experimental data and the statistical analyses showed that regarding effectiveness, the study findings indicated that participants encountered difficulties in certain tasks, as evidenced by the need for significant intervention from the instructor professor. In relation to efficiency, the results demonstrated a clear correlation between the successful execution of tasks and the duration of instruction provided by the instructor, thereby indicating the presence of a usability problem associated with the simulation manikin. And users are not entirely satisfied with the manikin, considering the room for improvement indicated by the SUS score. Conclusion: The experiment and the results reported in this paper contribute to addressing the existing gap in the literature concerning the usability of high-fidelity s

关键词： Efficiency

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Possible solutions for oxygenation support in critically ill patients with COVID-19

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Research on biomedical engineering 2021年第2期37卷 389-402页

作者： de Souza, Daniel Baldoino de Oliveira Andrade, Adriano Milagre, Selma Terezinha Pereira, Adriano Alves Centre for Innovation and Technology Assessment in Health Postgraduate Program in Electrical and Biomedical Engineering Faculty of Electrical Engineering Federal University of Uberlândia Uberlândia Brazil

Purpose: Due to the large number of patients with respiratory deficiency during the COVID-19 pandemic, several governments and their respective health care services have been studying ways to complement the care provided by offering immediate solutions. In view of this, the aim of this study was to carry out a systematic review of the advantages and disadvantages of possible solutions in oxygenation support. Methods: This systematic review used the PRISMA-P methodology and sought to list alternatives in oxygenation support that are being applied and studied worldwide. A bibliographic search was conducted in the MEDLINE and Cochrane Central databases, using the keywords SARS-CoV-2, COVID19, or coronavirus;combined with extracorporeal membrane oxygenation (ECMO), mechanical ventilation, mechanical ventilation support, low-cost, anesthesia, anesthesia machine, and ventilation therapy. The records were also found in the gray literature. Results: The search found 85 publications of which 41 articles were considered after excluding duplicate articles, reading the title and summary, and reading the articles in full. The oxygenation supports identified in these publications were the following: ECMO, shared mechanical ventilator, fast or low-cost production equipment, high-flow nasal cannula (HFNC), non-invasive ventilation, and use of anesthesia equipment as a mechanical ventilator. Conclusion: This study demonstrated the importance of a trained clinical team in the application of technologies. The alternatives found for support oxygenation require a more robust clinical evaluation to demonstrate their efficacy and safety for the COVID-19 patient. © 2021, Sociedade Brasileira de Engenharia Biomedica.

关键词： Oxygenation

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Evaluation of occupational doses in surgical staff via Monte Carlo simulation

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Applied Radiation and Isotopes 2025年 224卷 111894页

作者： Machado, Karen L. Maschio, Alessa Guimarães, Guilherme B. Santos, William S. Neves, Lucio P. Perini, Ana P. Postgraduate Program in Biomedical Engineering of Federal University of Uberlândia MG Uberlândia Brazil Institute of Physics of Federal University of Uberlândia MG Uberlândia Brazil Federal University of Sergipe Center for Exact Sciences and Technology Department of Physics SE São Cristóvão Brazil

This study evaluated radiation exposure during fluoroscopy-guided surgical procedures using Monte Carlo simulations. The methodology involved modeling femoral osteosynthesis scenarios, representing both the patient and the occupationally exposed individual (OEI) with a female reference phantom from ICRP Publication 145. The study included 24 simulations, categorized into posteroanterior (PA) and lateral cross (LC) projections, with tube voltages ranging from 60 to 90 kV for PA and 70 to 100 kV for LC. Protective equipment, such as aprons, suspended glass, and curtains, was tested using alternative materials to lead, including bismuth and tungsten. The results demonstrated that bismuth and tungsten exhibited varying levels of radiation attenuation efficiency compared to lead, with performance expressed as percentages relative to lead-based equipment. While certain scenarios showed that bismuth and tungsten outperformed lead in radiation protection, other scenarios highlighted their limitations. For instance, at 90 kV in the PA projection, both materials resulted in significant increases in radiation dose compared to lead. © 2025 Elsevier Ltd

关键词： Reactor shielding

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POTENTIAL UTILIZATION OF CRUDE GLYCERIN IN ORGANOSOLV PRETREATMENT OF EUCALYPTUS RESIDUAL BIOMASS 30th

POTENTIAL UTILIZATION OF CRUDE GLYCERIN IN ORGANOSOLV PRETRE...

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30th European Biomass Conference and Exhibition, EUBCE 2022

作者： Lima, Izabela da Silva Soares, Ricardo Reis Rezende, Mylene Cristina Alves Ferreira Rossa, Vinicius Federal University of Uberlândia Chemistry Department Postgraduate Program in Biofuels Uberlândia Brazil FederalUniversity of Uberlândia Department of Chemical Engineering 1K Uberlândia Brazil

With the growing search for alternative and renewable energy sources, lignocellulosic biomass is becoming more and more relevant. In Brazil, due to the abundance and variety of biomass, the forestry sector can be highlighted as an important segment in the construction of a green economy, since they have been investing in the total use of forests, including generated residues. The objective of this work is to perform in the residual biomass of eucalyptus an organosolv pretreatment using as a solvent the crude glycerin resulting from the production of biodiesel, to promote the delignification of biomass, in addition to an efficient fractioning and generation of bioproducts of interest. The experiments were performed in batch reactors varying temperature, crude glycerin/water concentration, and reaction time. At the end of each experiment, the pretreated biomass, and a liquid phase (black liquor) containing the solubilized organosolv lignin were obtained. The biomasses "in nature" and pretreated were chemically characterized to evaluate the pretreatment efficiency, and the lignin was recovered from the black liquor quantified and characterized. As a result, high rates of biomass delignification were obtained after pretreatment, reaching a maximum content of 83.09%. In the recovery of lignin, a maximum of 11.25 g of lignin/100 g of biomass was reached, lignin that presented similar chemical characteristics with commercial lignin. Considering the satisfactory results obtained, the use of by-products (forestry residues and crude glycerin) can help to make the process viable, besides generating interesting bioproducts to the market and being able to be integrated with biorefineries. © 2022, ETA-Florence Renewable Energies., All rights reserved.

关键词： Biomass

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Evaluation of Maternal and Fetal S-Values from Iodine Isotopes in Nuclear Medicine Using the Monte Carlo Method

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SSRN 2025年

作者： Coelho, Nathalia B.M. Alves, Arthur de Souza Borges Zuchet Santos, Carla J. Neves, Lúcio P. Perini, Ana P. Belinato, Walmir Ferreira, José Rafael S. Santos, William S. Postgraduate Program in Biomedical Engineering Faculty of Electrical Engineering Federal University of Uberlândia Uberlândia Brazil Institute of Physics Federal University of Uberlândia Uberlândia Brazil Federal Institute of Bahia - IFBA BA Vitória da Conquista Brazil Department of Physics Federal University of Sergipe São Cristóvão Brazil Universidade Federal da Bahia Brazil

The use of radionuclides for therapeutic and diagnostic purposes is the primary function of nuclear medicine. Among these radionuclides, the iodine family stands out as isotopes that can serve various purposes, including brachytherapy, scintigraphy, and research. The internal dosimetry of these nuclides becomes even more important when considering high-risk groups such as pregnant patients, as it involves concerns for both the mother and the fetus. This study aims to use Monte Carlo simulations to calculate S-values for a set of target organs in both the pregnant woman and the fetus, considering different source organs in the mother and three iodine isotopes: 131I, 125I, and 123I. The results indicated that 131I, with the highest emission energy, presented a high dose deposition pattern in target organs farther from the source organs, while 125I, with the lowest energy, showed a localized dose absorption pattern in adjacent organs. The highest S-values (all in mGy/MBq.s) were obtained for the pregnant woman, with values of 5.8E-05 in the thyroid using 123I and 125I, and 3.7E-04 in the bladder using 131I. For fetal organs, the most irradiated were the brain and skull using 131I, with values of 6.3E-06 and 5.6E-06, respectively, while the lowest values were associated with the use of 125I in source organs distant from the target organ, with contributions as low as 1E-12 for the thyroid as a source. This work presents a qualitative and quantitative study of the internal dosimetry of a pregnant patient and her fetus, addressing variables such as radioactive isotope and source and target organs, serving as a reference for dosimetric calculations deemed necessary in clinical practices to minimize the dose received by this critical group. © 2025, The Authors. All rights reserved.

关键词： Nuclear medicine

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Comparison between technical parameters recommended by regulatory agencies and relevant institutions for ventilatory therapy equipment used in patients with COVID-19

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Research on biomedical engineering 2021年第2期37卷 375-388页

作者： de Souza, Daniel Baldoino Frondana, Fernanda Vieira Silva, Fábia Diniz Centre for Innovation and Technology Assessment in Health Postgraduate Program in Electrical and Biomedical Engineering Faculty of Electrical Engineering Federal University of Uberlândia Uberlândia Brazil Health Science Center Postgraduate Program in Health Management and Innovation Federal University of Rio Grande do Norte Natal Brazil Pneumology Division Heart Institute at Clinical Hospital Faculty of Medicine University of São Paulo São Paulo Brazil

Background: Patients contaminated with the new coronavirus, SARS-CoV-2, and who develop the severe form of the disease require ventilatory support to maintain adequate gas exchange. The objective of this systematic review was to establish reference parameters of ventilator therapy used in the various levels of severity of adult patients affected by COVID-19 to assist health professionals and hospital managers who will purchase this equipment. Methods: It used four databases: Medline, Cochrane Central, Scielo, and Pubmed. Restrictions applied as to the language, restricted to English, and to the patient’s profile, only adults affected by SARS-CoV-2. The review process was carried out by three independent reviewers using the PRISMA-P method. Results: Nineteen articles were included, in addition to the recommendations of the Brazilian Association of Intensive Care Medicine (Brazil), federal Commission for Protection against Health Risks (Mexico), Medicines and Healthcare Products Regulatory Agency (UK), Pan American Health Organization, and World Health Organization. The types of ventilatory therapies found in the articles eligible for this study were continuous positive airway pressure (CPAP), non-invasive ventilation (NIV), and invasive mechanical ventilation (IMV). For each ventilatory therapy, the parameters presented in the article and the recommendations of regulatory agencies and relevant institutions were compared and analyzed. Conclusion: It was possible to suggest a relationship between the respiratory support strategy adopted by the clinical team and the clinical conditions of the patient infected with SARS-CoV-2. The included studies used ventilation modes and parameters within the specifications and recommendations of relevant regulatory agencies and institutions. However, some minor differences were observed in the instruction presented among the agencies more related to the recommended ventilation modes. Further studies are needed. © 2021, Sociedade Bras

关键词： Coronavirus

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Metrological evaluation of kyphosis in X-ray images: analysis of the Cobb angle and impact of operational variability

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Research on biomedical engineering 2025年第2期41卷

作者： de Andrade Palis, Angélica Arencibia, Rosenda Valdés Milagre, Selma Terezinha Postgraduate Program in Biomedical Engineering Federal University of Uberlândia MG Uberlândia Brazil Postgraduate Program in Mechanical Engineering Federal University of Uberlândia MG Uberlândia Brazil

Introduction: Kyphosis is a physiological curvature of the thoracic spine. This curvature assumes values between 20 and 40° Cobb angle in its normal state. The early detection of kyphosis is essential for an effective treatment, since the increase in this curvature can go on to cause a number of related problems. This article presents the evaluation of the effect of the operator factor on the Cobb angle values obtained in X-ray images with different degrees of kyphosis and the evaluation of the measurement uncertainty of this measurand by considering each measurement system used. Methods: Three operators, at three levels of experience, measured Cobb angle in nine images (three analogue, three digital and three computerized) of patients with different degrees of kyphosis. Measurements were carried out using a protractor for analogue images, whereas for digital and computerized images a specific software was used. The measurement uncertainty associated with angle was assessed by applying the GUM method. Results: Operator 3 (less experienced) obtained more dispersed Cobb values, which resulted in higher uncertainty. Operator 1 (more experienced) showed better measurement result repeatability and quality. The variability of the readings was the variable that most influenced the final uncertainty of the measurements performed by Operator 3, while the measurement system resolution was that which had greater influence on operators 1 and 2. Conclusion: Operator experience significantly influences Cobb angle values in digitized X-ray images. Failure to consider the associated measurement uncertainty can lead to inconsistent diagnoses, especially in digital images, highlighting the importance of standardized methods and uncertainty evaluation to ensure diagnostic accuracy. © The Author(s), under exclusive licence to The Brazilian Society of biomedical engineering 2025.

关键词： Kyphosis Measurement uncertainty Operator factor

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Effects of Superabsorbent Polymers on Autogenous Shrinkage and Microstructure in Metakaolin-Based Cementitious Materials

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SSRN 2025年

作者： Palma e Silva, Arthur Aviz Capuzzo, Valdirene Maria Silva da Silva, Eugência Fonseca Agostinho, Lívia Borba Pereira, André Maués Brabo University of Brasília Postgraduate Program in Structures and Civil Construction DF BrasíliaCEP: 70910-900 Brazil Federal Fluminense University Department of Computer Science RJ Rio de JaneiroCEP: 22290-240 Brazil Federal University Uberlândia Postgraduate Program in Civil Engineering Minas Gerais UberlandiaCEP: 38408-100 Brazil

The use of superabsorbent polymers (SAPs) in combination with supplementary cementitious materials like metakaolin presents an opportunity to enhance concrete performance while addressing environmental concerns in construction, lowering CO2 emissions by clincker substitution. This study investigates the behavior of high-strength microconcrete incorporating SAPs and metakaolin, evaluating their feasibility and sustainability for construction applications. Three microconcrete and paste mixes were analyzed: a reference mix and two mixes containing 0.15% and 0.30% SAP by cement mass. All mixes included a 10% metakaolin substitution by cement mass and maintained the same water/cement ratio, without additional curing water for SAPs. Fresh-state tests assessed consistency and specific mass, while hardened-state tests measured elastic modulus. Autogenous shrinkage was evaluated through linear volumetric variation using dial gauges. Microstructural analysis of the pastes and microconcretes involved thermogravimetry, isothermal conduction calorimetry, and X-ray microtomography. The results highlight the beneficial effects of SAPs with metakaolin, including enhanced hardened state properties and refined pore structure, achieved despite the absence of extra curing water. SAPs contributed to increased pozzolanic activity in metakaolin, likely due to delayed water release from SAP desorption. Furthermore, SAPs effectively mitigated autogenous shrinkage, making their application in concrete mixes promising. These findings emphasize the dual benefit of improving concrete performance and advancing environmental sustainability, showcasing the potential of SAPs and metakaolin in producing high-performance, eco-friendly concrete solutions for the construction industry. © 2025, The Authors. All rights reserved.

关键词： Hardening

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