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Motor control theories suggest that the brain uses forward models to predict self-generated tactile input during voluntary movements, thereby reducing the intensity of reafferent tactile sensations. When one's own body is the target, this phenomenon is called self-touch attenuation. Although self-touch attenuation is well-documented, it remains unclear how prediction-related neural mechanisms drive attenuation before the self-touch input. We used magnetoencephalography (MEG) to examine the neural correlates of self-touch prediction. 24 human participants (12 female, 12 male) performed a self-touch, and two control tasks. In one control, they received externally generated touch without movement. In the other, the touch was triggered by the participant's movement, but the hands were spatially misaligned. This manipulation is known to weaken attenuation despite identical tactile input, movement, and task demands, because the sensorimotor context reduces prediction of touch at that body site. Self-touch evoked weaker somatosensory activity (M50 component) than both control conditions. A psychophysics task mirrored the pattern of neural attenuation, as the perception of self-touch was attenuated compared to the two control conditions. To isolate predictive neural mechanisms from general movement-related activity, we subtracted activity from corresponding stimulus-absent trials. Comparing self-touch with misaligned touch allowed us to refine the signal specific to predictive processing in self-touch and revealed greater pre-stimulus beta-band desynchronization and increased cerebellar-to-somatosensory connectivity before self-touch compared to misaligned touch. Our results provide the first evidence of predictive neural activity that shapes the sensory consequences of self-touch, offering insights into the mechanisms through which predictive models modulate somatosensory processing.Significance statement The brain is thought to predict and attenuate the sensory consequences of self-generated actions, but neural evidence for prediction before sensation has been limited. Using magnetoencephalography, we show that self-touch attenuation is preceded by beta-band desynchronization and increased directed connectivity from the cerebellum to the primary somatosensory cortex. These effects cannot be attributed to movement, as they were reduced in a control condition with similar motor output but lower congruence between the action and tactile consequence, suggesting spatially specific predictive processing. Our study provides the first neural evidence of cerebellar influence on cortical sensory areas before self-touch. These pre-stimulus effects support forward models of sensorimotor control and shed new light on how the brain anticipates and modulates upcoming sensory input.
Infections are a leading cause of hospitalization and death in children receiving maintenance peritoneal dialysis (PD). Touch contamination is an established risk factor for development of peritonitis, but data regarding optimal management of touch contamination are limited. We conducted a retrospective cohort study using data submitted to the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative between 10/1/2011 and 7/31/2025 to evaluate touch contamination in children. Reported touch contamination events and their management, including administration of prophylactic antibiotics and transfer set changes, were evaluated. Univariate and multivariable generalized linear mixed modeling were used to assess relationships between demographic factors and episodes of touch contamination and between management of touch contamination events and temporally associated peritonitis. We also evaluated the microbiology of touch contamination-associated peritonitis and compared it to peritonitis not associated with touch contamination. Of 2685 children included, 846 (32%) reported at least one touch contamination. In a multivariable model, younger age and non-Hispanic Black race were associated with increased rates of touch contamination. Administration of prophylactic antibiotics following touch contamination was associated with a lower prevalence of peritonitis (23% vs. 38%). Most episodes of touch contamination-associated peritonitis were Gram-positive (46%) or culture negative (24%). Touch contaminations are common in children undergoing maintenance PD. Administration of prophylactic antibiotics following touch contamination is associated with decreased risk of peritonitis.
Improved cleaning in the anesthesia workspace is important for surgical site infection prevention. We sought to identify high-priority cleaning targets to guide post-induction surface disinfection and use of a triangular ultraviolet-C (UV-C) configuration involving placement of one emitter at the head and one on each side of the surgical bed. The 20 sites most frequently touched by anesthesia practitioners, previously identified via video-based workflow analysis, were filtered to remove disposable (eg, stopcocks) and transient (eg, the patient bed) sites, leaving durable cleaning targets amenable to repeated surface disinfection and UV-C irradiation within and/or between cases. Inequality in the distribution of cleaning target touches was quantified using the Gini coefficient, and uncertainty was estimated using bootstrap resampling (10,000 iterations). We then assessed residual contamination after standard terminal cleaning across three operating rooms and 171 sites to evaluate the difficulty of cleaning high-touch surfaces and the efficacy of UV-C disinfection. Simulations using medical devices composed of materials representative of cleaning targets contaminated with high-level Clostridium difficile were conducted to evaluate generalizability to more resistant pathogens. There were 13 of 20 frequently touched sites that were considered durable cleaning targets. Touches were relatively equal among the 13 cleaning targets (Gini coefficient 0.16, 95% confidence interval [CI], 0.12-0.20). Cleaning targets included components of the anesthesia cart (first and second drawer handles); anesthesia machine (reservoir bag, circuit ventilator control, oxygen dial, vaporizer dial, adjustable pressure-limiting valve), monitoring equipment (screen buttons/knob, electrocardiogram leads); and room infrastructure (intravenous pole, operating room table and chair). Residual contamination after cleaning was identified at 4% (7/171) of sites, mostly (6/7) within the anesthesia workspace, involving the anesthesia cart (N = 2), machine (N = 3), and monitor (N = 1). Only one site outside of the anesthesia workspace, the circulating nurse's mouse, had residual contamination. Triangular UV-C reduced mean (standard deviation [SD]) colony-forming units (CFU) from 60.47 (542.22) to 0.12 (1.08), achieving a 2.7-log reduction. Simulation with high-level C. difficile contamination demonstrated ≥3-log reductions on surfaces representative of high-touch sites, confirming applicability to resistant pathogens. Thirteen durable cleaning targets in the anesthesia workspace are largely equivalent in terms of risk of touch. They are amenable to UV-C augmentation of surface disinfection in the real-world clinical environment. These findings can guide targeted post-induction cleaning and use of triangular UV-C, particularly for surfaces with substantial contamination or resistant pathogens.
Clinical evidence indicates that tactile stimulation of the skin, such as stroking or gentle touch, elicits a range of beneficial physiological and psychological responses, such as increased social interaction, wellbeing, calm, restorative and growth promoting effects, as well as reduced fear, pain, and stress levels. These effects are mediated by activation of cutaneous sensory nerves, which relay signals to central regulatory systems. During this process, several neuropeptides and hormones are released, one of which is oxytocin produced in the supraoptic (SON) and paraventricular (PVN) nuclei of the hypothalamus. Oxytocin in turn stimulates social interaction, induces wellbeing and calm, and promotes growth and restorative processes in part via vagal activation of the endocrine system of the gastrointestinal tract and by inhibiting the activity within the hypothalamic pituitary adrenal (HPA)-axis and the sympathetic nervous system. It is proposed that cutaneous nerves are typically activated during social interaction through a two-step process. Gentle touch activates a two-neuron pathway involving tachykinin 1-neurons originating from the periaqueductal gray (PAG) and thereafter projecting to the SON and PVN. This activation triggers the release of oxytocin from neurons in the SON and PVN, which by activating oxytocin receptors promotes social interaction and rewarding mechanisms. Subsequent behaviors such as holding and caressing, trigger a second pool of cutaneous afferents, that respond to higher mechanical pressure than those triggered by gentle touch. We propose that these fibers are associated with oxytocin linked calming effects and with enhanced metabolic, restorative and growth promoting benefits, e.g., via vagal activation of the endocrine system of the gastrointestinal tract. In addition, anxiety, stress, pain and inflammation levels are decreased via oxytocinergic mechanisms in the brain. It is also possible that oxytocin released in response to cutaneous afferents exerts long-term effects by increasing oxytocin production and enhancing the function of oxytocin receptors. These two types of oxytocin-associated effect patterns may be activated, to varying degrees, in clinical practices involving skin-to-skin contact between individuals in certain therapeutic or caregiving contexts, such as skin-to-skin contact between infant and parent after birth or in the more long-term perspective during kangaroo care. Consequently, lack of social contact and closeness leads to reduced capacity for social interaction, increased stress levels, impaired health and even retarded growth at young age. Birth and breast-feeding, but not touch or closeness, are associated with a pulsatile release of oxytocin into the circulation. In addition, oxytocin linked pathways in the brain will be activated in response to birth and breastfeeding just as in response to touch and closeness. The release and effects of oxytocin will depend on the intensity and location of the cutaneous stimulation and of the oxytocin release pattern induced. Given the potential for different effects in response to distinct types of cutaneous stimulation manual therapies could be designed for targeted effects, such as reducing stress, relieving pain, boosting calm, or even promoting growth in early life. The aim of this narrative review was to explore the potential roles of central oxytocin, including its release and associated effects, in response to different types of sensory stimulation. In addition, we examine how oxytocin may contribute to social interaction and to clinical practices involving touch or close physical contact.
Touchless identity recognition is a crucial direction for future human-computer interaction, with broad application potential particularly in healthcare, remote security, and augmented reality. With advancements in contactless triboelectric nanogenerator (TENG) technology, employed as touch-free monitoring sensors, touchless interaction will pave the way for more natural and seamless user experiences. However, achieving more intelligent and complex touchless interactions using contactless sensors remains a grand challenge, primarily due to the difficulty in synergistically decoupling multidimensional signals such as interaction distance and velocity. Here, we present a contactless TENG based on a single-electrode mechanism that enables synergistic spatiotemporal decoding of object distance and velocity through the independent analysis of open-circuit voltage and short-circuit current signals. Benefiting from the synergy between interaction distance and velocity, the proposed system enhances identification security via spatiotemporal information encoding by mapping spatial and temporal parameters into dual-channel authentication inputs. The proposed design concept and guidelines would provide new insights into touchless sensor development, promising benefits for applications like artificial intelligence, network security, and access control for computers and networks.
In Italy, controlled Donation after Circulatory Determination of Death (cDCDD) requires a 20-min no-touch period documented by continuous electrocardiographic monitoring. Since Italian law adopts a single brain-based definition of death, this procedure serves as an indirect determination of the irreversible cessation of all brain functions. This differs from other countries using 5-min no-touch periods and focusing on permanent cessation of circulation. This paper argues that the Italian 20-min no-touch period lacks a convincing scientific and ethical basis. No evidence shows that 20 min is the minimum period required to establish beyond doubt the irreversible cessation of all brain functions after circulatory arrest. Moreover, the Italian legal definition of death relies on a standard that is not fully verifiable in practice, both regarding the cessation of all brain functions and irreversibility. It further maintains that the dead donor rule is vulnerable insofar as it is closely tied to legal definitions of death that do not fully capture the complexity of dying as a biological process. Donor protection should instead be based on what can be biologically proven, clinically confirmed, and ethically justified. The paper suggests a partial reformulation of the dead donor rule, based on the diagnosis of a permanent dying process that will inevitably lead to complete biological death. On this ground, Italy should reduce its no-touch period to the 5-min standard and revise death-determination protocols to document the permanent cessation of effective systemic circulation rather than the disappearance of cardiac electrical activity.
Contaminated hospital surfaces play a key role in the transmission of healthcare-associated infections (HAIs), particularly those caused by antimicrobial-resistant pathogens. Despite routine cleaning and disinfection, high-touch surfaces may remain reservoirs for multidrug-resistant organisms, including biofilm-forming Staphylococcus aureus. An environmental surveillance study was conducted in a single-bed room of an Internal Medicine ward in a hospital in Northern Italy. High-touch surfaces in the near-patient area and room furniture were sampled twice daily over one week, before and after routine cleaning/disinfection with chlorine-based agents (0.1-0.5% Cl). Cleaning effectiveness was evaluated using aerobic colony count (ACC) and detection of S. aureus as indicators of environmental hygiene, applying accepted microbiological benchmarks (ACC < 5 CFU/cm2; S. aureus < 1 CFU/cm2). S. aureus isolates were characterized by PFGE, spa typing, antimicrobial susceptibility testing, and biofilm production assays. Mean ACC decreased significantly after cleaning/disinfection (10.06 ± 15.67 vs 2.89 ± 5.52 CFU/cm2; p < 0.001), with a substantial reduction in non-compliant samples. However, residual contamination persisted on high-touch surfaces. S. aureus was detected in 12/238 samples, including post-cleaning samples from the near-patient area. Molecular analysis identified four distinct strains; notably, a spa type t032 (MLST ST22) isolate-methicillin-resistant, multidrug-resistant, and a strong biofilm producer-persisted on the bedside table handle both before and after cleaning. Routine cleaning and disinfection significantly reduce environmental bioburden but may not reliably eliminate biofilm-forming multidrug-resistant S. aureus from critical hand-contact surfaces. These findings highlight the need for continuous microbiological surveillance and targeted IPC interventions to address environmental reservoirs of antimicrobial resistance in healthcare settings.
Advances in virtual reality technology have facilitated research that leverages the plasticity of body schema. This study investigates whether the use of an avatar habituation method, in which participants voluntarily touch an avatar as a substitute body and receive haptic feedback, is crucial for updating body schema. This approach is called virtual self-touch (VST). We conducted an experiment with 10 participants using avatars that were the same size as the participants' actual bodies and with the length of the right forearm increased by 1.5 times. The effectiveness of VST was evaluated using questionnaire-based sense of body ownership and agency, proprioceptive drift measurements, and reaching tasks without displaying the avatar. Further, the proposed method was compared with an existing avatar habituation method, the arm swing task (AST). Our results demonstrated that VST produced larger changes in proprioceptive drift than AST. Furthermore, larger variations in the fingertip trajectories and reach endpoints were observed for VST than for the AST during the reaching task, which indicated that VST affects motor planning. This suggests that VST contributes to changes in the body schema. Additionally, distortions in spatial perception were detected in the environment when only somatosensory feedback was relied on. This result provides insights about the representation of spatial perception in the body schema.
Spontaneous activity in primary sensory neurons has been implicated in neuropathic symptoms, yet its earliest origins and immediate functional consequences remain incompletely understood. This gap is especially consequential in chemotherapy-induced peripheral neuropathy (CIPN), where sensory toxicities commonly limit effective cancer treatment. Using in vivo recordings in rats, we show that a single dose of oxaliplatin (OX) induces spontaneous firing within 24 h across touch and proprioceptive low-threshold mechanoreceptor (LTMR) afferents. Spontaneous firing consistently originated distally in peripheral axons and was accompanied by enhanced responses to mechanical stimulation, identifying LTMR sensory endings as the earliest source of spontaneous firing and a common site for spontaneous and stimulus-evoked hyperexcitability. OX also induced early structural abnormalities at sensory endings; however, SF+ LTMRs retained mechanosensory response profiles, indicating that spontaneous firing can emerge within otherwise functional sensory endings. Although coincident spontaneous and stimulus-evoked activity distorted encoding in individual LTMRs, these effects had little impact on population LTMR responses or motor behavior relying on mechanosensory feedback. Together, these findings identify sensory endings as an early target of OX neurotoxicity and demonstrate that spontaneous firing spanning multiple tactile and proprioceptive LTMR submodalities can coexist with largely preserved sensory function, indicating that even broad engagement across mechanosensory pathways is insufficient to disrupt all LTMR-dependent functions. These observations indicate that abnormal afferent activity initiated at sensory endings may be sufficient to engage sensory pathways underlying some paresthetic symptoms while leaving others largely unaffected, whereas progression to chronic neuropathic symptoms may require subsequent recruitment of the dorsal root ganglion. Oxaliplatin rapidly induces spontaneous firing across touch and proprioceptors.The earliest spontaneous firing localizes to sensory endings, not the DRG.Sensory endings are a shared site of spontaneous and evoked hyperexcitability.Spontaneous firing engages some sensory pathways while sparing others.
Relapsed or refractory extranodal natural killer/T-cell lymphoma (R/R NKTCL) remains a highly lethal disease, particularly after failure of PD-1 blockade-based therapy. Preclinical data suggest that inhibition of exportin-1 (XPO1) may enhance antitumor immunity and synergize with PD-1 blockade. We conducted a multicenter, open-label phase 1 b study (TOUCH, Arm C) evaluating selinexor plus tislelizumab in patients with R/R NKTCL previously treated with L-asparaginase-containing regimens. A standard 3 + 3 dose-escalation design was followed by dose expansion. Seventeen patients were enrolled; 16 had prior checkpoint inhibitor (CPI) exposure and comprised the efficacy population. No dose-limiting toxicities were observed. Grade ≥3 treatment-emergent adverse events occurred in 52.9% of patients; hematologic toxicities were the most common. Among patients with prior CPI exposure, the overall response rate was 75.0% (12/16), including complete responses in 43.8% (7/16). Responses were observed in patients with primary CPI-refractory disease. With a median follow-up of 21.7 months, median progression-free survival was 6.1 months (95% CI, 2.9-not estimable), and the 2-year progression-free survival rate was 37.5%. Median overall survival was not reached; the 2-year overall survival rate was 73.4%. Selinexor plus tislelizumab demonstrated manageable toxicity and substantial activity in patients with relapsed/refractory NKTCL previously treated with CPI, supporting further evaluation of nuclear export inhibition as a strategy to re-engage antitumor immunity after failure of PD-1 blockade. NCT04425070.
Although video head impulse testing (vHIT) is widely used to assess semicircular canal function, access to quantitative vestibular testing remains limited. Smartphone-based vHIT systems with goggle-based fixation have been described, but larger validation studies and improved fixation stability are needed. We evaluated a portable vHIT application using an iPod touch with an oral stabilization three-dimensional (3D)-printed mount to determine whether it detects laterality in unilateral vestibular hypofunction and is noninferior to a medical-grade device for a patient-level laterality endpoint. Thirteen patients with unilateral vestibular hypofunction and 14 healthy volunteers underwent testing with the portable and medical-grade vHIT systems on the same day. The primary endpoint was the patient-level laterality difference, defined as the difference between unaffected and affected vestibulo-ocular reflex (VOR) gain. Noninferiority was assessed using the two-sided 95% confidence interval (CI) for the mean between-device difference with a prespecified margin of 0.15. Agreement was evaluated using Bland-Altman analysis. Secondarily, absolute VOR gain agreement between devices was evaluated. False-positive classifications in healthy volunteers were assessed at the ear and subject levels using a gain threshold of <0.78. Both systems showed higher VOR gains on the unaffected side (paired t-test: medical device, p = 2.44 × 10-7; portable vHIT, p = 1.02 × 10-8). Mean laterality difference was 0.518 ± 0.180 for the medical-grade device and 0.453 ± 0.118 for the portable system. The between-device difference was -0.065 (95% CI: -0.149 to 0.018), supporting noninferiority. Bland-Altman analysis demonstrated a bias of -0.065, with 95% limits of agreement from -0.337 to 0.207. For absolute VOR gain, average between-device bias was small, but individual-ear agreement remained variable. In healthy volunteers, abnormal classifications occurred in 0 of 28 ears and 0 of 14 subjects with the medical-grade device, and in 2 of 28 ears (7.1%) and 2 of 14 participants (14.3%) with the portable system. The portable vHIT system detected laterality in unilateral vestibular hypofunction and met noninferiority criteria relative to a medical-grade device. Larger studies are warranted to refine quality control and define individual-ear absolute VOR gain agreement.
Virtual reality (VR) provides a controllable medium to couple perception and motor behavior in rehabilitation. This study investigated whether experiencing a foot-elongated avatar (FEA) via virtual self-touch (VST), which combines VR visual information and synchronized vibrotactile stimulation, is associated with body schema-related change and whether such change is reflected in motor behavior during obstacle crossing, indexed by maximum foot clearance (MFC). Twenty-two healthy young adults experienced two avatars in counterbalanced order: a life-size avatar (LA) and an FEA with a rightfoot length that was 1.5 times that of the LA. The primary outcome measure was MFC while stepping over 10-cm and 30-cm virtual obstacles; the secondary outcome measures were perceptual drift in the perceived toe-tip position and questionnaire scores for the sense of ownership and sense of agency. The VST task produced significantly greater perceptual drift with the FEA than with the LA (p < 0.05, r = 0.813). For the 30-cm obstacle, the MFC value was significantly greater with the FEA than with the LA (p < 0.05, r = 0.415). In contrast, the questionnaire scores did not exhibit statistically significant group-level differences between the avatars. These findings suggest that body schema-related change after experiencing a FEA via VST was mainly limited to the perceptual aspect and was not clearly observed in the subjective aspect. Furthermore, the finding suggests that an aspect-specific body schema-related change may be associated with measurable gait adjustment during a more demanding obstacle-crossing task, although VST contribution cannot be isolated in the present design.
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The Müller-Lyer Illusion has been extensively studied in the visual modality and, to a lesser extent, in haptic exploration. However, with the exception of an early descriptive study in the 1930s, no reports have investigated the illusion during passive tactile stimulation. Previous research uses the terms "tactile" and "haptic" interchangeably, despite exclusively examining active exploration. The present study investigated whether the illusion emerges during passive tactile stimulation, and whether its expression differs from that observed during haptic exploration with sensorimotor engagement. Twenty participants completed a manual bisection task of Müller-Lyer stimuli in a haptic exploratory or passive tactile form. Reliable illusory bias was observed in the haptic condition, with midpoint judgments shifted towards the arrow wings. Notably, this effect was mediated by the effector, with stronger bias when responses were made using the right index finger. In the tactile condition, a configuration-dependent effect emerged, in that distally pointing arrows on the forearm elicited significant illusory midpoint shifts, whereas proximal and neutral configurations did not. These findings show that the Müller-Lyer illusion arises under passive tactile stimulation, specifically, we show that contextual geometric cues bias somatosensory spatial perception in the absence of voluntary exploration.
How essential is a sense of significance for motivation-the feeling that our efforts matter beyond the trivial or momentary? Four studies (N = 604, children aged 4-9 years of age and 582 adults) show that no amount of significance is too small to matter, even for small actions from early in life. Children and adults strongly preferred artistic activities with minimal significance (i.e., where their work would be saved) over activities with no lasting existence. This preference held for both repetitive and one-time tasks and was specific to creating artwork, not just observing it. Anticipating even minimal significance motivated participants to engage in productive rather than effortless activities. When significance is absent, focusing on enjoying the process partially, but not fully, compensates for motivation. These findings illuminate the scope and sensitivity of significance, revealing it to be not a luxury concern but an essential, early-emerging motivational force in an increasingly fast-paced, transient world.
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Background: Postural problems such as head forward posture, thoracic hyperkyphosis, and lumbar hyperlordosis, when seen together, further complicate postural control, increasing the importance of comprehensive approaches in treatment. This study aims to examine the effect of 6 weeks of telerehabilitation with web-based exercises and compare the home-based exercises in individuals with postural problems. Trial Design: A Randomized Controlled Study. Methods: A total of 34 volunteers with postural deformity among young adults were randomly divided into telerehabilitation (n = 17) and control (n = 17) groups. Craniovertebral, thoracic kyphosis, and lumbar lordosis angles of all individuals were evaluated with a smartphone application (Clinometer+ Bubble), hamstring and pectoral muscle shortness with a goniometer, and trunk muscle endurance with endurance tests created by McGill and Sorenson. Whilst the tele-rehabilitation group was provided with a video-based exercise program, the control group was advised to follow the same exercise program at home. Exercises were performed 3 days a week for 6 weeks, as 1-h sessions. Participants in the telerehabilitation group were followed up with a synchronized video conference. Results: A significant difference was observed in the telerehabilitation group in muscle shortness and the endurance tests (p < 0.05). Only a significant difference in left (p = 0.03) and right (p = 0.04) muscle shortness was observed in the home exercise group. Significant differences were observed in Craniovertebral and lumbar lordosis angles between groups (p < 0.05), with the telerehabilitation group showing better outcomes. The kyphosis angle, muscle shortness, and endurance test results between groups were found to be similar (p > 0.05). Conclusions: Six weeks of telerehabilitation can improve muscle shortness and trunk endurance in young adults with postural deformities. Both the exercise program using telerehabilitation and the home exercise program were beneficial for individuals with postural problems, with more favorable effects observed in the telerehabilitation group.
To evaluate the disinfection efficacy of a third-generation gallium nitride (GaN)-based deep ultraviolet (UVC) LED disinfection cabinet on often-touch surfaces of small advanced electronic devices in hospital clinical environments, and to provide evidence for its application in hospital infection control. A total of 329 device surfaces from 10 randomly selected departments were sampled: 66 computer mice, 151 mobile phones, 53 Personal Digital Assistants (PDAs), 29 electronic glucometers, and 30 electronic sphygmomanometers. Pre-disinfection bacterial contamination levels were assessed. The UVC-LED cabinet was used for disinfection (10-min cycle, 24 mJ/cm2 dose), and a natural bacteria eradication test was conducted. A total of 658 sampling points (329 pre- and post-disinfection) were monitored. Before disinfection, 57.1% of device surfaces showed microbial contamination, with mice and cleaning staff's mobile phones exhibiting relatively severe bacterial contamination. After disinfection, 97.9% of device surfaces showed bacterial colony counts reduced to 0 CFU, with an average natural bacteria eradication rate of 99.9% (range ≥90%). High-frequency use of small advanced electronic devices by healthcare workers poses hospital infection risks. Deep LED Ultraviolet-C disinfection effectively reduces microbial load on surfaces of devices incompatible with chemical disinfectants or heat. It is recommended as a routine disinfection measure for hospital infection control. This study demonstrates high efficacy under controlled conditions; however, real-world effectiveness may be influenced by factors such as device positioning and surface shadows.
An adequate endotracheal tube depth is crucial for airway management and effective mechanical ventilation, as both too deep and superficial tube placement can be harmful to the patient. The aim of this study was to evaluate endotracheal tube depth using the ultrasound double twist sign as a new diagnostic tool using a cadaver model. In this diagnostic accuracy study, ultrasounds were performed by 12 sonographers (2 expert and 10 novice users, consisting of residents and specialists) on 3 cadavers. Novice users learned the technique in 15 min. Tubes were randomized to be placed in adequate, deep (tube tip touching main carina) or superficial (cranial edge of cuff touching vocal cords) position. The double twist sign showed an overall success rate of 90.6% to identify tube depth. It was particular reliable in identifying and ruling out deep placement, with a sensitivity of 99.2%, a specificity of 98.5%. The mean time to identify deep placement was 6.4 s; with an overall mean assessment time of 18.4 s. Test performance was not significantly impacted by cadaver (BMI, neck circumference) or sonographer characteristics ( sonographer experience); however, the study was not powered to exclude clinically meaningful effects of anatomy. In an embalmed cadaver model, the double twist sign enabled rapid and accurate assessment of endotracheal tube depth using POCUS( Point of care ultrasound)with an air-filled cuff. These findings support feasibility and diagnostic potential, but clinical performance in ventilated patients and comparison against radiography require prospective validation.
Intracortical microstimulation (ICMS) of somatosensory cortex can restore a sense of touch to people with spinal cord injury. In this early feasibility clinical trial (NCT01894802), we evaluated the safety, efficacy, and longevity of ICMS because there is a paucity of such long-term studies in humans. This information is crucial to the development of clinical neuromodulation devices, particularly for restoring touch, hearing, and vision. ICMS was delivered to five participants with spinal cord injury who were each implanted with two Blackrock NeuroPort microelectrode arrays in the hand representation of Brodmann's area 1. Across implant durations spanning 2 to 10 years, we measured single-electrode detection thresholds, projected fields, quality reports, and electrode health characteristics. ICMS-related adverse events were documented throughout. More than 168 million ICMS pulses were delivered across a combined implant duration of 27 years without any serious adverse events or direct negative effects on electrode health. ICMS consistently evoked sensations localized to the hand. Rarely, sensations persisted for brief periods after stimulation offset (3 to 25 events across participants). ICMS detection thresholds increased slowly over time (about 3.5 microamperes per year), but 64 ± 13% of the electrodes still reliably evoked tactile sensations (about 21% decrease in functional electrodes), including 60% of the electrodes after 10 years in one participant. The quality and projected field coverage of ICMS-evoked sensations were both consistent. Delivering ICMS to the somatosensory cortex was safe and effective, consistently evoking informative somatosensory percepts as long as 10 years, demonstrating the clinical promise of ICMS for sensory restoration.