Browse through all publications from the Institute of Global Health Innovation, which our Patient Safety Translational Research Centre is part of. This feed includes reports and research papers from our Centre. 

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  • Conference paper
    Hu M, Kassanos P, Keshavarz M, Yeatman E, Lo Bet al., 2021,

    Electrical and Mechanical Characterization of Carbon-Based Elastomeric Composites for Printed Sensors and Electronics

    Printing technologies have attracted significant interest in recent years, particularly for the development of flexible and stretchable electronics and sensors. Conductive elastomeric composites are a popular choice for these new generations of devices. This paper examines the electrical and mechanical properties of elastomeric composites of polydimethylsiloxane (PDMS), an insulating elastomer, with carbon-based fillers (graphite powder and various types of carbon black, CB), as a function of their composition. The results can direct the choice of material composition to address specific device and application requirements. Molding and stencil printing are used to demonstrate their use.

  • Journal article
    Ezzat A, Kogkas A, Holt J, Thakkar R, Darzi A, Mylonas Get al., 2021,

    An eye-tracking based robotic scrub nurse: proof of concept


    BackgroundWithin surgery, assistive robotic devices (ARD) have reported improved patient outcomes. ARD can offer the surgical team a “third hand” to perform wider tasks and more degrees of motion in comparison with conventional laparoscopy. We test an eye-tracking based robotic scrub nurse (RSN) in a simulated operating room based on a novel real-time framework for theatre-wide 3D gaze localization in a mobile fashion.MethodsSurgeons performed segmental resection of pig colon and handsewn end-to-end anastomosis while wearing eye-tracking glasses (ETG) assisted by distributed RGB-D motion sensors. To select instruments, surgeons (ST) fixed their gaze on a screen, initiating the RSN to pick up and transfer the item. Comparison was made between the task with the assistance of a human scrub nurse (HSNt) versus the task with the assistance of robotic and human scrub nurse (R&HSNt). Task load (NASA-TLX), technology acceptance (Van der Laan’s), metric data on performance and team communication were measured.ResultsOverall, 10 ST participated. NASA-TLX feedback for ST on HSNt vs R&HSNt usage revealed no significant difference in mental, physical or temporal demands and no change in task performance. ST reported significantly higher frustration score with R&HSNt. Van der Laan’s scores showed positive usefulness and satisfaction scores in using the RSN. No significant difference in operating time was observed.ConclusionsWe report initial findings of our eye-tracking based RSN. This enables mobile, unrestricted hands-free human–robot interaction intra-operatively. Importantly, this platform is deemed non-inferior to HSNt and accepted by ST and HSN test users.

  • Journal article
    Aufegger L, Soane E, Darzi A, Bicknell Cet al., 2021,

    Shared leadership in tertiary care: design of a simulation for patient safety decision-making in healthcare management teams

    , BMJ Simulation & Technology Enhanced Learning, Vol: 7, Pages: 216-222, ISSN: 2056-6697

    Introduction Simulation-based training (SBT) on shared leadership (SL) and group decision-making (GDM) can contribute to the safe and efficient functioning of a healthcare system, yet it is rarely incorporated into healthcare management training. The aim of this study was design, develop and validate a robust and evidence-based SBT to explore and train SL and GDM.Method Using a two-stage iterative simulation design approach, 103 clinical and non-clinical managerial students and healthcare professionals took part in an SBT that contained real-world problems and opportunities to improve patient safety set within a fictional context. Self-report data were gathered, and a focus group was conducted to address the simulation’s degree of realism, content, relevance, as well as areas for improvement.Results Participants experienced the simulation scenario, the material and the role assignment as realistic and representative of real-world tasks and decision contexts, and as a good opportunity to identify and enact relevant tasks, behaviours and knowledge related to SL and GDM. Areas for improvement were highlighted with regard to involving an actor who challenges SL and GDM; more preparatory time to allow for an enhanced familiarisation of the content; and, video debriefs to reflect on relevant behaviours and team processes.Conclusions Our simulation was perceived as an effective method to develop SL and GDM within the context of patient safety and healthcare management. Future studies could extend this scenario method to other areas of healthcare service and delivery, and to different sectors that require diverse groups to make complex decisions.

  • Journal article
    Riley S, Ainslie KEC, Eales O, Walters CE, Wang H, Atchison C, Fronterre C, Diggle PJ, Ashby D, Donnelly CA, Cooke G, Barclay W, Ward H, Darzi A, Elliott Pet al., 2021,

    Resurgence of SARS-CoV-2: detection by community viral surveillance

    , Science, Vol: 372, Pages: 990-995, ISSN: 0036-8075

    Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has mainly relied on case reporting, which is biased by health service performance, test availability, and test-seeking behaviors. We report a community-wide national representative surveillance program in England based on self-administered swab results from ~594,000 individuals tested for SARS-CoV-2, regardless of symptoms, between May and the beginning of September 2020. The epidemic declined between May and July 2020 but then increased gradually from mid-August, accelerating into early September 2020 at the start of the second wave. When compared with cases detected through routine surveillance, we report here a longer period of decline and a younger age distribution. Representative community sampling for SARS-CoV-2 can substantially improve situational awareness and feed into the public health response even at low prevalence.

  • Journal article
    Chapman M, Domínguez J, Fairweather E, Delaney BC, Curcin Vet al., 2021,

    Using Computable Phenotypes in Point-of-Care Clinical Trial Recruitment.

    , Stud Health Technol Inform, Vol: 281, Pages: 560-564

    A key challenge in point-of-care clinical trial recruitment is to autonomously identify eligible patients on presentation. Similarly, the aim of computable phenotyping is to identify those individuals within a population that exhibit a certain condition. This synergy creates an opportunity to leverage phenotypes in identifying eligible patients for clinical trials. To investigate the feasibility of this approach, we use the Transform clinical trial platform and replace its archetype-based eligibility criteria mechanism with a computable phenotype execution microservice. Utilising a phenotype for acute otitis media with discharge (AOMd) created with the Phenoflow platform, we compare the performance of Transform with and without the use of phenotype-based eligibility criteria when recruiting AOMd patients. The parameters of the trial simulated are based on those of the REST clinical trial, conducted in UK primary care.

  • Journal article
    Sivananthan A, Kogkas A, Glover B, Darzi A, Mylonas G, Patel Net al., 2021,

    A novel gaze-controlled flexible robotized endoscope; preliminary trial and report


    BackgroundInterventional endoluminal therapy is rapidly advancing as a minimally invasive surgical technique. The expanding remit of endoscopic therapy necessitates precision control. Eye tracking is an emerging technology which allows intuitive control of devices. This was a feasibility study to establish if a novel eye gaze-controlled endoscopic system could be used to intuitively control an endoscope.MethodsAn eye gaze-control system consisting of eye tracking glasses, specialist cameras and a joystick was used to control a robotically driven endoscope allowing steering, advancement, withdrawal and retroflexion. Eight experienced and eight non-endoscopists used both the eye gaze system and a conventional endoscope to identify ten targets in two simulated environments: a sphere and an upper gastrointestinal (UGI) model.Completion of tasks was timed. Subjective feedback was collected from each participant on task load (NASA Task Load Index) and acceptance of technology (Van der Laan scale).ResultsWhen using gaze-control endoscopy, non-endoscopists were significantly quicker when using gaze-control rather than conventional endoscopy (sphere task 3:54 ± 1:17 vs. 9:05 ± 5:40 min, p = 0.012, and UGI model task 1:59 ± 0:24 vs 3:45 ± 0:53 min, p < .001).Non-endoscopists reported significantly higher NASA-TLX workload total scores using conventional endoscopy versus gaze-control (80.6 ± 11.3 vs 22.5 ± 13.8, p < .001). Endoscopists reported significantly higher total NASA-TLX workload scores using gaze control versus conventional endoscopy (54.2 ± 16 vs 26.9 ± 15.3, p = 0.012). All subjects reported that the gaze-control had positive ‘usefulness’ and ‘satisfaction’ score of 0.56 ± 0.83 and 1.43 &

  • Journal article
    Barbot A, Wales D, Yeatman E, Yang GZet al., 2021,

    Microfluidics at fibre tip for nanolitre delivery and sampling

    , Advanced Science, Vol: 8, Pages: 1-10, ISSN: 2198-3844

    Delivery and sampling nanolitre volumes of liquid can benefit new invasive surgical procedures.However, the dead volume and difficulty in generating constant pressure flow limits the use of small tubes such as capillaries.This work demonstrates sub-millimetre microfluidic chips assembled directly on the tip of a bundle of two hydrophobic coated 100 μm capillaries to deliver nanolitre droplets in liquid environments.Droplets are created in a specially designed nanopipette and propelled by gas through the capillary to the microfluidic chip where a passive valve mechanism separates liquid from gas, allowing their delivery.By adjusting the driving pressure and microfluidic geometry we demonstrate both partial and full delivery of 10 nanolitre droplets with 0.4 nanolitre maximum error, as well as sampling from the environment.This system will enable drug delivery and sampling with minimally invasive probes, facilitating continuous liquid biopsy for disease monitoring and in-vivo drug screening.

  • Report
    Lawrance E, Thompson R, Fontana G, Jennings Net al., 2021,

    The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice

  • Conference paper
    Ashraf H, Sodergren M, Mylonas G, Darzi A, Ashraf H, Sodergren M, Mylonas G, Darzi Aet al., 2021,

    837 The Identification of Gaze Behaviour and Physiological Markers Associated With Making An Error During Laparoscopic Cholecystectomy

    , ASiT/MedAll Virtual Surgical Summit, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
  • Journal article
    Espinosa-Gonzalez AB, Neves AL, Fiorentino F, Prociuk D, Husain L, Ramtale SC, Mi E, Mi E, Macartney J, Anand SN, Sherlock J, Saravanakumar K, Mayer E, de Lusignan S, Greenhalgh T, Delaney BCet al., 2021,

    Predicting Risk of Hospital Admission in Patients With Suspected COVID-19 in a Community Setting: Protocol for Development and Validation of a Multivariate Risk Prediction Tool

    , JMIR RESEARCH PROTOCOLS, Vol: 10, ISSN: 1929-0748

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