BACKGROUND AND OBJECTIVES

Mouth retractors are essential in ensuring efficient yet safe exposure of the oral cavity and oropharynx. However, when applied improperly or haphazardly, retractors can cause tissue injuries and compromise patient safety. In addition, there are gaps in the usability of existing designs. This study aimed to identify the issues encountered by otorhinolaryngology surgeons in the use of commercially available mouth retractors, design and fabricate an improved retractor, and explore the use of additive manufacturing (popularly known as 3D printing) for retractor prototyping.

The study used the United States Food and Drug Administration (US FDA) Design Control as its framework. End-user requirements from otorhinolaryngologists were collected through key informant interviews. Results were organized into a Design Input template which was used to guide the design and development process. Prototype designs were iteratively created using computer-aided design software and 3D printing. Once design specifications were satisfied, a beta prototype was fabricated and given to another cohort of otorhinolaryngologists. The participants assessed the usability of the beta prototype. System Usability Scale (SUS) was used to quantify participant's feedback.

Five designs were created in the course of the study. The final prototype was fabricated using a Stereolithography (SLA) 3D printer. Several features were developed to address user requirements. The primary modification was to make the retractor modular to facilitate easier and shorter mounting and assembly. Gingival injury was addressed with the replacement of the maxillary alveolus hook with support bars. Five participants evaluated the beta prototype which received a mean SUS score of 75, well above the 50th percentile threshold.

This study demonstrates the applicability of the US FDA Design Control Process in the local setting to improve the mouth retractor design. Clinical and ergonomic issues were identified and design solutions were proposed and some have been implemented in a low-fidelity prototype. Results of the small-scale usability test suggest that the present form factor can be the basis for further iterations. Future studies can implement the proposed features to address other clinical and ergonomic needs.

BACKGROUND AND OBJECTIVES

The COVID-19 pandemic forced academic institutions to suspend face-to-face activities, causing a drastic shift to a remote and online setting for learning and teaching. While necessary, the sudden change created a lasting effect on the constituents of medical schools whose curriculum relied on lectures, clinical skills, and hospital experience in teaching its students. This study aims to describe the effect of the rapid digitalization on the medical faculty at the St. Luke’s Medical Center College of Medicine-William H. Quasha Memorial (SLMCCM) in Metro Manila, Philippines.

Members of the medical faculty of the college were invited to participate in focus group discussions (FGDs) where four frames were discussed, namely content, pedagogy, technology, and mindset. Responses taken in the FGDs underwent thematic analysis to find commonalities and patterns among the concerns and comments of the faculty.

Analysis of faculty feedback regarding the four frames revealed a spectrum of responses, encompassing both positive and negative sentiments. Content-related feedback predominantly focused on strategies for effectively segmenting and synthesizing information within the online environment. Pedagogical concerns are primarily centered on adapting teaching methods and delivery styles to the online format. Technological feedback highlighted the perceived advantages and limitations of online platforms and tools, as well as the role of technological support in facilitating the transition to online instruction. Finally, a significant portion of the feedback addressed the psychological effects of the pandemic on faculty members as medical educators, with responses ranging from expressions of fear to statements of confidence.

In the context of the evolving educational landscape, particularly the accelerated adoption of online and hybrid learning models in medical education, faculty recognition of the necessity of digitalization is paramount. Despite the inherent challenges of this transition, the faculty's demonstrated openness to change and innovation presents a significant opportunity for institutional growth. By continuing to invest in these technologies, institutions can not only enhance the medical curriculum but also prepare future physicians for the increasingly digital nature of healthcare delivery.

Plant bioreactor is a new production platform for expression of recombinant protein, which is one of the cores of molecular farming. In this study, the anti DYKDDDDK (FLAG) antibody was recombinantly expressed in tobacco (Nicotiana benthamiana) and purified. FLAG antibody with high affinity was obtained after immunizing mice for several times and its sequence was determined. Based on this, virus vectors expressing heavy chain (HC) and light chain (LC) inoculated into Nicotiana benthamiana leaves by using Agrobacterium-mediated delivery. Accumulation of the HC and LC was analyzed by SDS/PAGE followed by Western blotting probed with specific antibodies from 2 to 9 days postinfiltration (dpi). Accumulation of the FLAG antibody displayed at 3 dpi, and reached a maximum at 5 dpi. It was estimated that 66 mg of antibody per kilogram of fresh leaves could be obtained. After separation and purification, the antibody was concentrated to 1 mg/mL. The 1:10 000 diluted antibody can probe with 1 ng/mL FLAG fused antigen well, indicating the high affinity of the FLAG antibody produced in plants. In conclusion, the plant bioreactor is able to produce high affinity FLAG antibodies, with the characteristics of simplicity, low cost and highly added value, which contains enormous potential for the rapid and abundant biosynthesis of antibodies.
Animals ; Mice ; Antibodies ; Nicotiana/genetics* ; Agrobacterium/genetics* ; Bioreactors ; Blotting, Western

Acupuncture, a therapeutic treatment defined as the insertion of needles into the body at specific points (ie, acupoints), has growing in popularity world-wide to treat various diseases effectively, especially acute and chronic pain. In parallel, interest in the physiological mechanisms underlying acupuncture analgesia, particularly the neural mechanisms have been increasing. Over the past decades, our understanding of how the central nervous system and peripheral nervous system process signals induced by acupuncture has developed rapidly by using electrophysiological methods. However, with the development of neuroscience, electrophysiology is being challenged by calcium imaging in view field, neuron population and visualization in vivo. Owing to the outstanding spatial resolution, the novel imaging approaches provide opportunities to enrich our knowledge about the neurophysiological mechanisms of acupuncture analgesia at subcellular, cellular, and circuit levels in combination with new labeling, genetic and circuit tracing techniques. Therefore, this review will introduce the principle and the method of calcium imaging applied to acupuncture research. We will also review the current findings in pain research using calcium imaging from in vitro to in vivo experiments and discuss the potential methodological considerations in studying acupuncture analgesia.
Calcium ; Acupuncture Therapy ; Acupuncture ; Acupuncture Analgesia/methods* ; Acupuncture Points ; Technology

Humans ; Cardiovascular Diseases/prevention & control* ; China ; Technology

Humans ; Cardiovascular Diseases/prevention & control* ; China ; Technology

BACKGROUND

Leprosy continues to pose significant health challenges globally, leading to stigma and disability when left untreated. Patient education is crucial in addressing these challenges. While traditional health lectures (THL) are widely used, they face limitations such as inconsistent delivery and low patient engagement. Video-based education (VBE) offers a more modern, scalable alternative, enhancing learning through immersive technology.

This study compared the effectiveness of VBE versus THL in improving leprosy patients’ understanding, perspectives, and quality of life (QoL) in a tertiary hospital in the Philippines

A randomized controlled trial with 1:1 allocation ratio was conducted among 57 leprosy patients, divided into VBE and THL groups. Baseline and post-intervention questionnaires measured understanding, patient perspectives, and QoL using the Dermatology Life Quality Index, collected immediately after and two weeks post-intervention. Statistical analyses included chi-squared tests, t-tests, and Pearson’s correlations.

VBE significantly improved patients’ understanding, perspectives, and QoL compared to THL. Post-intervention, 43% of VBE participants showed a high level of understanding, versus 24% in the THL group (p = 0.048). VBE had greater positive impact on patient perspectives and QoL (p = 0.011 and p = 0.046). Knowledge retention was higher in VBE group after two weeks (p = 0.0373), with improvements in understanding strongly linked to better perspectives and QoL (r = 0.54 and r = 0.65).

VBE proved more effective than THL in enhancing understanding and retention, perspectives, and QOL. With its multi-sensory, scalable format, VBE offers a promising and efficient tool for patient education, particularly in resource-limited settings.

Background and Objective: To design and fabricate a suction port adapter to use various sizes of suction cannulas with a wireless otoendoscope enabling ear cleaning under endoscopic guidance demonstrated using an ear examination simulator. Methods: Design: Instrument Innovation. Setting: Tertiary Private Training Hospital. Patient: Ear Examination Simulator. Results: The fabricated suction port adapters were able to hold the wireless otoendoscope and suction cannulas together, allowing simultaneous inspection of the ear canal and suctioning of ear canal debris using the Ear Examination Simulator. Conclusion Our prototype 3D-printed suction port adapters for a wireless otoendoscope may improve ear cleaning by enhancing the accuracy of suctioning debris and decreasing duration since they hold the suction cannulas in place under endoscopic guidance. They may aid ENT physicians in easier visualization and simultaneous ear cleaning of patients and improve ear cleaning techniques and times, especially among less experienced physicians, but actual clinical trials are needed to confirm this.
Printing, Three-Dimensional ; Cerumen ; Otoscopy

Background: In this study, 3D printed floating tablet devices for Metronidazole (MTZ) were developed to prolong its exposure with Helicobacter pylori and eradicate it from causing peptic ulcer Objectives: To utilize Quality by Design (QbD) in the development of the tablet devices through Fused Deposition Modelling (FDM) 3D printing. This aimed to develop and construct optimized design dimensions of tablet devices subject for characterization. Methodology: Tablet designs were established using QbD, Design Failure Mode Effect and Analysis (DFMEA) and 2 factorial design. Four floating tablets devices were developed through FDM 3D printing using Polyvinyl alcohol (PVA) filament. Characterization tests determined their dimensions, density, floating mechanism, in vitro dissolution rate, drug release kinetics, surface morphology, infill and thermal characteristics. Significance of the QbD model was also assessed. Results: Density of all devices were less than 1.004 g/cm . The floating Lag time (FLT) showed instant floatation and Total Floating Time (TFT) lasted for an average of 1 hour. Drug release kinetics show Korsmeyer-Peppas kinetics. Thermal characteristics fall within o o 186.12 C-187.27 C. 3D CTX-ray results show accuracy of printing 3D renders. Tablet device 3 exhibited the best surface morphology, longest floating time and slowest drug release. Conclusion The study successfully developed 3D printed floating tablet devices for Metronidazole with sustained release mechanism. Thus, utilizing QbD in pre-formulation studies using novel technology is essential in optimizing drug dosage forms. Plots from Design Expert Software show the significant design models.
Printing, Three-Dimensional

Background and Objectives: The COVID-19 pandemic forced academic institutions to suspend face-to-face activities, causing a drastic shift to a remote and online setting for learning and teaching. While necessary, the sudden change created a lasting effect on the constituents of medical schools whose curriculum relied on lectures, clinical skills, and hospital experience in teaching its students. This study aims to describe the effect of the rapid digitalization on the medical faculty at the St. Luke’s Medical Center College of Medicine-William H. Quasha Memorial (SLMCCM) in Metro Manila, Philippines. Methods: Members of the medical faculty of the college were invited to participate in focus group discussions (FGDs) where four frames were discussed, namely content, pedagogy, technology, and mindset. Responses taken in the FGDs underwent thematic analysis to find commonalities and patterns among the concerns and comments of the faculty. Results: Analysis of faculty feedback regarding the four frames revealed a spectrum of responses, encompassing both positive and negative sentiments. Content-related feedback predominantly focused on strategies for effectively segmenting and synthesizing information within the online environment. Pedagogical concerns are primarily centered on adapting teaching methods and delivery styles to the online format. Technological feedback highlighted the perceived advantages and limitations of online platforms and tools, as well as the role of technological support in facilitating the transition to online instruction. Finally, a significant portion of the feedback addressed the psychological effects of the pandemic on faculty members as medical educators, with responses ranging from expressions of fear to statements of confidence. Conclusion In the context of the evolving educational landscape, particularly the accelerated adoption of online and hybrid learning models in medical education, faculty recognition of the necessity of digitalization is paramount. Despite the inherent challenges of this transition, the faculty's demonstrated openness to change and innovation presents a significant opportunity for institutional growth. By continuing to invest in these technologies, institutions can not only enhance the medical curriculum but also prepare future physicians for the increasingly digital nature of healthcare delivery
faculty ; education, medical ; technology