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BackgroundAdvancements in wearable sensors have caused a resurgence in their use, particularly because their miniaturization offers ambulatory advantages while performing continuous vital sign monitoring. Digital alerts can be generated following early recognition of clinical deterioration through breaches of set parameter thresholds, permitting earlier intervention. However, a systematic real-world evaluation of these alerting systems has yet to be conducted, and their efficacy remains unknown. ObjectiveThe aim of this study is to implement wearable sensors and digital alerting systems in acute general wards to evaluate the resultant clinical outcomes. MethodsParticipants on acute general wards will be screened and recruited into a trial with a pre-post implementation design. In the preimplementation phase, the SensiumVitals monitoring system, which continuously measures temperature, heart, and respiratory rates, will be used for monitoring alongside usual care. In the postimplementation phase, alerts will be generated from the SensiumVitals system when pre-established thresholds for vital parameters have been crossed, requiring acknowledgement from health care staff; subsequent clinical outcomes will be analyzed. ResultsEnrolment is currently underway, having started in September 2017, and is anticipated to end shortly. Data analysis is expected to be completed in 2021. ConclusionsThis study will offer insight into the implementation of digital health technologies within a health care trust and aims to describe the effectiveness of wearable sensors for ambulatory continuous monitoring and digital alerts on clinical outcomes in acute general ward settings. Trial RegistrationClinicalTrials.gov NCT04638738; https://clinicaltrials.gov/ct2/show/NCT04638738. International Registered Report Identifier (IRRID)DERR1-10.2196/26240

BackgroundThe rapid uptake of digital technology into the operating room has the potential to improve patient outcomes, increase efficiency of the use of operating rooms, and allow surgeons to progress quickly up learning curves. These technologies are, however, dependent on huge amounts of data, and the consequences of their mismanagement are significant. While the field of artificial intelligence ethics is able to provide a broad framework for those designing and implementing these technologies into the operating room, there is a need to determine and address the ethical and data governance challenges of using digital technology in this unique environment. ObjectiveThe objectives of this study are to define the term digital surgery and gain expert consensus on the key ethical and data governance issues, barriers, and future research goals of the use of artificial intelligence in surgery. MethodsExperts from the fields of surgery, ethics and law, policy, artificial intelligence, and industry will be invited to participate in a 4-round consensus Delphi exercise. In the first round, participants will supply free-text responses across 4 key domains: ethics, data governance, barriers, and future research goals. They will also be asked to provide their understanding of the term digital surgery. In subsequent rounds, statements will be grouped, and participants will be asked to rate the importance of each issue on a 9-point Likert scale ranging from 1 (not at all important) to 9 (critically important). Consensus is defined a priori as a score of 7 to 9 by 70% of respondents and 1 to 3 by less than 30% of respondents. A final online meeting round will be held to discuss inclusion of statements and draft a consensus document. ResultsFull ethical approval has been obtained for the study by the local research ethics committee at Imperial College, London (20IC6136). We anticipate round 1 to commence in January 2021. ConclusionsThe results of this study will define the term digital surgery, identify the key issues and barriers, and shape future research in this area. International Registered Report Identifier (IRRID)PRR1-10.2196/26552

Thermolectric cooling offers several advantages over conventional refrigeration systems due to its light weight, environmental friendliness, silent operation, and no moving parts. In this work, a thermoelectric water cooling system is created in which water flowing at various flowrates removes heat produced on the hot side of the Peltier module. The cooling effect and coefficient of performance (COP) of the cooling system are experimentally determined at various flowrates of water on the hot side of the module. The cooling effect produced in water increases with the increase in flowrate. A similar trend is noticed for the COP of the system. The maximum cooling effect produced in water is 1363 W at 43 mL/s. The maximum COP of the system is 3.99. [ABSTRACT FROM AUTHOR]