Implications of the new Food and Drug Administration draft guidance on human factors engineering for diabetes device manufacturers

This article discusses the implications of the new Food and Drug Administration's draft guidance on human factors and usability engineering for the development of diabetes-related devices. Important considerations include the challenge of identifying users, when the user population is so dramatically broad, and the challenge of identifying use environments when the same can be said for use environments. Another important consideration is that diabetes-related devices, unlike many other medical devices, are used constantly as part of the user's lifestyle--adding complexity to the focus on human factors and ease of use emphasized by the draft guidance.

Optical tweezers as a new biomedical tool to measure zeta potential of stored red blood cells

During storage, red blood cells (RBCs) for transfusion purposes suffer progressive deterioration. Sialylated glycoproteins of the RBC membrane are responsible for a negatively charged surface which creates a repulsive electrical zeta potential. These charges help prevent the interaction between RBCs and other cells, and especially among each RBCs. Reports in the literature have stated that RBCs sialylated glycoproteins can be sensitive to enzymes released by leukocyte degranulation. Thus, the aim of this study was, by using an optical tweezers as a biomedical tool, to measure the zeta potential in standard RBCs units and in leukocyte reduced RBC units (collected in CPD-SAGM) during storage. Optical tweezers is a sensitive tool that uses light for measuring cell biophysical properties which are important for clinical and research purposes. This is the first study to analyze RBCs membrane charges during storage. In addition, we herein also measured the elasticity of RBCs also collected in CPD-SAGM. In conclusion, the zeta potential decreased 42% and cells were 134% less deformable at the end of storage. The zeta potential from leukodepleted units had a similar profile when compared to units stored without leukoreduction, indicating that leukocyte lyses were not responsible for the zeta potential decay. Flow cytometry measurements of reactive oxygen species suggested that this decay is due to membrane oxidative damages. These results show that measurements of zeta potentials provide new insights about RBCs storage lesion for transfusion purposes.

Spintronic platforms for biomedical applications

Since the fundamental discovery of the giant magnetoresistance many spintronic devices have been developed and implemented in our daily life (e.g. information storage and automotive industry). Lately, advances in the sensors technology (higher sensitivity, smaller size) have potentiated other applications, namely in the biological area, leading to the emergence of novel biomedical platforms. In particular the investigation of spintronics and its application to the development of magnetoresistive (MR) biomolecular and biomedical platforms are giving rise to a new class of biomedical diagnostic devices, suitable for bench top bioassays as well as point-of-care and point-of-use devices. Herein, integrated spintronic biochip platforms for diagnostic and cytometric applications, hybrid systems incorporating magnetoresistive sensors applied to neuroelectronic studies and biomedical imaging, namely magneto-encephalography and magneto-cardiography, are reviewed. Also lab-on-a-chip MR-based platforms to perform biological studies at the single molecule level are discussed. Overall the potential and main characteristics of such MR-based biomedical devices, comparing to the existing technologies while giving particular examples of targeted applications, are addressed.

How places matter: telecare technologies and the changing spatial dimensions of healthcare

Dominant discourses on telecare technologies often celebrate the erasure of distance and place. This paper provides a critical intervention into these discourses by investigating how spaces still matter, despite the move from physical to virtual encounters between healthcare professionals and patients. I argue that science and technology studies (STS) research on telecare, as well as other technologies, can be enriched by including a focus on place to understand the dynamic interactions between people and things. Adopting insights of human geographers, I show how places in which technologies are used affect how technologies enable or constrain human actions and identities. Whereas some spaces may facilitate the incorporation of technologies, others may resist technologies. A focus on how places matter is important for understanding how telecare technologies reorder and redefine healthcare. Although other healthcare technologies are also important actors in transforming healthcare, telecare technologies do this in a very specific way: they redefine the spatial dimensions of healthcare. To capture and further explore this changing spatial configuration of healthcare, I introduce the notion of technogeography of care. This concept provides a useful heuristic to study how places matter in healthcare. Although telecare technologies introduce virtual encounters between healthcare providers and patients, the use of telecare devices still largely depends on locally grounded, situated care acts. Based on interviews with users of several cardiac telecare applications, including healthcare professionals and patients in Germany and The Netherlands, the paper shows how patients' homes and public spaces are important for shaping the implementation and use of telecare technologies, and vice versa. Last, but not least, telecare devices are implicated as well. The paper emphasizes the place-dependency of the use and meaning of technical devices by showing how the same technological device can do and mean different things in different places.

[Research on intelligent fitness partner based on the acceleration and photoelectric sensors]

Due to the drawbacks of the single function for the existing pedometers, this paper proposes an intelligent fitness partner based on the acceleration and photoelectric sensors.Through low-cost and single-chip three axles acceleration sensors MMA7260, it extracts and analysis the human's sports information. Furthermore, it detects and analyses the human's heart rate signal, by using the photoelectric sensor. Microcontroller PIC18F4520 is used to realize the algorithm of adaptive step counting model, and the heart rate detection circuit is also set up. The experimental results show that the proposed fitness partner can accurately display the heart rate wave of the testee, and the accurate rate is above 90%.

Self-monitoring technologies for type 2 diabetes and the prevention of cardiovascular complications: perspectives from end users

BACKGROUND

The objective of this study was to explore facilitators and barriers to the adoption of self-monitoring devices in individuals with type 2 diabetes mellitus (T2DM).

METHODS

Individuals with T2DM who were currently using one or more devices to monitor their disease participated in focus groups. Transcripts of focus group meetings were coded into themes by two reviewers using NVivo qualitative software.

RESULTS

Twenty-eight adults with T2DM reported using a blood glucose meter, and almost half reported monitoring their blood pressure. Few individuals consistently monitored other aspects of their cardiovascular health. Four major themes impacting device use/disuse were identified: knowledge gaps, relationships with health care providers, environment, and personal experience. Knowledge barriers included lack of information regarding diabetes and the associated risk of complications. Perceptions of inconvenience, pain, and financial restrictions were important factors influencing the adoption, use, and abandonment of self-monitoring devices. Community-run programs, as well as dieticians and pharmacists, were identified as important resources for accessing information related to T2DM.

CONCLUSIONS

We identified the need for development of accessible and relevant education material; improved communication of disease-specific information between patients and providers, as well as providers and community resources; and strategies to improve the convenience and cost of monitoring devices.

Biomedical instruments: safety, quality control, maintenance, prospects and benefits of African technology

Biomedical instruments are fundamental to successful medical practice. Medical instruments are devices intended to diagnose, treat, or monitor the patient under medical supervision. Such devices make physical or electrical contact with the patient and/or transfer energy to or from the patient and/or detect such energy transfer to or from the patient. These devices are imported to Africa from developed countries. They are operated in tropical African hospitals where as they were designed for more temperate environment. African countries pay high prices for these devices. The result is that these devices are not available in most African hospitals. Patients have to travel to the major cities to benefit from such devices.These devices must be properly installed in an environment in which they can give accurate and uninterrupted service. Proper operation, regular care and maintenance of these devices are essential. The consequences of breakdown of biomedical instruments include unusable equipment, untreated patients, wrong diagnosis, wrong treatment, frustrated medical staff and overloaded repair shops. The important interwoven issues of safety, quality control and maintenance are discussed. To achieve the millennium development goal of health for all, it is necessary to increase the availability of these devices in Africa. The prospects and benefits of manufacturing and or assembling these devices in Africa are discussed. Can the Engineering Faculties and Industries in Africa meet this challenge? The answer is 'yes'! The design and construction of Bedside Monitor by four Electrical/Electronic Engineering Undergraduates of the University of Ibadan, Ibadan, Nigeria is presented as a case study.

Top 10 technology hazards for 2011. A guide for prioritizing your patient safety initiatives

Most adverse incidents involving health technology are preventable. But they need to be clearly understood and thoughtfully acted upon. Here are 10 sources of potential danger that warrant particular attention in 2011, along with recommendations for protecting patients and staff.

[Biomedical engineering supports surgical planning and interventions]

Fundamental changes were achieved with the introduction of minimally invasive surgery. In this context, innovations in microtechnology played a significant role in the deployment of new tools. Developments for further integration are still ongoing. Furthermore, decisive progress was made by the timely provision of individual patient data prior to surgery. These comprise imaging data, electrophysiological or functional recordings, and synthetic data gained by modeling and simulation of anatomical or physiological conditions. Aside from the technical aspects of supporting surgery, effective quality management and optimized workflow are essential for therapeutic success. The vision of autonomously operating robots has been dropped in favor of permanently conducted and supervised interventions with the support of intelligent tools for the surgeon. Recent advances in reconstruction and transplantation surgery by tissue engineering and molecular biology are only the beginning of new promising concepts.

Bio-corrosion characterization of Mg-Zn-X (X = Ca, Mn, Si) alloys for biomedical applications

The successful applications of magnesium-based alloys as biodegradable orthopedic implants are mainly inhibited due to their high degradation rates in physiological environment. This study examines the bio-corrosion behaviour of Mg-2Zn-0.2X (X = Ca, Mn, Si) alloys in Ringer's physiological solution that simulates bodily fluids, and compares it with that of AZ91 magnesium alloy. Potentiodynamic polarization and electrochemical impedance spectroscopy results showed a better corrosion behaviour of AZ91 alloy with respect to Mg-2Zn-0.2Ca and Mg-2Zn-0.2Si alloys. On the contrary, enhanced corrosion resistance was observed for Mg-2Zn-0.2Mn alloy compared to the AZ91 one: Mg-2Zn-0.2Mn alloy exhibited a four-fold increase in the polarization resistance than AZ91 alloy after 168 h exposure to the Ringer's physiological solution. The improved corrosion behaviour of the Mg-2Zn-0.2Mn alloy with respect to the AZ91 one can be ascribed to enhanced protective properties of the Mg(OH)(2) surface layer. The present study suggests the Mg-2Zn-0.2Mn alloy as a promising candidate for its applications in degradable orthopedic implants, and is worthwhile to further investigate the in vivo corrosion behaviour as well as assessed the mechanical properties of this alloy.

Modeling and simulation of ultrasound fields generated by 2D phased array transducers for medical applications

Modern ultrasound imaging instrumentation for clinical applications allows real-time volumetric scanning of the patients' body. 4D imaging has been made possible thanks to the development of new echographic probes which consist in 2D phased arrays of piezoelectric transducers. In these new devices it is the system electronics which properly drives the matrix elements and focuses the beam in order to obtain a sequence of volumetric images. This paper introduces an ultrasound field simulator based on the Spatial Impulse Response method which is being properly developed to analyze the characteristics of the ultrasound field generated by a 2D phased array of transducers. Thanks to its high configurability by the user, it will represent a very useful tool for electronics designers in developing 4D ultrasound imaging systems components.

Between meaning culture and presence effects: contemporary biomedical objects as a challenge to museums

The acquisition and display of material artefacts is the raison d'être of museums. But what constitutes a museum artefact? Contemporary medicine (biomedicine) is increasingly producing artefacts that do not fit the traditional museological understanding of what constitutes a material, tangible artefact. Museums today are therefore caught in a paradox. On the one hand, medical science and technologies are having an increasing pervasive impact on the way contemporary life is lived and understood and is therefore a central part of the contemporary world. On the other hand, the objects involved in medical diagnostics and therapies are becoming increasingly invisible and intangible and therefore seem to have no role to play as artefacts in a museum context. Consequently, museums are at risk of becoming alienated from an increasingly important part of contemporary society. This essay elaborates the paradox by employing Gumbrecht's (2004) distinction between 'presence' and 'meaning'.

A model of locomotor-respiratory coupling in quadrupeds

Locomotion and respiration are not independent phenomena in running mammals because locomotion and respiration both rely on cyclic movements of the ribs, sternum, and associated musculature. Thus, constraints are imposed on locomotor and respiratory function by virtue of their linkage. Specifically, locomotion imposes mechanical constraints on breathing that require the respiratory cycle to be synchronized with gait. Thus, many mammals, including humans, synchronize respiration with the movement of the limbs during locomotion. For example, quadrupeds synchronize locomotor and respiratory cycles at a 1:1 ratio (stride/breath) over a wide range of speeds. Interestingly, quadrupeds maintain an almost constant stride frequency (and therefore respiratory frequency) at different speeds. To increase speed, quadrupeds lengthen their stride. Accordingly, to increase minute ventilation, quadrupeds must increase tidal volume since respiratory rate is coupled with stride frequency. We developed a simple, inexpensive, and easy to build model to demonstrate this concept. A model was chosen because models significantly enhance student understanding. Students are drawn into discussion by the power of learning that is associated with manipulating and thinking about objects. Building and using this model strengthen the concept that locomotor-respiratory coupling provides a basis for the appropriate matching of lung ventilation to running speed and metabolic power.

Health technologies for monitoring and managing diabetes: a systematic review

BACKGROUND

The primary objective of this review was to determine the strength of evidence for the effectiveness of self-monitoring devices and technologies for individuals with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) based on specific health-related outcome measures. Self-monitoring devices included those that assist patients with managing diabetes and preventing cardiovascular complications (CVCs). A secondary objective was to explore issues of feasibility, usability, and compliance among patients and providers.

METHODS

Study criteria included individuals >or=14 years and youth (7-14 years) with T1DM or T2DM, intervention with a self-monitoring device, assessment of clinical outcomes with the device, literature in English, and >or=10 participants. Relevant published literature was searched from 1985 to 2008. Randomized controlled trials and observational studies were included. Data were extracted for clinical outcomes, feasibility and compliance methods, and results. Selected studies were independently evaluated with a validated instrument for assessing methodological quality.

RESULTS

Eighteen trials were selected. Predominant types of device interventions included self-monitoring of blood glucose, pedometers, and cell phone or wireless technologies. Feasibility and compliance were measured in the majority of studies.

CONCLUSIONS

Self-monitoring of blood glucose continues to be an effective tool for the management of diabetes. Wireless technologies can improve diabetes self-care, and pedometers are effective lifestyle modification tools. The results of this review indicate a need for additional controlled trial research on existing and novel technologies for diabetes self-monitoring, on health outcomes associated with diabetes and CVCs, and device feasibility and compliance.

Minimally invasive diagnostics and treatment using micro/nano machining

Several medical tools with various functions have been developed for minimally invasive diagnostics and treatment. Microfabrication techniques such as MEMS technology are useful for the realization of high-performance multifunctional minimally invasive medical tools with small sizes. An ultra-miniature pressure sensor and an intravascular ultrasonic forward-viewing imager have been developed as microsensors for use in the human body. Active bending catheters have been developed for steering catheter tips without using traction of wires from outside the body. An ultrasonic therapeutic tool for sonodynamic therapy and sonoporation, and a micro scanner for precise laser treatment have been developed as therapeutic tools for use in the human body. High-functionalized endoscopic tools and catheters will enable more precise and safe diagnostics and therapy, as well as novel diagnostics and treatment which have been impossible to date.

Medical technology integration: CT, angiography, imaging‐capable OR‐table, navigation and robotics in a multifunctional sterile suite

Technology integration is an enabling technological prerequisite to achieve a major breakthrough in sophisticated intra-operative imaging, navigation and robotics in minimally invasive and/or emergency diagnosis and therapy. Without a high degree of integration and reliability comparable to that achieved in the aircraft industry image guidance in its different facets will not ultimately succeed. As of today technology integration in the field of image-guidance is close to nonexistent. Technology integration requires inter-departmental integration of human and financial resources and of medical processes in a dialectic way. This expanded techno-socio-economic integration has profound consequences for the administration and working conditions in hospitals. At the university hospital of Basel, Switzerland, a multimodality multifunction sterile suite was put into operation after a substantial pre-run. We report the lessons learned during our venture into the world of medical technology integration and describe new possibilities for similar integration projects in the future.

Adopting new technologies in stroke rehabilitation: the influence of the US health care system

Stroke rehabilitation is entering a new era of technological innovation, including the development of robotic aids for therapy, peripheral electrical stimulation devices, and brain stimulation systems. These technologies have the potential to significantly improve the efficiency and efficacy of stroke rehabilitation. The United States health care system creates both opportunities for new technologies to be created and adopted, as well as important barriers. Inadequate support of clinical trials of the efficacy of new non-invasive devices is a particular concern for practitioners seeking to determine if new devices are clinically useful. Government support of clinical trials of efficacy, coupled with reform of FDA approval processes for novel therapies, is needed to create an evidence-based approach to improving stroke rehabilitation.

Potential/charge induced nanoporous metal actuators

The mechanical response to the electrochemical charging of nanoporous metals with their pore space wetted by electrolyte have been studied in-situ using dilatometry and wide angle x-ray diffractometry techniques. The actuation strain reported in this manuscript is purely elastic and completely reversible. The capacitive double layer charging became more effective near to the potential to zero charge (pzc) and contribute significantly to the variations of surface stress and crystal strain. In a suitable experimental setup, the actuator effect from porous metals can be amplified, where deliberate movements of the actuator parts are desirable with minimum external force, suggesting that metallic foam-like materials with high surface to volume ratio could be used to mimic natural muscles.

Top 10 health technology hazards

Most medical device hazards are avoidable. But which ones should be at the top of your prevention list? Here are 10 key device risks and how to steer clear of them.

[Field 4. Environmental safety practice in the intensive care unit. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation]

Medical devices are known to carry risks from design to scrap. Accident reports in ICU show that medical device account for only 20% of accidents. Formation of users and providing a postmarketing incident reporting are thus essential in health institutions. Clinical and engineering departments should cooperate to produce and secure procedures which should be applied during the lifetime of each clinical device. Several points should be especially fulfilled: close cooperation between clinical departments and biomedical engineering departments with available technicians, computer-based inventory of all devices, evaluation of specifications required before purchasing a new device, education of users on utilisation and maintenance, technical follow-up of devices and keeping maintenance and repair logs, ability to provide users with replacement devices, provision of check-lists before use, forging criteria to decide when device should be discarded. These principles are simple and should be considered as mandatory in order to improve medical device related security.

One-chip sensing device (biomedical photonic LSI) enabled to assess hippocampal steep and gradual up-regulated proteolytic activities

We developed an implantable one-chip biofluoroimaging device (termed biomedical photonic LSI; BpLSI) which enabled real-time molecular imaging with conventional electrophysiology in vivo in deep brain areas. The multimodal LSI enabled long-term sequential imaging of the fluorescence emitted by proteolysis-linked fluorogenic substrate. Using the BpLSI, we observed a process of stimulation-dependent modulation at synapse with multi-site (16 x 19 pixel) in widespread area and a high-speed video rate, and found that the gradual up-regulated proteolytic activity in a wide range of hippocampal CA1 area and the steep activity in local area, indicating that the proteolysis system is a basis for the fixation of long-term potentiation in post-excited synapses in the hippocampus. Mathematical data analysis confirmed the direct involvement of functional proteolysis for neural plasticity.

Mobile healthcare in the home environment

Mobile healthcare provision in the home environment presents many challenges. Patients are becoming more informed about the management of chronic conditions and the use of technology to support the process is rising. Issues such as system interoperability, cost, security and training all have to be addressed to ensure effective use of mobile devices within the home healthcare arena. An aging population will impact upon traditional healthcare delivery methods.

Biomedical digital assistant for ubiquitous healthcare

The concept of ubiquitous healthcare service, which emerged as one of measures to solve healthcare problems in aged society, means that patients can receive services such as prevention, diagnosis, therapy and prognosis management at any time and in any place with the help of advanced information and communication technology. This service requires not only biomedical digital assistant that can monitor continuously the patients' health condition regardless of time and place, but also wired and wireless communication devices and telemedicine servers that provide doctors with data on patients' present health condition. In order to implement a biomedical digital assistant that is portable and wearable to patients, the present study developed a device that minimizes size, weight and power consumption, measures ECG and PPG signals, and even monitors moving patients' state. The biomedical sensor with the function of wireless communication was designed to be highly portable and wearable, to be operable 24 hours with small-size batteries, and to monitor the subject's heart rate, step count and respiratory rate in his daily life. The biomedical signal receiving device was implemented in two forms, PDA and cellular phone. The movement monitoring device embedded in the battery pack of a cellular phone does not have any problem in operating 24 hours, but the real-time biomedical signal receiving device implemented with PDA operated up to 6 hours due to the limited battery capacity of PDA. This problem is expected to be solved by reducing wireless communication load through improving the processing and storage functions of the sensor. The developed device can transmit a message on the patient's emergency to the remote server through the cellular phone network, and is expected to play crucial roles in the health management of chronic-aged patients in their daily life.

Use of medical technologies in rehabilitation medicine settings in Israel: results of the TECHNO-R 2005 survey

BACKGROUND

With the development of computer technology and the high-tech electronic industry over the past 30 years, the technological age is flourishing. New technologies are continually being introduced, and questions regarding the economic viability of these technologies need to be addressed.

OBJECTIVES

To identify the medical technologies currently in use in different rehabilitation medicine settings in Israel.

METHODS

The TECHNO-R 2005 survey was conducted in two phases. Beginning in 2004, the first survey used a questionnaire with open questions relating to the different technologies in clinical use, including questions on their purpose, who operates the device (technician, physiotherapist, occupational therapist, physician, etc.), and a description of the treated patients. This questionnaire was sent to 31 rehabilitation medicine facilities in Israel. Due to difficulties in comprehension of the term "technology," a second revised standardized questionnaire with closed-ended questions specifying diverse technologies was introduced in 2005. The responder had to mark from a list of 15 different medical technologies which were in use in his or her facility, as well as their purpose, who operates the device, and a description of the treated patients.

RESULTS

Transcutaneous electrical nerve stimulation, the TILT bed, continuous passive movement, and therapeutic ultrasound were the most widely used technologies in rehabilitation medicine facilities. Monitoring of the sitting position in the wheelchair, at the bottom of the list, was found to be the least used technology (with 15.4% occurrence). Most of the technologies are used primarily for treatment purposes and to a lesser degree for diagnosis and research.

CONCLUSIONS

Our study poses a fundamental semantic and conceptual question regarding what kind of technologies are or should be part of the standard equipment of any accredited rehabilitation medicine facility for assessment, treatment and/or research. For this purpose, additional data are needed.

Design of Health Care Technologies for the Developing World

Approximately 20 years ago, the international community embarked on a project to bring health care to everyone by the year 2000 featuring, among other things, technologies that were known to be effective and economical. It was largely a failure. In fact, health care deteriorated in many of the target nations. Problems such as public mistrust, lack of spare parts, lack of required consumables, lack of reliable power and water, lack of public infrastructure such as roads, lack of technical expertise, and other problems plague health care technology in the developing world. Biomedical engineers are just beginning to quantify and address the barriers to technology unique to the developing world. This article reviews the barriers, both real and perceived, to the introduction of health care technology with a main focus on health care technology in hospitals.

Healthcare technology and technology assessment

New technology is one of the primary drivers for increased healthcare costs in the United States. Both physician and industry play important roles in the development, adoption, utilization and choice of new technologies. The Federal Drug Administration regulates new drugs and new medical devices, but healthcare technology assessment remains limited. Healthcare technology assessment originated in federal agencies; today it is decentralized with increasing private sector efforts. Innovation is left to free market forces, including direct to consumer marketing and consumer choice. But to be fair to the consumer, he/she must have free knowledge of all the risks and benefits of a new technology in order to make an informed choice. Physicians, institutions and industry need to work together by providing proven, safe, clinically effective and cost effective new technologies, which require valid pre-market clinical trials and post-market continued surveillance with national and international registries allowing full transparency of new products to the consumer--the patient.

New directions in single-molecule imaging and analysis

Optical imaging and analysis of single molecules continue to unfold as powerful ways to study the individual behavior of biological systems, unobscured by ensemble averaging. Current expansion of interest in this field is great, as evidenced by new meetings, journal special issues, and the large number of new investigators. Selected recent advances in biomolecular analysis are described, and two new research directions are summarized: superresolution imaging using single-molecule fluorescence and trapping of single molecules in solution by direct suppression of Brownian motion.

Microtechnologies in medicine: an overview

Microsystems technology (MST) has become a significant enabler of novel medical devices and implants over the last years. Typical examples are MST units in cardiac rhythm management devices or in hearing implants. A classification of medical MST applications can be made according to their relationship with the anatomy that is based on the kind and duration of interaction with the human body: Class 1: Extra-corporeal devices such as telemetric health monitoring systems or point of care testing systems. Class 2: Intra-corporeal devices such as intelligent surgical instruments. Class 3: Temporarily incorporated or ingested devices, such as telemetric endoscopes. Class 4: Long-term implantable devices such as telemetric implants. Medical applications of MST are growing at double-digit compounded growth rates, leading to a forecasted global market volume of over USD 1 billion in 2006 or 2007, making MST devices a relevant segment of the medical technology market. The clinical foundation for promoting the use of MST in medicine is mainly based on the significant potential of MST to enable products that improve early disease detection and the monitoring of chronic illnesses. This refers to a number of the most important health problems such as cardiovascular disease, hypertension, diabetes and cancer, to name just a few. More recently microrobotics has become a relevant research area for enabling the atraumatic transport of MST-enhanced diagnostic and therapeutic devices inside the human body.

The future of hearing aid technology

Hearing aids have advanced significantly over the past decade, primarily due to the maturing of digital technology. The next decade should see an even greater number of innovations to hearing aid technology, and this article attempts to predict in which areas the new developments will occur. Both incremental and radical innovations in digital hearing aids will be driven by research advances in the following fields: (1) wireless technology, (2) digital chip technology, (3) hearing science, and (4) cognitive science. The opportunities and limitations for each of these areas will be discussed. Additionally, emerging trends such as connectivity and individualization will also drive new technology, and these are discussed within the context of the areas given here.

A novel method in measuring the stiffness of sensed objects with applications for biomedical robotic systems

BACKGROUND

In this research paper, a new method for determining the compliance of various objects with different mechanical properties is presented. The structure of the proposed tactile sensor assembly is discussed in detail and the performance of the sensor tested experimentally.

METHODS

In order to measure the stiffness of various sensed objects, the sensor consists of two separate parts. The first part is a rigid cylindrical section while the other part is a deformable foam-like section. As a practical application, the designed sensor is integrated with a typical endoscopic grasper used in minimally invasive surgeries. Two theoretical approaches are employed in our analysis. In the first approach, which is limited to flat surface objects, the stiffness of the object is obtained using a closed-form formula. In the second approach, which can be applied to objects with complex irregular shapes, the same parameter is computed using finite element analysis. To evaluate the performance of the designed grasper tool, eight sensors were placed on top and bottom jaws of the tool and objects with known modulus of elasticity were placed between the jaws.

RESULTS

Keeping the magnitude of the applied forces in the range of 0.1-1 N, we managed to measure the stiffness of the sensed objects with reasonable accuracy (an error of about 20%). Comparing the experimental data with the analytical and the numerical approaches proves that there is a good correspondence between the two methods.

CONCLUSIONS

The designed prototype can be used in various biomedical robotic procedures when performing minimally invasive surgeries. For the first time, we managed to make an endoscopic prototype suitable for measuring stiffness.

A wideband frequency-shift keying demodulation technique for inductively powered biomedical implants

A digital wideband frequency-shift keying (FSK) demodulator is presented. The primary application of this system is for inductively powered biomedical implants. By providing both the data and the power to the implant via an inductive link, the need for a battery and the interconnect wires are eliminated. This reduces revision surgeries that may take place for maintenance purposes, provides extra safety measures in the case of failures and reduces the risk of infection. However these devices are challenged by power requirements and size availability at the receiving site and often require a high data rate. These challenges lead to the need for an efficient demodulation technique, as traditional methods often do not overcome the restrictions that prevail. The demodulator circuitry presented relies solely on delaying elements, utilising a delayed FSK carrier to sample the incoming FSK waveform. The system architecture is based on a digital environment and both the data and a synchronised clock are derived concurrently. This can be achieved with the coherent-FSK modulated raw binary data stream without the need of any additional baseband coding schemes. The demodulator circuitry was simulated up to a data rate of 5 Mbps while receiving a 5/10 MHz FSK carrier. The system was also implemented on the bench and experimentally tested at a data rate of 1.042 Mbps with no detectable bit error rate while receiving a 4.16/6.25 MHz FSK carrier signal.

MST development for medical applications: results of the German Research Programme on MST over ten years

Today microsystems are important for the prevention, diagnosis and therapy of diseases. Physicians use small endoscopes for minimally invasive surgery. Patients regain their mobility by high-tech prostheses equipped with several sensors and actuators. Intelligent implants such as pacemakers support existential functions. Cochlea-implants enable deaf persons to hear. Safe convalescence at home is possible by tele-monitoring devices. Point-of-care such as biochips supply quick diagnostic results. A number of these remarkable developments have been successfully supported by the German Federal Ministry of Education and Research (BMBF) since 1990.

An innovative broken pedicle screw retrieval instrument

OBJECTIVE

To introduce a new broken pedicle screw fragment retrieval instrument, and evaluate its clinical viability and effectiveness.

METHODS

Following basic retrieval contrivance of broken pedicle screws described in literature, a new retrieval instrument was designed and developed; introducing its mechanism, technical components, and use. This innovative apparatus proved successful not only in saw bone and cadaver trials but in 10 clinical cases as well.

RESULTS

This particular unique instrument successfully retrieves broken pedicle screw fragments through original passage backing out the screw with preservation of pedicle integrity while maintaining pedicle biomechanics. No complications were observed.

CONCLUSIONS

With solid scientific theoretical planning and experimentation, the new retrieval instrument design proved clinical practicality and efficacy.

Real-time cooperating motion generation for man-machine systems and its application to medical technology

In this paper, we propose a cooperating motion generation method for man-machine cooperation systems in which the machines are controlled based on the intentional force applied by a human/humans for realizing several tasks in cooperation with a human/humans. By applying this method, the systems could avoid self-collisions, collisions with obstacles and other dangerous situations during the tasks. Proposed method consists of two parts; representation method of robots' body referred to as "RoBE (Representation of Body by Elastic elements)", and cooperating motion generation method using RoBE. As the application examples of proposed method, we focused on robots cooperating with a human/humans and surgery robot tools from the aspect of medical and welfare field. We did the experiments using human-friendly robot, referred to as MR Helper, for illustrating the validity of the proposed method. We also did the computer simulation to indicate the prospects of applications of our self-collision avoidance method to surgery robot tools.

The next exclusion debate: Assessing technology, ethics, and intellectual disability after the human genome project

Recent scientific discoveries have made it much easier to test prenatally for various genetic disabilities, such as Down syndrome. However, while many observers have heralded such "advances" for their effectiveness in detecting certain conditions, others have argued that they perpetuate discrimination by preventing the birth of children with disabilities. This article examines the ethical and social implications of the Human Genome Project for individuals with intellectual disabilities and their families. It details the critique of prenatal testing articulated by many disability rights activists as well as scholarly and professional responses to that critique. A review of the pertinent research literature includes perspectives of genetic professionals, ethicists, disability studies scholars, parents of children with disabilities, and disabled individuals themselves. Finally, the article explores how future research endeavors, policies, and practices may more effectively integrate and respect the positions of these various stakeholders.