BioMedical Devices

Early stage Health Technology Assessment (HTA) of biomedical devices necessitates approaches separate from those used by pharmaceuticals. The Analytic Hierarchy Process (AHP) to evoke consumer requirements, and early stage economic analyses utilising Markov Models, are two approaches for early stage HTA being built in the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) project. The spread of medical devices is accelerating at an incredible pace. The rising number of new patents issued per year shows that this trend will continue. Medical instruments, unlike medications, are inextricably linked to the context in which they are utilised and how they are managed. This provided a previously unseen global need for well-trained biomedical engineers who can assist healthcare facilities in evaluating them. The International Federation for Medical and Biological Engineering (IFMBE) is a multinational scientific society of biomedical engineers that has worked closely with the United Nations World Health Organization (WHO) to promote the involvement of biomedical engineers in health technology assessment (HTA). Summer schools, training material, an HTA eLearning platform, HTA guidelines, awards, and more are all promoted by the IFMBE Health Technology Assessment Division (HTAD), which is the IFMBE operative branch in this field, promoting studies, projects, and activities to foster the growth of this specific and very important science sector. The vision, goal, and plan of the HTAD are described in this report, with an emphasis on the outcomes and their effect on global policymaking.

The paper aims to illustrate the ongoing research based on the development of orthopedic devices, characterized by the integration between parametric design and data visualization, for the product customization on specific morphologies and needs of users, and the return of information of the course and therapeutic advancement made readable for both, patients and doctors.

Fetal heart rate (FHR) monitoring device is highly demanded to assess the fetus health condition in home environments. Conventional standard devices such as ultrasonography and cardiotocography are expensive, bulky and uncomfortable and consequently not suitable for long-term monitoring. Herein, we report a device that can be used to measure fetal heart rate in clinical and home environments. The proposed device measures and displays the FHR on a screen liquid crystal display (LCD). The device consists of hardware that comprises condenser microphone sensor, signal conditioning, microcontroller and LCD, and software that involves the algorithm used for processing the conditioned fetal heart signal prior to FHR display. The device's performance is validated based on analysis of variance (ANOVA) test. FHR data was recorded from 22 pregnant women during the 17th to 37th week of gestation using the developed device and two standard devices; AngelSounds and Electronic Stethoscope. The...

This paper discusses the current and future prospects of 3-D printing technology in the field of medical science encompassing biomedical engineering for improved human health care. It presents before the reader, an overview on the evolution of the 3D printing technology and its increased usage in the field of biomedical engineering and pharmaceutics. It is expected that it is going to change the future of manufacturing industries and technology.

Usage of intravenous (IV) saline solution been a rudimentary task for each patient in the context of modern clinical practice. Having a wide range of diversity in IV saline solution main intention of injecting IV saline includes recovering dehydration and loss of electrolytes from body, flush wounds and so on. Despite injecting saline to a patient seemingly easy task but it may have dangerous consequences if not properly monitored. Excessive or inadequate flow-rate of saline both can end up to the same result which is death of the patient. Due to insufficient healthcare professionals, many patients die for an imbalance of saline flow-rate. Controlling the saline flow-rate automatically, taking heart rate as a parameter and to ensure safety for patients is the main intention of this research work. To accomplish this task pulse sensor, a customized device (combination of gear motor and screw gauge), motor driver and Arduino is used. Based on the data from pulse sensor, Ardunio controls the motor driver and it results in the manipulation of flow-rate which unit is drops/min by the compression and relaxation of spindle of the screw gauge. In this particular task, three patient's data is taken under consideration and error from these data had been calculated to justify the authenticity of this research.

Force Sensing Resistors (FSR) are ultra-thin, low-cost, pressure sensors, which exhibit change in their electrical resistance when force is applied on their surface. The FSR has been used in wide ranging applications in the automotive industry, musical instruments, touch-buttons, portable electronic devices, etc. The FSR is also proving to be promising device for developing applications in healthcare. The present work reviews the reported work on developing novel applications of FSR in non-invasive diagnosis, and monitoring of patients undergoing treatment. The techniques used in biosignal acquisition and its subsequent processing after using FSR, as reported in the literature are briefly reviewed. This is followed by review of the recently reported innovations in diagnostic technology using FSR. The applications of the FSR for diagnosis and monitoring of several major medical disorders are described. The merits and of using FSR are highlighted. The limitations of the technology using FSR are also noted for future advancement. It is observed that application of FSR, despite its present limitations of the technology, opens new opportunities for developing novel applications in bio-medical instrumentation and healthcare.

There is enormous evidence that the initiation and growth of atherosclerosis is highly influenced by hemodynamic factors. In this study, hemodynamic factors in the following patient specific 3D carotid artery models were studied: i) normal, ii) stenosis (with plaque near to bifurcation of internal carotid artery (ICA)), and iii) surgical model (plaque with surgically fitted Palmaz–Schatz stent). The 3D model of the carotid artery was formed from CT image of a patient through a commercial software MIMICS. The geometrical measurement taken from the 3D model was used to form its CAD model using CATIA software. The CAD model was meshed in ANSYS ICEM CFD module. The inlet- and outlet- boundary conditions were defined and material properties were given in CFX-Pre module of ANSYS. Then the solver input file was given to CFX solver manager for performing computational fluid dynamics (CFD) on the model. The outputs of the CFD analysis were observed in CFD-Post. The wall shear stress and blood velocity were greater both at near the bifurcation and at bend of the carotid artery model. The abnormal model is characterized by high wall shear stress in the stenosed portion which indicates greater probability of growth of plaque. Disturbed flow patterns and oscillating velocity indicate that the vulnerability of plaque formation is high in such places. The hemodynamic values have come back near to normal values in the carotid model fitted with stent. The observed variations in hemodynamic factors in the carotid artery with plaque surgically fitted with stent were compared to its normal model. This information can be used to predict restenosis in future.

A growing number of posthuman neuroprosthetic devices are under development that will provide their users with sensory, motor, and cognitive capacities that radically differ from those of ‘natural’ human beings. Specialized organizations such as military agencies and departments are fashioning plans to proactively deploy such neurotechnologies among their personnel. While the use of such devices has been studied from biomedical and ethical perspectives, substantive analysis has not yet been carried out from the perspective of organizational management. In this text we investigate the implications of integrating such advanced neurotechnologies into the structures, processes, and systems of an organization through the lens of enterprise architecture (EA), a management discipline that is designed to facilitate the incorporation of innovative IT into an organization and which is a favored management approach of the kinds of large, complex, and technology-intensive organizations expected to be ‘early adopters’ of posthuman neuroprosthetics.

We identify and analyze two primary ways in which the practice of enterprise architecture will change within organizations that deploy posthuman neuroprosthetics. First, it is argued that EA will be forced to adapt as the introduction of posthuman neuroprosthetics results in: 1) blurring distinctions between human personnel and electronic information systems; 2) changes in the nature of HCI and interpersonal communication; 3) an extension of the functional scope of an organization’s IT systems into the bodies and minds of its workers; 4) legal and ethical constraints limiting an organization’s ability to impose an EA on implanted neuroprostheses; and 5) changes to the fundamental capacities of a workforce. Second, the deployment of posthuman neuroprosthetics will impact an organization’s ability to address four challenges facing contemporary EA: 1) fragmentation of the field; 2) underutilization of EA products; 3) the requirement for ‘soft’ skills in implementing EAs; and 4) the ongoing need to collect large quantities of real-time organizational data.

We further argue that EA is well-positioned to facilitate the technological aspects of integrating posthuman neuroprosthetics into an organization but ill-suited to address the non-technological aspects of that process. Finally, we suggest that EA should draw on fields such as biomedical engineering, management cybernetics, and organization development in order to more effectively design and maintain architectures that incorporate posthuman neuroprosthetics.

Recent days Computer-aided design and image processing techniques are one of the most emerging useful tools for analysis of models in various medical, industrial and research areas. In medical field for the diagnosis of various diseases in vivo techniques including biochemical test, enzymatic tests are needed for continuous monitoring of patients. These diagnosis procedures are time consuming and inconvenient for patients. Therefore Computer assisted designing and image processing techniques are most promising non invasive tools for faster diagnosis and useful tool for designing of biomedical implants. In this paper portal vein was segmented from patient’s Liver computed tomography (CT) image by dedicated software. A Liver’s CT image of 38 year old Indian male patient’s was collected and by using imaged based software MIMICS (Materialise’s Interactive Medical Image Control System, Belgium) 3D model of HPV (hepatic portal vein) was obtained and Solid Work Professional (Dassault Systems Solid Works Corporation, USA) software was used for designing of normal portal vein’s 3D model and various portal vein diseased models including minor right portal vein thrombosis ( 19-20% reduction in medial region of vein), severe right portal vein thrombosis (20-22% reduction in medial and distal region of vein), minor left portal vein thrombosis (19-20% reduction in medial region of vein, severe right portal vein
thrombosis(20-22% reduction in medial and distal region of vein), left aneurysm (150-200 % increase of medial region).These models can be used for designing for implants and analysis of portal vein’s disorder like portal thrombosis, and portal aneurysm which are main cause of portal hypertension and also useful for surgeon for planning surgery and also helpful for understanding of portal vein hemodynamic (pressure, velocity, wall shear force)

The structure and behavior of a neuroprosthetic device can be analyzed from different perspectives. In this text, we formulate an ontology that can be employed to describe the fundamental characteristics of a neuroprosthesis in its role as a computing device. The ontology draws on existing neuroprosthetic device typologies and ontologies developed for other kinds of devices such as mobile devices and robotic systems. It describes four key aspects that shape the functioning of a neuroprosthesis as computing device: 1) the device’s external context (including the human agents who participate in its development and use, factors impacting the device’s availability, and the device’s relationship to the body of its human host); 2) physical components of the neuroprosthesis (including the device’s basic morphology, input and output mechanisms, and computational substrate); 3) processes utilized by the device (including computational processes and input and output modalities); and 4) the types of information generated or handled by the device (which may include data regarding the device’s status and environment, data regarding the cognitive and biological processes of the device’s human host, and procedural and declarative knowledge). The use of such an ontology allows the functionality of a neuroprosthesis as a computing device to be more easily analyzed or designed and facilitates interoperability between neuroprostheses, their human hosts and users, and external computer systems.

Defibrillators are devices used for the treatment of sudden cardiac arrest such as ventricular arrhythmia and ventricular fibrillation. Defibrillator gives the particular amount of electrical energy to the heart. This electrical shock regains normal heart rhythm within seconds. Various types of defibrillators are available nowadays. Automated external defibrillator, wearable defibrillator etc. are some types of defibrillators used now. Most advanced technology develops the implantable cardioverter defibrillator. This defibrillators are placed within the body and which are capable to perform the cardio version, defibrillation and pacing of the heart.The implantation process is just like the pacemaker. This is placed in the apex or septum of the right ventricle. Like pacemaker the implantable cardioverter defibrillators have only one wire in the heart. That is, in the right ventricle. The rate of sudden death due to cardiac arrhythmia and other cardiac disorders can be reduced by the implantable cardioverter defibrillator therapy.

This paper presents the design of a wireless hand switch of X-Ray machine using RF Module. With the objective to avoid unnecessary exposure of radiation, a low cost RF Module is proposed. This method uses RF transmitter and RF receiver modules which are operating at 434 MHz along with encoder IC M145026 and decoder M145027 with the passive components. Here the transmission technique is amplitude shift keying (ASK) and the circuit is powered with 5v. A RF module based wireless hand switch commands the receiver for ready and exposure through transmitter wirelessly. There are two benefits from the design.
a) It can save the repetition of exposure when there are movements in patients especially for children, older and injured patients.
b) It can be operated from computed radiography room that can avoid exposure of x-ray radiation for the operator.
Keywords: X-ray machine, Radiation, Radiation protection, Hand switch, RF module.

This paper presents an electrocardiogram acquisition system course design project for an upper year bioinstrumentation course. The objective of this design project is to provide students an opportunity for an integrative learning, enhancing their educational experience. Unlike similar electrocardiogram instrumentation projects, this project is based on a commercially available instrumentation amplifier enabling better systems-level thinking. The project is described along with observations made from our pilot implementation of the project. The initial offering of the project is considered a success with positive feedback from students. Recommendations for improvements are also discussed.

Phyllanthus emblica  posses a vast ethnomedicinal history and
represents a large group of phytochemical reservoir of medicinal
uses. It is one of the ingredients used from time immemorial in
various ancient literatures like in “Ayurveda” and “Charka
Samhitha” as a potential ingredient for various ailments. The fruit
is studied for various phyto chemical constituents  like rich in
quercetin, gallic acid, tannins, flavonoids, pectin and Vitamin C
and also contains various polyphenolic compounds. A wide range
of phytochemical components from this plant have shown proven
results for biological activities like terpenoids,  alkaloids,
flavonoids and tannins. Many pharmacological studies also have
exhibited proven results for antioxidant, anticarcinogenic,
antitumour, antigenotoxic, antiinflamatory activities supporting its
traditional uses. In view of these studies the present work has been
focused on the GC–MS analysis of ethyl acetate extract of the bark
portion of the  P. emblica  which could be a possible source of
extracting the therapeutically useful products.

A number of recent articles attribute the origin of the use of cervical balloon dilation in the induction of labor to either Barnes in the 1860s or Embrey and Mollison in the 1960s. This review examines the historical record and reveals that, based on current practice attribution should rather be made to two contemporaries of Barnes: the Storer and Mattei. More importantly, Storer’s warning about the rubber used in dilators was ignored, leading to decades of possibly unnecessary deaths following childbirth. To conduct this study key search terms for PubMed, Google Scholar and the website of the University of Ryerson were utilized as “Barnes”, “Woodman”, “balloon dilation”, “balloon catheter”, “foley”, “colpeurynter”, “cervix uteri” and “induction.” Subsequent analysis was done on downloaded articles using BibDesk.

In India, number of people with type 2 Diabetes Mellitus (DM) would be 87 million by the year 2030. DM disturbs autonomic regulation of skin microcirculation, and causes decrease in resting blood flows through the skin. The skin blood flow has a major effect on its temperature. The aim of the study was to evaluate changes of skin temperature of all parts of the body and serum asymmetric dimethylarginine, ADMA (μmol/L) in type-2 DM Indian patients. Group-I: Normal (n=17; M/F: 10/15, mean±SD= 43.2±9.4 years); Group-II: Type-2 DM without cardiovascular (CV) complications (n=15; M/F: 10/7, mean±SD= 46.3 ± 14.0 years); Thermograms of all parts of the body were acquired using a non-contact infrared (IR) thermography camera (ThermaCAM T400, FLIR Systems, Sweden). Blood parameters and thyroid hormone were measured biochemically. Indian diabetic risk score (IDRS) was calculated for each subject. In type-2 DM patients without CV group (n=15), there was a statistically significant (p=0.01) negative correlations between HbA1c and skin temperature of eye and nose (r= -0.57 and r= -0.55 respectively). ADMA was correlated significantly (p=0.01) with HbA1c (r=0.65) and estimated average glucose, eAG (r=0.63). In normal subjects, mean minimum and maximum values of skin temperatures were observed at posterior side of sole (26.89°C) and ear (36.85°C) respectively. In type-2 DM without CV, mean values of skin temperature in different parts of the body from head to toe were lesser than those values in control group; but this decreases were statistically significant in nose (32.66 Vs 33.99°C, p=0.024) as well as in tibia (32.78 Vs 33.13°C, p=0.036) regions.

We present wafer-scale integrated microsupercapacitors
on an ultrathin and highly flexible parylene
platform, as progress toward sustainably powering biomedical
microsystems suitable for implantable and wearable applications.
All-solid-state, low-profile (<30 μm), and high-density
(up to ~500 μF/mm2) micro-supercapacitors are formed on an
ultrathin (~20 μm) freestanding parylene film by a wafer-scale
parylene packaging process in combination with a polyaniline
(PANI) nanowire growth technique assisted by surface plasma
treatment. These micro-supercapacitors are highly flexible and
shown to be resilient toward flexural stress. Further, direct integration
of micro-supercapacitors into a radio frequency (RF)
rectifying circuit is achieved on a single parylene platform,
yielding a complete RF energy harvesting microsystem. The
system discharging rate is shown to improve by ~17 times in
the presence of the integrated micro-supercapacitors. This result
suggests that the integrated micro-supercapacitor technology
described herein is a promising strategy for sustainably
powering biomedical microsystems dedicated to implantable
and wearable applications.
Keywords Energy storage .

This chapter explores the way in which standard preventive security controls (such as those described in NIST Special Publication 800-53) become more important, less relevant, or significantly altered in nature when applied to ensuring the information security of advanced neuroprosthetic devices and host-device systems. Controls are addressed using an SDLC framework whose stages are (1) supersystem planning; (2) device design and manufacture; (3) device deployment; (4) device operation; and (5) device disconnection, removal, and disposal.

Preventive controls considered include those relating to security planning; risk assessment and formulation of security requirements; personnel controls; information system architecture; device design principles; memory-related controls; cryptographic protections; device power and shutoff mechanisms; program execution protections; input controls; logical access control architecture; authentication mechanisms; session controls; wireless and remote-access protections; backup capabilities; component protections; controls on external developers and suppliers; environmental protections; contingency planning; system component inventory; selection of device recipients and authorization of access; physical and logical hardening of the host-device system and supersystem; device initialization and configuration controls; account management; security awareness training; vulnerability analysis; operations security (OPSEC); control of device connections; media protections; exfiltration protections; maintenance; security alerts; information retention; and media sanitization.

One of the drawbacks of the most commonly used tool for obesity screening, body mass index (BMI) is its inaccuracy in assessing body fat. In order to address the issue associated with the aforementioned screening tool; this study aims at predicting body fat percentage (%BF) using segmental body composition variables measured by bioelectrical impedance analysis (BIA). A total of ninety women between the age group of 20 to 75 years participated in the study. From the women who partook in the study %BF, regional (arm, leg, trunk) fat distribution parameters and bioelectrical impedance variables were measured using multi-frequency BIA. Pearson’s correlation was applied onto the obtained measurement data and was found that BMI and %BF were significantly correlated (r=0.952). Substantiated by the high value of correlation, %BF cut-off values for corresponding BMI cut off values recommended by WHO were calculated and obesity was evaluated for the population under study. Regression equations from the best model (r2 =0.97) was used to predict %BF values for the subjects. Receiver Operating Curves (ROC) analysis was executed to evaluate the ability of predicted %BF values to distinguish between obesity and non-obesity. With the help of the analyses that were performed it was inferred that the predicted %BF was able to distinguish obesity clearly with sensitivity being 95.5% and specificity being 97.7%, the Area Under the Curve (AUC) was found to be 0.997. Corroborated by the high levels of sensitivity, specificity and AUC obtained from the analysis, the %BF computed from the segmental BIA variables can be used as an additional tool for screening population for obesity.

End-users of biomedical devices, like many patients undergoing treatment in healthcare systems, often demonstrate
an active interest in their therapy. Patient-specific customization of medical devices, such as orthoses,
prostheses and implants, is an expensive, time-consuming process. Given how many of these patients are proactive
and self-motivated it seems appropriate to the authors that these characteristics be harnessed to make
the adaptation of the device to the patient more cost effective. In short, it is proposed that the device end-user –
the patient – play an active role in the tuning and adaptation of the device, especially in the out-patient context.
However, the perceived risk associated with a more pro-active and independent role for the patient is a barrier
to this possibility. These factors are examined and a proposal for a practical approach to a patient-controlled
device optimization process is put forward.

Tetracycline belongs to one of the extracellular pr oduced polyketide antibiotics having hydrophilic properties. Statistical based optimization, Plac kett–Burman design (PBD) and response surface methodology (RSM) were occupied to screen and optimize the medium co nditions for the production of tetracycline from Streptomyces aur eofaciens NCIM 2417, using solid state fermenta tion. pineapple peel waste was used as both the cur ious solid support and carbon and nitrogen sourc es and inorganic salts for the growth of Streptomyces aureofaciens NCIM 2417. Based on the positive influence of the half normal plot obtained from PBD on tetracycline production, three medium conditions – peanut meal, incubation period and s oluble starch were screened. Central composite design (CCD) was occupied using these three medium conditions at five levels, for advance optimization, and the second order polynomial equation was derived, based on the experiment al data. Response surface methodology showed ...

Objective:The aim of this study was to evaluate the progression of arthritis in a complete Freund’s adjuvant (CFA)-induced Wistar rat model and to monitor inflammatory arthritis activity using thermal imaging compared with histopathology.Methodology: Fifteen adult male Wistar rats were studied in an adjuvant induced arthritis model by the injection of complete Freund’s adjuvant in the right hind limb and right forelimb, respectively, with the left limbs used as controls. Thermal image analysis based on skin temperature measurement, radiographic analysis based on erosion, limb circumference measurement, and histopathological evaluation were performed.Results. The average skin temperature difference on the arthritis-induced side and control for both the forelimb and hind limb were found to be 1.09 °C and 0.98 °C, respectively. Pearson correlation analysis revealed that skin surface temperature was positively correlated with the arthritis severity score (forelimb: r=0.64, hind limb: r=0.66, p<0.05).A significant correlation also existed between thermal imaging temperature and visual scoring of X-ray (forelimb: r=0.56, hind limb: r=0.67, p<0.05). Conclusion:Thermal imaging measurements correlated with arthritis severity score,radiological score, and ankle diameters. Hence, thermography could be used to diagnose and analyze inflammatory activity of arthritis at the preclinical stage.

Abrasive machining and finishing processes are techniques of material removal that are introduced in order to cut workpiece materials
with the nominal mechanical and thermal residual stresses. These processes utilize continuous material removal by abrasive medium that
can be in forms of water, abrasive particles or a mixture of these two. The benefit of eliminating excessive mechanical cutting force results in
enhanced cutting of brittle or soft materials. On the other hand, removal of thermal cutting source provides a capability of cutting plastics and
diminished the chances of thermal cracking in workpiece. Abrasive finishing processes have been introduced as complementary to abrasive
cutting techniques in order to increase the precision and surface quality of manufactured parts. The most common of these techniques are water
jet machining (WJM), abrasive jet machining (AJM), abrasive water jet machining (AWJM) and magnetic abrasive machining processes such as
magnetic abrasive finishing (MAF), magneto-rheological abrasive finishing (MRF) and magneto-rheological abrasive flow finishing (MRAFF).

The goal of this project is to develop and utilize a microfluidic device to isolate and enrich tumor cells circulating in peripheral blood. Circulating tumor cells (CTCs) have been used as biomarkers for cancer diagnostics and prognosis. However, the rarity of these cells (roughly 1 in a billion) poses a technological challenge to sort and concentrate them. CTCs hold potential sources for early detection, characterization, monitoring of cancers, and development of personalized treatment. The project is currently funded by the US National Cancer Institute (NCI) of the National Institutes of Health (NIH).

This paper proposed a workpiece positioning system for electrical discharge machining that optimized to machine micro  pits perpendicularly to spherical surface of hip implant device. The micro pit on the acetabular cup is beneficial for lubrication purpose thus prolonging the lifespan of the hip implant device. Some methods and technique to machine the micro pits is discussed in this paper. This is a new invention which related to micro machining and utilizing Electrical Discharge Machining in biomedical engineering field especially in implant manufacturing process.

Diamond-like carbon (DLC) is a thin film coating that is dense, inert, low friction and hard wearing. Interdisciplinary research, involving materials scientists, physicists, mechanical engineers, biomedical specialists and clinicians, is continuously expanding the potential and applications of DLC and enhanced carbon-based materials in the medical sector. 

This paper investigates diamond-like carbon on medical devices, such as orthopaedic implants, trauma prostheses and laparoscopy surgical tools, and discusses the role of enhanced DLC in the future medical industry.

The application of data mining (DM) in healthcare is increasing. Healthcare organizations generate and collect large voluminous and heterogeneous information daily and DM helps to uncover some interesting patterns, which leads to the manual tasks elimination, easy data extraction directly from records, to save lives, to reduce the cost of medical services and to enable early detection of diseases. These patterns can help healthcare specialists to make forecasts, put diagnoses, and set treatments for patients in health facilities. This work overviews DM methods and main issues. Three case studies illustrate DM in healthcare applications: (i) In-Vitro Fertilization; (ii) Content-Based Image Retrieval (CBIR); and (iii) Organ transplantation.

A literature review presentation on "A novel method for pediatric heart sound segmentation without using the ECG". A novel method for pediatric heart sounds segmentation by paying special attention to the physiological effects of respiration on pediatric heart sounds is proposed in this paper. The segmentation is accomplished in three steps. First, the envelope of a heart sounds signal is obtained with emphasis on the first heart sound (S1) and the second heart sound (S2) by using short time spectral energy and autoregressive (AR) parameters of the signal. Then, the basic heart sounds are extracted taking into account the repetitive and spectral characteristics of S1 and S2 sounds by using a Multi-Layer Perceptron (MLP) neural network classifier. In the final step, by considering the diastolic and systolic intervals variations due to the effect of a child’s respiration, a complete and precise heart sounds end-pointing and segmentation is achieved.

An orthopedic distractor device is currently being developed
for extending bones or bridging a gap in a bone. The device is designed to fit into the medullary canal of a human femur or tibia. By virtue of telescopic motion between two mating parts, the device can extend axially inside a dissected bone, elongate it to desired length. The distractor is actuated by means of a miniature electrical drive system, which is energized and controlled from outside of the body without any direct physical connection or cabling. In this study mechanical design and prototype manufacturing considerations of the intramedullary distractor device are
discussed. An important limitation in design of this device is
the availability of a suitable drive system that will fit into the
intramedullary space of the bone, which has a diameter of less
then 12 mm. The nail must withstand axial forces with a magnitude of 2000 N, which is exerted by extending the muscles, especially during the late stages of the distraction operation. Since the designed device is intended to be used inside the human body,

A portable, non-invasive and easy to operate wireless system has been developed for monitoring the breathing activity of patient. The system is composed of a capacitive microsensor (airflow-humidity sensor) integrated on a silicon chip and of a Negative Temperature Coefficient thermistor; both are coupled to a Radio Frequency wireless link. The sensitive part of the microsensor is an array of interdigitated metallic electrodes covered by 100 nm-thick dense anodized aluminum oxide layer. The breath water vapor is adsorbed over the interdigitated electrode and changes the sensor characteristic capacitance. This modulated signal is then digitized and either stored in a memory or directly transmitted to a monitor through the short distance RF link. Full size of the microsensor is less than 1 cm2 and can be easily implemented in a classical adhesive bandage. This microsystem is proposed for monitoring sleep-disordered breathing as well as breathing rhythm of athletes during effort.

End-users of biomedical devices, like many patients undergoing treatment in healthcare systems, often demonstrate an active interest in their therapy. Patient-specific customization of medical devices, such as orthoses, prostheses and implants, is an expensive, time-consuming process. Given how many of these patients are proactive and self-motivated it seems appropriate to the authors that these characteristics be harnessed to make the adaptation of the device to the patient more cost effective. In short, it is proposed that the device end-user – the patient – play an active role in the tuning and adaptation of the device, especially in the out-patient context. However, the perceived risk associated with a more pro-active and independent role for the patient is a barrier to this possibility. These factors are examined and a proposal for a practical approach to a patient-controlled device optimization process is put forward.