Journal of Medical Engineering and Technology最新文献

The purpose of this research is to install a handrail on sliding doors used in hospitals and nursing facilities to support the elderly and disabled to walk by themselves. Semi-automatic lifting equipment is utilised for the retractable handrail to make sure people in bad health are able to open the door using minimal force. This paper summarises ergonomic considerations to develop the product above. For example, the maximum opening force should be a certain value or less for the elderly and disabled to open the product effortlessly. Additionally, the initial opening force is required to be a certain degree for safe use. When the product is used as a handrail, the handrail is required to be stable and unshakable in opening or closing directions. The results obtained by having the elderly and disabled use the prototype demonstrated that it improves their walking abilities.

The balloon surface temperature (BST) should be monitored to ensure the success of the ablation procedure using the HotBalloon^TM ablation catheter (HBC) in clinical settings. Therefore, we sought to develop a new HBC equipped with a surface temperature monitoring sensor. The BST was evaluated using a pseudo-tissue model and a thermocouple to imitate catheter insertion into the pulmonary vein. Thermo-fluid analysis with computer-aided engineering (CAE) was performed to analyse the temperature distribution in the catheter and the balloon. The CAE analysis reproduced the results from a pseudo-tissue model experiment and demonstrated that some fluid zones inside the catheter shaft had a nearly identical temperature as the BST during the liquid suction period. The pseudo-tissue model experiment confirmed that the temperature was almost the same between the balloon surface and the position of 5 mm inside the catheter shaft from the proximal end of the balloon. A thermocouple placed at 5 mm or 25 mm from the proximal end of the balloon within the catheter shaft showed an equivalent temperature result. This 5-25-mm distance is acceptable to set the BST monitoring sensor inside the catheter shaft, since the sensor can help accurately estimate the BST.

Blood pressure (BP) is a vital health parameter that varies throughout the day. As a single reading of high BP may not indicate hypertension, continuous monitoring of BP is usually recommended by medical doctors to confirm the diagnosis of hypertension. In the last few decades, researchers have investigated cuff-less and continuous BP measurements based on pulse transit time (PTT). The main purpose of this research is to develop an autoregressive (ARX) system identification (SI)-based PTT calculation model using two PPG signals acquired from carotid and toe. The signals were recorded from 65 subjects with an age range between 20 and 60 years. The results of the study have been validated in two stages. The first validation comprised the estimated BP from PTT using SI compared to the measured BP using the cuff-based method for all subjects. The results of the estimated BP using the proposed method compared to the measured BP obtained using the standard BP cuff measurement method are highly correlated to both systolic blood pressure (R² = 0.8132) and diastolic blood pressure (R² = 0.8357). The second validation consisted of comparing PTT values using system identification to the results of the PTT derived from the ECG-PPG method. The results showed that both methods are highly correlated (R² = 0.7808), and there is no significant difference between them (p < 0.05) with a slightly better PTT estimation related to DBP in the proposed method. Our results have proven that the PTT obtained from the carotid PPG and toe PPG using the system identification approach yielded SBP and DBP estimations that are consistent with the values of the conventional BP cuff method. The newly proposed method has the advantage of being cuff-less and able to provide continuous BP measurements.

The work presents a convenient and practical wearable heart rate monitoring method and a cost-effective implementation of a recording system based on commercial over-ear headphones. The selected headphones can be easily replaced by any other over-ear headphones due to the modular structure of the system and custom 3D printed ear pads. Dry contact conductive textile removes any discomfort and the need for preparation for electrodes or the user's skin. Evaluated 4.4% R-R interval detection error makes the proposed method a perfect candidate for continuous heart rate monitoring for daily use.

Millions of children and young people (CYP) in the UK are affected by chronic or rare health conditions. Rapid advances in science and technology have resulted in CYP with chronic and rare conditions now surviving well into adulthood. New technologies have the potential to improve short- and long-term health outcomes for CYP with health conditions, prevent adult onset disease and complications, and reduce the burden on health services. There is thus a need for targeted investment and appropriate governance in child health technology development to address the specific needs of this population; health technology must be versatile to meet the social, anatomical, cognitive, psychological, and physiological changes inherent to childhood development. Despite the growing demand for health technology for a sizeable global population, industry still wrongly perceives the market size is relatively small, and health technology development is often localised and fragmented with limited scope for spread and adoption. These challenges can be overcome by validating and prioritising unmet needs, involving CYP and their families throughout the innovation pathway, facilitating effective partnerships with key stakeholders, and utilising national and international infrastructure and networks. This paper outlines five innovations supported by NIHR Children and Young People MedTech Co-operative that illustrate how common challenges in child health technology development can be overcome. It is essential that we continue to address such challenges and invest in the health and wellbeing of CYP.

The successful development and implementation of any healthcare technology requires input from multiple stakeholders including clinical leads, trust information technology directorates as well as project management and procurement. In this process however, a key stakeholder that is often overlooked is the patient.This paper illustrates the crucial importance of patient involvement to avoid poor design and poor uptake of technology and subsequently poor health outcomes.To highlight this, we share a case example evidencing involvement of people with lived experience of foot ulcers resulting from Diabetic foot neuropathy throughout identification of unmet technology needs, design requirements for the device and iterative device development and evaluation.

Evidence suggests that much of the digital technology available and provided to older adults to enable self-management of long-term conditions is under-utilised. This research focuses on three conditions prevalent amongst older adults: diabetes, dementia and chronic kidney disease and explores the individual enablers and barriers to the use of digital self-management technology. The paper reports findings from a series of three systematic reviews of qualitative research (qualitative evidence syntheses). These reviews informed the design of a Delphi study. The first round of the Delphi involving 15 expert interviews is reported. The findings highlight common themes across the three conditions: how technology is used; barriers to use; assessing individual needs when selecting technology; support requirements; multi-functional self-management technologies; trust, privacy and data sharing; achieving accessible and aspirational design. Some emerging recommendations have been suggested to guide the design, and provision of technology to older adults. These will extended and refined through subsequent rounds of the Delphi method.

The anatomical, physiological, and developmental changes which arise as children mature through childhood and adolescence support the need to develop new health technologies that meet the specific requirements of children and young people (CYP). Failing to involve CYP during the development of technology increases the risk that the outcome falls short of their expectations and needs, leading to rejection of novel interventions. Through participation in health technology development, CYP and their families can provide context, insight, personal experience and tacit knowledge to ensure that the end-product is usable, acceptable, and can be integrated into its intended environment. A nuanced, balanced understanding of the methods that can be used to facilitate participation will support researchers in choosing an effective approach to involving CYP in health technology development. Methodological approaches include patient and public involvement and engagement, co-design, and experienced based co-design. These methods can be used in isolation or in combination, to facilitate meaningful involvement of CYP and encourage the development of impactful solutions, in consideration of the context, stakeholders, and objectives of the project. We provide the rationale and justification for involving CYP in health technology design and development, an explanation of the methods supporting meaningful involvement, and case studies exemplifying real world application of these methods with positive outputs.

People with mobility impairments have reported that improving their walking is one of the most important goals of their rehabilitation. Novel robotic technologies using powered exoskeletons for the lower limb could potentially offer efficient and less labour-intensive approaches to rehabilitation with shorter recovery times. To gather users' and carers' perspectives of assistive device use to provide information to design personalised and safe mobility rehabilitation technology. Semi-structured interviews were carried out with people with experience of mobility impairments. Iterative data collection was used to gather information about the social phenomena surrounding patient interaction and requirements for assistive devices for mobility impairments. Cycles of continuous data collection and thematic analysis using a theoretical, semantic approach was used to develop key themes within the data. We interviewed eight people: six people with mobility impairments and two carers. We identified five main themes: relationship with assistive technology, requirements for assistive technology, function and goal setting, personal factors to assistive device use and psychosocial factors to assistive device use. There was variability in the importance placed on each theme, particularly in the trade-off between the function and comfort of assistive technology. Patients emphasised the need for assistive technology to be personalised; they reported the ability to stand, control spasticity and involvement in community roles as key goals of their rehabilitation. These results highlight the variation in requirements for assistive technology between people with different mobility impairments; individuals' experiences are unique and future prototypes need to account for different levels of impairments and personal goals. These findings will also inform the user evaluation stage of assistive device testing. The acceptability of assistive devices is dependent upon a number of factors, including personalisation, comfort and function. Future pilot studies should gather qualitative data to determine the acceptability of actual device use.