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News Article | February 15, 2017
Site: www.newscientist.com

The future of healthcare could be in your pocket. Two new medical apps that help people monitor their health at home, reducing their need to visit a doctor, are set to be rolled out to as many as four UK National Health Service trusts over the next year. The apps, which are currently being trialled in four hospitals in Oxfordshire, UK, transmit patient data from a tablet or smartphone directly to clinicians. According to Ilan Lieberman, a member of the Royal Society of Medicine’s council on telemedicine and e-health, such apps will have a huge impact on the management of chronic diseases. One system, called GDm-health, helps manage the treatment of gestational diabetes – a condition that affects about 1 in 10 pregnant women. The smartphone app lets women send each blood glucose reading they take at home to their diabetes clinician. “Now when a diabetes midwife logs on between clinics, she will see all the patients who are most in need of attention,” says Lionel Tarassenko, of the Oxford University Institute of Biomedical Engineering, who led the development of the technology. A two-year trial at the Royal Berkshire NHS Foundation Trust found that the system meant that patients didn’t need to go in person to the clinic as often, reducing the number of patient visits by 25 per cent. “We’ve got three trusts wanting to install this for their gestation diabetes management,” Tarassenko says, but his research group is too small to support any more trials. To overcome this hurdle, Drayson Technologies, owned by entrepreneur and Labour peer Paul Drayson, is setting up a team of developers and support staff based in Oxford, UK, to commercialise it. The team will manage the rollout of this technology – as well as two other apps – at up to four as-yet-unnamed NHS trusts within a year. Beyond that, Drayson says he plans to eventually offer these products to the entire NHS. “This technology enables patients to go home and then be able to safely monitor their condition and be well connected back to the hospital,” Drayson says. Charles Lowe, managing director of the Digital Health and Care Alliance, says that these smartphone apps make it easier for patients to manage their conditions while carrying on with their daily routines. Another system being rolled out by Drayson Technologies, also developed by the Oxford University Insittute of Biomedical Engineering, is for managing chronic obstructive pulmonary disease (COPD), a condition that affects between 1 million and 1.5 million people in the UK. Patients with COPD use a finger probe to measure their heart rate and blood oxygen saturation every day and enter the results into an app. After three months of measurements, the app learns to recognise a patient’s specific range of normal oxygen saturation levels, and issues an alert to clinicians when the measurement falls below that range. “It is very important that the analysis adapts to individuals,” says Tarassenko. If the system is too sensitive, it will send too many alerts to clinicians, but if it’s not sensitive enough, it might miss problems. In a 12-month clinical trial, the app reduced hospital admissions by 17 per cent and GP visits by 40 per cent. “Patients are much more confident about managing themselves and are getting into trouble far less often,” Tarassenko says. A third product ready for rollout, called SEND, is an iPad app used by nurses to input details about patients’ vital signs as they make their rounds of the wards. It automatically calculates an early warning score based on the vital signs, giving an indication if the patient is deteriorating. Rury Holman, at the Oxford Biomedical Research Centre, thinks the NHS trials are the right way forward. Although smartphone app stores are already crammed full of medical apps designed to manage all kinds of conditions, he believes that if similar apps are going to be used in the UK healthcare system, it’s vital they are developed in close collaboration with the NHS. “It’s a bit like the Wild West out there with lots of keen and very motivated people producing these apps,” he says. “What we need are consistent standards and an interface with electronic patient records, particularly with the NHS, so that information, with permission from the patients, can be put to use centrally.” But approaches like this can raise privacy concerns. Last year, New Scientist revealed details of a data-sharing agreement between the NHS and Google’s DeepMind that gave the company access to healthcare data on 1.6 million patients including details of drug overdoses and abortions. Since late 2015, the AI company has been developing a healthcare app, Streams, that monitors the health of people with acute kidney injury. According to Tarassenko, his diabetes and lung disease apps only have access to information relating specifically to those conditions. The measurements sent to clinicians via the app are fed into existing patient records, but that process takes place outside of the app, within the NHS’s central patient record systems. Developing these apps has taken eight years, but Tarassenko says securing the appropriate ethical clearance and building up a clear evidence base for their use is a critical, journey. “It’s been very important for us to have credibility with our clinical colleagues, and we will continue to do that because it’s designed in the NHS, for the NHS.”

Chung Y.-C.,National Taiwan University | Hsieh W.-Y.,Industrial Technology Research Institute of Taiwan | Young T.-H.,National Taiwan University | Young T.-H.,Institute of Biomedical Engineering
Biomaterials | Year: 2010

Ternary nanoparticles with negatively charged surface were prepared by coating single-stranded oligonucleotides (5′-C10A20-3′) on histidine-conjugated polyallylamine (PAA-HIS)/DNA complexes for gene delivery. Characterization of PAA-HIS/DNA/oligonucleotide complexes demonstrated that nanoparticles possessed the negative surface charge -27 mV and size of around 100 nm when the molar ratio of oligonucleotide/PAA-HIS exceeded 1.5. The negatively charged oligonucleotide-coated PAA-HIS/DNA complexes could be entirely internalized by the living HeLa cells to exhibit high gene expression with low cytotoxicity and the resistance against erythrocyte agglutination and serum inhibition. Since the gene expression of PAA-HIS/DNA complexes was significantly inhibited by coating other polyanions and oligonucleotides, the ternary PAA-HIS/DNA/deoxyadenosine-rich oligonucleotide complexes were uptaken by specific receptor-mediated process. Additionally, the deposition of a layer of oligonucleotides onto the binary PAA-HIS/DNA complexes could effectively transfect various types of cells including HEK-293, HepG2 and Hs68 cells, indicating the technology of coating specific oligonucleotides on PAA-HIS/DNA complexes or other cationic binary DNA complexes might facilitate the use of nanoparticles for safe and efficient gene delivery and eventual therapy. © 2010 Elsevier Ltd. All rights reserved.

Chou W.-K.,Institute of Biomedical Engineering | Chien A.,Institute of Biomedical Engineering | Wang J.-L.,Institute of Biomedical Engineering | Wang J.-L.,National Taiwan University
Journal of Spinal Disorders and Techniques | Year: 2015

Study Design: An in vitro fatigue loading test with porcine specimens. Objectives: To comparatively analyze the in vitro biomechanical performance of Polyetheretherketone (PEEK) and Titanium rods construct subjected to a battery of fatigue loading testing. Summary of Background Data: PEEK rods construct has been proposed to allow better load sharing among spinal components than the more traditional Titanium rods constructs. However, such proposal has largely derived from single-load in vitro testing and the biomechanical differences when subjected to fatigue loading remain unknown. Methods: Twenty-four fresh 4-level motion segment were harvested from porcine. Specimens were randomly assigned into 3 groups: (1) intact, (2) destabilized group with Titanium alloy rods, and (3) destabilized group with PEEK rods. All specimens were subjected to a fatigue loading procedure with the disk height and intradiscal pressure (IDP) of the instrumented and adjacent levels were recorded and used for analysis. The stress levels on the rods and bone stress near the screw-bone interface were also collected to investigate the likely failure rates of the 2 constructs. Results: Titanium rods construct demonstrated a minimum amount of loss of disk height and IDP at the instrumented level; however, a significant loss of the disk height and IDP at adjacent levels compared with the intact spine were identified. In contrast, the disk height and IDP of the PEEK rods were found to be comparable with those of the intact spine for all levels. The PEEK rods group also showed significantly less bone stress near the screw-bone interface compared with the Titanium rods group. Conclusions: The current study has demonstrated the differences in biomechanical characteristics of PEEK and Titanium rods construct when subjected to fatigue loading. More specifically, the result is indicative of the potential benefits of the PEEK rods construct in reducing the risks of adjacent segment disease and implant failure rates. © Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.

Woods S.P.,Institute of Biomedical Engineering | Woods S.P.,Duckworth and Kent Ltd. | Constandinou T.G.,Institute of Biomedical Engineering
IEEE Transactions on Biomedical Engineering | Year: 2013

This paper describes a platform to achieve targeted drug delivery in the next-generation wireless capsule endoscopy. The platform consists of two highly novel subsystems: one is a micropositioning mechanism which can deliver 1 ml of targeted medication and the other is a holding mechanism, which gives the functionality of resisting peristalsis. The micropositioning mechanism allows a needle to be positioned within a 22.5 ° segment of a cylindrical capsule and be extendible by up to 1.5 mm outside the capsule body. The mechanism achieves both these functions using only a single micromotor and occupying a total volume of just 200 mm3. The holding mechanism can be deployed diametrically opposite the needle in 1.8 s and occupies a volume of just 270 mm 3. An in-depth analysis of the mechanics is presented and an overview of the requirements necessary to realize a total system integration is discussed. It is envisaged that the targeted drug delivery platform will empower a new breed of capsule microrobots for therapy in addition to diagnostics for pathologies such as ulcerative colitis and small intestinal Crohn's disease. © 1964-2012 IEEE.

Taherkhani S.,Institute of Biomedical Engineering | Taherkhani S.,McGill University | Mohammadi M.,Institute of Biomedical Engineering | Daoud J.,McGill University | And 2 more authors.
ACS Nano | Year: 2014

The targeted and effective delivery of therapeutic agents remains an unmet goal in the field of controlled release systems. Magnetococcus marinus MC-1 magnetotactic bacteria (MTB) are investigated as potential therapeutic carriers. By combining directional magnetotaxis-microaerophilic control of these self-propelled agents, a larger amount of therapeutics can be delivered surpassing the diffusion limits of large drug molecules toward hard-to-treat hypoxic regions in solid tumors. The potential benefits of these carriers emphasize the need to develop an adequate method to attach therapeutic cargos, such as drug-loaded nanoliposomes, without substantially affecting the cell's ability to act as delivery agents. In this study, we report on a strategy for the attachment of liposomes to MTB (MTB-LP) through carbodiimide chemistry. The attachment efficacy, motility, and magnetic response of the MTB-LP were investigated. Results confirm that a substantial number of nanoliposomes (~70) are efficiently linked with MTB without compromising functionality and motility. Cytotoxicity assays using three different cell types (J774, NIH/3T3, and Colo205) reveal that liposomal attachments to MTB formulation improve the biocompatibility of MTB, whereas attachment does not interfere with liposomal uptake. © 2014 American Chemical Society.

Hu Y.,Institute of Biomedical Engineering | Georgiou P.,Institute of Biomedical Engineering
IEEE Transactions on Biomedical Circuits and Systems | Year: 2014

This paper presents a robust, low-power and compact ion-sensitive field-effect transistor (ISFET) sensing front-end for pH reaction monitoring using unmodified CMOS. Robustness is achieved by overcoming problems of DC offset due to trapped charge and transcoductance reduction due to capacitive division, which commonly exist with implementation of ISFETs in CMOS. Through direct feedback to the floating gate and a low-leakage switching scheme, all the unwanted factors are eliminated while the output is capable of tracking a pH reaction which occurs at the sensing surface. This is confirmed through measured results of multiple devices of different sensing areas, achieving a mean amplification of 1.28 over all fabricated devices and pH sensitivity of 42.1 mV/pH. The front-end is also capable of compensating for accumulated drift using the designed switching scheme by resetting the floating gate voltage. The circuit has been implemented in a commercially-available 0.35 μ m CMOS technology achieving a combined chemical and electrical output RMS noise of 3.1 mV at a power consumption of 848.1 nW which is capable of detecting pH changes as small as 0.06 pH. © 2014 IEEE.

Martel S.,Institute of Biomedical Engineering | Martel S.,Ecole Polytechnique de Montréal
IEEE Control Systems | Year: 2013

Although navigation control has been applied in a multitude of environments, relatively little is known about the challenges and issues of navigation control in the vascular network. In an adult human, the vascular network consists of nearly 100,000 km of blood vessels, with diameters ranging from a few millimeters in the artery to just a few micrometers in the capillaries, and blood flow rates ranging from a few tens of centimeters per second to a few millimeters per second. Although vascular networks present great challenges, due to various environmental conditions, they are of special interest in medical microrobotics since they allow navigable agents to be delivered anywhere within the body. Controlled endovascular navigation would allow targeted surgical, diagnostic, and therapeutic interventions. In cancer therapy, for instance, although many of the most deadly cancers are initially located in a single region, modern therapies such as chemotherapy continue to inject excessive amounts of toxic agents thecirculate systematically throughout the vascular network. In general, only a tiny fraction of the drug reaches the treatment region [1]. Even the level of targeting achieved by agents with special coatings to enhance tumor cell specificity is far from optimal when they are injected systematically in the vascular network. Since the therapeutics do not discriminate between cancerous and healthy cells, systemic circulation of these agents must be avoided to eliminate, or at least minimize, secondary toxicity that affects healthy organs. © 2013 IEEE.

Martel S.,Institute of Biomedical Engineering
2014 IEEE Conference on Control Applications, CCA 2014 | Year: 2014

Navigation of untethered agents such as microscale robots or therapeutic micro-carriers in the blood circulatory network has been an increasing research area in recent years. Indeed, it opens new applications such as surgical, diagnostic, imaging and therapeutic interventions being conducted in the human body. Although many propelling and actuation methods with potential navigation control algorithms have been proposed, very little has been done on proposing a list and a general assessment of potential navigation control approaches taking into consideration the physiological and technological constraints that impact such control implementations. This paper identifies and summarizes the various control approaches for navigation in various sections of the vascular network that present different physiological environments and technical challenges with their main advantages and disadvantages in a control point-of-view. © 2014 IEEE.

Martel S.,Institute of Biomedical Engineering
IEEE/ASME International Conference on Advanced Intelligent Mechatronics, AIM | Year: 2014

Magnetic manipulation of untethered agents is likely to play a critical role in several interventions conducted in the human body. Such interventions ranging from surgeries to drug deliveries require magnetic manipulation methods with characteristics that are best suited for the type of interventions being considered. The main characteristics include but are not limited to the magnetic field strength, the magnitude of the magnetic gradients, the rate at which such directional gradients can vary, the degree-of-freedom (DOF) being supported, appropriateness of the imaging modality for real-time positional assessments of the agents being manipulated, the total workspace, and the duty cycle or the period of time that such magnetic manipulation can be performed without interruption. Since no single existing magnetic manipulation method is optimized for all of the above characteristics, emphasizes the need to select the appropriate method that will offer the best required characteristics for a given type of interventions. Here, a study and review of such main magnetic manipulation methods and systems with the corresponding characteristics and the related preferred type of interventions are provided. © 2014 IEEE.

Collin J.R.T.,Institute of Biomedical Engineering | Coussios C.C.,Institute of Biomedical Engineering
Journal of the Acoustical Society of America | Year: 2011

Quantitative experimental observations of single-bubble cavitation in viscoelastic media that would enable validation of existing models are presently lacking. In the present work, single bubble cavitation is induced in an agar gel using a 1.15 MHz high intensity focused ultrasound transducer, and observed using a focused single-element passive cavitation detection (PCD) transducer. To enable quantitative observations, a full receive calibration is carried out of a spherically focused PCD system by a bistatic scattering substitution technique that uses an embedded spherical scatterer and a hydrophone. Adjusting the simulated pressure received by the PCD by the transfer function on receive and the frequency-dependent attenuation of agar gel enables direct comparison of the measured acoustic emissions with those predicted by numerical modeling of single-bubble cavitation using a modified Keller-Miksis approach that accounts for viscoelasticity of the surrounding medium. At an incident peak rarefactional pressure near the cavitation threshold, period multiplying is observed in both experiment and numerical model. By comparing the two sets of results, an estimate of the equilibrium bubble radius in the experimental observations can be made, with potential for extension to material parameter estimation. Use of these estimates yields good agreement between model and experiment. © 2011 Acoustical Society of America.

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