Ron S. Leder

Advances in Medical Devices and Medical Electronics

Medical devices and medical electronics are areas that had little to offer 100 years ago. However, there were three important existing technologies that led to many further developments over the following 100 years. These are the stethoscope, electrocardiography, and X-ray medical imaging. Although these technologies had been described and were available to some extent when the Proceedings of the IEEE pages first appeared, they had yet to achieve the widespread use that they have today. The stethoscope is the oldest of these, and it helped physicians to hear sounds of the body and relate them to functioning and malfunctioning organs. The early use of the stethoscope by physicians was more of an art than a science, but as the Proceedings matured, so did this technology. Engineers were able to make this a more quantitative process by graphically displaying the sounds and ultimately using techniques such as voiceprint analysis to assist the physician in diagnosis and monitoring of treatment. The electrocardiograph had been invented a few years prior to the appearance of the Proceedings, but the apparatus was awkward to use, especially for sick people, and was considered more of an oddity than a viable medical technology 100 years ago. Today, it and devices derived from it such as cardiac patient monitors are important parts of our healthcare system. Similarly, X-rays represented a new technology 100 years ago, but unlike electrocardiography physicians immediately saw the value of this technology and quickly adopted it. Many improvements have been made to the basic technology over the last 100 years culminating in computer tomography and complex image processing. Other devices to create high-quality and 3-D medical images have also been developed in recent years to make medical imaging a very important aspect of clinical care today. Looking to the future is always a difficult task, but it is clear that the electronic health record will play an important role in consolidating the information from various medical devices as well as providing readily available data on patients wherever it might be needed. Future medical devices will need to not only address the problems of diagnostic and therapeutic medicine but also be capable of addressing important societal problems such as worldwide disparities in the availability of medical care, continually rising healthcare costs, and healthcare for travel beyond Earth. The next 100 years promises to be even more exciting than the last from the perspective of medical devices and medical electronics.

Nintendo WII remote and Nunchuck as a wireless data subsystem for digital acquisition of analog physiologic data relevant to motor rehabilitation after stroke; part II

The Nintendo Wiimote sends 22 byte data packets to the Wii console over a Bluetooth wireless channel at a typical rate of 100 packets per second. The Wiimote wireless channel can be made to carry arbitrary digitized analog data via an I2C serial expansion port. The Nunchuck I2C accessory unit provides a convenient five channel input port for analog data. One simply substitutes their signals for any of two channels of joystick axes and three axes of the accelerometer which are part of the standard Nunchuck configuration. This research describes customizing the low-cost and widely-available Wiimote to be used to transmit relevant physiological data from stroke patients while they perform therapy exercises. An example is grip pressure or finger force from a handle while they are exercising in a virtual environment presented on a computer screen. This Wiimote wireless data acquisition subsystem may be adequate to achieve a low-cost therapy oriented data system for the hand.

Gesture Therapy: A Vision-Based System for Arm Rehabilitation after Stroke

Each year millions of people in the world survive a stroke, in the U.S. alone the figure is over 600,000 people per year. Movement impairments after stroke are typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. However, due to economic pressures, stroke patients are receiving less therapy and going home sooner, so the potential benefit of the therapy is not completely realized. Thus, it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. Current solutions are too expensive, as they require a robotic system for rehabilitation. We have developed a low-cost, computer vision system that allows individuals with stroke to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a web based virtual environment for facilitating repetitive movement training, with state-of-the art computer vision algorithms that track the hand of a patient and obtain its 3-D coordinates, using two inexpensive cameras and a conventional personal computer. An initial prototype of the system has been evaluated in a pilot clinical study with promising results.

Nintendo WII remote and nunchuck as a wireless data subsystem for digital acquisition of analog physiologic data relevant to motor rehabilitation after stroke; poster

The Nintendo wiimote sends 22 byte data packets to the Wii console over a blue tooth wireless channel at a typical rate of 100 packets per second. The wiimote wireless channel can be made to carry arbitrary digitized analog data via an I2C serial expansion port. The nunchuck I2C accessory unit provides a convenient five channel input port for analog data. One simply substitutes their signals for any of two channels of joystick axes and three axes of accelerometry which are part of the standard nunchuck configuration. This research describes customizing the low-cost and widely-available wiimote to be used to transmit relevant physiological data from stroke patients while they perform therapy exercises. An example is grip pressure or finger force from a handle while they are exercising in a virtual environment presented on a computer screen. This wiimote wireless data acquisition subsystem may be adequate to achieve a low-cost therapy oriented data system for the hand.

The modern hospital in historical context

The evolution and development of hospitals in their historical context is quickly reviewed, starting first as simple shelters for the sick and indigent, waiting essentially for death, up to the relatively recent concept of true health centers where patients face a high probability of actual recovery and rehabilitation. Anesthesia, microbiology, asepsia, antibiotics, virology, radiology, transfusion and different biomedical engineering technologies, along with other basic sciences knowledge, led to the intensive care and emergency units introduced in the 1960s, leading to the specialty of critical care medicine and underlining the patient as the center of care.

Robust control for propofol induced anesthesia based on Second-Order Sliding-Mode Control

The effect of anesthesia can be different in every patient. It is often the case that anesthesia has to be induced in emergency situations, where identification of the patients parameters cannot be done. It is preferable to have a controller insensitive to parameter variations, such as Second-Order Sliding-ModeControl (SOSMC). This kind of controller is also robust with respect to singular perturbations that may occur during surgery; therefore SOSMC is well suited to perform a closed loop propofol dosage. This in silico study tests the performance of an SOSMC for 4 different patients, to evaluate its insensibility to parameter variation (interpatient variability). SOSMC robustness with respect to perturbations is evaluated by a bleeding simulation, that changes the parameters of the pharmacokinetic model (intrapatient variability), and also by inducing a surgical stimuli.

The Modern Hospital in Historical Context: A Modern Health Bonanza [Retrospectroscope]

The evolution and development of hospitals in their historical context are quickly reviewed in this column, starting first as simple shelters for the sick and indigent who were waiting essentially for death, and up to the relatively recent concept of true health centers where patients face a high probability of actual recovery and rehabilitation. Anesthesia, microbiology, asepsia, antibiotics, virology, radiology, transfusion, and different biomedical engineering technologies, as well as knowledge in other basic sciences, have led to the intensive care and emergency units that were introduced in the 1960s, which lead to the specialty of critical care medicine and positioning the patient as the center of care.

High-Order Sliding-Mode control of blood glucose concentration via practical relative degree identification

This research introduces a novel concept of practical relative degree and presents a numerical method of practical relative degree identification. The concept efficacy is demonstrated by computer simulation of a High-Order Sliding-Mode controller, effectively stabilizing the blood glucose concentration for two well known models with different relative degrees.

Experimental glucose regulation with a High-Order Sliding-Mode Controller

Theoretically High-Order Sliding-Mode Controllers are well suited to perform closed loop glucose regulation because they are insensitive to parameter uncertainties and robust to unknown dynamics that may perturb the system. The implementation of the controller based on the concept of practical relative degree is presented. The controller was tested in Sprague-Dawley rats with steptozotocin induced diabetes. The tests demonstrated high efficacy and robustness of the controller.

The educational value of teaching biomedical engineering history

It has been previously argued that science and engineering undergraduate students can benefit greatly from learning the history of their discipline. In order to successfully enhance learning by introducing history into undergraduate curriculum, it would be desirable to assess what the current educational uses of history are and to understand the needs and perceptions of teachers. Nevertheless, to our knowledge no quantitative study of the role of the history of science, engineering, and technology in the classroom has been so far conducted. In this paper we present the design of a survey aimed at assessing the current perception of teachers towards using the history of biomedical engineering (HBME) to enhance learning. This survey was part of a broader project originally led by the EMBS History Committee aimed at evaluating the educational value of the HBME, both for future biomedical engineers and for the broader public. The main goals of the survey are (1) to find out the current uses of the HBME in the classroom, and (2) to identify possible obstacles to expanding the HBME in the classroom.