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Wearable biomedical sensors and systems at RWTH Aachen
Interview with Prof. Steffen Leonhardt, Director of the Chair for Medical Information Technology (MEDIT), Helmhotlz-Institute for Biomedical Engineering
 
Prof. Steffen Leonhardt was one of the joint organisers of the BSN 2007 International Workshop, and is the principle investigator on a number of BSN related research projects. A selection of these include:  
 
1. The wearable Aachen “Thirst Sensor”
Project “NutriWear” funded by BMBF (German Federal Ministry of Research)
This project aims to address the problem of dehydration and malnutrition of the elderly patient by using bioimpedance spectroscopy. Ongoing research adresses hardware design, investigation of textile electrodes, physiological modeling of fluid distribution and experiemental investigations in local elderly homes and – for comparison - during dialysis.
 
 2. Wearable SaO2 sensing
Project “In-Monit” funded by BMBF (German Federal Ministry of Research)
This project is working on the development of electronic components and signal processing algorithms fo an in-ear measurement device for heart rate and SaO2 detection. It also focuses on signal processing and artefact cancelation. Finally, application of the device in sleep surveillance and for monitoring in the ICU will also be investigated.
 
 3 . Capacitive measurement of biopotentials
Project will be funded within the EU project “HeartCycle” starting Jan. 2008
This project aims to establish and improve a capacitive technique to measure biopotentials without conductive contact (i.e., through cloth). A major challenge is how to deal with movement artefacts and with static charges. First demonstrators have included office chairs and car seats, but the final goal is textile integration for mobile use.
 
4. Inductive measurement of vital signals using eddy currents
Project will be funded within the EU project “HeartCycle” starting Jan. 2008
Development of a magnetic contact-free technique to measure changes in bioimpedance related to heart and lung activity. A single coil setup has been developed for mobile application, but we also work on multi-coil scenarios. One future step is a complete textile integration.
 
 
Interview
 
What initiated your interest in the field of biomedical engineering technologies? And how did this lead to your interest in the field of Body Sensor Networks?
Biomedical Engineering has been my passion since I read an article on artificial hearts at the age of 16. I immediately wanted to build artificial organs myself. Shortly afterwards, I began to study medicine and physics (which later became electrical engineering instead). In biomedical engineering, Body Sensor Networks are a new modality and a natural extension to the existing technologies allowing us to fight some of the consequences of the demographic changes to come.
Your work has spanned across different areas of biotechnology. What is the main drive or goal of your work?
There are two main goals:

1)     With respect to the ‘silver generation’: "ubiquitous monitoring of health anywhere anytime" and, 

2)     With regards to improving treatment and monitoring techniques: "optimization of medical therapy using feedback control"


Can you discuss some of the main difficulties and obstacles that your research has faced and overcome? Which are the most challenging (e.g. funding, resources, biocompatibility, etc.?)

Coping with the phase transition between body and electronics (ion vs- electron conduction) by developing non-contact techniques (capacitive, magnetic induction). Secondly, dealing with the boundary layer between body tissue and implants (immune reaction, protein deposition, etc.). The challenges associated here are many and most are yet to be addressed and overcome.

Besides biomedical monitoring, what other applications have been considered for these technologies?

Examples could include monitoring applications in the automotive, aircraft and spacecraft industries.

What do you consider to be a realistic time-scale from the R&D phases to bringing products that incorporate this technology to the mainstream market?

I foresee many of the wearable monitoring applications becoming widely available within the next, 5 years. Integrated therapeutic applications will take longer, although progress in this area is being made each year.

Who do you consider will be the main beneficiaries of these technologies and what are the potential barriers to uptake? (How easily can these be overcome? e.g. legislation, standards, etc.)
The main beneficiaries for BSN technologies will be the next generation of mature adults (65+), and probably the healthcare insurance businesses. Inertia for funding reimbursement procedures (for the initial investment in BSN technologies and their associated services) may be a major obstacle to uptake. 

Can you give some personal insights into future of Body Sensor Network technologies? What would you most like to see in the near future?
I would like to see a solution to the energy problem of distributed sensors (batteries alone will not be a solution for the market). Intelligent recharging technologies, energy harvesting, improvements to low-power communication, etc.

As far as the applications of systems to real-word scenarios is concerned, I would like to see the advantages of a pervasive monitoring system, without any sense of  a ‘Big Brother’ watching me.
 
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Internet enabled sensors and analytical measurements at Dublin City University (DCU)
Interview with Prof. Dermot Diamond, Director of the National Centre for Sensor Research at DCU (www.ncsr.ie)   
 
 
 What initiated your interest in the field of biomedical and environmental sensors? And how did this lead to your interest in the field of Body Sensor Networks?
I was always fascinated by the fact that sensors could provide ‘instantaneous’ information about important parameters that affect our lives.  I tinkered with transducers – temperature sensors, LDRs for light levels etc. and interfaced them with computers (old BBCs), wrote programmes, made up analog circuits to process signals (mostly self-taught)
 
In parallel, my PhD research (mid 1980s) was linking molecular structure to selective binding of guests (host-guest chemistry) and ways to transduce this effect i.e. how to get a signal.  I have continued this research through to today, and have a multidisciplinary team of 30 people working on many aspects of chemo/bio sensing as part of the National Centre for Sensor research (this currently has ca. 230 researchers, one of the biggest sensor research efforts world-wide; I will take over as director next week Oct 2007).
 
Your work has spanned across different areas of biotechnology. What is the main drive or goal of your work?
My main interest is to provide a window into the molecular world through sensors and to develop applications based on this that have real socio-economic impact.
 
Can you discuss some of the main difficulties and obstacles that your research has faced and overcome? Which are the most challenging (e.g. funding, resources, biocompatibility, etc.?)
In the early days, funding was a problem but these days funding is good and investment in R&D is still growing in Ireland and in Europe, additionally  there are new mechanisms for encouraging global networking which is important.  There still is an issue in getting universities to really embrance multidisciplinary centres, as these often run contrary to the traditional admin structures we have constructed over decades.  Another systemic obstacle is the lack of clearly defined career structures for younger researchers.
 
On the scientific side, the challenges involved in integrating molecular sensing into non-conventional formats such as wearables are considerable.  The key issue revolves around changes in the sensor characteristics with time which are typically dealt with by calibration – however, integrating calibration into an autonomous system that is compatible with a wearable format is a very significant challenge.  The key to this is the interface with the real ‘messy’ world.
 
Besides biomedical monitoring, what other applications have been considered for these technologies?
We use them extensively for environmental monitoring, and external hazard/threat detection, and even (bio)process monitoring
 
What do you consider to be a realistic time-scale from the R&D phases to bringing products that incorporate this technology to the mainstream market?
BSN products are already being commercialised, and the next 5 years will see a huge expansion in commercially available products tracking breathing rate, heart rate, locaiton, possibly blood pressure, skin and indirectly core body temperature etc.; however, integrating monitoring of molecular targets will take longer -10 years perhaps.  In the meantime, these will become increasingly available as spot tests for personal use at home and gradually become integrated into the pHealth environment
 
Who do you consider will be the main beneficiaries of these technologies and what are the potential barriers to uptake? (How easily can these be overcome? e.g. legislation, standards, etc.)
In the environment, EU directives will drive the market.  Threat detection is unfortunately driven by terrorist acts (homeland security), pHealth will be driven by the need to drive down health costs (e.g. by health insurance companies)
 
Can you give some personal insights into future of Body Sensor Network technologies?
I think the future is very optimistic – products that tackle lifestyle change will be critical and have high impact; monitoring of the degree of physical activity by individuals will become the norm in the USA (compliance) if you want reductions in health insurance costs – and wearables are the way to do this; will also lead to virtual communities of people exercising (perhaps to the demise of the expensive private gyms!)
 
Wearables will also help in the monitoring of the aged – these two issues, ageing population and obesity are where we can expect real socio-economic benefit in the next 5 years.
 
 
Dermot Diamond received his Ph.D. and D.Sc. from Queen’s University Belfast (Chemical Sensors, 1987, Internet Scale Sensing, 2002), and was Vice president for Research at Dublin City University (DCU), Ireland (2002-2004). 
He has published over 150 peer reviewed papers in international science journals, is a named inventor in 13 patents, and is co-author and editor of four books. 
 
 Professor Diamond is currently director of the National Centre for Sensor Research at DCU (www.ncsr.ie) and a PI with the Adaptive Information Cluster (AIC), a major research initiative in the area of wireless sensor networks founded by Science Foundation Ireland (see www.adaptiveinformation.ie). 
 
He was also formerly the director of the Centre for Bioanalytical Sciences (www.cbas.ie).  He is a member of the editorial advisory boards of the international journals ‘The Analyst’ and ‘Talanta’.  In 2002 he was awarded the inaugural silver medal for Sensor Research by the Royal Society of Chemistry, London .  Details of his research can be found at http://www.dcu.ie/chemistry/asg/.

Biologically inspired electronics at MIT
Interview with Professor Rahul Sarpeshkar, Associate Professor of Electrical Engineering, Department of Electrical Engineering and Computer Science, MIT
 
Can you summarise why biological systems are useful for inspiring new generations of engineering devices?
 Biological systems have developed over hundreds of millions of years of evolution to perform sensory, motor, and chemical tasks extremely efficiently and robustly whilst using very little power, in very little volumes, and in real time. The average neuronal cell in the human brain consumes less than a nW of power, and the average cell in the body uses approximately 1pW of power. The entire brain and body are put together with energy-efficient neurons and cells to robustly perform complex information-processing tasks in the chemical, mechanical, or electrical domains with about 12W and 100W of power, respectively.  Much can be learned from biology to develop efficient technologies, to integrate technologies well, to develop sophisticated control systems, to learn to architect systems that can perform efficiently and reliably with unreliable devices, to build systems that automatically learn and adapt to a changing environment, and to build systems that can recover gracefully from failure.
 
What are the main challenges associated with this approach?
 It is important to copy nature insightfully, i.e., to keep the baby and throw out the bathwater. Blind mimicry can lead to a degradation in engineering performance since the constraints and purpose for which the biological system was designed may not be exactly that for which the engineering system is designed. Often, we also don’t know enough about nature to understand why it is architected the way it is or its architecture may have be a frozen accident of evolution. Thus, it is still important to try to evaluate one’s overall success when one is done by the same metrics used to judge traditional engineering architectures. As in all interdisciplinary fields, it is important to synergistically combine the creativity and excitement generated by new non-traditional thinking with the discipline and knowledge of older ideas.
 
 How have you applied this technology towards healthcare technology or other applications?
 Healthcare is a natural area for applying biologically inspired technologies since we are trying to engineer systems that perform the normal functions of biological ones, so mimicking the biology can be helpful in fixing it. Recently, my lab has done work on designing analog cochlear implant processors and biologically inspired algorithms for the deaf to lower power and improve performance in noise. In collaboration with biologists, we have begun to work on extremely energy-efficient prosthetics for curing paralysis by decoding movement intentions from neurons in the brain and using these outputs to control prosthetic or natural limbs. In non-healthcare areas we are working on taking inspiration from the architecture of the inner ear or cochlea to design very energy-efficient radios that extract signals quickly over a very wide bandwidth. We are investigating how cells process information to design efficient hybrid analog-digital processors.
 
 What do you feel are the current barriers to the uptake of these technologies?
 The desire of engineers is usually to make the most innovative technologies, yet some innovations may not be clinically useful. Engineers often don’t understand the complex constraints of biology and medicine because they don’t bother to learn enough about it. In turn, several clinicians are resistant to innovative approaches because they do not fit in with existent medical approaches and thinking. The gap between engineers and clinicians is closing through improved collaboration and greater understanding. It will continue to close further as engineering helps biology through improved measurement, improved quantitative analysis approaches, and improved technologies for repair of biological systems while biology helps engineering by inspiring non-traditional architectures. Medicine is poised to experience a revolutionary growth due to the increasing cross fertilization with engineering.
 
 Professor Rahul Sarpeshkar is a principal investigator in the Research Laboratory of Electronics (RLE) at the Massachusetts Institute of Technology (MIT). Professor Sarpeshkar has received numerous awards including the Packard Fellow award given to outstanding young faculty, the ONR Young Investigator Award, and the NSF Career Award. He holds over twenty patents and has authored several publications including one that was featured on the cover of NATURE. His research interests include analog and mixed-signal VLSI, ultra low power circuits and systems, biologically inspired circuits and systems, biomedical systems, neuroscience, cell biology, and control theory.
 

Developing BSN technologies for healthcare technologies

 Dr. Leonard Fass, Director of Academic Relations, GE Healthcare

With the number of wireless, on-body and in-vivo healthcare monitoring devices on the market ever increasing, we asked Dr. Leonard Fass (GE Healthcare) about some of the considerations that should apply to current research in developing BSN technologies for use in the healthcare industry.
 
  
What do you view as the most useful applications for BSN technologies in healthcare?
The overarching value of BSN research for healthcare is the concept of being able to assess the relevance of day-to-day changes for chronic disease sufferers. The most urgent conditions are generally cardiovascular, which require monitoring of heart-rhythm (using ECG) and other vital signs such as blood pressure and oxygen saturation. It is a real priority for care service providers to enable patients with long-term conditions to manage their conditions at home, away from the acute care setting: patients are usually more comfortable at home, and generally respond better to treatment in a familiar environment.
 
What do you consider to be the most exciting developments in BSN research?
Long-term blood glucose monitoring is probably the next step for the BSN research community to address.  Improving closed-loop drug-delivery systems is a major research theme for both commercial and academic researchers: this includes putting safety mechanisms in place that ensure that over-doses of insulin are never administered. At the component level, there are several promising developments for implantable devices, such as glucose fuel cell technologies and other power scavenging techniques.
  
Any significant reduction in the power requirement for a BSN device, or where possible, the removal of battery power sources is going to be beneficial for the patient. There have been some very positive developments using analogue signal processing to reduce overall power consumption. There is also the problem of wireless signal transmission, and how to transmit the signal via body tissue, which requires further investigation for implantable devices.
  
What are the most immediate challenges facing the uptake of BSN clinical applications?
In terms of immediate challenges, one of the greatest barriers to the adoption of emerging BSN technologies is the whether or not they can be integrated with existing systems, under common standards. Data fusion, encryption and security management are also issues where further research is needed. Given the difficulties currently being experienced by the NHS in transferring existing medical records to electronic systems, it is clear that the choice of correct software (with flexible specifications) is of great consequence. This however, is not necessarily an issue to be addressed by the research community alone, but requires a strong and dedicated industrial lead with the expertise and resources to take on the associated challenges.
 
In the short-term, clinicians will have to lead the way in the adoption of BSN technologies, which is why ensuring swift and reliable access to data is a key consideration for any developer of such technologies. Most clinicians are very time-constrained, and would be unlikely to promote the use of an application that is not capable of providing immediate, consistent access to real-time data when required. Health-monitoring devices themselves must be autonomous, and part of a self-managing framework, enabling those with little technological experience to use them with ease. The challenge is for technology developers to produce systems which are reliable, accessible and unintrusive. 
 
Dr. Leonard Fass obtained a degree in Electrical Engineering and a Ph.D. in Materials Science at Imperial College , London and has spent the last 36 years in medical technology R&D and marketing roles. Currently he is involved in developing collaborations between academia, government and industry in the field of healthcare. His expertise includes Molecular Medicine, Biomedical Imaging, Bioinformatics, Photonics, remote patient monitoring and Nanotechnology. He has advised institutions such as the Cambridge MIT Institute, the DTI and the European Bioinformatics Institute.
 
Dr. Leonard Fass will be presenting at the following forthcoming conferences/events:
 ·          IEEE-BioCas Conference 29 Nov – 01 Dec 2006
·          Investing in Medical Technologies Conference and Exhibition 13 -14 Dec 2006
·          Trends in Drugs Discovery Executive Summit 17 – 18 Jan 2007

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