Medicine-Based Informatics and Engineering PDF
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Lecture Notes in Bioengineering Franco Simini Pedro Bertemes-Filho Editors Medicine-Based Informatics and Engineering Lecture Notes in Bioengineering Advisory Editors Nigel H. Lovell, Graduate School of Biomedical Engineering, University of New South Wales, Kensington, NSW, Australia Luca Oneto, DIBRIS, Università di Genova, Genova, Italy Stefano Piotto, Department of Pharmacy, University of Salerno, Fisciano, Italy Federico Rossi, Department of Earth, University of Salerno, Fisciano, Siena, Italy Alexei V. Samsonovich, Krasnow Institute for Advanced Study, George Mason University, Fairfax, VA, USA FabioBabiloni,DepartmentofMolecularMedicine,UniversityofRomeSapienza, Rome, Italy Adam Liwo, Faculty of Chemistry, University of Gdansk, Gdansk, Poland RatkoMagjarevic,FacultyofElectricalEngineeringandComputing,Universityof Zagreb, Zagreb, Croatia Lecture Notes in Bioengineering (LNBE) publishes the latest developments in bioengineering. It covers a wide range of topics, including (but not limited to): (cid:129) Bio-inspired Technology & Biomimetics (cid:129) Biosensors (cid:129) Bionanomaterials (cid:129) Biomedical Instrumentation (cid:129) Biological Signal Processing (cid:129) Medical Robotics and Assistive Technology (cid:129) Computational Medicine, Computational Pharmacology and Computational Biology (cid:129) Personalized Medicine (cid:129) Data Analysis in Bioengineering (cid:129) Neuroengineering (cid:129) Bioengineering Ethics OriginalresearchreportedinproceedingsandeditedbooksareatthecoreofLNBE. Monographs presenting cutting-edge findings, new perspectives on classical fields or reviewing the state-of-the art in a certain subfield of bioengineering may exceptionally be considered for publication. Alternatively, they may be redirected to more specific book series. The series’ target audience includes advanced level students, researchers, and industry professionals working at the forefront of their fields. Indexed by SCOPUS, INSPEC, zbMATH, SCImago. More information about this series at https://link.springer.com/bookseries/11564 Franco Simini Pedro Bertemes-Filho (cid:129) Editors Medicine-Based Informatics and Engineering 123 Editors Franco Simini PedroBertemes-Filho Núcleo deIngenieríaBiomédica delas Departamento deEngenharia Elétrica FacultadesdeMedicina eIngeniería Universidade doEstadodeSantaCatarina Universidad delaRepública Joinville, Brazil Montevideo, Uruguay ISSN 2195-271X ISSN 2195-2728 (electronic) Lecture Notesin Bioengineering ISBN978-3-030-87844-3 ISBN978-3-030-87845-0 (eBook) https://doi.org/10.1007/978-3-030-87845-0 ©TheEditor(s)(ifapplicable)andTheAuthor(s),underexclusivelicensetoSpringerNature SwitzerlandAG2022 Thisworkissubjecttocopyright.AllrightsaresolelyandexclusivelylicensedbythePublisher,whether thewholeorpartofthematerialisconcerned,specificallytherightsoftranslation,reprinting,reuseof illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmissionorinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilar ordissimilarmethodologynowknownorhereafterdeveloped. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained hereinorforanyerrorsoromissionsthatmayhavebeenmade.Thepublisherremainsneutralwithregard tojurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Preface Medicine-BasedInformaticsandEngineeringisnowavailableafteramajorregional Congress(Fig.1)oneweekpriortotheoutbreakofCOVID-19pandemicsinLatin America. The plenary and semi-plenary speakers of the 700 strong SABI2020 RegionalMeetingwereinvitedtowriteachapterwhilepreparingtheirpresentations and their—sometimes canceled—trip to Piriápolis, Uruguay. The SABI2020 Biomedical Engineeringand Medical Informatics Congress was a special occasion Fig. 1 SABI2020CongressheldinPiriápolis,UruguayMarch4–6,2020,oneweekbeforethe COVID-19pandemicreachedtheCountry.Plenaryandsemi-plenaryspeakersatSABI2020were invitedtocontributeachapterforthisbook v vi Preface to discuss new devices and software to foster medical care and patient–physician relationship,as well asinterdisciplinary approaches orsocialmotivations. Technology has evolved to such a multiplicity of possibilities, and the software can perform so many different functions, that only meaningful applications should be considered for development and clinical use.The mere fact that aphysiological parametercanbemeasuredorafunctioncanbeperformedisnotbyitselfareason for engineering to suggest a clinical device. To fulfill such adherence of develop- ment efforts to clinical needs, interdisciplinary work is necessary to put forward combinations of medical and technological knowledge to feed the Biomedical Engineering research agenda. This line of thought was the first motivation for the authors to contribute chapters for this book. Within modern technology, information and communication (ICT) are increas- ingly associated and sometimes included in specific hardware technical solutions. Therefore, the classical distinction between “systems engineering” or “software engineering/computer science” on one side and classical engineering (mechanical, electrical, materials, etc.) on the other side is no longer valid. Throughout the book, two concepts are present: (i) Medicine should drive the development of Biomedical Engineering (BME) and Medical Informatics (MI) from available and new technology. Since the limitations of technology are reduced, technology “per se” is no longer the privileged starting point of research. Today, the development of biomedical devices, software and systems can almost freely stem from clinical wish lists and desiderata. (ii) The second idea treated implicitly in the book is that BME and MI should merge into a single body of knowledgetobetterfollowthedemandingclinicalchallengesofmodernmedicine. Having mastered the problems to be solved for survival, physiological compen- sation, repair andpain reduction,BME+MI arenowasked tostartfrombedsideor living milieu to develop ever more sophisticated tools for increasing cohorts of aging populations to contribute to their quality of life: should we call it “Medical Engineering” to include BME+MI? Within this framework, the book includes chapters addressing these ideas from eachauthorownpointofviewandexpertise.Therangeoffieldsinthebookiswide enough to give the reader an overview of what to expect in the coming decades in Medical Engineering, concerning new medical software systems, pervasive medi- cine, wearable devices,prosthesis, intelligent follow-up and anticipatory medicine, aswellastheimpactofinstrument-connectedelectronicclinicalrecord(ECR)with knowledge derived from the use of artificial intelligence (AI) data analysis. Chapter “Medicine Based Engineering and Informatics to Foster Patient Physician Relationship” by Franco Simini describes interdisciplinary work within aUniversityHospital,withdetailsoflessonslearnedwiththedevelopmentofnew devicesandofinnovativeMedicalInformatics,suchasclinicalrecordsystemsand chronic condition patient follow-up applications. The translation of software sys- tems from other activities into medicine is described as the possible cause of delayed adoption of ECR when patient–physician relationship is valued and respected. Part of the chapter mentions Technology Transfer to allow a timely Preface vii disseminationofBME+MIbenefitswithinhealthcaresystems,involvinglicensing to industrial and commercial companies. Chapter “Statistical Gait Analysis Based on Surface Electromyography” by ValentinaAgostiniandcoworkersisonStatisticalGaitAnalysis,acontributiontoa new way to study gait—a basic human motor task—from an Electromyography (EMG) perspective. By processing surface EMG, this chapter introduces Inertial measurements (IMU—inertial measuring unit) to detect muscle activation gait phases in a simple way, robust to repetitions. The follow-up of entire cohorts of patients in the future will depend on the methods and devices derived from this research, optimizing health care system resources. Chapter “Brain-Computer Interfaces with Functional Electrical Stimulation for Motor Neurorehabilitation: From Research to Clinical Practice” by Carolina Tabernig and coworkers deals with brain-computer interfaces and specific reha- bilitation applications, as developed from clinical practice and described in an interdisciplinary approach. Clinical needs clearly drive this research field. Chapter“BiopotentialAcquisitionSystems”byEnriqueSpinelliandcoworkeris an electrical engineering breakthrough contribution to the design of electronic circuits for biopotential amplification. It includes next generation configurations andstateoftheartdesignstoobtainthebestpossiblesignaltonoiseratioinhuman signal capture for all kinds of biomedical devices. Chapter “Wearable Bioimpedance Measuring Devices” by Pedro Bertemes-Filho describes a very special kind of signal derived from biological tissues: bioimpedanceasusedfor wearable devices.Thereisanimmensepotential behind the availability of non invasive time series to monitor (and therefore the opportunity to act upon) diverse physiological parameters, in intensive care, reha- bilitation and assistive devices. Bioimpedance is the modern low cost “general purpose” technology to tackle unsolved problems from a medical perspective with simple non invasive clinical applications. Chapter“PredictiveCardiovascularEngineering:TransformingDataintoFuture InsightsonCardiovascularDisease” byRicardoArmentanoleaves behind decades of cardiology and associated palliative pharmaceutical approach to introduce arte- rial biomechanics to keep us in good health. This is a tremendous “back to the basics” of Medicine made possible by Biomedical Engineering interdisciplinary development stemmed from a profound understanding of cardiovascular physiol- ogy. It is a new approach to arterial biomechanics which allows to act with pre- ventive medicine before any symptoms appear later in age. In Chapter “Engineering Special Medical Devices for Vulnerable Groups”, Martha Ortiz and coworker bridge the gap toward vulnerable groups. Biomedical Engineering and Medical Informatics hold the key to develop special medical devices for all, following WHO recommendations. Chapter“SeriousGamesandVirtualRealityforRehabilitationandFollowupof Wheelchaired Persons” by Marta Bez and coworkers describe the development of seriousgameswithvirtualrealityforrehabilitationandfollow-upofwheel-chaired persons, opening the way for interdisciplinary work by clinicians and engineers. viii Preface Chapter “Society 5.0 and a Human Centred Health Care” by Violeta Bulc and coworkersisaboldintroductiontothinkhealthandtechnologyinanewway,with cooperation from industry, politics, business and scientific research to foster better medical devices and software applications. This synergy empowers individuals, firms and government to a yet to be reached level of connection between clinical needs, societal potential and health care system. Chapter “Clinical Practice, Patient-Physician Relationship and Computers” by Alvaro Díaz Berenguer is a warning to avoid deteriorating the patient–physician relationshipwithmisusesofinformationandcommunicationtechnology.Computer technology does not always respect the delicate empathy necessary to fulfill the basic medical functions. Medical Engineering and Medical Informatics can add considerable efficiency, error reduction, follow-up capacity, but should neither hinder nor replace the human species intrinsic patient–physician relationship. Chapter “Interdisciplinary Collaboration Within Medicine-Based Informatics and Engineering for Societal Impact” by Bianca Vienni and Franco Simini con- sidersMedicalEngineeringandMedicalInformaticsfromanepistemologicalpoint ofview.Intrinsicallyinterdisciplinary,thesubjectmatterofthebookisanalyzedin this chapter from the point of view of “Science, Technology and Society.” It is argued that engineering and medicine are also part of the STEMM conglomerate alongwithmathematics.Readingthischapterwillallowthereader toseethelinks tosocietalchange,asaconsequenceofevermoresophisticateddevices,better(and longer) life spans and closer communications. Medicine and clinical knowledge cannot evolve unconnected to engineering development of devices and software systems. Thisbookisacontributiontoanup-to-dateapproachtoBiomedicalEngineering andMedicalInformaticsfromaninterdisciplinarypointofview,tohelpthereader put forward new ideas and goals. Within this book, diverse clinical applications, technologies and approaches will help the reader adopt criteria to tackle projects starting from clinical problems and using all available technology. Wewishthereaderapleasantandexcitingexperienceindirectcontactwiththe authors, through their carefully written texts, all meant to foster Medical Engineering! Montevideo, Uruguay Franco Simini [email protected] Joinville, SC, Brazil Pedro Bertemes-Filho Editors, Contributors and Co-authors The authors of the chapters of this book are the group of invited speakers at SABI2020 Biomedical Engineering and Medical Informatics Congress held in Piriápolis, Uruguay. The careful selection of plenary and semi-plenary SABI2020 speakerswasagoodopportunitytogathertheirvaluableacademiccontributionsin a book. A few speakers declined writing a chapter, while others were specially invited to contribute with topics within the scope of the book: Medicine-based Engineering and Informatics. The variety of experiences and points of view will help the reader understand how engineering can be part of medicine, provided the goalandstartingpointofengineeringdesignisbasedonclinicalneeds.Inorderof appearance of the chapters, the following are the authors of this book: About the Editors Franco Simini is a professor at the Universidad de la República, Uruguay, PAHO/WHO National Professional (1990–2008), founding member of Espacio Interdisciplinario (2008–2013), pioneering Biomedical Engineering research from Núcleo de Ingeniería Biomédica since 1985 after his Electronics Engineering degree from Universitá degli Studi di Pisa, Italy (1977). He designed telecommu- nications and medical equipment 1978–1989 in Uruguay. As CLABIO2015 and SABI2020organizer,heisactiveinuniversitygovernmentandtechnologytransfer. His research spans from biomedical equipment design to medical reasoning mod- eling in Medical Informatics. Pedro Bertemes-Filho is a professor of Electrical Engineering, Universidade do Estado deSanta Catarina(UDESC),Brazil,anddonePh.D. inMedical Physicsby the University of Sheffield, UK (2002). He is a leader of the Biomedical EngineeringGroupsince2006,aFulbrightresearcheratDartmouthCollege(USA), a member of the Brazilian Society of Biomedical Engineering and IEEE Senior Member, a secretary of the International Society of Electrical Bioimpedance and a ix
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