Global Summit on Telemedicine & eHealth August 17-18, 2015 Houston, Texas, USA

Biography:

Rolf Rossaint is Professor and Head of the Department of Anaesthesiology at the University Hospital (since 1997). Prior to his present appointment, he was Associate Professor in the Clinics for Anaesthesiology and Surgical Intensive Care at the Humboldt University of Berlin. He is member of the National Academy of Science Leopoldina. He has (co) authored over 500 articles in peer-reviewed journals. His clinical and research interests include pulmonary pathophysiology, ARDS treatment, extracorporeal lung assist, xenon anaesthesia, coagulation management, and telemedicine in emergency medicine. He developed a holistic telemedicine system for a broad spectrum of different prehospital emergency cases, which acts now on a routine basis synergistically to the existing ground- and air-based rescue systems.

Abstract:

Objectives: Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that Emergency Medical Services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene. Hence our aim was to develop, to test and to introduce a specific tele-consultation emergency system in routine care. Methods: Telemedical functionalities including audio communication, real-time vital data transmission, 12-lead electrocardiogram, picture transmission on demand and video streaming from a camera embedded into the ceiling of each ambulance and in mobile devices which were used at the scene outside the ambulance were incorporated in the hardware part of the system. The developed medical software is algorithm and guideline-based. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability providing end-to-end measurements. Finally, the system was used in real out of hospital emergencies as part of routine care. Results: In the pilot phase six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicated that the developed system performed well in terms of usability and robustness. The major challenges were as expected, mobile communication and data network availability which was possible in >99% at the end of the development period. After demonstrating the feasibility of the telemedical approach more than 1000 patients were treated within the project phase. In the meanwhile all ambulances of the city of Aachen are staffed with this telemedicine equipment and the system has been established as an additional structure in the care of out-of-hospital EMS. So far, more than 2000 patients have been treated with the help of this telemedicine-based out-of-hospital emergency system. Conclusions: An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organizational and technical aspects were considered and practical requirements specified. The feasibility of the telemedical approach was demonstrated. Tele-consultation enabled early initiation of treatments by paramedics operating under the real-time medical direction. Tele-consultation can be used to provide advanced care until the patient is under a physician's care; moreover, it can be used to support the paramedics who work alone to provide treatment in non-life-threatening as well as in life-threatening emergencies.

Biography:

Steven R Levine is a distinguished Professor of Neurology & Emergency Medicine and Vice Chairman of Neurology, College of Medicine at SUNY Downstate Medical Center in Brooklyn, NY. He is also an Associate Dean for Clinical Research & Faculty Development. He completed his Neurology Residency at University of Michigan and did a 2-year stroke research fellowship. He is a Board Certified Vascular Neurology. He was the Detroit area PI for the NIH-funded NINDS rt-PA Stroke Trial that led to FDA approval of the first treatment for acute ischemic stroke-tissue plasminogen activator (tPA). He serves/served on the Editorial Boards of several peer-reviewed journals and serves as a consultant for NIH, AHA/ASA, NSA and the pharmaceutical industry. He is a local PI for 2 NIH/NINDS-funded clinical trial networks (NETT, NeuroNEXT). He has published over 175 peer-reviewed original papers, 19 case reports, 3 books, 63 book chapters, 71 reviews/invited articles and 33 editorials.

Abstract:

Telestroke is the application of telemedicine to stroke. The use of telemedicine in the ambulance for more precise and rapid prehospital/EMS care of acute stroke patients including performing an NIHSS analysis dates back to 1988 and now with innovative Mobile Stroke Units (MSUs) equiped with head CT scanning in the ambulance, patients are now given intravenous t-PA for acute ischemic stroke prior to hospital arrival in Germany and now in Houston and Cleveland. These studies and their cost effectiveness will be reviewed as will new telemedicine technologies in development for acute stroke. The future should see further research emphasizing better study design and larger sample size to improve reliability of results and conclusions, wearable technology (head-mounted displays), further reductions in response times with incorporating smartphone technology into EMS and thus facilitate patient or bystander incident reporting and prehospital triage-Primary Stroke Center vs. Comprehensive Stroke Center (IA/mechanical thrombectomy)/Neurosurgery for SAH/ICH. Although technological advances will continue to outpace their utilization in clinical practice incorporating emerging technologies into medical practice holds promise in improving care and enhancing clinical outcomes and researchers must continue to evaluate the effectiveness of telemedicine so that communication technology-assisted care is optimized.

Biography:

Alessandro Grattoni has obtained his PhD in Biomedical Engineering at Politecnico of Torino while working in Dr Mauro Ferrari’s team at the University of Texas Health Science Center in Houston. He is an Assistant Professor and Chair of the Nanomedicine Department at HMRI. His laboratory’s research focuses on the development and validation of nanochannel membranes for long-term administration of therapeutics and cell transplantation. This includes experimental and phenomenological analyses within both in vitro and in vivo models. He has received support from NASA, NIH, CASIS, Vivian Smith Foundation, Nancy Owens Memorial Foundation and NanoMedical Systems, Inc.

Abstract:

We have developed a ceramic material-based nanochannel technology for the sustained and controlled administration of therapeutics from implantable devices. The technology leverages the nanoscale interactions between molecules and channels to achieve the tight modulation of drug transport throughout the membrane’s nanochannels. When used in “passive mode”, the device is capable of zero-order sustained release of drugs for months to years without the need for pumping mechanism, as demonstrated in vivo in rodent and canine models. If an electrical filed is applied across the nanofluidic network, drug release can be tuned, interrupted, reactivated with unlimited modulation capabilities. In this case, drug release is controlled by judiciously redistributing the concentration of the ions in solution at the inlet and outlet of nanochannels and generating an ionic concentration polarization. Based on this, we have developed a next generation implant technology which comprises of a drug reservoir, and electrode coated nanochannel membrane a low-energy Bluetooth antenna for RF communications and electronics. The implant can be remotely controlled through radio frequency to activate or interrupt the drug release. This technology has received the attentions of the Center for the Advancement of Science in Space, which is supporting its development in the context of enhanced capabilities for life-science investigations on the International Space Station. Beyond testing in Space, this technology holds massive potential for the implementation of telemedicine approaches on-Earth and the improvement of the quality of life of patients. Furthermore, it mays be adapted to delivering medical care to remote geographical areas or warzones.

Biography:

Professor Philippe Louis ARBEILLE UMPS-CERCOM Medecine Nucleaire/Ultrasons. CHUUniversity HospitalTrousseau - 37044-TOURS-France. Education - Position: - PHD in solid Physics, Faculty of Sciences - Poitiers Univ (1974) - MD General practitioner, Specialized in Clinical Ultrasounds Tours Univ (1984). - Professor of Biophysics, Dept. Nuclear Medicine & Ultrasound – University Hospital Trousseau (Tours-France). - Director of « UMPS » Space Medicine and Physiology research Unit. University Hospital Trousseau (Tours-France) Area of research: 1) Human adaptation and deconditioning in extreme environment (microgravity, bed rest, confinement...) 2) Tele-echography (Robotic arm, motorized transducer, 3D capture, remote echograph) for ground and space application.

Abstract:

Objective: The objective was to design an integrated echograph and motorized probe unit which could be fully controlled from away by an expert. Method: The function (Gain, depth, freeze, PW colour Doppler, 3D capture and measures.) of a commercial echograph were controlled via internet. Two engines inside a probe allowed tilting and rotating the transducer from away according to the movement of expert hand on a dummy probe. A non-sonographer person by the side of the patient located the motorized probe (400 g, 240 cm3) on the patient, on top of the acoustic window of the organ as indicated by the expert by visio conference. Then the expert controlled the orientation of the transducer, until he got the appropriate view of the organ. He also adjusted the image display (Gain, depth.) and activated at his convenience the different function (PW or Colour Doppler, TM, 3D and measures) using a conventional PC keyboard. At last he captured images or video directly on his computer. Results: The system was successfully tested through terrestrial and satellite network on 100 patients with abdominal, vascular and small parts pathologies and pregnancies in small medical centre away from the university hospital. The right diagnostic was found in 90% of the cases. Conclusion: The ergonomy of the tele-operated echograph and probe unit was found particularly well adapted for investigating patient in isolated places was no sonographer was available. It is now schedule to be used for investigating human in extreme environment like space or hostile and restricted places.

Biography:

Abstract:

Although some of the severe consequences of cardiovascular disease (CVD) can be minimized through vital signs monitoring and treatment adherence tools, the magnitude of CVD continues to accelerate globally, with high rates of mortality and hospitalization. The aim of this talk is two-folds: first to present various self-care decisions patients make in everyday life and second to explore the support available for everyday decision making. Focus group studies with CVD patients show that self-care can get quite complicated due to everyday decisions that range from routine ill-structured problems, e.g., “What to eat?” to uncertain symptoms-related decisions, e.g., “Is this pain related to heart burn or heart attack?” to time-constraint treatment-related decisions, e.g., “Do I go to the doctor or wait and see?” Patients should be able to address such ambiguities through the use of appropriate self-management systems by considering the cognitive and behavioural process involved in the choice of behaviours to maintain physiological stability including symptoms monitoring, treatment adherence, and response to symptoms. Literature shows that the current tools available for supporting self-care are based on clearly defined rules and procedures similar to supporting patients in an episodic or acute condition. As CVD is a long-term condition involving multiple patient attributes (knowledge, experience, situation recognition) and treatment attributes, patients need to understand the impact of their decision or of the symptoms in relation to their health condition for deciding an appropriate course of action rather than a rule-based solution to a problem.

Biography:

Abstract:

There has been a vast amount of research in the field of psychological interventions primarily in the efficacy of Cognitive Behavioural Therapy (CBT) for a range of severe mental health disorders. Technological advances in healthcare have shown promise when delivering interventions for mental health problems such as psychosis. The aim of the current project is to develop a mobile phone intervention for people with psychosis and to conduct a feasibility study of the TechCare App. The TechCare App will assess participant’s symptoms and respond with a personalized guided self¬-help based psychological intervention with the aim of reducing participant’s symptoms. The project will recruit 16 service users and 8¬-10 health professionals and will be conducted at the Lancashire Care NHS Foundation Trust Early Intervention Service. In phase one of the study, we will invite people to discuss their experience of psychosis and give their opinions on the existing evidence based treatment (CBT) and how the mobile app can be developed to deliver the intervention in real-time. In phase two, we will complete a test run with a small number of participants (n=4) to refine the mobile intervention (TechCare). Finally, in phase three of the study the TechCare App will be examined in a feasibility study with a total of 12 participants. Hollis et al has suggested a need for the rapid increase in the evidence base for the clinical effectiveness of digital technologies with mHealth research being potentially helpful in addressing the demand on mental health services globally.

Biography:

Abstract:

At the hospital care of a newborn, the iatrogenic risk may be related to the specific side effects of drugs but also to errors during preparation (dilution error, calculation error, error due to combination of two incompatible products from a physicochemical point of view) and or during the administration of products (dose error, administration of a non-prescription medication) committed by the nursing staff. These errors are common and constitute a real concern of medical teams. The steps of preparation and drug administration are particularly at risk. The majority of administration errors are related to the human factor. They are associated with increased stress among nurses. These errors can have consequences for the patient, professionals, health institutions and health insurance. Many studies have proposed and evaluated measures to limit the occurrence of these errors. The research is now shifting focus towards multimodal approaches integrating traceability of operations. However, these measures are struggling to be integrated in daily clinical practice. Hence, the introduction of new technologies in health care system must be considered. To avoid these errors, we propose to design and develop an innovative decision support system based on the technology of Augmented Reality built into intelligent glasses freeing user hands. This system ensures traceability, usability, dynamism, security and transparency for better management of patient medicinal care. The application implemented on the augmented reality glasses have been tested by 7 nurses. Most of them estimate that the glasses enable them to gain time and to reduce the mistakes while preparing drugs.

Biography:

Papadopoulos Homer holds a Physics degree and a Pre-PhD on telecommunications from the University of Athens and a Bio-design graduate certificate from Stanford University US. He has an MBA at Warwick University and he holds a PhD from IS/IT Department of Bath University UK. He has been working for NCSR "Demokritos" for 15 years (now under permanent contract at NCSR “D”DAT) managing various European funded Research programs within the fields of e-services, mobile services and technologies and broadband telecommunication networks. He has published several papers in journals and international conferences. Recently, he has set up a spin off private company, Syndesis Ltd., with a main focus to exploit commercially state of the art bio-medicine technologies and electronic health services.

Abstract:

Elderly people face enough challenges to their independence often related to feeling loneliness to a decline in mobility or cognitive problems. These challenges cause direct or indirect health problems. Within the realm of successful implementation of EU funded projects innovative infrastructures, architectures, IoT and WoT frameworks and applications have been developed for providing e-Health and wellbeing services to cope with this problem. The use cases that will be presented intend to cope with ageing diseases providing advanced, affordable and unobtrusive monitoring and web communication solutions for seniors living independently. The developed systems enhances social care and medical service provision by exploiting “frugal” ICT solutions. The main system components that have been used are low cost video cameras equipped with wireless communication capability to provide monitoring of person’s movements, emotional and physiological parameters. wrist-worn smart phones able to recognize daily activities and monitor some physiological parameters, tablet PC to act as one of the end-user interaction devices with the focus on provision of social awareness of friends and relatives, Web-enabled TV as the main end-user interaction device with end users, machine learning algorithms able to provide decision support and environmental and energy consumption monitoring sensors. Aim of the presentation is to demonstrate the use of these ICT technologies which were implemented and are udner continuous validation over the last three years with real end users, their unofficial carers and doctors. Results demonstrate that the technology readily succeeds in meeting the study`s initial objectives.

Biography:

Michelangelo Bartolo is the Director of Telemedicine Department in S. Giovanni Hospital, Italy. He is the author of about 50 publications in the field of Vascular Disease and Telemedicine Service. In 2005, he has been registered as Medical Practitioner from the Medical Council of Tanganika (Tanzania, east Africa).

Abstract:

Global Health Telemedicine (GHT) is a non-profit organization created in September 2013 in charge of offering specialized medical tele-consultation to Sub-Saharan Africa medical centers. Through a particular software we enhanced, the local doctor can live submit a request to the GHT volunteer specialist attaching clinical question, triage, anamnesis, previous medical examinations and laboratory exams, essential instrumental tests, pictures and videos. Simultaneously, through an SMS, the italian specialist receives the tele-consultation request inviting him to log in the platform in order to proceed to reply. The requesting doctor immediately receive the required advice. Currently the active branches are eight: Cardiology, neurology, ophtalmology, internal medecine, radiology, infectious diseases and dermatology. Twelve GHT centers opened in Central and Southern Africa: Four in Tanzania, three in Malawi, two in Mozambique and one in Angola, Democratic Republic of Congo and Togo. Each GHT center supports already exisiting medical centers and is equipped with basic instrumentation as electrocardiograph, pulse oximeter, back light panels, scanner for x-ray film and internet acces for sending tele-consultation requests. In twenty months activity we provided more than 2500 tele-consultations receiving an average of 30 weekly requests. Cardiology is the most required branch with 2000 tele-consultations (86%) followed by infectious diseases with 150 (6%) and radiology with 60 (3%). Most of these came from Arusha-Tanzania (1257 requests, 50%) and from Beira-Mozambique (750, 26%) which are the first GHT opened centers. The GHT volunteer doctors involved in the project are fifty working in different italian cities and contexts and the average response time is about 17 hours. Our experience clearly shows that the increase in life expectancy in developing countries in which we are involved caused the increase of chronic and before unknown, degenerative diseases as the cardiovascular and the metabolic one. Some of these diseases need a local outpatient tratment and receiving an expert second opinion as a telemedical one would positively impact the patient outcoming.

Biography:

C V Rao has obtained his PhD from Washington State University in 1969. He did his Postdoctoral work at Albert Einstein College of Medicine and Cornell University Medical College. He has joined University of Louisville School of Medicine in 1972 as an Assistant Professor and became Full Professor with tenure in 1979. In 2008, he moved to Herbert Wertheim College of Medicine, Florida International University, Miami. He has extensively published in peer reviewed journals, trained more than 60 post-doctoral and clinical fellows and students and gave 200 invited presentations in the US and around the world.

Abstract:

Birth before 37th completed gestational week is considered preterm. Preterm births are the leading cause of perinatal morbidity and mortality. The prematurely born babies require intensive medical care during the first several weeks after birth followed by medical interventions to take care of short and long term health problems and the developmental disabilities. In addition, parents go through considerable amount of emotional turmoil. Preterm labor results in preterm birth in approximately 40-50% of the cases. The incidence of preterm births is about 10% in US and higher in third world countries. Despite an extensive basic science and clinical research advances, the incidence of preterm birth has not only remained the same but also may now be on the increase. The current therapies with calcium antagonists, calcium channel blockers and non-steroidal anti-inflammatory drugs can delay birth for about 24-48 hours when corticosteroids are administered to increase the fetal lung maturity. These therapies are invariably associated with maternal and fetal side effects and sometimes even death. The paradigm shift on human chorionic gonadotropin (hCG) actions revealed that it can act on human myometrium. It contains hCG/luteinizing hormone receptors and their activation results in an inhibition of contractions in vitro and in vivo in animals and in women. These findings are consistent with the notion that hCG promotes myometrial quiescence which is a prerequisite for pregnancy initiation and continuation. The quiescence declines as pregnancy advances which permits myometrial stimulants to dominate so that they can facilitate normal labor progression. The maintenance of myometrial quiescence by hCG suggests that it could be used for suppression of prematurely activated myometrial contractions that are responsible for preterm birth. In fact, hCG has been shown to be effective in preventing preterm birthin in a mouse model. Based on these findings, several studies have tested hCG as a treatment in women with preterm labor and as a prophylactic to prevent preterm birth. In women with preterm labor, hCG has been found to be just as effective as magnesium sulfate (MgSO4), a first line therapy with an important difference. That is while MgSO4 had side effects in 100% of the women, hCG had none. In another study, hCG treatment prolonged the gestation by approximately 38 days, without any side effects. In prophylactic use, hCG has been found to be superior to micronized vaginal progesterone therapy. In spite of these advances, there are no large scale multinational clinical trials with hCG. hCG is not expensive and is safe to use. In third world countries where access to medical care in rural areas is minimal to non-existent, inexpensive therapies that have a minimal or no maternal or fetal side effects are easy to adopt. Should hCG be proven useful, it is possible to develop combination therapies to increase the treatment effectiveness and oral and other (nanoparticles) hCG administration strategies. hCG therapy may not turn out to be a panacea but it is likely to become an important part of an obstetricians tool box to prevent preterm births.

Biography:

Abstract:

Background: There have been several imaging studies of cervical/lumbar radiculopathy but no three-dimensional (3D) images have shown the position, its running pathway and pathological changes of the nerve roots and spinal root ganglion relative to the bony structure. Moreover, the spinal roots are small and soft and can change shape during motion. Characteristic anatomical features of the nerve roots include curved running, no merkmal and no enhancement with contrast media. The objective of this presentation is to introduce a technique that enables the virtual pathology of the nerve root to be assessed using 3D magnetic resonance (MR)/computed tomography (CT) fusion images that show the compression of the nerve root by the herniated disc, yellow ligament and the bony spur in patients with degenerative cervical/lumbar radiculopathy. Methods: 3D MR images were placed onto 3D CT images using a computer workstation. Results: The entire nerve root could be visualized in 3D with or without the vertebrae. The most important characteristic evident on the images was flattening of the nerve root by a bony spur or hard disc. The affected root was constricted at a pre-ganglion site. In cases of severe deformity, the flattened portion of the root seemed to change the angle of its path resulting in tortuosity. Conclusions: The 3D MR/CT fusion imaging technique enhances visualization of pathoanatomy in lateral spinal hidden area that is composed of the root and inter-vertebral foramen. This technique provides two distinct advantages for diagnosis of radiculopathy. First, the isolation of individual vertebra clarifies the deformities of the whole shape for root groove. Second, the tortuous or twisted condition of a compressed root can be visualized. 3D-MRI/CT fusion imaging is very useful for all clinicians treating irritable radicular pain. In addition, this technique can also be used as educational material for all hospital staff (new doctors, nurses, radiological technicians, therapists, medical students) and for patients and patients’ families who provide informed consent for treatments. Virtual images have thus enabled the visualization of previously inaccessible anatomical locations and depicting conditions clearly at a glance without the need for hard-to-understand medical terminology.

Biography:

Kuanchun Chen received complete medical education in National Defense Medical Center, Taipei, Taiwan during 1992-1999. He completed internal medicine resident and fellowship training in Taipei Veterans General Hospital. Since 1996-November, he began to get involved in a new booming growth area: TeleHealth and now become a team member and leader of TeleCare Services Center of department of cardiology, heart center in Cheng Hsin General Hospital, Taipei, Taiwan. As the pioneer of this field, he tried many possibility of telemedicine in daily medical practice and in different disease population as acute myocardial infarction, hypertension, or diabetes patients.

Abstract:

Tele-ECG triage has been used worldwide in many difference scenarios including home monitoring for arrhythmia detection, post pacemaker or ICD implantation followed up and pre-hospital ECG triage by ambulance staffs; reasons for monitoring including arrhythmia detection, chest pain evaluation for possible acute heart attack. How to shorten diagnosis and treatment delay are challenging to clinical practice. Current guidelines recommend that >75% of patients with ST-elevation myocardial infarction (STEMI) receive primary percutaneous coronary intervention (PPCI) within 90 minutes. The goal has been hardly achievable. Many steps were associated with delay diagnosis and treatment from ED to cathroom. However, ECG reading adds PPCI activation is the most critical step. So we conducted a 2-year before-and-after study to determine the impact of emergency department (ED) tele-electrocardiographic (tele-ECG) triage and interventional cardiologist activation of the infarct team at door-to-balloon time (D2BT) and the proportion of patients undergoing PPCI within 90 minutes since arrival. This triage was successfully shorten D2BT and also associated better clinical outcomes in subsequent 3 years follow up. In my presentation, I will share our experience about what difficulty we face before and after implantation these strategy and possible influence to associated team members.

Biography:

Papadopoulos Homer holds a Physics degree and a Pre-PhD on telecommunications from the University of Athens and a Bio-design graduate certificate from Stanford University US. He has an MBA at Warwick University and he holds a PhD from IS/IT Department of Bath University UK. He has been working for NCSR \\\\\\\"Demokritos\\\\\\\" for 15 years (now under permanent contract at NCSR “D”DAT) managing various European funded Research programs within the fields of e-services, mobile services and technologies and broadband telecommunication networks. He has published several papers in journals and international conferences. Recently, he has set up a spin off private company, Syndesis Ltd., with a main focus to exploit commercially state of the art bio-medicine technologies and electronic health services.

Abstract:

Elderly people face enough challenges to their independence often related to feeling loneliness to a decline in mobility or cognitive problems. These challenges cause direct or indirect health problems. Within the realm of successful implementation of EU funded projects innovative infrastructures, architectures, IoT and WoT frameworks and applications have been developed for providing e-Health and wellbeing services to cope with this problem. The use cases that will be presented intend to cope with ageing diseases providing advanced, affordable and unobtrusive monitoring and web communication solutions for seniors living independently. The developed systems enhances social care and medical service provision by exploiting “frugal” ICT solutions. The main system components that have been used are low cost video cameras equipped with wireless communication capability to provide monitoring of person’s movements, emotional and physiological parameters. Wrist-worn smart phones able to recognize daily activities and monitor some physiological parameters, tablet PC to act as one of the end-user interaction devices with the focus on provision of social awareness of friends and relatives, Web-enabled TV as the main end-user interaction device with end users, machine learning algorithms able to provide decision support and environmental and energy consumption monitoring sensors. Aim of the presentation is to demonstrate the use of these ICT technologies which were implemented and are under continuous validation over the last three years with real end users, their unofficial carers and doctors. Results demonstrate that the technology readily succeeds in meeting the study`s initial objectives.

Biography:

Sarah Ben Othman is a PhD student within CRIStAL laboratory in the Ecole Centrale de Lille (Ec-Lille) in France. Her current work handles: control flow in Emergency Department (ED), assess and anticipate ED crowding mainly in pediatric ED. She developed skills in: modeling and optimization, Supply Chain issues and Decision Support Systems. She is an automation engineer graduated from the National Engineering School of Gabès (ENIG) in Tunisia, in June 2012 and she obtained her master degree in Supply Chain Management in November 2013 from Ec-Lille in France.

Abstract:

At the hospital care of a newborn, the iatrogenic risk may be related to the specific side effects of drugs but also to errors during preparation (dilution error, calculation error, error due to combination of two incompatible products from a physicochemical point of view) and or during the administration of products (dose error, administration of a non-prescription medication) committed by the nursing staff. These errors are common and constitute a real concern of medical teams. The steps of preparation and drug administration are particularly at risk. The majority of administration errors are related to the human factor. They are associated with increased stress among nurses. These errors can have consequences for the patient, professionals, health institutions and health insurance. Many studies have proposed and evaluated measures to limit the occurrence of these errors. The research is now shifting focus towardsmultimodal approaches integrating traceability of operations. However, these measures are struggling to be integrated in daily clinical practice. Hence, the introduction of new technologies in health care system must be considered. To avoid these errors, we propose to design and develop an innovative decision support system based on the technology of Augmented Reality built into intelligent glasses freeing user hands. This system ensures traceability, usability, dynamism, security and transparency for better management of patient medicinal care. The application implemented on the augmented reality glasses have been tested by 7 nurses. Most of them estimate that the glasses enable them to gain time and to reduce the mistakes while preparing drugs.

Biography:

Alessandro Grattoni has obtained his PhD in Biomedical Engineering at Politecnico of Torino while working in Dr Mauro Ferrari’s team at the University of Texas Health Science Center in Houston. He is an Assistant Professor and Chair of the Nano medicine Department at HMRI. His laboratory’s research focuses on the development and validation of nanochannel membranes for long-term administration of therapeutics and cell transplantation.This includes experimental and phenomenological analyses within both in vitro and in vivo models. He has received support from NASA, NIH, CASIS, Vivian Smith Foundation, Nancy Owens Memorial Foundation and Nano Medical Systems, Inc.

Abstract:

We have developed a ceramic material-based nanochannel technology for the sustained and controlled administration of therapeutics from implantable devices. The technology leverages the nanoscale interactions between molecules and channels to achieve the tight modulation of drug transport throughout the membrane’s nanochannels. When used in “passive mode”, the device is capable of zero-order sustained release of drugs for months to years without the need for pumping mechanism, as demonstrated in vivo in rodent and canine models. If an electrical filed is applied across the nanofluidic network, drug release can be tuned, interrupted, reactivated with unlimited modulation capabilities. In this case, drug release is controlled by judiciously redistributing the concentration of the ions in solution at the inlet and outlet of nanochannels and generating an ionic concentration polarization. Based on this, we have developed a next generation implant technology which comprises of a drug reservoir, and electrode coated nanochannel membrane a low-energy Bluetooth antenna for RF communications and electronics. The implant can be remotely controlled through radio frequency to activate or interrupt the drug release. This technology has received the attentions of the Center for the Advancement of Science in Space, which is supporting its development in the context of enhanced capabilities for life-science investigations on the International Space Station. Beyond testing in Space, this technology holds massive potential for the implementation of telemedicine approaches on-Earth and the improvement of the quality of life of patients. Furthermore, it mays be adapted to delivering medical care to remote geographical areas or warzones.

Biography:

Ph Arbeille is the Director of UMPS, Space Medicine and Physiology Research Unit, at University Hospital Trousseau, France. His area of research is Human adaptation and deconditioning in extreme environment (microgravity, bed rest, confinement...), and Tele-echography (Robotic arm, motorized transducer, 3D capture, remote echograph) for ground and space application.

Abstract:

Objective: The objective was to design an integrated echograph and motorized probe unit which could be fully controlled from away by an expert. Method: The function (Gain, depth, freeze, PW colour Doppler, 3D capture and measures.) of a commercial echograph were controlled via internet. Two engines inside a probe allowed tilting and rotating the transducer from away according to the movement of expert hand on a dummy probe. A non-sonographer person by the side of the patient located the motorized probe (400 g, 240 cm3) on the patient, on top of the acoustic window of the organ as indicated by the expert by visio conference. Then the expert controlled the orientation of the transducer, until he got the appropriate view of the organ. He also adjusted the image display (Gain, depth.) and activated at his convenience the different function (PW or Colour Doppler, TM, 3D and measures) using a conventional PC keyboard. At last he captured images or video directly on his computer. Results: The system was successfully tested through terrestrial and satellite network on 100 patients with abdominal, vascular and small parts pathologies and pregnancies in small medical centre away from the university hospital. The right diagnostic was found in 90% of the cases. Conclusion: The ergonomy of the tele-operated echograph and probe unit was found particularly well adapted for investigating patient in isolated places was no sonographer was available. It is now schedule to be used for investigating human in extreme environment like space or hostile and restricted places.

Biography:

Junji Kamogawa (Birth: 1969, PhD; Pathology of autoimmune arthritis: 2000, University of Ehime) is a chief Director of Spine & Sport Center in Shiraishi Hospital, a spinal surgeon, an expert for radiculopathy treatment. His clinical and research interests include spinal pain, microscopic-spinal surgery, spinal imaging, pathology, sport medicine and therapeutic stretching (Awards: Ehime medical 2002, Spine radiology 2013). For future task, he is researching for new image of both sympathetic nerve and epi-dural circulatory dynamics. He wants to get new ideas from experts in other fields such as angiography, MRI physics, and anatomy.

Abstract:

Background: There have been several imaging studies of cervical/lumbar radiculopathy but no three-dimensional (3D) images have shown the position, its running pathway and pathological changes of the nerve roots and spinal root ganglion relative to the bony structure. Moreover, the spinal roots are small and soft and can change shape during motion. Characteristic anatomical features of the nerve roots include curved running, no merkmal and no enhancement with contrast media. The objective of this presentation is to introduce a technique that enables the virtual pathology of the nerve root to be assessed using 3D magnetic resonance (MR)/computed tomography (CT) fusion images that show the compression of the nerve root by the herniated disc, yellow ligament and the bony spur in patients with degenerative cervical/lumbar radiculopathy. Methods: 3D MR images were placed onto 3D CT images using a computer workstation. Results: The entire nerve root could be visualized in 3D with or without the vertebrae. The most important characteristic evident on the images was flattening of the nerve root by a bony spur or hard disc. The affected root was constricted at a pre-ganglion site. In cases of severe deformity, the flattened portion of the root seemed to change the angle of its path resulting in tortuosity. Conclusions: The 3D MR/CT fusion imaging technique enhances visualization of pathoanatomy in lateral spinal hidden area that is composed of the root and inter-vertebral foramen. This technique provides two distinct advantages for diagnosis of radiculopathy. First, the isolation of individual vertebra clarifies the deformities of the whole shape for root groove. Second, the tortuous or twisted condition of a compressed root can be visualized. 3D-MRI/CT fusion imaging is very useful for all clinicians treating irritable radicular pain. In addition, this technique can also be used as educational material for all hospital staff (new doctors, nurses, radiological technicians, therapists, medical students) and for patients and patients’ families who provide informed consent for treatments. Virtual images have thus enabled the visualization of previously inaccessible anatomical locations and depicting conditions clearly at a glance without the need for hard-to-understand medical terminology.

Biography:

Amir Khoshvaghti has completed his PhD of Anatomical Sciences from Shahid Beheshti University of Medical Sciences. He is the Assistant Professor and Head of Department (Basic Sciences of Aerospace and Sub aquatic Medicine Faculty) in Iran. He has published more than 10 papers in reputed journals (English and Farsi). He has also presented more than 30 oral presentations or posters in national and international congresses.

Abstract:

Introduction: Inflight, medical and cardiac emergencies always occur and air travels are increasing every year. There are not so many researches about the problem. Physicians have limited experience because of lack of formal medical education. Cardiac emergencies are not recorded as a standard format by airlines. Telemedicine is considered to provide health care at a distance. Methods: The systematic study has been done for Pub Med articles from 2000-2015. Results: Every year, 17000 in-flight medical emergencies occur in America. It has been shown that there are potential stresses in air travel. Commercial airplanes are pressurized but if pressure reduction happens, there would be a serious problem; hypoxia. Cardiac and respiratory patients (symptomatic coronary disease, uncompensated heart failure, heart congenital and valvular disorders, sickle cell anemia and sleep apnea) will suffer from lack of oxygen. Chest pain and cardiovascular emergencies have been diverted flights in most instances as reported. Discussion & Conclusion: Telemedicine seems as the best solution for the problem especially with supervision of an aerospace medicine specialist. The following suggestions are proposed by aerospace medicine: Travelers screening, educational programs for travelers, education of aircrew, founding a central standard recording system, designing proper medical kits for airplanes and considering telemedicine as the basic necessity for emergencies in air travel.

Biography:

Anandhi Dhukaram is passionate about combining multidisciplinary design approach, technology and cognitive engineering to create a state of the art solution. Her PhD at the University of Birmingham is funded by the European Union project titled \"Pervasive Technology for Cardiac care\". She has been a speaker and presented in various conferences. Her recent work is published in the Journal of Medical Informatics. Before entering academia, she had a distinguished career for more than a decade working for various clients including Accenture, Barclays, and ACNielsen across the globe: India, Australia, Canada, USA and UK.

Abstract:

Although some of the severe consequences of cardiovascular disease (CVD) can be minimized through vital signs monitoring and treatment adherence tools, the magnitude of CVD continues to accelerate globally, with high rates of mortality and hospitalization. The aim of this talk is two-folds: first to present various self-care decisions patients make in everyday life and second to explore the support available for everyday decision making. Focus group studies with CVD patients show that self-care can get quite complicated due to everyday decisions that range from routine ill-structured problems, e.g., “What to eat?” to uncertain symptoms-related decisions, e.g., “Is this pain related to heart burn or heart attack?” to time-constraint treatment-related decisions, e.g., “Do I go to the doctor or wait and see?” Patients should be able to address such ambiguities through the use of appropriate self-management systems by considering the cognitive and behavioural process involved in the choice of behaviours to maintain physiological stability including symptoms monitoring, treatment adherence, and response to symptoms. Literature shows that the current tools available for supporting self-care are based on clearly defined rules and procedures similar to supporting patients in an episodic or acute condition. As CVD is a long-term condition involving multiple patient attributes (knowledge, experience, situation recognition) and treatment attributes, patients need to understand the impact of their decision or of the symptoms in relation to their health condition for deciding an appropriate course of action rather than a rule-based solution to a problem.

Biography:

Esther Arrieta-Cerdán has completed her Medical Degree from Valladolid University and Master in Public Health and Preventive Medicine from Alcalá University. She is a Public Health and Preventive Medicine resident physician in Burgos Universitary Hospital

Abstract:

Telemedicine is a remote medical attention that could be practiced in most medical specialties. Focusing on rural and mountain medicine, there are two examples of projects carried out in the Pyrenees: SUP and STIPP. SUP (Safety and Emergencies in the Pyrenees) had as objective to improve emergency management in different scenarios like mountains, hostile areas and isolated villages. They used portable equipment and specifically worked with ECG in twelve derivations, heart rate, blood pressure, respiratory frequency and O2 saturation in real time. It transmits data by Internet and a specialist physician at hospital helps the rescue team or GP make decisions. The SUP project has improved quality of life in rural areas, optimized limited resources management and enhanced safety and quality in Pyrenees tourism. STIPP (Transfrontier Information System for Prevention in the Pyrenees) objectives are to improve people’s safety in critical situations in cross-border mountains until specialized assistance arrival and to improve risk prevention in Pyrenees by the creation of a transfrontier information system. It gives an instant distribution of information on acts of nature in the mountains, weather information and geo-location by satellite alert system. They have a telemedicine “go” bag placed in mountain shelters and a computer submersible up to 1m, humidity, cold and knock resistant with an anti-glare touch screen. To sum up, telemedicine is a new way of organizing and planning human and material resources, an excellent tool in extra-hospital assistance and guarantees care access and continuity for all patients.