Towards remote monitoring and remotely supervised training

The growing number of elderly and people with chronic disorders in our western society puts such pressure on our healthcare system that innovative approaches are demanded to make our health care more effective and more efficient. One way of innovation of healthcare can be obtained by introducing new services which enable less pressure on the intramural health care and support a more independent living and self efficacy of patients. Two of such services are Remote monitoring and remotely supervised training (RMT). Remote monitoring enables freedom to the patient with the assurance that assistance is possible whenever required. Remotely supervised treatment enables efficient and effective user-centred training anywhere and anytime with an intensity not feasible in an intramural setting. It is our vision that remote monitoring and remotely supervised treatment applications will become very important for patients (safety, more in control, convenience), health care insurances (efficiency, cost reduction) and healthcare service providers (more effective, innovative)

Constraints on Macroscopic Realism Without Assuming Non-Invasive Measurability

Macroscopic realism is the thesis that macroscopically observable properties must always have definite values. The idea was introduced by Leggett and Garg (1985), who wished to show a conflict with the predictions of quantum theory. However, their analysis required not just the assumption of macroscopic realism per se, but also that the observable properties could be measured non-invasively. In recent years there has been increasing interest in experimental tests of the violation of the Leggett-Garg inequality, but it has remained a matter of controversy whether this second assumption is a reasonable requirement for a macroscopic realist view of quantum theory. In a recent critical assessment Maroney and Timpson (2017) identified three different categories of macroscopic realism, and argued that only the simplest category could be ruled out by Leggett-Garg inequality violations. Allen, Maroney, and Gogioso (2016) then showed that the second of these approaches was also incompatible with quantum theory in Hilbert spaces of dimension 4 or higher. However, we show that the distinction introduced by Maroney and Timpson between the second and third approaches is not noise tolerant, so unfortunately Allen's result, as given, is not directly empirically testable. In this paper we replace Maroney and Timpson's three categories with a parameterization of macroscopic realist models, which can be related to experimental observations in a noise tolerant way, and recover the original definitions in the noise-free limit. We show how this parameterization can be used to experimentally rule out classes of macroscopic realism in Hilbert spaces of dimension 3 or higher, including the category tested by the Leggett-Garg inequality, without any use of the non-invasive measurability assumption.Comment: 20 pages, 10 figure

A serious game for COPD patients to perform physiotherapeutic exercises

The goal of this research was 1) to investigate the usability of the Orange Submarine game, and 2) to explore the changes in saturation and pulse rate in COPD patients while playing the game. The game was positively received by the patients and could provide a new fun way for performing exercises, either at home or as part of the regular treatment

Development of biobased building blocks, polymers and coatings

Coatings are omnipresent in daily life, indispensable in construction and applied everywhere around us to enhance the durability and aesthetics of numerous products ranging from cars to wood to electronics. One of the most conventional sets of building blocks used to build these polymer chains, justified by their high reactivity and broad versatility, are the petrochemical feedstock derived acrylates. Despite their promise, the high demand and the resulting large-scale production from fossil fuels contribute heavily to an unsustainable ecological footprint. As a result of the growing environmental awareness and the desire for a green future, sustainable production of acrylates and the development of acrylate alternatives derived from biorenewable resources have gained increased attention over the last decades. Although great progress has been made, the commercialization of a competing sustainable process has not yet been achieved due techno-economic challenges arising from the underdeveloped larger scale syntheses and expensive starting materials and reagents. In this thesis we implemented both strategies and present several new developments towards sustainable acrylate alternatives (alkoxybutenolides) and biobased acrylic acid, all starting from furfural and using oxygen and visible light for sustainable chemical transformations. In order to account for a larger scale synthesis, a photochemical reactor was developed for the continuous production of our sustainable building blocks. The resulting biobased coatings obtained from these alkoxybutenolides are hard, transparent and resistant to solvent and water, similar to commercial coatings. Above all, the coatings are functional and have tunable properties, based on the different building blocks we developed

MUAP rate and MUAP shape properties in subjects with work-related muscle pain

The objective of this study was to investigate differences in motor control of the trapezius muscle in cases with work-related chronic pain, compared to healthy controls. Ten cases with chronic pain and 13 controls participated in the study. Electromyographic (EMG) signals were recorded from the upper trapezius during five computer work-related tasks. Motor control was assessed using global root-mean-square value (RMSG), motor unit action potential (MUAP) rate (number of MUAPs per second, MR) and two MUAP shape parameters, i.e. root-mean-square (RMSMUAP) and median frequency (FMEDMUAP). MR and FMEDMUAP were higher for the cases than for the controls (P<0.05). RMSMUAP showed a trend for higher values in the chronic pain group (P<0.13), whereas RMSG did not show a significant difference between the groups. The higher MR, FMEDMUAP and the trend for higher RMSMUAP suggest that more high-threshold MUs contribute to low-level computer work-related tasks in chronic pain cases. Additionally, the results suggest that the input of the central nervous system to the muscle is higher in the cases with chronic pain

Telemedicine provides new treatment possibilities in COPD care

Chronic Obstructive Pulmonary Disease (COPD) is a chronic, progressive lung disease. COPD has a high impact on quality of life, large social consequences, a progressive course and it cannot be cured. Physiotherapy, increasing physical participation in daily activities, and early detection and treatment of exacerbations are important elements in current COPD disease management. Home-exercise programmes and self-management of exacerbations are effective new treatment methods. When these programmes are offered as a telemedicine application, they could contribute to a reduction in labour and costs. This paper describes a number of telemedicine applications designed for implementation in COPD care: 1) remote monitoring of physical activity and symptoms; 2) coaching and feedback in daily life to gain an active lifestyle; 3) a web portal for online exercising, self-management of exacerbations and communication between professionals and patient and; 4) serious gaming. For each application we share the motivation, design, and (future) evaluations with the target group: COPD patients. The designed applications are in general positively received by patients and professionals and seem to be able to improve the patient’s well-being. Further development and further scaling of these technologies in everyday care would be an important next step

The political economy of e-learning educational development: Strategies, standardisation and scalability

The development of e-learning by government through policy, funding allocations, research-based collaborative projects and alliances has increased recently in both developed and under-developed nations. The paper notes that government, industry and corporate users are increasingly focusing on standardisation issues and the scalability of technology platforms to meet demand. This paper assesses the challenges for further development that e-learning faces in the coming years, including: access to appropriate technology, scalability, measurement, and changed governance structures. © 2004, Emerald Group Publishing Limite

Changes in circle area after gravity compensation training in chronic stroke patients

After a stroke, many people experience difficulties to selectively activate muscles. As a result many patients move the affected arm in stereotypical patterns. Shoulder abduction is often accompanied by elbow flexion, reducing the ability to extend the elbow. This involuntary coupling reduces the patient's active range of motion. Gravity compensation reduces the activation level of shoulder abductors which limits the amount of coupled elbow flexion. As a result, stroke patients can instantaneously increase their active range of motion [1]. The objective of the present study is to examine whether training in a gravity compensated environment can also lead to an increased range of motion in an unsupported environment. Parts of this work have been presented at EMBC2009, Minneapolis, USA