Komunikacja w grupie pacjentów z zaburzeniami świadomości – wnioskiz projektu InteRDoCTor

Thanks to recent advances in health care an increased number of patients may recover from  severe brain injuries, but some of them are still assessed as non-responsive. Reliance on behavioural measures in communication with DoC patients seems be too prone to errors. There is need for solutions providing more objective attempts of bidirectional communication (intentional questions/commands and adequate related responses) in patients with DoC using significant processed by the patient stimuli and novel technologies (EEG-, fMRI-, BCI-based, etc.) based on recent scientific and clinical evidences. Such communication may be fulfilled even in the absence of behavior.This article aims at assessment the extent to which current possibilities in the area of devices for extended communication has been exploited, including own experiences within InteRDoCTor project.Dzięki najnowszym osiągnięciom w opiece zdrowotnej coraz większa liczba pacjentów może powrócić do zdrowia z poważnych urazów mózgu, lecz część z nich jest ciągle diagnozowana jako niereagujący na bodźce. Poleganie jedy-nie na miarach behawioralnych w komunikacji z pacjentami z zaburzeniami świadomości wydaje się zbyt podatne na błędy. Istnieje zapotrzebowanie na rozwiązania zapewniające bardziej obiektywne próby komunikacji dwukierunkowej (celowe pytania/polecenia i odpowiadające im reakcje)u pacjentów z zaburzeniami świadomości, z wykorzystaniem bodźców znaczących dla pacjenta i przetwarzanych przez niego oraz nowych technologii (opartych na EEG, fMRI, BCI, itd.) w oparciu o najnowsze dowody naukowe i kliniczne. Ww. komunikacja może być realizowana nawet w przypadku braku obserwowalnych zmian zachowania pacjenta.Artykuł ma na celu ocenę, w jakim zakresie wykorzystuje się możliwości w tym obszarze, w tym w oparciu o doświadczenia własne z projektu InteRDoCTor

Communication in patients with disorders of consciousness – lessons learned From InteRDoCTor project

Thanks to recent advances in health care an increased number of patients may recover from  severe brain injuries, but some of them are still assessed as non-responsive. Reliance on behavioural measures in communication with DoC patients seems be too prone to errors. There is need for solutions providing more objective attempts of bidirectional communication (intentional questions/commands and adequate related responses) in patients with DoC using significant processed by the patient stimuli and novel technologies (EEG-, fMRI-, BCI-based, etc.) based on recent scientific and clinical evidences. Such communication may be fulfilled even in the absence of behavior. This article aims at assessment the extent to which current possibilities in the area of devices for extended communication has been exploited, including own experiences within InteRDoCTor project.Dzięki najnowszym osiągnięciom w opiece zdrowotnej coraz większa liczba pacjentów może powrócić do zdrowia z poważnych urazów mózgu, lecz część z nich jest ciągle diagnozowana jako niereagujący na bodźce. Poleganie jedy-nie na miarach behawioralnych w komunikacji z pacjentami z zaburzeniami świadomości wydaje się zbyt podatne na błędy. Istnieje zapotrzebowanie na rozwiązania zapewniające bardziej obiektywne próby komunikacji dwukierunkowej (celowe pytania/polecenia i odpowiadające im reakcje)u pacjentów z zaburzeniami świadomości, z wykorzystaniem bodźców znaczących dla pacjenta i przetwarzanych przez niego oraz nowych technologii (opartych na EEG, fMRI, BCI, itd.) w oparciu o najnowsze dowody naukowe i kliniczne. Ww. komunikacja może być realizowana nawet w przypadku braku obserwowalnych zmian zachowania pacjenta. Artykuł ma na celu ocenę, w jakim zakresie wykorzystuje się możliwości w tym obszarze, w tym w oparciu o doświadczenia własne z projektu InteRDoCTor

Bydgoski egzoszkielet na rękę - koncepcja i wyniki wstępne

Possibility of grasping and manipulation of various object constitute basic finctional abilities allowing for further development toward use of tools, hand writing, and other acitivies od daily living. This paper focuses onthe concept ofthe hand exoskeleton for adult patients as far as preliminary findings in th area of improvement of the parameters fo hand with deficit comapred to parameters in healthy hand. It causes not only immediate functional recovery but also shapes this recovery during next phases of the rehabilitation.Możliwość chwytu oraz manipulacje różnymi obiektami stanowią podstawowe umiejętności funkcjonalne umożliwiające dalsze przejście do korzystania z narzędzi, pisania i innych czynności codziennego życia. W niniejszym artykule skupiono się na koncepcji egzoszkieletu na rękę dorosłego człowieka oraz wstępnych wynikach w obszarze poprawy parametrów ręki dysfunkcyjnej w porównaniu z ręką zdrową. Pozwala to nie tylko na natychmiastową poprawę funkcji, ale również na kształtowanie jej w dłuższym okresie czasu podczas dalszych faz rehabilitacji

Związane z pracą niekorzystne zmiany zdrowotne w grupie zawodowej informatyków – narracyjny przegląd literatury

Occupational medicine is increasingly using modern technology and becoming more interdisciplinary. This may be a response to both the development of medical and other sciences that support contemporary clinical practice as well as new therapeutic approaches that are oriented towards collaboration within an interdisciplinary team, are patient-centred and meet the requirements of Evidence-Based Medicine. This article attempts to assess the extent to which opportunities in this area are being exploited and to identify factors that offer opportunities for breakthrough.Medycyna pracy coraz częściej korzysta z nowoczesnych technologii i staje się coraz bardziej interdyscyplinarna. Może to być reakcją zarówno na rozwój nauk medycznych i innych nauk wspierających współczesną praktykę kliniczną, jak również nowe sposoby terapii ukierunkowane na współpracę w ramach zespołu interdyscyplinarnego, zorientowaną na pacjenta i spełniająca wymagania Medycyny Opartej na Faktach. Artykuł stanowi próbę oceny, w jakim stopniu wykorzystuje się możliwości w tym obszarze i wskazania czynników dających szanse na przełom

Egzoszkielet na rękę - koncepcja i rozwój w ramach grantu "Rzeczy są dla ludzi"

The Institute of Computer Science and the Faculty of Mechatronics at Kazimierz Wielki University, together with Edurewolucje Sp. z o. o. z/s in Bydgoszcz, received funding under the 'Things are for people' competition of the National Centre for Research and Development for the project entitled 'Development of a functional arm exoskeleton for active training and rehabilitation'. The aim of the project is to carry out research and development work leading to the development of an innovative technology allowing for the independent rehabilitation ofpeople with special needs (with the participation of rehabilitators and physiotherapists). The project envisages the construction of a prototype of a mechanical rehabilitation robot, the so-called hand exoskeleton, which will support the process of rehabilitation of people with paresis and other specific needs regarding lack of mobility in the hand area. The project will develop specialised, dedicated software that will adapt the strength and type of work of the hand exoskeleton to the current needs and goals of the patient's rehabilitation programme. The aim ofthis paper is to provide an insight into the origins and development of the above concept within the project team during the project work to date.Instytut Informatyki oraz Wydział Mechatroniki Uniwersytetu Kazimierza Wielkiego wraz z firmą Edurewolucje Sp. z o. o. z/s w Bydgoszczy w ramach konkursu Narodowego Centrum Badań i Rozwoju "Rzeczy są dla ludzi" otrzymali dofinansowanie na realizacjęprzedsięwzięcia pn. „Opracowanie funkcjonalnego egzoszkieletu ręki do aktywnego treningu i rehabilitacji”. Celem projektu jest realizacja prac badawczo-rozwojowych prowadzących do opracowania innowacyjnej technologii pozwalającej na samodzielną rehabilitację osób zeszczególnymi potrzebami (przy udziale rehabilitantów i fizjoterapeutów). Projekt przewiduje skonstruowanie prototypu mechanicznego robota rehabilitacyjnego tzw. egzoszkieletu ręki, który wspomoże proces rehabilitacji osób z jej niedowładem oraz innymi szczególnymipotrzebami dotyczącymi braku mobilności w obszarze ręki. W ramach projektu powstanie specjalistyczne, dedykowane oprogramowanie, które będzie dostosowywało siłę i rodzaj pracy egzoszkieletu na rękę do aktualnych potrzeb i celów programu rehabilitacyjnego pacjenta. Celem niniejszej pracy jest przybliżenie powstania i rozwoju ww. koncepcji w ramach zespołu projektowego podczas dotychczasowych prac projektowych

Specificity of 3D Printing and AI-Based Optimization of Medical Devices Using the Example of a Group of Exoskeletons

Three-dimensional-printed medical devices are a separate group of medical devices necessary for the development of personalized medicine. The present article discusses a modern and specific group of medical devices and exoskeletons, which aims to present our own experiences in the selection of materials, design, artificial-intelligence optimization, production, and testing of several generations of various upper limb exoskeletons when considering the Medical Devices Regulation (MDR) and the ISO 13485 and ISO 10993 standards. Work is underway to maintain the methodological rigor inherent in medical devices and to develop new business models to achieve cost-effectiveness so that inadequate legislation does not stop the development of this group of technologies (3D scanning, 3D printing, and reverse engineering) in the healthcare system. The gap between research and engineering practice and clinical 3D printing should be bridged as quickly and as carefully as possible. This measure will ensure the transfer of proven solutions into clinical practice. The growing maturity of 3D printing technology will increasingly impact everyday clinical practice, so it is necessary to prepare medical specialists and strategic and organizational changes to realize the correct implementation based on the needs of patients and clinicians

A Semi-Automated 3D-Printed Chainmail Design Algorithm with Preprogrammed Directional Functions for Hand Exoskeleton

The problem of computerising the design and development of 3D-printed chainmail with programmed directional functions provides a basis for further research, including the automation of medical devices. The scope of the present research was focused on computational optimisation of the selection of materials and shapes for 3D printing, including the design of medical devices, which constitutes a significant scientific, technical, and clinical problem. The aim of this article was to solve the scientific problem of automated or semi-automated efficient and practical design of 3D-printed chainmail with programmed directional functions (variable stiffness/elasticity depending on the direction). We demonstrate for the first time that 3D-printed particles can be arranged into single-layer chainmail with a tunable one- or two-directional bending modulus for use in a medical hand exoskeleton. In the present work, we accomplished this in two ways: based on traditional programming and based on machine learning. This paper presents the novel results of our research, including 3D printouts, providing routes toward the wider implementation of adaptive chainmails. Our research resulted in an automated or semi-automated efficient and practical 3D printed chainmail design with programmed directional functions for a wrist exoskeleton with variable stiffness/flexibility, depending on the direction. We also compared two methodologies of planning and construction: the use of traditional software and machine-learning-based software, with the latter being more efficient for more complex chainmail designs

Intelligent system supporting technological process planning for machining and 3D printing

The study aimed to develop a system supporting technological process planning for machining and 3D printing. Such a system should function similarly to the way human experts act in their fields of expertise and should be capable of gathering the necessary knowledge, analysing data, and drawing conclusions to solve problems. This could be done by utilising artificial intelligence (AI) methods available within such systems. The study proved the usefulness of AI methods and their significant effectiveness in supporting technological process planning. The purpose of this article is to show an intelligent system that includes knowledge, models, and procedures supporting the company’s employees as part of machining and 3D printing. Few works are combining these two types of processing. Nowadays, however, these two types of processing overlap each other into a common concept of hybrid processing. Therefore, in the opinion of the authors, such a comprehensive system is necessary. The system-embedded knowledge takes the form of neural networks, decision trees, and facts. The system is presented using the example of a real enterprise. The intelligent expert system is intended for process engineers who have not yet gathered sufficient experience in technological-process planning, or who have just begun their work in a given production enterprise and are not very familiar with its machinery and other means of production

Personalization of the 3D-Printed Upper Limb Exoskeleton Design—Mechanical and IT Aspects

The human hand is the most precise and versatile tool that nature has given man, and any deficits in this area affect the functional capabilities and quality of human life. Scientists, engineers and clinicians are constantly looking for solutions in the field of diagnosis, treatment, rehabilitation and care of patients with hand function deficits. One such solution is a hand exoskeleton. In the process of designing and testing the hand exoskeleton, emphasis should be placed on the full usability and comfort of the system; hence, the issues of personalization, matching and testing are crucial for the development of the discussed group of solutions. The aim of this paper is to present the possibilities of personalizing 3D-printed medical devicesbased on our own experience in functional user assessment andthe material selection, design, optimization using artificial intelligence and production and testing of several generations of different upper limb exoskeletons, incorporatingthe considerations of the Medical Device Regulation (MDR), ISO 13485 and ISO 10993 standards.The novelty and possible contribution of the proposed approach consist of the possibilities and limitations of the personalization of the upper limb exoskeleton discussed in the article as well as the directions of further development of significant scientific, technical and clinical importance

Intelligent System Supporting Technological Process Planning for Machining

The aim of the study was to develop a system supporting technological process planning, the functioning of which would resemble the way human experts act in their fields of expertise, one capable of gathering necessary knowledge, analysing data, and drawing conclusions to solve problems. This could be done by utilising artificial intelligence (AI) methods available within such systems. The study proved the usefulness of AI methods, and their significant effectiveness in supporting technological process planning. Technological-process planning based on an expert system is divided into the following stages: the selection of the semi-finished products; the establishing of the technological process structure, and the selection of the workpiece instrumentation, machine tools, tools, and tooling and machining parameters for each technological operation. The system-embedded knowledge takes the form of neural networks, decision trees and facts. The system is presented using the example of a real enterprise. The intelligent expert system is dedicated to process engineers who have not yet gathered sufficient experience in technological-process planning, or who have just begun their work in a given production enterprise, and are not very familiar with its machinery and other means of production