Biomedical Principles Research Articles

Hardware-software implementation of a local Wi-Fi network for the transmission of biomedical signals

The object of this study is a wireless local Wi-Fi network for broadcasting biomedical signals, its structure, and principles of construction. The task of minimizing the power consumption of a Wi-Fi transmitter has been addressed, which provides the possibility of building a wireless system for long-term monitoring of biomedical signals. As a result, a functional diagram of a wireless Holter monitoring system based on an ESP32 microcontroller was constructed, which includes a subsystem for setting up and diagnosing system units using MATLAB software packages, an ECG signal generator, and a multifunctional PCIe board from National Instruments. Evaluation criteria and methods for minimizing power consumption by an autonomous Wi-Fi transmitter have been proposed. Methods for synchronizing the working cycles of the transmitter and receiver of the Holter monitoring system were determined. A procedure for determining the optimal biosignal measurement frequency is presented, at which the distortion of ECG signals would be minimal, which means that the signal could be transmitted without losses. The concept of constructing an algorithm for implementing a program for a Wi-Fi transmitter has been developed, ensuring parallel execution of ECG signal measurement operations and their transmission over a local network. The data from semi-naturalistic tests with an experimental Holter monitoring system with a pre-setup subsystem and using external measuring devices, a computer, and the MATLAB software environment are presented. A comparative analysis of the experimental data with primary ECG signals and ECG signals at the receiver output showed a fairly stable correspondence between the input and output ECG signals. The proposed algorithms make it possible to reduce the average current consumption of the ESP32 microcontroller to 50.5 mA. The results of the study demonstrate the possibility of constructing an energy-efficient wireless system for long-term monitoring of biomedical signals based on the Wi-Fi interface

Biopsychosocial model in psychiatry: an anthropo-synergistic view of the problem (Report №1)

The article is devoted to the problem of the identity of psychiatry as a medical science in the descriptive categories of biological reductionism and humanitarian-anthropological approach. The positive and negative aspects of the use of biomedical principles of evidence-based medicine in psychiatric discourse are presented. The importance of cognition of a person as a synergistic (holistic) reality is emphasized, taking into account scientific prejudices. A systematic holistic description of pathokinesis and the content of a mental disorder is given through the study of the emergent qualities of a personality and its potential. The features of various types of biopsychosocial models are given, which, in the opinion of their adherents, provide a systematic approach to the relationship of the biological substrate (the brain) with mental phenomena and social behavior.

Code-Free Machine Learning Solutions for Microscopy Image Processing: Deep Learning.

In recent years, there has been a significant expansion in the realm of processing microscopy images, thanks to the advent of machine learning techniques. These techniques offer diverse applications for image processing. Currently, numerous methods are used for processing microscopy images in the field of biology, ranging from conventional machine learning algorithms to sophisticated deep learning artificial neural networks with millions of parameters. However, a comprehensive grasp of the intricacies of these methods usually necessitates proficiency in programming and advanced mathematics. In our comprehensive review, we explore various widely used deep learning approaches tailored for the processing of microscopy images. Our emphasis is on algorithms that have gained popularity in the field of biology and have been adapted to cater to users lacking programming expertise. In essence, our target audience comprises biologists interested in exploring the potential of deep learning algorithms, even without programming skills. Throughout the review, we elucidate each algorithm's fundamental concepts and capabilities without delving into mathematical and programming complexities. Crucially, all the highlighted algorithms are accessible on open platforms without requiring code, and we provide detailed descriptions and links within our review. It's essential to recognize that addressing each specific problem demands an individualized approach. Consequently, our focus is not on comparing algorithms but on delineating the problems they are adept at solving. In practical scenarios, researchers typically select multiple algorithms suited to their tasks and experimentally determine the most effective one. It is worth noting that microscopy extends beyond the realm of biology; its applications span diverse fields such as geology and material science. Although our review predominantly centers on biomedical applications, the algorithms and principles outlined here are equally applicable to other scientific domains. Furthermore, a number of the proposed solutions can be modified for use in entirely distinct computer vision cases.

Biomedical and ethical principles of transplantation in the context of the protection of human rights and the application of the EEC Convention

The article examines the biomedical and ethical principles of transplantation in the context of the protection of human rights and the application of the Oviedo Convention. The Convention on Human Rights and Biomedicine established the basic principles of protection of living donors (Article 19 and Article 20), in particular directed against any financial or comparable benefit resulting from the use of the human body or body parts (Article 21). The additional protocol to the Convention extended their effect to all aspects of the transplantation process, in particular the procurement and distribution of organs and tissues and the technical and medical techniques used in this process. It is noted that the requirement for the transplantation system is to ensure the safety of potential recipients by guaranteed tracking of the origin of all organs, tissues or cells intended for transplantation. This requirement should not conflict with the need to protect the privacy and personal data of donors and recipients. Its ultimate goal, together with the requirement to comply with ethical standards, is to optimally use the available organs while simultaneously reducing the possibility of their unfair distribution and preventing the risk of trafficking in them. It was emphasized that the Additional Protocol establishes important requirements of transparency and fairness: the transplantation system created in the states must be well structured, take into account all available organs and follow the official sequence of their distribution (Article 3). The nature or organization of the transplantation system is not defined in the Additional Protocol itself, so whether to involve local, regional, national or international organizations in order to guarantee the functioning of such a system is up to each state to decide at its own discretion. Transplant candidates should be prioritized on a medical basis, and the persons or bodies responsible for deciding on the allocation of places in the queue should adhere to this framework. The transparency of the distribution system of donor materials is important in this aspect. This is stated, in particular, in Art. 3 of the Protocol, according to which the transplantation system itself exists to ensure fair access of patients to transplantation services. At the same time, organs and tissues «are distributed only among patients from the official waiting list according to transparent, objective and duly confirmed rules and medical indications», and the transplantation system «provides for the collection and recording of information that is necessary to ensure the tracking of organs and tissues» .

길랑바레증후군에 대한 ‘의학적 상상’

Guillan-Barré Syndrome (GBS) is a rare neuropathic disease characterized by the monophasic progression of paralysis, affecting the limbs and the trunk, and by the high rate of recovery. The condition is frequently preceded by intestinal infection caused by Campylobacter jejuni, on the basis of which it is believed that the destruction of the myelin sheath covering the peripheral nerve is triggered by a mechanism called ‘molecular mimicry.’ This process occurs when antibodies created by previously generated bacterial infection mistakenly attack the nerve tissues by the misrecognition of molecular markers. This article engages with this interesting condition philosophically through the concept of ‘imaginary’ based on the author’s role as a physician of Korean medicine, the mainstream medical profession in South Korea associated with the practice of traditional East Asian medicine (EAM). With some epistemic freedom from the constraining ‘embrace’ of biomedical principles granted by that positionality, the author offers two imaginaries concerning GBS: one linguistic, the other EAM-based. For the linguistic interpretation, the author argues, based on studies on walking that illustrate the shared properties between walking and speech (having rhythm and cadence, as well as the intent to engage with the outside world), the paralysis of GBS can be analogous to that of speech, i.e. mutism or aphasia, in that those shared properties disintegrate. For the EAM-based interpretation, the author argues that given the non-musculoskeletal characteristics manifested in GBS, the condition can be considered as ‘the cold-damp disorder’(寒濕病), or diarrheal disease, in the imaginaries of EAM. These deliberations open the door for philosophical engagement with medical conditions for improving the clinical management of GBS.

Transgenderism: Bioethical Issues

The article analyses bioethical problems related to the concept of transgenderism and its understanding in the framework of biomedical discourse. The concept of “transgenderism” is linked with medicine, and gender dysphoria (International Classification of Diseases, 11th Edition) in particular. At the same time, the concept of transgenderism interacts with the social context. The article shows that the perception of transgenderism and transgenders by society has an impact both on the medical discourse and the notion of transgenderism in its context, and on the perception of “ordinary” people, or cisgender people, which is due to the gradual normalization of transgenderism. Thus, the concept of transgenderism requires an interdisciplinary approach and ethical, philosophical and bioethical consideration. Since the analyzed concept is directly related to medical problems, this study is based not only on bioethical studies, but also on sources in the field of medicine and sociological studies related to medicine. The article also analyzes the problem of applying the biomedical principles nonmaleficence" and principle of autonomy by Beauchamp and Childress, that have specifics applied to transgender children. This is due to the connection of transgenderism with another problem that lies in the interdisciplinary field —suicide. A number of studies on the quality of life of transgender people, as well as encyclopedic literature, mention suicidal thoughts and suicide attempts of transgenders. The article shows how the reinterpretation of transgenderism and its normalization change the boundaries of medical discourse, deducing transgenderism and suicide from medicine. The author concludes that the normalization of transgenderism and the change of its place in the medical discourse entails not only a transformation of medical discourse, but also affects other concepts like suicide, changes the approach to the treatment of transgender children, making the therapy of such children questionable from bioethical viewpoint.

A course in medical device design & commercialization for medical students pursuing surgical fields

BackgroundThe modern surgeon faces an ever-changing landscape of procedural innovation. The demands of present-day healthcare highlight the importance of successfully developing new medical devices and technologies. This effort requires multidisciplinary collaborations of professionals ranging from manufacturers and engineers to researchers and healthcare providers. Surgeons regularly interact with complex equipment and user interfaces without substantial formal education on their design and development. The objective of this study was to ascertain the impact of a 10-week BME course into a medical school curriculum on surgery-bound students’ knowledge of product design and gauge their ability to develop an actual product to meet a real need in a surgical field. MethodsA Medical Device Design and Commercialization co-enrolled elective course was offered to medical students at a single institution. Five students with an expressed surgical and procedural interest were enrolled. At the beginning of the course, they were tasked with developing a product to meet a clinical need they observed. At the conclusion of the course, students filled out a questionnaire about their level of comfort and knowledge of the material using a 5-point Likert scale. This survey was administered to a control group of medical students who did not take the course. ResultsThe BME student cohort was able to successfully identify a post-operative need, develop a prototype of a novel device, and present their product to attending surgeons. A total of 35 survey entries were received: five from the experimental group and 30 from the comparison group. The experimental group scored higher than the comparison group for all survey questions and reached the level of statistical significance in 13 of the 15 questions (p < 0.05). Survey respondents reported similar degrees of knowledge and comfort in recognizing unmet needs in a hospital setting and formulating a comprehensive statement describing them. ConclusionThe principles of biomedical engineering are integral to advancing the field of surgery. Presently, a small cohort of medical students/residents successfully acquired and applied basic BME concepts in a relatively short period of time relative to other training paradigms. Our findings also suggest medical students recognize unmet needs in the hospital setting, and those who completed a BME course felt more able to take steps to meet those needs. Early integration of biomedical engineering principles in medical training may help produce more innovative and well-rounded surgeons.

Neuromuscular dentistry - A myth or reality: A literature review

Neuromuscular dentistry is the treatment philosophy involving all the important structures like teeth, muscles (associated nerves), temporomandibular joint and the interrelation between them. The ultimate aim of a doctor is to restore and maintain the well being of the patients’ stomatognathic system, and to have a long term favourable prognosis of the treatment provided. As the need of the hour, the treatment protocols should be evidence based and must have the approval of independent studies and researches. Relationship between occlusion, posture and TMDs has been a debatable topic in prosthodontics. Rectifying the occlusal and postural abnormalities to treat Temporomandibular disorders according to pathophysiological concepts is under extensive scrutiny. The muscles act as the driving force of the whole system which works in co-ordination with its neural stimulation. This discipline is a comprehensive concept of a dynamic stomatognathic system that are in lines with the biomedical principles governing the other organs to treat the patient. This speciality uses highly advanced instrumentation to quantify the subjective parameters of lower jaw movements and formulate a robust diagnosis and treatment plan. There exists a group of believers and non- believers who still co-exist and the philosophy is still not universally accepted. This literature reviews attempts to provide an insight on the topic.

Creative Contributions of the Methods of a Biomimetic Inventive Design of Novel Medical Drainage Materials Derived From Polyvinyl Alcohol Foam with Air Cavities Bioinspired by Avian Skeleton and Feather Rachises

Traditional drainage materials used in a surgical treatment or in wound management are not good enough in both the effectiveness and efficiency because they may cause infection due to their characteristics. Therefore, a novel drainage material should be essential and designed to solve the problem. Avian skeleton and feather rachises may be good reference objects to mimic in designing a novel drainage material because its good cell structure which support a bird to fly safe and efficient. The term “nature-Bioinspired” is associated with a sequence of efforts to understand, synthesize and imitate any natural object or phenomenon either in a tangible or intangible form, which allows us to obtain improved insights into nature. Such inspirations can come through materials, processes, or designs. In this study, a new medical matrix derived from polyvinyl alcohol foam with air cavities inspired by avian skeleton and feather rachises for drainage medical treatments was designed, prepared, and characterized. Establishment of biomimetic biomedical inventive principles and a bio-inspired design-thinking method for innovative design of biomimetic medical devices and biomaterials were achieved. Also, the medical device (MD) unified problem-driven bioinspired evaluating approach was established to guide biomimetic design of biomaterials and the corresponding medical devices for various clinic applications.

Blind Spots Reconsidered – Epistemic Injustice in Clinical Ethics Support

"Conducting ethical case discussions is a core aspect of any clinical ethics support service or work as an ethical consultant in a hospital. Numerous case discussion methods can be used to do this, many of which are based on Beauchamp and Childress’ four biomedical principles. Other commonly used types are the ‘moral case deliberations’ by prominent authors such as Widdershoven, Molewijk et al. However, based on our practical work as clinical ethicists, and doctoral students in the field of clinical ethics, we would like to hypothesize that most of the methods seem to be in need of philosophical supplementation, especially on the blind spots regarding the is-ought fallacy, i.e. how to relate empirical data to normative conclusions. A further weakness may be found in the inadequate handling of power structures, which may lead to an unjust handling of opinions. In our talk, we will therefore present Miranda Fricker’s conceptual idea of ‘epistemic injustice’ and we will apply these insights to clinical cases of our everyday practice. Epistemic injustice is injustice related to knowledge. The concept focuses on exclusion and silencing people in public discourse. This silencing leads to a systematic distortion or misrepresentation of one’s meanings or contributions and/or to an undervaluing of someone’s status in communicative practices. We think that this concept has not been considered in clinical ethics thus far, and we would like to discuss whether ethical case discussions should not help to avoid epistemic injustice. If so, then the case discussion methods of our discipline should be adapted accordingly. "

Revival or Innovation? Chinese medicine at the crossroads of professionalization in Hong Kong

Based on 67 in-depth interviews of Chinese medicine (CM) Practitioners in Hong Kong, this paper reviews the ongoing debate within Hong Kong's CM community between the two pathways of professionalization: revival of the Chinese traditional knowledge or innovate by incorporating biomedical principles. Following earlier efforts to apply social movement perspectives onto the study of professionalization, we examine how segments of CM practitioners strive to forge divergent collective identities in their quest for professional status along three analytical dimensions: consciousness, boundary and strategies. This paper deepens our understanding of the professionalization of complementary and alternative medicines by documenting the construction of distinctive sub-identities not just over how the modality should interact with the mainstream biomedicine but also how to interpret the essence of their own practice. It shall also account for the emergence of the schism of professional identities in Hong Kong as distinctive results of the institutional configuration of the Hong Kong medical system under the One Country Two Systems, shaped by the twin forces of biomedical dominance locally as well as the thrust towards integrative medicines in Mainland China.

A Tomada de decisão em prevenção quaternária

Introdução: O processo de tomada de decisões na prática clínica pode ser analisado sobre diversos aspectos, que confluem em um caminho que tramita entre o conhecimento teórico e a sua aplicação na prática. Nas situações que envolvem bioética, as questões que envolvem as tomadas de decisão são ainda mais complexas, considerando que são momentos que tangenciam a subjetividade dos atores envolvidos. Objetivo: Verificar as tendências de justificativa bioética durante as tomadas de decisão que envolvem situações clínicas de prevenção quaternária entre residentes e preceptores de medicina de família e comunidade. Métodos: Qualitativo, utilizando como instrumento entrevistas projetivas individuais, com vinhetas clínicas fictícias como gatilho das perguntas norteadoras da entrevista. Após a transcrição das mesmas, foi realizado a técnica de análise temática do material. Resultados: Os participantes tiveram uma tendência em justificar suas escolhas de tomada de decisão através de três grandes blocos temáticos, que se relacionam entre si. O primeiro bloco foi a justificativa das tomadas de decisão pelos conhecimentos científicos, o segundo bloco foi baseado nos princípios biomédicos principialistas e o terceiro bloco foi um conteúdo relacionado a relação médico paciente. Conclusões: Pela discussão destes resultados foi possível verificar que existe uma trama entre objetividade clínica e subjetividade pessoal, que não demonstram ser concorrentes, mas sim simbióticas, para alcançar o fim único que é a beneficência do usuário.

The Infectious Diseases Act and Resource Allocation during the COVID-19 Pandemic in Bangladesh.

The Infectious Diseases (Prevention, Control and Eradication) Act entered into force officially on 14 November 2018 in Bangladesh. The Act is designed to raise awareness of, prevent, control, and eradicate infectious or communicable diseases to address public health emergencies and reduce health risks. A novel coronavirus disease (COVID-19) was first identified in Bangladesh on 8 March 2020, and the Ministry of Health and Family Welfare issued a gazette on 23 March, listing COVID-19 as an infectious disease and addressing COVID-19 as a public health emergency. The gazette empowers the government to monitor the spread of infection. Despite there being an infrastructure of research ethics committees in almost all hospitals in Bangladesh, a lack of such committees in the clinical setting often forces healthcare professionals to allocate scarce healthcare resources to the task. These personnel are often either influenced by materialistic matters or guided by the emergency policies, without reaching a consensus on how to allocate scarce resources in times of need, especially in the time of the COVID-19 pandemic. Ethical dilemmas often arise when a number of patients with COVID-19, especially in poor and middle-class areas, are denied care while elites are prioritized to receive such scarce resources. Resource allocation in healthcare during the COVID-19 pandemic in Bangladesh appears to be unethical and in direct conflict with the biomedical principles of non-maleficence and procedural justice. The findings of this study suggest that the Act needs substantive changes in the stipulation of policy directing hospitals in the provision of resource allocation framework. Furthermore, parliament should produce guidance outlining how to successfully implement the law with the aim of protecting public health in times of emergency, especially the COVID-19 pandemic.

Penn State College of Medicine.

Penn State College of Medicine.

Making the Connection: Using Concept Mapping to Bring the Basic Sciences to the Diagnosis.

Although medical education has historically emphasized the role and importance of basic science in clinical reasoning, educators have struggled to teach basic science to optimize its use for students. Concept mapping helps students develop relationships between basic and clinical science, which can enhance understanding of the material. Educators at the University of New England College of Osteopathic Medicine developed a weekly concept-mapping activity connecting biomedical principles with clinical signs, symptoms, and laboratory values from a comprehensive clinical case. This activity elicits cross-disciplinary discussion, illustrates content integration by the students, and enhances faculty collaboration across disciplines.

Life Origin on Earth, Knowledge Development

An enigmatic and important feature of life origin on Earth is embodied with a number of different hypotheses and knowledge based on experimental data and biomedical principles. These hypotheses and understanding generally contain some small-scale experimental simulation, chemical structure comparisons and a series of guesswork from existing biological knowledge and principles. So far, there is no widely agreement of single hypothesis without significant arguments and conflicts between researchers of different disciplines and individual biological characters. Thus, it needs more heated debates, cooperation and circulation for life origin topics academically and in large media to all human population. These debates and publication may invite interests of non-academic careers and solve this enigma from widest human professions. Keywords : Human evolution, life-origin, RNA-world, systems biology, genetic information system, environmental ecology.

Development and Presentation of an Ethical Framework for Health and Medical Apps

The ubiquity of mobile applications makes it difficult to weigh up opportunities and potential risks. One significant aspect of an ethical assessment regarding the development and use of health and medical apps is the lack of clear and consistent guidelines and measures of value. Aim: The aim of this paper was to identify the main ethical determinants associated in the context of health and medical apps and develop a framework for ethical reflection. Methods: A systematic literature search in the database PubMed was undertaken and the journal Biomed Central Medical Ethics was hand searched and 32 met the review criteria. On this basis of the review an interview guide was developed and five purposively selected experts on the field of payers, science, consumers, medical ethics and society were interviewed regarding health and medical apps. Results: There is a lack of consistent and clear guidelines regarding the use of health and medical apps in literature. Indeed, findings refer to established biomedical principles. The interviews identified that several insecurities related to legal and regulatory issues are common. On the other hand, many advantages of the use of health and medical apps have been pointed out by experts. Conclusion: Debates on ethics and the use of health and medical apps should play a significant role in public discussion. Ethical endpoints cannot be considered isolated from each other, and must be regarded as a complex network of aspects connected with each other. Further research should concentrate on the development of consistent guidelines and a framework for reflection of occurring ethical concerns.

Promoting Scholarship at Regional Medical Campuses

Multiple regional medical campuses (RMCs) have been established in North America as part of the effort to train physicians in locations geographically removed from the main medical school campus. RMCs may vary in size, geographic location and mission from the main campus, but scholarly activity by faculty and students is expected and should be promoted on all campuses. If the definition of scholarship is limited to research demonstrated by publication, and academic recognition and advancement is largely based on this criterion, faculty at the RMC who fail to participate may be at a disadvantage. Thus, in addition to expanding research opportunities at the RMC, it is argued that the definition of scholarship needs to be expanded to recognize the accomplishments of RMC faculty. RMC students must also be introduced to biomedical research principles and provided opportunities to engage in scholarly pursuits. Documented participation in scholarly activity may be necessary to make the student more competitive for residency positions. The authors review an expanded definition of scholarship, present an approach to promote faculty and student scholarship, and describe achievable options for scholarly activity on the RMC.

Suppression of Metastasis by Primary Tumor and Acceleration of Metastasis Following Primary Tumor Resection: A Natural Law?

We study metastatic cancer progression through an extremely general individual-patient mathematical model that is rooted in the contemporary understanding of the underlying biomedical processes yet is essentially free of specific biological assumptions of mechanistic nature. The model accounts for primary tumor growth and resection, shedding of metastases off the primary tumor and their selection, dormancy and growth in a given secondary site. However, functional parameters descriptive of these processes are assumed to be essentially arbitrary. In spite of such generality, the model allows for computing the distribution of site-specific sizes of detectable metastases in closed form. Under the assumption of exponential growth of metastases before and after primary tumor resection, we showed that, regardless of other model parameters and for every set of site-specific volumes of detected metastases, the model-based likelihood-maximizing scenario is always the same: complete suppression of metastatic growth before primary tumor resection followed by an abrupt growth acceleration after surgery. This scenario is commonly observed in clinical practice and is supported by a wealth of experimental and clinical studies conducted over the last 110years. Furthermore, several biological mechanisms have been identified that could bring about suppression of metastasis by the primary tumor and accelerated vascularization and growth of metastases after primary tumor resection. To the best of our knowledge, the methodology for uncovering general biomedical principles developed in this work is new.

Acquired Immunodeficiency Syndrome A Forensic Perspective

This article provides a review of the science of HIV/AIDS for nonspecialist stakeholders such as lawyers, regulators, and policy analysts. The purpose of the article is twofold: it (1) aims to communicate the biomedical principles that underlie the pandemic in a rigorous yet accessible format and (2) shows that an understanding of the interaction between a legal rule and medical science is essential if the intended meaning, purpose, and policy rationale of the rule are to be preserved. It illustrates the interaction between law and science by analyzing the application of a doctrine in medical malpractice to litigation involving HIV/AIDS. It then draws parallels to other emerging diseases and shows how the analysis can be generalized and extended to legal issues involving any novel disease.