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McGrath C, Chau CWR, Molina GF. Monitoring oral health remotely: ethical considerations when using AI among vulnerable populations. FRONTIERS IN ORAL HEALTH 2025; 6:1587630. [PMID: 40297341 PMCID: PMC12034695 DOI: 10.3389/froh.2025.1587630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2025] [Accepted: 03/31/2025] [Indexed: 04/30/2025] Open
Abstract
Technological innovations in dentistry are revolutionizing the monitoring and management of oral health. This perspective article critically examines the rapid expansion of remote monitoring technologies-including artificial intelligence (AI)-driven diagnostics, electronic health records (EHR), wearable devices, mobile health applications, and chatbots-and discusses their ethical, legal, and social implications. The accelerated adoption of these digital tools, particularly in the wake of the COVID-19 pandemic, has enhanced accessibility to care while simultaneously raising significant concerns regarding patient consent, data privacy, and algorithmic biases. We review current applications ranging from AI-assisted detection of dental pathologies to blockchain-enabled data transfer within EHR systems, highlighting the potential for improved diagnostic accuracy and the risks associated with over-reliance on remote assessments. Furthermore, we underscore the challenges posed by the digital divide, where disparities in digital literacy and access may inadvertently exacerbate existing socio-economic and health inequalities. This article calls for the development and rigorous implementation of ethical frameworks and regulatory guidelines that ensure the reliability, transparency, and accountability of digital health innovations. By integrating multidisciplinary insights, our discussion aims to foster a balanced approach that maximizes the clinical benefits of emerging technologies while safeguarding patient autonomy and promoting equitable healthcare delivery.
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Affiliation(s)
- Colman McGrath
- Applied Oral Sciences and Community Dental Care Division, The Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chun Wang Reinhard Chau
- Applied Oral Sciences and Community Dental Care Division, The Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Gustavo Fabián Molina
- Special Care Dentistry, School of Dentistry, Universidad Católica de Córdoba, Cordoba, Argentina
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Ibrahim M, Al-Wadi A, Elhafiz R. Security Analysis for Smart Healthcare Systems. SENSORS (BASEL, SWITZERLAND) 2024; 24:3375. [PMID: 38894166 PMCID: PMC11175093 DOI: 10.3390/s24113375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
The healthcare industry went through reformation by integrating the Internet of Medical Things (IoMT) to enable data harnessing by transmission mediums from different devices, about patients to healthcare staff devices, for further analysis through cloud-based servers for proper diagnosis of patients, yielding efficient and accurate results. However, IoMT technology is accompanied by a set of drawbacks in terms of security risks and vulnerabilities, such as violating and exposing patients' sensitive and confidential data. Further, the network traffic data is prone to interception attacks caused by a wireless type of communication and alteration of data, which could cause unwanted outcomes. The advocated scheme provides insight into a robust Intrusion Detection System (IDS) for IoMT networks. It leverages a honeypot to divert attackers away from critical systems, reducing the attack surface. Additionally, the IDS employs an ensemble method combining Logistic Regression and K-Nearest Neighbor algorithms. This approach harnesses the strengths of both algorithms to improve attack detection accuracy and robustness. This work analyzes the impact, performance, accuracy, and precision outcomes of the used model on two IoMT-related datasets which contain multiple attack types such as Man-In-The-Middle (MITM), Data Injection, and Distributed Denial of Services (DDOS). The yielded results showed that the proposed ensemble method was effective in detecting intrusion attempts and classifying them as attacks or normal network traffic, with a high accuracy of 92.5% for the first dataset and 99.54% for the second dataset and a precision of 96.74% for the first dataset and 99.228% for the second dataset.
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Affiliation(s)
- Mariam Ibrahim
- Department of Mechatronics Engineering, German Jordanian University, Amman 11180, Jordan; (A.A.-W.); (R.E.)
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Tettey F, Parupelli SK, Desai S. A Review of Biomedical Devices: Classification, Regulatory Guidelines, Human Factors, Software as a Medical Device, and Cybersecurity. BIOMEDICAL MATERIALS & DEVICES 2024; 2:316-341. [DOI: 10.1007/s44174-023-00113-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/29/2023] [Indexed: 01/05/2025]
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Yogev D, Goldberg T, Arami A, Tejman-Yarden S, Winkler TE, Maoz BM. Current state of the art and future directions for implantable sensors in medical technology: Clinical needs and engineering challenges. APL Bioeng 2023; 7:031506. [PMID: 37781727 PMCID: PMC10539032 DOI: 10.1063/5.0152290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Implantable sensors have revolutionized the way we monitor biophysical and biochemical parameters by enabling real-time closed-loop intervention or therapy. These technologies align with the new era of healthcare known as healthcare 5.0, which encompasses smart disease control and detection, virtual care, intelligent health management, smart monitoring, and decision-making. This review explores the diverse biomedical applications of implantable temperature, mechanical, electrophysiological, optical, and electrochemical sensors. We delve into the engineering principles that serve as the foundation for their development. We also address the challenges faced by researchers and designers in bridging the gap between implantable sensor research and their clinical adoption by emphasizing the importance of careful consideration of clinical requirements and engineering challenges. We highlight the need for future research to explore issues such as long-term performance, biocompatibility, and power sources, as well as the potential for implantable sensors to transform healthcare across multiple disciplines. It is evident that implantable sensors have immense potential in the field of medical technology. However, the gap between research and clinical adoption remains wide, and there are still major obstacles to overcome before they can become a widely adopted part of medical practice.
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Affiliation(s)
| | | | | | | | | | - Ben M. Maoz
- Authors to whom correspondence should be addressed: and
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Schulz S, Harzheim L, Hübner C, Lorke M, Jünger S, Woopen C. Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants - a scoping review. BMC Med Ethics 2023; 24:68. [PMID: 37641094 PMCID: PMC10464431 DOI: 10.1186/s12910-023-00945-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals' lifeworlds and need to be considered in implant care and in the course of technical developments. METHODS This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. RESULTS Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. CONCLUSIONS Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in "lived experiences" may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design.
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Affiliation(s)
- Sabine Schulz
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany.
| | - Laura Harzheim
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics, University of Bonn, 53113, Bonn, Germany
| | - Mariya Lorke
- Faculty of Engineering and Mathematics, University of Applied Sciences and Arts (HSBI), 33619, Bielefeld, Germany
| | - Saskia Jünger
- Department of Community Health, University of Applied Health Sciences Bochum, Gesundheitscampus 6-8, 44801, Bochum, Germany
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Serrano MJ, Rolfo C, Expósito-Hernandez J, Garrido-Navas C, Lopez-Hidalgo J, Denninghoff V. Circulating tumor cells in cancer-risk populations as a cancer interception tool. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2023; 381:113-129. [PMID: 37739481 DOI: 10.1016/bs.ircmb.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Cancer interception (CI) is a new approach to cancer prevention and treatment in a cancer-risk population that aims to detect and treat pre-tumoral stages. It has several potential advantages over traditional cancer diagnosis and monitoring methods because it is non-invasive, making it less painful and risky than conventional biopsy procedures. The circulating tumor cells (CTCs), liquid biopsy family members, are essential for the CI approach; then, the liquid biopsy (LB) is used as a CI tool. LB can be performed frequently because of its easy sampling and early pathological stages, which allow repeated non-invasive monitoring of cancer progression and response to treatment. CTCs have been found in the bloodstream of several types of cancer patients, including in early-stage cancer and premalignant lesions, suggesting a tumor development role in cancer's early stages. This chapter will present foundational scientific studies addressing CI and the clinical impact of CTC screening in a population at risk for cancer.
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Affiliation(s)
- María José Serrano
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, Granada, Spain; IBS Granada, Biosanitary Research Institute, Spain; Comprehensive Oncology Division, Virgen de las Nieves University Hospital, Granada, Spain.
| | - Christian Rolfo
- Center for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - José Expósito-Hernandez
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, Granada, Spain; IBS Granada, Biosanitary Research Institute, Spain; Comprehensive Oncology Division, Virgen de las Nieves University Hospital, Granada, Spain
| | - Carmen Garrido-Navas
- IBS Granada, Biosanitary Research Institute, Spain; Comprehensive Oncology Division, Virgen de las Nieves University Hospital, Granada, Spain
| | - Javier Lopez-Hidalgo
- Department of Pathological Anatomy, Faculty of Medicine, University of Granada, Spain
| | - Valeria Denninghoff
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, Granada, Spain; Molecular-Clinical Lab - University of Buenos Aires (UBA) - National Council for Scientific and Technical Research (CONICET), Argentina.
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Tovar-Lopez FJ. Recent Progress in Micro- and Nanotechnology-Enabled Sensors for Biomedical and Environmental Challenges. SENSORS (BASEL, SWITZERLAND) 2023; 23:5406. [PMID: 37420577 DOI: 10.3390/s23125406] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
Micro- and nanotechnology-enabled sensors have made remarkable advancements in the fields of biomedicine and the environment, enabling the sensitive and selective detection and quantification of diverse analytes. In biomedicine, these sensors have facilitated disease diagnosis, drug discovery, and point-of-care devices. In environmental monitoring, they have played a crucial role in assessing air, water, and soil quality, as well as ensured food safety. Despite notable progress, numerous challenges persist. This review article addresses recent developments in micro- and nanotechnology-enabled sensors for biomedical and environmental challenges, focusing on enhancing basic sensing techniques through micro/nanotechnology. Additionally, it explores the applications of these sensors in addressing current challenges in both biomedical and environmental domains. The article concludes by emphasizing the need for further research to expand the detection capabilities of sensors/devices, enhance sensitivity and selectivity, integrate wireless communication and energy-harvesting technologies, and optimize sample preparation, material selection, and automated components for sensor design, fabrication, and characterization.
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Gamboa J, Paulo-Mirasol S, Estrany F, Torras J. Recent Progress in Biomedical Sensors Based on Conducting Polymer Hydrogels. ACS APPLIED BIO MATERIALS 2023; 6:1720-1741. [PMID: 37115912 DOI: 10.1021/acsabm.3c00139] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Biosensors are increasingly taking a more active role in health science. The current needs for the constant monitoring of biomedical signals, as well as the growing spending on public health, make it necessary to search for materials with a combination of properties such as biocompatibility, electroactivity, resorption, and high selectivity to certain bioanalytes. Conducting polymer hydrogels seem to be a very promising materials, since they present many of the necessary properties to be used as biosensors. Furthermore, their properties can be shaped and enhanced by designing conductive polymer hydrogel-based composites with more specific functionalities depending on the end application. This work will review the recent state of the art of different biological hydrogels for biosensor applications, discuss the properties of the different components alone and in combination, and reveal their high potential as candidate materials in the fabrication of all-organic diagnostic, wearable, and implantable sensor devices.
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Affiliation(s)
- Jillian Gamboa
- Departament d'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, Barcelona 08019, Spain
| | - Sofia Paulo-Mirasol
- Departament d'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, Barcelona 08019, Spain
| | - Francesc Estrany
- Departament d'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, Barcelona 08019, Spain
| | - Juan Torras
- Departament d'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, Barcelona 08019, Spain
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Shalabi N, Searles K, Takahata K. Switch mode capacitive pressure sensors. MICROSYSTEMS & NANOENGINEERING 2022; 8:132. [PMID: 36568136 PMCID: PMC9780122 DOI: 10.1038/s41378-022-00469-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 06/07/2023]
Abstract
Switch mode capacitive pressure sensors are proposed as a new class of microfabricated devices that transform pressure into a mechanically switching capacitance to form an analog-to-digital signal with zero power, high sensitivity, and a high signal-to-noise ratio. A pressure-sensitive gold membrane suspended over a capacitive cavity makes ohmic contact with patterned gold leads on the substrate, closing circuits to fixed on-chip capacitors outside the cavity and leading to significant step responses. This function is achieved by allocating the switch leads on the part of the counter electrode area, while the remaining area is used for touch mode analog capacitive sensing. The sensor microchip is prototyped through a novel design approach to surface micromachining that integrates micro-Tesla valves for vacuum sealing the sensor cavity, showing an unprecedented response to applied pressure. For a gauge pressure range of 0-120 mmHg, the sensor exhibits an increase of 13.21 pF with resultant switch events, each of which ranges from 2.53-3.96 pF every 12-38 mmHg, in addition to the touch mode linear capacitive increase between switches. The equivalent sensitivity is 80-240 fF/mmHg, which is 11-600× more than commercial and reported touch mode sensors operating in similar pressure ranges. The sensor is further demonstrated for wireless pressure tracking by creating a resonant tank with the sensor, showing a 32.5-101.6 kHz/mmHg sensitivity with frequency jumps led by the switch events. The developed sensor, with its promising performance, offers new application opportunities in a variety of device areas, including health care, robotics, industrial control, and environmental monitoring.
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Affiliation(s)
- Nabil Shalabi
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4 Canada
| | - Kyle Searles
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
| | - Kenichi Takahata
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4 Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
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Gaobotse G, Mbunge E, Batani J, Muchemwa B. The future of smart implants towards personalized and pervasive healthcare in Sub-Saharan Africa: Opportunities, barriers and policy recommendations. SENSORS INTERNATIONAL 2022. [DOI: 10.1016/j.sintl.2022.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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