Pain Management Mobile Applications: A Systematic Review of Commercial and Research Efforts

Shared decision making is crucial in the pain domain. The subjective nature of pain demands solutions that can facilitate pain assessment and management. The aim of the current study is to review the current trends in both the commercial and the research domains in order to reveal the key issues and guidelines that could further help in the effective development of pain-focused apps. We searched for scientific publications and commercial apps in 22 databases and the two major app stores. Out of 3612 articles and 336 apps, 69 met the requirements for inclusion following the PRISMA guidelines. An analysis of their features (technological approach, design methodology, evaluation strategy, and others) identified critical points that have to be taken into consideration in future efforts. For example, commercial and research efforts target different types of pain, while no participatory design is followed in the majority of the cases examined. Moreover, the evaluation of the final apps remains a challenge that hinders their success. The examined domain is expected to experience a substantial increase. More research is needed towards the development of non-intrusive wearables and sensors for pain detection and assessment, along with artificial intelligence techniques and open data.

Incubation pit analysis and calculation of the hydrodynamic impact pressure from the implosion of an acoustic cavitation bubble

An experimental study to evaluate cavitation bubble dynamics is conducted. The aim is to predict the magnitude and statistical distribution of hydrodynamic impact pressure generated from the implosion of various individual acoustic cavitation bubbles near to a rigid boundary, considering geometrical features of the pitted area. A steel sample was subjected to cavitation impacts by an ultrasonic transducer with a 5mm diameter probe. The pitted surface was then examined using high-precision 3D optical interferometer techniques. Only the incubation period where surface is plastically deformed without material loss is taken into account. The exposure time was adjusted in the range of 3-60 s to avoid pit overlapping and a special procedure for pit analysis and characterisation was then followed. Moreover, a high-speed camera device was deployed to capture the implosion mechanisms of cavitation bubbles near to the surface. The geometrical characteristics of single incubation pits as well as pit clusters were studied and their deformation patterns were compared. Consequently, a reverse engineering approach was applied in order the hydrodynamic impact pressure from the implosion of an individual cavitation bubble to be determined. The characteristic parameters of the cavitation implosion process such as hydrodynamic impact pressure and liquid micro-jet impact velocity as well as the hydrodynamic severity of the cavitation impacts were quantified. It was found that the length of the hypotenuse of the orthographic projections from the center of the pit, which basically represents the deformed area of the pit, increases with the hydrodynamic impact aggressiveness in a linear rate. Majority of the hydrodynamic impacts were in the range of 0.4-1 GPa while the corresponding micro-jet velocities were found to be in the range of 200-700 m/s. Outcomes of this study, contribute to further understanding the cavitation intensity from the implosion of acoustically generated bubbles and could certainly represent a significant step towards developing more accurate cavitation models.

Enriching healthcare applications with cryptographic mechanisms and XML- based security services

The paper presents the enrichment of an existing e-referral / e-prescription application within a Regional Healthcare Information Network with security functionality, solving current authentication, integrity, non-repudiation and confidentiality issues and thus significantly enhancing the overall system security, operability, applicability and user acceptance. The application makes use of an underlying PKI framework, in order to provide strong authentication, digital signature, encryption and time-stamping services. XML is used for the representation of the healthcare data itself, the encrypted form of this data, as well as the relevant data security information, following W3C standards.

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support

The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC) or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile) unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3-12 lead ECG, SPO2, NIBP, IBP, Temp) and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three different countries using a standardized medical protocol.

RESHEN, a best practice approach for secure healthcare networks in Europe

Electronic communication of healthcare related information (in the framework of Regional Healthcare Information Networks), introduces a number of security risks with regard to confidentiality, integrity and availability, which can become quite crucial taking into account its sensitive nature. Public Key Infrastructure (PKI) is acknowledged as an appropriate means for dealing with such risks, as long as all the involved critical factors are first practically assessed. This paper presents a best-practice approach for secure regional healthcare networks in Europe, examining all the identified crucial parameters (technical, organisational, legal/regulatory, medical and business). Our approach is conducted at two levels (the regional and the European), including the integration of PKI-aware security mechanisms (strong authentication, encryption, digital signature, time-stamping) in three regional pilot sites in Greece, Finland and Germany and demonstrating their interconnection in a pan-European architecture. Following the above approach, some major conclusions are excluded, pointing out existing open issues and possible steps forward.