Japan is suffering from a "device gap." Compared to its American and European counterparts, Japan lags in adopting innovative medical devices and making new treatments and procedures available to its patients. Many blame its government and bureaucracy for Japan's delayed access to modern medicine and new medical devices. Christa Altenstetter examines the contextual social, historical, and political conditions of Japan's medical field to make sense of the state of the country's medical profession and its regulatory framework. She explores the development of regulatory frameworks and considers possibilities for eventual reform and modernization. More specifically, Altenstetter looks into how physicians and device companies connect to the government and bureaucracy, the relationships connecting Japanese patients to their medical system and governmental bureaucracy, and how the relationships between policymakers and the medical profession are changing. The issues addressed here are becoming increasingly relevant as numerous countries in Asia, Latin America, and Central and Eastern Europe are only now beginning to regulate medical technology, following the lead of the US and the European Union. Those interested in global medicine and Asian studies will find this book both informative and compelling.

Agile Implementation describes the underlying theories and frameworks that explain health delivery systems and lays out the 8 steps of the Agile Implementation Model founded by Malaz Boustani, MD, MPH and Jose Azar, MD. In today's complex healthcare environment, implementing evidence-based care into real-world practices is difficult and time consuming. Even methods that are known to be effective allow for limited flexibility and therefore fail as often as they succeed. Through much study and experimentation, Malaz Boustani, MD, MPH, Jose Azar, MD, and Craig A. Solid, PhD have come to understand how individuals' interactions within the complex social systems of hospitals, clinics, and other care delivery organizations shape the decisions and behaviors of those involved. Upon this foundation and through leveraging theories of behavioral economics, we have developed the Agile Implementation Model, a process for selecting, adapting, implementing, evaluating, sustaining, and scaling evidence-based healthcare interventions. This model acknowledges the uniqueness of each individual facility and considers individuals within the system to be semiautonomous but interconnected. In tandem with illustrative examples, Agile Implementation describes the underlying theories and frameworks that explain health delivery systems and lays out the 8 steps of the Agile Implementation Model. Upon completing Agile Implementation, readers have a better understanding of why certain quality initiatives succeed while others fail and have tangible, actionable tools for implementing effective and sustainable change in the healthcare setting.

Anna Tarrant's revealing research explores the dynamics of men's caring responsibilities in low-income families' lives. The book draws on pioneering multigenerational research to examine men's involvement in care for their families. It interrogates how this is affected by the resources available and the constraints upon them, considering intersections of gender, generation and work, as well as the impact of austerity and welfare support. Illuminating aspects of care within economic hardship that often go unseen, it deepens our understanding of masculinities and family life and the policies and practices that support or undermine men's participation.

This book presents an advanced systematic mapping review (SMR) and state-of-the-art taxonomy of emergency departments (EDs). Focusing on the patients' level of fulfilment and how it can be enhanced, it examines existing problems like waiting periods and overcrowding and how these can be alleviated to provide a better service. The author examined research papers from 1964 to 2018, and developed six research questions, organising them using mapping studies, the primary objectives of which were firstly, to obtain a common understanding of the problems that need to be highlighted in EDs, and secondly, to re-analyse the methods used. Focusing on quality, the book encourages citations of experimental methods from important studies concerning EDs that can improve services. Through different research papers, various thematic areas in the healthcare sector were examined, like the determination of the relative efficiency of pre-discharge interventions; the analysis of care and managing common indications during the last stages of life; using e-Health to enhance effectiveness and proficiency; the seriousness of patient differences among EDs; the identification of quality problems in healthcare contexts; existing opportunities and the suggested plans. The book concludes that an analytical decision-making process should be used to assess a health technology on the basis of its performance. It stresses the importance of updating this analytical system frequently.

The mechanical properties of cells can be used to distinguish pathological from normal cells and tissues in many diseases. This book will outline the physics behind cell and tissue mechanics, describe the methods which can be used to determine their mechanical properties, and present various diseases in which a mechanical fingerprint could be established. The book is designed to not require a background in either Physics or Life Sciences.

The mechanical properties of cells can be used to distinguish pathological from normal cells and tissues in many diseases. This book will outline the physics behind cell and tissue mechanics, describe the methods which can be used to determine their mechanical properties, and present various diseases in which a mechanical fingerprint could be established. The book is designed to not require a background in either Physics or Life Sciences.

MRI: Essentials for Innovative Technologies describes novel methods to improve magnetic resonance imaging (MRI) beyond its current limitations. It proposes smart encoding methods and acquisition sequences to deal with frequency displacement due to residual static magnetic field inhomogeneity, motion, and undersampling. Requiring few or no hardware modifications, these speculative methods offer building blocks that can be combined and refined to overcome barriers to more advanced MRI applications, such as real-time imaging and open systems.

After a concise review of basic mathematical tools and the physics of MRI, the book describes the severe artifacts produced by conventional MRI techniques. It first tackles magnetic field inhomogeneities, outlining conventional solutions as well as a completely different approach based on time-varying gradients and temporal frequency variation coding (acceleration). The book then proposes two innovative acquisition methods for reducing acquisition time, motion, and undersampling artifacts: adaptive acquisition and compressed sensing. The concluding chapter lays out the author s predictions for the future of MRI.

For some of the proposed solutions, this is the first time the reported results have been published. Where experimental data is preliminary or unavailable, the book presents only numerical solutions. Offering insight into emerging MRI techniques, this book provides readers with specialized knowledge to help them design better acquisition sequences and select appropriate correction methods.

The author s proceeds from the sale of this book will be entirely donated to Bambin Gesu Children s Hospital in Rome.

Drs. Guhl, Parisien, and Boynton have prepared a third edition of this successful volume, heretofore published by Slack (who no longer publishes books on orthopaedic surgery, only journals). The editors have invited a prestigious group of contributors, including such stellar names in the field as Ferkel, Lundeen, Tasto, etc. The new edition will address the most recent and valuable developments in foot and ankle arthroscopy, including the practical applications of instrumentation and technique in the clinical setting. Unique to this book are the imaging techniques, laser surgery, mid-foot arthroscopy, and most importantly - endoscopic surgery of the ankle and foot. Sections and chapters on anatomy, differential diagnosis, soft tissue pathology, rehabilitation, and again, unique to this volume, office and outpatient arthroscopy make this a comprehensive reference.

Practical Data Analytics for Innovation in Medicine: Building Real Predictive and Prescriptive Models in Personalized Healthcare and Medical Research Using AI, ML, and Related Technologies, Second Edition discusses the needs of healthcare and medicine in the 21st century, explaining how data analytics play an important and revolutionary role. With healthcare effectiveness and economics facing growing challenges, there is a rapidly emerging movement to fortify medical treatment and administration by tapping the predictive power of big data, such as predictive analytics, which can bolster patient care, reduce costs, and deliver greater efficiencies across a wide range of operational functions. Sections bring a historical perspective, highlight the importance of using predictive analytics to help solve health crisis such as the COVID-19 pandemic, provide access to practical step-by-step tutorials and case studies online, and use exercises based on real-world examples of successful predictive and prescriptive tools and systems. The final part of the book focuses on specific technical operations related to quality, cost-effective medical and nursing care delivery and administration brought by practical predictive analytics.

Agile Implementation describes the underlying theories and frameworks that explain health delivery systems and lays out the 8 steps of the Agile Implementation Model founded by Malaz Boustani, MD, MPH and Jose Azar, MD. In today's complex healthcare environment, implementing evidence-based care into real-world practices is difficult and time consuming. Even methods that are known to be effective allow for limited flexibility and therefore fail as often as they succeed. Through much study and experimentation, Malaz Boustani, MD, MPH, Jose Azar, MD, and Craig A. Solid, PhD have come to understand how individuals' interactions within the complex social systems of hospitals, clinics, and other care delivery organizations shape the decisions and behaviors of those involved. Upon this foundation and through leveraging theories of behavioral economics, we have developed the Agile Implementation Model, a process for selecting, adapting, implementing, evaluating, sustaining, and scaling evidence-based healthcare interventions. This model acknowledges the uniqueness of each individual facility and considers individuals within the system to be semiautonomous but interconnected. In tandem with illustrative examples, Agile Implementation describes the underlying theories and frameworks that explain health delivery systems and lays out the 8 steps of the Agile Implementation Model. Upon completing Agile Implementation, readers have a better understanding of why certain quality initiatives succeed while others fail and have tangible, actionable tools for implementing effective and sustainable change in the healthcare setting.

Oligonucleotides represent one of the most significant pharmaceutical breakthroughs in recent years, showing great promise as diagnostic and therapeutic agents for malignant tumors, cardiovascular disease, diabetes, viral infections, and many other degenerative disorders. The Handbook of Analysis of Oligonucleotides and Related Products is an essential reference manual on the practical application of modern and emerging analytical techniques for the analysis of this unique class of compounds. A strong collaboration among thirty leading analytical scientists from around the world, the book provides readers with a comprehensive overview of the most commonly used analytical techniques and their advantages and limitations in assuring the identity, purity, quality, and strength of an oligonucleotide intended for therapeutic use. Topics discussed include: Strategies for enzymatic or chemical degradation of chemically modified oligonucleotides toward mass spectrometric sequencing Purity analysis by chromatographic or electrophoretic methods, including RP-HPLC, AX-HPLC, HILIC, SEC, and CGE Characterization of sequence-related impurities in oligonucleotides by mass spectrometry and chromatography Structure elucidation by spectroscopic methods (IR, NMR, MS) as well as base composition and thermal melt analysis (Tm) Approaches for the accurate determination of molar extinction coefficient of oligonucleotides Accurate determination of assay values Assessment of the overall quality of oligonucleotides, including microbial analysis and determination of residual solvents and heavy metals Strategies for determining the chemical stability of oligonucleotides The use of hybridization techniques for supporting pharmacokinetics and drug metabolism studies in preclinical and clinical development Guidance for the presentation of relevant analytical information towards meeting current regulatory expectations for oligonucleotide therapeutics This resource provides a practical guide for applying state-of-the-art analytical techniques in research, development, and manufacturing settings.

A reflection of the intense study of the effects of electromagnetic fields on living tissues that has taken place during the last decades, Advanced Electroporation Techniques in Biology and Medicine summarizes most recent experimental findings and theories related to permeabilization of biomembranes by pulsed electric fields. Edited by experts and including contributions from pioneers in the field, the book focuses on biophysical mechanisms of electroporation and applications of this phenomenon in biomedical research and medicine. The field of electroporation is now mature enough to move from journal pages to book covers. The book leads readers from the basics and history of electroporation, through mechanisms of membrane permeabilization in lipid bilayers and living cells, to electrically-mediated gene delivery and cancer therapy in animals and humans. This book is an interdisciplinary compilation intended broadly for biomedical and physical scientists, engineers, and clinicians. It can also be used as a textbook for students in advanced courses in biomedical engineering, molecular and cell biology, as well as in biophysics and clinical medicine.

Point of care ultrasound is a critical tool required for assessing all patients, providing rapid answers to clinical questions and facilitating high quality care for patients. This essential guide caters for all generalist clinicians beginning their ultrasound journey and extends to more advanced assessments for those with established ultrasound experience wishing to advance their knowledge and skills. It covers a wide range of ultrasound topics from echocardiography, thoracic and COVID-19 to emerging areas such as palliative care, hospital at home and remote and austere medicine. An extensive collection of colour images, videos and examples of clinical applications will inspire readers to acquire the skills of point of care ultrasound quickly, safely and systematically. The printed code on the inside of the cover provides access to an online version on Cambridge Core. An essential aid for acute clinicians, paramedics, general practitioners as well as remote medical providers, medical educators and students.

This book fosters a scientific debate for sophisticated approaches and cognitive technologies (such as deep learning, machine learning and advanced analytics) for enhanced healthcare services in light of the tremendous scope in the future of intelligent systems for healthcare. The authors discuss the proliferation of huge data sources (e.g. genomes, electronic health records (EHRs), mobile diagnostics, and wearable devices) and breakthroughs in artificial intelligence applications, which have unlocked the doors for diagnosing and treating multitudes of rare diseases. The contributors show how the widespread adoption of intelligent health based systems could help overcome challenges, such as shortages of staff and supplies, accessibility barriers, lack of awareness on certain health issues, identification of patient needs, and early detection and diagnosis of illnesses. This book is a small yet significant step towards exploring recent advances, disseminating state-of-the-art techniques and deploying novel technologies in intelligent healthcare services and applications. Describes the advances of computing methodologies for life and medical science data; Presents applications of artificial intelligence in healthcare along with case studies and datasets; Provides an ideal reference for medical imaging researchers, industry scientists and engineers, advanced undergraduate and graduate students, and clinicians.

This book reviews the convergence technologies like cloud computing, artificial intelligence (AI) and Internet of Things (IoT) in healthcare and how they can help all stakeholders in the healthcare sector. The book is a proficient guide on the relationship between AI, IoT and healthcare and gives examples into how IoT is changing all aspects of the healthcare industry. Topics include remote patient monitoring, the telemedicine ecosystem, pattern imaging analytics using AI, disease identification and diagnosis using AI, robotic surgery, prediction of epidemic outbreaks, and more. The contributors include applications and case studies across all areas of computational intelligence in healthcare data. The authors also include workflow in IoT-enabled healthcare technologies and explore privacy and security issues in healthcare-based IoT.

Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone? In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst. Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.

The aim of the two-volume set of Placenta and Trophoblast: Methods and Protocols is to offer contemporary approaches for studying the biology of the placenta. The chapters contained herein also address critical features of the female organ within which the embryo is housed, the uterus, and some aspects of the embryo-fetus itself, particularly those of common experimental animal models. In keeping with the organization used effectively in other volumes in this series, each chapter has a brief introduction followed by a list of required items, protocols, and notes designed to help the reader perform the expe- ments without difficulty. In both volumes, sources of supplies are given and illustrations highlight particular techniques as well as expected outcomes. A key aspect of these volumes is that the contributors are at the forefronts of their disciplines, thus ensuring the accuracy and usefulness of the chapters. Placenta research has progressed rapidly over the past several decades by taking advantage of the technical advances made in other fields. For example, the reader will note that many techniques, such as reverse transcriptase po- merase chain reaction, northern and western blotting, microarray analyses and in situ hybridization experiments, are routinely used for dissecting a wide range of experimental questions. Protein analysis and functional experiments on tissues and cells that comprise the maternal-fetal interface benefit from studies in en- crinology, immunology, and developmental biology. These volumes also present new ideas on investigating gene imprinting and gene transfer via viral vectors.

Mechanical Behaviour of Biomaterials focuses on the interface between engineering and medicine, where new insights into engineering aspects will prove to be extremely useful in their relation to the biomedical sciences and their applications. The book's main objective focuses on the mechanical behavior of biomaterials, covering key aspects, such as mechanical properties, characterization and performance. Particular emphasis is given to fatigue, creep and wear, fracture, and stress and strain relationships in biomaterials. Chapters look at both experimental and theoretical results. Readers will find this to be an essential reference for academics, biomechanical researchers, medical doctors, biologists, chemists, physicists, mechanical, biomedical and materials engineers and industrial professionals.

Intelligent and adaptive techniques are rapidly being used in all stages of medical treatment, from the initial diagnosis to planning delivery and follow-up therapy.To realize the full potential of these techniques, developers and end users must understand both the underlying technology and the specifics of the medical application considered. Focusing on this growing area of interest, Intelligent and Adaptive Systems in Medicine clearly and concisely explains a range of adaptive and intelligent systems, highlighting their benefits and limitations with realistic medical examples.

Bringing together theory and practice, this volume describes the application of adaptive and intelligent control as well as intelligent systems in the diagnosis, planning, treatment, and follow up of diseases such as cancer. Each chapter presents a family of an intelligent and adaptive system, explains the techniques and algorithms behind these systems, and explores how to solve medical and biomedical problems using intelligent and adaptive systems. The book focuses on the methods of fuzzy logic, artificial neural networks, neuro-fuzzy modeling, adaptive and predictive control, systems and statistical modeling, and image processing.

By assessing the use of intelligent and adaptive techniques for medical diagnosis and therapy, this guide promotes further research in this area of "techno-medicine." It provides researchers and clinicians with the tools and processes that are leading to the invaluable use of intelligent systems in early diagnoses and effective treatment.

Efforts to measure neurotransmitters and related s- cies in living brain tissue by faradic electrochemistry began in earnest in the early 1970s. During the ensuing years, s- eral monographs and various symposia on the subject have appeared. The present volume of Neuromethods, Voltammetric Methods in Brain Systems, can be considered different from previous offerings in several respects. The methodology of in vivo electrochemistry has now reached a stable level of maturity. It is no longer necessary to convince interested re- ers that the techniques can measure, with specified degrees of reliability, certain neurotransmitters and metabolites in the extracellular fluid space. Moreover, the basic approaches of electroanalytical measurements are more widely appre- ated by neuroscientists and one need not explain in tutorial fashion the details of oxidative electrochemistry. Nevert- less, in keeping with the nature of the Neurumethods series, this is a "how to" volume and readers will find ample detail on the preparation of electrodes, practical experimental details, and the interpretation of results. But the emphasis is strongly on the application of voltammetric methods. The first two chapters deal with fundamentals inherent in employing in vivo electrochemical measures. The first - ticle offers an authoritative account of our understanding of the surface states of carbon and carbon fiber electrodes. It provides a rationale for the various pretreatments that have allowed the "tuning" of electrode properties to obtain sen- tivity and fast response times.

Microbiological matters continue to exercise considerable influence on product quality. In both the pharmaceutical and medical device industries, products of greater sophistication, along with evolving regulatory requirements, are elevating the challenges related to maintaining microbiological integrity.
Updated to reflect technological and regulatory changes, the Guide to Microbiological Control in Pharmaceuticals and Medical Devices, Second Edition covers thoseprincipal aspects of microbiology that arerelevant to the preformulation, formulation, manufacturing, and license application stages involved with the production of pharmaceuticals and medical devices.
In recognition of the diverse disciplines involved in pharmaceutical and medical device production, this work provides a brief introduction to microbiology geared towards the nonmicrobiologist. Covering good manufacturing practice in the control of contamination, the text explores quality control, the preservation of formulations, and principles of sterilization, including microbiological-specific considerations for biotechnological products and other medical devices. It also provides additional materials on package integrity and contamination risks in clean rooms.
The editors have produced a companion text, the Handbook of Microbiological Quality Control in Pharmaceuticals and Medical Devices ("see reverse"), which when paired with the Guide offers a complete theoretical and practical treatment of microbiological control.
This book provides a comprehensive distillation of information concerning methodology and regulations that would otherwise remain scattered throughout the literature. It allows scientists frommany fields to address potential problems in advance and implement suitable strategies at the earliest stages of development.

This book provides an interdisciplinary look at emerging trends in signal processing and biomedicine found at the intersection of healthcare, engineering, and computer science. It examines the vital role signal processing plays in enabling a new generation of technology based on big data, and looks at applications ranging from medical electronics to data mining of electronic medical records. Topics covered include analysis of medical images, machine learning, biomedical nanosensors, wireless technologies, and instrumentation and electrical stimulation. Biomedical Signal Processing: Innovation and Applications presents tutorials and examples of successful applications, and will appeal to a wide range of professionals, researchers, and students interested in applications of signal processing, medicine, and biology.

Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This ground-breaking book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the 'natural' body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the body and identity, Medical Technologies and the Life World explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create 'new illness'. Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this sensational text is essential reading for students and academics of medical sociology, health and allied studies, and anyone with an interest in new health technologies.

Bioenhancers have been used in Ayurveda historically and are now being investigated for their pharmacological effi cacy. Herbal bioenhancers work on the gastrointestinal tract to improve absorption and drug bioavailability by acting on the drug metabolic process. Many herbal drugs show low activity due to their poor lipid solubility or improper molecular size. Piperine, gingerol, naringin, quercetin, niaziridin, glycyrrhizin, allicin, curcumin, genistein and others are able to enhance the bioavailability of active pharmaceuticals. This book details various facets of herbal bio-enhancers in a single comprehensive text.

This book presents innovative research works to demonstrate the potential and the advancements of computing approaches to utilize healthcare centric and medical datasets in solving complex healthcare problems. Computing technique is one of the key technologies that are being currently used to perform medical diagnostics in the healthcare domain, thanks to the abundance of medical data being generated and collected. Nowadays, medical data is available in many different forms like MRI images, CT scan images, EHR data, test reports, histopathological data and doctor patient conversation data. This opens up huge opportunities for the application of computing techniques, to derive data-driven models that can be of very high utility, in terms of providing effective treatment to patients. Moreover, machine learning algorithms can uncover hidden patterns and relationships present in medical datasets, which are too complex to uncover, if a data-driven approach is not taken. With the help of computing systems, today, it is possible for researchers to predict an accurate medical diagnosis for new patients, using models built from previous patient data. Apart from automatic diagnostic tasks, computing techniques have also been applied in the process of drug discovery, by which a lot of time and money can be saved. Utilization of genomic data using various computing techniques is another emerging area, which may in fact be the key to fulfilling the dream of personalized medications. Medical prognostics is another area in which machine learning has shown great promise recently, where automatic prognostic models are being built that can predict the progress of the disease, as well as can suggest the potential treatment paths to get ahead of the disease progression.