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The purpose of this paper is to describe the knowledge generation in a cross‐disciplinary group in Norway that developed a new medical device. The aim is to shed light on how knowledge was generated and how the relationships between different communities of practice were mediated. In particular, the paper seeks to examine how material objects and contextual conditions influenced the innovation process.

In this longitudinal case study an innovation process was followed for five years, and the research material was constructed through extensive observations, interviews and document analysis.

The innovation process exhibited different themes in varying degrees of blend throughout the process. First, the practices of constructing the device and ascertaining technical feasibility are described. Then the enacted nature of the work is outlined; how it was significantly dependent on circumstantial factors, but also strongly shaped by the need to ensure clinical usability of the device. Finally, the work to package the innovation and turn it into a commercial product is explored.

In contrast with many previous studies, this study follows large parts of the innovation process, and it emphasises how knowing and practice are a result of networked, and changing, relations between both human and non‐human actors. Rather than one community of practice emerging around the innovation work, what can be called an object‐centred assemblage of communities of practice was seen, which grew and changed according to the changing nature of knowledge needs for the project to continue and succeed. This has interesting implications for the understanding of cross‐disciplinary innovation processes.

The purpose of this paper is to review the design and fabrication of a micro‐accelerometer to be used to measure the heart wall motion of patients who have just undergone coronary artery bypass graft (CABG) surgery. The sensor will provide a means of early warning for the medical staff of associated complications with this surgery occurring.

A feasibility paper is carried out with the use of commercially available MEMS three‐axis accelerometers. The sensors are used in animal studies during which the sensor is stitched directly to the surface of a pig's heart. A need for smaller sensors is required and these are designed in‐house and fabricated using a MEMS process. The final dimensions of the sensors are 2.5×3.5×1.4 mm in width, length and height, respectively.

The results of the feasibility studies demonstrate the viability of this type of sensor for heart wall motion measurement. It is possible to detect abnormalities, which can indicate complications associated with CABG. The sensors presented here are fabricated within the tight overall size specifications deemed necessary for this application.

This paper demonstrates an application of MEMS for implantable medical sensors.

In the UK, approximately 300,000 people have a heart attack each year. One of the most common surgeries that is used to treat this is CABG. This sensor is to be used by the medical staff in post‐surgery to provide “real‐time” monitoring of the heart and give early warning of regional cardiac ischemia which can save lives and reduce hospital waiting times and costs.

This paper demonstrates an original way of measuring heart wall motion. Results from the feasibility studies have proven that this can provide an invaluable way of providing early warning of complications after heart surgery.

A clinical pathway for patients with acute ischemic stroke was implemented in 2014 by one Italian teaching hospital multidisciplinary team. The purpose of this paper is to determine whether this clinical pathway had a positive effect on patient management by comparing performance data.

Volume, process and outcome indicators were analyzed in a pre-post retrospective observational study. Patients’ (admitted in 2013 and 2015) medical records with International Classification of Diseases, ICD-9 code 433.x (precerebral artery occlusion and stenosis), 434.x (cerebral artery occlusion) and 435.x (transient cerebral ischemia) and registered correctly according to hospital guidelines were included.

An increase context-sensitive in-patient numbers with more severe cerebrovascular events and an increase in patient transfers from the Stroke to Neurology Unit within three days (70 percent, p=0.25) were noted. Clinical pathway implementation led to an increase in patient flow from the Emergency Department to dedicated specialized wards such as the Stroke and Neurology Unit (23.7 percent, p<0.001). Results revealed no statistically significant decrease in readmission rates within 30 days (5.7 percent, p=0.85) and no statistically significant differences in 30-day mortality.

The pre-post retrospective observational study design was considered suitable to evaluate likely changes in patient flow after clinical pathway implementation, even though this design comes with limitations, describing only associations between exposure and outcome.

Clinical pathway implementation showed an overall positive effect on patient management and service efficiency owing to the standardized application in time-dependent protocols and multidisciplinary/integrated care implementation, which improved all phases in acute ischemic stroke care.

Physical restraints have been commonly used in health care settings for people with challenging behaviours. The function performance of restraint garments in relation to their design attributes is evaluated so as to optimise the protection and safety of patients. In contrast to the traditional approach of evaluating fabric properties, this study proposes a practical and systematic approach in which the effects of the design attributes of restraint garments can be evaluated based on their unique functions of mobility control, safety and practical use of restraint in medical/healthcare settings. The design and performance of traditional restraint vests are assessed and compared against two new prototypes of restraint garments in terms of the amplitude of arm movement, garment interface pressures and displacements of 3D motion coordinates by using the Novel Pliance X pressure and motion capturing system. The results reveal that design attributes affect the performance of mobility restriction and safety of restraint garments. Necklines with collar piping and the use of reinforcement seams to withstand continuous stress during struggling may lead to extremely high interface pressures at the neckline and armholes, which result in ischemia injuries and even potential strangulation.

Nursing has for a long time used a variety of technological tools to improve and support patient care. Tool use changes knowledge processes, offering opportunities to explore processes of specialization in this field. The purpose of this paper is to report from a collaborative process to achieve shared meaning potential while adapting a generic learning tool to meet learning needs of specialized nursing. A complex chain of actions, interactions and negotiations during the adaptation process is disentangled. The paper draws from the theoretical construct known as trajectories of participation.

The method employed in data analysis is interaction analysis, allowing detailed studies of the actions represented in the participants' intersecting trajectories.

The analysis shows how project members seek to combine different modes of knowledge when they sort out and establish shared meaning potential. Typically the negotiations start with a concrete problem arising from the current practice's use of tools. The participants clarify and specify a shared object of activity by mobilizing three different modes of knowledge (practical, diagnostic and technical). During this process, the participants' trajectories converge toward consensus. This consensus is a process of constructing and reconstructing tools and practices and an interdependency of tools and practices that is “materialized” in the adapted learning tool.

This analysis shows the importance of taking account of processes in the concrete settings when developing new tools for change in specialist nursing. Different trajectories of participation that intersected in the planning activities give insight into how knowledge is mobilized when tools and practices co-evolve on an interactional level.

The purpose of this paper is to develop a prototype of a wearable medical device in the form of a bandage with a real-time data monitoring platform, which can be used domestically for diabetic patients to identify the possibility of foot ulceration at the early stage.

The prototype can measure blood volumetric change and temperature variation in the forefoot area simultaneously. The waveform extracted using a pulsatile-blood-flow signal was used to assess blood perfusion-related information, and hence, predict ischemic ulcers. The temperature difference between ulcerated and the reference was used to predict neuropathic ulcers. The medical device can be used as a bandage during the application wherein the sensory module is placed inside the hollow pocket of the bandage. A platform was developed through a mobile application where doctors can extract real-time information, and hence, determine the possibility of ulceration.

The height of the peaks in the pulsatile-blood-flow signal measured from the subject with foot ischemic ulcers is significantly less than that of the subject without ischemic ulcers. In the presence of ischemic ulcers, the captured waveform flattens. Therefore, the blood perfusion from arteries to the tissue of the forefoot is considerably low for the subject with ischemic ulcers. According to the temperature difference data measured over 25 consecutive days, the temperature difference of the subject with neuropathic ulcers occasionally exceeded the 4 °F range but mostly had higher values closer to the 4 °F range. However, the temperature difference of the subject who had no complications of neuropathic ulcers did not exceed the 4 °F range, and the majority of the measurements occupy a narrow range from −2°F to 2 °F.

The proposed prototype of wearable medical apparatus can monitor both temperature variation and pulsatile-blood-flow signal on the forefoot simultaneously and thereby predict both ischemic and neuropathic diabetes using a single device. Most importantly, the wearable medical device can be used domestically without clinical assistance with a real-time data monitoring platform to predict the possibility of ulceration and the course of action thereof.

The purpose of this study is to assess the effects of two green leafy vegetables (Gongronema latifolium and Celosia argentea) on the hepatic biomarkers [Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)], cardiac biomarkers [Creatine Kinase (CK) and Lactate Dehydrogenase (LDH)] and histopathology of the heart of high-fat diet-induced hyperlipidemic rats, with the aim of evaluating the vegetables as functional foods.

Experimental diets consisted of Control Diet (CD), High-Fat Diet (HFD), High-Fat Diet with Blanched Celosia argentea (HCB), High-Fat Diet with Unblanched Celosia argentea (HCU), High-Fat diet with Blanched Gongronema latifolium (HGB) and High-Fat Diet with Unblanched Gongronema latifolium (HGU). Seventy-five albino male rats (weighing 180–200 g) were used. The animals were divided into 15 groups of five albino rats each. Animals in Groups 1, 2 and 3 were fed with CD, HFD only and HFD with Atorvastin (5 mg/kg b.w), respectively. Animals in Groups 4, 5 and 6 were fed with 5, 10 and 15% HCB, respectively. Animals in Groups 7, 8 and 9 were fed with 5, 10 and 15% HCU, respectively, whereas animals in Groups 10, 11 and 12 were fed with 5, 10 and 15% HGB, respectively, and animals in Groups 13, 14 and 15 were fed with 5, 10 and 15% diet-inclusion of HGU, respectively.

The incorporation of the vegetal matter into the diet brought about a significant reduction (p = 0.05) in the activities of ALT, AST, CK and LDH when compared with HFD. However, the histological examination showed no pathological lesion, only at 15% inclusion of the vegetables.

The paper established that the incorporation of Celosia argentea and Gongronema latifolium into diet, most especially at 15% inclusion, may serve as functional food in the management of hyperlipidemia and associated complications.

Clinical outcome in patients with ischemic heart disease can be significantly improved with the implementation of targeted drug delivery into the ischemic myocardium. The purpose of this paper is to review the data of recent literature and present original findings relevant to the problem of therapeutic heart targeting with use of nanoparticles.

For literature review, a public‐domain database (Medline) was searched using a web‐based search engine (PubMed) and the following key words: “nanoparticles”, “nanocarriers”, and “targeted drug delivery”. Experimental approaches included fabrication of carbon and silica nanoparticles, their characterization and surface modification. The acute hemodynamic effects of nanoparticle formulation as well as nanoparticle biodistribution were studied on male Wistar rats.

Carbon and silica nanoparticles are biocompatible materials that can be used as carriers for heart‐targeted drug delivery. Concepts of passive and active targeting can be applied to the development of targeted drug delivery to the ischemic myocardial cells.

The present paper is believed to be the first on ligand‐directed targeted drug delivery into the damaged myocardium.

A learning algorithm called CLILP2 (Cover Learning Using Integer Linear Programming) is applied to medical data to generate rules to recognize patients with coronary artery disease. The algorithm partitions a data set into subsets using features which best describe and distinguish a particular subset from all other subsets. These features are used to form the rules which can be used as the knowledge base of a diagnostic expert system. Results from the application of the algorithm to coronary artery stenosis data are compared with the results obtained from the existing expert system.