Dissertations / Theses on the topic 'SphygmomanometerD'

PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO
Observa-se um crescente interesse na determinação da incerteza de medição para a avaliação de conformidade e garantia da qualidade, principalmente nos setores de meio- ambiente, segurança, saúde e indústria, nos quais o resultado da medição é considerado crítico por lidar diretamente com seres humanos. Na medição da pressão arterial, conforme estudos realizados em países como a Austrália, Inglaterra, Turquia e Brasil, observa-se uma grande preocupação com a confiabilidade dos resultados obtidos por esfigmomanômetros mecânicos não invasivos. Nestes estudos, erros de até 4,4 kPa (33 mmHg) foram encontrados nos instrumentos avaliados, contra o valor de erro máximo de 0,53 kPa (4 mmHg) definido na OIML R 16-1:2002. Atualmente, a avaliação da confiabilidade dos esfigmomanômetros mecânicos é obtida considerando apenas o erro de medição, sem considerar a incerteza de medição. Com a motivação de contribuir para a garantia da confiabilidade metrológica dos esfigmomanômetros mecânicos não invasivos, usados mundialmente em hospitais e residências, o presente trabalho tem por objetivo associar a incerteza de medição na avaliação da confiabilidade metrológica destes instrumentos. Para a realização das medições foi montado um aparato envolvendo instrumentos de monitoração ambiental conforme recomendações internacionais (OIML R-16-1:2002) e nacionais (ABNT NBR-14105:1998 e NIEDIMEL- 006). Os dados do presente trabalho foram obtidos por meio de medições diretas em esfigmomanômetros novos e usados utilizando um padrão de pressão. Foram avaliados: o erro de medição, a histerese, o erro fiducial e a incerteza de medição. Os resultados obtidos com o presente trabalho mostram que, em função da incerteza de medição, o erro máximo permissível de 0,53 kPa (4 mmHg) pode não fornecer a confiabilidade adequada. Se for considerado apenas o erro de medição do manômetro conforme a OIML R 16- 1:2002, 60 % dos esfigmomanômetros avaliados foram aprovados. Se for considerado o erro e a incerteza de medição do manômetro, conforme proposto, apenas 12 % dos esfigmomanômetros foram aprovados. Com base nos resultados obtidos no presente trabalho, propõe-se reduzir o erro máximo admissível para estes instrumentos, incorporando a incerteza de medição, sem a necessidade de realizar na prática o seu cálculo. Com base nos resultados do presente trabalho recomenda-se uma revisão na faixa de erro máximo permissível na avaliação da OIML, em conjunto com a proposta de uma nova especificação do manômetro usado nos esfigmomanômetros, com redução do erro intrínseco e melhora de sua resolução.
It is observed an increasing interest on the estimation of measurement uncertainty to deciding on conformity and quality assurance, mainly in the fields of environment, safety, health and industry, in which the measurement results are critical once they directly deal with human beings. According to studies performed in Australia, England, Turkey and Brazil, a great concern is observed with the reliability of the results obtained for blood pressure measurements by noninvasive mechanical sphygmomanometers. In these studies, errors of up to 4,4 kPa (33 mmHg) were obtained in the evaluated instruments, against the value of maximum error of 0,53 kPa (4 mmHg) required by OIML R 16-1:2002. Nowadays, the evaluation of the reliability of these measurement instruments for medical diagnosis is obtained considering only the measurement error (according to OIML R 16-1:2002), without taking into account the measurement uncertainty. Motivated to contribute for the metrological reliability of non- invasive mechanical sphygmomanometers, globally used in hospitals and residences, the present work aims at developing a model to associate the measurement uncertainty on the metrological reliability evaluation of these instruments. In order to perform the measurements with the sphygmomanometers, a set-up were prepared with environmental monitoring according to international recommendation (OIML R-16:2002) and national standards (ABNT NBR-14105:1998 and NIE-DMEL-006). The data of the present work were obtained by means of direct measurements in new and in use sphygmomanometers, utilizing a pressure pattern. Calculation of the following parameters was performed: measurement error, hysteresis, fiducial error and measurement uncertainty. The obtained results show that, as a function of the measurement uncertainty, the maximum permissible error of 0.53 kPa (4 mmHg) can be overcome. Considering the manometer measurement error, according to OIML R 16-1:2002, 60 % of the non- invasive mechanical sphygmomanometers evaluated were approved. When considering not only the measurement error, but also measurement uncertainty of the manometer, only 12% of the non-invasive mechanical sphygmomanometers were approved. Based on the present results, a reduction of the maximum permissible error for these instruments, incorporating the measurement uncertainty, without the need to calculate it in the verification procedure, is proposed. This work recommends not only a review of OIML maximum permissible error for sphygmomanometers, but also proposes a new configuration of the instrument, with reduction of intrinsic error and improvement of resolution.

Thesis (M.S.)--University of Akron, Dept. of Biomedical Engineering, 2006.
"May, 2006." Title from electronic thesis title page (viewed 01/16/2008) Advisor, Dale Mugler; Co-Advisor, Bruce Taylor; Committee member, Daniel Sheffer; Department Chair, Daniel Sheffer; Dean of the College, George K. Haritos; Dean of the Graduate School, George R. Newkome. Includes bibliographical references.

Orientador: José Luiz Tatagiba Lamas
Dissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciências Médicas
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Resumo: A medida da pressão arterial é uma prática rotineira nas instituições de saúde e, mais recentemente, em muitos lares. Levando em consideração fatores como praticidade e riscos ambientais com a produção e o descarte do mercúrio, vem aumentando a oferta e a utilização sistemática de aparelhos automáticos para essa medida. Mesmo em decorrência das novas tecnologias, normas foram instituídas para garantir a precisão e o desempenho desses aparelhos, passando então por critérios rigorosos a fim de testar sua validação para uso. O presente estudo tem como objetivo avaliar a confiabilidade e o desempenho do aparelho automático de punho, visomat® handy IV, para medida indireta da pressão arterial, de acordo com o Protocolo Internacional da European Society of Hypertension. PI/ESH. Para isso, medidas da pressão arterial sistólica e diastólica em 33 voluntários (15 para a Fase I e mais 18 para a Fase II, contando 99 medidas), foram obtidas usando um esfigmomanômetro de coluna de mercúrio (Unitec®) e um esfigmomanômetro automático (visomat® handy IV). Nove medidas sequenciais no braço/punho entre o esfigmomanômetro de mercúrio e o automático em teste, foram realizadas de acordo com o Protocolo Internacional em suas fases (Fase I, Fase II.a e Fase II.b), além do exame de eletrocardiograma. O aparelho passou na Fase I com 32 medidas para pressão sistólica e 26 para a diastólica, excedendo 25 exigidas, no intervalo de 0-5 mmHg. Já na Fase II.a o aparelho passou, com 64 medidas para a sistólica e não passou na diastólica, atingindo apenas 40 das 60 exigidas. Finalmente, na Fase II.b pelo menos 22 voluntários deveriam ter duas de suas três comparações situadas na faixa até 5 mmHg, o que aconteceu com somente 21 voluntários na sistólica e 12 na diastólica; além disso, no máximo três poderiam ter todas suas comparações acima de 5 mmHg e isso aconteceu com 5 voluntários na sistólica e 12 na diastólica. A média das diferenças mostrou uma discordância entre o esfigmomanômetro de mercúrio e o aparelho automático de 0,5 (±8,5) mmHg para a pressão arterial sistólica e de - 3,8 (±9,1) mmHg para a diastólica, respectivamente. Conclui-se que o esfigmomanômetro automático visomat® handy IV não conseguiu atingir os critérios mínimos do PI/ESH, não sendo recomendado para o uso clínico
Abstract: The measurement of blood pressure is a routine practice in health care institutions and, more recently, at home. Taking into account factors like convenience and environmental risks related to production and discard of mercury, supply and systematic application of automated device for the measurement has increased. As a result of new technologies, standards were established to ensure the accuracy and performance of the devices, which were submitted to strict criteria in order to test its validation for use. This study aims to evaluate the wrist automatic device for indirect measurement of blood pressure, visomat® handy IV, according to the International Protocol of the European Society of Hypertension - IP/ESH. For this, measurements of systolic and diastolic blood pressure in 33 volunteers (15 for Phase I and a further 18 for Phase II, counting 99 measurements) were obtained using a mercury sphygmomanometer (Unitec®) and an automatic sphygmomanometer (visomat® handy IV). Nine sequential measurements with a mercury sphygmomanometer (five, on the arm) and automatic device (four, on the wrist) were performed according to the International Protocol in its phases (Phase I, Phase II.a and Phase II.b), besides the electrocardiogram. The device passed Phase I with 32 measurements for systolic and 26 for diastolic in the range of 0-5 mmHg (25 are required). In Phase II.a, the device reached 64 adequate values for systolic and 40 for diastolic pressure (60 are required). In Phase II.b, at least 22 volunteers should have two of their three comparisons situated in the range up to 5 mmHg, and this occurred with only 21 volunteers in systolic and 12 in diastolic. Moreover, at most three could have all their comparisons above 5 mmHg and this happened to five volunteers in systolic and 12 in diastolic. The mean differences showed a disagreement between the Mercury sphygmomanometer and the automated device of 0,5 (±8,5) mmHg for systolic and - 3,8 (±9,1) mmHg for diastolic, respectively. We conclude that the automatic sphygmomanometer visomat® handy IV failed to achieve the minimum criteria of the IP/ESH, and is not recommended for clinical
Mestrado
Enfermagem e Trabalho
Mestre em Enfermagem

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Mestrado Profissional em Enfermagem Assistencial
O estudo aborda os processos de limpeza e desinfecção dos principais dispositivos de monitoramento não críticos (termômetros, esfigmomanômetro, cabos de eletrocardiograma e oxímetro) considerando a sua participação na transmissão das infecções relacionadas à assistência à saúde. Estes equipamentos têm sido apontados como uma das principais fontes de infecção por bactérias multirresistentes causadoras de surtos infecciosos em ambiente hospitalar portanto, exigem padronização da limpeza e desinfecção, mediante um protocolo que norteie o processo de trabalho. Este estudo teve como objetivos: elaborar um protocolo de limpeza/desinfecção dos principais dispositivos de monitoramento não críticos, com base nas boas práticas e evidências na literatura, e validar este protocolo com avaliação de experts em infecção hospitalar. Trata-se de estudo descritivo e exploratório, que no seu desenvolvimento seguiu as seguintes etapas: revisão integrativa da literatura, elaboração do protocolo de limpeza e desinfecção dos principais dispositivos de monitoramento não críticos e validação do protocolo por experts em infecção hospitalar. A elaboração do protocolo ocorreu a partir das boas práticas identificadas nos estudos selecionados na revisão integrativa, livros, teses, dissertações e documentos de órgãos nacionais e internacionais sobre a temática. Para validação do protocolo foram selecionados cinco experts em infecção hospitalar, de acordo com os critérios de seleção sugeridos no estudo. Após avaliação de cada recomendação do protocolo proposto, em um questionário, foi calculado o grau de concordância entre eles por média ponderada. A partir da análise dos registros dos experts e, considerando o grau de concordância das respostas, foi elaborado o protocolo final. Assim, respondendo aos objetivos do estudo, inicialmente tem-se o protocolo construído a luz do conhecimento científico que foi chancelado por um grupo de experts gerando o protocolo final. Este protocolo é portanto, o produto desta pesquisa e com ele pretende-se padronizar os processos de limpeza e desinfecção destes dispositivos, visando preencher as lacunas do conhecimento teórico/prático identificadas sobre a temática e reduzir os riscos de transmissão de infecção por estes artigos. Este protocolo será proposto à Comissão de Controle de Infecção Hospitalar da Secretaria Estadual de Saúde do Rio de Janeiro, a fim de implementá-lo nas unidades de pronto atendimento 24 horas (UPAs 24hs) testando sua aplicabilidade e futuramente sua eficácia.
The study discusses the procedures of cleaning and disinfection of the main non-critical monitoring devices (thermometers, sphygmomanometer, electrocardiography wires and oximeters wires) considering their participation in the transmission of infections related with health care. These equipments have been identified as the major source of infection by multiresistant bacteria that causes hospital infections, therefore, require standardization of cleaning and disinfection, by using a protocol that guides the work process. This study aims to: develops a protocol for cleaning / disinfection of the main non-critical monitoring devices, based on best practices and evidence in the literature, and validate this protocol with assessment of experts in hospital infections. It is descriptive and exploratory study, which involved the following steps: integrative literature review, development of the protocol for cleaning and disinfection of the main devices of non-critical monitoring and a validation of this protocol by the experts of hospital infection. The protocol development is based on best practices identified in the studies selected in integrative review, books, thesis, dissertations and national and international documents on the subject. To validate the protocol, five experts in hospital infection were selected according to the selection criteria suggested in the study. After evaluating each recommendation of the proposed protocol, in a questionnaire, the degree of agreement was calculated by weighted average. From the analysis of the observations of experts and considering the degree of agreement of answers, a final protocol was developed. So, to answer the aim of this work, first of all, a protocol was developed with scientific knowledge and afterward judged by some experts, which leads to a final protocol. Therefore this final protocol is the result of this study and it is intended to standardize the process of cleaning and disinfection of these devices, fill gaps in theoretical/practical knowledge on the subject and reduce the risk of infection transmission by these objects. These protocol will be proposed to the of Hospital Infection Control Committee at the State Department Health of Rio de Janeiro, to implement it in emergency care unit (called “UPAs 24 hs”) testing its applicability and future effectiveness.

Recently, novel concepts and medical technologies have developed rapidly with enormous growth and unprecedented expansion in the range of interventions and knowledge offered for health professionals in their clinical decision making. This burgeoning innovation has not necessarily resulted in an incremental availability of knowledge to policymakers and clinicians. In this study critical translation gaps have been addressed strategically in the research-into-action cycle to improve outcomes and services. Given widespread acceptance that waveform morphology and blood pressure (BP) differ considerably between the central aorta and peripheral arterial system, it is clear that BP measurements in the peripheral arteries cannot serve as direct substitutes for their central counterparts. Although non-invasive BP measured in the brachial artery (cuff BP) is the basis for the present management of hypertension, central blood pressure (CBP) has been shown to be the better predictor of cardiovascular outcomes than cuff BP. Consequently, there are substantial research efforts to develop non-invasive estimating methods for CBP, mainly based on the technique of applanation tonometry. However, CBP measured has not been widely adopted in clinical practice. One of the possible gaps is that tonometry-based measurement requires some skills and time to perform and it is a relatively expensive technique. Besides, the accuracy of the current tonometry-based techniques has been questioned. To identify and address the gaps of translating the evidence of the importance of CBP, a series of studies were conducted. To identify existing gaps, I carried out a systematic review and meta-analysis of studies comparing tonometry-based CBP estimates with invasively measured central BP and found that present tonometry-based CBP estimating methods are acceptable in theory, with small errors. However, there is substantial room for improvement in measurement accuracy of CBP. To develop a more accurate, less expensive, and less technically dependent CBP measurement technique, the pulse wave analysis (PWA) technique for brachial pulse volume plethysmography (PVP) waveforms from an oscillometric blood pressure monitor was implemented. Evaluation demonstrated that large random and systematic errors are introduced into the central pulse pressure (PP) estimates when they are calculated as the difference between the estimated central systolic BP (SBP) and central or cuff diastolic BP (DBP), which can be improved substantially with the novel PWA approach. Subsequently, the novel technique was seamlessly incorporated into a standalone automatic BP monitor. In a rigorous validation study, it was demonstrated that CBP can be measured accurately by this stand-alone automatic blood pressure monitor. To apply the CBP concept in clinical practice, the gap between innovation and clinical application should be closed. The diagnostic threshold for confirming a diagnosis of hypertension with CBP has never been proposed; I therefore derived and validated the diagnostic threshold of CBP based on two independent event-based cohorts with long-term follow-up. With the proposed cut-off limits for the diagnosis of hypertension, the diagnostic accuracy of the stand-alone CBP monitor reference to invasively measured CBP was estimated. It was then suggested that traditional cuff BP may be reliable in confirming the diagnosis of hypertension and in justifying subsequent treatment with its high specificity. However, because of low sensitivity, the cuff BP could render possible management inaccessible to a considerable proportion of hypertensive subjects, who may be identifiable through the noninvasive CBP monitor. Finally, in responding to the gap between clinical application and policy, a health economic evaluation was required to support the cost-effectiveness of the new emerging technique. A comprehensive Markov modelling was performed and this confirmed the cost-effectiveness of CBP monitoring, which resulted from a greater quality gain that outweighed its supplementary cost. Given more data supporting the diagnostic and prognostic role of CBP, it should be considered to be an effective strategy for the management of hypertension.
Thesis (Ph.D.) -- University of Adelaide, School of Translational Health Science, 2013

碩士
國立交通大學
電控工程研究所
102
In the clinical study, the invasive measurement of the blood pressure can provide signal which is continuous. However, it’s much more inconvenient than the non-invasive one. Due to this reason, this study develops a novel approach and algorithm to measure blood pressure and operate on the smart phone. Using the HD recording function on the smart phone, the wavelength could be detected instantaneously, and the algorithm could be written based on its relationship with blood pressure. In this paper, the approach can be applied to color video recordings of the human face using the HTC smart phone. Post analysis of the video recordings were done using software written in Matlab. The heart rate , systolic and diastolic are derived from the method for measuring multiple physiological parameter. In addition, it is then written into JAVA scripts and transferred into Android phones via the Eclipse program for realistic simulation. It is currently uploaded onto GooglePlay for application download.

碩士
國立交通大學
電控工程研究所
102
Human being’s irregular lifestyles and inappropriate eating habits nowadays result in cardiovascular diseases for citizens at large. The population that is examined having cardiovascular diseases increases every year. Such phenomenon has given blood pressure a lot of attention in the medical field. Blood pressure is an important indicator of a person’s health well being because blood pressure reflects the health status of an individual’s cardiovascular system. This research provides a comprehensive explanation on the methods of measuring blood pressure. The most popular method for blood pressure measuring is by using an electronic sphygmomanometer. Though the electronic sphygmomanometer is advanced enough to adapt a non-invasive measuring method, it still has numerous disadvantages. First, a cuff is required to occlude the blood flow in the arteries during blood pressure measuruing, which causes unpleasant feelings for the users when using. Second, a fixed cuff size may cause measuring errors, which decrease the result accuracy. Last but not least, these devices are bulky and extremely inconvenient to carry around. To remedy the problems that an electronic sphygmomanometer has, this research will illustrate how to use a camera sensor with algorithm to measure the blood pressure. Then such technology is implemented through Android smart phone application. The creation can make an accurate sphygmomanometer available to all citizens who own a smart phone. From that, they can measure their blood pressure wherever they go conveniently and accurately.

The Omron M4 (AS) is an upper arm automatic sphygmomanometer that has not been conclusively validated in clinical trials. The aim of this research was to determine whether the Omron M4 was accurate enough for clinical use. Sixty-two young, apparently healthy participants were recruited. Participants had their blood pressure (BP) taken once with the AS and once with a mercury sphygmomanometer (MS) in random order. Results were compared against the British Hypertension Society (BHS), and the Association for the Advancement of Medical Instrumentation (AAMI) protocols for evaluation of automatic sphygmomanometers. We concluded that the Omron M4 is questionable rating according to previously stated guidelines. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

碩士
朝陽科技大學
資訊工程系碩士班
100
In Taiwan, people die in Blood vessel disease have higher ratio, the age distribution of death occurs mainly between 65-84 years, but, due to the living environment factors and abnormal rhythms of life, leading to death Age of hypertensive disease have downward trend. In this study , we made a device of measurement of blood pressure, differences with the traditional sphygmomanometer is the pressure sensor and flow meter sensor are all digital sensors, and use the digital filter to replace the traditional analog filter, , then the dynamic ratio of systolic and diastolic to replace the traditional theory of systolic and diastolic ratio, finally, we use estimate the systolic, diastolic and mean blood pressure to comparison with the stethoscope actual systolic, diastolic and mean blood pressure, relevance were 0.84,0.90,0.88.

碩士
國立臺北科技大學
自動化科技研究所
103
This study is describing that using PPG (Photoplethysmography) method to analyze the physical information of heartbeat by photographic images of the right index finger recorded by smart mobile devices. Then we tried to find out the diastolic and systolic blood pressure through the cardiovascular circulatory system model, Windkessel, and use time constant method and genetic algorithm with grey decision to improve cardiovascular circulation system and to increase blood pressure measurement accuracy.

The Omron M4 (AS) is an upper arm automatic sphygmomanometer that has not been conclusively validated in clinical trials. The aim of this research was to determine whether the Omron M4 was accurate enough for clinical use. Sixty-two young, apparently healthy participants were recruited. Participants had their blood pressure (BP) taken once with the AS and once with a mercury sphygmomanometer (MS) in random order. Results were compared against the British Hypertension Society (BHS), and the Association for the Advancement of Medical Instrumentation (AAMI) protocols for evaluation of automatic sphygmomanometers. We concluded that the Omron M4 is questionable rating according to previously stated guidelines. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

碩士
崑山科技大學
電子工程研究所
103
According to the statistics of Ministry of Health and Welfare, hypertensive diseases were ranked the eighth of ten leading cause death in 2014. The increasing probability of hypertensive with increasing ages and the annually increasing proportion of aged population has gradually increased the number of people suffering from hypertension. Besides, hypertension would result in several negative effects on human bodies, such as heart and kidney failure and cerebrovascular and cardiovascular diseases, which could cause pain for patients and even result in death. Moreover, blood pressure would change with physiology, emotion and other factors. Without attention, hypertension patients would suffer from sudden heart and cerebrovascular diseases. The control of blood pressure therefore is necessary. Besides, most elders would like to stay at home that hypertension home care is considered important. In addition to design a sphygmomanometer, wireless network transmission technology and voice reminder are added for remote monitoring and recording blood pressure in this study. Accordingly, healthcare workers could receive and record patients’ blood pressure measurement data for analyses and reference at any time. The voice reminder could prevent patients from forgetting the time to measure blood pressure and take medicine. The system is applied to achieve the hypertension home care.

碩士
亞洲大學
電腦與通訊學系碩士班
96
Recently the application of the wireless communication is worth to research and develop with the advance of wireless communication technology and the popularity of medical device. The aim of this work is to design and build a set of interface of Bluetooth wireless transmission with the blood pressure meter which incorporates the blood pressure measurement and transmission software. Therefore systolic pressure, diastolic pressure, heart beat rate can be received automatically. The transmission technique used in the work is IEEE802.15.4 technologies with Bluetooth characterizing low power, simple structure, low costs and small size. It is particularly suitable for homecare application.

碩士
亞洲大學
光電與通訊學系碩士班
97
In this paper, the authors propose a measuring system of physiological signals based on the concepts of Ubiquitous healthcare. By using the Bluetooth technology and the physiological signals can be transferred to a server appropriately via personal digital assistant (PDA). In order to protect the patients’ privacy and preserve the security of the large number of measured signals, we use DES and RSA joint algorithms to encrypt all the data of the cared people and the key of DES algorithm, respectively. It provides the well-compromise between the speed of encryption/decryption and the information security. In contrast to the conventional nursing, that is, the nurses record the physiological data via hand write and input the data to a computer when they go back to the nursing station. Our proposed approach can effectively improve the efficiency, correctness, and security.

碩士
聖約翰科技大學
電子工程系碩士班
98
This research is based on the structure of electronic sphygmomanometers, develop low cost, and simple exercise to do without professional Arterial stiffness measurement system. Using the oscillometric method to measure blood pressure and pulse signals, with the dry electrode to obtain ECG, automatic calculation of the Pulse Wave Velocity(PWV) and Arterial Stiffness Index(ASI), make electronic sphygmomanometers not only can measure blood pressure and heart rate, but also to have Arterial stiffness measurement function, with graphical user interface. So users will not longer be neglected by operation of complex measurements. The system consists of hardware and software of two parts. Hardware systems by the blood pressure and ECG processing circuitry, is mainly responsible for signal acquisition, filtering and amplification. Software system is responsible for blood pressure, heart rate, pulse wave velocity and arteriosclerosis index values calculated and stored, can also put pulse wave and ECG drawn on the screen, for medical staff to diagnose the supporting information.

碩士
國立臺北科技大學
製造科技研究所
102
This paper investigates the flow balance of two-cavity mold plastic product (sphygmomanometer cover and housing) using Moldex3D_CAE software to analyze the filling process of the melt. At first, Taguchi method L8 orthogonal array was used for noise experiment to find the significant factors influence the flow balance, including melt temperature, injection pressure, and gate diameter. These three factors compound to a noise factor N (bad flow balance at level N1, and good at N2). Secondly, L18 orthogonal array was employed in main experiment to compare the melt front of the two cavities. Results show the significant factors are runner diameter, gate diameter, injection pressure, and melt temperature, respectively. Maximizing S/N ratio is to find the combination of optimum process parameters. Finally, analysis of variance (ANOVA) was used for the significance tests and pooling of errors. The significant factors obtained in Taguchi method does agree with by ANOVA. The S/N ratio difference between experimental and predict value is 1.07 dB before improving process, and 0.2 dB after improving process. These two values are smaller than 2.81 dB of confidence intervals. Empirical model is enough accurate under the confidence level of 95%.

碩士
朝陽科技大學
資訊工程系
103
Atherosclerosis is the major reason to make people unhealthy. The pathogens of atherosclerosis are the connective tissue growing and cholesterol depositing on the arterial wall which make the arterial vessel stiffness and narrow. Thus, the artery vessel loses the compliance characteristics. The atherosclerosis has the relation with the endothelial dysfunction that could be assessed by the arterial flow mediated vasodilation (FMD). In this study, we designed a cuff measurement system to assess the FMD degree. In order to determine the performance of this system, we measured the women’s FMD on the menstrual and progesterone phases. This cuff instrument could occlude the brachial arterial blood flow to make the hyperemia reaction, and it also could measure the pressure waveform before and after the occluding blood flow. The stable amplitude of pressure waveform before occluding blood flow was defined as the base line of FMD, and the maximum amplitude of pressure waveform after occluding blood flow was defined as the hyperemia reaction of FMD. Twenty-six women participated this study. The results show that the FMD degree had the significant difference between menstrual and progesterone phases (Menstrual: 1.14±0.50, Progesterone: 1.46±0.67, p<0.015, first menstrual cycle; Menstrual: 0.98±0.37, Progesterone: 1.28±0.58, p<0.0026, second menstrual cycle). Therefore, the cuff instrument system could assess the brachial FMD degree.

碩士
亞洲大學
光電與通訊學系碩士在職專班
103
In this Thesis, an information system implementation based on Linux op-erating system for wireless sphygmomanometer is proposed. The purpose of this approach is to enhance the weakness of real-time vital signs sur-veillances in today’s emergency medical service system of the fire de-partment in Taiwan. In this Thesis, we use a virtual machine to build a backend information system by using the Linux operating system. The implemented system may collect the data automatically and send the warning message when the measured signals are abnormal. Finally, a practical project is provided for verifying the effectiveness of the pro-posed approach.

Trabalho de Projeto do Mestrado Integrado em Engenharia Física apresentado à Faculdade de Ciências e Tecnologia
O crescente desenvolvimento tecnológico tem potenciado a implementação de novas ferramentas de ensino, em particular relativamente ao ensino médico e à melhor preparação para a prática clínica. Fatores limitadores a esta prática como o tempo disponível para treino clínico e a falta de disponibilidade de doentes são responsáveis pela rápida inovação nos sistemas de educação médica. O recurso a simuladores para a prática do ensino médico tem-se tornado cada vez mais comum e presente, tanto em fases mais iniciais do treino como em contexto de desenvolvimento e consolidação de conhecimentos. Acompanhando o desenvolvimento tecnológico, tem-se verificado uma crescente diversidade de simuladores, com diferentes características e direcionados para diferentes áreas, mas com uma progressiva melhoria na fidelidade dos mesmos o que os torna ótimos recursos para integrarem o ensino médico. Este projeto tem como objetivo o desenvolvimento de uma plataforma de simulação que integra quatro instrumentos: oxímetro, glicómetro, esfigmomanómetro e estetoscópio. Para cada um destes, é possível simular várias patologias de forma a permitir o treino e a avaliação de conhecimentos dos formandos nestas áreas específicas. De forma a desenvolver esta plataforma, foi necessário explorar os vários componentes da mesma de forma individual. Primeiramente, exploraram-se os instrumentos que pretendiam ser simulados, isto é, estudou-se o funcionamento de cada um, quais os valores medidos que correspondem a valores normais e anormais (inclusivamente valores correspondentes a patologias específicas) e analisaram-se ainda vários instrumentos reais de forma a averiguar quais as dimensões usuais dos mesmos. Desenharam-se ainda os correspondentes aos simuladores dos instrumentos para posterior impressão 3D de forma a garantir o realismo da plataforma. Seguidamente, desenvolveram-se as aplicações que permitem a realização da simulação. Construíram-se duas aplicações: uma direcionada ao formador e outra direcionada ao formando. O formador escolhe qual o instrumento sobre o qual irá decorrer a simulação e são lhe apresentadas as diversas opções de valores/patologias relativos a esse determinado instrumento. O valor correspondente à opção escolhida é enviado para a aplicação do formando que irá realizar uma análise da situação que lhe foi exposta. Existe ainda a possibilidade para o formador avaliar o formando. De forma a ser possível realizar esta comunicação foi construída uma base de dados que regista todas as decisões tomadas e onde ficam guardadas todas as avaliações. É sempre possível aceder a estas avaliações, havendo ainda a possibilidade de selecionar as avaliações relativas a um formando em particular. A plataforma, assim como os seus componentes que a constituem, foram desenvolvidos de forma funcional. Ainda que existam fatores que possam ser melhorados, verifica-se a comunicação entre as aplicações e entre as aplicações e os instrumentos sendo possível concluir que os requisitos do projeto foram concluídos com sucesso.
The increasing technological developments have been responsible for the implementation of new teaching tools, particularly regarding medical education and better preparation for clinical practice. Limiting factors to this practice, such as the time available for clinical training and the lack patients’ availability, are some of the factors responsible for the accelerated innovation in medical education systems. The use of simulators for the practice of medical education has become increasingly more common and present, both in early stages of training and in the context of development and consolidation of knowledge. Parallel to the technological developments, there has been a growing diversity of simulators, with different characteristics and directed to different areas, but with a progressive improvement in the fidelity, which makes them great resources to integrate medical education. This project aims to develop a simulation platform that integrates four instruments: oximeter, glucometer, sphygmomanometer and stethoscope. For each of these, it is possible to simulate various pathologies allowing training and assessment of the trainees' knowledge in these specific areas. In order to develop this platform, it was necessary to explore its various components individually. Firstly, the instruments that were intended to be simulated were explored, that is, the functioning of each one was studied, which measured values correspond to normal and abnormal values (including values corresponding to specific pathologies) and several real instruments were also analyzed in such a way as to find out what their usual dimensions are. The simulators of all the instruments were also designed for later 3D printing to guarantee the most realism of the platform. Afterwards, the applications that allow the simulation to be carried out were developed. Two applications were built: one directed to the trainer and another directed to the trainee. The trainer chooses the instrument on which the simulation will take place and is presented with different options of values/pathologies related to that particular instrument. The value corresponding to the chosen option is sent to the application of the trainee who will carry out an analysis of the situation that was exposed to. There is also the possibility for the trainer to evaluate the trainee. In order to make this communication possible, a database was built that records all the decisions taken and where all the evaluations are stored. It is always possible to access these assessments as well as to select a particular trainee and only have those evaluations regarding that one individual specifically available. The platform, as well as its components, were developed in a functional way. Although there are factors that can be improved, communication between applications and between applications and instruments is verified, and it is possible to conclude that the project requirements were successfully completed.

碩士
亞洲大學
光電與通訊學系碩士在職專班
103
During the process in emergency medical services, time plays the most important role among others. However, in ambulances, emergency medical technicians have to watch many vital signs to judge the injury or disease severity of the patients. One of most important vital signs is blood pressure. It can be the important reference of some medical treatments. To date, almost everyone has a smart phone. In this Thesis, we will construct a communication system to transfer the acquired signals from a sphygmomanometer to a smart phone via Bluetooth transmission. We expect that such a system may effectively reduce the working load of the emergency medical technicians as well as promote the service quality before the patients arrive at hospitals. In contrast to conventional processes in the Fire Department in Taiwan, the proposed approach may improve the efficiency, correctness, and safety in measuring the vital signs.

碩士
國立台中教育大學
事業經營研究所
99
As progress in line with the development of time and uplift of living standard, the aging population and low birth rate around the world accelerate the usage of electronic products for home health care. Moreover, the increase of “three hyper population” (hypertension, hyperlipidemia, hyperglycemia) becomes one of the ten major causes of death in Taiwan, of which hypertension is always the first occurrence symptom of diseases. In order to prevent from hypertension, sphygmomanometer should be used to measure blood pressure regularly. In recent years, along with emphasis of health care and rapid development of electronic technology, the easy-to-use and convenient-to-carry electronic sphygmomanometer has become the most popular medical device, and hence our research target. However, the purchase decision of electronic sphygmomanometer is often subjected to product quality, price, sales service, staff professional knowledge, etc. GLOVAL model has been developed to construct customer perceived value, following literature review of medical device and perceived value, and then Analytic Hierarchy Process (AHP) is used to find out the most important value and to explore the cognitive differences between consumer and medical device merchant. In order to collect information 56 questionnaire has been sent to consumer and the medical device merchant, and 50 feedbacks are valid which includes of 18 copies of medical device merchant, 34 copies of consumer. The finding of this study suggests that consumer in contrast of medical device merchant pays more attention on product quality and price, and regards less on professionalism and service quality of sales, professional knowledge recognized by trader. The paper provides managers the difference of perceived value between consumer and medical device merchant when they develop marketing strategies and sales performance.

The aim of this study was to observe the rate of compliance that postgraduate (4th and 5th year) osteopathy students demonstrate when applying their undergraduate blood pressure (BP) measurement training in a clinical situation. Thirty-seven volunteer postgraduate participants were watched measuring blood pressure in a mock clinical situation by two observers. Both observers according to whether or not each component of blood pressure measuring was observed ticked a 20-point checklist. Overall the participants showed a 56% compliance rate according to the guidelines taught to them. Inter-class correlation coefficient showed a high level of inter-examiner reliability with a significant ICC of 0.996 found in observation of the students. The results from this investigation indicated that the osteopathic students failed to comply with the blood pressure measurement guidelines taught to them. This may lead to practitioner introduced error. The importance of performing and recording certain variables should be taken into account when teaching and assessing osteopathy students in the future. Further investigation into the knowledge retention of the students is suggested before major conclusions are drawn. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

The aim of this study was to observe the rate of compliance that postgraduate (4th and 5th year) osteopathy students demonstrate when applying their undergraduate blood pressure (BP) measurement training in a clinical situation. Thirty-seven volunteer postgraduate participants were watched measuring blood pressure in a mock clinical situation by two observers. Both observers according to whether or not each component of blood pressure measuring was observed ticked a 20-point checklist. Overall the participants showed a 56% compliance rate according to the guidelines taught to them. Inter-class correlation coefficient showed a high level of inter-examiner reliability with a significant ICC of 0.996 found in observation of the students. The results from this investigation indicated that the osteopathic students failed to comply with the blood pressure measurement guidelines taught to them. This may lead to practitioner introduced error. The importance of performing and recording certain variables should be taken into account when teaching and assessing osteopathy students in the future. Further investigation into the knowledge retention of the students is suggested before major conclusions are drawn. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

碩士
國立臺北大學
企業管理學系
91
Because of the increasing of National Income, the aging of population composition, and the introduction of new medicotechnology, the people raise the needs of medical treatment & health to promote the growing rate of medicine and hygiene industry, especially the noticeable increasing potential of household medical device. The target of the research is household electronic sphygmomanometer, so the research mainly explores the relationship between customers’ shopping orientation, perceive risk and selection of channel types. Through collecting relational documents and using statistic analysis to segment several shopping- orientation clusters, the research also investigates into every cluster’s relation to selection of channel types and demographic variables, and whether interfere with the relationship between perceived risk and selection of channel types. It is including two purposes: one is that the conclusion of the research could make the household electronic sphygmomanometer firms to know the target market, and another one is that the suggestion of the research could assist firms to make effective strategies. The objects of the research limited the people in Taipei area who have bought the household electronic sphygmomanometer. The research got 347 valid observations by adopting convenient sampling method and sending to traditional and on-line questionaries at the same time. The research distinguished the marketing channels of household electronic sphygmomanometer into 4 types: “the channel of special stores”, “the channel of pharmacies and drugstores”, “the channel of large stores”, “the channel of non-stores”, and used factor-cluster analysis to extract four shopping orientation factors named “search and comparison”, “brand perspective”, “convenience orientation”, “store preference”; and named three clusters: “ brand perspective and store preference both concerned cluster”, “search and comparison cluster”, “convenient cluster”. After using statistic methods to analyze the data, the summary of the conclusion and suggestion as follows: 1. Customers choose different channel types by the influence of their perceived risk. Based on the result, the household electronic sphygmomanometer firms should take the effective strategies to reduce customers’ perceived risk. For financial risk, firms can show the watchword: ”If the product is not suitable then we will return your money” or have discount or on a special sale sometimes. For performance risk, firms can encourage customers to try out before buying the product, provide the certificate of quality or exchange the product in the next week. For social risk, firms can improve the prevention and health ideas of young people. For physical risk, firms can state clearly in writing the operating method and a point for attention in the operation manual. 2. Household electronic sphygmomanometer firms should actively discover consumer’s shopping orientation and the market segments so as to understand their component characters and purchasing motive and attitude, which will make the consumers more satisfying. For the brand perspective and store preference both concerned cluster, firms should enhance the brand image to spread brand familiarity, and strengthen the functions of marketing stores. For search and comparison cluster, firms can develop new medical products and reduce price on a sale, reinforce the services of maintenance and upkeep in retail shops. For convenient cluster, firms should have intensive marketing channel and consider the convenience of communications and shopping, they also should enhance the professional training and attitude of salesmen.

Student Number :9900127Y - MSc (Eng) dissertation - Faculty of Engineering and the Built Environment
Arterial pulse wave analysis studies the wave shape of the blood pressure pulse. The pulse wave provides more information than the extreme systolic and dia- stolic pressures, measured with a cuff sphygmomanometer. The aim of the research is to investigate the design issues in a pulse wave analysis system, and to compare these to a commercially available system. The system was compared and validated by measuring the pulse wave at the radial artery (wrist) using the non-invasive technique of arterial tonometry. The design conformed to the IEC-601 safety standard to ensure patient safety. The data was compared against the data from the commercial system and analysis was performed in the time and frequency domain. The performance of the design suggests that, in some respects, the design was comparable to the commer- cial system, however, a number of performance characteristics fell short of the commercial system. Suggestions have been made to address these problems in further research.