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Protecting ultra- and hyperhydrophilic implant surfaces in dry state from loss of wettability

  • Steffen Lüers , Markus Laub and Herbert P. Jennissen EMAIL logo
Published/Copyright: September 30, 2016
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Current Directions in Biomedical Engineering
From the journal Current Directions in Biomedical Engineering Volume 2 Issue 1

Abstract

Ultrahydrophilic titanium miniplates with sandblasted and acid etched (SLA) surfaces were protected from loss of hydrophilicity by an exsiccation layer of salt and stored in a dry state. Various salts in different concentrations were tested in respect to their conservation capacity and optical appearance. Potassium phosphate buffer in a specified composition appeared to be optimal. This optimal system was applied in a long time storage experiment showing no loss of hydrophilicity over years. It was also transferred with success to hyperhydrophilic dental implants.

Keywords: dental implants; dry conservation; exsiccation layer; hydrophilic; hyperhydrophilic; imaginary contact angles; sandblasted and acid etched (SLA); Titanium; ultrahydrophilic

1 Introduction

Hydrophilic surfaces are very sensitive and lose their wetting properties by storing in air [1]. So a conservation of the hydrophilicity is necessary. As early as 2000 [2], [3] Jennissen reported the preparation of ultrahydrophilic surfaces (θ < 10°) on titanium by treatment with chromosulphuric acid and its conservation in dry methanol (for review see [4]). The accelerated and improved osseointegration of this surface has been demonstrated in the mandible of dogs [5]. Later Steinemann and Simpson reported that hydrophilic but not ultrahydrophilic sandblasted and acid etched (SLA) surfaces could be stored and conserved in certain salt solutions (e.g. NaCl) [6], now employed by Straumann GmbH known under the name SLActive®. Its benefits have been demonstrated over the years in preclinical as well as clinical studies [7]. Here we report the preservation of surfaces with ultra- and hyperhydrophilic properties in the dry state by an exsiccation layer of salt ions, which protects the surface from loss of wettability [4], [8], [9].

2 Material and methods

SLA (type 1): Titanium miniplates (14 × 14 × 1.5 mm) were manufactured from a titanium rod (grade 4, ASTM F67) and sandblasted with corundum. The sandblasted plates were etched with 50% H2SO4 at evaluated temperature by a proprietary method developed by Morphoplant GmbH leading to an ultrahydrophilic and microstructured surface containing 1–3% corundum [9]. SLA (type 2): Titanium sheets (300 × 300 × 1 mm, grade 4, ASTM F67) were sandblasted with corundum and sandblasted miniplates (14 × 14 × 1.0 mm) were stamped from these sheets. The sandblasted minplates were etched by a combined process, which is developed and proprietary by Morphoplant GmbH. The first step is etching in diluted HF at room temperature and the second step etching in 50% H2SO4 at evaluated temperature leading to an ultrahydrophilic, microstructured and nearly corundum free surface.

Dry Conservation of the SLA surface by an exsiccation layer of salt: The test samples with the initial SLA surfaces were incubated in the specified salt solution for several hours at room temperature. Afterwards they were taken out from the salt solution and air dried for 2 h under clean conditions [4], [9] in two variants: (1) open storage: in air under ambient conditions; (2) in closed glass vials.

The following abbreviations are used for the tested buffers (in parenthesis the molar ratio is given).

– PBS: phosphate buffered saline: 136.8 mM NaCl, 2.7 mM KCl, 1.5 mM KH2PO4 and 8.1 mM Na2HPO4

– PBS(+): phosphate buffered saline with Mg and Ca: 136.8 mM NaCl, 2.7 mM KCl, 1.5 mM KH2PO4, 8.1 mM Na2HPO4, 1.0 mM CaCl2, 0.5 mM MgCl2.

– NaPB: sodium phosphate buffer: Na2HPO4, NaH2PO4 (5.4/1)

– KPB: potassium phosphate buffer: K2HPO4, KH2PO4 (5.4/1)

– MgPB: magnesium phosphate buffer: The specified amount of MgHPO4 was suspended in water and the minimum amount for solubility of H3PO4 was added.

Contact Angle Measurements: Before measurement the exsiccation layer of salt was washed off [8] the sample by dipping in water and MeOH and dried in air. Classical contact angles were measured by the method of Wilhelmy in ultrapure water on a DCAT 11 EC tensiometer (Dataphysics GmbH, Filderstadt, Germany) at constant 20°C with the Dataphysic’s SCAT software (vers. 3.2.2.86). In this software there is no base line correction for imbibition [10] yielding contact angles (θ) from 0° to 180°, whereby the mathematically incorrect definition θ = 0 for cos(θ) > 1 is reported [11], [12], [13], [14]. Imaginary contact angles after base line correction were calculated by a custom made algorithm in the program MatLab (vers. 7.14, The MathWorks Inc., Natick, MA, USA). Herewith for −1 < cos(θ) < 1 the value of the contact angle lays between 180° and 0° as above, whereas for cos(θ) > 1 contact angles in imaginary number space, i.e. imaginary contact angles, are obtained [15], [16], [17].

Nomenclature: Classical and real contact angles are denoted by a small letter theta (θ) and imaginary contact angles by a capital theta (Θ) [14]. Advancing and receding angles are identified by the indices a and r, respectively. Hybrid dynamic contact angles denote the combination of an advancing contact angle in real with a receding contact angle in imaginary number space [10]. For surfaces θ < 10° the term “ultrahydrophilic” and for surfaces with pure imaginary contact angles the term “hyperhydrophilic” is employed [10].

Long Term Stability: For long term stability testing 200 miniplates with SLA (type 2) surface were prepared and contact angles were measured immediately after etching with the mean classical values: θa = 1.1 ± 3.2° and θr = 0.0 ± 0.0°. For the storage experiment only samples with classical contact angles of 0° were chosen (87% of the samples). These samples were conserved by an exsiccation layer of 96 mM KPB, fixed in alumina tubes and packaged in closed glass vessels and sterilized by gamma irradiation with a dose of minimum 25 kGy by BBF Sterilisationsservice GmbH (Kernen, Germany). One part of the sterile samples were stored at ambient temperature (real time ageing), whereas the other part was stored at 60°C (accelerated ageing) in an oven under recording of the temperature according to ASTM F1980 [18]. Since this ASTM is valid for sterile packaging and the activation energy for the chemistry involved in dry salt conservation is unknown the statement “Real time aging programs provide the best data” [18] should be noted. After defined storage times contact angle were measured.

Application to Dental Implants: Screw type test implants (l = 13 mm, Ø(top) = 5 mm, for the shape of the implants see [16]) were manufactured from a titanium rod (grade 4, ASTM F67) and sandblasted with corundum. The sandblasted implants were etched under similar condition like the SLA (type 2) plates on a semiautomatic pilot construction (medSurface dent, RENA GmbH, Gütenbach, Germany) [16]. The dry conservation was also performed on this pilot construction. Therefore the etched samples were transferred in a salt bath containing 96 mM of KPB and incubated for 60 min at ambient temperature in a flow. Afterward the implants were dried at 60°C for 60 min and packed in closed glass vessels. Contact angles were measured by the method of Wilhelmy as described previously after storage for 1 month and washing off the protective layer [8], [17].

3 Results

3.1 Examination of different salts for conservation of hydrophilicity in dry state by classical analysis

Contact angles obtained by different ions contained in the exsiccation layers during storage for 3–5 days under open conditions are shown in Table 1. PBS preserves the ultrahydrophilicity quite well, but shows a blotchy pattern after drying (Figure 1B) impairing the optical appearance and homogeneity. Therefore an alternative exsiccation layer showing the same conservation with a homogenous appearance was necessary. Our screening efforts led to PBS containing Mg and Ca (PBS(+)) and to pure phosphate buffers (Table 1).

Table 1

Influence of the exsiccation layer on the dynamic contact angles (classical evaluation) of SLA surfaces after 3–5 days storage under open conditions.

Initial mediumConc. (mM)pHS*nθa ± SDθr ± SD
Initial surface150.0 ± 0.00.0 ± 0.0
Air1572.0 ± 17.00.0 ± 0.0
PBS1497,4154.6 ± 10.21.3 ± 3.0
NaPB9607,3150.0 ± 0.00.0 ± 0.0
NaPB967,3150.6 ± 1.30.0 ± 0.0
NaPB9.67,3150.0 ± 0.00.0 ± 0.0
KPB9607,6150.0 ± 0.00.0 ± 0.0
KPB967,6150.0 ± 0.00.0 ± 0.0
KPB9.67,6156.0 ± 7.43.6 ± 6.5
Initial surface2400.3 ± 1.50.0 ± 0.0
Air2584.2 ± 6.70.0 ± 0.0
PBS(+)1517.4250.0 ± 0.00.0 ± 0.0
KPB967.6252.8 ± 3.90.0 ± 0.0
MgPB1002.7250.0 ± 0.00.0 ± 0.0
MgPB103.5250.0 ± 0.00.0 ± 0.0
(NH4)2(HPO4)1007.9253.5 ± 7.80.0 ± 0.0

*S, Surface; 1, SLA (type 1); 2, SLA (type 2).

Figure 1 Optical appearance of exsiccation layers obtained from different salts. (A) 96 mM KPB, (B) 149 mM PBS.
Figure 1

Optical appearance of exsiccation layers obtained from different salts. (A) 96 mM KPB, (B) 149 mM PBS.

Table 2 shows the contact angle of surfaces protected by exsiccation layers of different salts after storage in closed vessels for 14 days. Ultrahydrophilicity is not only retained by phosphate salts but also by MgCl2 and CaCl2. In contrast to PBS it was found out that KPB in the initial concentration of 96 mM was optimal for homogeneity (Figure 1A). In lower concentrations homogeneity is reduced and in higher a viscous layer (syrup) is formed. NaPB shows comparable behavior as KPB, but it is more difficult to obtain a homogenous film. In higher concentrations NaPB tends to form residues of white salt on the dark film additionally. However, the exsiccation layer obtained by ammonia phosphate show a quite inhomogeneous appearance. As well, by using MgPB in low concentration (10 mM) the allocation of the salt film on the surface was poor, and in higher concentration (100 mM) large amounts of syrup like residues retain on the surface.

Table 2

Influence of the exsiccation layer on the dynamic contact angles (classical evaluation) of SLA surfaces (type 2) after 14 days storage under packed conditions.

Initial mediumnConc. (mM)pHθa ± SDθr ± SD
Initial surface200.6 ± 1.80.0 ± 0.0
Air586.9 ± 6.80.0 ± 0.0
KPB5967.60.0 ± 0.00.0 ± 0.0
MgCl251006.37.9 ± 5.50.0 ± 0.0
CaCl251006.73.3 ± 7.40.0 ± 0.0

In conclusion, KPB in initial concentration of 96 mM is the best system for conservation of surfaces of SLA titanium in dry state in respect to preservation of hydrophilicity, optical appearance and biocompability.

3.2 Long term wetting stability evaluated by imaginary contact angles

Long term stability of wettability conserved by a 96 mM produced KPB exsiccation layer was now controlled by baseline correction and imaginary dynamic contact angles for the first time (Table 3). Imaginary contact angles (hyperhydrophilicity) give information on wettability non amenable to measurements hitherto. After acid etching one real contact angle (5%), eight hybrid (40%) and 11 imaginary contact angles (55%) are observed. After exsiccation layer formation and γ-sterilization zero real, one hybrid (10%) and nine imaginary (7i°–9i°, 90%) contact angles are observed. Real time ageing by storage for 30 months (ca. 900 days) at ambient temperature yields 100% imaginary contact angles of 12i°–13i° for both dynamic contact angles! These studies will be extended to 5 years. In contrast accelerated ageing at 60°C, assumed to correspond to a storage time of 5 years, reduces the imaginary contact angles to 6i°–8i° (80%) and reintroduces a hybrid contact angle (20%). However the wettability of the surfaces after accelerated ageing is still to be classed as hyperhydrophilic. These experiments also clearly show that exsiccation layer conservation of contact angles is based on chemistry and is not due to the salt layer physically protecting from putative atmospheric contaminations.

Table 3

Comparison of contact angles of SLA surfaces after etching and after conservation (exsiccation layer of 96 mM KPP).

Table 3 Comparison of contact angles of SLA surfaces after etching and after conservation (exsiccation layer of 96 mM KPP).

aNo. of samples (n) in parentheses.

bAssumed accelerated ageing corresponding to storage for 5 years at ambient temperature.

The good conservation ability of hydrophilicity as well as the appealing optical appearance of the KPB exsiccation layer, can be transferred to dental implants with more complicated geometry. Figure 2 shows the homogeneity of a KPB exsiccation layer on test implant with screw-type shape. Contact angle measurement by Wilhelmy of five of these KPB protected implants after storage for 31 days lead to: Θa = (19.5 ± 2.5)i and Θr = (27.2 ± 1.0)i. Static pico-drop analysis yielded contact angels of 0° [17]. These values match well with the values after etching indicating stability of the contact angle [16], [17]. By classical evaluation all advancing and receding angles are wrongly classed as zero.

Figure 2 Pictures of dental implants with an original SLA surface (left) and after conservation with an exsiccation layer of KPB (96 mM).
Figure 2

Pictures of dental implants with an original SLA surface (left) and after conservation with an exsiccation layer of KPB (96 mM).

4 Conclusion

Ultra- and hyperhydrophilic titanium mini plates as well as dental implants with SLA surfaces can be protected from loss of hydrophilicity with an exsiccation layer of salt. KPB in an initial concentration of 96 mM appears to be optimal considering conservation capacity, biocompatibility and optical appearance. Those protected samples are suitable for gamma sterilization and could be stored for several years.

Author’s Statement

Research funding: The author state no funding involved. Conflict of interest: Authors state no conflict of interest. Material and methods: Informed consent: Informed consent is not applicable. Ethical approval: The conducted research is not related to either human or animal use.

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Published Online: 2016-9-30
Published in Print: 2016-9-1

©2016 Herbert P. Jennissen et al., licensee De Gruyter.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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https://doi.org/10.1515/cdbme-2016-0123
Keywords for this article
dental implants; dry conservation; exsiccation layer; hydrophilic; hyperhydrophilic; imaginary contact angles; sandblasted and acid etched (SLA); Titanium; ultrahydrophilic
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  8. Protection of active implant electronics with organosilicon open air plasma coating for plastic overmolding
  9. Examination of dielectric strength of thin Parylene C films under various conditions
  10. Open air plasma deposited antimicrobial SiOx/TiOx composite films for biomedical applications
  11. Systemic analysis about residual chloroform in PLLA films
  12. A macrophage model of osseointegration
  13. Towards in silico prognosis using big data
  14. Technical concept and evaluation of a novel shoulder simulator with adaptive muscle force generation and free motion
  15. Usability evaluation of a locomotor therapy device considering different strategies
  16. Hypoxia-on-a-chip
  17. Integration of a semi-automatic in-vitro RFA procedure into an experimental setup
  18. Fabrication of MEMS-based 3D-μECoG-MEAs
  19. High speed digital interfacing for a neural data acquisition system
  20. Bionic forceps for the handling of sensitive tissue
  21. Experimental studies on 3D printing of barium titanate ceramics for medical applications
  22. Patient specific root-analogue dental implants – additive manufacturing and finite element analysis
  23. 3D printing – a key technology for tailored biomedical cell culture lab ware
  24. 3D printing of hydrogels in a temperature controlled environment with high spatial resolution
  25. Biocompatibility of photopolymers for additive manufacturing
  26. Biochemical piezoresistive sensors based on pH- and glucose-sensitive hydrogels for medical applications
  27. Novel wireless measurement system of pressure dedicated to in vivo studies
  28. Portable auricular device for real-time swallow and chew detection
  29. Detection of miRNA using a surface plasmon resonance biosensor and antibody amplification
  30. Simulation and evaluation of stimulation scenarios for targeted vestibular nerve excitation
  31. Deep brain stimulation: increasing efficiency by alternative waveforms
  32. Prediction of immediately occurring microsleep events from brain electric signals
  33. Determining cardiac vagal threshold from short term heart rate complexity
  34. Classification of cardiac excitation patterns during atrial fibrillation
  35. An algorithm to automatically determine the cycle length coverage to identify rotational activity during atrial fibrillation – a simulation study
  36. Deriving respiration from high resolution 12-channel-ECG during cycling exercise
  37. Reducing of gradient induced artifacts on the ECG signal during MRI examinations using Wilcoxon filter
  38. Automatic detection and mapping of double potentials in intracardiac electrograms
  39. Modeling the pelvic region for non-invasive pelvic intraoperative neuromonitoring
  40. Postprocessing algorithm for automated analysis of pelvic intraoperative neuromonitoring signals
  41. Best practice: surgeon driven application in pelvic operations
  42. Vasomotor assessment by camera-based photoplethysmography
  43. Classification of morphologic changes in photoplethysmographic waveforms
  44. Novel computation of pulse transit time from multi-channel PPG signals by wavelet transform
  45. Efficient design of FIR filter based low-pass differentiators for biomedical signal processing
  46. Nonlinear causal influences assessed by mutual compression entropy
  47. Comparative study of methods for solving the correspondence problem in EMD applications
  48. fNIRS for future use in auditory diagnostics
  49. Semi-automated detection of fractional shortening in zebrafish embryo heart videos
  50. Blood pressure measurement on the cheek
  51. Derivation of the respiratory rate from directly and indirectly measured respiratory signals using autocorrelation
  52. Left cardiac atrioventricular delay and inter-ventricular delay in cardiac resynchronization therapy responder and non-responder
  53. An automatic systolic peak detector of blood pressure waveforms using 4th order cumulants
  54. Real-time QRS detection using integrated variance for ECG gated cardiac MRI
  55. Preprocessing of unipolar signals acquired by a novel intracardiac mapping system
  56. In-vitro experiments to characterize ventricular electromechanics
  57. Continuous non-invasive monitoring of blood pressure in the operating room: a cuffless optical technology at the fingertip
  58. Application of microwave sensor technology in cardiovascular disease for plaque detection
  59. Artificial blood circulatory and special Ultrasound Doppler probes for detecting and sizing gaseous embolism
  60. Detection of microsleep events in a car driving simulation study using electrocardiographic features
  61. A method to determine the kink resistance of stents and stent delivery systems according to international standards
  62. Comparison of stented bifurcation and straight vessel 3D-simulation with a prior simulated velocity profile inlet
  63. Transient Euler-Lagrange/DEM simulation of stent thrombosis
  64. Automated control of the laser welding process of heart valve scaffolds
  65. Automation of a test bench for accessing the bendability of electrospun vascular grafts
  66. Influence of storage conditions on the release of growth factors in platelet-rich blood derivatives
  67. Cryopreservation of cells using defined serum-free cryoprotective agents
  68. New bioreactor vessel for tissue engineering of human nasal septal chondrocytes
  69. Determination of the membrane hydraulic permeability of MSCs
  70. Climate retainment in carbon dioxide incubators
  71. Multiple factors influencing OR ventilation system effectiveness
  72. Evaluation of an app-based stress protocol
  73. Medication process in Styrian hospitals
  74. Control tower to surgical theater
  75. Development of a skull phantom for the assessment of implant X-ray visibility
  76. Surgical navigation with QR codes
  77. Investigation of the pressure gradient of embolic protection devices
  78. Computer assistance in femoral derotation osteotomy: a bottom-up approach
  79. Automatic depth scanning system for 3D infrared thermography
  80. A service for monitoring the quality of intraoperative cone beam CT images
  81. Resectoscope with an easy to use twist mechanism for improved handling
  82. In vitro simulation of distribution processes following intramuscular injection
  83. Adjusting inkjet printhead parameters to deposit drugs into micro-sized reservoirs
  84. A flexible standalone system with integrated sensor feedback for multi-pad electrode FES of the hand
  85. Smart control for functional electrical stimulation with optimal pulse intensity
  86. Tactile display on the remaining hand for unilateral hand amputees
  87. Effects of sustained electrical stimulation on spasticity assessed by the pendulum test
  88. An improved tracking framework for ultrasound probe localization in image-guided radiosurgery
  89. Improvement of a subviral particle tracker by the use of a LAP-Kalman-algorithm
  90. Learning discriminative classification models for grading anal intraepithelial neoplasia
  91. Regularization of EIT reconstruction based on multi-scales wavelet transforms
  92. Assessing MRI susceptibility artefact through an indicator of image distortion
  93. EyeGuidance – a computer controlled system to guide eye movements
  94. A framework for feedback-based segmentation of 3D image stacks
  95. Doppler optical coherence tomography as a promising tool for detecting fluid in the human middle ear
  96. 3D Local in vivo Environment (LivE) imaging for single cell protein analysis of bone tissue
  97. Inside-Out access strategy using new trans-vascular catheter approach
  98. US/MRI fusion with new optical tracking and marker approach for interventional procedures inside the MRI suite
  99. Impact of different registration methods in MEG source analysis
  100. 3D segmentation of thyroid ultrasound images using active contours
  101. Designing a compact MRI motion phantom
  102. Cerebral cortex classification by conditional random fields applied to intraoperative thermal imaging
  103. Classification of indirect immunofluorescence images using thresholded local binary count features
  104. Analysis of muscle fatigue conditions using time-frequency images and GLCM features
  105. Numerical evaluation of image parameters of ETR-1
  106. Fabrication of a compliant phantom of the human aortic arch for use in Particle Image Velocimetry (PIV) experimentation
  107. Effect of the number of electrodes on the reconstructed lung shape in electrical impedance tomography
  108. Hardware dependencies of GPU-accelerated beamformer performances for microwave breast cancer detection
  109. Computer assisted assessment of progressing osteoradionecrosis of the jaw for clinical diagnosis and treatment
  110. Evaluation of reconstruction parameters of electrical impedance tomography on aorta detection during saline bolus injection
  111. Evaluation of open-source software for the lung segmentation
  112. Automatic determination of lung features of CF patients in CT scans
  113. Image analysis of self-organized multicellular patterns
  114. Effect of key parameters on synthesis of superparamagnetic nanoparticles (SPIONs)
  115. Radiopacity assessment of neurovascular implants
  116. Development of a desiccant based dielectric for monitoring humidity conditions in miniaturized hermetic implantable packages
  117. Development of an artifact-free aneurysm clip
  118. Enhancing the regeneration of bone defects by alkalizing the peri-implant zone – an in vitro approach
  119. Rapid prototyping of replica knee implants for in vitro testing
  120. Protecting ultra- and hyperhydrophilic implant surfaces in dry state from loss of wettability
  121. Advanced wettability analysis of implant surfaces
  122. Patient-specific hip prostheses designed by surgeons
  123. Plasma treatment on novel carbon fiber reinforced PEEK cages to enhance bioactivity
  124. Wear of a total intervertebral disc prosthesis
  125. Digital health and digital biomarkers – enabling value chains on health data
  126. Usability in the lifecycle of medical software development
  127. Influence of different test gases in a non-destructive 100% quality control system for medical devices
  128. Device development guided by user satisfaction survey on auricular vagus nerve stimulation
  129. Empirical assessment of the time course of innovation in biomedical engineering: first results of a comparative approach
  130. Effect of left atrial hypertrophy on P-wave morphology in a computational model
  131. Simulation of intracardiac electrograms around acute ablation lesions
  132. Parametrization of activation based cardiac electrophysiology models using bidomain model simulations
  133. Assessment of nasal resistance using computational fluid dynamics
  134. Resistance in a non-linear autoregressive model of pulmonary mechanics
  135. Inspiratory and expiratory elastance in a non-linear autoregressive model of pulmonary mechanics
  136. Determination of regional lung function in cystic fibrosis using electrical impedance tomography
  137. Development of parietal bone surrogates for parietal graft lift training
  138. Numerical simulation of mechanically stimulated bone remodelling
  139. Conversion of engineering stresses to Cauchy stresses in tensile and compression tests of thermoplastic polymers
  140. Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging
  141. Principle study on the signal connection at transabdominal fetal pulse oximetry
  142. Influence of Siluron® insertion on model drug distribution in the simulated vitreous body
  143. Evaluating different approaches to identify a three parameter gas exchange model
  144. Effects of fibrosis on the extracellular potential based on 3D reconstructions from histological sections of heart tissue
  145. From imaging to hemodynamics – how reconstruction kernels influence the blood flow predictions in intracranial aneurysms
  146. Flow optimised design of a novel point-of-care diagnostic device for the detection of disease specific biomarkers
  147. Improved FPGA controlled artificial vascular system for plethysmographic measurements
  148. Minimally spaced electrode positions for multi-functional chest sensors: ECG and respiratory signal estimation
  149. Automated detection of alveolar arches for nasoalveolar molding in cleft lip and palate treatment
  150. Control scheme selection in human-machine- interfaces by analysis of activity signals
  151. Event-based sampling for reducing communication load in realtime human motion analysis by wireless inertial sensor networks
  152. Automatic pairing of inertial sensors to lower limb segments – a plug-and-play approach
  153. Contactless respiratory monitoring system for magnetic resonance imaging applications using a laser range sensor
  154. Interactive monitoring system for visual respiratory biofeedback
  155. Development of a low-cost senor based aid for visually impaired people
  156. Patient assistive system for the shoulder joint
  157. A passive beating heart setup for interventional cardiology training
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