Final Report Summary - DYNICP (Innovative Intracranial Pressure and Volume Wave Monitoring System)
Executive Summary:
DynICP project aimed to develop an advanced, portable prototype of non-invasive intracranial dynamic pressure (dynamic ICP) diagnosing and monitoring device which could be utilized at hospitals. Comparing with ICP solutions that requires perforation of cranium and the results would be available after an hour; nICP enables to get the results during ten minutes. This device consists of a wearable head gear capable of precise positioning of two ultrasonic transducers, software and hardware for dynamic ICP analysis and data communication that can be used to connect the device to hospital patient monitoring systems.
ICP monitoring is crucial for surveillance of patients with dementia, chronic headache, hydrocephalus, head injury, stroke, brain tumours and other brain diseases; for diagnostic purposes to determine the optimum treatment and for monitoring of effects of treatment. However, despite the fact that ICP monitoring has been available for the past 60 or so years, all currently available options rely on invasive placement of ICP probe in the patient cerebral spinal fluid, thus reducing its use to the intensive care units (ICU) or hospital wards as a result, less than 100,000 patients receive ICP monitoring in the EU each year.
46 patients were monitored (76 independent monitoring sessions) in Oslo and Vilnius clinics during the project with developed DynICP system. Both invasively measured ICP and non-invasively measured Intracranial Blood Volume (nIBV or TOF signal) and Arterial Blood Pressure (ABP) were recorded. This data provided input for developing a correlative model between nIBV, ABP and ICP. Software algorithm was developed for estimation of dynamic / pulsatile nICP pressure pulse-waves based on nIBV and ABP inputs. The results of nICP were validated against invasively measured ICP and DynICP device resolution is < ± 0.5 mm Hg at a sampling rate of 50 Hz.
Additional Area Under Curve (AUC) analysis were also performed during the project. Strong correlation of AUC with the amplitudes of ICP(t) pulse wave peaks confirms a diagnostic value of non-invasive DynICP device.
Project Context and Objectives:
DynICP project aimed to develop an advanced, portable prototype of non-invasive intracranial dynamic pressure (dynamic ICP) diagnosing and monitoring device which could be utilized at hospitals. Comparing with ICP solutions that requires perforation of cranium and the results would be available after an hour; nICP enables to get the results during ten minutes. This device consists of a wearable head gear capable of precise positioning of two ultrasonic transducers, software and hardware for dynamic ICP analysis and data communication that can be used to connect the device to hospital patient monitoring systems.
ICP monitoring is crucial for surveillance of patients with dementia, chronic headache, hydrocephalus, head injury, stroke, brain tumours and other brain diseases; for diagnostic purposes to determine the optimum treatment and for monitoring of effects of treatment. However, despite the fact that ICP monitoring has been available for the past 60 or so years, all currently available options rely on invasive placement of ICP probe in the patient cerebral spinal fluid, thus reducing its use to the intensive care units (ICU) or hospital wards as a result, less than 100,000 patients receive ICP monitoring in the EU each year.
Meanwhile, each year estimated 40Mn EU citizens suffer from chronic headaches, dementia, head injuries, strokes and brain tumours. These citizens would greatly benefit from the portable, non-invasive ICP monitoring. Thus, the number of Europeans who could benefit from ICP monitoring as a result of DynICP project may increase by a factor of 400, from 100,000 to 40 Mn per year; a similar expansion in the number of patients benefiting from an innovative non-invasive technology was seen almost a hundred years ago when non-invasive arterial blood monitoring (ABP) systems were introduced.
The objectives of the DynICP project were:
• Scientific: develop reference method to correlate cerebral blood volume and intracranial pressure dynamics and thus predict dynamic / pulsatile intracranial pressure during the cardiac cycle;
• Technological: develop a novel ultrasound time of flight (TOF) monitor module that can deliver a wave form signal based on cerebral blood volume changes to be processed to yield a dynamic ICP signal. The resolution needs to be + 0.5 mmHg a dynamic ICP diagnostic value at a sampling rate of 50 Hz;
• Technological: develop signal processing algorithm and software for cerebral blood volume to intracranial pressure signal processing with resolution < ± 0.5 mm Hg at a sampling rate of 50 Hz. The analysis will be optimized to run on a Microprocessor (MCU);
• Technological: Develop a lightweight rigid wearable head frame that fixes ultrasound transducer(s) on the head precisely. Patient should be able to mount it correctly after a 10 min instruction;
• Technological: Develop integration, analysis and communication electronics for converting the nIBV signal to dynamic ICP, storing data and for communication with user and/or patient monitoring systems for hospital use;
• Integrative: Integrate the modules into a DynICP prototype unit for non-invasive dynamic ICP monitoring;
• Validation: To test the non-invasive dynamic ICP monitoring prototype against the “gold standard” and/or “best practice” of the currently available in ICUs invasive ICP monitoring probes and devices The resolution of nICP needs to be < ± 0,5 mm Hg at a sampling rate of 50 Hz, and a battery life of > 1 hour.
In order to achieve these objectives, five innovative steps were taken:
1. Establishing a model of the relationship between cerebral blood volume s and intracranial pulse pressures changes by combining non-invasive Intracranial Blood Volume (nIBV) with the required mathematical modelling needed for the intracranial waveform transformation; and validating it against the “gold standard” invasive ICP measurements;
2. Adaptation of existing Sensometrics® technology detection of single ICP wave during the cardiac cycle based on both non-invasive and invasive ICP, to ultrasound based sensing of dynamic volumetric variations;
3. Development of improved TOF monitor that can be optimized for dynamic ICP measurements and with the S/N ratio required.
4. Adaptation of the head fixation to make it easy-to-use and sturdy enough to obtain the necessary measurement accuracy.
5. Development of portable integration, analysis and communication hardware that will handle communication with the monitor hardware and external devices and will work as a platform for analysis of the nIBV and prediction of the dynamic/pulsatile ICP as a stand-alone unit.
Project Results:
During the DynICP project, system specifications were developed, followed by development of the hardware and software and conducting patient measurements as soon as the TOF monitor was tested. After collecting enough clinical data, a correlative model was created, followed by adopting it to the mathematical model and integrating with the whole DynICP system. Patient measurements and validation of the DynICP system lasted iteratively during the whole year of 2013.
Main results achieved during the project:
1. Securing ethical approval for parametric tests necessary to develop the correlative model for blood volume and pressure changes and clinical assessment of DynICP system.
2. Carrying out a study of ultrasonic transmission of VTECH device to analyse the potential bio-effects of continuous ultrasound waves in the brain and providing evidence that the VTECH device can be considered safe.
3. Specifying the hardware and software requirements for DynICP system.
4. Developing a correlative model for blood volume and pressure changes.
5. Finalisation of DynICP sensor prototype (improved TOF monitor and new headframe) according to parameters of correlative model from WP1.
6. Conducting testing of the monitor module which demonstrated that the VTECH DynICP monitor can record TOF pulse waves with resolution not worse than invasive parenchymal ICP monitor and that the objective of S/N ratio of TOF recording and 0.5 mmHg resolution was achieved.
7. Completing the prototype DynICP hardware modules and further developing it to a potential spin-off product.
8. Finalisation of DynICP mathematical model and software integration with Sensometrics and TOF.
9. Integration, testing and validation of the DynICP system and its subcomponents.
10. Collecting patient recordings from 76 independent monitoring sessions and analysing the results’ scientific value and potential clinical application.
11. Additional AUC analysis were performed to get confirmation for the value of DynICP system as diagnostic tool
12. Disseminating DynICP preliminary project results on several conferences.
13. Partners agreed about the exploitation and use and further development of DynICP system.
Potential Impact:
The main results in the DynICP project were:
1. Correlative model of nIBV and dynamic ICP changes (knowhow which enabled to develop result 4).
2. Lightweight rigid wearable head frame that fixes transducers (patent application to be submitted).
3. Ultrasound TOF measurement module.
4. Software algorithm for estimation of dynamic / pulsatile ICP pressure based on nIBV (patent application to be submitted).
5. External communication module and communication protocol (know-how and industrial design).
The main goal of the project was to develop a non-invasive dynamic ICP monitoring device in order to help at least some of around 40-45Mn people in Europe who could benefit from non-invasive ICP monitoring. If the DynICP non-invasive solution can only help 5-10% of these, it could mean substantial Quality of Life (QoL) improvement for over 2 to 4.5Mn Europeans, substantially reduce associated healthcare costs. Further, non-invasive DynICP solution could be expected to save lives of head injury and Traumatic Brain Injury (TBI) sufferers: currently, at least 2 Mn of TBI and head injury sufferers do not receive fast enough ICP monitoring or do not receive ICP monitoring at all due to the invasive nature of the current State of Art (SoA) equipment that is confined to the hospitals. Hence, the distance to the hospitals and availability of space and qualified medical assistance for invasive ICP monitoring becomes a limiting factor that may be causing loss of lives; arguably, up to 1,6Mn TBI patients have very limited or no access to ICP monitoring each year in Europe. The mortality rate in TBI patients is at least 4% -- if DynICP could help only 5% of those to survive, it could mean 3,200 lives saved in Europe each year.
For the overwhelming majority of chronic headache suffers, current invasive ICP monitoring technologies are not suitable; DynICP solution is therefore expected to bring benefits of ICP monitoring to over 40Mn Europeans who simply cannot benefit from the current SoA technology.
Furthermore, among various groups of European citizen who could benefit from non-invasive ICP monitoring, the stroke and TBI victims account for the highest hospitalization costs. If DynICP solution is able to reduce hospital stay of only 10% of the at least 500,000 TBI victims that are hospitalized each year in Europe (most of them in acute departments), as well as 10% of 1.5Mn annually hospitalized stroke victims, this would save Europe the costs of 200,000 emergency hospital days per annum; at an average price tag of at least €250 in costs per day at the hospital for acute stroke victims, savings to the European society for implementing DynICP solution in hospitals would be at least €50Mn per annum.
All SMEs are projected to participate in the supply chain of production of the DynICP device: dPCom in relation to software, VTECH in relation to sensors and hardware and Artec Design in relation to assembly and packaging. At the end of the DynICP project an advanced validated prototype will have been completed. It would take the SME partners around 3 to 4 years to bring a CE-marked Class IIb medical device solution to the market. Therefore, the year of expected product launch is 2018.
DynICP development program may also present a cornerstone for post-project development of a novel platform technology that can be used for a range of applications that require bridging of volume change and pressure waves in a monitoring device. Creation of such platform technology will give the SME partners the opportunity to increase their perceived value to their customers as strategic supply partners with innovative technologies to offer and modern product development capabilities.
Although the results of the DynICP project were impressive, we must explicitly state that the technology developed is still very novel – before it can be applied clinically to patients, much work is still left to be done. The fact that even simple Area Under Curve (AUC) change metrics perfectly correlates with ICP pulse wave shape (ratios of peaks) reassures that DynICP can become a measurement tool in the future. It was confirmed that nICP pulse wave analysis after normalization can be based on current clinical evidences on the value of peaks' ratio based diagnosing of intracraniospinal compliance changes.
DynICP technology is very promising to get quick and safe initial screening of the patient by normalized non-invasively recorded pulse waves – analysis of P1, P2, P3 curve relations is just one potential application of the device. We expect that our results will encourage more scientists working on ICP pulsewaves and how to apply this novel medical device clinically. Additional R&D , D&D and prospective clinical studies are needed in order to achieve widely clinically applicable sensitivity and specificity of nICP pulse waves. The consortium foresees to continue the work in a follow-up project.
List of Websites:
Project website: http://www.dynicp.eu/(si apre in una nuova finestra)
Coordinator:
Eesti Innovatsiooni Instituut OÜ
Sepapaja 6, Ülemiste City, Tallinn 11415 Estonia
Mr. Lauri Nirgi
e-mail: lauri.nirgi@eii.ee
Mr. Marko Toom
e-mail: marko.toom@pera.com
SME partners:
dPCom AS
Solveien 29C, Oslo 1177, Norway
Mr. Trond Standheim
e-mail: trs@dpcom.com
UAB Vittamed Technologijos
V.Putvinskio st. 47-10, Kaunas LT-44243, Lithuania
Mr. Dinas Ragauskas
e-mail: dinas@takas.lt
Artec Design OÜ
Teaduspargi 6/1, Tallinn 12618, Estonia
Mr. Kaido Kevvai
e-mail: Kaido.Kevvai@artecdesign.ee
RTD partners:
Kauno Technologijos Universitetas
K Donelaicio 73, Kaunas 44029, Lithuania
Prof. Arminas Ragauskas
e-mail: telematics@ktu.lt
NXTECH AS
K.G. Meldahlsvei 9, 1671 Kråkerøy, 0106 Fredrikstad, Norway
Mr. Terje Wahlstrom
e-mail: terje.wahlstrom@nxtech.no
Other partners:
Oslo University Hospital HF
Forskningsveien 2B, Oslo 0373, Norway
Dr. Geir Gogstad
e-mail: eu@ous-hf.no
DynICP project aimed to develop an advanced, portable prototype of non-invasive intracranial dynamic pressure (dynamic ICP) diagnosing and monitoring device which could be utilized at hospitals. Comparing with ICP solutions that requires perforation of cranium and the results would be available after an hour; nICP enables to get the results during ten minutes. This device consists of a wearable head gear capable of precise positioning of two ultrasonic transducers, software and hardware for dynamic ICP analysis and data communication that can be used to connect the device to hospital patient monitoring systems.
ICP monitoring is crucial for surveillance of patients with dementia, chronic headache, hydrocephalus, head injury, stroke, brain tumours and other brain diseases; for diagnostic purposes to determine the optimum treatment and for monitoring of effects of treatment. However, despite the fact that ICP monitoring has been available for the past 60 or so years, all currently available options rely on invasive placement of ICP probe in the patient cerebral spinal fluid, thus reducing its use to the intensive care units (ICU) or hospital wards as a result, less than 100,000 patients receive ICP monitoring in the EU each year.
46 patients were monitored (76 independent monitoring sessions) in Oslo and Vilnius clinics during the project with developed DynICP system. Both invasively measured ICP and non-invasively measured Intracranial Blood Volume (nIBV or TOF signal) and Arterial Blood Pressure (ABP) were recorded. This data provided input for developing a correlative model between nIBV, ABP and ICP. Software algorithm was developed for estimation of dynamic / pulsatile nICP pressure pulse-waves based on nIBV and ABP inputs. The results of nICP were validated against invasively measured ICP and DynICP device resolution is < ± 0.5 mm Hg at a sampling rate of 50 Hz.
Additional Area Under Curve (AUC) analysis were also performed during the project. Strong correlation of AUC with the amplitudes of ICP(t) pulse wave peaks confirms a diagnostic value of non-invasive DynICP device.
Project Context and Objectives:
DynICP project aimed to develop an advanced, portable prototype of non-invasive intracranial dynamic pressure (dynamic ICP) diagnosing and monitoring device which could be utilized at hospitals. Comparing with ICP solutions that requires perforation of cranium and the results would be available after an hour; nICP enables to get the results during ten minutes. This device consists of a wearable head gear capable of precise positioning of two ultrasonic transducers, software and hardware for dynamic ICP analysis and data communication that can be used to connect the device to hospital patient monitoring systems.
ICP monitoring is crucial for surveillance of patients with dementia, chronic headache, hydrocephalus, head injury, stroke, brain tumours and other brain diseases; for diagnostic purposes to determine the optimum treatment and for monitoring of effects of treatment. However, despite the fact that ICP monitoring has been available for the past 60 or so years, all currently available options rely on invasive placement of ICP probe in the patient cerebral spinal fluid, thus reducing its use to the intensive care units (ICU) or hospital wards as a result, less than 100,000 patients receive ICP monitoring in the EU each year.
Meanwhile, each year estimated 40Mn EU citizens suffer from chronic headaches, dementia, head injuries, strokes and brain tumours. These citizens would greatly benefit from the portable, non-invasive ICP monitoring. Thus, the number of Europeans who could benefit from ICP monitoring as a result of DynICP project may increase by a factor of 400, from 100,000 to 40 Mn per year; a similar expansion in the number of patients benefiting from an innovative non-invasive technology was seen almost a hundred years ago when non-invasive arterial blood monitoring (ABP) systems were introduced.
The objectives of the DynICP project were:
• Scientific: develop reference method to correlate cerebral blood volume and intracranial pressure dynamics and thus predict dynamic / pulsatile intracranial pressure during the cardiac cycle;
• Technological: develop a novel ultrasound time of flight (TOF) monitor module that can deliver a wave form signal based on cerebral blood volume changes to be processed to yield a dynamic ICP signal. The resolution needs to be + 0.5 mmHg a dynamic ICP diagnostic value at a sampling rate of 50 Hz;
• Technological: develop signal processing algorithm and software for cerebral blood volume to intracranial pressure signal processing with resolution < ± 0.5 mm Hg at a sampling rate of 50 Hz. The analysis will be optimized to run on a Microprocessor (MCU);
• Technological: Develop a lightweight rigid wearable head frame that fixes ultrasound transducer(s) on the head precisely. Patient should be able to mount it correctly after a 10 min instruction;
• Technological: Develop integration, analysis and communication electronics for converting the nIBV signal to dynamic ICP, storing data and for communication with user and/or patient monitoring systems for hospital use;
• Integrative: Integrate the modules into a DynICP prototype unit for non-invasive dynamic ICP monitoring;
• Validation: To test the non-invasive dynamic ICP monitoring prototype against the “gold standard” and/or “best practice” of the currently available in ICUs invasive ICP monitoring probes and devices The resolution of nICP needs to be < ± 0,5 mm Hg at a sampling rate of 50 Hz, and a battery life of > 1 hour.
In order to achieve these objectives, five innovative steps were taken:
1. Establishing a model of the relationship between cerebral blood volume s and intracranial pulse pressures changes by combining non-invasive Intracranial Blood Volume (nIBV) with the required mathematical modelling needed for the intracranial waveform transformation; and validating it against the “gold standard” invasive ICP measurements;
2. Adaptation of existing Sensometrics® technology detection of single ICP wave during the cardiac cycle based on both non-invasive and invasive ICP, to ultrasound based sensing of dynamic volumetric variations;
3. Development of improved TOF monitor that can be optimized for dynamic ICP measurements and with the S/N ratio required.
4. Adaptation of the head fixation to make it easy-to-use and sturdy enough to obtain the necessary measurement accuracy.
5. Development of portable integration, analysis and communication hardware that will handle communication with the monitor hardware and external devices and will work as a platform for analysis of the nIBV and prediction of the dynamic/pulsatile ICP as a stand-alone unit.
Project Results:
During the DynICP project, system specifications were developed, followed by development of the hardware and software and conducting patient measurements as soon as the TOF monitor was tested. After collecting enough clinical data, a correlative model was created, followed by adopting it to the mathematical model and integrating with the whole DynICP system. Patient measurements and validation of the DynICP system lasted iteratively during the whole year of 2013.
Main results achieved during the project:
1. Securing ethical approval for parametric tests necessary to develop the correlative model for blood volume and pressure changes and clinical assessment of DynICP system.
2. Carrying out a study of ultrasonic transmission of VTECH device to analyse the potential bio-effects of continuous ultrasound waves in the brain and providing evidence that the VTECH device can be considered safe.
3. Specifying the hardware and software requirements for DynICP system.
4. Developing a correlative model for blood volume and pressure changes.
5. Finalisation of DynICP sensor prototype (improved TOF monitor and new headframe) according to parameters of correlative model from WP1.
6. Conducting testing of the monitor module which demonstrated that the VTECH DynICP monitor can record TOF pulse waves with resolution not worse than invasive parenchymal ICP monitor and that the objective of S/N ratio of TOF recording and 0.5 mmHg resolution was achieved.
7. Completing the prototype DynICP hardware modules and further developing it to a potential spin-off product.
8. Finalisation of DynICP mathematical model and software integration with Sensometrics and TOF.
9. Integration, testing and validation of the DynICP system and its subcomponents.
10. Collecting patient recordings from 76 independent monitoring sessions and analysing the results’ scientific value and potential clinical application.
11. Additional AUC analysis were performed to get confirmation for the value of DynICP system as diagnostic tool
12. Disseminating DynICP preliminary project results on several conferences.
13. Partners agreed about the exploitation and use and further development of DynICP system.
Potential Impact:
The main results in the DynICP project were:
1. Correlative model of nIBV and dynamic ICP changes (knowhow which enabled to develop result 4).
2. Lightweight rigid wearable head frame that fixes transducers (patent application to be submitted).
3. Ultrasound TOF measurement module.
4. Software algorithm for estimation of dynamic / pulsatile ICP pressure based on nIBV (patent application to be submitted).
5. External communication module and communication protocol (know-how and industrial design).
The main goal of the project was to develop a non-invasive dynamic ICP monitoring device in order to help at least some of around 40-45Mn people in Europe who could benefit from non-invasive ICP monitoring. If the DynICP non-invasive solution can only help 5-10% of these, it could mean substantial Quality of Life (QoL) improvement for over 2 to 4.5Mn Europeans, substantially reduce associated healthcare costs. Further, non-invasive DynICP solution could be expected to save lives of head injury and Traumatic Brain Injury (TBI) sufferers: currently, at least 2 Mn of TBI and head injury sufferers do not receive fast enough ICP monitoring or do not receive ICP monitoring at all due to the invasive nature of the current State of Art (SoA) equipment that is confined to the hospitals. Hence, the distance to the hospitals and availability of space and qualified medical assistance for invasive ICP monitoring becomes a limiting factor that may be causing loss of lives; arguably, up to 1,6Mn TBI patients have very limited or no access to ICP monitoring each year in Europe. The mortality rate in TBI patients is at least 4% -- if DynICP could help only 5% of those to survive, it could mean 3,200 lives saved in Europe each year.
For the overwhelming majority of chronic headache suffers, current invasive ICP monitoring technologies are not suitable; DynICP solution is therefore expected to bring benefits of ICP monitoring to over 40Mn Europeans who simply cannot benefit from the current SoA technology.
Furthermore, among various groups of European citizen who could benefit from non-invasive ICP monitoring, the stroke and TBI victims account for the highest hospitalization costs. If DynICP solution is able to reduce hospital stay of only 10% of the at least 500,000 TBI victims that are hospitalized each year in Europe (most of them in acute departments), as well as 10% of 1.5Mn annually hospitalized stroke victims, this would save Europe the costs of 200,000 emergency hospital days per annum; at an average price tag of at least €250 in costs per day at the hospital for acute stroke victims, savings to the European society for implementing DynICP solution in hospitals would be at least €50Mn per annum.
All SMEs are projected to participate in the supply chain of production of the DynICP device: dPCom in relation to software, VTECH in relation to sensors and hardware and Artec Design in relation to assembly and packaging. At the end of the DynICP project an advanced validated prototype will have been completed. It would take the SME partners around 3 to 4 years to bring a CE-marked Class IIb medical device solution to the market. Therefore, the year of expected product launch is 2018.
DynICP development program may also present a cornerstone for post-project development of a novel platform technology that can be used for a range of applications that require bridging of volume change and pressure waves in a monitoring device. Creation of such platform technology will give the SME partners the opportunity to increase their perceived value to their customers as strategic supply partners with innovative technologies to offer and modern product development capabilities.
Although the results of the DynICP project were impressive, we must explicitly state that the technology developed is still very novel – before it can be applied clinically to patients, much work is still left to be done. The fact that even simple Area Under Curve (AUC) change metrics perfectly correlates with ICP pulse wave shape (ratios of peaks) reassures that DynICP can become a measurement tool in the future. It was confirmed that nICP pulse wave analysis after normalization can be based on current clinical evidences on the value of peaks' ratio based diagnosing of intracraniospinal compliance changes.
DynICP technology is very promising to get quick and safe initial screening of the patient by normalized non-invasively recorded pulse waves – analysis of P1, P2, P3 curve relations is just one potential application of the device. We expect that our results will encourage more scientists working on ICP pulsewaves and how to apply this novel medical device clinically. Additional R&D , D&D and prospective clinical studies are needed in order to achieve widely clinically applicable sensitivity and specificity of nICP pulse waves. The consortium foresees to continue the work in a follow-up project.
List of Websites:
Project website: http://www.dynicp.eu/(si apre in una nuova finestra)
Coordinator:
Eesti Innovatsiooni Instituut OÜ
Sepapaja 6, Ülemiste City, Tallinn 11415 Estonia
Mr. Lauri Nirgi
e-mail: lauri.nirgi@eii.ee
Mr. Marko Toom
e-mail: marko.toom@pera.com
SME partners:
dPCom AS
Solveien 29C, Oslo 1177, Norway
Mr. Trond Standheim
e-mail: trs@dpcom.com
UAB Vittamed Technologijos
V.Putvinskio st. 47-10, Kaunas LT-44243, Lithuania
Mr. Dinas Ragauskas
e-mail: dinas@takas.lt
Artec Design OÜ
Teaduspargi 6/1, Tallinn 12618, Estonia
Mr. Kaido Kevvai
e-mail: Kaido.Kevvai@artecdesign.ee
RTD partners:
Kauno Technologijos Universitetas
K Donelaicio 73, Kaunas 44029, Lithuania
Prof. Arminas Ragauskas
e-mail: telematics@ktu.lt
NXTECH AS
K.G. Meldahlsvei 9, 1671 Kråkerøy, 0106 Fredrikstad, Norway
Mr. Terje Wahlstrom
e-mail: terje.wahlstrom@nxtech.no
Other partners:
Oslo University Hospital HF
Forskningsveien 2B, Oslo 0373, Norway
Dr. Geir Gogstad
e-mail: eu@ous-hf.no