A new Stratified Approach For Enhanced Reliability (SAFER) pre-clinical simulation testing of joint prostheses has been described in a preceding paper in this volume. The application of SAFER in vitro simulation and testing to metal-on-metal bearings is described in this review paper. The review aims to provide further understanding of the reasons for, and causes of, increased wear in metal-on-metal hips in a proportion of patients. Variation in positioning (mal-positioning) of the head and cup in hip prostheses results in the head contacting the rim of the cup and producing increased wear. Variation in both translational and rotational positioning has been investigated. Variation in translational positioning of the centres of the head and cup, which is not detected on radiographs, is a frequent occurrence clinically and can result in a substantial increase in wear rate. The variation in translational positioning acts synergistically with variation in rotational positioning to produce substantial increases in wear. These recent findings are consistent with the wear mechanisms and formation of stripe wear reported for ceramic-on-ceramic bearings over a decade ago, and provide insight into the reasons for the variation and increases in the wear rate found clinically in metal-on-metal hips in specific patients, which may cause premature failure.

Acute cardiac arrest, reoperation for other cardiac reasons, new dialysis, atrial fibrillation, and prolonged mechanical ventilation are associated with the largest increase in attributable deaths. Prevention and treatment of these complications may improve mortality rates after cardiac operations.

The interest in high performance chip architectures for biomedical applications is gaining a lot of research and market interest. Heart diseases remain by far the main cause of death and a challenging problem for biomedical engineers to monitor and analyze. Electrocardiography (ECG) is an essential practice in heart medicine. However, ECG analysis still faces computational challenges, especially when 12 lead signals are to be analyzed in parallel, in real time, and under increasing sampling frequencies. Another challenge is the analysis of huge amounts of data that may grow to days of recordings. Nowadays, doctors use eyeball monitoring of the 12-lead ECG paper readout, which may seriously impair analysis accuracy. Our solution leverages the advance in multi-processor system-on-chip architectures, and it is centered on the parallelization of the ECG computation kernel. Our Hardware-Software (HW/SW) Multi-Processor System-on-Chip (MPSoC) design improves upon state-of-the-art mostly for its capability to perform real-time analysis of input data, leveraging the computation horsepower provided by many concurrent DSPs, more accurate diagnosis of cardiac diseases, and prompter reaction to abnormal heart alterations. The design methodology to go from the 12-lead ECG application specification to the final HW/SW architecture is the focus of this paper. We explore the design space by considering a number of hardware and software architectural variants, and deploy industrial components to build up the system

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