This report presents issues relating to the kinematics and control of dexterous robotic hands using the Utah-MIT hand as an illustrative example. The emphasis throughout is on the actual implementation and testing of the theoretical concepts presented. The kinematics of such hands is interesting and complicated owing to the large number of degrees of freedom involved. The implementation of position and force control algorithms on such tendon driven hands has previously suffered from inefficient formulations and a lack of sophisticated computer hardware. Both these problems are addressed in this report. A multiprocessor architecture has been built with high performance microcomputers on which real-time algorithms can be efficiently implemented. A large software library has also been built to facilitate flexible software development on this architecture. The position and force control algorithms described herein have been implemented and tested on this hardware.

Background: Laboratory results are of central importance for clinical decision making. The time span between availability and review of results by clinicians is crucial to patient care. Clinical decision support systems (CDSS) are computational tools that can identify critical values automatically and help decrease treatment delay. Objective: With this work, we aimed to implement and evaluate a CDSS that supports health care professionals and improves patient safety. In addition to our experiences, we also describe its main components in a general manner to make it applicable to a wide range of medical institutions and to empower colleagues to implement a similar system in their facilities. Methods: Technical requirements must be taken into account before implementing a CDSS that performs laboratory diagnostics (labCDSS). These can be planned within the functional components of a reactive software agent, a computational framework for such a CDSS. Results: We present AMPEL (Analysis and Reporting System for the Improvement of Patient Safety through Real-Time Integration of Laboratory Findings), a labCDSS that notifies health care professionals if a life-threatening medical condition is detected. We developed and implemented AMPEL at a university hospital and regional hospitals in Germany (University of Leipzig Medical Center and the Muldental Clinics in Grimma and Wurzen). It currently runs 5 different algorithms in parallel: hypokalemia, hypercalcemia, hyponatremia, hyperlactatemia, and acute kidney injury. Conclusions: AMPEL enables continuous surveillance of patients. The system is constantly being evaluated and extended and has the capacity for many more algorithms. We hope to encourage colleagues from other institutions to design and implement similar CDSS using the theory, specifications, and experiences described in this work.