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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: The relationship between surface electromyography (EMG) and force have been the subject of ongoing investigations and remain a subject of controversy. Even under static conditions, the relationships at different sensor placement locations in the biceps brachii (BB) muscle are complex. OBJECTIVE: The aim of this study was to compare the activity and relationship between surface EMG and static force from the BB muscle in terms of three sensor placement locations. METHODS: Twenty-one right hand dominant male subjects…(age 25.3 ± 1.2 years) participated in the study. Surface EMG signals were detected from the subject's right BB muscle. The muscle activation during force was determined as the root mean square (RMS) electromyographic signal normalized to the peak RMS EMG signal of isometric contraction for 10 s. The statistical analysis included linear regression to examine the relationship between EMG amplitude and force of contraction [40–100% of maximal voluntary contraction (MVC)], repeated measures ANOVA to assess differences among the sensor placement locations, and coefficient of variation (CoV) for muscle activity variation. RESULTS: The results demonstrated that when the sensor was placed on the muscle belly, the linear slope coefficient was significantly greater for EMG versus force testing (r^2 = 0.62, P < 0.05) than when placed on the lower part (r^2 = 0.31, P> 0.05) and upper part of the muscle belly (r^2 = 0.29, P< 0.05). In addition, the EMG signal activity on the muscle belly had less variability than the upper and lower parts (8.55% vs. 15.12% and 12.86%, respectively). CONCLUSION: These findings indicate the importance of applying the surface EMG sensor at the appropriate locations that follow muscle fiber orientation of the BB muscle during static contraction. As a result, EMG signals of three different placements may help to understand the difference in the amplitude of the signals due to placement.
Abstract: BACKGROUND AND OBJECTIVE: Personalization in healthcare refers to individualizing services and products based on patients' health conditions and interests. In order to deliver highly personalized offerings, mHealth providers need to use patients' health information, which provokes patients' concerns over personal health information leakage. So the personalization-privacy paradox is an important issue in the mHealth context. To gain a better understanding of this paradox, we take the personalization and privacy paradox factors as…independent variables, incorporating the nonlinear relationships between personalization and privacy, and take attitude and perceived usefulness as middle variables to study mHealth adoption. METHODS: The hypothesized model is tested through an empirical research of a 489-respondent sample in China. PLS is used for data analysis. KEY FINDINGS: (1) Personalization and privacy are found to influence mHealth adoption intention via attitude and perceived usefulness; (2) there is a substitution relationship, also called negative synergy between personalization and privacy in mHealth contexts; (3) attitude mediates the effect of perceived usefulness on intention, indicating a significant role of attitude.
Keywords: mHealth, personalization, privacy, attitude, TAM, nonlinear modeling
Abstract: BACKGROUND: Now-a-days, some new classes of diseases have come into existences which are known as lifestyle diseases. The main reasons behind these diseases are changes in the lifestyle of people such as alcohol drinking, smoking, food habits etc. After going through the various lifestyle diseases, it has been found that the fertility rates (sperm quantity) in men has considerably been decreasing in last two decades. Lifestyle factors as well as environmental factors are mainly responsible for…the change in the semen quality. OBJECTIVE: The objective of this paper is to identify the lifestyle and environmental features that affects the seminal quality and also fertility rate in man using data mining methods. METHOD: The five artificial intelligence techniques such as Multilayer perceptron (MLP), Decision Tree (DT), Navie Bayes (Kernel), Support vector machine+Particle swarm optimization (SVM+PSO) and Support vector machine (SVM) have been applied on fertility dataset to evaluate the seminal quality and also to predict the person is either normal or having altered fertility rate. While the eight feature selection techniques such as support vector machine (SVM), neural network (NN), evolutionary logistic regression (LR), support vector machine plus particle swarm optimization (SVM+PSO), principle component analysis (PCA), chi-square test, correlation and T-test methods have been used to identify more relevant features which affect the seminal quality. These techniques are applied on fertility dataset which contains 100 instances with nine attribute with two classes. RESULTS: The experimental result shows that SVM+PSO provides higher accuracy and area under curve (AUC) rate (94% & 0.932) among multi-layer perceptron (MLP) (92% & 0.728), Support Vector Machines (91% & 0.758), Navie Bayes (Kernel) (89% & 0.850) and Decision Tree (89% & 0.735) for some of the seminal parameters. This paper also focuses on the feature selection process i.e. how to select the features which are more important for prediction of fertility rate. In this paper, eight feature selection methods are applied on fertility dataset to find out a set of good features. The investigational results shows that childish diseases (0.079) and high fever features (0.057) has less impact on fertility rate while age (0.8685), season (0.843), surgical intervention (0.7683), alcohol consumption (0.5992), smoking habit (0.575), number of hours spent on setting (0.4366) and accident (0.5973) features have more impact. It is also observed that feature selection methods increase the accuracy of above mentioned techniques (multilayer perceptron 92%, support vector machine 91%, SVM+PSO 94%, Navie Bayes (Kernel) 89% and decision tree 89%) as compared to without feature selection methods (multilayer perceptron 86%, support vector machine 86%, SVM+PSO 85%, Navie Bayes (Kernel) 83% and decision tree 84%) which shows the applicability of feature selection methods in prediction. CONCLUSION: This paper lightens the application of artificial techniques in medical domain. From this paper, it can be concluded that data mining methods can be used to predict a person with or without disease based on environmental and lifestyle parameters/features rather than undergoing various medical test. In this paper, five data mining techniques are used to predict the fertility rate and among which SVM+PSO provide more accurate results than support vector machine and decision tree.
Keywords: Particle swarm optimization, multilayer perceptron, seminal, support vector machine
Abstract: BACKGROUND: Recent advancement in Internet based technologies have resulted in the growth of a sub-specialized field, termed as "Infodemiology" and "Infoveillance". Infoveillence refers to the collation of infodemiology measures for the purpose of surveillance and trending. Previous research has only demonstrated the research potential of Web 2.0 medium in collation of data in crisis situation. OBJECTIVES: The objectives for the current study are to demonstrate the methodology of implementation of a smartphone-based application for…dissemination and collation of information during a crisis situation. METHODS: The Haze Smartphone application was developed using an online application builder and using HTML5 as the core programming language. A five-phase developmental method including a) formulation of user requirements, b) system design, c) system development, d) system evaluation and finally e) system application and implementation were adopted. The smartphone application was deployed during a one-week period via a self-sponsored Facebook post and via direct dissemination of the web-links by emails. RESULTS: A total of 298 respondents took part in the survey within the application. Most of them were between the ages of 20- to 29-years old and had a university education. More individuals preferred the option of accessing and providing feedback to a survey on physical and psychological wellbeing via direct access to a Web-based questionnaire. In addition, the participants reported a mean number of 4.03 physical symptoms (SD 2.6). The total Impact of Event Scale–Revised (IES-R) score was 18.47 (SD 11.69), which indicated that the study population did experience psychological stress but not posttraumatic stress disorder. The perceived dangerous Pollutant Standards Index (PSI) level and the number of physical symptoms were associated with higher IES-R Score (P< 0.05). CONCLUSIONS: This study demonstrates how a smartphone application could potentially be used to acquire research data in a crisis situation. However, it is crucial for future research to further evaluate its effectiveness in a crisis situation.
Keywords: Smartphone application, methodologies, information technology, crisis, haze
Abstract: BACKGROUND: Mobile devices have been impacting on human standard of living by providing timely and accurate information anywhere and anytime through wireless media in developing nations. Shortage of experts in medical fields is very obvious throughout the whole world but more pronounced in developing nations. OBJECTIVE: Thus, this study proposes a telemedicine platform for the vulnerable areas of developing nations. The vulnerable area are the interior with little or no medical facilities, hence…the dwellers are very susceptible to sicknesses and diseases. METHODS: The framework uses mobile devices that can run LightWeight Agents (LWAs) to send consultation requests to a remote medical expert in urban city from the vulnerable interiors. The feedback is conveyed to the requester through the same medium. The system architecture which contained AgenRoller, LWAs, The front-end (mobile devices) and back-end (the medical server) is presented. The algorithm for the software component of the architecture (AgenRoller) is also presented. The system is modeled as M/M/1/c queuing system, and simulated using Simevents from MATLAB Simulink environment. RESULT: The simulation result presented show the average queue length, the number of entities in the queue and the number of entities departure from the system. These together present the rate of information processing in the system. CONCLUSION: A full scale development of this system with proper implementation will help extend the few medical facilities available in the urban cities in developing nations to the interiors thereby reducing the number of casualties in the vulnerable areas of the developing world especially in Sub Saharan Africa.
Keywords: Agentroller, LWAs, M/M/1, mobile agent, GSM, ICT
Abstract: BACKGROUND/PURPOSE: Polymers have a wide range of applications in dentistry. Poly methyl methacrylate (PMMA) is the most popular for making orthodontic retainers, dentures as well as synthetic teeth. Prior to clinical applications, the appliances are polished in the dental laboratory to achieve smooth, polished and comfortable surfaces. The objective of this study was to analyze the surface roughness profiles of PMMA dentures polished using two different approaches. In addition, the effects of ultrasonication and…sandblasting were also evaluated on the fitting surface of PMMA dentures. MATERIALS AND METHODS: This was an in vitro study using non-contact mode surface roughness profilometer and nano-indenter. Samples were polished using two different techniques (Standard and modified). Both cold cure and heat cure PMMA denture surfaces were evaluated for roughness, nanohardness and elastic modulus. RESULTS: The absolute hardness was recorded 297.72 ± 19.04 MPa and 229.93 ± 18.53 MPa for heat cured PMMA and cold cured PMMA. Manufactured acrylic teeth were harder (319.20 ± 12.58 MPa) with an elastic modulus of (4.34 ± 1.86 GPa). Modified polishing techniques (group 3) produced smoother surface. CONCLUSIONS: It was concluded that elastic moduli of acrylic tooth and heat cure PMMA is not very different. Surface treatments such as ultrasonication or sandblasting do not affect the roughness profiles of denture fitting surfaces.
Abstract: BACKGROUND: Coronary artery disease due to atherosclerosis is an epidemic in India. An estimated 1.3 million Indians died from this in 2000. The projected death from coronary artery disease by 2016 is 2.98 million. OBJECTIVE: To build an effective model which assorts the individuals, whether they belong to the normal group, risk group and pathologic group regarding atherosclerosis in real time by doing necessary preprocessing techniques and to compare the performance with other state-of-the-art machine…learning techniques. METHODS: In this work we have employed STULONG dataset. We have made a deep case study in selecting the attributes which contributes for higher accuracy in predicting the target. The selected attributes includes missing values. Initially our work includes imputation of missing values using Iterative Principal Component Analysis (IPCA). The second step includes selecting best features using Fast Correlation Based Filter (FCBF). Finally the classifier Multiclass Support Vector Machine (SVM) with kernel Radial Basis Function (RBF) is used for classification of atherosclerotic community. RESULTS: For the subjects belonging to the classes of normal, risk and pathologic, our methodology has outperformed with an accuracy of 99.85%, 99.80% and 99.46% respectively. CONCLUSION: The combined optimization methods such as Iterative Principal Component Analysis (IPCA) for missing value imputation, Multiclass SVM for classifying normal, risk and pathologic community in real time has performed with overall accuracy of about 98.97%. The essential pre-processing technique, Fast Correlation Based Filter (FCBF) was employed to further intensifying the target.
Abstract: The burden of lifestyle related chronic diseases have increased in recent times. The objective of this pilot study was to explore perceptions about using online lifestyle counseling services among individuals living in rural settings in India. A pilot convenient sample of 100 individuals living in rural settings of Chennai with age 18 years and above was enrolled for the study. Information was gathered about socio-demographic characteristics, health behavior, current disease status; familiarity with technology and perceptions…about online lifestyle counseling. The average age of the individuals was 34 years (SD=15). More than half of the individuals had access to computers at home and workplace. Individuals indentified various barriers for unable to obtain lifestyle counseling. Nearly 47% of the individuals were interested in obtaining online lifestyle counseling. There is an urgent need for evaluating the role of an online lifestyle counseling intervention among individuals living in rural settings.
Abstract: BACKGROUND: Pedicle screw pullout due to poor bone quality, mainly caused by osteoporosis, is a common problem in spine surgery. Special implants and techniques, especially PMMA augmentation, were developed to improve the fixation of pedicle screws. PMMA injection into a pilot hole or through a screw involves the same risks as vertebroplasty or kyphoplasty, regardless of the technique used. Especially when using fully cannulated screws anterior leakage is possible. OBJECTIVE: To prove PMMA injection…is safe and possible without leakage through an incompletely cannulated screw and also increases pullout forces in the osteoporotic vertebra. METHODS: Incompletely cannulated pedicle screws were tested by axial pullout in human cadavers, divided into osteoporotic and non-osteoporotic groups. Non-augmented and PMMA-augmented pedicle screws were compared. Twenty-five human vertebrae were measured by DEXA and divided into osteoporotic and non-osteoporotic groups. In each vertebra both pedicles were instrumented with the new screw (WSI-Expertise 6 × 45 mm, Peter Brehm Inc. Germany); the right screw was augmented with a 3 mL PMMA injection through the screw. On each screw axial pullout was performed after X-ray and CT scan. RESULTS: Radiographs and CT scans excluded PMMA leakage. Cement was distributed in the middle and posterior third of the vertebrae. Pullout forces were significantly higher after pedicle screw augmentation, especially in the osteoporotic bone. All augmented pedicle screws showed higher pullout forces compared with the unaugmented screws. CONCLUSIONS: We minimized the risk of leakage by using a screw with a closed tip. On the whole, PMMA augmentation through an incompletely cannulated pedicle screw is safe and increases pullout forces in osteoporotic bone to the level of healthy bone. Therefore the new incompletely cannulated screw can be used for pedicle screw augmentation.
Abstract: OBJECTIVES: Normally, surface electromyography electrodes are used to evaluate the activity of superficial muscles during various kinds of voluntary contractions of muscle fiber. The objective of the present study was to investigate the effect of repetitive isometric contractions on the three heads of the triceps brachii muscle during handgrip force exercise. METHODS: Myoelectric signals were recorded from the lateral, long and medial heads of the triceps brachii muscle in 13 healthy males during maximal…isometric contractions for 10 s of concurrent handgrip force and elbow extension. The subjects were asked to perform their contraction task five times with 3 minutes interval between two successive contractions. RESULTS: Decreasing electromyographic activities were found for the lateral and long heads, and increasing for the medial head throughout the 5 different contractions. Electromyographic activities were found for the lateral head with mean=199.84, SD=7.65, CV=3.83%, the long head with mean=456.76, SD=18.10, CV=3.96%, and the medial head with mean=505.16, SD=8.47, CV=1.68%. Electromyographic activities among the three heads of triceps brachii were significantly different (F=3.82) at the alpha level of (p < 0.05). CONCLUSIONS: These findings support that repetitive isometric contractions decrease the contractile activity in the lateral and long heads, and increases in the medial head of the triceps brachii muscle during handgrip force exercise with full elbow extension, and the electromyographic activity changes are observed to be more significant at the long head as compared to the lateral and medial heads.
Keywords: Surface electromyography, triceps brachii muscle, isometric contraction, grip force