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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: Bronchitis is considered a non-specific inflammation in the peripheral tissues of the trachea and bronchus. Many therapeutic schemes for chronic bronchitis have been reported in existing research. METHODS: This work attempted to conduct optimization analysis of the therapeutic scheme for chronic bronchitis using a data mining method. To overcome the shortfalls of the current fuzzy C-means clustering (FCM) algorithm, this research proposed an improved kernel fuzzy C-means (KFCM) clustering algorithm. The improved KFCM algorithm solved traditional cluster algorithm problems in two ways: firstly FCM clustering was mapped in high-dimensional kernel space; and the samples…in the initial input space R^S were mapped to high-dimensional feature space R^p. Finally, the improved and traditional algorithms by computer simulation experiments. RESULTS: Based on the analysis of the simulation experiments on IRIS dataset in this research, improved KFCM algorithm could improve calculation accuracy by 10% because the initial value greatly decreased the number of iterations and improved the accuracy of the calculation. CONCLUSION: The improved KFCM algorithm was used to optimize the relationship between data structures in the process of iteration clustering so as to accelerate iteration convergence. The simulation results show that the improved KFCM algorithm performs better in terms of both calculating performance and clustering correctness.
Keywords: Data mining, chronic bronchitis, KFCM algorithm, medical information
Abstract: BACKGROUND: Elderly people are often affected by age-related knee osteoarthritis (KOA). The development of sensors for measuring and diagnostic devices used in preventive healthcare of that illness therefore constitutes an urgent issue. OBJECTIVE: After developing a bone joint acoustic sensor (BJAS) that receives signals of mechanical vibrations in the knee joints during bending and stretching motions, we tested it and compared responses with those of an acceleration sensor used as a reference. METHODS: For six examinees in their 20 s, using an acceleration sensor as a reference for comparison with BJAS, we…conducted two frequency-response tests of impact excitation and knee bending and stretching. For impact excitation tests, two transmission systems of hard materials and soft materials were applied. We examined the cross spectral density, coherence function, Fourier transform and quantified signal. RESULTS: Although BJAS detected signals of 0.5-15.0 kHz in impact excitation tests, considerably strong damping was found for soft specimens at higher frequencies. Therefore, acceleration sensors showed superiority over BJAS for impact excitation. However, for knee bending and stretching, BJAS detected signal frequencies of 0.5-8.0 kHz for all six examinees. BJAS demonstrated marked superiority over the acceleration sensor. Furthermore, we were able to quantify the signal intensity for each frequency for comparison. CONCLUSIONS: The BJAS frequency response was superior to that of the acceleration sensor for capturing signals from knee bending and stretching. This superiority suggests its promise for application to clarify mechanical signals from knees.
Keywords: Bone joint, acoustic sensor, frequency response, short time Fourier transform (STFT), coherence, impact excitation method, pig skin, knee joint
Abstract: BACKGROUND: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Patients who have undergone Bariatric surgery tend to need chronic long-term follow-up with a multi-disciplinary team. In the past decade, there has been massive advancemcent and development in Internet, Web-based and Smartphone technologies. However, there seemed to be a pacuity of applications in this area that enables post-bariatric patients to self-manage their own condition. In addition, past research have highlighted the…limited evidence based with regards to currently available bariatric applications, mainly due to the lack of medical professionals involvement. OBJECTIVE: Our current research objective is to illustrate the development of a Bariatric After-care smartphone application and to highlight user preferences with regards to the features integrated within the application. METHODOLOGY: The Bariatric Aftercare application was developed between the months of March 2014 to April 2014. Making use of low-cost online web-based application developmental technologies, the authors embarked on the development of the web-based application. Patients who attended their routine follow-up appointments are given the links to the web-based application. They were also recruited to participate in an online user evaluation survey to identify their preferences with regards to the features integrated. RESULTS: Since the inception of the web-based application to date, there has been a cumulative total of 385 unique assess to the online web-based application. There is a slight change in the confidence levels of the participants with regards to using the application to help them self-manage their own condition. The majority of the users have indicated that they preferred the information pertaining to what happens during each consult with members of the multidisciplinary team and also greatly valued the feature with regards to the ability to re-schedule their appointments. The vast majority also found the additional resources to be helpful. CONCLUSIONS: This is one of the first studies to demonstrate the potential use of smartphone innovations in Bariatric After-care self-management. The current study has shown that users are generally receptive towards such an innovative implementation and has also highlighted some of their preferences with regards to such a self-management application for self-management of their health condition post bariatric surgery. In addition, the authors have also managed to demonstrate how clinicians could be involved in the formulation of a bariatric care application, which has an evidence base.
Abstract: BACKGROUND: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help…in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. OBJECTIVE: Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. METHODOLOGY: The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users' requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. RESULTS: Since the inception of the online portal to date, in terms of usage rates, there have been a total of 2408 visitors to the online portal. The majority of the visitors are from Canada (n= 1879). From the analytics, a total of 8 users have participated in the pre-assessment questionnaire and have attempted and tried to use the individual modules. Since the inception of the pilot study from January 2014 till October 2014, 4 individuals have completed at least 3 modules available on the online portal. CONCLUSIONS: This is one of the first few studies that have demonstrated the potential feasibility of having an online and smartphone cognitive behavioral portal to serve the psychological needs of bariatric surgery patients.
Keywords: Bariatric psycho-social care, CBT, online interventions, smartphone, psychiatry
Abstract: BACKGROUND: While advancements in technology have encouraged the development of novel prompting systems to support cognitive interventions, little research has evaluated the best time to deliver prompts, which may impact the effectiveness of these interventions. OBJECTIVE: This study examined whether transition-based context prompting (prompting an individual during task transitions) is more effective than traditional fixed time-based prompting. METHODS: Participants were 42 healthy adults who completed 12 different everyday activities, each lasting 1-7 minutes, in an experimental smart home testbed and received prompts to record the completed activities from an electronic memory notebook.…Half of the participants were delivered prompts during activity transitions, while the other half received prompts every 5 minutes. Participants also completed Likert-scale ratings regarding their perceptions of the prompting system. RESULTS: Results revealed that participants in the transition-based context prompting condition responded to the first prompt more frequently and rated the system as more convenient, natural, and appropriate compared to participants in the time-based condition. CONCLUSIONS: Our findings suggest that prompting during activity transitions produces higher adherence to the first prompt and more positive perceptions of the prompting system. This is an important finding given the benefits of prompting technology and the possibility of improving cognitive interventions by using context-aware transition prompting.
Keywords: Prompting technology, cognitive intervention, assistive technology, cognitive aids
Abstract: BACKGROUND: Reading mammograms is a difficult task and for this reason any development that may improve the performance in breast cancer screening is of great importance. OBJECTIVE: We proposed optimized computer aided diagnosis (CAD) system, equipped with reliability estimate module, for mass detection on digitized mammograms. METHODS: Proposed CAD system consists of four major steps: preprocessing, segmentation, feature extraction and classification. We propose a simple regression function as a threshold function for extraction of potential masses. By running optimization procedure we estimate parameters of the preprocessing and segmentation steps thus ensuring maximum mass…detection sensitivity. In addition to the classification, where we tested seven different classifiers, the CAD system is equipped with reliability estimate module. RESULTS: By performing segmentation 91.3% of masses were correctly segmented with 4.14 false positives per image (FPpi). This result is improved in the classification phase where, among the seven tested classifiers, multilayer perceptron neural network achieved the best result including 77.4% sensitivity and 0.49 FPpi. CONCLUSION: By using the proposed regression function and parameter optimization we were able to improve segmentation results comparing to the literature. In addition, we showed that CAD system has high potential for being equipped with reliability estimate module.
Keywords: Breast cancer, computer-assisted image processing, data mining, mammography, optimization
Abstract: BACKGROUND: Bone drilling is a common practice of surgical treatments in orthopaedics and traumatology. Penetration of a high-speed drill into bone tissue is accompanied by generation of a significant amount of heat. Cooling of the drilling region is necessary to avoid potential risk of thermal damage to bone. OBJECTIVE: The purpose of this study was to measure and predict bone temperature by conducting experiments and numerical simulations using cooling by means of irrigation at two different temperatures. METHODS: A series of experiments and numerical studies were performed to investigate the effect of cooling…conditions on the rise in bone temperature in drilling. The temperature increase in bone was assessed for different drilling speeds and feed rates in the presence irrigation at 5°C and 25°C. RESULTS: Bone temperature was found to be strongly affected by the drilling parameters and cooling conditions. Irrigation with water at 5°C kept bone temperature well below the thermal threshold level. CONCLUSION: This study strongly recommends the use of irrigation at lower temperature for safe surgical incision.
Keywords: Orthopaedic, bone drilling, experimental analysis, FE modelling, thermal necrosis
Abstract: BACKGROUND: High importance is given to plantar pressure monitoring in the field of biomedical engineering for the diagnosis of posture related ailments associated with diseases such as diabetes and gonarthrosis. OBJECTIVE: This paper presents the proof-of-concept development of a new high resolution plantar pressure monitoring pad based on fiber Bragg grating (FBG) sensors. METHODS: In the proposed configuration, the FBG sensors are embedded within layers of carbon composite material (CCM) in turn conforming to an arc shape. A total of four such arc shaped sensors are instrumented in the pad at the locations…of the forefoot and the hind foot. As a test of the pad, static plantar pressure is monitored on normal subjects under various posture conditions. The pad is evaluated both as a standalone platform as well as a pad inserted inside a standard shoe. RESULTS: An average pressure sensitivity of 1.2 pm/kPa and a resolution of approximately 0.8 kPa is obtained in this special configuration. The pad is found to be suitable in both configurations- stand-alone pad as well as an insert inside a standard shoe. CONCLUSION: The proposed set up offers a cost-effective high resolution and accurate plantar pressure measurement system suitable for clinical deployment. The novelty of the developed pressure pad lies in its ability to be used both as platform type as well as inserted in-sole type sensor system.
Abstract: BACKGROUND: Unilateral Spatial Neglect, or neglect, is a common behavioral syndrome in patients following unilateral brain damage, such as stroke. In recent years, new technologies, such as computer-based tools and virtual reality have been used in order to solve some limitations of the traditional neglect evaluation. Within this perspective, also mobile devices such as tablets seems to be promising tools, being able to support interactive virtual environments and, at the same time, allowing to easily reproduce traditional paper-and-pencil test. OBJECTIVE: In this context, the aim of our study was to investigate the potentiality of a new…mobile application (Neglect App) designed and developed for tablet (iPad) for screening neglect symptoms. METHODS: To address this objective, we divided a sample of 16 right-damaged patients according to the presence or absence of neglect and we administered assessment test in their traditional and Neglect App version. RESULTS: Results showed that the cancellation tests developed within Neglect App were equally effective to traditional paper-and-pencil tests (Line cancellation test and Star Cancellation test) in detecting neglect symptoms. Secondly, according to our results, the Neglect App Card Dealing task was more sensitive in detecting neglect symptoms than traditional functional task. CONCLUSIONS: Globally, results gives preliminary evidences supporting the feasibility of Neglect App for the screening of USN symptoms.
Abstract: BACKGROUND: e-Health is a widespread healthcare practice in the medical community, supported by technology-based applications aiming to deliver health services in an efficient manner, improving the quality of life and providing a wide range of health and socio-economic benefits to patients. OBJECTIVE: To investigate the use of e-Health and mobile applications for the follow-up of major joint arthroplasty patients and the socio-economic impact of e-Health services on arthroplasty patients. METHODS: Studies published after 2000 in English language, enrolling patients who underwent total knee or hip replacement, applying e-Health solutions and highlighting the economic…benefits obtained by patients, doctors and healthcare systems were considered for inclusion in the present study. RESULTS: Five studies satisfied our inclusion criteria and were included in qualitative analysis. In this paper, the use of e-Health for the follow-up of major joint arthroplasty patients and the positive impact in terms of cost, time and hospital visits reduction by applying e-Health solutions on arthroplasty patients are reviewed in detail as reported in the included studies. CONCLUSION: The majority of the included studies reported a positive impact in terms of cost, time and hospital visits reduction.