Technology and Health Care - Volume Preprint, issue Preprint
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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: Speech synthesis models have been considered as viable tools for performance evaluation of cochlear stimulation algorithms, due to the difficulties of clinical tests. OBJECTIVE: The present study has developed a tool that can be used before any audio signal reconstruction algorithm, which shows more conformity with the electrophysiological parameters of the patient in evaluation of the cochlear implant stimulation algorithms. METHODS: In this method, excitable nerve fiber characteristics such as stimulation threshold and effective refractory period have been considered in the signal pre-reconstruction process. This algorithm subsumes the user's biological parameters (e.g.,…the manner of distribution of the remaining intact nerve fibers) as well as the stimulation signal parameters (e.g., stimulation rate, pulse width, amplitude of stimulation, the distance between stimulation electrode and fibers) in the signal pre-reconstruction. RESULTS: Effect of changes in these parameters can be observed by the number of excited fibers, which is directly related to the signal intensity and pitch frequency perceived by the user. The obtained results from simulations are in accordance with previous clinical findings. Also, the ability of the proposed tool can be seen by the correspondence between the results obtained from the proposed modeland the amplitude growth functions of the cochlear implant users. CONCLUSIONS: This paper has introduced a tool for signal reconstruction from electrical stimulation so that a more comprehensive criterion for examination of the stimulating algorithms in cochlear implant can be achieved.
Abstract: Body circumference is a known health-related factor. This cross-sectional study aimed to investigate the associations of relative lower body circumferences with metabolic syndrome (MetS) and arterial stiffness (AS) in 684 men aged > 40 (mean, 54.6 ± 8.5) years. Participants were measured for waist, thigh, and calf circumferences; underwent blood tests and blood pressure measurements to detect MetS; and received brachial ankle pulse wave velocity measurements to measure AS. The waist-to-thigh, waist-to-calf, and thigh-to-calf circumferences were calculated and classified into quartiles. Age-adjusted multiple logistic regression models were used to assess the associations between the circumference ratios and AS vs.…non-AS and MetS vs. non-MetS (systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting plasma glucose). The mean body mass index was 24.9 ± 2.8 kg/m2 ; the mean waist, thigh, and calf circumferences were 87.4 ± 7.6, 53.8 ± 4.2, and 36.4 ± 2.7 cm, respectively. Compared to the lowest quartiles, participants in waist-to-thigh circumference quartiles 3 (odds ratio [OR] = 3.195, 95% confidence interval [CI] = 1.825-5.594, p < 0.001) and 4 (OR = 4.755, 95% CI = 2.715-8.325, p < 0.001), and participants in waist-to-calf circumference quartiles 2 (OR = 2.511, 95% CI = 1.397-4.511, p = 0.002), 3 (OR = 3.929, 95% CI = 2.076-7.435, p < 0.001), and 4 (OR = 5.298, 95% CI = 2.847-9.858, p < 0.001) had significantly greater risks of MetS; participants in waist-to-calf circumference quartile 4 (OR = 2.481, 95% CI = 1.477-4.167, p < 0.001) and participants in waist-to-calf circumference quartile 4 (OR = 1.763, 95% CI = 1.088-2.856, p = 0.021) had a significantly greater risk of AS, indicating that age-adjusted relative lower body circumferences associate with MetS and AS. Large thigh and calf circumferences may indicate reduced risks for cardiovascular disease.
Keywords: Arterial stiffness, body circumference, metabolic syndrome
Abstract: Evaluating the biomechanical and performance factors of the knee joint during golf swing can provide objective and quantitative information about improving the performance and development of efficient physical training, as the legs are important for achieving an efficient swing and maximum speed of the club head in golf. In the present study, kinematic movements of the knee joint were identified during the downswing by using 3-dimensional motion analysis, and isokinetic strength was measured with driver and 5-iron clubs in 15 professional (PRO) golfers and 10 amateur (AMA) golfers. Results showed that PRO golfers had a narrower minimal angle between the…thigh and lower leg in the trail knee than the AMA golfers, regardless of the club used, and the angular velocity of the lead knee was faster during the downswing with a 5-iron club in the AMA golfers than in the PRO golfers. The PRO and AMA golfers had a wider minimal angle between the thigh and lower leg, smaller total range of movement, and slower angular velocity of the trail knee when swinging a 5-iron club than when swinging a driver club. These results are expected to provide useful information to prevent golf-related injuries that usually arise in the knee joint and help improve the golf performance of amateur golfers.
Keywords: Downswing, golf, knee joint, isokinetic strength, kinematic movement
Abstract: BACKGROUND: The non-image-forming effects of luminous radiation on people with intellectual disabilities or dementia received attention from researchers. Such studies, however, have generally been conducted using disparate methodologies which precludes generalization and reproducibility. OBJECTIVE: The aim of this study was to determine the practical applicability of measurement devices for studies investigating non-image-forming effects of luminous radiation, specifically for people with intellectual disabilities or dementia. METHODS: In three experiments, ten cognitive impaired people and thirty-nine unaffected subjects participated by wearing one or more portable devices. Six devices were assessed in total. Measurement…data was accompanied with user experiences obtained from questionnaires, interviews and observations in order to assess the devices on practical and comfort issues. RESULTS: On average, the devices worn by the cognitive impaired subjects were not experienced as annoying or irritating. No significant differences are found between genders and for one of the portable devices significantly less annoyance was reported by the cognitive impaired participants compared to the unaffected group of participants. INNOVATIVE SOLUTION: The three phases of the research process in towards measuring personal luminous exposures are: selection of the most suitable portable device, application of the assessment method, and the application of the device in the (pilot) study. CONCLUSIONS: However, the findings of this study suggest that inaccuracies potentially caused by practical and comfort issues associated with the portable devices need to be considered.
Abstract: PURPOSE: To develop a mobile application (app) for oral cancer screening. METHODS: The app was developed using Android system version 4.4.2, with JAVA language. Information concerning sociodemographic data and risk factors for oral cancer development, e.g., tobacco and alcohol use, sun exposure and other contributing factors, such as unprotected oral sex, oral pain and denture use, were included. We surveyed a population at high risk for oral cancer development and then evaluated the sensitivity/specificity/accuracy and predictive values of clinical oral diagnosis between two blinded trained examiners, who used movies and data from the app, and…in loco oral examination as gold-standard. RESULTS: A total of 55 individuals at high risk for oral cancer development were surveyed. Of these, 31% presented homogeneous/heterogeneous white lesions with potential of malignancy. The clinical diagnoses performed by the two examiners using videos were found to have sensitivity of 82%-100% (average 91%), specificity of 81%-100% (average 90.5%), and accuracy of 87.27%-95.54% (average 90.90%), as compared with the gold-standard. The Kappa agreement value between the gold-standard and the examiner with the best agreement was 0.597. CONCLUSION: Mobile apps including videos and data collection interfaces could be an interesting alternative in oral cancer research development.
Keywords: Oral cancer, health informatics, health public policy
Abstract: BACKGROUND: Sacroiliac joint (SIJ) syndrome can cause various symptoms and may also be one reason for persistent low back pain, especially in patients with prior spinal fusions. If conservative treatments fail to improve symptoms, arthrodesis surgery can be considered. Minimally invasive approaches have emerged recently providing a good alternative to conventional methods. A novel triangular implant system (iFuse) can achieve an arthrodesis of the SIJ without the use of additional screws or bone material. OBJECTIVE: Aim of the present study was an evaluation of short-term safety and efficacy of the implant system. METHODS:…Twenty-four patients were included in the study and treated with the iFuse system. In addition to demographic data, pain intensity (visual analogue scale) and functional impairment (Oswestry-disability index) were assessed prior to surgery and 1 month, 3 months, 6 months, 12 months and 24 months thereafter. During surgery and the follow up period all adverse events were documented and the correct implant position was controlled via plain radiographs. RESULTS: VAS scores and ODI improved significantly directly after surgery from 84.3 ± 9.2 mm to 40.7 ± 9.2 mm and from 76.8 ± 9.2% to 40.7 ± 9.2 % (p < 0.001). The ODI improved further to 31 ± 5.4% after 24 months whereas the VAS improved until the 3 months examination and ten stayed constant between 27.7 mm and 26.5 mm to 27 ± 6.6 mm at 24 months. No adverse events, intraoperative complications, implant malpositioning or loosening could be recorded at any time. CONCLUSIONS: The iFuse system is an effective and safe treatment for minimally invasive surgical arthrodesis of the SIJ. Pain and functional impairment can be significantly improved. However, in addition to this case series, further controlled studies are necessary, particularly in terms of a previous spinal fusion history.
Abstract: OBJECTIVE: To establish a three-dimensional finite element model of the human chest for engineering research on individual protection. METHOD: Computed tomography (CT) scanning data were used for three-dimensional reconstruction with the medical image reconstruction software Mimics. The finite element method (FEM) preprocessing software ANSYS ICEM CFD was used for cell mesh generation, and the relevant material behavior parameters of all of the model's parts were specified. The finite element model was constructed with the FEM software, and the model availability was verified based on previous cadaver experimental data. RESULTS: A finite element model…approximating the anatomical structure of the human chest was established, and the model's simulation results conformed to the results of the cadaver experiment overall. CONCLUSION: Segment data of the human body and specialized software can be utilized for FEM model reconstruction to satisfy the need for numerical analysis of shocks to the human chest in engineering research on body mechanics.
Keywords: Human chest, finite element model, availability check
Abstract: BACKGROUND: Some healthcare managers use computer simulation to assist with staffing. As staffing actions are usually slow to evolve and long term in nature, computer simulation can provide the opportunity to evaluate different alternatives at substantially lower costs with fewer risks. OBJECTIVE: Using computer simulation, this paper seeks to determine the optimal number and allocation of clerks involved in the patient registration process of a hospital. METHODS: This paper is based on a case study conducted in a hospital and uses historical data provided by the hospital in simulating the patient registration process.…RESULTS: The simulation results indicate that computer simulation can be an effective decision supporting tool in modeling the patient registration process and evaluating the effects of changes in the number and allocation of clerks in the process. CONCLUSIONS: Based upon a case study applying real-world data, the results of this paper would be beneficial to those who consider utilizing computer simulation for staffing decisions.
Abstract: BACKGROUND: Subjects with Spinal Cord Injury (SCI) should use various assistive devices to stand and walk. Unfortunately they suffer from slow walking speed, high energy consumption, and too much force applied on upper limb while walking. The aim of this study was to determine the gap between the gait performance of SCI and normal subjects to conclude how the performance of SCI can be improved. METHOD : Three groups of SCI walked with orthosis, SCI walked without orthosis, and normal subjects were recruited in this study. The normal subjects also walked with the same orthoses as SCI…subjects. Some parameters such as ranges of motion of hip, knee and spatiotemporal gait parameters were evaluated by use of Qualysis motion analysis system. The difference between the gait parameters of three groups were evaluated by use of two sample t test. RESULTS : The mean values of hip joint range of motion of normal subjects while walking with and without orthosis were 48.3 ± 2.5 and 18.5 ± 8.8 degrees, respectively (p-value = 0.00). There was a significant difference between walking speed of normal subjects with and without orthosis. The walking speed of SCI subject with and without orthosis differed significantly. CONCLUSION : Although use of orthosis enable SCI subjects to stand and walk, but has some restrictions. As use of orthosis decreased the abilities of normal subjects it can be concluded that more attention should be done on design of orthosis and style of walking.
Keywords: Spinal cord injury, kinematic, gait, style of walking, orthosis
Abstract: OBJECTIVE: To investigate the effects of strengthening exercise integrated repetitive transcranial magnetic stimulation (rTMS) on motor function recovery in subacute stroke patients. SUBJECTS AND METHODS: Thirty subacute stroke patients were randomly assigned to three groups: an ankle strengthening exercise group (group I), ankle strengthening exercise integrated rTMS group (group II), or an rTMS group (control group (CG)). Study subjects received therapy five days per week for eight weeks. Motor-evoked potential testing, peak torque at the ankle joint, and 10 m walk test were performed before and after the eight-week treatment period. RESULTS: Subjects…in group II showed significantly higher amplitude of MEP, plantarflexor and dorsiflexor of peak torque, 10 m walk test than groups I and CG (p < 0.05). Subjects in groups I and II differed significantly in the pre- and post-test for all variables, (p < 0.05). In the CG group, the pre- and post-test scores for the amplitude of MEP, dorsiflexor, and 10-walk test differed significantly (p < 0.05). CONCLUSIONS: Strengthening exercise integrated rTMS has positive effects on motor function recovery in subacute stroke patients.
Keywords: Motor recovery, repetitive transcranial magnetic stimulation, stroke