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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: The aim of the paper is to present a novel tracking system for the assessment and training of grip force control. The system consists of two force measuring units of different shapes, which can be connected to a personal computer for visual feedback and data acquisition. We present the results of the assessment of the grip force control in 32 healthy subjects of different age groups and preliminary results obtained in a patient after head-injury who was treated with Botulinum-Toxin for hand spasticity. The proposed tracking system was also applied as a training tool in 10 post-stroke patients to possibly…improve their grip force control. The results in healthy subjects showed significant differences in grip force control among different age groups. In the patient after Botulinum-Toxin treatment the method revealed noticeable effects of the therapy on the patient’s tracking performance. Training with the tracking system showed considerable improvements in the grip force control in 8 out of 10 stroke patients. The proposed tracking method is aimed to be used in connection with different rehabilitation therapies (e.g. physiotherapy, functional electrical stimulation, drug treatment) to follow the influence of the therapy on patient's muscular strength and grip force control.
Keywords: grasp, grip strength, hand, sensory motor performance, stroke rehabilitation
Abstract: A soft decision algorithm for Obstructive Sleep Apnea (OSA) patient classification using R-R interval (RRI) data is investigated. This algorithm is based on fast and approximate estimation of the entropy of the wavelet-decomposed bands of the RRI data. The classification is done on the whole record as OSA patient or non-patient (normal). The ratio of the estimated entropy of the low-frequency (LF) band to that of the very-low frequency (VLF) band is used as a classification factor. RRI data used in this work are drawn from MIT database. The MIT trial records are used to set the threshold value of…the classification factor using the Receiver Operating Characteristics (ROC). This threshold value is used then to classify the MIT challenge (test) records to obtain the efficiency of classification. The new algorithm classifies correctly 30/30 of MIT-test data using different wavelet filters. Comparison of the results of different wavelet filters is done in terms of complexity and distance parameters. The method is also compared with other two techniques using wavelets in their analysis. The consistency of the results is examined using the leave-one-out technique.
Abstract: Besides a large body of research on user innovation, little is known which role users play in the emergence of radically new health care technologies. Such technologies are 'new-to-the-world', highly complex, shift market structures, and require user learning as they often induce significant behaviour changes on side of the users. In a multi-case-study-analysis we identified an 'entrepreneurial' role of inventive users. Those surgeons that were the original inventors of radically new health care technologies established and organized the required innovation networks. They identified relevant partners, formed a network of experts with complementary knowledge bases, and coordinated this network. These innovation…networks were required to transform their radically new ideas into first physical prototypes. To better understand the observed phenomenon we analysed factors that might explain this exclusive role. We find that a high problem pressure, an active role of users in the idea generation phase, a high degree of innovativeness of the prospective product, and missing competencies as well as missing resources explain the networking activities of inventive users. The findings shed light on the role of users in the emergence of radically new health care technologies.
Keywords: health care technology, user innovation, entrepreneurship, innovation networks, radical innovation
Abstract: Current research in foot biomechanics includes studies on prevention of recurrence of neuropathic foot ulcers. This paper attempts to prescribe accommodative insoles, which reduce plantar pressure levels particularly under the hallux. There is little quantitative information available regarding the effects of insole materials on reduction of plantar pressure. The insole models available in the literature are mostly two-dimensional (2-D). Hence, there is a need to develop a 3-D model with actual geometry which includes sufficient details. In this study a three-dimensional (3-D) model of the insole was constructed. A linear and non-linear static analysis using finite element method (FEM) was…performed. Results were compared for different materials such as Silicon Gel, Plastozot, Polyfoam, and Ethinil Vinyl Acetate (EVA). Our 3-D finite element model was constructed using 16170 ten-node tetrahedral, mixed U-P (displacement-pressure), hyperelastic, solid elements. Four different hyperelastic and foam materials were used and compared and the loading condition was based on the mid-stance phase of the gait. This research has shown that most of these materials are very effective in terms of reduction of plantar stress concentrations. The technique used in this research provides a promising approach to understanding of behavior of insole materials and suggests a design guideline for therapeutic footwear and orthoses.
Keywords: diabetic insoles, silicon gel, plastozot, polyfoam, ethinil vinyl acetate (EVA), hyperelasticity, three dimensional FEM
Abstract: Although currently in the research stage, scientists argue that drug-releasing microchip implants are on the horizon for future patients. This paper presents ethical reflection on these implants and identifies specific areas of concern; namely, patient monitoring and tracking, and patient privacy and confidentiality. It is foreseeable that drug delivery chips could be multifunctional with the overt or covert addition of sensors that monitor more than just the bloodstream concentrations of prescribed drugs (e.g., cotinine and alcohol in non-compliant patients, patient location via radio frequency or global positioning satellite). Similarly, it is foreseeable that these chips could be embedded with a…patient's protected health information that could potentially be accessed and used by unauthorized persons. While drug delivery microchips are theoretically convenient and accurate for dosing, and might offer faster drug delivery with fewer side effects, ethical issues loom and should be contemplated now, while the technology is still under development.
Keywords: ethics, drug implant, privacy, confidentiality, monitoring
Abstract: This paper introduces the design and implementation of a generic wireless and Real-time Multi-purpose Health Care Telemedicine system applying Bluetooth protocol, Global System for Mobile Communications (GSM) and General Packet Radio Service (GPRS). The paper explores the factors that should be considered when evaluating different technologies for application in telemedicine system. The design and implementation of an embedded wireless communication platform utilising Bluetooth protocol is described, and the implementation problems and limitations are investigated. The system is tested and its telecommunication general aspects are verified. The results showed that the system has (97.9 ± 1.3)% Up-time, 2.5 × 10−5…Bit Error Rate, 1% Dropped Call Rate, 97.4% Call Success Rate, 5 second transmission delay in average, (3.42 ± 0.11) kbps throughput, and the system may have application in electrocardiography.