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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: Fractures of the femoral bone are frequent injuries with a wide range of affected individuals. New treatment strategies and technologies are being explored permanently. Their quality is biomechanically judged by the accuracy of the anatomical reduction. Malalignment of the fragments would have an eminent impact on the overall outcome and rehabilitation. To establish a method for investigations of the reduction results of femoral fractures, we developed a model, using a navigation system for taking measurement. The dynamic reference bases (DRBs) where mounted to the intact femoral bone and registered as the reference position. A special construction allowed removal and reattachment…of the DRBs without provoking change in the DRB-bone system. The model was evaluated in it's constancy. Translational deviations remained below 0.9 mm and rotational deviations below 0.3° after 40 repetitive reattachments. The model could prove to be valid and reliable. An application in long-bone trauma research is reasonable.
Abstract: It is estimated that 10% of the patients admitted to North American hospitals die of hospital acquired infections. Approximately half of these are thought to be a consequence of poor hand hygiene practices by the hospital staff. Electronic hand washing reminders that prompt caregivers to wash their hands before and after the patient/patient's environment contact may help to increase the hand hygiene compliance rate. However, the current systems fail to identify the nursing procedures happening around the patient to issue proper hand hygiene prompt. In this research we used the hardware of a low-cost wireless Sony game controller,…which included a 3-axis accelerometer, to identify six nursing activities happening around a patient. We attached five sensors to eight nurses' left and right wrists, left and right upper arms, and the backs. Each nurse performed 10 trials of each nursing activity in sequence, followed by a combined nursing activities trial. We extracted mean, standard deviation, energy, and correlation among axes per sensor and compared the results of 1-Nearest Neighbour (1-NN), Decision Tree (J48), and Naïve Bayes classifiers. 1-NN classifier had the best performance and on average regardless of the sensor locations, we achieved 84% ± 2% accuracy.
Keywords: Infection control, hand hygiene, accelerometer, nursing activities Sony PlayStation, Sixaxis
Abstract: We present an Agent-Based Modelling Tool (ABMT) for scheduling patients at a diagnostic imaging facility. The ABMT accommodates multiple diagnostic imaging devices, a variety of patient classes, and an uneven distribution of server availability. The tool was tested using data and expertise from a hospital in Ontario, Canada. We show that the tool was able to identify a previously undetected increase in patient arrivals, establishing its effectiveness as a management tool.
Keywords: Simulation, scheduling, diagnostic imaging, agent-based modelling, patient wait times, health care
Abstract: Objective: To investigate whether epileptic seizures could be predicted or detected by means of spectral analysis of heart rate variability (HRV). Methods: Six patients with temporal lobe epilepsy (4 females, 2 males) participated in the prospective pilot study while enrolled for video/EEG monitoring (24 h/day, 2–4 days). ECG was continuously recorded and 30 min seizure-sessions (25–30 min pre-seizure to 30 sec-5 min post-seizure onset) and 30 min non-seizure-sessions (day- and night sessions for each patient, as control) were chosen for further HRV-analysis. Low frequency (LF) (0.04–0.15 Hz), High frequencies (HF) (0.15–0.40 Hz), LF/HF, LF/(LF+HF) and reciprocal HF-power…was determined using continuous FFT- spectral analysis of 64 R-R interval windowing with maximum overlapping. Results: Six seizures were recorded and analyzed from three patients (2 females, 1 male). All of the analyzed EEG-correlated seizures showed reciprocal HF-power peaks between 10 sec pre seizure-onset and 24 sec post seizure-onset with peak amplitudes 2.96–93.63 times higher than control maximum peak. For the other parameters we could not find significant difference between seizure and non-seizure sessions. Conclusion: Specifically high reciprocal HF-power peaks suggest suppressed parasympathetic activity just around seizure-onset time. Seizure detection using HRV-analysis seems to be a promising method for non-invasive seizure detection in the early phase of the clinical event (even preceding the onset).
Abstract: Decision support systems (DSS) are software entities that assist the physician in the decision making process. They have found application in medicine due to the large amounts of data (e.g. laboratory measurements such as blood pressure, heart rate, body-mass index) and information (e.g. patient history, population statistics based on age and sex) that must be considered before diagnosing any disease or recommending a therapy. A well known example is the embedded software in defibrillators which allows a ‘shock’ to be delivered, by analyzing the electrocardiogram for known conditions (heart attack). The shock can restart the heart and timely delivery can…resuscitate the patient. As well as assisting in primary diagnosis, a DSS can reduce medical error, assist compliance with clinical guidelines, improve efficiency of care delivery and improve quality of care. Decision support still has significant acceptance issues in clinical routine, but can achieve more prominence, as systems are demonstrated to provide effective knowledge based support. Data mining is often used to provide some insight to a data set and update our accepted knowledge. In this section, we discuss a study which examines where electrocardiographic information should be recorded from a patient's torso in order to increase diagnostic yield.
Keywords: Decision support, data mining, ecg electrode placement
Abstract: There is a constant need in medicine to obtain objective measurements of physical and cognitive function as the basis for diagnosis and monitoring of health. The body can be considered as a chemical and electrical system supported by a mechanical structure. Measuring and quantifying such electrical activity provides a means for objective examination of heath status. The term electrogram, from the Greek electro meaning electricity and gram meaning write or record, is the broad definition given to the recording of electrical signal from the body. In order that comparisons of electrical activity can be made against normative data, certain methods…and procedures have been defined for different electrograms. This paper reviews these methods and procedures for the more typical electrograms associated with some of the major organs in the body, providing a first point of reference for the reader.