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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: Purpose: The efficiency of functional electrical-stimulation (FES) cycling in spinal cord injured and anaesthetised able-bodied cyclists has been found to be about one third of that reported during volitional cycling. The stimulation paradigm itself appears to be the main source of this inefficiency. It is unknown whether a period of high-volume training can induce adaptations that may influence the metabolic and electrical cost of FES cycling. Method: 11 individuals with paraplegia completed a 12-month, home-based, progressive FES cycle training programme (up to 5 × 60 min per wk). Stimulation cost, oxygen cost, efficiency and markers of anaerobic…metabolism were determined before and after 6 and 12 months of training, during constant work-rate tests. Results: Oxygen cost and efficiency did not significantly change after training. Total stimulation cost and blood lactate values reduced overall, while respiratory exchange ratios remained relatively high. Conclusions: The high metabolic cost of FES cycling is a result of non-physiological recruitment of predominantly fast muscle fibres. The electrical cost of cycling reduced by 37%, probably due to motor unit hypertrophy, and lactate oxidation capacity improved.
Abstract: Various types of bone preserving total hip prostheses with a proximal force transmission concept have been developed for younger adults, one of these being the implant "Delfi M®", produced by ESKA until 2009. Since the demand could not meet the expectations, the production was stopped due to economic reasons so that only 31 implants of this type were sold and even less actually implanted. This study followed up 15 Delfi M® prostheses in 12 patients for 3.1 years and represents the only existing valid data about this implant. Demographical, preoperative and postoperative data including clinical scores (HOOS and mHHS)…were collected retrospectively. Postoperative X-rays were analyzed by an independent radiologist. One implant had to be exchanged due to an infection and another one due to excessive implant migration. The mHHS and the HOOS scores showed a significant improvement after surgery. In the radiological analysis, there were no signs of radiolucent lines or osteolyses. This trial demonstrates good clinical and radiological midterm results for the Delfi M prosthesis. Limitations of this study are a small sample size and a follow-up time of 3 years at only one timepoint.
Keywords: Total hip arthroplasty, femoral neck preserving prosthesis, total hip replacement
Abstract: Introduction: This study compared the effect of Nintendo Wii Fit to the Matter of Balance program, a valid and reliable program, on improving balance, and well-being to decrease the risk of falls. Methods: Residents of an independent living senior housing facility were recruited and thirty-two residents ages 63 to 90 participated. Participants were separated into three groups: (1) Wii Fit group (n=11) completed balance games on the Wii Fit in individual sessions twice a week and supplemental home exercises; (2) Matter of Balance Group (n=11) completed exercises from the Matter of Balance Program in a group setting…twice a week; (3) Control group (n=10) received no intervention. Intervention lasted three weeks. Results/findings: One-way ANOVA's were completed. Scores from the assessments were not statistically significant at post-test Berg Balance Scale (p=0.837); Tinetti Gait and Balance Assessment (p=0.913); SF-36 (p=0.256). Results from a self-report demonstrated that Wii Fit is an enjoyable form of exercise for an elderly population. Conclusion: Although, the interventions failed to significantly increase balance, with an increase in intervention duration of Wii Fit or Matter of Balance balance may be improved. Although results were not significant this study adds to the growing body of evidence regarding the use of Wii Fit as a rehabilitation tool.
Keywords: Fall prevention, balance, exergaming, Wii Fit
Abstract: Background: Technological development has made the health information easily accessible to the general community through the internet. The number of health information seekers is increasing gradually and there is sufficient evidence indicating its usefulness in informed decision making. The objective of the study is to evaluate the quality of malnutrition related information on the internet by using different search engines. Methods: The three search engines: Google, MSN/Bing, and Yahoo were used to search malnutrition related information. The general assessment tool and content assessment tool were adopted to evaluate the quality of the included websites from different groups…such as .org, .com, .gov, and others. The analysis was performed by using SPSS 17.0. Results: Of all 29 sites, the .gov group showed the highest score for general assessment (mean=317; SD=14.68) and content assessment (mean=51.5; SD=18.26). The .org group got the lowest scores for both the tools. Reliability was 57% among rater1 and rater2 for the general assessment tool while it was 51% between rater2 and rater3 for content assessment. Conclusion: The study produced a quality assessment of websites containing malnutrition information. Sites provided more information on etiology, clinical information, and available treatment option for malnutrition. Assessment tools that were used in the study were good, extensive in assessing both surface and content quality.
Abstract: Introduction: Compared to rigid arthroscopic optics, a flexible camera system offers theoretically significant advantages: It has the potential to adapt to the naturally curved surface of joints, to move within the joint without stress to the cartilage or capsule and thereby to reduce the number of portals needed. Former studies evaluated flexible fiberoptic systems which were insufficient regarding image resolution. This is the first report on a new flexible videoendoscope with the so called “chip-on-the-tip” technology used in human joints. Methods: With a plasma sterilized 3.9 diameter flexible video endoscopy system (Visera ENF V, OLYMPUS) commonly used…in diagnostic rhino-laryngoscopy, we performed preliminary testing in cadaveric knee joints. After successful feasibility testing we utilized the tool in two qualitative diagnostic knee and five hip arthroscopies in combination with conventional rigid 30° and 70° arthroscopes (STORZ). Results: Qualitative evaluation showed superior visualisation of the posterior aspects of the knee joint as insertion of the posterior medial and lateral meniscal horn, tibial insertion of the posterior cruciate ligament and the posterolateral capsulo-ligamentous corner with acceptable image resolution and clarity compared to the rigid arthroscope. In the hip, it was possible to pass around the femoral neck, avoiding additional portals. There seemed to be virtually no risk for cartilage damage at all. Difficulties of the system were scope handling, navigation and orientation within the joint as well as potential damage to the tool itself. Conclusion: This is to our knowledge the first report on flexible videoarthroscopy. Some of the expectations were met, such as to reach virtually every corner the joint with minimal risk for the cartilage or other joint structures and with acceptable image quality. However, there are many significant disadvantages which question the routine use of such a videoendoscopic system with its present technical features.
Abstract: A three-dimensional finite element model of a vascular smooth muscle cell is based on models published recently; it comprehends elements representing cell membrane, cytoplasm and nucleus, and a complex tensegrity structure representing the cytoskeleton. In contrast to previous models of eucaryotic cells, this tensegrity structure consists of several parts. Its external and internal parts number 30 struts, 60 cables each, and their nodes are interconnected by 30 radial members; these parts represent cortical, nuclear and deep cytoskeletons, respectively. This arrangement enables us to simulate load transmission from the extracellular space to the nucleus or centrosome via membrane receptors (focal adhesions);…the ability of the model was tested by simulation of some mechanical tests with isolated vascular smooth muscle cells. Although material properties of components defined on the basis of the mechanical tests are ambiguous, modelling of different types of tests has shown the ability of the model to simulate substantial global features of cell behaviour, e.g. “action at a distance effect” or the global load-deformation response of the cell under various types of loading. Based on computational simulations, the authors offer a hypothesis explaining the scatter of experimental results of indentation tests.
Keywords: Cell biomechanics, tensegrity structure, cytoskeleton, computational model