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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: This article is an analysis of the Health Information Technology Education published research. The purpose of this study was to examine selected literature using variables such as journal frequency, keyword analysis, universities associated with the research and geographic diversity. The analysis presented in this paper has identified intellectually significant studies that have contributed to the development and accumulation of intellectual wealth of Health Information Technology. The keyword analysis suggests that Health Information Technology research has evolved from establishing concepts and domains of health information systems, technology and management to contemporary issues such as education, outsourcing, web services and security. The…research findings have implications for educators, researchers, journal.
Keywords: Health Information Technology, education editors, research institutions
Abstract: Individuals are widely using different sources to acquire health information. To better understand the adolescents' needs of having tailored health information, it becomes important to assess the existing sources that they utilize to obtain that information. Our study objective was to identify sources of STI related health information studied among adolescents. A search was conducted using Google during November 2011 to January 2012 to identify different STI related health information sources. A combination of 3 key words including adolescent sexual health survey, sex health information survey, and sexual health education assessment were used. The first 20 weblinks from each search…were combined resulting in a total of 60 primary weblinks. Secondary search was conducted to identify additional relevant articles. A total of 10 articles were found relevant, of which 52% were non US-based. 87% of the primary articles were excluded as they did not gather the source of STI related health information in their surveys. Most common sources assessed were TV, doctor, books, magazines, friends, and parents. Internet was assessed only in 3 of the final 10 articles. Future research should be done to assess role of internet as a possible source of disseminating STI related health information among adolescents.
Keywords: STI, adolescents, survey, internet, health information
Abstract: This paper presents a wireless body area network platform that performs physical activities recognition using accelerometers, biosignals and smartphones. Multiple classifiers and sensor combinations were examined to identify the classifier with the best recognition performance for the static and dynamic activities. The Functional Trees classifier proved to provide the best results among the classifiers evaluated (Naive Bayes, Bayesian Networks, Support Vector Machines and Decision Trees [C4.5, Random Forest]) and was used to train the model which was implemented for the real time activity recognition on the smartphone. The identified patterns of daily physical activities were used to examine conformance with…medical advice, regarding physical activity guidelines. An algorithm based on Skip Chain Conditional Random Fields, received as inputs the recognized activities and data retrieved from the GPS receiver of the smartphone to develop dynamic daily patterns that enhance prediction results. The presented platform can be extended to be used in the prevention of short-term complications of metabolic diseases such as diabetes.
Keywords: Smartphones, wearable sensors, physical activities, real time recognition, conformance, pattern recognition
Abstract: Activity recognition has become a key component within smart environments that aim at providing assistive solutions for their users. Learning high level activities from low level sensor data depends on several parameters, one of which is the duration of the activities themselves. Nevertheless, directly incorporating continuous duration values into a model is a complex process and may not prove to be very qualitative. In this paper we aim at discretising activity related durations using different clustering algorithms. We explore the possibility of discretising duration data through the use of rudimentary clustering algorithms such as visual inspection to more established methods…such as model based clustering. In addition, a probabilistic model is built that predicts both person and activities from the observed values of sensor sequence, time and discrete duration values. Each of the models created is compared in terms of its performance in the prediction of activities. Following analysis of the results attained it has been found that irrespective of the clustering algorithm used for duration discretisation, incorporating the duration information increases the prediction performance. Prediction accuracy was improved by almost 3% when the model was built incorporating durations.
Abstract: Aims and objective: The purpose of this study was to evaluate the knowledge and the use of Transcutaneous Electrical Nerve Stimulation (TENS) by Nigerian physical therapists. Methods: A cross sectional study design was carried out among Nigerian physical therapists. Eighty-six physical therapists participated in this study and data were collected using a structured and validated questionnaire. Copies of the questionnaires were distributed by hand and by mail (with self addressed envelopes) to various hospitals, clinics, universities that offer physical therapy services/programmes across Nigeria. Data were analyzed using descriptive statistics. Results: Academic staff constituted 10.5%…while 89.5% were clinicians. First degree holders constituted 61.6% while 38.4% had postgraduate degrees. Majority of physical therapists, 90.7% use TENS, 83% of those who use TENS are aware of the different types of TENS; 98.72% use TENS for 30 minutes or less, 48.7% use it for 15 minutes or less. The frequency commonly use is between 1–30 Hz and about 12.8% of those using this frequency believed that TENS relieves pain through the pre-synaptic inhibition, endogenous pain control, and direct inhibition of abnormally excited nerve and restoration of afferent input. Furthermore, 12.8% calibrated their TENS devices. Only 6.4% have published TENS related papers in the last five years while 29.5% have attended TENS related seminar in the past. Majority, 88.5% considered TENS to be cost effective. Conclusion: This study concluded that TENS is widely used among Nigerian physical therapists and tend to have adequate knowledge of TENS and its application in the management of pain.
Abstract: Percutaneous transluminal coronary angioplasty (PTCA) with stent implantation is widely used for the treatment of coronary stenosis. However, restenosis after stent implantation frequently reported by intravascular ultrasound evaluation. This may occur because of the reduced luminal area after implantation, insufficient stent expansion, or by the elastic recoil of the stent (ERS). Quantitative evaluation of stent expanding should provide further information on how to decrease the incidence of re-stenosis. Many previous studies have observed stent properties in 2D. However, the stent geometry is changed in 3D space, and 3D measurements will provide further information on factors such as the risk for…asymmetric ERS. We performed 3D reconstruction using high spatial resolution images obtained with a Micro-CT system to observe the 3D expansion behavior of a test stent and quantitatively evaluate ERS. The expansion behavior of each structural component of the stent varied, as did the ERS and eccentricity. ERS ranged from 2.4% to 9.2% during observation form proximal and distal positions in each component. The greatest difference in ERS between 2D and 3D measurements was 5.2%. 3D measurements provide more information on ERS than 2D measurements. Our result shows the importance of the observation, and the evaluation by three dimensions.
Keywords: Three dimensional, Micro-CT, expansion behavior, elastic recoil of stent, balloon-expandable stent
Abstract: Background: Patient tracking helps improve workflow, decrease wait times, optimize costs, and enhance medical treatment in the outpatient setting. In that regard, real-time patient tracking may serve as a potential way to perform efficient patient care. In recent years, the increasing popularity of wireless local area networks (WLANs) has led to a growing number of devices utilizing wireless fidelity (WiFi) networks. This application has been used in various industries to enhance management processes. In that regard, we believe that this technology may enhance patient tracking, as the existing WLAN architecture in many clinics may allow for real-time tracking of patients.…However, current literature regarding the clinical applicability of these devices is sparse. The aim of this study is to analyze the developmental process and feasibility of our protytope model for real-time patient tracking, using WLAN in the outpatient setting of our Level I Trauma center. Methods: We performed the study in various stages. First, we analyzed our current patient workflow, and then devised a study protocol and prototype model that implemented both this workflow schematic and our current technology infrastructure. Second, we implemented our prototype model to determine the accuracy, feasibility, and safety of data transmission in our clinical setting. The factors examined during prototype implementation included the accuracy of patient localization and the time spent by each patient in the various areas of our clinic (as determined by patient tracking). Results: In our outpatient clinic, our prototype was capable of localizing and automating patient data with excellent accuracy and security. Conclusions: WLAN-based real-time patient localization systems can help overcome a number of common challenges and inefficiencies seen in the outpatient clinics. Real-time localization systems using WLAN technology performed adequately and safely in this pilot study. We believe that this will eventually lead to lower costs overall due to the improvements in efficiency. While the initial investment costs may be high, implemeting this system in a pre-existing WLAN and WiFi infrastructure should help minimize the start-up costs.
Abstract: The study demonstrates that the minipig urethra is an appropriate animal model for in vitro experiments and therefore promising for long-term animal tests of artificial urinary sphincter systems in vivo. Freshly explanted porcine and minipig urethras were connected to a fluid reservoir that simulated the bladder pressure. This bladder pressure was adjusted by changing the water level (hydrostatic pressure). Specially designed aluminum sphincters loaded with a fluid-filled container were used to close/open the urethras. Results from minipigs and domestic pigs were compared to data published for human urethras. We measured the leak-point pressures (LPP) by adjusting the bladder pressure at…a constant sphincter length and by changing the sphincter length at a constant bladder pressure. Because the urethral tissue shows visco-elastic behavior, LPPs for both opening and closing were measured. By fitting the in vitro data, we evaluated the three characteristic parameters from the empirical urethra compression model, i.e. wall pressure (p W ), rim force (F R ), and rim length (L R ). From the experimental data we found agreement of mean values between (male) human urethras: ⟨ p W ⟩ opening = − ( 12.9 ± 0.9 ) cmH2 O, ⟨ p W ⟩ closing = ( 8.6 ± 1.1 ) cmH2 O, ⟨ F R ⟩ opening = ( 0.06 ± 0.02 ) N, ⟨ F R ⟩ closing = ( 0.10 ± 0.02 ) N, ⟨ L R ⟩ opening = ( 3.0 ± 0.3 ) mm, ⟨ L R ⟩ closing = ( 5.1 ± 0.3 ) mm, and (male) minipig urethras: ⟨ p W ⟩ opening = − ( 13.4 ± 0.3 ) cmH2 O, ⟨ p W ⟩ closing = − ( 8.6 ± 0.4 ) cmH2 O, ⟨ F R ⟩ opening = ( 0.19 ± 0.01 ) N, ⟨ F R ⟩ closing = ( 0.21 ± 0.02 ) N, ⟨ L R ⟩ opening = ( 2.4 ± 0.1 ) mm, ⟨ L R ⟩ closing = ( 3.3 ± 1.0 ) mm. These in vitro tests quantified by means of the urethra compression model demonstrate that the minipig (especially the male one) represents a suitable animal model for testing artificial urinary sphincters.
Keywords: In vitro testing, animal model, artificial urinary sphincter, minipig urethra, urinary incontinence, urethra compression model
Abstract: Poly-Methylmethacrylate (PMMA) is widely-used in orthopaedic surgery in revision arthroplasty or as a spacer in temporary arthrodesis of periprostehtic knee joint infection during a two stage procedure. The intra-operative temperature behaviour, however, has not yet been quantified. It is known that high temperature induce thermally necrosis of surrounding bone tissue during polymerisation process. The aim was to evaluate the PMMA surface temperature during polymerisation phase in situ. We hypothesized, that temperature measured in vivo could become critical in terms of the induction of thermal bone necrosis during the polymerisation phase of PMMA. The PMMA surface was measured tele-thermographically…in situ during knee arthroplasty revision surgery. Infrared pictures were analyzed for temperature peaks and changes. Measurements yielded maximum PMMA-surface-temperatures ranging from 101 to 110 degrees and a two-minute-plateau of > 100°. Hot PMMA during the polymerisation phase could potentially induce tissue (bone) necrosis. Therefore temperature of PMMA of more than 70 degrees should be avoided. Cooling of the PMMA is highly recommendable.
Keywords: PMMA, temperature, bone necrosis, tele-thermography