Technology and Health Care - Volume 23, issue 5

Authors: Duif, Christian | Koutah, Mohamed Abou | Ackermann, Ole | Spyrou, Georgios | von Engelhardt, Lars Victor | Kaya, Daimi | Willburger, Roland E. | Lahner, Matthias

Article Type: Review Article

Abstract: OBJECTIVES: Modern orthopaedic surgery provides a variety of techniques for cartilage repair. Despite comprehensive scientific data about the single procedures, there is little experience with the combination of these methods. Inspired by a case from our clinic, we performed a PubMed based literature search about the combination of cartilage restoration principles. MATERIALS AND METHODS: The literature search was performed using the terms: ``mosaicplasty'' OR ``osteochondral transplantation'' OR ``OATS'' AND ``autologous chondrocyte implantation'' OR ``autologous chondrocyte transplantation'' OR ``ACI'' OR ``matrix-associated autologous chondrocyte implantation'' OR ``MACI'' AND ``combination''. Abstracts were revised for relevance to our case. Additionally, …we present a case report of the combinatory use of three established techniques. RESULTS: Two relevant publications, both reporting satisfying results concerning postoperative functional outcome, were found. Our results confirm this first encouraging assessment, although statistically valid data and prospective studies are still missing. CONCLUSIONS: The simultaneous use of different techniques for cartilage repair may provide alternative operative solutions for single complex cases, although further studies are required for a general recommendation. Show more

Keywords: Cartilage repair, OATS, mosaicplasty, ACI, osteochondral defect

DOI: 10.3233/THC-151003

Citation: Technology and Health Care, vol. 23, no. 5, pp. 531-537, 2015

Authors: Haga, Tomofumi | Javadzadegan, Ashkan | Kabir, Kaveh | Simmons, Anne | Barber, Tracie

Article Type: Research Article

Abstract: BACKGROUND: Haemodynamic parameters such as separated flow regions play a key role in the progression and development of atherosclerotic lesions in renal arteries, which typically originate at the renal ostium. OBJECTIVE: The aim of this study was to analyse the flow dynamics in a two-dimensional model of aorta-renal bifurcation, with a particular focus on the effect of aorta-to-renal flow ratio on flow separation regions. METHOD: A particle image velocimetry (PIV) experiment was conducted in an acrylic model of the aorta-renal ostium and the relationship between renal-to-aorta flow ratio and separated flow region …was investigated. RESULTS: For high flow ratios, a stagnation region was observed near the cranial side of the aorta. With a decrease in the flow ratio, however, this stagnation region disappeared. Furthermore, our results showed that an increase in the renal flow rate was associated with an increase in the length of the separated flow region, but a decrease in the width of the separation regions. CONCLUSIONS: As the renal-to-aorta flow ratio increased a longer separation region was observed on the cranial side of the renal channel. Show more

Keywords: Atherosclerosis, aorta-renal ostium, separated flow region, particle image velocimetry, renal-to-aorta flow ratio

DOI: 10.3233/THC-151005

Citation: Technology and Health Care, vol. 23, no. 5, pp. 539-545, 2015

Authors: Anzai, H. | Yoshida, Y. | Sugiyama, S. | Endo, H. | Matsumoto, Y. | Ohta, M.

Article Type: Research Article

Abstract: BACKGROUND: Optimal design of stents for a cerebral aneurysm is desired for efficient flow reduction in the aneurysm. OBJECTIVE: In this study, we aimed to optimize stent design at several porosities, estimate the influence of stent design on aneurysm flow, and evaluate the ability of stents to reduce flow. METHODS: Stent models were constructed as sets of squares or rectangles in the necks of a two-dimensional (2D) and realistic aneurysm. Then, automated optimization was performed using a combination of simulated annealing and lattice Boltzmann flow simulation. RESULTS: By simulated annealing, …stents were gradually modified to reduce the average velocity in an aneurysm. As a result of optimization, stents of all porosities demonstrated an inhomogeneous distribution with dense struts in the inflow area. Flow reduction was increased compared with the initial stent. Under the condition of high porosity, flow reduction by the stent drastically increased as porosity decreased. Under low porosity, the increase of velocity reduction was moderate even as porosity decreased. CONCLUSIONS: Optimization can enhance flow reduction by stents. However, the increase in reduction associated with decreasing porosity is moderate under lower-porosity conditions. This threshold may help in the choice of stent porosity for each specific aneurysm. Show more

Keywords: Computational fluid dynamics, design optimization, cerebral aneurysm, flow diverter stent, lattice boltzmann method

DOI: 10.3233/THC-151007

Citation: Technology and Health Care, vol. 23, no. 5, pp. 547-556, 2015

Authors: Panetta, Daniele | Pelosi, Gualtiero | Viglione, Federica | Kusmic, Claudia | Terreni, Marianna | Belcari, Nicola | Guerra, Alberto Del | Athanasiou, Lambros | Exarchos, Themistoklis | Fotiadis, Dimitrios I. | Filipovic, Nenad | Trivella, Maria Giovanna | Salvadori, Piero A. | Parodi, Oberdan

Article Type: Research Article

Abstract: BACKGROUND: Micro-CT is an established imaging technique for high-resolution non-destructive assessment of vascular samples, which is gaining growing interest for investigations of atherosclerotic arteries both in humans and in animal models. However, there is still a lack in the definition of micro-CT image metrics suitable for comprehensive evaluation and quantification of features of interest in the field of experimental atherosclerosis (ATS). OBJECTIVE: A novel approach to micro-CT image processing for profiling of coronary ATS is described, providing comprehensive visualization and quantification of contrast agent-free 3D high-resolution reconstruction of full-length artery walls. METHODS: Accelerated …coronary ATS has been induced by high fat cholesterol-enriched diet in swine and left coronary artery (LCA) harvested en bloc for micro-CT scanning and histologic processing. A cylindrical coordinate system has been defined on the image space after curved multiplanar reformation of the coronary vessel for the comprehensive visualization of the main vessel features such as wall thickening and calcium content. A novel semi-automatic segmentation procedure based on 2D histograms has been implemented and the quantitative results validated by histology. RESULTS: The potentiality of attenuation-based micro-CT at low kV to reliably separate arterial wall layers from adjacent tissue as well as identify wall and plaque contours and major tissue components has been validated by histology. Morphometric indexes from histological data corresponding to several micro-CT slices have been derived (double observer evaluation at different coronary ATS stages) and highly significant correlations (R2 > 0.90) evidenced. Semi-automatic morphometry has been validated by double observer manual morphometry of micro-CT slices and highly significant correlations were found (R2 > 0.92). CONCLUSION: The micro-CT methodology described represents a handy and reliable tool for quantitative high resolution and contrast agent free full length coronary wall profiling, able to assist atherosclerotic vessels morphometry in a preclinical experimental model of coronary ATS and providing a link between in vivo imaging and histology. Show more

Keywords: Micro-CT, experimental atherosclerosis, artery segmentation, histomorphometry, cylindrical coordinates

DOI: 10.3233/THC-151010

Citation: Technology and Health Care, vol. 23, no. 5, pp. 557-570, 2015

Authors: Sucharitha, M. | Geetha, K. Parimala

Article Type: Research Article

Abstract: BACKGROUND: Medical image segmentation is an essential step for most consequent image analysis tasks. Medical images can be segmented manually, but the accuracy of image segmentation using the automated segmentation algorithms is more when compared with the manual calculations. In this paper, an automated segmentation and classification of tissues are proposed for MR brain images. OBJECTIVE: To classify MR brain image into three segments such as Grey Matter (GM), White Matter (WM) and Cerebro-Spinal Fluid (CSF). Classification of brain into tissues helps to diagnose several diseases such as tumors, Alzheimer's disease, stroke, multiple sclerosis. …METHODS: An unsupervised clustering technique such as Fuzzy C-Means (FCM) algorithm has been widely used in segmenting the images. The spatial information is not fully utilized by the conventional clustering algorithm and hence it is not applicable for clustering a noisy image. We incorporate a method for image clustering called out as Reformulated Fuzzy Local information C-Means Clustering algorithm [RFLICM] which is a variant of traditional Clustering algorithm by considering both spatial and gray level information. In RFLICM, spatial distance is replaced by local coefficient of variation in a fuzzy manner. RESULTS: Experiments are conducted on brain images to validate the performance of the proposed technique in segmenting the medical images and the efficiency achieved in the presence of salt and pepper noise is 99.86%. CONCLUSION: Standard FCM, Fuzzy Local information C-means clustering algorithm [FLICM], Reformulated Fuzzy Local information C-means clustering algorithm [RFLICM] are compared to explore the accuracy of our proposed approach. Clustering results show that RFLICM segmentation method is appropriate for classifying tissues in brain MR image. Show more

Keywords: Image segmentation, fuzzy clustering, spatial information, grey level information, classification, brain MRI

DOI: 10.3233/THC-151012

Citation: Technology and Health Care, vol. 23, no. 5, pp. 571-580, 2015

Authors: Morina, Nexhmedin | Brinkman, Willem-Paul | Hartanto, Dwi | Kampmann, Isabel L. | Emmelkamp, Paul M.G.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: Research on virtual reality exposure therapy (VRET) has demonstrated good treatment efficacy with regards to several anxiety disorders. Yet, there is lack of knowledge about the value of integrating interaction between clients and virtual humans in VRET. Such interaction might prove effective in treating psychological complaints that involve social interactions, such as social anxiety. METHODS: A VRET system specifically designed to expose clients with social anxiety disorder to anxiety provoking social situations was applied to 16 and 18 individuals with high and low levels of social anxiety, respectively. Participants engaged in …two exposure sessions in several free speech dialogues with virtual humans while being monitored by a therapist. RESULTS: Participants with high levels of social anxiety reported significantly lower levels of social anxiety three months after exposure to two virtual reality interaction sessions than before treatment (p < 0.01). In the group with low levels of social anxiety, no significant change of social anxiety was reported between pre-treatment and follow-up. Additionally, participants in both groups reported higher self-efficacy three months after treatment than before treatment (ps ≤ 0.001). CONCLUSION: These findings indicate that virtual reality technology that incorporates social interactions may be successfully applied for therapeutic purposes. Show more

Keywords: Virtual reality, exposure, social phobia, social anxiety

DOI: 10.3233/THC-151014

Citation: Technology and Health Care, vol. 23, no. 5, pp. 581-589, 2015

Authors: Mendez-Zorrilla, A. | Garcia-Zapirain, B.

Article Type: Research Article

Abstract: BACKGROUND: Given the importance of the voice in our daily lives, any study focused on its pathologies and the way of caring and promoting the health of them is of common interest. OBJECTIVE: This paper describes a method to automatically aid indetecting vocal folds benign pathologies based on glottal space segmentation vocal fold video sequences captured by a laryngoscope. METHODS: The proposed algorithm is based on automatic segmentation supported by Gabor filters, and features classification with Principal Component Analysis (PCA) to achieve the expected results. RESULTS: The authors wish …to emphasize that the proposed algorithm is independent from the images' resolution and zoom, but their quality depends on specialist experience with the instrumentation. Segmentation block provides good results for 95% of images and classification block distinguishes successfully between pathological and healthy images in 92.1% of cases. The proposed system's findings have been compared with the diagnosis made by doctors and it obtains the same results in all the 45 sequences. CONCLUSIONS: One of the proposed study's key elements has been which objective measurements are of significance for the specialist. In this case, it is those that enable the specialist to calculate the size of the pathology (previously classified automatically) that he/she is observing, thus enabling them to provide the patient with more information or to prescribe treatment and even measure its development. Show more

Keywords: Gabor filters, principal component analysis, vocal folds, stroboscope, glottal space

DOI: 10.3233/THC-151016

Citation: Technology and Health Care, vol. 23, no. 5, pp. 591-604, 2015

Authors: Xiang, Wei | Li, Chong

Article Type: Research Article

Abstract: BACKGROUND: Operating Room (OR) is the core sector in hospital expenditure, the operation management of which involves a complete three-stage surgery flow, multiple resources, prioritization of the various surgeries, and several real-life OR constraints. As such reasonable surgery scheduling is crucial to OR management. OBJECTIVE: To optimize OR management and reduce operation cost, a short-term surgery scheduling problem is proposed and defined based on the survey of the OR operation in a typical hospital in China. METHOD: The comprehensive operation cost is clearly defined considering both under-utilization and overutilization. A nested Ant …Colony Optimization (nested-ACO) incorporated with several real-life OR constraints is proposed to solve such a combinatorial optimization problem. RESULTS: The 10-day manual surgery schedules from a hospital in China are compared with the optimized schedules solved by the nested-ACO. Comparison results show the advantage using the nested-ACO in several measurements: OR-related time, nurse-related time, variation in resources' working time, and the end time. CONCLUSIONS: The nested-ACO considering real-life operation constraints such as the difference between first and following case, surgeries priority, and fixed nurses in pre/post-operative stage is proposed to solve the surgery scheduling optimization problem. The results clearly show the benefit of using the nested-ACO in enhancing the OR management efficiency and minimizing the comprehensive overall operation cost. Show more

Keywords: Surgery scheduling, operation cost, operating room management, ant colony optimization

DOI: 10.3233/THC-151017

Citation: Technology and Health Care, vol. 23, no. 5, pp. 605-617, 2015

Authors: Chen, Chih-Wen | Lin, Wei-Chao | Ke, Shih-Wen | Tsai, Chih-Fong | Hu, Ya-Han

Article Type: Research Article

Abstract: BACKGROUND: To collect medical datasets, it is usually the case that a number of data samples contain some missing values. Performing the data mining task over the incomplete datasets is a difficult problem. In general, missing value imputation can be approached, which aims at providing estimations for missing values by reasoning from the observed data. Consequently, the effectiveness of missing value imputation is heavily dependent on the observed data (or complete data) in the incomplete datasets. OBJECTIVE: In this paper, the research objective is to perform instance selection to filter out some noisy data (or …outliers) from a given (complete) dataset to see its effect on the final imputation result. Specifically, four different processes of combining instance selection and missing value imputation are proposed and compared in terms of data classification. METHODS: Experiments are conducted based on 11 medical related datasets containing categorical, numerical, and mixed attribute types of data. In addition, missing values for each dataset are introduced into all attributes (the missing data rates are 10%, 20%, 30%, 40%, and 50%). For instance selection and missing value imputation, the DROP3 and k-nearest neighbor imputation methods are employed. On the other hand, the support vector machine (SVM) classifier is used to assess the final classification accuracy of the four different processes. RESULTS: The experimental results show that the second process by performing instance selection first and imputation second allows the SVM classifiers to outperform the other processes. CONCLUSIONS: For incomplete medical datasets containing some missing values, it is necessary to perform missing value imputation. In this paper, we demonstrate that instance selection can be used to filter out some noisy data or outliers before the imputation process. In other words, the observed data for missing value imputation may contain some noisy information, which can degrade the quality of the imputation result as well as the classification performance. Show more

Keywords: Instance selection, missing value imputation, incomplete data, medical data mining

DOI: 10.3233/THC-151018

Citation: Technology and Health Care, vol. 23, no. 5, pp. 619-625, 2015

Authors: Hagen, Marco | Lemke, Martin | Kutsch, Heinrich-Peter | Lahner, Matthias

Article Type: Research Article

Abstract: BACKGROUND: The strength training industry has failed in designing a machine for exercising the pronators and supinators, despite their substantial medio-lateral bracing function. OBJECTIVE: The present study documents the muscle strength generation capabilities of the pronators and supinators within their functional anatomic movement plane, using an innovative strength training machine with an oblique axis. METHODS: By using two force transducers, the angle-torque relationship of the pronators and supinators of 18 healthy male subjects was identified during maximum voluntary isometric contractions at five anatomical joint angles. Surface EMG was recorded from anterior tibial …(TA), peroneus longus (PL) and soleus (SOL) muscles. RESULTS: The pronator strength curve showed an inverted U-shaped characteristic, whereas the supinator curve descends from pronated to supinated position. Compared to the muscle activities for one-leg heel raise and toe raise, PL (108-131%) and TA (59-83%), respectively, showed highest activity during pronations. The most activated supinator is SOL (67% of a one-leg heel raise). CONCLUSIONS: Differences in the shape of the pronator and supinator strength curves revealed that two different variable cams have to be implemented for matching the human torque capability. We anticipate our study to be a starting point for preventive machine-based training interventions. Show more

Keywords: Machine-based strength training, subtalar joint, ankle stability, strength curves, muscle activity

DOI: 10.3233/THC-151004

Citation: Technology and Health Care, vol. 23, no. 5, pp. 627-635, 2015

Authors: Pastor, M.F. | Ezechieli, M. | Claassen, L. | Kieffer, O. | Miltner, O.

Article Type: Research Article

Abstract: BACKGROUND: The volleyball game has a high complexity and thus entails a lot of strain to the players. Due to this high and different training and competition strain comprehensive and individual training plans should be developed with competing training objectives in order to prevent injuries. OBJECTIVE: The aim of the study was to analyse prospectively over six seasons the acute and overuse injuries of a German male professional volleyball team. METHODS: The study included 34 male national league players from season the 2007/08 to 2012/13. All players received a sport medicine examination and …a functional diagnosis before each season. Based on the results the players received an individual training plan. RESULTS: The players suffered 186 injuries. The prevalence of acute injuries was 1.94 per player and overuse injuries 0.64 per player. The incidence of acute injuries was 3.3/1000 h volleyball and overuse injuries 1.08/1000 h volleyball. The largest number of injuries was found in the spine. The players had most likely minor injuries. The players had significantly fewer injuries in their second season (1.92) than in their first season (3.25; p= 0.004). CONCLUSION: It could be concluded that volleyball is a sport with a relative low prevalence of injuries compared to other team sports. The prevalence of injury is 2.58 per player. Due to an injury a player dropped out 16.91 days per season. An individual training program seems to reduce the incidence of injury. Show more

Keywords: Volleyball, injury, prevalence, prevention, risk factors

DOI: 10.3233/THC-151009

Citation: Technology and Health Care, vol. 23, no. 5, pp. 637-643, 2015

Authors: Teske, Wolfram | Schwert, Martin | Zirke, Sonja | Pellengahr, Christoph von Schulze | Wiese, Matthias | Lahner, Matthias

Article Type: Research Article

Abstract: BACKGROUND: The spinal canal stenosis is a common disease in elderly. The thecal sac narrowing is considered as the anatomical cause for the disease. There is evidence that the anatomical proportions of the lumbar spinal canal are influenced by postural changes. The liquor volume shift during these postural changes is a valuable parameter to estimate the dynamic qualities of this disease. OBJECTIVE: The aim of this human cadaver study was the determination of intrathecal fluid volume changes during the lumbar flexion and the extension. A special measuring device was designed and built for the study to …investigate this issue under controlled conditions. METHODS: The measuring apparatus fixed the lumbar spine firmly and allowed only flexion and extension. The dural sac was closed water tight. The in vitro changes of the intrathecal volumes during the motion cycle were determined according to the principle of communicating vessels. Thirteen human cadaver spines from the Institute of Anatomy were examined in a test setting with a continuous adjustment of motion. The diagnosis of the lumbar spinal stenosis was confirmed by a positive computer tomography prior testing. The volume changes during flexion and extension cycles were measured stepwise in a 2 degree distance between 18° flexion and 18° extension. Three complete series of measurements were performed for each cadaver. RESULTS: Two specimens were excluded because of fluid leaks from further investigation. The flexion of the lumbar spine resulted in an intrathecal volume increase. The maximum volume effects were seen in the early flexion positions of 2° and 4°. The spine reclination resulted in a volume reduction. The maximum extension effect was seen between 14° and 16°. CONCLUSION: According to our results, remarkable volume effects were seen in the early movements of the lumbar spine especially for the flexion. The results support the concept of the spinal stenosis as a dynamic disease and allow a better understanding of the pathophysiology of this nosological entity. Under clinical aspects our data support the value of a body upright position under avoiding of extended spinal inclination and reclination. Show more

Keywords: Lumbar spinal canal stenosis, dural sac volume determination, lumbar flexion and extension

DOI: 10.3233/THC-151011

Citation: Technology and Health Care, vol. 23, no. 5, pp. 645-652, 2015

Authors: Qi, Bao-Chang | Ju, Wei-Na | Wang, Tie-Jun | Yu, Tie-Cheng | Zhao, Yi | Sun, Da-Hui

Article Type: Research Article

Abstract: BACKGROUND: Cannulated screws (4.0 mm) provide inter-fragmentary compression and stability to fractures. A guide wire is used to define the screw trajectory and hold the fracture fragment while the screw is being inserted. The cannulated shaft typically accommodates a 1.25 mm guide pin. Since the guide pin is very slender and undergoes elastic deformation during insertion, there is a high probability of pin breakage. METHODS: The authors have devised a new way to place the 4.0 mm cannulated screws in a manner that prevents the intraoperative complication of guide wire breakage. For this technique, …predrilling was achieved using a 2.0 mm K-wire which was subsequently replaced with a 1.25 mm guide pin under the protection of sleeve. 4.0 mm cannulated screws were then inserted into a defined trajectory over the guide pin. RESULTS: Using the technique, over 20 patients were managed in our department over a period of two years without any complications. CONCLUSION: We have observed that patients treated with this method experience short operation time, combined with good clinical outcome and we recommend its use in cases where cannulated screw use is warranted. Show more

Keywords: Cannulated screws, elastic deformation, screw trajectory, fracture fragment, pin breakage, defined trajectory

DOI: 10.3233/THC-151019

Citation: Technology and Health Care, vol. 23, no. 5, pp. 653-658, 2015

Authors: Geßlein, M. | Roessler, P.P. | Schüttler, K.F. | Biber, R. | Bail, H.J. | Efe, T.

Article Type: Research Article

Abstract: BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) using free tendon grafts has become a widespread treatment option for patellofemoral instability. As the numbers of cases gradually grow, so do the reports of possible peri- and postoperative complications following this procedure. OBJECTIVE: The present review summarizes all known complications of MPFL reconstruction with regard to postoperative outcome and seeks to highlight possible pitfalls that may occur during treatment. CONCLUSIONS: MPFL reconstruction generally has to be regarded as a safe procedure today due to low patellar re-dislocation rates. Complication rates however are not …trivial owing to the complexity of the underlying pathology. Complications can arise from graft fixation or femoral tunnel placement. Postoperative flexion deficits and medial knee pain have been described as predominant complaints. Anatomical preconditions as the grade of trochlear dysplasia, axis or torsion of the lower extremity have to be considered in search of causes for possible graft failure as well as in the thorough preoperative planning of the procedure. Show more

Keywords: Mediopatellofemoral ligament (MPFL), complications, patellofemoral instability

DOI: 10.3233/THC-151020

Citation: Technology and Health Care, vol. 23, no. 5, pp. 659-666, 2015

Authors: Peng, Yuping | Qiu, Mingxing | Yu, Lei | Fan, Jun | Qi, Songtao | Li, Yu | Hu, Zheng | Song, Ye

Article Type: Research Article

Abstract: BACKGROUND: The sheath is a crucial piece of equipment during endoscopic third ventriculostomy (ETV). However, the normally used metal sheath can not provide clear images around the tube. OBJECTIVE: We developed a new transparent sheath (TS) in order to overcome the inherent disadvantages of the metal sheath (MS). MATERIAL AND METHODS: Between August 2010 and February 2013, a total of 120 hydrocephalus patients received ETV in our hospital. Patients were retrospectively divided into two groups, the transparent sheath group (TSG) and metal sheath group (MSG). The success rate of the first puncture, …the operative time and the incidence of complications were used to compare the efficiency between transparent sheath and metal sheath. RESULTS: There were 32 patients in the TSG and 88 patients in the MSG. The success rate of the first puncture was 100% in the TSG and 87.5% in the MSG, respectively (p= 0.036). The operative time of the TSG was significant shorter than the MSG (p= 0.001). While the incidence of complications was similar between the two groups (p= 0.757). CONCLUSIONS: Compared with the tranditional metal sheath, the newly developed transparent sheath for ETV is more efficient and showed lower risk. This may be explained by the better surgical view of the whole puncture channel provide by the TS. Show more

Keywords: Neuroendoscope, surgical instrument, transparent sheath, hydrocephalus, endoscopic third ventriculostomy, intracranial tumors

DOI: 10.3233/THC-151006

Citation: Technology and Health Care, vol. 23, no. 5, pp. 667-673, 2015

Authors: Lou, Ching-Wen | Shiu, Bing-Chiuan | Lin, Jia-Horng | Chang, Yuan-Jen

Article Type: Research Article

Abstract: BACKGROUND: Urinary incontinence mostly affects infants, the elderly, and the disabled. However, no diaper is equipped with an effective immediate reminder feature that signifies when changing is needed. OBJECTIVE: This study proposes eco-diapers containing metallic fibers, such that eco-diapers and sensors are combined to transmit a signal when changing is necessary. METHODS: Polyester multifilaments serve as the warp yarn and water absorbent cotton fibers (witvarying finesses of 5, 10, 20, 30, and 40 counts) as the weft yarns to form five woven fabric types. A stereomicroscope is used and the optical contact …angle is measured to determine the optimal parameters for the structure. RESULTS: Obtain the optimal cotton fiber finesse is determined, the influence of the finesse of the metallic fibers on resistance is then examined. The yielded optimal parameters are then integrated to manufacture a wearable sensor, which is then combined with the woven fabrics to develop intelligent diapers. CONCLUSION: A health care system needs a new paradigm, that is, wearable computing is very attractive and extensively examined. The use of metallic fabric can solve complicated wires, and it does not affect the wearing comfort. It will help solve the problem of lacking medical human resources. Show more

Keywords: Intelligent textiles, stainless steel fibers, woven fabrics

DOI: 10.3233/THC-151008

Citation: Technology and Health Care, vol. 23, no. 5, pp. 675-684, 2015

Authors: Yamaguchi, Yoshikazu | Miyashita, Tetsuya | Toki, Keiko | Takaki, Shunsuke | Goto, Takahisa

Article Type: Research Article

Abstract: BACKGROUND/AIM: Penetrating injuries to the oral cavity involving a toothbrush are relatively common among children. Sometimes general anesthesia is recommended. Although the handle prevents adequate mask ventilation in the induction of anesthesia, it is unknown what is the best tool to cut it preventing complications. The aim of this study was to evaluate the optimal tool to cut off the toothbrush handle. MATERIALS AND METHODS: Six anesthesiologists participated in this study. We attached a triaxial acceleration sensor to the tip of the toothbrush to virtually measure force toward the wound. Each participant cut off the …handle of the toothbrush using 3 tools: Gluck rib shears (GRS: cutting horizonal); Sklar Coryllos rib shears (SCRS: cutting vertical); and an ultrasonic scalpel (USS). Acceleration and time required to cut the toothbrush were measured. Each anesthesiologist evaluated the usability of each tool on a 5-point scale. RESULTS: The USS showed the longest mean time (GRS, 1.78 ± 1.01 s; SCRS, 7.30 ± 4.58 s; USS, 28.13 ± 13.41 s), lowest 3-dimensional acceleration (GRS, 2.15 ± 0.69 G; SCRS, 2.13 ± 0.57 G; USS, 1.01 ± 1.07 G), and highest mean score for usability. CONCLUSION: The USS appeared preferable to rib shears for cutting off toothbrush handles, even though it takes longer. Show more

Keywords: Impalement oral injury, rib shear, ultrasonic scalpel, anesthesia induction

DOI: 10.3233/THC-151013

Citation: Technology and Health Care, vol. 23, no. 5, pp. 685-690, 2015

Authors: Ambusam, Subramaniam | Omar, Baharudin | Joseph, Leonard | Meng, Seng Poh | Padzil, Fazlina Asma Mohd

Article Type: Research Article

Abstract: BACKGROUND: The reliability of a triaxial accelerometer in measuring the head excursion during typing task among occupational typists has not been reported so far. OBJECTIVE: This study aimed to investigate the intra-rater reliability of triaxial accelerometer measurement of head excursion. METHODS: The triaxial accelerometer measurements were taken to measure head excursion of 8 participants typing in the computer. The intra-rater reliability such as intraclass correlation coefficient, standard error of measurements and coefficient of variation was calculated. The Bland-Altman plot was performed to strengthen the study result. RESULTS: …The analysis of the results showed that the intra-rater reliability of triaxial accelerometer was high with intraclass correlation coefficient (2,1) of 0.986, standard error of measurements (1.05 Hz) and coefficient of variation (3.2%) for two trials of measurements. The Bland-Altman reported an acceptable agreement between the two measurements taken using the triaxial accelerometer to measure head excursion. CONCLUSIONS: The triaxial accelerometer is a simple, objective and useful technology to measure head excursion among the occupational typists. Show more

Keywords: Accelerometer, head excursion, neck movement, reliability, measurement

DOI: 10.3233/THC-151015

Citation: Technology and Health Care, vol. 23, no. 5, pp. 691-697, 2015