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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: INTRODUCTION: Injuries cover about 11% of World's Disease Burden depicting fractures to be the leading severe consequence of trauma. Fractures occur due to force impact or osteoporosis. Fracture healing is a complicated process. Fracture fixation techniques focus on imparting reduction to fractured fragments and induce healing. When considering possible fixation methods, the aspect of micro-movement is an important one, as this induces callus formation which tends to be a crucial step for fracture healing. Internal fixation of long bone fractures using metallic plates has been carried out since decades and recently advancements have…been in synthesizing biodegradable plates as well. The purpose of this research was to fabricate an Auxetic Polymeric Bone Plate that can be used as an internal fixator for long bone fracture; this bone plate renders micro-movement due to its counter intuitive behavior, has the potential to reduce the effect of stress shielding and allow the same range of motion as that of natural bone. METHODS: Polyurethane was chosen as a material for the fabrication of the Auxetic device because of its biocompatibility and non-toxic effects. The plate was then tested for mechanical properties such as Tensile and Compression testing to determine the strength. RESULTS AND DISCUSSION: The tensile testing of the Auxetic polyurethane specimens showed that the mean of the Poisson's ratio of the samples lies between -0.68 and -0.87 at different uni-axial tensile load values. The Auxetic structure of our device has the potential to allow for efficient fixation because its negative Poisson's ratio offers micro-movement, thereby causing fixation with relative stability rather than absolute stability. The Auxetic bone plate can be superior to contemporary plate fixation systems, as it demands meaningfully small contact points. The suitable mechanical properties might lessen stress shielding effects that are normally caused by rigid bone plates. The Auxetic nature of the bone will help align and sustain the bone fragments with small fracture gaps in order to impart appropriate assembly to accomplish bone healing.
Keywords: Bone plate, internal fixation, bone fracture, rigid fixation, auxetic, polymeric
Abstract: BACKGROUND : Quantification of sedentary time still remains a challenge. OBJECTIVES: This study examined: 1) whether a multisensory activity monitor could accurately measure sedentary activities and discriminate them from light intensity activities; and 2) the validity of activity log diary (AL) in estimating sedentary time using the monitor as a criterion measure. METHODS: Thirty healthy individuals performed sedentary and light intensity activities in a laboratory while being equipped with a metabolic measurement cart (MMC) and the multisensory monitor. Subsequently, a subset of 19 participants completed AL while wearing the monitor for three days…under free-living conditions. RESULTS: Metabolic equivalents (METs) measured by the multisensory monitor during sedentary activities were similar to those measured by MMC and were significantly lower than light-intensity activities (p< 0.001). Relative criterion validity of AL assessed by Pearson's correlation coefficient was high (r= 0.68, p< 0.01). Absolute criterion validity examined by Bland-Altman plots showed small mean difference between AL and the monitor (36.9 minutes ⋅ day - 1 ) with its limits of agreement ranging from -103.3 to 177.1 minutes ⋅ day - 1 . CONCLUSION: The multisensory monitor is capable of accurately measuring sedentary activities and distinguishing them from light-intensity activities. Compared to the multisensory monitor, our results showed that AL provides valid estimate of overall sedentary time.
Abstract: INTRODUCTION: Changes in pelvic position can influence the sagittal alignment of the lumbar spine. The restoration of hip kinematics by hip replacement thus appears to offer the possibility of correcting sagittal alignment. This preliminary retrospective study used EOS imaging to investigate the influence of total hip arthroplasty on pelvic parameters in patients with normal preoperative pelvic parameters. METHODS: Twenty patients with hip osteoarthritis undergoing total hip arthroplasty (THA) between 2011 and 2012 received unilateral THA. To evaluate the preoperative and postoperative changes of the pelvic parameters, we analyzed EOS imaging of the patients to determine…pelvic incidence, sacral slope, sacral tilt, pelvic tilt, anterior pelvic plane inclination and pelvic axial rotation. Additionally, anteversion and inclination of the acetabular cup position were determined. RESULTS: No statistically significant difference was found between the preoperative and postoperative measurements of pelvic parameters, although the change in pelvic tilt approached significance. Postoperatively, respective average values of 42.6° and 22.7° were measured for inclination and anteversion of the acetabular cup position. CONCLUSION: THA did not influence pelvic position and sagittal alignment in patients with normal preoperative pelvic parameters. A subsequent study will investigate whether corrections of pelvic parameters outside the norm in patients with OA are possible with THA.
Keywords: Sagittal alignment, total hip arthroplasty, lumbar spine, pelvic parameters, hip osteoarthritis
Abstract: BACKGROUND: There is no biomechanical basis to determine the influence of different length of the central peg of the baseplate anchored within the native scapula in glenoid defect reconstruction in cases of degenerative or posttraumatic glenoid bone loss in reversed shoulder arthroplasty. OBJECTIVE: The purpose of this study was to analyse the stability of different peg lengths used in glenoid bone loss in reversed shoulder arthroplasty. METHODS: Different lengths of metaglene pegs with different depths of peg anchorage performed with or without metaglene screws in sawbone foam blocks were loaded in vertical…and horizontal directions for differentiating load capacities. Simulated physiological loadings were then applied to the peg implants to determine the limits of loading in each depth of anchorage. RESULTS: The loading capacity of the implant was reduced as less of the peg was anchored. The vertically loaded implants showed a significantly higher stability, in contrast to those loaded horizontally at a corresponding peg length and depth of anchorage (p< 0.05). The tests revealed that the metaglene screws are more essential for primary stability than is the peg particularly in the vertically directed loadings (2/3 anchored: peg contributed to 28% of the stability, 1/3 anchorage: peg contributed to 12%). Under the second test conditions, the lowest depth of peg anchorage (1/3) resulted in 322 Newtons [N] in the long peg with a vertical loading direction, and in 130 N in the long peg with a horizontal loading direction (p< 0.05). CONCLUSION: The pegs should be anchored as deeply as possible into the native scapula bone stock. The metaglene screws play a major role in the initial stability, in contrast to the peg, and they become more important when the depth of the peg anchorage is reduced. If possible, four metaglene screws should be used in cases of uncontained bone loss to guarantee the highest stability.
Keywords: Glenoid bone loss, glenoid defect, reversed shoulder arthroplasty, total shoulder arthroplasty, glenoid bone grafting, peg length, omarthrosis, primary stability
Abstract: BACKGROUND: Non-operative treatment is widely accepted for early stages of lumbar spinal stenosis. In general, a trial of conservative treatment is recommended prior to surgery. OBJECTIVE: The influence of sagittal alignment on treatment outcomes remains unclear. METHODS: Twenty-five patients were included in this prospective study. All patients received repeated epidural injections and facet joint injections as well as physiotherapy during a one week hospitalization. Patient characteristics, VAS scores, COMI scores, ODI scores and SF-36 were assessed prior to and immediately after treatment as well as after six, twelve, and 26 weeks.…Spinopelvic parameter measurements were performed. Outcome parameters were correlated to spinopelvic parameters. RESULTS: ODI and PCSS scores improved significantly up to three months follow-up. COMI score improved significantly over the entire follow-up. Back pain improvement at six weeks and three months follow-up correlated inversely with pelvic incidence. Sacral slope correlated significantly with ODI improvement immediately after therapy. Low lumbar lordosis also correlated significantly with ODI improvement at three months follow-up. CONCLUSIONS: Subjects with higher pelvic incidence reported significantly greater back pain improvements at three months follow-up. ODI improvements were higher for patients with high sacral slope immediately after treatment and for patients with a higher lumbar lordosis after three months. No influence of sagittal alignment was observed on leg pain or quality of life.
Abstract: BACKGROUND: The 24-h urine collection technique is the reference method for assessing sodium intake. Frequent assessments of urinary sodium excretion improve patients' motivation in adhering to sodium-restricted diets. No portable, inexpensive, user-friendly and reliable sodium analyzers are available on the market. Allowing field practitioners access to such an instrument could facilitate patients' monitoring of urinary sodium output, potentially improving patients care and overall population health. OBJECTIVE: To determine the validity and intra- and inter-instruments reliability of two portable, easy-to-use and inexpensive sodium analyzers. METHODS: Urine samples (N= 77) were collected from 31…men and compared against reference values of an ion chromatograph. RESULTS: Both analyzers demonstrated excellent absolute (95% limits of agreement (LoA) of ± 3-4%) and relative intra-instrument reliability (intraclass correlation coefficients (ICC) of 1.00). Inter-instruments relative reliability was excellent (ICC: 0.99), whereas absolute reliability was good (95% LoA of ± 13%). Compared with results obtained by ion chromatography, relative validity was excellent for both analyzers. Absolute validity was good-to-moderate (95% LoAs ranging from ± 15% to ± 20%). CONCLUSIONS: A low cost, portable analyzer can reliably be used by field practitioners to monitor changes in urinary sodium excretion across time and provide adequate guidance for individuals on sodium-restricted diets.