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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: BACKGROUND: Study of imagination offers a perfect setting for study of a large variety of states of consciousness. OBJECTIVE: Here, we studied the characteristics of two electroencephalographic (EEG) patterns evoked by two different imaginary tasks and evaluated the binary classification performance. METHODS: Fifteen individuals (11 male and 4 female, age range of 22 to 33) participated in five sessions of 32-channel EEG recordings. Only by analyzing the subjects' output EEG signals from the central parieto-occipital region of PZ electrode, under the circumstances of consciousness of relaxation-meditation or tension-imagination, we carried out the…experiment of feature extraction for spontaneous EEG, as the subjects were blindfolded but asked to open their eyes all the same. The Hilbert-Huang Transform (HHT) was utilized to obtain the Hilbert time-frequency amplitude spectrum, and then with the feature vector set extracted, a two-class Fisher linear discriminant analysis classifier was trained for classification of data epochs of those two tasks. RESULTS: The overall result was that about 90% (± 5%) of the epochs could be correctly classified to their originating task. CONCLUSION: This study not only brings new opportunities for consciousness studies, but also provides a new classification paradigm for achieving control of robots based on the brain-computer interface (BCI).
Keywords: EEG-based brain-computer interface (BCI), mental task of relaxation-meditation, mental task of tension-imagination, Hilbert-Huang transform, feature extraction, pattern classification
Abstract: BACKGROUND: A virtual navigation system (VNS) can combine two imaging modalities for synchronous observation and can be beneficial for diagnosis and treatment. Ultrasound elastography (UE) can distinguish between soft and hard tissues. However, the application of UE to musculoskeletal structures is rare. OBJECTIVE: To evaluate UE of the supraspinatus tendon using ultrasound-magnetic resonance imaging (US-MRI) virtual navigation. METHODS: Sixty patients with an ache in the shoulder were diagnosed with supraspinatus tendon injuries using MRI. US-MRI virtual navigation was used to identify lesions in the supraspinatus tendon, and finally US elastography (UE) was performed.…Volunteers whose supraspinatus tendons were diagnosed as normal by MRI were also selected for US elastography. The UE scores were then compared between patients and volunteers. RESULTS: A total of 60 patients were diagnosed with supraspinatus tendon injuries using MRI and forty-two patients classified as Grade I exhibited no obvious abnormality by US. The supraspinatus tendon injury scores were significantly higher in Grade I patients compared with volunteers (P< 0.05). CONCLUSION: US elastography is helpful for the diagnosis of the supraspinatus tendon injuries when used with US-MRI virtual navigation.
Abstract: BACKGROUND: Medical equipment is closely related to personal health and safety, and this can be of concern to the equipment user. Furthermore, there is much competition among medical equipment manufacturers. Innovative design is the key to success for those enterprises. OBJECTIVE: The design of medical equipment usually covers vastly different domains of knowledge. The application of modern design methodology in medical equipment and technology invention is an urgent requirement. METHODS: TRIZ (Russian abbreviation of what can be translated as `theory of inventive problem solving') was born in Russia, which contain some problem-solving methods…developed by patent analysis around the world, including Conflict Matrix, Substance Field Analysis, Standard Solution, Effects, etc. TRIZ is an inventive methodology for problems solving. RESULTS: As an Engineering example, infusion system is analyzed and re-designed by TRIZ. The innovative idea is generated to liberate the caretaker from the infusion bag watching out. The research in this paper shows the process of the application of TRIZ in medical device inventions. CONCLUSION: It is proved that TRIZ is an inventive methodology for problems solving and can be used widely in medical device development.
Keywords: Innovation design, TRIZ, medical equipment
Abstract: BACKGROUND: Heart rate monitoring is useful to detect many cardiovascular diseases. It can be implemented in a small device with low power consumption, and it can exploit low-cost piezoelectric pressure sensors to measure heart rate. However, it is also desirable to transmit heartbeat waveform for emergency treatment, which significantly increases transmission power. OBJECTIVE: In this paper, a low-cost wireless heart condition monitoring SoC is proposed. It can monitor and transmit both heart rate and heartbeat waveform, but the hardware is extremely simplified to achieve in a small package. METHODS: By slight modification…of successive-approximation analog-digital converter, it can count heart rate and read out heartbeat waveform with the same hardware. In the normal mode, only an 8-bit heart rate is transmitted for power reduction. If the heart rate is out of a given range, it goes to the emergency mode and a 10-bit heartbeat waveform is transmitted for fast treatment. RESULTS: The fabricated chip size is 1.1 mm2 in 0.11 μ m CMOS technology, including the radio-frequency transmitter. The measured power consumption is 161.8 μ W in normal mode and 507.3 μ W in emergency mode, respectively. CONCLUSION: The proposed SoC achieves low-cost, small area, and low-power. It is useful as part of a disposable healthcare system.
Abstract: BACKGROUND: There is an urgent need for blood oxygen saturation (SpO2) tests when participants are ambulatory, as in daily activity monitoring, sleep monitoring, or even athletes' cardiovascular function tests. In such situations, measuring equipment needs to be wearable. This restricts the processor volume, and the corresponding algorithm should be microprocessor compatible. OBJECTIVE: This article proposes an anti-motion interference blood oxygen saturation algorithm for the microcontroller based on AC and DC analysis, named de-trended FFT. METHODS: An experiment was conducted to compare the de-trended FFT algorithm with two other algorithms commonly used in…the time and frequency domains. In the experiment, participants' oxygen saturation levels were calculated from Photoplethysmography (PPG) signals that were recorded continuously. Meantime, five types of hand motions were conducted, including hand trembling movements, horizontal hand movements, vertical hand movements, finger tapping, and finger bending, with each state lasting 2 minutes. RESULTS: Results show significant performance of de-trended FFT in SpO2 calculation (P < 0.05), in both accuracy and stability. CONCLUSION: De-trended FFT stands out in both mean deviation and variance by eliminating trending influence when compared with the other two algorithms. The motion interference's influence on SpO2 calculation mainly comes from the AC component, not the DC.
Abstract: BACKGROUND: Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies. OBJECTIVE: To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions. METHOD: One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated. RESULTS: The…maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate. CONCLUSION: Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.
Keywords: Shear wave elastography, quantitative analysis, breast lesion, diagnostic performance
Abstract: OBJECTIVE: In this paper, we investigated the parameters with effective traceability to assess the mechanical properties of interventional devices. METHODS: In our evaluation system, a box-shaped poly (vinyl alcohol) hydrogel (PVA-H) and silicone were prepared with realistic geometry, and the measurement and evaluation of traceability were carried out on devices using load hand force. The phantom models had a total of five curve pathways to reach the aneurysm sac. RESULTS: Traceability depends on the performance of the interventional devices in order to pass through the curved part of the model simulation…track. The traceability of the guide wire was found to be much better than that of the balloon and stent loading catheter, as it reached the aneurysm sac in both phantom models. CONCLUSIONS: Observation using the video record is another advantage of our system, because the high transparency of the materials with silicone and PVA-H can allow visualization of the inside of an artery.
Abstract: Though18 F-FDG PET/CT scans are widely used in non-small cell lung cancer (NSCLC), the mechanism of FDG uptake by lung cancer cells has not yet been fully elucidated. This study evaluated the relationship between FDG uptake and the expression of glucose transporters in NSCLC. Sixty-four NSCLC patients who underwent both preoperative18 F-FDG PET/CT scanning and thoracotomy were included. The maximum standardized uptake value (SUVmax) of the primary lung cancer was compared to the immunohistochemistry results for Glut expression and tumor size. In all the NSCLC cases, degree of FDG uptake significantly correlated with both Glut-1 and Glut-3 expression. When…stratified by the histology, squamous cell carcinomas showed higher mean SUVmax, Glut-1 expression intensity, and percentage of area positive for Glut-1 expression than adenocarcinomas. Glut-1 and Glut-3 expressions correlated with SUVmax in adenocarcinomas, but there was no significant correlation in squamous cell carcinomas. No significant correlation was observed between tumor size and FDG uptake or Glut expression. These results show that Glut expression was significantly correlated with SUVmax in NSCLC, especially in adenocarcinomas, and that neither FDG uptake nor the expression of Glut was associated with tumor size.
Keywords: Glut-1, Glut-3, glucose transporter, FDG, non-small cell lung cancer
Abstract: BACKGROUND: Breast cancer is a tumor that begins in the breast tissue and is largely identified through X-ray imaging; however, human tissue, illumination, noise and other factors make the image's calcifications and masses unclear, which in turn affects the doctors' identification of lesions and normal tissue through X-ray imaging. Therefore, the rate of misdiagnoses can be reduced through the enhancement of X-ray images that make the images' calcifications and masses more prominent. OBJECTIVE: Enhancing the breast image would highlight the calcifications and masses. METHODS: One such way to do so is to…use a curvelet that can detect curves and can, therefore, enhance the tumor characteristics. Essentially, existing methods perform a curvelet transform on each sub-image simultaneously; as the curvelet is based on the Radon transform, it involves complex computation and can easily result in difficulties. Based on this information, this article improved the algorithm that detects edges by curvelet and refines edges by wavelet. Simulation experiments using mammography X-ray images are implemented through Matlab. RESULTS: The results suggest that, after implementation of the improved algorithm, the image's edges and textures are clear, the calcifications are independent, and there is no caking. CONCLUSIONS: The curvelet method is imporved in efficacy with respect to the wavelet method.
Abstract: BACKGROUND: An appropriate feature study of hysteria electroencephalograms (EEG) would provide new insights into neural mechanisms of the disease, and also make improvements in patient diagnosis and management. OBJECTIVE: The objective of this paper is to provide an explanation for what causes a particular visual loss, by associating the features of hysterical blindness EEG with brain function. METHODS: An idea for the novel feature extraction for hysterical blindness EEG, utilizing combined-channel information, was applied in this paper. After channels had been combined, the sliding-window-FastICA was applied to process the combined normal…EEG and hysteria EEG, respectively. Kurtosis features were calculated from the processed signals. As the comparison feature, the power spectral density of normal and hysteria EEG were computed. RESULTS: According to the feature analysis results, a region of brain dysfunction was located at the occipital lobe, O1 and O2. Furthermore, new abnormality was found at the parietal lobe, C3, C4, P3, and P4, that provided us with a new perspective for understanding hysterical blindness. CONCLUSIONS: Indicated by the kurtosis results which were consistent with brain function and the clinical diagnosis, our method was found to be a useful tool to capture features in hysterical blindness EEG.