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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: As one of the pervasive healthcare services, Ubiquitous cardiac care (UCC) systems should have at least two significant characteristics: real-time detection capability for cardiac arrhythmia events and a small resource requirement for its computation and storage. PURPOSE: Due to the strict-constrained system support and ambulatory signal quality in the out-of-hospital pervasive healthcare applications, a dedicated real-time AED (Ambulatory Electrocardiograph Detection) algorithm has been implemented. METHODOLOGY: By adopting the piecewise geometric analysis method, this algorithm can provide a real-time continuous detection capability for QRS complexes, which consists of three main functional modules:…the Data preparation; the R-wave vertex discovery; and the QRS complex recognition. Currently, this algorithm has been applied on an on-line UCC application system at the hospital for more than 30 patients. RESULT: The performance evaluation has been made not only on the standard MIT-BIH cardiac arrhythmia database but also on the clinical testing. The experiential results explore this algorithm has in average sensitivity of 99.37% and specificity of 99.72%. CONCLUSION: This AED algorithm has minimal beat detection latency and a less computation consumption, which make it meet the requirements of ubiquitous cardiac care applications.
Abstract: BACKGROUND: As a new authentication method developed years ago, vein recognition technology features the unique advantage of bioassay. OBJECTIVE: This paper studies the specific procedure for the extraction of hand back vein characteristics. METHODS: There are different positions used in the collecting process, so that a suitable intravenous regional orientation method is put forward, allowing the positioning area to be the same for all hand positions. In addition, to eliminate the pseudo vein area, the valley regional shape extraction operator can be improved and combined with multiple segmentation algorithms. The images should be…segmented step by step, making the vein texture to appear clear and accurate. Lastly, the segmented images should be filtered, eroded, and refined. This process helps to filter the most of the pseudo vein information. RESULTS: Finally, a clear vein skeleton diagram is obtained, demonstrating the effectiveness of the algorithm. CONCLUSION: This paper presents a hand back vein region location method. This makes it possible to rotate and correct the image by working out the inclination degree of contour at the side of hand back.
Keywords: Vein recognition, image processing, region segmentation, feature extraction
Abstract: BACKGROUND: Gait recovery is very important to stroke survivors to regain their independence in activity of daily life. OBJECTIVE: This study aimed to investigate the effects of virtual reality (VR) coupled body weight support treadmill training (BWSTT) on pelvic control at the early stage of stroke. METHODS: Kinematic and kinetic changes of pelvic motion were evaluated by a 3D gait analysis system and were compared to the results from over-ground walking training. Twenty-four patients having unilateral hemiplegia with subacute stroke were recruited to a VR coupled BWSTT group (n= 12) and a conventional…therapy (CT) group (n= 12). Both of the groups received training of 20-40 min/day, 5 days/week, for 3 weeks. RESULTS: The results showed the tilt of pelvis in sagittal plane improved significantly (P= 0.038) after treatment in the BWSTT+VR group, in terms of decreased amplitude of anterior peak (mean, from 10.99° to 6.25°), while there were no significant differences in the control group. CONCLUSION: The findings suggested that VR coupled BWSTT gait training could decrease anterior tilt of pelvis in early hemiparetic persons following a modest intervention dose, and the training may have advantages over conventional over-ground gait training and can assist the therapists in correcting abnormal gait pattern of stroke survivors.
Abstract: BACKGROUND: Bioartificial liver support system (BALSS) based on culturing hepatocytes is an important research field for the treatment of acute liver failure. It is necessary to monitor the state of liver cell functions during the treatment of BALSS in order to guide clinical treatment. OBJECTIVE: To design a micro-channel chip to achieve flash mixing for timely detection of liver cell status in bioreactors and improving liver cells growth environment to ensure the efficacy of the bio-artificial liver support system. METHODS: Alanine aminotransferase (ALT) and Urea are chosen as detection indicators to reflect the…degree of liver cell injury and the detoxification function. A diamond tandem structure micro-channel is designed and optimized to achieve the efficient mixing of serum and ALT or Urea reagent. RESULTS: The simulation and experimental results show that the diamond tandem structure micro-channel can significantly improve the mixing efficiency and meet the online detecting requirements. CONCLUSION: The easily controllable diamond tandem structure micro-channel combines the advantages of active and passive mixer and can effectively mix the serum and ALT or Urea reagent. It lays the foundation for online monitoring of liver cells and will help to improve the viability of liver cell in the bioreactor.
Abstract: BACKGROUND: Human factors involved with visual attention mechanism and fatigue are critical causes of modern aviation accidents. OBJECTIVE: To investigate the connection between attention and flight fatigue, a mathematical model of pilot's visual attention allocation was established based on information processing channels. Multi-task condition and current psychophysical state were taken into account as well. METHODS: Sixteen participants were recruited to perform a long-term dual-task in a Boeing 737-800 flight simulator. The primary task was an envelope flight task and the secondary was an unusual attitude (UA) recovery task. Reaction time of the secondary…task was recorded as a behavior performance index, while heart rate and respiration rate were measured as physiological indices as well as fixation distribution as attention allocation index. RESULTS: The experiment results showed a significant affect of experiment time that indicated the occurrence and influence of fatigue. Eye movement tracking also revealed good agreement with the predictable model and hence verified its effectiveness. Moreover, applicability of the model was validated under flight fatigue and multiple tasks condition. CONCLUSION: The current study provided a quantitative connection between pilot's visual attention allocation and flight fatigue, which was verified in the ergonomics experiment.
Abstract: BACKGROUND: Because of the complexity and construction, the failure rate of lumbar surgery is still high. It is necessary to find a solution to help improve the accuracy and safety of surgery. OBJECTIVE: Construction and stress analysis of lumbar spine. METHODS: The generated FE model based on CT scan images was validated and used to investigate the motion, and stress/strain of the vertebrae under different physiological loadings. A degenerated model was also simulated by changing the materials properties (E and Poisson's Ratio) of the intervertebral disc nucleus and annulus fibers from 1.0 N/mm^2…to 3.0 N/mm^2, and 0.42 to 0.45, respectively. RESULTS: When annulus fibrosis is degenerating or under ictal external loadings, the annulus fibrosis will be in a state of protrusion and there will potential for other pathological changes, such as herniation of the nucleus pulpous. CONCLUSION: The effects of these changes in the corresponding motion and stress/strain of the spinal motion segments were investigated with some conclusions drawn in relation to the normal model for future application of medical diagnosis and surgical treatment.
Abstract: BACKGROUND: According to the analysis of the challenges faced by the current public health circumstances such as the sharp increase in elderly patients, limited medical personnel, resources and technology, the agent-based intelligent medical diagnosis system for patients (AIMDS) is proposed in this research. OBJECTIVE: Based on advanced sensing technology and professional medical knowledge, the AIMDS can output the appropriate medical prescriptions and food prohibition when the physical signs and symptoms of the patient are inputted. METHODS: Three core modules are designed include sensing module, intuition-based fuzzy set theory/medical diagnosis module, and medical knowledge…module. RESULTS: The result shows that the optimized prescription can reach the desired level, with great curative effect for patient disease, through a case study simulation. CONCLUSION: The presented AIMDS can integrate sensor technique and intelligent medical diagnosis methods to make an accurate diagnosis, resulting in three-type of optimized descriptions for patient selection.
Keywords: Intuitionistic fuzzy set theory, sensing technology, intelligent medical diagnosis, agent, medical knowledge
Abstract: OBJECTIVE: Surgical planning for scoliosis relies on the classification of spinal curve pattern. The widely used King classification is subject to human measurement and judgment errors. To reduce the variability of King classification, a computer-aided method is proposed and its reliability is evaluated in this study. METHODS: At the first step, endplate inclination and position of each vertebra are measured by a computerized system on the posteroanterior radiograph. Based on these measurements, the apical and end vertebrae are identified and then the Cobb angles are calculated automatically. The system subsequently classifies the curve types automatically…based on the computerized Cobb measurements, the vertebral inclination, and the analysis of the relationship between the center sacral vertical line, and the apical lumbar vertebra. Five observers participated in the experiments. The kappa statistic was used to evaluate the variability. RESULTS: Classifications of 105 scoliotic cases by the five observers showed that with the aid of our system, the average intraobserver and interobserver kappa values improved from 0.75 to 0.90 and from 0.66 to 0.86, respectively. CONCLUSION: Results indicate that the proposed computerized system can assist a surgeon with the King classification of scoliosis.
Keywords: Computer-aided diagnosis, King classification, radiograph, scoliosis
Abstract: BACKGROUND: Korotkoff sounds have been used to measure systolic and diastolic arterial blood pressures noninvasively for over 100 years. However, most of the research concerning the Korotkoff sound were focused on the origin and frequency component analyzing the Korotkoff sound signal. OBJECTIVE: To show that the occurrence time of the Korotkoff sounds for each cardiac cycle demonstrates a characteristic value during the cuff deflating process of blood pressure measurement. METHODS: The Korotkoff sound delay time (KDT) decreases as the cuff pressure P deflates and KDT is a function of arterial transmural pressure. In…the present research, an experiment system was established to explore the relationship between the KDT and the cuff pressure in different subjects. RESULTS: A pilot experiment was conducted to obtain different subjects' KDTs and investigate the relationship between KDT and cuff pressure. CONCLUSION: The relationship between KDT and invasive blood pressure was also studied and its potential application in detection of cardiovascular status was discussed.
Keywords: Cardiovascular, noninvasive measurement, Korotkoff sound delay time, transmural pressure
Abstract: OBJECTIVE: To investigate the effect of force level and fatigue on brain activity during handgrip tasks. METHODS: Electroencephalography (EEG) signals were recorded from eleven healthy male subjects when they performed 25%, 50% and 75% maximal voluntary contraction (MVC), and were in fatigue state. EEG powers in different handgrip tasks were analyzed in the frequency domain and time domain respectively. RESULTS: The EEG power at 25%MVC was significantly lower than that at 75%MVC in gamma band (p< 0.05) for electrode C3, C4, Cz, Pz and Fz. EEG power at 25%MVC was also significantly…lower than that at 75%MVC in beta band (p< 0.05) for electrode C3. However, the handgrip force level and fatigue did not affect the EEG powers for the other frequencies and electrodes (p> 0.05). CONCLUSION: The results suggest that handgrip force level may modulate the brain activity in certain frequency bands and cortical regions. EEG power is a useful tool to characterize the motor state.