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ISSN 0928-7329 (P)
ISSN
1878-7401 (E)
Impact Factor 2024: 1.4
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 paper proposes a novel wearable wireless-sensing technology on a glove to measure the bio-potentials and impedances of acupunctures on a whole palm in a non-invasive manner. Moreover, the device can transmit the information to a remote cloud server to learn at normal condition, and take measurement later for health condition analysis and monitoring. An example is given how to measure the acupuncture impedances and bio-potentials on a palm. One can see if certain acupuncture's impedance or bio-potential is not follow the Ohm's law or voltage divider rule along a meridian, then the health condition of the corresponding organ maybe…with some problem. This discovery is not found in the previous literatures.
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Keywords: Wireless health monitor, wearable rubber glove, acupuncture bio-potentials and impedances, scanning elastic electrodes
Abstract: This study measured epidermal and dermal temperatures under different cryogen spray cooling (CSC) conditions to determine the optimum cooling conditions for skin rejuvenation. For this purpose, CSC conditions were applied before a laser transmission for varying spurt times of 50, 150, and 200 ms with delay times of 150 and 200 ms. A long-pulsed 1,064 nm Nd:YAG laser irradiated the skin surface of a pig with a condition of fluence of 26 J/cm2 and a spot diameter of 8 mm. The pulse duration was set to 30 ms during all experiments. This study found that all employed CSC conditions…significantly decreased internal-external skin temperatures. Moreover, skin temperatures were influenced more by variations in spurt time of CSC compared with the delay times. Based on these experimental results, two spurt times were selected as the optimum CSC conditions for skin rejuvenation: 50 ms with delay time of 150 and 200 ms and 150 ms with a delay time of 150 and 200 ms.
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Abstract: Nowadays, detecting fetal ECG using abdominal signal is a commonly used method, but fetal ECG signal will be affected by maternal ECG. Current FECG extraction algorithms are mainly aiming at multiple channels signal. They often assume there is only one fetus and did not consider multiple births. This paper proposed a single channel blind source separation algorithm to process single abdominal acquired signal. This algorithm decomposed single abdominal signal into multiple intrinsic mode function (IMF) utilizing empirical mode decomposition (EMD). Correlation matrix of IMF was calculated and independent ECG signal number was estimated using eigenvalue method. Nonnegative matrix was constructed…according to determined number and decomposed IMF. Separation of MECG and FECG was achieved utilizing nonnegative matrix factorization (NMF). Experiments selected four channels man-made signal and two channels ECG to verify correctness and feasibility of proposed algorithm. Results showed that the proposed algorithm could determine number of independent signal in single acquired signal. FECG could be extracted from single channel observed signal and the algorithm can be used to solve separation of MECG and FECG.
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Abstract: The authors have developed a practical wrist rehabilitation robot for hemiplegic patients. It consists of a mechanical rotation unit, sensor, grip, and computer system. A myoelectric sensor is used to monitor the extensor carpi radialis longus/brevis muscle and flexor carpi radialis muscle activity during training. The training robot can provoke training through myoelectric sensors, a biological signal detector and processor in advance, so that patients can undergo effective training of extention and flexion in an excited condition. In addition, both-wrist system has been developed for mirror effect training, which is the most effective function of the system, so that autonomous…training using both wrists is possible. Furthermore, a user-friendly screen interface with easily recognizable touch panels has been developed to give effective training for patients. The developed robot is small size and easy to carry. The developed aspiring interface system is effective to motivate the training of patients. The effectiveness of the robot system has been verified in hospital trails.
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Keywords: Wrist rehabilitation robot, myoelectric sensor, mirror effect, interface system
Abstract: Malaria must be diagnosed quickly and accurately at the initial infection stage and treated early to cure it properly. The malaria diagnosis method using a microscope requires much labor and time of a skilled expert and the diagnosis results vary greatly between individual diagnosticians. Therefore, to be able to measure the malaria parasite infection quickly and accurately, studies have been conducted for automated classification techniques using various parameters. In this study, by measuring classification technique performance according to changes of two parameters, the parameter values were determined that best distinguish normal from plasmodium-infected red blood cells. To reduce the stain…deviation of the acquired images, a principal component analysis (PCA) grayscale conversion method was used, and as parameters, we used a malaria infected area and a threshold value used in binarization. The parameter values with the best classification performance were determined by selecting the value (72) corresponding to the lowest error rate on the basis of cell threshold value 128 for the malaria threshold value for detecting plasmodium-infected red blood cells.
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Abstract: In this study, an automatic microfluidic fluorescence-array measurement system is developed to detect the concentration of organic phosphate based on the luminol-hydrogen peroxide catalytic fluorescent mechanism. Not only sample quantity and cost can be reduced, but also detection time, accuracy and precision can be improved in the system. The system is composed of a CCD image module, a stepper motor with driver, a microfluidic fluorescence array, a background light elimination module, and a dynamic image-analyzed interface. The pesticides of chlorpyrifos and fenitrothion of organic phosphate are chosen as experimental samples. Only a 2.5 μ l quantity of sample is required…to have a fast response time of 1.4 second. Experimental results show that the sensitivities of chlorpyrifos and fenitrothion are 1.88 V/ppm in the range of 0.166 ∼ 10 ppm with averaged error of 1.66% and 0.32 V/ppm in the range of 0.03 ∼ 10 ppm with averaged error of 1.68% respectively. The organophosphorus effective detection range of the developed system covers the legal prescription for pesticide residues.
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Keywords: Organophosphorus measurement, centrifugal microfluidic, fluorescence-array, chlorpyrifos and fenitrothion
Abstract: As the focus of personal healthcare shifts from patient treatment to early detection and prevention, it is becoming increasingly important to manage personal wellness in our daily lives. Personal health monitoring of physical activities and status can be used to show users the distribution of their daily activities, making it easier for people to assess their health, adopt better lifestyles, and potentially decrease the occurrence of chronic diseases. In this paper, we propose a CA5W1H Onto-based life data monitoring model that provides basic monitored information from various devices and ensures preventive and proactive service for personalized healthcare. Additionally, we propose…a life data analysis method to correlate the self-monitoring of activities with the status of the human body.
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Keywords: Life data monitoring, life data analysis, personalized healthcare, self-monitoring, ontological concept, CA5W1HOnto
Abstract: In this study, several variables related to the thickness of the retinal layer were measured via optical coherence tomography (OCT), and the clinical applicability of such measurements was evaluated to differentiate between diabetic cystoid macular edema (DCME) and postoperative cystoid macular edema (PCME). To this end, a total of 120 subjects (30 healthy individuals, 60 DCME patients, and 30 PCME patients) were selected as the experimental subjects. The six risk factors included the thicknesses for the total retina (TR), the inner retina (IR), the photoreceptor outer segments (POS), the outer retina (OR), the ganglion cell (GC), and the retinal nerve…fiber layer (RNFL), and these were estimated by using a hierarchical approach through observations from OCT image scans. All of the risk factors were obtained from the OCT images captured within a 6-mm diameter from the center of the macula. The results of the experiment indicated that the proposed method can reliably differentiate between DCME and PCME. Moreover, as DCME and PCME progressed, the most significant deterioration was found in the central macular region. These results suggest that the proposed method has clinical applicability for the diagnosis of DCME and PCME from OCT images.
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Abstract: Although researches had analyzed gait using small sensors, they analyzed only normal gaits. Thus, a research that can overcome the spatial limitations of the existing motion analyses and diagnose abnormal gaits for medical treatment is needed. Accordingly, this research developed the portable gait detection system that can detect gait using a gyroscope, and evaluated the accuracy of the system. The results showed an average recognition error rate of 1.7% for the normal and abnormal gaits, and confirmed that the gait cycle was detected with a high degree of accuracy. Using these characteristics, we could distinguish or diagnose, and treat, an…abnormal gait.
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Abstract: Many image acquisition methods of nucleic acids still depend on UV illumination, especially after the electrophoresis when determining the size of the target DNA. Therefore the quality of the UV illuminator in the gel documentation system, and the comparison of the fluorescence detected are crucial. This paper presents a fluorescence standard reference plate using quantum dots compared to the conventional method where an agarose gel containing ethidium bromide is loaded with standard samples. The fluorescence standard reference plate consists of chambers filled with commercially available quantum dots such as phosphor dots. The chamber is made by thermally attaching nylon and…polyester, the former on the inside and the latter on the outside, for increased stability. The images of the proposed reference plate were captured more than 2 months in regular intervals. The intensity analysis of the images shows that the proposed reference plate delivers stable fluorescence over a long term period. The proposed reference plate can be utilized to compare the performance of various UV illuminators, or to set a standard fluorescence point for certain analyses.
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Keywords: Gel documentation system, gel image analysis, DNA detection, UV illuminator, quantum dots
Abstract: A novel pulse-diagnosis system was proposed in this study for measuring pulse wave velocities. In contrast with most conventional mechanical, rigid-type pulse diagnosis instruments such as pressure transducers and microactuators, a conductive elastic polymer was adopted as the sensor material. The soft and formability properties of such material enabled fabricating a flexible pulse diagnosis instrument. In addition, the flexible design was integrated with a contemporary, wrist-type pulse-wave acquisition system to ensure stable measurements. Closely related to the incidence of cardiovascular diseases, pulse wave velocity was analyzed in applications to verify the feasibility of this system. Regarding signal processing, the cun…, guan , and chi pulse signals obtained through the data acquisition device were sent to the LabVIEW platform for reconstructing the pulse waveforms. Finally, the results of 20 measured samples were compared and analyzed to evaluate the level of system performance.
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Abstract: Almost all stroke patients experience a certain degree of fine motor impairment, and impeded finger movement may limit activities in daily life. Thus, to improve the quality of life of stroke patients, designing an efficient training device for fine motor rehabilitation is crucial. This study aimed to develop a novel fine motor training glove that integrates a virtual-reality based interactive environment with vibrotactile feedback for more effective post stroke hand rehabilitation. The proposed haptic rehabilitation device is equipped with small DC vibration motors for vibrotactile feedback stimulation and piezoresistive thin-film force sensors for motor function evaluation. Two virtual-reality based games…``gopher hitting'' and ``musical note hitting'' were developed as a haptic interface. According to the designed rehabilitation program, patients intuitively push and practice their fingers to improve the finger isolation function. Preliminary tests were conducted to assess the feasibility of the developed haptic rehabilitation system and to identify design concerns regarding the practical use in future clinical testing.
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Keywords: Hand rehabilitation, haptics, virtual reality, vibrotactile feedback, finger dexterity
Abstract: There have been many studies to detect infectious diseases with the molecular genetic method. This study presents an automation process for a DNA extraction system based on microfluidics and magnetic bead, which is part of a portable molecular genetic test system. This DNA extraction system consists of a cartridge with chambers, syringes, four linear stepper actuators, and a rotary stepper actuator. The actuators provide a sequence of steps in the DNA extraction process, such as transporting, mixing, and washing for the gene specimen, magnetic bead, and reagent solutions. The proposed automation system consists of a PC-based host application and an…Arduino-based controller. The host application compiles a G code sequence file and interfaces with the controller to execute the compiled sequence. The controller executes stepper motor axis motion, time delay, and input-output manipulation. It drives the stepper motor with an open library, which provides a smooth linear acceleration profile. The controller also provides a homing sequence to establish the motor's reference position, and hard limit checking to prevent any over-travelling. The proposed system was implemented and its functionality was investigated, especially regarding positioning accuracy and velocity profile.
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Keywords: Molecular genetic test, DNA extraction, Arduino, automation
Abstract: Unlike traditional rigid actuators, the significant features of Series Elastic Actuator (SEA) are stable torque control, lower output impedance, impact resistance and energy storage. Recently, SEA has been applied in many exoskeletons. In such applications, a key issue is how to realize the human-exoskeleton movement coordination. In this paper, double closed-loop cascade control for lower limb exoskeleton with SEA is proposed. This control method consists of inner SEA torque loop and outer contact force loop. Utilizing the SEA torque control with a motor velocity loop, actuation performances of SEA are analyzed. An integrated exoskeleton control system is designed, in which…joint angles are calculated by internal encoders and resolvers and contact forces are gathered by external pressure sensors. The double closed-loop cascade control model is established based on the feedback signals of internal and external sensor. Movement experiments are accomplished in our prototype of lower limb exoskeleton. Preliminary results indicate the exoskeleton movements with pilot can be realized stably by utilizing this double closed-loop cascade control method. Feasibility of the SEA in our exoskeleton robot and effectiveness of the control method are verified.
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Keywords: Exoskeleton, Series Elastic Actuator (SEA), torque control, cascade control
Abstract: When sharing and storing healthcare data in a cloud environment, access control is a central issue for preserving data privacy as a patient's personal health data may be accessed without permission from many stakeholders. Specifically, dynamic authorization for the access of data is required because personal health data is stored in cloud storage via wearable devices. Therefore, we propose a dynamic access control model for preserving the privacy of personal healthcare data in a cloud environment. The proposed model considers context information for dynamic access. According to the proposed model, access control can be dynamically determined by changing the context…information; this means that even for a subject with the same role in the cloud, access permission is defined differently depending on the context information and access condition. Furthermore, we experiment the ability of the proposed model to provide correct responses by representing a dynamic access decision with real-life personalized healthcare system scenarios.
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Abstract: It's important to improve the stability of intravenous (IV) lines and bottles during patient activity and nursing care. We developed an intravenous line and fluid bottle fixation design (ILFBFD) which includes a bottle retaining clip and line fixation kit. We randomly assigned 60 participants each to the experimental and control groups. Participants were asked to push an IV stand without and with ILFBFD 11 meters on uneven pavement and a sloping floor. The distance the IV bottle moved was recorded. Self-administered questionnaires were used to collect the opinions of the participants. Use of ILFBFD, resulted in less movement in the…anteroposterior and left/right directions (differences of 46.98 cm2 , t= 12.80, p < 0.000 and 39.24 cm2 , t= 8.01, p< 0.000, respectively) compared with not using ILFBFD. The average scores for bottle movement when participants walked on a flat floor, uneven pavement and sloping floor, IV line tangling and dropping, and organization of Liv lines were significantly better in those using than not using ILFBFD. The results can be used in clinical practice to reduce knotting of IV lines, and to enhance the safety and quality of patient care.
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Abstract: This paper proposes the optimal structure of a PCB-based micro PCR chip constructed on a PCB substrate using commercial adhesive tapes and plastic covers. The solder mask of the PCB substrate was coated black, and the area where the reaction chamber is attached was legend printed with white silk to minimize the noise during fluorescence detection. The performance of the PCR and fluorescence detection was compared using 6 types of reaction chambers, each made with different double-sided tapes. Three of the chambers were unsuccessful in completing the PCR. The performance of the other three chambers that successfully amplified DNA was…compared using Taqman probe for Chlamydia Trachomatis DNA. The amplified product was illuminated diagonally with a blue LED to excite the product just before imaging, and the LED was turned off when the image was captured to prevent quenching of the probe. The images were taken 10 seconds prior to the last extension step for each cycle using a DSLR camera. The experiments were run as a quartet for each three chambers made with different double-sided tape. The results showed that there were significant difference between the three tapes.
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Abstract: Jelly fig (Ficus awkeotsang ) achenes have been utilized to prepare a traditional drink in Taiwan. Herein, we evaluated the effect of water extract from jelly fig seed residues (WERJFA) on cancer cells. WERJFA could inhibit the growth of human colorectal cancer cells, COLO205 and HT29 in both dose- and time-dependent manners. The flow cytometric analysis with propidium iodide (PI) showed that WERJFA primarily arrested COLO205 and HT29 cells at the G2/M phase of cell cycle as the concentration reached to at least 0.5 mg/ml. WERJFA induced apoptosis of these two cell lines, as evidenced by annexin V-FITC/PI and 4',…6-diamidino-2-phenylindole (DAPI) staining using flow cytometry and confocal microscopy, respectively. Reactive oxygen species (ROS) production and the loss of mitochondrial membrane potential in WERJFA-treated cells were detected by flow cytometry with H2 DCF-DA and 5,5', 6,6'-Tetrachloro-1, 1', 3,3'-tetraethylbenzimidazolocarbocyanine iodide (JC-1). Our results showed that WERJFA exerted anti-proliferative and apoptotic effects on colorectal cancer cells. WERJFA arrested cell cycle, and caused apoptotic death in these cancer cells possibly via mitochondrial pathway involved with exceeding ROS level.
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Abstract: Rupture-prone plaques in the coronary arteries, called ``vulnerable plaques'', are recognized as the key factor in acute myocardial infarction. Vulnerable plaques have a thin fibrous cap over a large fatty core and are highly susceptible to rupture. In general, this type of plaque rupture is mainly associated with stress concentrated on the fibrous cap. Fibrous cap stresses are counted among the most important factors in the plaque rupture process and must be taken into consideration when assessing the plaque vulnerability leading to heart attacks. The objective of this paper was to investigate the effects of nitinol stent deployment on the…morphological changes of vulnerable plaques and then to propose a new stent design concept for effectively reducing fibrous cap stresses and the associated rupture risk. The deployment of a self-expanding nitinol stent was modeled, and the resulting stress distribution on the fibrous cap was investigated. The fibrous cap stresses were more uniformly distributed and the maximum stress was reduced by 13% when the crown number of the stent was increased. This study demonstrates an excellent approach to stent design that could effectively reduce the risk of a vulnerable plaque rupturing and causing a heart attack.
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Keywords: Heart attack, vulnerable plaque, fibrous cap stresses, nitinol stent, finite element analysis
Abstract: We try to find out the best weight values of CA125 and HE4 in a discriminant formula classifying ovarian cancer patients from benign patients. We utilize a logistic regression analysis for the early screening system of the ovarian cancer for Korean patients. We compare our system with ROMA (Risk of Ovarian Malignancy Algorithm) of Abbot corp. In view of AUC (Area under the ROC curve), sensitivity with 95% of specificity and accuracy are considered. We performed experiments based on the logistic regression analysis separated by the case of pre- and post- menopausal stages and by the stages of progression of…cancer. In our experiments, we can increase about 15.6% points of sensitivity with 95% of specificity, compared to that of ROMA. In premenopausal cases, ROMA shows 93.32% of AUC value and our system shows 97.48% of AUC, 4.1% points higher than ROMA. AUC of the ROMA for premenopausal women was 93.32%, whereas the AUC of our system was 97.48%. Furthermore, the AUC of the ROMA for early-staged ovarian cancer was 91.35%, whereas the AUC of our system was 97.22%, showing that the diagnostic performance of our system was superior over that of the ROMA in Korean patient cases.
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Keywords: Risk of ovarian malignancy algorithm, CA125, HE4, tumor marker, ovarian cancer, sensitivity, specificity, epithelial ovarian cancer
Abstract: This study uses a split-Hopkinson bar to investigate the mechanical response and microstructural evolution of Ti-13Zr-13Nb biomedical alloy under dynamic loading. Dynamic compression tests are performed at room temperature (25°C) and 500°C under strain rates of 900 s - 1 , 1900 s - 1 and 2800 s - 1 , respectively. It indicates that the mechanical response of Ti-13Zr-13Nb biomedical alloy is very influenced by strain rate and temperature. The plastic flow stress and strain rate sensitivity increase with the increasing strain rate but decrease with increasing temperature. It reveals that the Ti-13Zr-13Nb alloy fail due to the…intensive localized shearing by fracture observation. Furthermore, TEM observations reveal that the dislocation density increases with an increasing strain rate, but decrease with increasing temperature.
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Abstract: A polymerase chain reaction is a test method currently used in almost all process steps of a genetic manipulation experiment. It involves the amplification of the given genetic material targeted by the detection test. In consideration of the graphical user interface development environment or user accessibility, if a PC with the windows operating system or its embedded version can be employed as a host, it will contribute significantly to resource saving, including development-related human resources and time, along with enabling a broad use of the product. In this study, we focus on the low cost implementation of a PCR thermal…cycler for the personal usage. It is aimed to drastically reduce the product development time and maintenance/repair costs. To achieve this, we implement the functions for biochemical process in a local embedded system, and the functions of data management, including the PCR protocol, and user-interface management are implemented on a PC.
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Abstract: This study presents a simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly. It can transmit ECG signals of patient around his/her house through Bluetooth to computers in house. ECG signals are analyzed by the computer. If abnormal case of heartbeat is found, the emergency call is automatically dialed. Meanwhile, the determined heartbeat case of ECG signals will be forwarded to patient's MD through internet. Therefore, the patient can do whatever he/she wants around his/her house with our proposed simple cardiac arrhythmias signal analyzer. The proposed consists of five major processing stages: (i) preprocessing stage for enlarging ECG…signals' amplitude and eliminating noises; (ii) ECG signal transmitter/receiver stage, ECG signals are transmitted through Bluetooth to the signal receiver in patient's house; (iii) QRS extraction stage for detecting QRS waveform using the Difference Operation Method (DOM) method; (iv) qualitative features stage for qualitative feature selection on ECG signals; and (v) classification stage for determining patient's heartbeat cases using the Principal Component Analysis (PCA) method. In the experiment, the total classification accuracy (TCA) was approximately 93.19% in average.
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Abstract: Current paper focus on Parkinson's patients with autonomic dysfunction and how their interactions between cerebral autoregulation and ventilatory control are affected. The experimental data of dynamic CA assessment from the ANS Laboratory of CCGH was accessed for further processing and analysis. The subjects were classified into the groups of healthy and with Parkinson's disease. Based on the accessed ventilation and CBF data, the percentage changes in ventilation and CBF responses to PETCO2 were examined. To minimize effects of changes in ABP on cerebral vasomotor reactivity (CVMR) estimation, cerebrovascular conductance index (CVCi ) was calculated, and CBFV-PETCO2 and CVCi…-PETCO2 relationships were quantified by nonlinear logistic regression. The interaction between ventilation responses and CBF autoregulation will be modeled and parameters will be validated.
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Keywords: Parkinson's, cerebral autoregulation, cerebral vasomotor reactivity, cerebrovascular conductance index
Abstract: Mobile apps provide diverse services and various convenient functions. This study applied the modified technology acceptance model (MTAM) in information systems research to the use of the mobile hospital registration system in Taiwan. The MTAM posits that perceived ease of use and perceived usefulness of technology influence users' attitudes toward using technology. Research studies using MTAM have determined information technology experience as a factor in predicting attitude. The objective of this present study is to test the validity of the MTAM model when it is being applied to the mobile registration system. The data was collected from 501 patients in…a Taiwan's medical center. Path analysis results have shown that TAM is an applicable model in examining factors influencing users' attitudes of using the mobile registration system. It can be found that the perceived usefulness and the perceived ease of use are positively associated with users' attitudes toward using the mobile registration system, and they can improve users' attitudes of using it. In addition, the perceived ease of use is positively associated with the perceived usefulness. As for the personal prior experience, the information technology experience is positively associated with perceived usefulness and the perceived ease of use.
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Keywords: Hospital information system, mobile technology, technology acceptance model, partial least squares (PLS)
Abstract: With the advent of the era of global high-tech industry and commerce and its associated sedentary lifestyle, opportunities for physical activity are reduced. People's physical fitness and health is deteriorating. Therefore, it is necessary to develop a system that can enhance people's physical fitness and health. However, it is difficult for general physical fitness and healthcare systems to meet individualized needs. The main purpose of this research is to develop a method of intelligent diagnosis and prescription for a customized physical fitness and healthcare system. The proposed system records all processes of the physical fitness and healthcare system via a…wireless sensor network and the results of the diagnosis and prescription will be generated by fuzzy logic inference. It will improve individualized physical fitness and healthcare. Finally, we demonstrate the advantages of intelligent diagnosis and prescription for a customized physical fitness and healthcare system.
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Abstract: Communication between people with normal hearing and hearing impairment is difficult. Recently, a variety of studies on sign language recognition have presented benefits from the development of information technology. This study presents a sign language recognition system using a data glove composed of 3-axis accelerometers, magnetometers, and gyroscopes. Each data obtained by the data glove is transmitted to a host application (implemented in a Window program on a PC). Next, the data is converted into angle data, and the angle information is displayed on the host application and verified by outputting three-dimensional models to the display. An experiment was performed…with five subjects, three females and two males, and a performance set comprising numbers from one to nine was repeated five times. The system achieves a 99.26% movement detection rate, and approximately 98% recognition rate for each finger's state. The proposed system is expected to be a more portable and useful system when this algorithm is applied to smartphone applications for use in some situations such as in emergencies.
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Keywords: Data glove, sign language recognition, inertial sensor, accelerometer
Abstract: Visual fatigue is commonly encountered in modern life. Clinical visual fatigue characteristics caused by 2-D and 3-D animations may be different, but have not been characterized in detail. This study tried to distinguish the differential effects on visual fatigue caused by 2-D and 3-D animations. A total of 23 volunteers were subjected to accommodation and vergence assessments, followed by a 40-min video game program designed to aggravate their asthenopic symptoms. The volunteers were then assessed for accommodation and vergence parameters again and directed to watch a 5-min 3-D video program, and then assessed again for the parameters. The results support…that the 3-D animations caused similar characteristics in vision fatigue parameters in some specific aspects as compared to that caused by 2-D animations. Furthermore, 3-D animations may lead to more exhaustion in both ciliary and extra-ocular muscles, and such differential effects were more evident in the high demand of near vision work. The current results indicated that an arbitrary set of indexes may be promoted in the design of 3-D display or equipments.
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Abstract: Correct classification and prediction of tumor cells are essential for microarrays to construct a diagnostic system. Differential evolution (DE) is a powerful optimization algorithm, which has been widely used in many areas. However, the standard DE and most of its variants search in the continuous space, which cannot solve the binary optimizations directly. In this paper, the hybrid framework based on the binary DE algorithm and silhouette filter, is proposed to improve searching ability to classify breast and leukemia cancers in microarray for biomarker discovery. The study is focused to use hybrid DE algorithm for gene selection and silhouette statistics…as a discriminant function to classify multiple tumor types in microarray data. Distance metrics on silhouette statistics have also been discussed for high classification accuracy. Experimental results show that the hybrid method is effective to discriminate breast and leukemia cancer subtypes and find potential biomarkers for cancer diagnosis.
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Keywords: Gene selection, cancer classification, hybrid differential evolution, silhouette statistics
Abstract: Vascular access dysfunction commonly occurs in hemodialysis patients. Regularly monitoring and evaluating the vascular access condition is an important issue for these diseased patients. The objective of this study was to identify acoustic parameters and hemodynamics that related to changes in the stenosis of vascular access. In-vitro experimental circulation system offered pulsatile and physiological condition to simulate the arteriovenouse access in hemodialysis patient. We created the environments of various degrees of stenosis (DOS) inside the arteriovenouse access to simulate the stenotic conditions in patients. And we also used the computational fluid dynamics (CFD) to simulate the pressure distribution, primary axial…velocity distribution, and secondary flow distribution in the same various DOS and boundary condition. There are two findings, one is recorded the bruit which caused by the fluctuation of fluid in different severe stenosis, the other is described the correlation between bruit and hemodynamic parameters. Experimental results show the time constants have linear regression with a positive correlation as the degree of stenosis (DOS) increases. Finally, in contrast to CFD computerized analysis and acoustic methods, the proposed parameter provides a feasibility index for evaluating the risk of AVG dysfunction in on-line/real time analysis.
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Abstract: Spirometry evaluates the integrated function of lung capacity and chest wall mechanics measuring the total volume of air forcefully exhaled from a fully inflated lung. This non-invasive, informative technique for characterizing pulmonary function has an important role in clinical trials to narrow the differential diagnosis of subjects being assessed for pulmonary disorders. The test however requires patient co-operation and sometimes sub maximal effort affects the results potentially thereby leading to incomplete test and misdiagnosis. The aim of this work is to develop a prediction model based on Multivariate adaptive regression splines (MARS) technique to estimate the spirometric parameter Peak Expiratory…Flow (PEF) volume. In the present study, flow-volume data from N = 220 subjects are considered. Model performances are evaluated statistically with coefficient of determination (R2 ) and Root Mean Squared Error (RMSE). The significant spirometric features captured in the model were FEV1 , FEF50 , FEF25 and the demographic parameter weight. Bland-Altman plots for the estimated PEF values showed a minimal bias. The MARS model successfully adopted the important features for prediction of PEF parameter with overall good fit and these findings can assist clinicians with enhanced spirometric investigations on respiratory disorders.
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Abstract: Nowadays, people can easily use a smartphone to get wanted information and requested services. Hence, this study designs and proposes a Golf Swing Injury Detection and Evaluation open service platform with Ontology-oritened clustering case-based reasoning mechanism, which is called GoSIDE, based on Arduino and Open Service Gateway initative (OSGi). GoSIDE is a three-tier architecture, which is composed of Mobile Users, Application Servers and a Cloud-based Digital Convergence Server. A mobile user is with a smartphone and Kinect sensors to detect the user's Golf swing actions and to interact with iDTV. An application server is with Intelligent Golf Swing Posture Analysis…Model (iGoSPAM) to check a user's Golf swing actions and to alter this user when he is with error actions. Cloud-based Digital Convergence Server is with Ontology-oriented Clustering Case-based Reasoning (CBR) for Quality of Experiences (OCC4QoE), which is designed to provide QoE services by QoE-based Ontology strategies, rules and events for this user. Furthermore, GoSIDE will automatically trigger OCC4QoE and deliver popular rules for a new user. Experiment results illustrate that GoSIDE can provide appropriate detections for Golfers. Finally, GoSIDE can be a reference model for researchers and engineers.
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Keywords: Open service platform, ontology, case-based reasoning, quality of experience, Golf swing
Abstract: In lighting application, the color mixing of the RGB LEDs can provide more color selection in correlated color temperature and color rendering. Therefore, the purpose of this study is to propose a RGB color mixing mechanism by applying the mechanism design. Three sets of lamp-type RGB LEDs are individually installed on three four-bar linkages. A crank is used to drive three groups of RGB LEDs lamp-type to project lights onto a single plane in order to mix the lights. And, simulations of the illuminance and associated color temperatures are conducted by changing the distance to the projection plane, under the…assumption that the stability of the color temperature of the projected light does not change according to the projecting height. Thus, the effect of change in the color temperature on color determination by the humans' eyes was avoided. The success of the proposed method will allow medical personnel to choose suitable wavelengths and color temperatures according to the particular requirements of their medical-examination environments.
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Keywords: Color temperature, RGB LEDs color mixing, illuminance, projection distance, mechanism design
Abstract: The application of information technology in health education plan in Taiwan has existed for a long time. The purpose of this study is to explore the relationship between information technology application in health education and patients' preoperative knowledge by synthesizing existing researches that compare the effectiveness of information technology application and traditional instruction in the health education plan. In spite of claims regarding the potential benefits of using information technology in health education plan, results of previous researches were conflicting. This study is carried out to examine the effectiveness of information technology by using network meta-analysis, which is a statistical…analysis of separate but similar studies in order to test the pooled data for statistical significance. Information technology application in health education discussed in this study include interactive technology therapy (person-computer), group interactive technology therapy (person-person), multimedia technology therapy and video therapy. The result has shown that group interactive technology therapy is the most effective, followed by interactive technology therapy. And these four therapies of information technology are all superior to the traditional health education plan (leaflet therapy).
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Keywords: Health education plan, healthcare, patients' knowledge, network meta-analysis
Abstract: The aim of this study was to discuss the Research of Community Tai Chi Chuan Participants' Leisure Benefits and Well-being. A questionnaire survey was conducted on the community Tai Chi Chuan participants in Taoyuan city. A total of 500 valid questionnaires were retrieved, and the data were analyzed with SPSS 12.0 and AMOS 7.0 structural equation model analysis (SEM). The findings were as followed: 1) The background variables of the community Tai Chi Chuan participants in Taoyuan City: Gender had no difference in the factor of ``psychological benefit'' of leisure benefits. Occupation, age, education, the number of times a week…to participate community Tai Chi Chuan and participation in seniority reached significant difference in leisure benefits. 2) The background variables of the community Tai Chi Chuan participants in Taoyuan City: gender, occupation, age, education, the number of times a week to participate community Tai Chi Chuan, participation in seniority reached significant difference in well-being. 3) The study showed community Tai Chi Chuan participants' leisure benefits had a significant positive correlation in well-being. Based on the findings, suggestions were proposed to related Taiwan Tai Chi Chuan promotion for reference.
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Keywords: Community, Tai Chi Chuan, leisure benefits, well-being
Abstract: The study explores the perceptions of physicians and hospital managers regarding the key success factors (KSFs) of a clinical knowledge management system (CKMS). It aims to eliminate the perception gap and gain more insights for a successful CKMS. A survey was conducted in four medical centers in Taiwan. A total of 340 questionnaires, including 15 for hospital managers and 70 for physicians in each hospital, were administered. The effective response rates are 78.3% and 56.1% respectively. Partial least square (PLS) were used to analyze the data. The results identified six KSFs of CKMS including system software and hardware,…knowledge quality, system quality, organizational factors, user satisfaction, and policy factors. User satisfaction and policy factors have direct effects on perceived CKMS performance. Knowledge quality is regarded as an antecedent to user satisfaction, while system quality is the antecedent to both user satisfaction and policy factors. System software and hardware was supported only by managers, and organizational factors were supported only by physicians. Among the factors, this study highlighted the policy factor. Besides, the study provides hospital managers additional insights into physician requirements for organizational support. Third, more physician participation and involvement are recommended when introducing and developing a CKMS.
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Keywords: Clinical knowledge management system (CKMS), key success factors (KSFs), partial least squares (PLS)
Abstract: This paper proposes body posture recognition and turning recording system for assisting the care of bed bound patients in nursing homes. The system continuously detects the patient's body posture and records the length of time for each body posture. If the patient remains in the same body posture long enough to develop pressure ulcers, the system notifies caregivers to change the patient's body posture. The objective of recording is to provide the log of body turning for querying of patients' family members. In order to accurately detect patient's body posture, we developed a novel pressure sensing pad which…contains force sensing resistor sensors. Based on the proposed pressure sensing pad, we developed a bed posture recognition module which includes a bed posture recognition algorithm. The algorithm is based on fuzzy theory. The body posture recognition algorithm can detect the patient's bed posture whether it is right lateral decubitus, left lateral decubitus, or supine. The detected information of patient's body posture can be then transmitted to the server of healthcare center by the communication module to perform the functions of recording and notification. Experimental results showed that the average posture recognition accuracy for our proposed module is 92%.
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Keywords: Bed sensing, force sensing resistor, body posture, posture recognition, healthcare
Abstract: BACKGROUND: Computerized acoustic voice measurement is essential for the diagnosis of vocal pathologies. Previous studies showed that ambient noises have significant influences on the accuracy of voice quality assessment. OBJECTIVE: This paper presents a voice quality assessment system that can accurately measure qualities of voice signals, even though the input voice data are contaminated by low-frequency noises. METHODS: The ambient noises in our living rooms and laboratories are collected and the frequencies of these noises are analyzed. Based on the analysis, a filter is designed to reduce noise level of the input…voice signal. Then, improved numerical algorithms are employed to extract voice parameters from the voice signal to reveal the health of the voice signal. RESULTS: Compared with MDVP and Praat, the proposed method outperforms these two widely used programs in measuring fundamental frequency and harmonic-to-noise ratio, and its performance is comparable to these two famous programs in computing jitter and shimmer. CONCLUSIONS: The proposed voice quality assessment method is resistant to low-frequency noises and it can measure human voice quality in environments filled with noises from air-conditioners, ceiling fans and cooling fans of computers.
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Keywords: Human voice assessment, noise reduction, home-based medical caring system
Abstract: The purpose of this study was to construct the quality indicators of professional competence for exercise instructors of the elderly, and then to rank the importance among those indicators. This study used the Delphi technique to integrate the opinions of 11 experts to construct the indicators, and then adopts the analytic hierarchy process (AHP) to calculate the relative rank among each individual indicator. Results revealed that the experts identified 3 first-degree indicators (professional attitude, professional skills, and professional knowledge), 10 second-degree indicators (teaching attitude, exercise knowledge, professional growth, exercise safety, personal characteristics, exercise instructor, gerontology knowledge, communicative competence, curriculum design,…and motor skill), and 72 third-degree indicators. In the indicator weighting system, professional attitude was the most important among all other first-degree indicators, and the teaching attitude was the most important among all other second-degree indicators. The results provided will help in planning the curriculums of training, professional growth and evaluation. The results also provide a reference for future research.
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Keywords: Elderly people, professional growth, Delphi technique, analytic hierarchy process (AHP)
Abstract: Dementia is a syndrome characterized by the progressive decline in cognitive function and memory that impairs a person's ability to function normally. Although dementia mainly affects older people, it is not a normal part of aging. The population of Taiwan is experiencing a multi-decade ageing trend and regrettably the absolute numbers of people with dementia is also rapidly rising. In 2008, the Taiwan Government initiated a ``Ten-Year Long-term Care Plan'' to categorize dementia's disability and severity, and it evaluates access to home care, respite care services, daycare or home nursing care. This review figure out the features of the features…of ``Taiwan Dementia Policy: A Framework for Prevention and Care'' and discuss care pathway network as a guideline for people with dementia in Taiwan. The expectation is for many Taiwanese providers and patients in need simply don't know what services are available or how to access them. A properly designed dementia website could be one such effective tool to meet this need. There is an ongoing risk that future resources allocated will not reach the intended individuals unless this implementation problem is addressed urgently.
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Keywords: Dementia, care pathway, lasting power of attorney
Abstract: The phenomenon of aging populations has produced widespread health awareness and magnified the need for improved medical quality and technologies. Statistics show that ischemic heart disease is the leading cause of death for older people and people with reduced mobility; therefore, wheelchairs have become their primary means of transport. Hence, an arrhythmia-detecting smart wheelchair was proposed in this study to provide real-time electrocardiography (ECG)-monitoring to patients with heart disease and reduced mobility. A self-developed, handheld ECG-sensing instrument was integrated with a wheelchair and a lab-written, arrhythmia-detecting program. The measured ECG data were transmitted through a Wi-Fi module and analyzed and…diagnosed using the human-machine interface.
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Abstract: In recent years, positron emission tomography imaging (PET) and Computed tomography (CT) fusion images can be observed metabolic information, they can get a more accurate spatial information. People have to construct 3D models in the first place when they try to examine images from different angles. Once a cross-section which we want to inspect has been revealed, it can be observed from any angles. However, a issue people encounter in above-mentioned procedures is that they have to either process images fusion at the beginning and then reconstruct the 3D models with these images to generate section or rebuilt the 3D…models with these images and fuse section images as the second step. The main objective of this research is to discriminate the divergences and merits between two types of procedures.This research discovers that two different procedures will exactly bring about dissimilar types of images. Therefore, this research particularly aims at the analysis of two images and evaluates the extent of fringe and remaining information. We calculates entropy and standard deviation of the images. Nevertheless, finding section on 3D models first and fusing images secondly will generate the images which retain more information.
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Abstract: It was noted worldwide while learning fundamental skills and facing skills assessments, nursing students seemed to experience low confidence and high anxiety levels. Could simulation-based learning help to enhance students' self-efficacy and performance? Its effectiveness is mostly unidentified. This study was conducted to provide a shared experience to give nurse educators confidence and an insight into how simulation-based teaching can fit into nursing skills learning. A pilot study was completed with 50 second-year undergraduate nursing students, and the main study included 98 students where a pretest-posttest design was adopted. Data were gathered through four questionnaires and a performance assessment under…scrutinized controls such as previous experiences, lecturers' teaching skills, duration of teaching, procedure of skills performance assessment and the inter-rater reliability. The results showed that simulation-based learning significantly improved students' self-efficacy regarding skills learning and the skills performance that nurse educators wish students to acquire. However, technology anxiety, examiners' critical attitudes towards students' performance and their unpredicted verbal and non-verbal expressions, have been found as possible confounding factors. The simulation-based learning proved to have a powerful positive effect on students' achievement outcomes. Nursing skills learning is one area that can benefit greatly from this kind of teaching and learning method.
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Keywords: Self-efficacy, fundamental nursing skills, simulation-based learning
Abstract: Comorbidities are the presence of one or more additional disorders or diseases co-occurring with a primary disease or disorder. The purpose of this study is to identify diseases that co-occur with HIV/AIDS and analyze the gender differences. Data was collected from 536 HIV/AIDS outpatient department medical records out of 1,377,469 outpatient department medical records from 1997 to 2010 in Taiwan. In this study, the comorbidity relationships are presented in the phenotypic disease network (PDN), and ϕ -correlation is used to measure the distance between two diseases on the network.
Abstract: Physical fitness and health of white collar business person is getting worse and worse in recent years. Therefore, it is necessary to develop a system which can enhance physical fitness and health for people. Although the exercise prescription can be generated after diagnosing for customized physical fitness and healthcare. It is hard to meet individual execution needs for general scheduling of physical fitness and healthcare system. So the main purpose of this research is to develop an intelligent scheduling of execution for customized physical fitness and healthcare system. The results of diagnosis and prescription for customized physical fitness and healthcare…system will be generated by fuzzy logic Inference. Then the results of diagnosis and prescription for customized physical fitness and healthcare system will be scheduled and executed by intelligent computing. The scheduling of execution is generated by using genetic algorithm method. It will improve traditional scheduling of exercise prescription for physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent scheduling of execution for customized physical fitness and healthcare system.
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Abstract: This paper presents the time sequence image analysis technique of positron emission tomography (PET) using a wavelet transformation method. The abdominal cavity of a person taking [18 F]Fluoro-2-deoxy-2-D-glucose (18 F-FDG) was scanned by the dynamic PET. The organ selection with dynamic PET images was conducted by the wavelet transformation to implement automatic selection of the region of interest (ROI). The image segmentation was carried out by the processes of sampling, wavelet transformation, erosion, dilation, and superimposition. Wavelet constructed image (WCI) contours were created by sampling 512 images from 1960 consecutive dynamic sequence PET images. The image segmentation technology developed can…help doctors automatically select ROI, accurately identify lesion locations of organs, and thus effectively reduce human operation time and errors.
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Keywords: Image segmentation, positron emission tomography (PET), region of interest (ROI), wavelet transformation
Abstract: The research aimed to develop a nursing information system in order to simplify the admission procedure for caring clinical in-patient, enhance the efficiency of medical information documentation. Therefore, by correctly delivering patients' health records, and providing continues care, patient safety and care quality would be effectively improved. The study method was to apply Spiral Model development system to compose a nursing information team. By using strategies of data collection, working environment observation, applying use-case modeling, and conferences of Joint Application Design (JAD) to complete the system requirement analysis and design. The Admission Care Management Information System (ACMIS) mainly included: (1)…Admission nursing management information system. (2) Inter-shift meeting information management system. (3) The linkage of drug management system and physical examination record system. The framework contained qualitative and quantitative components that provided both formative and summative elements of the evaluation. System evaluation was to apply information success model, and developed questionnaire of consisting nurses' acceptance and satisfaction. The results of questionnaires were users' satisfaction, the perceived self-involvement, age and information quality were positively to personal and organizational effectiveness. According to the results of this study, the Admission Care Management Information System was practical to simplifying clinic working procedure and effective in communicating and documenting admission medical information.
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Keywords: Satisfaction, admission care, nursing information system
Abstract: In recent years, it is quite important to develop a customized system which can enhance physical fitness and health for people. And the system reliability is more important. In the paper, a fool-proofing design and crisis management for customized physical fitness and healthcare system is proposed. It is designed to prevent the failure of the various mechanisms of customized physical fitness and healthcare system, including records, surveillance, assessments, predictions, diagnosis, prescription, and scheduling. It is separated into (1) fool-proofing design module (2) crisis management module. The fool-proofing indexes are set to prevent the failure of the various mechanisms. The states…of the various mechanisms are managed by the auto-checked fool-proofing indexes. If mistakes prevention was fail, we have to execute the crisis management for stopping harmful results. The crisis management will find the error level and response the solution by using fuzzy method. By the experiments, we can find the advantages of the fool-proofing design and crisis management for customized physical fitness and healthcare system. And it is effective to prevent the failure of the various mechanisms of intelligent customized physical fitness and healthcare system.
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Abstract: RNA interference (RNAi) employs double-stranded RNA or siRNA (small interfering RNA) to silence gene expression in cells. The widespread use of RNAi therapeutics requires the development of clinically suitable, safe and effective delivery vehicles. PEI (Poly(ethylene imine)) carrying the positive charges has attracted considerable attention for siRNA delivery. Gold nanorods (GNRs) exhibit specially localized surface plasmon resonance when excited by the visible and near-infrared laser, which is useful for photothermal therapy. However, the toxicity derived from a large amount of the surfactant cetyltrimethylammonium bromide (CTAB) during GNR synthesis severely limits their medical applications. Here, we report the synthesis of GNRs-PEI/GNRs-PEI-folate…to improve biocompatibility, siRNA delivery and photothermal therapy of GNRs. Firstly, GNRs were synthesized according to the seed-mediated template-assisted protocol. The characterization results of GNRs showed: the size was length about 218 nm and width about 26.8 nm; the Zeta potential was +38.1 mV derived from CTAB on their surface; the dipole resonance extinction spectrum peak was 752 nm which is effective for photothermal therapy in vivo. Secondly, we synthesized PEI-MUA (Mercaptoundecanoic acid) and PEI-MUA-folate based on the chemical reaction between amino group of PEI and carboxyl group of MUA or Folate. PEI-MUA or PEI-MUA-folate to replace CTAB on GNRs obtained the GNRs-MUA-PEI system or the GNRs-MUA-PEI-folate system due to the solid conjugation between the thiol group of MUA and GNRs. The products were measured using the FTIR Spectrometer, and the spectra suggest MUA-PEI or PEI-MUA-folate has successfully replaced CTAB on the surface of GNRs. Finally, GNRs-MUA-PEI was incubated with siRNA-Cy3. The unbound siRNA-Cy3 was measured the intensity of fluorescence for calculating the uploaded amount of siRNA by GNRs-MUA-PEI, and the results indicate that the uploaded percentage of siRNA is about 70%. We conclude that the GNRs-MUA-PEI system is an effective siRNA loading vehicle.
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