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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: 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Keywords: Heart attack, vulnerable plaque, fibrous cap stresses, nitinol stent, finite element analysis