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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: 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.
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.
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.
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.
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).
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.
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.
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%.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Abstract: Long-term care (LTC) for the elderly has become extremely important in recent years. It is necessary for the different physiological monitoring systems to be integrated on the same interface to help oversee and manage the elderly's needs. This paper presents a novel health monitoring system for LTC services using radio-frequency identification (RFID) technology. Dual-band RFID protocols were included in the system, in which the high-frequency (HF) band of 13.56 MHz was used to identify individuals and the microwave band of 2.45 GHz was used to monitor physiological information. Distinct physiological data, including oxyhemoglobin saturation by pulse oximetry (SpO2 ), blood…pressure, blood sugar, electrocardiogram (ECG) readings, body temperature, and respiration rate, were monitored by various biosensors. The intelligent RFID health monitoring system provided the features of the real-time acquisition of biomedical signals and the identification of personal information pertaining to the elderly and patients in nursing homes.
Keywords: Radio frequency identification (RFID), tag, reader, health monitoring, long-term care (LTC)