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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: New technology should be extensively tested before it is tried on patients. Unfortunately representative models are lacking. In theory, fresh frozen human cadavers are excellent models. OBJECTIVE: To identify strengths and weaknesses of fresh frozen human cadavers as research models for new technology prior to implementation in gynecological surgery. METHODS: During pre-clinical validation studies regarding the MobiSep uterine manipulator, test procedures were performed on fresh frozen cadavers. Both the experimental setup as the performance of the prototype were assessed. RESULTS: Five tests including six human cadavers were performed. Major…changes were made to the MobiSep prototype design. The cadavers of two tests closely resembled surgical experiences as found in live patients. The anatomy of 4 of the 6 cadavers was not fully representative due to atrophy of the internal genitalia caused by age and due to the presence of pathology such extensive tumorous tissue. CONCLUSION: The cadaver tests provided vital information regarding design and functionality, that failed to emerge during the in-vitro testing. However, experiments are subject to anatomical uncertainties or restrictions. Consequently, the suitability of a cadaver should be carefully assessed before it is used for testing new technology.
Keywords: Laparoscopy, hysterectomy, technology, medical devices, innovation
Abstract: BACKGROUND: Measuring portal venous pressure is necessary to examine, diagnose, and treat portal hypertension, but current methods are invasive. OBJECTIVE: This study aimed to determine whether a noninvasive peripheral blood measurement could be used to estimate portal venous pressure by investigating correlations between certain physical parameter measurements in the peripheral blood with those obtained in portal blood samples. METHODS: A total of 128 peripheral and portal blood samples from patients (n = 128) were analyzed for blood rheology and routine blood parameters. RESULTS: The mean…peripheral and portal whole blood viscosities under the shear rates of 200 s - 1 (BV 200 s - 1 ) were 2.97 ± 0.50 mPa.s and 3.06 ± 0.39 mPa.s. The mean peripheral and portal BV 30 s - 1 values were 3.96 ± 0.79 mPa.s and 4.16 ± 0.64 mPa.s. We observed strong correlations between peripheral and portal blood measurements of BV 200 s - 1 (r 2 = 0.9649), BV 30 s - 1 (r 2 = 0.9622), BV 5 s - 1 (r 2 = 0.9610), and BV 1 s - 1 (r 2 = 0.9623). CONCLUSIONS: Our results indicate that peripheral blood can be used to evaluate certain parameters in portal blood for use in biofluid mechanics studies, and to provide noninvasive measurement of portal venous pressure.
Abstract: BACKGROUND: Smartphone sensors are underutilised in rehabilitation. OBJECTIVE: To validate the step count algorithm used in the STARFISH smartphone application. METHODS: Twenty-two healthy adults (8 male, 14 female) walked on a treadmill for 5 minutes at 0.44, 0.67, 0.90 and 1.33 m⋅ s - 1 . Each wore an activPAL TM and four Samsung Galaxy S3 TM…smartphones, with the STARFISH application running, in: 1) a belt carrycase, 2) a trouser or skirt pocket), 3a) a handbag on shoulder for females or 3b) shirt pocket for males and 4) an upper arm strap. Step counts of the STARFISH application and the activPAL TM were compared at corresponding speeds and Bland-Altman statistics used to assess level of agreement (LOA). RESULTS: The LOA between the STARFISH application and activPAL TM varied across the four speeds and positions, but improved as speed increased. The LOA ranged from 105–177% at 0.44 m⋅ s - 1 ; 50–98% at 0.67 m⋅ s - 1 ; 19–67% at 0.9 m⋅ s - 1 and 8–53% at 1.33 m⋅ s - 1 . The best LOAs were at 1.33 m⋅ s - 1 in the shirt pocket (8%) and upper arm strap (12%) positions. CONCLUSIONS: Step counts measured by the STARFISH smartphone application are valid in most body positions especially at walking speeds of 0.9 m⋅ s - 1 and above.
Abstract: BACKGROUND: A major problem associated with distraction osteogenesis is the long time required for consolidation. OBJECTIVE: The goal of this study was to determine whether a percutaneous injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a Gelfoam carrier would enhance bone consolidation following distraction. METHODS: A unilateral tibial osteotomy combined with external stabilization was performed in 14 adult sheep. After a latency of four days, distraction was performed at 1.25 millimetres per day for 20 days. On days 23 and 30, the sheep received an injection of rhBMP-2/Gelfoam or buffer/Gelfoam. During the following…50 days, radiographs and in vivo torsional stiffness measurements were obtained weekly. The effect of rhBMP-2 treatment post-mortem was assessed using destructive biomechanical testing, quantitative CT and DXA analysis. RESULTS: The in vivo stiffness measurements of the sheep treated with rhBMP-2 were significantly higher than those of the carrier control group (p < 0.05). These in vivo data were verified by post-mortem biomechanical testing and quantitative CT analysis. The maximum torsional moment observed was 55% greater in the sheep treated with rhBMP-2. CONCLUSIONS: These data support the potential use of rhBMP-2 in an injectable carrier for enhancing consolidation, as it may ultimately lead to shorter treatment times for patients undergoing distraction procedures.
Keywords: BMP, bone consolidation, distraction osteogenesis, gelfoam, growth factor
Abstract: In psychiatry, mindfulness based intervention has been increasingly popular as a means of psychosocial intervention over the last decade. With the alvanche of technological advances, there has been a myriad of mindfulness based applications. Recent reviews have highlighted how these applications are lacking in functionalities and without demonstrated efficacy. Other reviews have emphasized that there is a need to take into consideration the design of an application, due to placebo effects. It is the aim of this technical note to illustrate how the 5-Minutes Mindfulness application, which is an application designed to provide mindfulness exercises to relieve distress and suffering…amongst palliative patients, have been conceptualized. The conceptualized application builds on previous evidence of the efficacy of 5-Minutes Mindfulness demonstrated by pilot and randomized trials. In terms of design, the currently conceptualized application has been designed such that placebo effects could be controlled for.
Keywords: Mindfulness, smartphone, palliative care
Abstract: People residing in rural and remote areas (worldwide) have substantially worse outcome in early detection and diagnosis of glaucoma than those living in metropolitan areas. This gap can be reduced by improved glaucoma diagnosis activities in primary care, but there is little empirical evidence regarding use of tonometry in rural settings, or the expertise associated with quality of eye care. This article describes a feasibility study of a novel through-eyelid tonometer based on the use of an instrumented form of indentation and applanation tonometry.
Abstract: BACKGROUND: Poor fine motor skills are common among chronic stroke patients. Conventional rehabilitation programs only emphasize intensive and repeated exercises that do not motivate patients to continue rehabilitation. Using a vibrotactile glove rehabilitation system with a human-computer interaction interface can therefore resolve this issue. OBJECTIVE: The objective of this study was to examine the potential benefits of this vibrotactile glove rehabilitation system for chronic stroke patients who have already reached the recovery plateau. METHODS: Two interesting computer games were designed to coordinate with the vibrotactile gloves in patient training. The training sessions lasted…for about 30 minutes twice a week for five consecutive weeks. We compared finger ROM, grip strength, pinch strength, NHPT, and MHQ results before and after the intervention and surveyed subject satisfaction afterwards. RESULTS: The subjects showed slight improvements in muscle strength and hand after five weeks. The patients reported progress, but the differences did not reach statistical significance. In the satisfaction questionnaire, the subjects gave positive ratings. CONCLUSIONS: This vibrotactile glove rehabilitation system has the potential to help chronic stroke patients who have reached their recovery plateau to make progress and is clinically quite effective in increasing their motivation.
Keywords: Motor recovery, hemiparesis, vibrotactivel glove
Abstract: Wireless body area network (WBAN) is a breakthrough technology in healthcare areas such as hospital and telemedicine. The human body has a complex mixture of different tissues. It is expected that the nature of propagation of electromagnetic signals is distinct in each of these tissues. This forms the base for the WBAN, which is different from other environments. In this paper, the knowledge of Ultra Wide Band (UWB) channel is explored in the WBAN (IEEE 802.15.6) system. The measurements of parameters in frequency range from 3.1–10.6 GHz are taken. The proposed system, transmits data up to 480 Mbps by using…LDPC coded APSK Modulated Differential Space-Time-Frequency Coded MB-OFDM to increase the throughput and power efficiency.
Keywords: Low Density Parity Check (LDPC), Amplitude Phase Shift Key (APSK), orthogonal frequency-division multiplexing (OFDM), ultra-wideband (UWB), differential space-time-frequency codes (DSTFC), wireless body area network (WBAN)
Abstract: OBJECTIVE: This study proposed a method of using a modified micro-bubble generator with its ejection nozzle connected to an ergonomically designed soft teeth-tray for plaque removal. The applicability of this method was verified and the influence on plaque removal efficacy of some parameters of this device was clarified. METHODS: The micro-bubble generator used in this study has 5 rotation speed settings, 5 nozzle sizes, and a soft teeth-tray ejection pore diameters. These were used as independent variables to investigate their effect on the ejected flow volume, velocity and micro-bubble dimension, and how they eventually affect the…plaque removal efficacy from a denture. RESULTS: When the micro-bubble generator coupled with large (4.8 mm) ejection pore teeth-tray and the largest (1.2 mm) nozzle diameter more than 98% of plaque can be removed; its applicability on cleaning denture can be verified. In general, the larger nozzle diameter and teeth-tray ejection pore diameter will remove more plaques; while the higher the flow velocity and the smaller the micro-bubble of the ejected stream, better cleaning efficacy can be achieved. CONCLUSION: The application of micro-bubble on plaque removal seems effective, although at this moment it is applied on denture cleaning. The finding of the influence of some critical design parameters of micro-bubble generator and variables of ejected stream can be referred to further design a new micro-bubble cleaner for effective plaque removal from the teeth in human oral cavity.
Keywords: Micro-bubble generator, the soft teeth-tray, dental plaque removal