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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: Wearable healthcare systems require measurements from electrocardiograms (ECGs) and photoplethysmograms (PPGs), and the blood pressure of the user. The pulse transit time (PTT) can be calculated by measuring the ECG and PPG simultaneously. Continuous-time blood pressure without using an air cuff can be estimated by using the PTT. OBJECTIVE: This paper presents a biosignal acquisition integrated circuit (IC) that can simultaneously measure the ECG and PPG for wearable healthcare applications. METHODS: Included in this biosignal acquisition circuit are a voltage mode instrumentation amplifier (IA) for ECG acquisition and a current mode transimpedance…amplifier for PPG acquisition. The analog outputs from the ECG and PPG channels are muxed and converted to digital signals using 12-bit successive approximation register (SAR) analog-to-digital converter (ADC). RESULTS: The proposed IC is fabricated by using a standard 0.18 μ m CMOS process with an active area of 14.44 mm 2 . The total current consumption for the multichannel IC is 327 μ A with a 3.3 V supply. The measured input referred noise of ECG readout channel is 1.3 μ V RMS with a bandwidth of 0.5 Hz to 100 Hz. And the measured input referred current noise of the PPG readout channel is 0.122 nA/√ Hz with a bandwidth of 0.5 Hz to 100 Hz. CONCLUSIONS: The proposed IC, which is implemented using various circuit techniques, can measure ECG and PPG signals simultaneously to calculate the PTT for wearable healthcare applications.
Abstract: BACKGROUND: Typical radio frequency identification (RFID) access control system can be ineffective if an unauthorized person tailgates an authorized person through an access area. OBJECTIVE: To propose a system by using indoor locating and tracking techniques address this problem, which is to prevent unauthorized Alzheimer’s and dementia patients from getting lost including by tailgating. METHODS: To achieve accurate target location, passive RFID deployment strategy is studied and a fingerprinting based passive RFID localization algorithm is proposed. The proposed system was evaluated in a building environment to simulate the performance of access control. RFID…reader was installed on ceiling near the access area and tags were stitched on both shoulders of the experiment subject’s garments. RESULTS: The probability of the error distance within 0.3 m achieved 97% in the warning area; the location precision achieved 97% within 0.4 m in the monitoring area. CONCLUSIONS: The result showed that if an unauthorized person enters the restricted area, the system can initiate an alert signal accurately. Therefore, the proposed system is very suitable to be used in nursing home or hospital to prevent unauthorized personnel and assets entering/exiting a confined location.
Keywords: Indoor location, access control, passive RFID
Abstract: BACKGROUND: Effective neurological rehabilitation requires long term assessment and treatment. The rapid progress of virtual reality-based assistive technologies and tele-rehabilitation has increased the potential for self-rehabilitation of various neurological injuries under clinical supervision. OBJECTIVE: The objective of this study was to develop a fuzzy inference mechanism for a smart mobile computing system designed to support in-home rehabilitation of patients with neurological injury in the hand by providing an objective means of self-assessment. METHODS: A commercially available tablet computer equipped with a Bluetooth motion sensor was integrated in a splint to obtain a smart…assistive device for collecting hand motion data, including writing performance and the corresponding grasp force. A virtual reality game was also embedded in the smart splint to support hand rehabilitation. Quantitative data obtained during the rehabilitation process were modeled by fuzzy logic. Finally, the improvement in hand function was quantified with a fuzzy rule database of expert opinion and experience. RESULTS: Experiments in chronic stroke patients showed that the proposed system is applicable for supporting in-home hand rehabilitation. CONCLUSIONS: The proposed virtual reality system can be customized for specific therapeutic purposes. Commercial development of the system could immediately provide stroke patients with an effective in-home rehabilitation therapy for improving hand problems.
Keywords: Hand rehabilitation, neurological patient, fuzzy logic, intelligent system
Abstract: BACKGROUND: Local hospitals must deal with large numbers of patients during mass casualty incidents, and the wireless sensor networks (WSNs) can help in these situations by monitoring vital signs. Conventional ZigBee nodes can obtain the ID of a device by assigning a unique 16-bit short address or by burning firmware into an IC. These methods tend to complicate node management and lack portability. OBJECTIVE: The study developed a node management mechanism to deal with a large number of patients in real-time, through the wireless monitoring of physiological signals. The mechanism proposed for the ZigBee WSN is…based on a three-layer (Coordinator, Control Router, and End Device) tree topology. METHODS: The proposed system includes a node deployment process to formulate a ZigBee WSN as a tree topology, an algorithm to automatically number ZigBee nodes for monitoring and control system (MCS) , and an algorithm to automatically obtain the short addresses of nodes for data collection. Specifically, an algorithm automatically collects data from ZigBee nodes for display on a computer graphical user interface (GUI) . We also developed a reliable data transmission method capable of resolving the problem of packet loss. RESULTS: The proposed method has been applied in a local hospital. Our research findings provide a valuable reference for the development of ZigBee-based MCS . CONCLUSIONS: The proposed node management mechanism is faster, more reliable, and more intuitive to use, than traditional methods.
Keywords: ZigBee WSN, Mass casualty incidents, systematic node management, large number of patients, monitoring GUI, reliable data transmission
Abstract: BACKGROUND: Collisions between emergency vehicles for emergency medical services (EMS) and public road users have been a serious problem, impacting on the safety of road users, emergency medical technicians (EMTs), and the patients on board. OBJECTIVE: The aim of this study is to develop a novel intelligent emergency vehicle warning system for EMS applications. METHODS: The intelligent emergency vehicle warning system is developed by Internet of Things (IoT), radio-frequency identification (RFID), and Wi-Fi technologies. RESULTS: The system consists of three major parts: a system trigger tag, an RFID system in…an emergency vehicle, and an RFID system at an intersection. The RFID system either in an emergency vehicle or at an intersection contains a controller, an ultrahigh-frequency (UHF) RFID reader module, a Wi-Fi module, and a 2.4-GHz antenna. In addition, a UHF ID antenna is especially designed for the RFID system in an emergency vehicle. The IoT system provides real-time visual warning at an intersection and siren warning from an emergency vehicle in order to effectively inform road users about an emergency vehicle approaching. CONCLUSION: The developed intelligent IoT emergency vehicle warning system demonstrates the capabilities of real-time visual and siren warnings for EMS safety.
Keywords: Emergency medical service (EMS), emergency vehicle, Internet of Things (IoT), radio-frequency identification (RFID), Wi-Fi
Abstract: BACKGROUND: Information and communications technology has attracted attention as a useful way of sharing care records in community-based care. Such information sharing systems, however, imposed the burden of inputting the same records into different information systems due to a lack of interoperability of the systems. OBJECTIVES: The purpose of this study was to develop a gateway that links information systems and to investigate the functionality and usability of the gateway through an empirical study. METHODS: We developed a gateway with healthcare and welfare professionals in Kashiwa city, Japan. The gateway system consisted of…two sub-systems: a data exchange sub-system and a common sub-system. Regarding the security, we used the transport layer security 1.2 and a public key infrastructure. For document formats, we utilized the health level seven international, extensible markup language, and portable document format. In addition, we performed an empirical study with 11 scenarios of four simulated patients and a questionnaire survey to the professionals. RESULTS: Professionals of eight occupations participated the empirical study and verified the gateway to link information systems of six vendors. For a questionnaire survey, 32 professionals out of 40 reported that the gateway would eliminate the burden of inputting the same records into different information systems.
Keywords: Health information system, electronic health record, community network, home care service, long-term care
Abstract: BACKGROUND: Survival rates of out-of-hospital cardiac arrest remain poor. Bystander cardiopulmonary resuscitation (CPR) is crucial for survival and feedback devices could improve its quality. OBJECTIVE: We investigated the quality of chest compression when using the Cardio First Angel TM (CFA) feedback device compared to standard basic life support (BLS). The analysis focused on laymen. METHODS: Laymen without (n = 43) and with (n = 96) explanation of the device, medical students (n = 128)…and medical staff (n = 27) performed 60 seconds of standard versus assisted chest compression using the CFA on a resuscitation manikin. Compression frequency, depth and position were analyzed according to current guidelines. RESULTS: Laymen showed significantly better success rates regarding correct compression depth when using the CFA (23.3% vs. 55.8%, p = 0.004 and 25.0% vs. 52.1%, p < 0.001, laymen without and with explanation of the device, respectively). Medical students likewise improved (22.7% vs. 42.2%, p = 0.004). Hand positioning was 100% correct in all groups with the device. Improvement in frequency yielded by the CFA was more pronounced for probands with fears of contact (p = 0.02). The benefit of using the device did not differ significantly in laymen with or without explanation. CONCLUSIONS: Chest compression as performed by laymen was significantly improved with regard to compression depth when using the CFA for guidance and feedback. With the device, no cases of incorrect hand positioning occurred in any group.
Abstract: OBJECTIVES: This research assesses the use of Radio Frequency Identification (RFID) technologies as an alternative for insurance costs in hospitals. METHODS: Despite the advantages of RFID, this technology has not been applied in most hospitals due to implementation costs and amortization of RFID. In this paper, we intend to model the total profit of hospitals in three scenarios namely, application of RFID technology in the hospital, without applying RFID technology in the hospital and insuring patients and equipment in the hospital. RESULTS: We analyzed the aforementioned situations over a period of time to…find out how they affect the profit of the hospital. Based on this analysis we concluded that if applying RFID technology is costly, it will be feasible for advanced hospitals with more beds. In the scenario of insuring patients and equipment, if insurance organization takes over a small portion of the cost of the mistakes and oversights, insuring patients and equipment will not be feasible for the hospital, and it is better to apply RFID technology Instead. CONCLUSIONS: RFID is among the technologies applied to reduce mistakes of the personnel in hospitals. Moreover, applying this technology has led to a decrease in the number of personnel required in hospitals. This study models total profit of hospitals in three aforementioned scenarios. Based on analyzing these models we conclude that if applying RFID technology is costly, it will be feasible for advanced hospitals with more beds.
Keywords: Radio Frequency Identification, health care system, insurance, economic evaluation (cost-effectiveness)
Abstract: BACKGROUND: HL-60 cells have been used in in vitro experiments of neutrophils rolling. They lose uniform spherical appearance and enhance deformability by differentiation to neutrophil-like cells, which would affect their rolling characteristics. OBJECTIVE: We investigate the influence of differentiation and coating of target substrate on the fundamental rolling characteristics of the cells under a constant pressing force which mimics the pressing force to the vessel wall by erythrocytes in vivo . METHODS: Motions of undifferentiated and differentiated HL-60 cells on plain or MPC-polymer-coated flat glass substrate were compared using a homemade inclined…centrifuge microscope system. RESULTS: Most of the cells alternated between stop and go during the motion. The differentiation resulted in a high temporal ratio of the non-moving state and low mean velocity during the moving state, together with a high suppression performance of cell adhesion by the polymer. It was also suggested that the cells were mostly rolling but that the coating probably induced an infrequent slip on the substrate to stabilize the cells motion. CONCLUSIONS: Differentiation strongly affects adhesivity of HL-60 cells but less affects the mean velocity. Our findings also demonstrate the importance of the pressing force and advantage of the present system with respect to classical flow chambers.