Technology and Health Care - Volume 26, issue 1

Authors: Brokaw, E.B. | Fine, M.S. | Kindschi, K.E. | Santago II, A.C. | Lum, P.S. | Higgins, M.

Article Type: Research Article

Abstract: BACKGROUND: Repeated mild traumatic brain injury (mTBI) has been associated with increased risk of degenerative neurological disorders. While the effects of mTBI and repeated injury are known, studies have only recently started examining repeated subconcussive impacts, impacts that do not result in a clinically diagnosed mTBI. In these studies, repeated subconcussive impacts have been connected to cognitive performance and brain imaging changes. OBJECTIVE: Recent research suggests that performance on a visuomotor tracking (VMT) task may help improve the identification of mTBI. The goal of this study was to investigate if VMT performance is sensitive to the …cumulative effect of repeated subconcussive head impacts in collegiate men’s lacrosse players. METHODS: A cross-sectional, prospective study was completed with eleven collegiate men’s lacrosse players. Participants wore helmet-mounted sensors and completed VMT and reaction time assessments. The relationship between cumulative impact metrics and VMT metrics were investigated. RESULTS: In this study, VMT performance correlated with repeated subconcussive head impacts; individuals approached clinically diagnosed mTBI-like performance as the cumulative rotational velocity they experienced increased. CONCLUSION: This suggests that repeated subconcussive impacts can result in measurable impairments and indicates that visuomotor tracking performance may be a useful tool for monitoring the effects of repeated subconcussive impacts. Show more

Keywords: Subconcussive, lacrosse, visuomotor tracking, head injury

DOI: 10.3233/THC-171079

Citation: Technology and Health Care, vol. 26, no. 1, pp. 109-118, 2018

Authors: Zhang, Peng | Shi, Yikai | Wang, Wendong | Wang, Yaohui

Article Type: Research Article

Abstract: PURPOSE: To design planar gradient coil for MRI applications without discretization of continuous current density and loop-loop connection errors. METHODS: In the new design method, the coil current is represented using a spiral curve function described by just a few control parameters. Using a proper parametric equation set, an ensemble of spiral contours is reshaped to satisfy the coil design requirements, such as gradient linearity, inductance and shielding. RESULTS: In the given case study, by using the spiral coil design, the magnetic field errors in the imaging area were reduced from 5.19% (non-spiral …design) to 4.47% (spiral design) for the transverse gradient coils, and for the longitudinal gradient coil design, the magnetic field errors were reduced to 5.02% (spiral design). The numerical evaluation shows that when compared with conventional wire loop, the inductance and resistance of spiral coil was reduced by 11.55% and 8.12% for x gradient coil, respectively. CONCLUSION: A novel spiral gradient coil design for biplanar MRI systems, the new design offers better magnetic field gradients, smooth contours than the conventional connected counterpart, which improves manufacturability. Show more

Keywords: Spiral function, gradient coil, discrete wire method, open MRI, magnetic field

DOI: 10.3233/THC-171081

Citation: Technology and Health Care, vol. 26, no. 1, pp. 119-132, 2018

Authors: Cao, Wujing | Yu, Hongliu | Zhao, Weiliang | Li, Jin | Wei, Xiaodong

Article Type: Research Article

Abstract: BACKGROUND: Prosthetic knee is the most important component of lower limb prosthesis. Speed adaptive for prosthetic knee during swing flexion is the key method to realize physiological gait. OBJECTIVE: This study aims to discuss the target of physiological gait, propose a speed adaptive control method during swing flexion and research the damping adjustment law of intelligent hydraulic prosthetic knee. METHODS: According to the physiological gait trials of healthy people, the control target during swing flexion is defined. A new prosthetic knee with fuzzy logical control during swing flexion is designed to realize the …damping adjustment automatically. The function simulation and evaluation system of intelligent knee prosthesis is provided. Speed adaptive control test of the intelligent prosthetic knee in different velocities are researched. RESULTS: The maximum swing flexion of the knee angle is set between sixty degree and seventy degree as the target of physiological gait. Preliminary experimental results demonstrate that the prosthetic knee with fuzzy logical control is able to realize physiological gait under different speeds. The faster the walking, the bigger the valve closure percentage of the hydraulic prosthetic knee. CONCLUSIONS: The proposed fuzzy logical control strategy and intelligent hydraulic prosthetic knee are effective for the amputee to achieve physiological gait. Show more

Keywords: Physiological gait, speed adaptive, prosthetic knee, fuzzy logical control, function simulation and evaluation

DOI: 10.3233/THC-170981

Citation: Technology and Health Care, vol. 26, no. 1, pp. 133-144, 2018

Authors: Zhang, Shuang | Qin, Yu-Ping | Kuang, Jiang-Ming | Liu, Yi-He

Article Type: Research Article

Abstract: BACKGROUND: Osteosarcoma, which is also termed osteogenic sarcoma or osteoma sarcomatosum, is the most common form of bone cancer. Typical osteosarcoma can occur at any age, including in infants, children, and the elderly, but more than half of cases occur in individuals who are 10–20 years old. OBJECTIVE: Here, the objective was to search for protein markers to indicate resistance to cisplatin in osteosarcoma and provide a theoretical basis for the early and accurate use of cisplatin to treat osteosarcoma. METHODS: Thirty patients with osteosarcoma were selected for the study. Experimental studies on the chemosensitivity …of osteosarcoma using an in vitro kit method were performed, and cisplatin-resistant and cisplatin-sensitive osteosarcoma tissues were obtained. A representative sample was chosen to analyze and identify differentially expressed proteins in cisplatin-resistant tissues. RESULTS: The osteosarcoma-sensitive tissue was analyzed using 2-D electrophoresis and time-of-flight mass spectrometry. Differently expressed proteins were analyzed by western blotting to identify markers. Cisplatin-resistant and cisplatin-sensitive osteosarcoma tissues were obtained. Five significantly differentially expressed proteins were identified, including ALDOA and PGK1. CONCLUSIONS: The results indicate that ALDOA and PGK1 might be appropriate markers that can be used when treating osteosarcoma with cisplatin. Show more

Keywords: Osteosarcoma, chemosensitivity, proteomics, cisplatin

DOI: 10.3233/THC-171038

Citation: Technology and Health Care, vol. 26, no. 1, pp. 145-153, 2018

Authors: Kraxenberger, Michael | Schröder, Christian | Geith, Tobias | Büttner, Andreas | von Schulze-Pellengahr, Christoph | Birkenmaier, Christof | Müller, Peter E. | Jansson, Volkmar | Wegener, Bernd

Article Type: Research Article

Abstract: BACKGROUND: Fractured vertebral bodies are a common and wide spread health issue. OBJECTIVE: The purpose of this study was to develop a standardized method to experimentally generate compression fractures in vertebral bodies. The influence of the pedicles has been investigated with regards to the fracture behavior. The correlation between bone mineral density (BMD), the cause of fractures and the fracture behavior was investigated. METHODS: Twenty-one fresh frozen human lumbar spines were examined for bone mineral density (BMD) by means of quantitative computed tomography (qCT). All soft tissue was removed, vertebrae were carefully separated …from each other and the exposed cranial and caudal endplates were covered with a thin layer of resin to generate a plane and homogeneous surface. A total of 80 vertebral bodies were tested until fracture. RESULTS: A good positive correlation was found between BMD, fracture compression force and stiffness of the vertebral body. No significant differences were found between the fractures generated in vertebral bodies with and without pedicles, respectively. CONCLUSIONS: Our model represents a consolidation of already existing testing devices. The comparative measurement of the BMD and the fracture behavior shows validity. In contrast to other authors, the force was applied to the whole vertebral body. Furthermore the upper and lower plates were not parallelized and therefore the natural anatomic shape was imitated. Fracture behavior was not altered by removing the pedicles. Show more

Keywords: Spine, vertebral body, bone mineral density, pedicle, fracture force, osteoporosis

DOI: 10.3233/THC-171086

Citation: Technology and Health Care, vol. 26, no. 1, pp. 155-163, 2018

Authors: Novak, Kamil | Polzer, Stanislav | Bursa, Jiri

Article Type: Research Article

Abstract: In the paper impact of different material models on the calculated peak wall stress (PWS) and peak wall rupture risk (PWRR) in abdominal aortic aneurysms (AAAs) is assessed. Computational finite element models of 70 patient-specific AAAs were created using two different material models – a realistic one based on mean population results of uniaxial tests of AAA wall considered as reference, and a 100 times stiffer artificial model. The calculated results of PWS and PWRR were tested to evaluate statistical significance of differences caused by the non-realistic material model. It was shown that for majority of AAAs the differences are …insignificant but for some 10% of them their relative differences exceed 20% which may lead to incorrect decisions on their surgical treatment. This percentage of failures favours application of realistic material models in clinical practise although they are much more time-consuming. Show more

Keywords: Abdominal aortic aneurysm, peak wall stress, finite element model

DOI: 10.3233/THC-171024

Citation: Technology and Health Care, vol. 26, no. 1, pp. 165-173, 2018

Authors: Prodhan, Uzzal Kumar | Rahman, Mohammad Zahidur | Jahan, Israt

Article Type: Research Article

Abstract: OBJECTIVES: Telemedicine based healthcare service faces different difficulties especially in the remote people of Bangladesh. The objective of this study was to implement an advanced telemedicine model in order to provide the healthcare services for the rural people of Bangladesh. METHODS: We developed the telemedicine model using an ardunio based low cost portable telemedicine tool kit by interfacing android application. Then we collected ECG, blood pressure, temperature, concentration of glucose in blood, SPO2, body position, airflow, height and weight through our developed model. Moreover, we designed a server for storing the recorded signal from the patients …in order to treat them by health care professionals. Finally, this model is successfully tested with the patients of Marie Stopes Bangladesh Hospital Dhaka. RESULTS: We have removed noise from the recorded signal successfully through our developed hardware and software based techniques. Real time data were visualized to the expert doctor in order to prescribe them through our model. CONCLUSIONS: These results support that rural patient vital information can be collected in an automated way through the advanced model. Both rural and urban doctors can share and exchange patient information more effectively for the treatment of patient. The results of this research indicated that our developed telemedicine system can be used effectively in order to deliver healthcare services for the rural people of Bangladesh. Show more

Keywords: Telemedicine, business process modeling notation, health level seven, electronic health record, information and communication technology

DOI: 10.3233/THC-171101

Citation: Technology and Health Care, vol. 26, no. 1, pp. 175-180, 2018

Authors: Habib, Syed Rashid | Otaibi, Asim Khaled Al | anazi, Talal Ali Al | anazi, Samer Mosleh Al

Article Type: Research Article

Abstract: Despite several advantages of digitalized workflow, researchers have noted discrepancies in the precision and trueness. This study investigated the accuracy in the final thickness of Zirconia (Zr) cores fabricated by five CAD/CAM systems. Standardized manufacturing of the cores with 1 mm thickness were carried out. Cores were then sectioned into two halves and measurement made with Digital Microscope at 5 points in micrometers. Overall, mean thickness for the groups was 1048.81 ± 94.01, which was 48 μ m higher than the thickness programmed in the software. Anova showed a statistically significant difference between the groups …(p = 0.000). Presence of variations in the thickness and 5 measurement points for the CAD/CAM systems investigated was found. No significant difference was observed and the thickness of the cores were within acceptable level. Show more

Keywords: Zirconia, zirconia core, zirconia copings, CAD/CAM, zirconia crowns

DOI: 10.3233/THC-171144

Citation: Technology and Health Care, vol. 26, no. 1, pp. 181-185, 2018

Authors: Siogkas, Panagiotis K. | Stefanou, Kostas A. | Athanasiou, Lambros S. | Papafaklis, Michail I. | Michalis, Lampros K. | Fotiadis, Dimitrios I.

Article Type: Research Article

Abstract: BACKGROUND: Due to the incremental increase of clinical interest in the development of software that allows the 3-dimensional (3D) reconstruction and the functional assessment of the coronary vasculature, several software packages have been developed and are available today. OBJECTIVE: Taking this into consideration, we have developed an innovative suite of software modules that perform 3D reconstruction of coronary arterial segments using different coronary imaging modalities such as IntraVascular UltraSound (IVUS) and invasive coronary angiography images (ICA), Optical Coherence Tomography (OCT) and ICA images, or plain ICA images and can safely and accurately assess the hemodynamic status …of the artery of interest. METHODS: The user can perform automated or manual segmentation of the IVUS or OCT images, visualize in 3D the reconstructed vessel and export it to formats, which are compatible with other Computer Aided Design (CAD) software systems. We employ finite elements to provide the capability to assess the hemodynamic functionality of the reconstructed vessels by calculating the virtual functional assessment index (vFAI), an index that corresponds and has been shown to correlate well to the actual fractional flow reserve (FFR) value. RESULTS: All the modules of the proposed system have been thoroughly validated. In brief, the 3D-QCA module, compared to a successful commercial software of the same genre, presented very good correlation using several validation metrics, with a Pearson’s correlation coefficient (R) for the calculated volumes, vFAI, length and minimum lumen diameter of 0.99, 0.99, 0.99 and 0.88, respectively. Moreover, the automatic lumen detection modules for IVUS and OCT presented very high accuracy compared to the annotations by medical experts with the Pearson’s correlation coefficient reaching the values of 0.94 and 0.99, respectively. CONCLUSIONS: In this study, we have presented a user-friendly software for the 3D reconstruction of coronary arterial segments and the accurate hemodynamic assessment of the severity of existing stenosis. Show more

Keywords: Hemodynamics, virtual functional assessment index, stenosis

DOI: 10.3233/THC-170881

Citation: Technology and Health Care, vol. 26, no. 1, pp. 187-193, 2018

Authors: Hackenberg, Roslind Karolina | Nessler, Jochen | König, Dietmar Pierre

Article Type: Research Article

Abstract: BACKGROUND: Tumor prostheses are established as a standard procedure in tumors of the lower extremities. Septic and aseptic loosening remains the main reason for the failure of tumor prostheses. Due to bone defects, the possibilities of anchoring revision prostheses are limited. Trabecular metal cones are established in prosthetic revision surgery. However, the use of segmental trabecular metal cones in a custom-made tumor revision prosthesis has not yet been described. OBJECTIVE: A 58-year-old patient, who initially received a resection of the distal femur and reconstruction with a tumor prosthesis due to chondrosarcoma, attended our clinic. Because of …aseptic loosening of this tumor prosthesis, revision surgery was indicated. METHODS: On account of huge bone defects, a reconstruction using a modular standard prosthesis was not possible. In order to prevent further resection of the bone and not replace the total femur, a custom-made revision tumor prosthesis was implanted. RESULTS: After preoperative planning and explantation of the loosened prosthesis, a partially cemented custom-made revision tumor prosthesis was successfully implanted using a Revitan ® Curved revision stem with a custom-made Revitan ® -Taperadapter and a custom-made segmental trabecular metal cone connected to a custom-made titanium segmental distal femur and a Zimmer ® NexGen ® RH Knee Tibia with a straight stem (Zimmer, Inc., USA). CONCLUSIONS: The application of segmental trabecular metal in a custom-made revision tumor prosthesis offers a new option to the previously existing treatment strategies. Show more

Keywords: Revision tumor prosthesis, custom-made, segmental trabecular metal cones, revision total knee arthroplasty, bone defect

DOI: 10.3233/THC-170895

Citation: Technology and Health Care, vol. 26, no. 1, pp. 195-202, 2018

Authors: Alarcón-Paredes, Antonio | Rebolledo-Nandi, Zaic | Guzmán-Guzmán, Iris Paola | Yáñez-Márquez, Cornelio | Alonso, Gustavo Adolfo

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: The treatment and care of patients with chronic diseases depends directly on the evolution of biomedical parameters. It is important to have a monitoring health care system that provides biomedical data at any time and place. Here, a multi-sensing health care monitoring system with a built-in non-invasive blood glucose level estimation method is presented. METHODS: Six biomedical parameters were obtained from 15 participants. Glucose levels were obtained using a computer vision approach. A standard glucose laboratory test was taken as a baseline, and a commercial glucometer as a secondary reference. The remaining parameters …were also contrasted with a commercial vital signs monitor. RESULTS: In comparison to standard test, our proposal reported a better performance (RMSE of 9.811) than obtained with the commercial glucometer; the Mann-Whitney test found no significant differences. The remaining biomedical parameters exhibit similar results to the commercial vital signs monitor as validated by a cardiologist. CONCLUSION: The results suggest the proposed approach could be considered highly competitive regarding standard tests and validated with commercial health care monitoring systems. Show more

Keywords: Non-invasive glucose estimation, chronic diseases, biomedical parameters, microcontroller, Bluetooth communication, mobile health care system, Android application, image analysis

DOI: 10.3233/THC-171075

Citation: Technology and Health Care, vol. 26, no. 1, pp. 203-208, 2018