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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: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock METHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced. Following trauma, hypothermia of 33 ∘ C was induced for 12 h and intensive care treatment…was evaluated for 48 h. As outcome parameters, we assessed liver function and serum transaminase levels as well as a histopathological analysis of tissue samples. A further 10 animals served as controls. RESULTS: Serum transaminase levels were increased at the end of the observation period following hypothermia without reaching statistical significance compared to normothermic groups. Liver function was preserved (p ⩽ 0.05) after the rewarming period in hypothermic animals but showed no difference at the end of the observation period. In H&E staining, cell death was slightly increased hypothermic animals and caspase-3 staining displayed tendency towards more apoptosis in hypothermic group as well. CONCLUSIONS: Induction of hypothermia could not significantly improve hepatic damage during the first 48 h following major trauma. Further studies focusing on multi-organ failure including a longer observation period are required to illuminate the impact of hypothermia on hepatic function in multiple trauma patients.
Abstract: There are so many beauty salons in Metropolis who provide services to women exclusively [1 ]. These beauty salons depend mostly on electricity for their services to customers, without it there is no effective means of operation [2 ]. These beauty salons are definitely leading to women empowerment. The beauty salons are run by the women for women. Since they fall under the category of micro and small enterprises, these salons may avail so many financial and non- financial advantages from the Government of India. They also provide employment opportunities to the women employees. The development of such beauty salons…rests on the clients’ satisfaction on the provision of their services. Hence it is essential to measure the clients attitude towards the services offered by the beauty salons, especially electro therapy facial, laser skin whitening and laser hair removal treatments, which are coming under micro current treatment as a cosmetic tool.
Keywords: Electro therapy, micro current treatment, laser treatment, facial therapy
Abstract: BACKGROUND: Flow recirculation occurs in eccentric coronary stenosis, which can lead to adverse outcome. The complex local geodesic patterns of eccentric stenosis are critical factors in determining the flow characteristics in post-stenotic flow. OBJECTIVE: The main objective of this study is to relate the relationship between the detailed morphological parameters in eccentric coronary stenosis and the post-stenotic flow characteristics. METHODS: Several idealized eccentric coronary stenosis models with variable morphological parameters are created to conduct a series of computational fluid dynamics analysis. The impact of four specific lesion morphological parameters, eccentricity index (EI), diameter stenosis (DS), stenosis…length (SL) and shape of lesion, are investigated. RESULTS: When EI is small (< 0.33), the length of recirculation zones would increase as EI increase; while when EI is large (> 0.33), it would decreased as EI increase; Larger magnitude of retrograde flow occurs in models with smaller EIs. Both the recirculation zone length and maximum shear rate increase significantly as DS increases. Increase of SL will lead to increase of recirculation zone length. Higher maximum shear rate and larger recirculation zone are observed in models with sharper stenosis shape. CONCLUSIONS: Except DS, the detailed geometry patterns (EI, SL and shape of the stenosis) also have great impact on post-stenotic flow behaviors in eccentric coronary stenosis.
Abstract: BACKGROUND: Piercings are placed at different body sites often invisible to medical staff. They may cause additional injuries in trauma and emergency surgery by electro-cautery. OBJECTIVE: To clarify whether electrosurgery will have a direct damaging effect to the skin around a pierced skin area. METHODS: Metallic piercings were fixed at defined distances from the neutral and active electrode on abdominal pig skin. The distance of the active electrode was reduced by 5 mm increments to 0. The respective increases in temperature were determined with a thermal camera. A macroscopic and histological analysis of the area around…the piercing to detect thermal damage was carried out. RESULTS: Significant increases in temperature and visible changes in the tissue around the piercing only occurred when the active electrode was in direct contact with the piercing (increase of 47.3 ∘ C). Electro-cautery in distance of 5 to 10 mm to the piercing showed only temperature increases of less than 5 ∘ C. CONCLUSIONS: If metallic piercings are not directly touched by the active electrode and the distance is more than 5–10 mm, no clinically relevant effect is created on the tissue in direct proximity to the piercings by electro-cautery. In an emergency surgery situation, a piercing not fixed in direct proximity to the surgical field may likely be ignored.
Keywords: Electrosurgery, body piercing, body jewelry, burn injury
Abstract: BACKGROUND AND OBJECTIVES: Categorization of the casualties in accordance with medical care priorities is crucial in a military environment. Automation of the triage process is still a challenging task. The goal of the paper is to propose a novel algorithm for automation of medical emergency protocol in the military environment by the creation of classifiers that can provide accurate prioritization of injured soldier cases. It is a part of a complex military telemedicine system that provides continuous monitoring of soldiers’ vital data gathered on-site using an unobtrusive set of sensors. METHODS: After pre-processing the collected raw…physiological data and eliminating the outliers using Naïve Bayesian Classifier, the system is capable of calculating the risk level and categorizing the victims based on Markov Decision Process. The NBC has been trained with a dataset that has contained labels and 6 features. Training set has held 8000 randomly chosen samples. Twenty percent of the determined dataset has been used for the validation set. RESULTS: For algorithm verification, several evaluation scenarios have been created. In each scenario, randomly generated vital sign data describing the hypothetical health condition of soldiers was contemporarily assessed by the system as well as by 50 experienced military medical physicians. CONCLUSION: The obtained correlation result of the proposed algorithm and medical physicians’ classifications is strong evidence that the system can be implemented in warfare emergency medicine.
Keywords: Triage, emergency care systems, efficiency, first responders, military
Abstract: BACKGROUND: Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity. OBJECTIVE: The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting. METHODS: This one-group pre-test post-test model quasi-experimental study was carried out with 39 students in Ankara, Turkey, from October 2014 to July 2015. RESULTS: Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and…self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.7%, 97.3%, 84.2%, and 92.1%, respectively). CONCLUSION: The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.
Abstract: BACKGROUND: The aging-related disease and associated neurodegenerative complications, such as cognitive impairment, has received increasing attention. OBJECTIVE: The aim of this study was to show changes in cognitive behavior and molecular related the synaptic plasticity in aged-induced cognitive deficits rats. METHODS: We used novel object recognition testing and morphological staining as well as western blot to detect changes in cognitive behavior and molecular related the synaptic plasticity. RESULTS: The morphological changes of synaptic structure and number on hippocampal neurons and learning and memory deficits were shown during natural aging. Moreover,…learning and memory improvement was associated with alterations of hippocampal synaptic plasticity-related proteins, such as SNAP-25, synaptophysin, snapsoin-1 and so on, which distributes to cognitive decline in natural aging. CONCLUSIONS: Our study provides more behavior and molecular evidence on relationship of cognitive deficits and aging.
Abstract: The most appropriate organizational software is always a real challenge for managers, especially, the IT directors. The illustration of the term “enterprise software selection”, is to purchase, create, or order a software that; first, is best adapted to require of the organization; and second, has suitable price and technical support. Specifying selection criteria and ranking them, is the primary prerequisite for this action. This article provides a method to evaluate, rank, and compare the available enterprise software for choosing the apt one. The prior mentioned method is constituted of three-stage processes. First, the method identifies the organizational requires and assesses…them. Second, it selects the best method throughout three possibilities; indoor-production, buying software, and ordering special software for the native use. Third, the method evaluates, compares and ranks the alternative software. The third process uses different methods of multi attribute decision making (MADM), and compares the consequent results. Based on different characteristics of the problem; several methods had been tested, namely, Analytic Hierarchy Process (AHP), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), Elimination and Choice Expressing Reality (ELECTURE), and easy weight method. After all, we propose the most practical method for same problems.
Keywords: Software selection criteria, multi-attribute decision-making (MADM), buying model, buy vs. make, organizational buying behavior (OBB), hospital management system
Abstract: BACKGROUND: Scientific management methods are urgently needed to balance the demand and supply of heath care services in Chinese hospitals. Operating theatre is the bottleneck and costliest department. Therefore, the surgery scheduling is crucial to hospital management. OBJECTIVE: To increase the utilization and reduce the cost of operating theatre, and to improve surgeons’ satisfaction in the meantime, a practical surgery scheduling which could assign the operating room (OR) and surgeon for the surgery and sequence surgeries in each OR was provided for hospital managers. METHODS: Surgery durations were predicted by fitting the distributions.…A two-step mixed integer programming model considering surgery duration uncertainty was proposed, and sample average approximation (SAA) method was applied to solve the model. RESULTS: Durations of various surgeries were log-normal distributed respectively. Numerical experiments showed the model and method could get good solutions with different sample sizes. CONCLUSIONS: Real-life constraints and duration uncertainty were considered in the study, and the model was also very applicable in practice. Average overtime of each OR was reducing and tending to be stable with the number of surgeons increasing, which is a discipline for OR management.
Keywords: OR scheduling, surgeon assignment, stochastic programming, sample average approximation
Abstract: BACKGROUND: Low vitamin D is a major risk factor for osteoporotic fractures. Evidence also suggests correlation between deficiency and musculoskeletal pain. OBJECTIVE: Non-interventional study in patients undergoing spine surgery to investigate links between vitamin D levels and clinical features. METHODS: 25-OH vitamin D levels were assessed in two cohorts: Cohort 1 (vertebral fractures; VF) and Cohort 2 (other spinal issues; excluding VF). Lab values as well as painDETECT questionnaires, VAS and Oswestry Disability Index (ODI) were recorded. Follow-up visits were conducted a few days and 6 weeks postoperatively. RESULTS: One…hundred and nine patients were enrolled. Mean VAS measured 72 mm in Cohort 1 and 55 mm in Cohort 2. Mean vitamin D concentrations were 16.8 ± 11 ng/ml in Cohort 1 and 18.3 ± 11 ng/ml in Cohort 2. VAS and ODI significantly correlated with vitamin D levels. Median painDETECT scores were 9 in Cohort 1 and 16 in Cohort 2. Six weeks postoperatively mean VAS was 31.4 ± 28 mm in Cohort 1 and 23.3 ± 21 mm in Cohort 2. Median painDETECT scores were 5 in both cohorts. CONCLUSION: Interactions are apparent between neuropathic pain and vitamin D serum levels. Consequently, vitamin D should be monitored in all patients requiring spinal surgery.