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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: OBJECTIVE: To investigate the association of single nucleotide polymorphisms (SNPs) of soluble low-density lipoprotein receptor 11 (sLR11) genes with type-2 diabetes mellitus (T2DM) and carotid atherosclerosis (CAS) in Korean and Han nationalities in the Yanbian area. METHODS: 530 T2DM patients were divided into two groups according to the intima-media thickness (IMT) of the carotid artery: CAS group (n = 256, T2DM patients with carotid artery IMT ⩾ 1.0 mm and plaque) and non-CAS group (NCAS group, n = 274, T2DM patients with carotid…IMT < 1.0 mm). IMT and plaque were measured by color Doppler ultrasound. SNP typing and sequencing were performed by PCR-LDR. RESULTS: 1. Allele frequency and genotype frequency distribution results: Differences in genotype and allele frequency distribution between the CAS and NGT groups, the NCAS and NGT groups, and the CAS and NCAS groups were not statistically significant (P > 0.05). The dominant and recessive modes were analyzed, but the difference in genotype frequency among these three groups was not statistically significant (P > 0.05). Differences in genotype frequency distribution between Korean and Han populations in all three groups were not statistically significant (P > 0.05). 2. Correlation analysis with clinical indicators: LDL-C levels in TT and AT patients in the CAS group were significantly higher than those in AA patients (P > 0.05), representing the dominant mode of inheritance.. CONCLUSION: This study is the first to determine that the sLR11 gene rs3824968 polymorphic of factor T may increase the risk of CAS in T2DM patients by regulating the concentration of LDL-C, showing the dominant mode of inheritance.
Keywords: sLR11, gene polymorphism, type 2 diabetes mellitus, carotid intima media thickness
Abstract: OBJECTIVE: To investigate the effects of conscious (ADIM) and subconscious (DNS) core stabilization exercises on cortical changes in adults with core instability. PARTICIPANTS: Five non-symptomatic participants with core instability. METHODS: A novel core stabilization task switching paradigm was designed to separate cortical or subcortical neural substrates during a series of DNS or ADIM core stabilization tasks. RESULTS: fMRI blood BOLD analysis revealed a distinctive subcortical activation pattern during the performance of the DNS, whereas the cortical motor network was primarily activated during an ADIM. Peak voxel volume values showed significantly…greater DNS (11.08 ± 1.51) compared with the ADIM (8.81 ± 0.21) (p = 0.043). CONCLUSION: The ADIM exercise activated the cortical PMC-SMC-SMA motor network, whereas the DNS exercise activated both these same cortical areas and the subcortical cerebellum-BG-thalamus-cingulate cortex network.
Abstract: BACKGROUND: Loss of upper limb function often appears after stroke. Robot-assisted systems are becoming increasingly common in upper extremity rehabilitation. Rehabilitation robot provides intensive motor therapy, which can be performed in a repetitive, accurate and controllable manner. OBJECTIVE: This study aims to propose a novel center-driven robot for upper extremity rehabilitation. METHODS: A new power transmission mechanism is designed to transfer the power to elbow and shoulder joints from three motors located on the base. The forward and inverse kinematics equations of the center-driven robot (CENTROBOT) are deduced separately. The theoretical values of…the scope of joint movements are obtained with the Denavit-Hartenberg parameters method. A prototype of the CENTROBOT is developed and tested. RESULTS: The elbow flexion/extension, shoulder flexion/extension and shoulder adduction/abduction can be realized of the center-driven robot. The angles value of joints are in conformity with the theoretical value. CONCLUSIONS: The CENTROBOT reduces the overall size of the robot arm, the influence of motor noise, radiation and other adverse factors by setting all motors on the base. It can satisfy the requirements of power and movement transmission of the robot arm.
Abstract: BACKGROUND: Trunk control ability greatly influences functional movement of the upper limbs. PURPOSE: Our primary aims were to assess trunk control ability, sway, and upper limb functions in children with cerebral palsy (CP), and to investigate the relationship between trunk control ability and upper limb function. METHODS: We included 15 children (8 boys and 7 girls) with CP. We used the Trunk Control Measurement Scale (TCMS) to evaluate trunk control ability and sway. We employed the Jebsen-Taylor Hand Function Test (JTHFT), the Quality of Upper Extremity Skills Test (QUEST), the Box and Blocks…Test (BBT), and the ABILHAND-Kids questionnaire to explore upper limb function and arm movement acceleration. We calculated correlations between trunk control ability and parameters of upper limb function. RESULTS: TCMS scores correlated positively with the QUEST, BBT, and ABILHAND-Kids data, but negatively with the JTHFT findings. Anteroposterior acceleration correlated positively with JTHFT data, but negatively with QUEST, BBT, and ABILHAND-Kids data. Mediolateral acceleration correlated positively with the JTHFT outcomes, but negatively with those of QUEST, BBT, and ABILHAND-Kids. CONCLUSIONS: Upper limb function test data exhibited moderate to strong correlations with trunk control ability, as measured via the TCMS and triaxial accelerometry, in children with CP. Our results suggest that trunk control ability should be assessed when evaluating upper limb function in such children.
Keywords: Accelerometer, cerebral palsy, trunk control, upper limb function
Abstract: OBJECTIVE: The main purpose of this study was to measure the peak acceleration of the upper limb (UL) during reaching, and to calculate correlations between peak acceleration data and functional test results in children with cerebral palsy (CP). METHODS: We recruited 15 children with CP (8 boys and 7 girls) and measured peak acceleration and function as revealed by the Jebsen Taylor Hand Function Test (JTHF), the Quality of Upper Extremity Skills Test (QUEST), the Box and Blocks Test (BBT), and the ABILHAND-Kids questionnaire. We calculated correlations between peak acceleration data and scores on the functional…tests. RESULTS: The peak acceleration of the more-affected UL was significantly higher than that of the less-affected UL (p < 0.05). The peak acceleration data were positively correlated with JTHFT scores. On the other hand, the peak acceleration data were negatively correlated with QUEST, BBT, and ABILHAND-Kids scores. The test-retest reliability of the peak acceleration was excellent, with an intra-class correlation coefficient (ICC) 0.87–0.98. CONCLUSIONS: Peak acceleration data correlated with UL functional test results; as this proved to be reliable, the tri-axial accelerometer is a clinically useful assessment tool for evaluating UL movement. Therefore, our results suggest that measurement of acceleration using a tri-axial accelerometer is appropriate when clinicians quantify UL movement during therapeutic rehabilitation in clinical settings.
Abstract: PURPOSE: The purpose of this study was to investigate the effects of live and video form action observation training (AOT) on upper limb (UL) movement acceleration and function in children with cerebral palsy (CP). METHODS: In total, 12 children (7 boys, 5 girls) with CP participated in this study. The children were allocated randomly to live (experimental) and video (control) AOT groups. All children completed 20 treatment sessions, each 30 minutes in duration, 5 days per week for a month. Mediolateral (ML) and vertical (VT) acceleration data, Jebsen-Taylor Hand Function (JTHF) scores, and Box and Block…Test (BBT) scores were obtained at baseline and at 4 weeks after the intervention. RESULTS: ML and VT movement acceleration and JTHF scores were significantly lower in the live group (p < 0.05). The BBT score was significantly higher in the live than in the video group (p < 0.05). CONCLUSIONS: Our findings suggest that live AOT is more effective than video AOT for improving UL movement acceleration and function. Clinically, our findings offer important insights for clinicians when planning AOT interventions to reduce UL movement acceleration and improve UL function.
Abstract: BACKGROUND: This cross-sectional retrospective study utilized Natural Language Processing (NLP) to extract tobacco-use associated variables from clinical notes documented in the Electronic Health Record (EHR). OBJECITVE: To develop a rule-based algorithm for determining the present status of the patient’s tobacco-use. METHODS: Clinical notes (n = 5,371 documents) from 363 patients were mined and classified by NLP software into four classes namely: “Current Smoker”, “Past Smoker”, “Nonsmoker” and “Unknown”. Two coders manually classified these documents into above mentioned classes (document-level gold standard classification (DLGSC)). A tobacco-use status was derived…per patient (patient-level gold standard classification (PLGSC)), based on individual documents’ status by the same two coders. The DLGSC and PLGSC were compared to the results derived from NLP and rule-based algorithm, respectively. RESULTS: The initial Cohen’s kappa (n = 1,000 documents) was 0.9448 (95% CI = 0.9281–0.9615), indicating a strong agreement between the two raters. Subsequently, for 371 documents the Cohen’s kappa was 0.9889 (95% CI = 0.979–1.000). The F-measures for the document-level classification for the four classes were 0.700, 0.753, 0.839 and 0.988 while the patient-level classifications were 0.580, 0.771, 0.730 and 0.933 respectively. CONCLUSIONS: NLP and the rule-based algorithm exhibited utility for deriving the present tobacco-use status of patients. Current strategies are targeting further improvement in precision to enhance translational value of the tool.
Keywords: Data mining, decision support systems clinical, health information systems, smoking, electronic health records, information storage and retrieval
Abstract: BACKGROUND: Studies on antioxidant enzyme activity and apoptosis related protein expression associated with diabetes are mainly limited to aerobic exercise. Since the effectiveness and efficiency of the resistance to diabetes has recently emerged, it is necessary to investigate the effects of regular resistance exercise on these factors. OBJECTIVE: The purpose of this study was to investigate the effects of resistance exercise on antioxidant enzymes activities and apoptosis related protein expression in hippocampus of diabetic rats. METHODS: Twenty-one male rats were divided into 3 groups: LETO (control group), OLETF (diabetes group) and OLETF +…EX (OLETF with resistance exercise group). Resistance exercise consisted of ladder climbing every 5 days for 30 minutes for 8 weeks. The exercise group was trained to climb a 180-cm vertical ladder with weights secured to their tails. Antioxidant enzyme activities, apoptosis related protein expression, and HOMA-IR level were measured. RESULTS: The lipid peroxide and superoxide dismutase (SOD) activity were significantly increased in OLETF + EX compared to OLETF (p < 0.001). Glutathione peroxidase (GPx) activity was significantly lower in OLETF + EX than OLETF (p < 0.001). Caspase-3 expression of hippocampus was significantly decreased in OLETF + EX compared to OLETF (p < 0.05). Bax protein expression was significantly lower in OLETF + EX than OLETF (p < 0.05) whereas Bcl-2 expression was significantly higher in OLETF + EX than OLETF (p < 0.05). HOMA-IR level was significantly decreased in OLETF + EX compared to OLETF (p < 0.05). CONCLUSIONS: Regular resistance exercise intervention can decrease oxidative stress by enhancing antioxidant enzyme activity and this may lead to attenuate apoptosis related protein such as caspase-3, bax and bcl-2 expression in hippocampus of diabetic population.
Abstract: BACKGROUND: P300-spellers are brain-computer interface (BCI)-based character input systems. Support vector machine (SVM) ensembles are trained with large-scale training sets and used as classifiers in these systems. However, the required large-scale training data necessitate a prolonged collection time for each subject, which results in data collected toward the end of the period being contaminated by the subject’s fatigue. OBJECTIVE: This study aimed to develop a method for acquiring more training data based on a collected small training set. METHODS: A new method was developed in which two corresponding training datasets in two sequences are superposed and…averaged to extend the training set. The proposed method was tested offline on a P300-speller with the familiar face paradigm. RESULTS: The SVM ensemble with extended training set achieved 85% classification accuracy for the averaged results of four sequences, and 100% for 11 sequences in the P300-speller. In contrast, the conventional SVM ensemble with non-extended training set achieved only 65% accuracy for four sequences, and 92% for 11 sequences. CONCLUSION: The SVM ensemble with extended training set achieves higher classification accuracies than the conventional SVM ensemble, which verifies that the proposed method effectively improves the classification performance of BCI P300-spellers, thus enhancing their practicality.
Keywords: Brain-computer interface, familiar face paradigm, P300 speller, SVM ensemble, training set extension
Abstract: This study was aimed at investigating the role of IVI angle on the induced stresses and deformations among the components of the eye. Thereafter, the most optimal angle of IVI to minimize the complications of post IVI at the injection site on a basis of the computed stresses via a Fluid-Structure Interaction (FSI) computational model was proposed. IntraVitreal Injection (IVI) is broadly employed as a principal treatment of vascular vitro-retinal diseases. So far, there have been reports regarding the complications of post IVI and determine them as severe uveitis, tractional retinal detachment, IntraOcular Pressure (IOP) elevation as well as ocular…haemorrhage. However, there is a lack of knowledge on how to reduce the subsequent ocular tissue damage and patient symptoms in the injection site. Seven different IVI angles were simulated, including 0 ∘ , 15 ∘ , 30 ∘ , 45 ∘ , 60 ∘ , 75 ∘ , and 90 ∘ , through the Finite Element (FE) code; and the term, ‘post IVI complication’ or ‘injury’, in the results was interpreted as the level of maximal principal stress in the eye components. The results revealed the lowest amount of stresses at the angle of 45 ∘ in respect to the horizontal line (acute to the surface of the sclera) for the lens, iris, vitreous body, aqueous body, ciliary body, sclera, retina, and choroid. The cornea illustrated the same amount of stress at the angles of 45 ∘ , 60 ∘ , 75 ∘ , and 90 ∘ with the highest one at the IVI angle of 30 ∘ . The lowest and the highest stresses among the eye components regardless of IVI angle were observed in the choroid and retina/sclera, respectively, which imply the importance of the IVI angle on the stresses of these eye components. The findings of the contemporary research revealed that the IVI angle of 45 ∘ would trigger less post IVI complications and, as a result, a more effective surgery outcome compared to the other angles, i.e., 0 ∘ , 15 ∘ , 30 ∘ , 60 ∘ , 75 ∘ , and 90 ∘ .
Keywords: Human eye, intravitreal injection, injection angle, fluid-structure interaction, maximal principal stress