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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: Integration of the verticalization robot, Erigo, with functional electric stimulation and passive leg movements in the postacute rehabilitation of neurological patients could reduce the risk of secondary complications and improve functional outcomes (i.e. orthostatic hypotension, postural control and walking ability). OBJECTIVE: The aim of this study was to estimate and quantify changes in the postacute stage, mainly related to heart rate and blood pressure in functional recovery, postural parameters, walking ability and psychoemotional reactions, during training using the verticalization robot Erigo. METHODS: Six patients [three suffering from a stroke (ST) and three…with spinal cord injuries (SCI)] participated in 10 sessions of physical therapy with the verticalization robot during primary inpatient rehabilitation. Functional state changes were assessed using clinical tests before and after the treatment, and the loading tolerance during Erigo training was noted. RESULTS: In early rehabilitation, Erigo training was safe and effective at improving orthostatic tolerance, posture and positive emotional reactions in both the ST and SCI patients (P < 0.05). In addition, advanced technologies were more effective at boosting the orthostatic tolerance in SCI patients, while they were more effective at increasing the dynamic balance and walking ability in ST patients (P < 0.05).
Abstract: BACKGROUND: Majority of limb amputations are caused by circulatory disturbances such as vascular occlusions and strictures. Discovery of modern and more advanced ultrasonic interventional vascular debulking methodology would likely save limbs of CVD patients and their lives in an economical way. However, there is a lack of researches regarding the ultrasound’s effect on physiological functions of human blood cells. The tube-shaped ultrasound waveguide wire with orifices at its operational end was offered as the alternative to some currently patented interventional thrombosis treatment solutions. OBJECTIVE: To establish the safe operating regime of the proposed device.…METHODS: The temperature rise induced by the cavitation process and friction between the waveguide and surrounding fluids was measured and microscopic pictures of human blood were made. RESULTS: Blood insonation lasting 15 seconds, leads to blood clot formation. If insonation continues for 30 seconds some cells are totally destroyed. In addition, the safe operating regime was established. To avoid heating of the environment to the temperature harmful for the medium (blood) and surrounding tissues, is achieved when the system should be on for 40%, and of for 60% of the period of 1 second. CONCLUSIONS: The safe operating regime of the proposed device was established.
Abstract: BACKGROUND: Transapical off-pump mitral valve (MV) repair is a novel minimally-invasive surgical technique, allowing to correct mitral regurgitation (MR) caused by chordae tendineae rupture. While numerical simulation of the MV structure has proven to be useful to evaluate the effects of the MV surgical repair techniques, no numerical simulation studies on the outcomes of transapical MV repair have been done up to now. OBJECTIVE: The purpose of this study is to evaluate the transapical MV repair using finite element modeling and to determine the effect of the neochordal length on the function of the prolapsing MV.…METHODS: The reconstruction of the MV geometry based on the patient-specific data was performed. In order to simulate prolapse, chordae inserted into the middle segment of the posterior leaflet (P2) were ruptured. A total of four virtual transapical repairs using neochordae of different length were performed. The function of the MV before and after virtual repairs was simulated. RESULTS: The evaluation of the effect of the neochordal length on post-repair MV function showed that the length of the implanted neochordae has a significant impact on the correction of MR caused by chordae tendineae rupture. CONCLUSIONS: The presented results can improve the understanding of the effects of transapical MV repair.
Keywords: Mitral valve, prolapse, transapical, neochordae, finite element model
Abstract: BACKGROUND: Upper extremity (UE) motor function deficits are commonly noted in multiple sclerosis (MS) patients and assessing it is challenging because of the lack of consensus regarding its definition. Instrumented biomechanical analysis of upper extremity movements can quantify coordination with different spatiotemporal measures and facilitate disability rating in MS patients. OBJECTIVE: To identify objective quantitative parameters for more accurate evaluation of UE disability and relate it to existing clinical scores. METHODS: Thirty-four MS patients and 24 healthy controls (CG) performed a finger-to-nose test as fast as possible and, in addition, clinical evaluation kinematic…parameters of UE were measured by using inertial sensors. RESULTS: Generally, a higher disability score was associated with an increase of several temporal parameters, like slower task performance. The time taken to touch their nose was longer when the task was fulfilled with eyes closed. Time to peak angular velocity significantly changed in MS patients (EDSS > 5.0). The inter-joint coordination significantly decreases in MS patients (EDSS 3.0–5.5). Spatial parameters indicated that maximal ROM changes were in elbow flexion. CONCLUSIONS: Our findings have revealed that spatiotemporal parameters are related to the UE motor function and MS disability level. Moreover, they facilitate clinical rating by supporting clinical decisions with quantitative data.
Abstract: BACKGROUND: Long sitting causes many health problems for people. Healthy sitting monitoring systems, like real-time pressure distribution measuring, is in high demand and many methods of posture recognition were developed. Such systems are usually expensive and hardly available for the regular user. OBJECTIVE: The aim of study is to develop low cost but sensitive enough pressure sensors and posture monitoring system. METHODS: New self-made pressure sensors have been developed and tested, and prototype of pressure distribution measuring system was designed. RESULTS: Sensors measured at average noise amplitude of a =…56 mV (1.12%), average variation in sequential measurements of the same sensor s = 17 mV (0.34%). Signal variability between sensors averaged at 100 mV (2.0%). Weight to signal dependency graph was measured and hysteresis calculated. Results suggested the use of total sixteen sensors for posture monitoring system with accuracy of < 1.5% after relaxation and repeatability of around 2%. CONCLUSION: Results demonstrate that hand-made sensor sensitivity and repeatability are acceptable for posture monitoring, and it is possible to build low cost pressure distribution measurement system with graphical visualization without expensive equipment or complicated software.
Abstract: BACKGROUND: Weight gain is the most significant change during pregnancy. The lack of consensus among scientists as far as significant spine alterations are concerned requires basic knowledge to be increased. OBJECTIVE: The aim of the paper is to determine changes in spine parameters occurring during pregnancy accompanying the increasing body gain. METHODS: Twelve pregnant women were included in this study. Winspine Pointer, a three-dimensional motion analysis system, was applied for the tests. The output measurements were: pelvic torsion, pelvic obliquity, pelvic/shoulder obliquity, thoracic kyphosis angle, lumbar lordosis angle, and sacral angle. The correlation…between the BMI index and the spine parameters was investigated using Spearman’s correlation coefficient. RESULTS: Differences between women in the 2nd and 3rd trimester of pregnancy were found for thoracic kyphosis angle and lumbar lordosis angle (P < 0.05). A statistically significant relationship was revealed between the BMI and the thoracic kyphosis in the 3rd trimester of pregnancy (R = 0.50, p = 0.005). With the increase of the BMI, the measured parameter also increased. CONCLUSIONS: Understanding the changes in spine parameters during pregnancy is important as far as prevention and treatment are concerned.
Abstract: BACKGROUND: Due to the problem of aging societies, there is a need for smart buildings to monitor and support people with various disabilities, including rheumatoid arthritis. OBJECTIVE: The aim of this paper is to elaborate on novel techniques for wireless motion capture systems for the monitoring and rehabilitation of disabled people for application in smart buildings. METHODS: The proposed techniques are based on cross-verification of distance measurements between markers and transponders in an environment with highly variable parameters. To their verification, algorithms that enable comprehensive investigation of a system with different numbers of…transponders and varying ambient parameters (temperature and noise) were developed. In the estimation of the real positions of markers, various linear and nonlinear filters were used. Several thousand tests were carried out for various system parameters and different marker locations. RESULTS: The results show that localization error may be reduced by as much as 90%. It was observed that repetition of measurements reduces localization error by as much as one order of magnitude. CONCLUSIONS: The proposed system, based on wireless techniques, offers a high commercial potential. However, it requires extensive cooperation between teams, including hardware and software design, system modelling, and architectural design.
Abstract: BACKGROUND: Polydimethylsiloxane (PDMS) is widely used in biomedical research and technology, but its mechanical properties should be tuned according to the desired product specifications. Mixing ratio of base polymer to curing agent or additives enables its mechanical properties to be manipulated and fit to mechanical properties of biological tissues. OBJECTIVE: In this paper, we analysed the effect of mechanical load on silk-reinforced PDMS depending on silk concentration. METHODS: We prepared cylinder-type PDMS samples with different silk concentrations and performed cyclic uniaxial compression tests with a fixed magnitude of applied strain. Next, we analysed…the mechanical charascteristics of PDMS using computational modelling. RESULTS: The stress-strain data within the large-strain region of different PDMS cylinders without silk and with 1%, 5% and 10% silk concentrations was fitted to non-linear second order Mooney-Rivlin, and third-order Ogden models. The results show the equivalence of both models for investigated strain region of PDMS. On the other hand, PDMS cylinders with 10% silk concentration allowed the successful fitting of experimental data just for the second-order Mooney-Rivlin model, while all numerical probes to find an appropriate fitting parameters for third-order Ogden models were unsuccessful. CONCLUSIONS: The second-order Mooney-Rivlin model is preferable for analysing the properties of silk-reinforced PDMS over the entire measurement range.