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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: Telemedicine is an alternative to traditional face-to-face doctor-patient office visits. Although telemedicine is becoming more prevalent, few studies have looked at the perceived favorability rate among patients utilizing telemedicine over the traditional office visit to a provider’s office considering data samples from more than 5 clinics in northern Louisiana. OBJECTIVE: This study aims to measure patient favorability of using telemedicine to receive care. This study looks at the perceived positive and negative favorability rates of patients in the oncology settings. The researchers analyzed how age, income level, and education level influenced the perceived patient favorability…rates and their willingness to utilize telemedicine. METHODS: The investigators used Chi-Square analysis to identify favorability with respect to age education and income levels. In addition to this Artificial Neural Networks were used to identify the threshold for favorability with respect to age, income, and education. RESULTS: Chi-Square tests of association showed that of the variables analyzed, only education level had a statistically significant relationship with a patient’s favorability rate of telemedicine utilization. While our neural network analysis indicated that the threshold for income, age, and education are $34,999, 66 years, and a college degree. CONCLUSION: In this article the investigators have successfully demonstrated the use of Artificial Neural Networks in identifying favorability of telemedicine used in addition to the traditional statistical methods such as Chi-Square. Thereby, creating a path for future research using advanced computational techniques like Artificial Neural Networks in analyzing human behavior.
Abstract: BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a promising treatment strategy for patients with severe symptomatic aortic stenosis (AS). Moreover, characteristics of Chinese patients that are different from those of patients in Western countries, such as a high prevalence of bicuspid aortic valve (BAV), severe calcification, and a small peripheral artery diameter, have been observed. OBJECTIVE: A novel large medical balloon with ultra-high strength was fabricated through the blending modification of PA12/TR55. METHODS: The mechanical properties, particularly puncture resistance, of large balloons were thoroughly studied, and TR55, a modified nylon pellet…with good mechanical properties and excellent compatibility with PA12, was applied to modify PA12. RESULTS: Compared with pure PA12, the fabricated PA12/TR55 balloon exhibited a higher bursting pressure, lower compliance, and higher punctures resistance while retaining good processability and excellent biocompatibility. The improved mechanical properties can be attributed to an increase in crystallinity and densification. CONCLUSIONS: The PA12/TR55 balloon is suitable for Chinese patients with bicuspid aortic valve and severe calcification and therefore has potential for clinical application in transcatheter aortic valve implantation. Moreover, this blending modification provides a simple but efficient method of solving other problems in cardiac angioplasty or cryoablation in which mechanical reinforcement of balloons may be necessary.
Keywords: Aortic stenosis, large medical balloon, blending modification
Abstract: BACKGROUND: It is difficult to distinguish solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (AM) by conventional imaging.As far as we know,diffusion weighting imaging may identify them effectively. OBJECTIVE: The purpose of this study was to determine the role of apparent diffusion coefficient (ADC) values to distinguish and predict prognosis of solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) (WHOII) and atypical meningioma (AM). METHODS: Preoperative diffusion-weighted imaging (DWI) of 30 cases with histopathologic and immunhistochemical testified SFT/HPC WHOII (n = 11) and AM (n =…19) were performed retrospectively. The ADC values of lesion, peritumoral edema, normal white matter and lesion NADC ratio (lesion ADC values/ADC values of normal white matter (NWN ADC)) were compared. The immunhistochemical markers (Ki-67, CD34, Vim, EMA, GFAP, S-100, PR, CD56) were compared. The correlation between the ADC values and Ki-67 index was evaluated. RESULTS: The mean lesion ADC values of SFT/HPC (1.15 ± 0.04 × 10 - 3 mm 2 /s) was significantly higher than that of AM (0.80 ± 0.04 × 10 - 3 mm 2 /s) (t = 23.824, p < 0.05). The mean NADC ratio was lower for AM (1.03 ± 0.06) compared with SFT/HPC (1.51 ± 0.05) (t = 23.105, p < 0.05). The mean edema ADC for SFT/HPC (1.47 ± 0.06 × 10 - 3 mm 2 /s) was lower compared with AM (1.68 ± 0.05 × 10 - 3 mm 2 /s) (t = - 9.926, p < 0.05 ). There was no statistical difference between the two groups of NWM ADC (t = - 1.475, p > 0.05) . The mean Ki-67 of SFT/HPC (7.18 ± 2.60%) was lower than the mean Ki-67 of AM (13.58 ± 4.50%) (t = - 4.934, p < 0.05). The CD34 showed statistically differences between two groups (X 2 = 13.659, p < 0.05). The EMA also showed statistically differences between two groups (X 2 = 4.474, p < 0.05). Vim,GFAP, S-100, PR, CD56 showed no statistical difference in the two group (p > 0.05). The pearson analysis indicated that there was a negative correlation between lesion ADC and Ki-67 in SFT/HPC group (r = - 0.770, p < 0.05) and AM group (r = - 0.727, p < 0.05). There was also a negative correlation between lesion NADC ratio and Ki-67 in SFT/HPC group (r = - 0.673, p < 0.05) and AM group (r = - 0.707, p < 0.05). There was a positive correlation between edema ADC and Ki-67 in SFT/HPC group (r = 0.819, p < 0.05) and AM group (r = 0.942, p < 0.05). Furthermore,there was no correlation between NWM A DC and Ki-67 in SFT/HPC group (r = - 0.403, p > 0.05) and AM group (r = 0.202, p > 0.05). CONCLUSIONS: The lesion ADC, lesion NADC ratio and edema ADC can distinguish the SFT/HPC WHO II from AM and be helpful to predict prognosis of the two tumors before operation. Further more, histopathologic and immunhistochemical can make a definite diagnosis of the two tumors.
Keywords: Solitary of fibrous tumor/hemangiopericytoma, atypical meningioma, ADC, Ki-67, CD34, EMA
Abstract: BACKGROUND: Although commonly used in clinical settings, evidence regarding the beneficial effectiveness of joint mobilization and therapeutic exercise in patients with stroke is still lacking. OBJECTIVE: This study aimed to investigate the effects of mid-thoracic spine mobilization and therapeutic exercise on dynamic balance and inspiratory function in patients with subacute stroke. METHODS: The participants included 33 patients with subacute stroke. Participants were randomly allocated to 1 of 2 groups: (1) a group that received segmental mobilization (T4-8), and (2) a group that received foam roller exercises (T4-8). Outcome measure included the limits…of stability (LOS), inspiratory function, and global rating of change (GRC). RESULTS: The improvement in inspiratory function was statistically significant at 4 and 6 weeks after the initiation of the intervention and changes in the LOS were statistically significant at 6 weeks in the mobilization group (p < 0.05). In addition, 15 of 17 (88.2%) participants in the mobilization group, compared to 9 of 16 participants (56.2%) in the exercise group, indicated a GRC score of + 4 or higher at the 4-week follow-up. CONCLUSIONS: This study demonstrates that patients with subacute stroke who receive mid-thoracic spine mobilization demonstrate effective short-term improvements in LOS and GRC.
Abstract: BACKGROUND: Functional action observation (FAO) is likely to activate the corticospinal tract and is likely to increase the potential ability of a functional task. OBJECTIVE: The purpose of this study was to investigate the effects of FAO training on gait ability in patients with post-stroke hemiparesis. METHODS: Thirty-five patients with hemiparesis caused by stroke participated in this study. All subjects had suffered from stroke for more than 6 months. Subjects received either a FAO or a general action observation (GAO) training for 30 minutes each time, five times per week, for four weeks.…The GAITRite was used to measure walking velocities and spatio-temporal variables. The functional gait assessment (FGA) was used to assess gait ability. The independent t -test was used to analyze whether there were significant differences of all dependent variables between groups. RESULTS: After four weeks of training, the step length, stride length, cadence, velocity, and FGA score in FAO group were statistically different from GAO group (p < 0.05). CONCLUSION: The results of this study suggest that FAO is an effective and easy method for improvement of gait ability in chronic stroke patients.
Abstract: BACKGROUND/OBJECTIVE: There are two routine pulse-sequences for single voxel spectroscopy (SVS), point resolved spectroscopy (PRESS) and stimulated echo acquisition mode (STEAM). Although STEAM has several advantages in comparison to PRESS, signal/noise ratio (SNR) superiority of PRESS makes it the first choice for SVS. Application of fast Padé transform (FPT) instead of Fast Furrier transform (FFT) might increase the SNR of the signal produced by STEAM pulse-sequence and therefore allows the benefits of its advantages. We aimed to evaluate and compare the noise root mean square (RMS) and SNR provided by STEAM pulse-sequence using both FPT and FFT.…MATERIALS AND METHOD: A gelatin-based phantom was constructed in a 19-cm acrylic cylinder. The phantom had two normal/tumoral parts. The SVS was performed using a 3T MRI scanner. STEAM pulse-sequence were used with the following parameters: TR = 2000 ms, TM = 10 ms, and three TEs of 20, 135 and 270 ms with two data-points of 1024 and 512 and voxel-size of 1 cm 3 . The raw data were extracted and processed using both FFT and FPT estimators to produce the spectrum. The noise RMS and SNR of Cho and Cr metabolites were assessed. RESULTS: According to the results, noise RMS of spectra provided by FPT were decreased between 3619.01–14252.94% in comparison to FFT (p < 0.00001). The SNR of Cr1 and Cho peaks of the spectra provided by FPT were increased more than 96.80 and 97.18, respectively (0.00006 < p < 0.02). DISCUSSION: The difference of noise RMS’s provided by FPT are thousands percent less than FFT. This enormous decrease in noise provides a good increase of SNR. While the range of Cr1 and Cho SNR by FFT are between 41.55–120.32 the range of SNRs of these peaks provided by FPT are between 1719.99–9744.79, which implies a significant difference between the efficiency of FPT and FFT. CONCLUSION: This study showed that application of FPT in comparison to FFT can increase the spectra SNR and so that its usage can be helpful during the application of STEAM pulse-sequence which results in lower SNR in comparison to PRESS pulse-sequence. Thus, we should make use of the advantages of STEAM pulse-sequence.
Keywords: Magnetic resonance spectroscopy, fast Padé transform, Fast Furrier Transform, STEAM pulse sequence, signal to noise ratio
Abstract: BACKGROUND: Applying the proper technique for connections in Peritoneal Dialysis (PD) is crucial in preventing potential infectious complications. OBJECTIVES: The aim of this study is to investigate the effects of different education methods in PD application training on the psychomotor skills and self-efficacy of nursing students. METHODS: The randomized controlled and experimental study was conducted with a total of 28 nursing student participants. The PD training was provided theoretically and by using a PD simulator for the experimental group and by using videos for the control group. At the end of the training,…each student who was included in the experimental and control group were asked to perform PD on the PD simulator one by one. Psychomotor skills were evaluated according to the PD application skill evaluation criteria. Self-efficacy of the students before and after the application was also measured. RESULTS: Psychomotor skill scores of the students were found to be significantly higher in the experimental group, and there was no significant difference between the experimental and control groups in terms of self-efficacy scores. No statistically significant difference was detected between the self-efficacy scores of the experimental group regarding pre-test and post-test results. CONCLUSION: This technique can be used to improve the development of psychomotor skills, since the demonstration of the PD application with the simulation technique is effective in the development of psychomotor skills.
Abstract: BACKGROUND: Sleep is a natural periodic state of rest for body and mind and daily sleep affects physical and mental health. However, it is essential to address intensity of sleep characteristics affecting the memory capacity of humans positively or negatively. OBJECTIVE: Using wearable devices to observe and assess the effect of daily sleep on memory capacity of college students. METHODS: This study assessed the daily sleep characteristics and memory capacity of 39 college students who used wrist-worn devices. The spatial span test (SST) was used to evaluate the memory capacity. RESULTS:…The study indicated a negative correlation between memory capacity and awake count on the test date and during the week before the test date (r = - 0.153 (95% CI: - 0.032, - 0.282), r = - 0.391 (95% CI: - 0.520, - 0.235), respectively). However, the minutes asleep on the test date and during the week before the test date positively affected memory capacity (r = 0.127 (95% CI: 0.220, 0.025), r = 0.370 (95% CI: 0.208, 0.500), respectively). In addition, spending ⩾ 6 hours and 42 minutes asleep on the test date or ⩾ 6 hours and 37 minutes asleep per day on average during the week before the test date resulted in a better memory capacity. CONCLUSIONS: A lower awake count led to a higher memory capacity in college students, as did more minutes asleep.
Keywords: Wearable devices, daily sleep, memory, college student
Abstract: BACKGROUND: Previous research regarding the humanistic care ability of Chinese medical professionals was limited to small groups of nurses or students. More systemic analyses involving more general medical professionals are scarce and urgently needed. OBJECTIVE: To survey the sense and ability of humanistic care on medical professionals in China and to identify the potential influencing factors. METHODS: A novel scale of humanistic care indicators was developed. Based on the new scale, a questionnaire was designed, tested and used to survey a total of 928 medical professionals recruited from three hospitals in the Chinese…Western city Chongqing. Chi-square test was used for single factor analyses. For multiple factor analyses, multivariate logistic regression was performed. RESULTS: Our selected group of medical professionals scored nearly 4 or above on a 1–5 scale for all our query items related to the sense and ability of humanistic care. The main factors affecting humanistic care ability of medical professionals in Chongqing include gender, nature of department/division, modes of employment and participation in humanistic care ability training and so on. CONCLUSIONS: In general, the participants in our study group had a humanistic care ability score lower than the aimed value, suggesting that the ability of humanistic care of these medical professional was not satisfactory. The study also shows that one effective way to enhance the humanistic care ability is to provide more targeted training.
Keywords: Humanistic care, sense and ability, influencing factor, medical education
Abstract: BACKGROUND: Blood sampling is frequently used in health to evaluate diagnosis and treatments. The first blood drawing is most important skill for nursing students. Nursing students gain these skills during their first years of education. OBJECTIVE: To identify the self-confidence and self-efficacy levels of first year nursing students when performing taking blood on their peers for the first time. METHODS: The sample (n = 70) of this descriptive and cross-sectional research comprised first year nursing students. The research was conducted in two stages; theoretical training and laboratory work…and students’ first taking blood on their peers. A Student Information Form, Blood drawing Skill Practice Evaluation Control Form, Self-Confidence Scale, and General Self-Efficacy Scale were used for data collection. Percentage calculations and the Mann-Whitney U test were used for data analysis. RESULTS: The total mean score of the students’ self-confidence was 130.09 ± 15.94 (Min = 91, Max = 157), and total mean score of self-efficacy was identified as 31.71 ± 3.92 (Min = 20, Max = 39). No statistically significant difference was detected between the students’ sex and high school type regarding self-confidence and self-efficacy total mean scores (p > 0.05). CONCLUSIONS: It was observed that students’ self-confidence and self-efficacy levels were high when performing taking blood on their peers for the first time.
Keywords: Blood drawing, nursing students, self-confidence, self-efficacy, skill training
Abstract: BACKGROUND: High-fidelity simulation (HFS) as a teaching-learning method has increased, especially in medical programs. OBJECTIVE: This study was conducted to assess the effectiveness of using HFS on the satisfaction, self-confidence, self-efficacy, and knowledge of undergraduate students in oncology care. METHODS: A pre-test post-test quasi-experimental design was utilized. Random sampling technique was used to recruit the participants. The scenarios including septic shock and infusion reaction were implemented. The training program including lectures and the simulation was run in a high fidelity simulation lab. RESULTS:…There was a significant difference ( t = - 5.95, p = 0.001) between the experimental group ( M = 13.95, S D = 3.35) and the control group ( M = 6.25, S D = 2.65) regarding knowledge, confidence ( t = - 22.75, p = 0.001) between the experimental group ( M = 61.25, S D = 12.10) and the control group ( M = 38.50, S D = 6.20), satisfaction level t = - 18.25, p = 0.001; experimental group – M = 42.25, S D = 4.25; and control group – M = 28.50, S D = 3.15), and there was a significant difference between the experimental group ( M = 35.50, S D = 3.25) and control group ( M = 24.25, S D = 2.85) regarding self-efficacy ( t = - 13.25, p = 0.001). CONCLUSIONS: High-fidelity simulation in nursing increased student knowledge, self-confidence, satisfaction, and self-efficacy in managing septic shock and infusion reaction as common oncology emergencies.