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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: Recognition of sources in the brain and their interaction with mental fatigue states are interesting subjects for researchers. OBJECTIVE: The aim of this study was to investigate the mental fatigue effects on brain areas by dynamic causal modeling (DCM) parameters that are extracted from event-related potential (ERP) signals which were then estimated based on mental fatigue data with visual stimulation. METHODS: ERP were recorded based on a Continuous Performance Task in four consecutive trials. Active regions and brain sources were extracted by a Multiple Sparse Priors algorithm. RESULTS: Four…models are proposed for DCM. The parameters and the structure of the best model were obtained by SPM software for ERP in each of the four trials. CONCLUSION: The results illustrate that an increase of mental fatigue through trials leads to increased likelihood of choosing forward models.
Abstract: BACKGROUND: Exergaming has the potential to improve physical function, cognition and dual-task function, and could be an effective new strategy for reducing risk of falling in older adults. OBJECTIVE: To evaluate and test custom Microsoft Kinect-based motion-tracking exergames in older adults at risk for falls. METHODS: Community-dwelling older adults who reported mobility difficulties or had fallen in the past year played three newly developed exergames (Target Trackers, Double Decision, and Visual Sweeps, 5 minutes each) in random order. Heart rate (HR) was measured during, and blood pressures (BPs), rating of perceived exertion (RPE),…and rating of the enjoyment were recorded immediately after each exergame. RESULTS: Seven participants (median age 75 y; 4 females) completed the study. There were no adverse events reported during the exergaming session . Exercise HRs and RPEs were statistically significantly higher than resting for all exergames (p < 0.05). The differences were not significant for BPs. Enjoyment ratings ranged from 79.6–90.6% and there were no statistically significant differences between the exergames. CONCLUSIONS: The newly developed exergames were light in exercise intensity and enjoyable for older adults at risk for falls. Future intervention studies are warranted to examine the benefits of exergames for this special population.
Abstract: BACKGROUND: Parkinson’s disease (PD) is a neurological disorder, progressive in nature. In order to provide customized patient care, diagnosis and monitoring using smart gadgets, smartphones, and smartwatches, there is a need for a system that works in natural as well as controlled environments. OBJECTIVE AND METHODS: The primary purpose is to record speech signal, and identify whether the speech signal is Parkinson or not. For this work, a comparison of three feature extraction methods, i.e. Wavelet Packets, MFCC, and a fusion of MFCC and WPT, were carried out. Apart from the feature extraction, two classifiers were…used, i.e. HMM and SVM. RESULTS: In this study, a fusion of MFCC, WPT with HMM shows the best performance parameters. CONCLUSION: The best of the three feature extraction and classifier results are described in this paper.
Abstract: BACKGROUND: Facial expression recognition plays an essential role in affective computing, mental illness diagnosis and rehabilitation. Therefore, facial expression recognition has attracted more and more attention over the years. OBJECTIVE: The goal of this paper was to improve the accuracy of the Electroencephalogram (EEG)-based facial expression recognition. METHODS: In this paper, we proposed a fusion facial expression recognition method based on EEG and facial landmark localization. The EEG signal processing and facial landmark localization are the two key parts. The raw EEG signals is preprocessed by discrete wavelet transform (DWT). The energy feature…vector is composed of energy features of the reconstructed signal. For facial landmark localization, images of the subjects’ facial expression are processed by facial landmark localization, and the facial features are calculated by landmarks of essence. In this research, we fused the energy feature vector and facial feature vector, and classified the fusion feature vector with the support vector machine (SVM). RESULTS: From the experiments, we found that the accuracy of facial expression recognition was increased 4.16% by fusion method (86.94 ± 4.35%) than EEG-based facial expression recognition (82.78 ± 5.78%). CONCLUSION: The proposed method obtain a higher accuracy and a stronger generalization capability.
Abstract: BACKGROUND: Obstructive Sleep Apnea (OSA) is the cessation of breathing during sleep due to the collapse of the upper airway. Polysomnographic recording is a conventional method for detection of OSA. Although it provides reliable results, it is expensive and cumbersome. Thus, an advanced non-invasive heart rate variability (HRV) signal processing technique other than the standard spectral analysis, which also has efficiency limitations, is needed for identification of OSA and classification of apnea levels. OBJECTIVE: The main purpose of this work was to predict the severity of sleep apnea using an efficient method based on the combination…of time-domain and frequency-domain analysis of the HRV to classify sleep apnea into three different levels (mild, moderate, and severe) according to its severity and to distinguish them from normal subjects. METHODS: The statistical signal characterization of the FFT-based spectrum of the RRI data is used in this work in order to rank patients to full polysomnography. Data of 20 normal subjects, 20 patients with mild apnea, 20 patients with moderate apnea and 20 patients with severe apnea were used in this study. RESULTS: Accuracy result of 100% was obtained between severe and normal subjects, 100% between mild and normal subjects, and 100% between apnea (mild, moderate, severe) and normal subjects. This perfect accuracy is obtained using the parameter mean (mt). The physiological interpretation of the SSC parameters has been derived using a mathematical model system. CONCLUSIONS: An efficient method for screening of sleep apnea with 100% efficiency in classification of sleep apnea levels, is investigated in this work.
Keywords: Obstructive sleep apnea, severity of apnea, HRV, statistical signal characterization, FFT spectral
Abstract: BACKGROUND: The mechanical stretch injury imposed by the intravascular intervention contributes to neointimal hyperplasia. Lessening of this damage without the compromise of luminal dilation could be an alternative way to alleviate restenosis. OBJECTIVE: We aimed to assess the relationship of lumen diameter and neointimal hyperplasia with inflation pressure using color Doppler ultrasound-guided balloon dilation. METHODS: The anteroposterior diameter of the given aortic segment in rabbits was measured by ultrasonography to ensure the similar original diameter. Then they were assigned into three groups with the inflation force at 1, 5, 10 atmosphere pressure (atm), respectively.…Balloon dilation and injury of the given aortic segment were performed. Two weeks later, all rabbits were euthanized for histologic evaluation. RESULTS: After operation, the lumen diameter of each group enlarged significantly (P < 0.05) with a similar rate of change. However, neointimal area, circumference and hepatocyte growth factor (HGF) positive cells in group with 1 atm were significantly less than those of the other two (P < 0.05). Maximal neointima thickness increased significantly with the elevation of the inflation pressure (P < 0.05). CONCLUSIONS: Based on sufficient dilation of the balloon, the balloon inflated with the less pressure caused the similar increase in lumen diameter as the higher pressure but the less neointimal hyperplasia and HGF positive cells.
Keywords: Lumen diameter, neointimal hyperplasia, inflation pressure, color Doppler
Abstract: Prevailing technological solutions that address the problems that are experienced by the infirm and elderly people in terms of locomotion needs, offer limited options when it comes to control mechanism and customization. For more than a decade, joysticks have served the purpose of steering and navigation of autonomous wheelchairs. An alternative gesture-based method for navigation of wheelchairs by the physically impaired could very well replace the conventional joystick controls. A prototype system, ‘Mudra’ (Sanskrit word for gesture), incorporates a gesture capture module, developed for recognition and identification of hand gestures. Mudra is a no-nonsense user-friendly system that enables control of…the navigational platform, merely by four gestures of the human hand. This paper presents a comprehensive report on the implementation of the Mudra system’s hardware and software, performance analysis and safety evaluation. Verification tests of the conceptual design show promising results, where 97.8% of the hand gestures were recognized accurately. Furthermore, the response timings of wheelchairs with Mudra controls were noticeably faster than the joystick-based wheelchairs, as affirmed by live testing with wheelchair-users. Pursuant to the positive feedback from the wheelchair-user experience, we conclude that Mudra’s gesture controlled wheelchairs would be a preferable alternative to joystick-controlled wheelchairs.
Abstract: BACKGROUND: Treatment of distal intra-articular humerus fractures is still a technical challenge. Until now, little is known about the regain of strength and elbow agility after surgical treatment of these fractures. Due to small collectives there is only limited data. OBJECTIVE: Investigation of regained strength and elbow agility in patients with intra-articular distal humerus fractures. METHODS: A total of 28 patients were treated with distal intra-articular humerus fractures followed up for an average period of 62.3 months. The following parameters were examined: Arthrosis, heterotopic ossification, functional outcome (MEPS, DASH score, LES) and isometric…strength of the elbow in extension and flexion was tested in 30 ∘ , 60 ∘ and 90 ∘ in a custom-made positioning device. RESULTS : There was a high complication rate with 32%. At the 60th month post injury, range of motion (ROM) of the elbow was 114 ∘ with a reduction of 32 ∘ compared to the contralateral uninjured side (p < 0.001). The highest reduction was seen in extension with an average loss of 16 ∘ (p < 0.001). Loss of motion correlated with the fracture severity regarding the AO-classification (r = 0.54, p < 0.01). The average regained muscle force was 81.5% in flexion and 92% in extension in comparison to the contralateral healthy side. Patients over 60 years had less range of motion and inferior results in the DASH score compared to younger patients. CONCLUSIONS: Functional impairment in terms of reduced ROM and muscle force is a common complication after distal intra-articular humerus fracture. Patients over 60 years have a higher deficit of motion in the injured elbow joint and an inferior clinical outcome. Superiority of modern angle-stable implants could yet not be shown.
Keywords: Distal intra-articular humerus fracture, reduction of elbow agility, loss of muscle force, angle-stable implants
Abstract: BACKGROUND: Very few studies have evaluated biomechanical characteristics of the disc degenerated human lumbar spine after bilateral pedicle screw fixation (BPSF) under whole body vibration (WBV) that is typically present in vehicles. OBJECTIVE: To examine the influence of BPSF on stress responses of the disc degenerated human lumbar spine to WBV using finite element (FE) method. METHODS: Two previously validated L1–S1 FE models with different grades of disc degeneration (mild and moderate) at L4–L5 were employed, and the two degenerated models were instrumented with bilateral pedicle screws and rods across the L4–L5 level,…respectively. Transit dynamic analyses were performed on all these models under a 400 N compressive follower preload and a 40 N sinusoidal vertical vibration load. Intradiscal pressure (IDP) and von Mises stress (VMS) of the annulus ground substance in all disc levels of the degenerated models and the corresponding implanted models were recorded and compared. RESULTS: BPSF decreased maximum response values and vibration amplitudes of the IDP and annulus VMS in both the degenerated and adjacent levels of the lumbar spine. CONCLUSIONS: Application of the BPSF system is helpful in prevention of further injury of the disc degenerated lumbar spine during WBV.
Keywords: Disc degeneration, finite element model, human lumbar spine, pedicle screw fixation, stress responses, whole body vibration
Abstract: The intrauterine device (IUD) has corresponding side effects including reproductive tract infectious diseases, irregular vaginal bleeding, menoxenia, lower abdominal pain, pain in the lumbosacral region and ectopic gestation. A prior study conducted by Bhatia and Cleland reflected that contraceptive usage was one of the factors that influence the occurrence of RTIs in South India. Although many studies have been conducted in various parts of different countries with the aim to document the prevalence of RTIs and its risk factors, there remains a lack of sizable literature for Chinese women who use specific IUDs. Therefore, we conducted an analysis on the…relationship of IUD type and processing period with the occurrence rate of RTI.