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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: Electric cars are increasingly used for public and private transportation and represent possible sources of electromagnetic interference (EMI). Potential implications for patients with cardiac implantable electronic devices (CIED) range from unnecessary driving restrictions to life-threatening device malfunction. This prospective, cross-sectional study was designed to assess the EMI risk of electric cars on CIED function. METHODS: One hundred and eight consecutive patients with CIEDs presenting for routine follow-up between May 2014 and January 2015 were enrolled in the study. The participants were exposed to electromagnetic fields generated by the four most common electric cars (Nissan Leaf,…Tesla Model S, BMW i3, VW eUp) while roller-bench test-driving at Institute of Automotive Technology, Department of Mechanical Engineering, Technical University, Munich. The primary endpoint was any abnormalities in CIED function (e.g. oversensing with pacing-inhibition, inappropriate therapy or mode-switching) while driving or charging electric cars as assessed by electrocardiographic recordings and device interrogation. RESULTS: No change in device function or programming was seen in this cohort which is representative of contemporary CIED devices. The largest electromagnetic field detected was along the charging cable during high current charging (116.5 μ T). The field strength in the cabin was lower (2.1–3.6 μ T). CONCLUSIONS: Electric cars produce electromagnetic fields; however, they did not affect CIED function or programming in our cohort. Driving and charging of electric cars is likely safe for patients with CIEDs.
Abstract: OBJECTIVE: This study aims to investigate failure factors in retrograde wire-guided cannulation (retrograde approach) for the treatment of coronary chronic total occlusion (CTO). METHODS: Data of 285 patients treated for CTO using retrograde approach in the General Hospital of Shenyang Military Region from August 2004 to May 2016 were collected. RESULTS: The average age of the 285 patients was 63.89 ± 11.3 years old. Multivariate analysis revealed that the operation risk factors include the number of diseased vessels, collateral circulation, as well as whether anterograde intervention for CTO target vessels…was previously performed (OR = 0.875, 95% CI = 0.779–0.940, P = 0.026) and whether other vessels were intervened (OR = 22.372, 95% CI = 2.059–243.031, P = 0.011). CONCLUSION: Based on the present study, the success rate of retrograde approach for CTO was negatively correlated with the number of diseased vessels and collateral circulation. It was furthermore of importance whether anterograde intervention for CTO target vessels was previously performed and whether other vessels beside CTO vessels were intervened, which were also risk factors.
Abstract: BACKGROUND: An electroencephalogram (EEG) is the most dominant method for detecting epileptic seizures. However, the existing techniques use single-channel EEGs from public databases and the sample size is small. OBJECTIVE: This study proposes a strategy to distinguish multichannel EEGs for health control, particularly the interictal and ictal multichannel EEGs of epileptic patients. METHOD: We calculated five features (variance, Pearson correlation coefficient, Hoeffding’s D measure, Shannon entropy, inter-quartile range), which are based on maximal overlap discrete wavelet transform. These features were then fed into linear discriminant analysis for classification purposes. Finally, the proposed method…was tested on data on 34 healthy people, 21 interictal patients and 30 ictal patients taken from a hospital. RESULTS: Our experimental results show that the accuracy between healthy and epileptic seizures was 96.88% and the area under the curve (AUC) is 1. The accuracy between interictal and epileptic seizures was 94.12% and the AUC was 0.97. We also obtained an accuracy and AUC equal to 1 for discrimination of interictal EEGs from normal. Finally, we obtained an AUC of 0.83 and an accuracy of 85.88% for discrimination in these three classes. Therefore, our study achieves sufficient performance. CONCLUSIONS: Our proposed method can serve as an auxiliary tool for clinicians who wish to make clinical decisions and reduces the burden of detecting epileptic seizures.
Abstract: BACKGROUND: Clinicians routinely encounter the endodontically treated teeth with wide flared canals and mineral trioxide aggregate (MTA) repair on the canal wall. OBJECTIVE: To assess the effect of customized glass reinforced composite (FRC) post and reshaped root canal along with different acid etching protocol of MTA surface on push-out bond strength (PBS) in flared, MTA repaired root canal. METHODS: Ninety recently extracted single-rooted premolar teeth were sequentially subjected to root canal obturation, post space preparation, flaring, and MTA application. The samples were randomly divided into 3 groups of control (no relining or reshaping),…customized FRC post by relining with self-adhesive resin cement and reshaping the canal with flowable composite. Each group was subdivided into 3 subgroups (n = 10) as no surface treatment, 37% H 3 PO 4 and 19% EDTA etching of MTA surface. Teeth samples cemented with FRC post were sectioned into 2 mm and push-out testing. RESULTS: Control group had the lowest PBS at 1.988 N. The PBS values for the groups with customized post relining were 8.489 N, 8.888 N and 7.911 N for control, H 3 PO 4 etch and EDTA etch. The corresponding PBS values for root canal reshaping were 7.323 N, 8.318 N and 7.785 N. CONCLUSIONS: Customized FRC post with 37% H 3 PO 4 etching is advised for the flared and MTA repaired root canals.
Keywords: Flared root canal, mineral trioxide aggregate, customized fiber post, root canal reshaping
Abstract: BACKGROUND: The gait ability of stroke patients is highly related with trunk control. Studies that addressed the effects of trunk control training using visual feedback on gait parameters of stroke patients are lacking. OBJECTIVE: The purpose of this study was to investigate the role of smartphone-based visual feedback trunk control training for improvement of trunk control and spatio-temporal gait parameter in stroke patients. METHODS: Twenty-four stroke patients participated in this study. Participants were randomly allocated to the experimental and control groups. Both groups completed conventional rehabilitation over 4 weeks. The experimental group additionally…received smartphone-based visual feedback trunk control training for 4 weeks. The primary outcome of this study was evaluated by trunk impairment scale and spatio-temporal gait parameters. RESULTS: The trunk impairment scale in the experimental group was significantly improved compared to the control group (P < 0.05). The spatio-temporal gait parameters are significantly more different in the experimental group than in the control group (P < 0.05). CONCLUSIONS: Additional smartphone-based visual feedback trunk control training may improve trunk control and spatio-temporal gait parameter in chronic stroke patients.
Abstract: Analysis of human brain activity is an important topic in human neuroscience. Human brain activity can be studied by analyzing the electroencephalography (EEG) signal. In this way, scientists have employed several techniques that investigate nonlinear dynamics of EEG signals. Fractal theory as a promising technique has shown its capabilities to analyze the nonlinear dynamics of time series. Since EEG signals have fractal patterns, in this research we analyze the variations of fractal dynamics of EEG signals between four datasets that were collected from healthy subjects with open-eyes and close-eyes conditions, patients with epilepsy who did and patients who did not…face seizures. The obtained results showed that EEG signal during seizure has greatest complexity and the EEG signal during the seizure-free interval has lowest complexity. In order to verify the obtained results in case of fractal analysis, we employ approximate entropy, which indicates the randomness of time series. The obtained results in case of approximate entropy certified the fractal analysis results. The obtained results in this research show the effectiveness of fractal theory to investigate the nonlinear structure of EEG signal between different conditions.
Abstract: BACKGROUND: Drug-eluting stent technology has rapidly developed in recent years. In particular, stents are used in percutaneous coronary intervention (PCI), which has become a vital method in clinic treatment. Although various methods are currently used to prepare drug-eluting stents, these methods are associated with respective limitations. OBJECTIVE: To design equipment for preparing drug-eluting stents with single-sided coating and to precisely accomplish the drug-coating process for a single side. METHODS: This coating equipment prepared stents in three stages: the precise displacement and translational motion and rotational motion of the operating platform; the recognition and…positioning of the stent strut; and the utilisation of a pL-scale inkjet system. In order to control and synchronise the work of each subsystem, a central processing unit was installed. RESULTS: Through the analysis and solutions of various problems occurring in the experiment, the spraying equipment was improved, and its functions were perfected. Thus, the successful operation of the spraying equipment was realised. CONCLUSIONS: The design of the equipment introduced in this article meets the requirements for preparing drug-eluting stents.
Keywords: Coating equipment design, drug-eluting stent, single-sided drug coating
Abstract: BACKGROUND: Radial extracorporeal shock wave therapy (rESWT) is an effective and safe non-invasive therapeutic option for various musculoskeletal pathologies. However, data on possible application of radial extracorporeal shock waves (rESWs) on soft tissue components of fingers is still scarce. OBJECTIVE: We now aimed to analyze the feasibility of applying rESWs to human fingers ex vivo. METHODS: Fresh frozen human cadaveric fingers were exposed to rESWs of varying energy density. The penetration of the rESWs into the soft tissue was determined using pressure sensitive Fuji films that were placed underneath the flexor tendons and…other soft tissue components at the proximal phalanx. Then, rESWs were applied and activation of the Fuji film was recorded. Software based image analysis was performed on all films treated with rESWT under ultrasound gel. RESULTS: Penetration of the rESWs through the soft tissue was detected in all settings. Increasing energy density of the rESWs resulted in increasing film activation. Image analysis of films used under ultrasound showed a significant difference among the groups. CONCLUSION: The results of this study demonstrate that rESWs can penetrate soft tissues including the flexor tendons of human cadaveric fingers. rESWT should be considered as a valuable potential therapeutic option of different finger pathologies. Further studies focusing on the clinical application of rESWT for finger pathologies are required.
Abstract: BACKGROUND : Fractures of the talus often lead to permanent restrictions of the affected limb. Possible alterations after these fractures in gait have not been evaluated yet. OBJECTIVE: To evaluate possible alterations of gait by pedybarography after talar fractures. METHODS: We conducted a retrospective single-centre study at a level I trauma center. Twenty patients with operatively treated talar fractures were followed up. Objective and subjective function of the ankle was measured using range of motion, clinical scores and dynamic pedobarography (emed-M; Novel, Germany). RESULTS: There were 11 talar neck and 9…talar body fractures. All patients received screw fixation. There was a significant reduction in range of motion. The outcome was moderate to satisfying and the severity of the injury correlated with the clinical outcome and the range of motion. The presence of posttraumatic arthritis and joint incongruity lead to a decreased function of ankle and subtalar joint and resulted in a worse clinical outcome. AVN rate was associated to initial displacement. Dynamic pedobarography showed no significant changes in gait pattern. CONCLUSIONS: Fractures of the talus lead to dissatisfaction, pain and malfunction. However, a change in gait pattern could not be proved.
Abstract: BACKGROUND: A prosthetic knee is the key component of the transfemoral prosthesis. The performance of the prosthetic knee determines the walking ability of transfemoral amputees. OBJECTIVE: This study proposes a microprocessor-controlled prosthetic knee with a novel hydraulic damper and evaluates the performance of the prosthetic knee by gait symmetry index. METHODS: The homotaxial knee joint with electrical-controlled hydraulic cylinder which adjusts knee flexion and extension damping independently and continuously by single motor was designed. Gait symmetry tests under different walking speeds (0.6 m/s, 1.1 m/s and 1.6 m/s) were conducted to evaluate the performance of the…proposed microprocessor-controlled prosthetic knee. RESULTS: The symmetry index values indicated that the stance phase was more asymmetry than swing phase. In the swing phase, the knee angle symmetry was observed in different speeds. The number values of symmetry index were smaller than 15% in swing phase. CONCLUSIONS: The proposed microprocessor-controlled prosthetic knee could meet the demands of walking.
Abstract: BACKGROUND: An assessment of needs to develop a system that provides consultations using a telepresence robot and education for health professionals was conducted. The absence of a structured methodology for user-needs analysis has been identified as a problem. OBJECTIVE: To use a telepresence robot for medical consultation in future usability testing, the robot has been developed by analyzing end-user needs in a multifaceted manner. METHODS: In designing the telepresence robot for consultation, required functions and forms were defined based on the results of a user-needs survey. The robot was implemented based on specifications of needs.…The prototype robot was developed and after repeated internal tests, the final version was completed. CONCLUSIONS: The present study holds significance as it systemized user needs, applied them to a new medical technology’s components and functions, and provided a technology development process that could improve usability.
Abstract: Body mass index (BMI) is used widely as an indicator in general health. Determination of BMI using non-intrusive measurements are of interest and recent advancements in the availability of digital imaging sensors have paved the way for performing quick and automatic measurements. In this work, we consider automatic computation of BMI using correlation features from face images. We show that using face detection based facial fiducial points analysis provides good BMI prediction. Experimental results on comparing the correlation coefficients of facial ratios along with the colour feature has higher significance in BMI of a person.
Keywords: Body mass index (BMI), facial features, correlation coefficient