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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: Autofluorescence imaging technology has been utilized for preserving or identifying parathyroid glands (PTGs) during thyroid surgery. We developed a wireless PTGs detection device linked with smart glasses that allows for real-time video recording and screen switching according to the light source. OBJECTIVE: This study aimed to confirm the feasibility of the device and whether it would help preserve the PTG during the surgery. METHODS: This prospective study was conducted in 30 patients with 66 PTGs. The device’s agreement with the physician’s judgment was evaluated, and we determined how many PTGs were preserved from thyroidectomy.…RESULTS: The positive agreement rate for PTGs detection between the surgeon and device was 70.9%. Inadvertent parathyroidectomy was identified in surgical specimens of 6 patients (20%). No PTG was removed when it was confirmed by the device (0/39). Of the 27 glands not detected by the device, there was inadvertent removal of 6 PTGs. CONCLUSIONS: PTGs can be preserved successfully when the detection of them by the device is consistent with the surgeon’s discretion. A large-scale controlled study is necessary to demonstrate the practical effect of this device on hypoparathyroidism after thyroidectomy.
Abstract: BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA), including balloon angioplasty, is a standard clinical invasive treatment for coronary artery disease. The coronary lesion with calcification is difficult to dilate and the prevention of balloon failure is especially important. OBJECTIVE: A novel superpressure balloon was fabricated with bilayered structure of polyethylene terephthalate (PET) and PA12 (polyamide). METHODS: The structures of bilayer balloon were adjusted to achieve overall excellent performance. Physicochemical, thermal and mechanical properties of bilayer balloons were characterized by X-ray diffraction, differential scanning calorimeter, hydraulic tester and theoretical simulation. RESULTS: Compared…with pure PA12 and PET balloons, PA12 outer layer: PET inner layer balloon with layer ratio of 3:7 shows the highest burst stress and relatively low compliance due to an increase in crystallinity and orientation. CONCLUSIONS: The produced bilayer balloon proved to possess a small folding dimension thanks to its ultrathin bilayer structure, which is good for crossing cramped vessels. We believe these optimally fabricated bilayer balloons are proved to provide attractive opportunities for preparation, performance enhancement, and practical applications of super-pressure balloon catheters and cryoablation balloons, that will significantly promote the development of percutaneous transluminal coronary angioplasty for clinical applications.
Abstract: BACKGROUND: The treatment of adolescent patients with distal femoral cancer has always been a concern. The limb-salvage, regarded as a mainstream treatment, had been developed in recent years, but its application in children still remains challenging. This is because it can lead to potential limb-length discrepancy from the continued normal growth of the contralateral lower body. The extendable prosthesis could solve this problem. The principle is that it can artificially control the length of the prosthesis, making it consistent with the length of the side of the lower limbs. However, this prosthesis has some complications. The extendable prosthesis is classified…into invasive and minimally invasive, which extends the prosthesis with each operation. OBJECTIVE: We designed a new non-invasive prosthesis that can be extended in the body. Based on the non-invasive and extendable characteristics, we need to verify the supporting performance of this prosthesis. METHODS: We carried out a mechanical testing method and finite element analysis simulation. CONCLUSION: The support performance and non-invasively extension of this prosthesis were verified.
Abstract: OBJECTIVE: This study aims to accurately measure the range of motion of the sternoclavicular (SC) joint using 3D reconstruction and image registration. The motion of the SC joint is analyzed by means of axial angle representation to identify the kinematical characteristics of this joint. METHODS: A total of 13 healthy volunteers were enrolled in the study. The limit postures of four SC joint movements were scanned by computerized tomography. The images were integrated with reconstruction and registration techniques. The range of motion of the SC joint was measured using 3D modelling. The axial angle was used…to indicate the range of motion of the SC joint. The difference between the dominant side and non-dominant side was compared and the differences in axial angle of the SC joint in different postures were compared. RESULTS: The active axial angle of the SC joint on the dominant side was approximately 1 ∘ higher than that of the non-dominant side when the upper limb moved from a rest position to a posteroinferior position. In the sagittal motion of the upper limbs, the axial angle of the SC joint was greatest when moving from a horizontal position to a posterosuperior position, with an average of 23.55 ∘ . Of the flexion and extension movements of the upper limbs from a rest position to a horizontal position, 13.66% (the smallest proportion) were completed by the SC joint. CONCLUSION: The combination of 3D reconstruction and image registration is a direct and accurate method of measuring the motion of the SC joint. Axial angle representation is an intuitive method of expressing rotation in a 3D space that allows for more convenient comparison; it is also more in line with the characteristics of human anatomy and kinesiology and therefore more accurately reflects the characteristics of joint motion. It is therefore useful for guiding clinical practice. In a physical examination, the extension of the upper limb from the horizontal position to the posterosuperior position and from the rest position to the posteroinferior position can best reflect the rotation function of the SC joint in the combined motion of shoulder joints.
Abstract: BACKGROUND: Dental caries is one of the most common diseases around the world. The newly erupted permanent posterior teeth are at great risk due to the complex occlusal morphology of pits and fissures, infraocclusion and incomplete maturation of enamel. Pit and fissure sealants are the treatment of choice in such conditions. OBJECTIVES: To compare the successful outcome of pit and fissure sealants bonded with etch-and-rinse adhesive system and self-etch adhesive systems in newly erupted permanent first molars. METHODS: This randomized clinical trial was conducted at the Fatimah Jinnah Dental Hospital from June 2017…to May 2019. Children aged between 6 to 9 years who fulfilled the inclusion criteria were recruited for this study after parents’ consent. Patients were randomly divided into two groups by the lottery method. Thirty patients with 60 first molar teeth in Group A were treated with etch-and-rinse adhesive system, while the other thirty patients with 60 first molar teeth in Group B were treated with self-etch adhesive system. After adhesive placement, all children received the same fissure sealants in newly erupted maxillary and mandibular permanent first molar. Each group was clinically evaluated at 6 and 12 months follow-up visit. Modified United States Public Health Service (USPHS) criteria were used for direct clinical evaluation of successful outcomes such as sealant retention and marginal discoloration. RESULTS: Successful outcome was statistically significant in Group B compared to Group A (60% vs. 30% p = 0.020) at 12 months follow-up. Stratification analysis was performed with respect to age in which a successful outcome was not significant (p = 0.43) between groups for 6 to 7 years of age, while it was significant (p = 0.012) between groups in 8 to 9 years of age children. CONCLUSION: Self-etch adhesive system is better than etch-and-rinse adhesive system in terms of long-term sealant retention. In addition, the bonding procedure is simple with relatively short clinical application time therefore it would offer great benefit to clinicians in treating pediatric patients.
Keywords: Self-etch adhesive, etch-and-rinse adhesive, pits and fissure sealant
Abstract: BACKGROUND: The definition of rehabilitation training trajectory is of great significance during rehabilitation training, and the dexterity of human-robot interaction motion provides a basis for selecting the trajectory of interaction motion. OBJECTIVE: Aimed at the kinematic dexterity of human-robot interaction, a velocity manipulability ellipsoid intersection volume (VMEIV) index is proposed for analysis, and the dexterity distribution cloud map is obtained with the human-robot cooperation space. METHOD: Firstly, the motion constraint equation of human-robot interaction is established, and the Jacobian matrix is obtained based on the speed of connecting rod. Then, the Monte Carlo…method and the cell body segmentation method are used to obtain the collaborative space of human-robot interaction, and the VMEIV of human-robot interaction is solved in the cooperation space. Finally, taking the upper limb rehabilitation robot as the research object, the dexterity analysis of human-robot interaction is carried out by using the index of the approximate volume of the VMEIV. RESULTS: The results of the simulation and experiment have a certain consistency, which indicates that the VMEIV index is effective as an index of human-robot interaction kinematic dexterity. CONCLUSIONS: The VMEIV index can measure the kinematic dexterity of human-robot interaction, and provide a reference for the training trajectory selection of rehabilitation robot.
Abstract: BACKGROUND: The transport of the inpatients to and from locations inside the hospital can vary in complexity depending on the patient location, status, and logistical needs. Most transport systems have not developed at the same speed as other medically related technologies. We conducted a pilot study of a new automated transport system for patients within the hospital. METHODS: Our innovative system was introduced in January 2020. We present a retrospective case review of all in-patient transport request during April 15, 2020 through May 30, 2020 at the Shaare Zedek Medical Center, Jerusalem, Israel. The system is fully…automated and works via smartphone and electronic medical record integration. Transfer requests are processed on the basis of priority, proximity, and availably. RESULTS: During the study period there were 15, 581 transfer requests. Mean times to hospital destinations ranged from 9:25 to 28:02 minutes. Overall, mean times were quicker for emergency and surgical services. Trip times by priority code were likely influence by unmeasured confounders. There were no reported patient identification adverse events. Peak requests occurred during 0900-1500, and at the beginning of the week. CONCLUSION: Our automated in-patient transfer system appears to be efficient, safe, well received, and capable of servicing our large tertiary care medical center. Future controlled studies are needed to assess efficacy, adverse events, and clinical outcomes.