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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: Ventriculo-peritoneal shunt (VPS) is one of the routine methods used to treat communicating hydrocephalus. OBJECTIVE: To sum up the clinical effectiveness of ventriculo-peritoneal shunt (VPS), assisted with neuroendoscopy and laparoscopy, for the treatment of patients with communicating hydrocephalus. METHODS: From January 2010 to 2014, we performed VPS surgery on 209 patients with communicating hydrocephalus, using neuroendoscopy and laparoscopy, which helped to implant the shunt catheter in a suitable position in the ventricles and abdominal cavity, respectively. The subsequent survival following the surgery was analyzed using Kaplan-Meier analysis. RESULTS: A…total of 209 patients received 255 VPSs or revisions and all the operations were successfully completed. Open operation or oraniotomy was not needed for any technical complications, while 46 revisions were performed. After the operations, 203 patients with communicating hydrocephalus exhibited improvement of symptoms following surgery. The follow-up period ranged from one month to four years; the shunt surgery efficiencies were 91.0%, 86.7%, 83.9%, and 82.0% in the first, second, third, and fourth years, respectively. CONCLUSION: For ventriculo-peritoneal shunt, laparoscopy and neuroendoscopy can help to implant shunt catheter in a suitable position, in the ventricles or abdominal cavity, respectively. Hence, the combination of the two techniques can reduce the failure rate of VPS, and has an obvious impact on survival following the surgery.
Abstract: BACKGROUND: Polycystic ovary syndrome (PCOS) is a common gynecologic endocrinopathy, characterized by menstrual disorders, ovulation disorders, polycystic ovary, hyperandrogen syndrome and insulin resistance. At present, the etiology and exact pathogenesis of PCOS are still unclear. Anti-Müllerian hormone is a local regulator secreted by ovarian granulosa cells, and participates in regulating the occurrence and development of PCOS. Insulin resistance is another important pathophysiological feature of PCOS. Although the expression of anti-müllerian hormone receptor (AMHR) and insulin receptor (INSR) in PCOS have been previously reported, the DNA methylation of the genes have not been well characterized. OBJECTIVE: To…study AMHR II/INSR and its role in gene methylation in Ovarian and endometrial pathology of PCOS subjects. METHODS: We recruited seventy-five women with PCOS as cases and twenty healthy women as controls, using immunohistochemical method, study localization, distribution and expression of MHRII/INSR in ovary and endometrium and then discover the correlation of AMHRII/INSR gene methylation. RESULTS: Different clinical features in PCOS group AMHRII gene methylation level and insulin resistance relations have significant differences (r = 0.532, P = 0.000); INSR gene methylation level and insulin resistance relations have significant differences (r = 0.281, P = 0.03). CONCLUSIONS: The analysis of DNA methylation suggested that methylation of AMHRII and INSR genes was associated with basic clinical characteristics and insulin resistance of PCOS. These results provide evidence for AMHRII and INSR genes, and their methylation levels are intimately associated with the pathogenesis of PCOS.
Abstract: BACKGROUND: Three-dimensional (3D) printing technology for heart simulation can be represented as complex anatomical structures, and objective information can be provided. OBJECTIVE: We studied 3D print material to find a material with the same elastic coefficient as pig elastic coefficient. METHODS: Pig heart sample, Agilus sample, Tango sample, TPU sample, and silicone sample were studied. The elastic coefficient of each specimen was measured using an elastic coefficient measuring instrument. The analysis was performed using the average value of ten specimens of the same size. We suggested an equation to find the elastic coefficient…of material by the thickness using the elastic coefficient of Agilus, Tango, and silicone. RESULTS: The sample with similar elasticity to the pig sample did not show the same coefficient of elasticity at the same sample size. In Tango, the 0.5 mm high elastic force was about 3 times higher than the pig sample 7 mm elastic force. CONCLUSIONS: The study was conducted using 3D print material and silicone which can reproduce the elasticity of pig heart. However, no material is currently available to reproduce pig heart sample of the same size. However, if the heart is developed considering only elasticity, it can be sufficiently reproduced using the research results.
Abstract: BACKGROUND: Post-stroke depression (PSD) is a consequential neuropsychiatric sequela that occurs after stroke. However, the pathophysiology of PSD are not well understood yet. OBJECTIVE: To explore alterations in functional connectivity (FC) between anterior insula and fronto-cortical and other subcortical regions in the non-affected hemisphere in patients with PSD compared to without PSD and healthy control. METHODS: Resting-state FC was estimated between the anterior insula and cortical and subcortical brain regions in the non-affected hemisphere in 13 patients with PSD, 12 patients without PSD, and 13 healthy controls. The severity of depressive mood was…measured by the Beck Depression Inventory (BDI)-II. RESULTS: Patients with PSD showed significant differences in FC scores between the anterior insula and the superior frontal, middle frontal, and orbitofrontal gyrus in the non-affected hemisphere than healthy control or patients without PSD (P < 0.05). In post-hoc, patients with PSD showed higher FC scores between the anterior insula and the superior frontal region than patients without PSD (P < 0.05). Furthermore, alterations in FC of the superior frontal, middle frontal, and orbitofrontal gyrus were positively correlated with depression severity, as measured with the BDI-II (P < 0.001).
Abstract: BACKGROUND: Sound normally enters the ear canal, passes through the middle ear, and stimulates the cochlea through the oval window. Alternatively, the cochlea can be stimulated in a reverse manner, namely round window stimulation. The reverse stimulation is not well understood, partly because in classic lumped-parameter models the path of reverse drive during the round window stimulation is usually not considered. OBJECTIVE: The study goal is to gain a better understanding of the hearing mechanism during round window stimulation. METHODS: A piezo actuator was coupled to the oval and round window of the…guinea pigs. The auditory brainstem response produced by the forward and reverse stimulation at four frequencies was recorded. RESULTS: The results show that the input voltage of the actuator required at the hearing threshold in the round window drive was higher than that in the oval window drive. In order to understand the data, we designed a lumped-parameter cochlear model that can simulate both forward and reverse drive. The model-predicted results were consistent with the experimental results. CONCLUSIONS: The response of the auditory system to stimulus of oval window and round window was quantified through animal experimentation, and guinea pigs were used as experimental animals. When the same stimulus was applied to the oval window and round window of the cochlea, the ABR signals were compared. A lumped parameter model was designed to incorporate the sound transmission paths in both oval and round window stimulation. The simulated results are consistent with those of animal experiments. This model will be useful in understanding the inner-ear response in round window.
Abstract: BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor,…respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.
Keywords: Prediction model, gestational diabetes mellitus, rest energy metabolism
Abstract: BACKGROUND: Due to the increasing interest in human anti-aging, demand for a higher quality of life, and technological advancement, the development of anti-aging skincare has great market prospects. Most cosmetic companies develop products driven by the market or focus on the mechanism of action of substances and the behavior of skin; however, little research utilizes skin parameters and large data methodology to develop skincare products. OBJECTIVE: To instruct consumers to purchase skincare products and to guide skincare research toward the development of customer-targeted products. METHODS: A total of 815 Chinese subjects (83 male;…732 female) from five different cities were included. We measured 14 indices in each subject, including moisture, transepidermal water loss (TEWL), and sebum levels. We performed multiple regression analysis to understand the relationship between skin indices and aging; a novel approach is shown using the R software. RESULTS: The exact age at which changes in each skin index occurred could be demonstrated by this method of analysis: 39, 38, 48, 46, and 56 years old with respect to the L value, Melanin, Rt, Rm, and Rz, respectively. CONCLUSION: With the use of statistical analysis, consumers can be more efficiently targeted and choose suitable products considering particular skin parameter changing points; thus, skincare companies will not only meet customer requirements but also better control budgets.
Keywords: Multiple regression analysis, R software, skin aging, skin parameters, changing point
Abstract: BACKGROUND: The pulse-echo test is used to evaluate the performance of ultrasonic probes before manufacturing ultrasonic systems. However, commercial alignment instruments are very large and use complex programs with long operation times. OBJECTIVE: To develop a low-cost alignment instrument used in the pulse-echo test for evaluating the performance of various 2D and 3D ultrasonic probes. METHODS: The developed alignment instrument can be aligned with the X, Y, Z, azimuth, elevation, and tilt axes with manual structure to support mounting fixtures that hold 2D and 3D ultrasonic probes. Each axis has a manual lever…and is designed to have no movement when fixed. In particular, tilt and azimuth directions are designed to move more than 5 ∘ left and right. RESULTS: The probe mounted in the X, Y, and Z axes can move at above 50 mm. The probe mounted in the azimuth, elevation, and tilt axes can move more than 5 ∘ in the left and right directions. The pulse-echo test using commercial ultrasonic probes showed maximum error rate of less than 5%. CONCLUSIONS: Our developed alignment instrument can reduce costs by eliminating the need for shortening inspection times for probe manufacturers.
Keywords: Ultrasonic probes, alignment instruments, water tank, ultrasonic transducers
Abstract: BACKGROUND: There is a dearth of information on the effects of different types (Segmental rehabilitation service (SRS) vs Community-based rehabilitation service (CRS)) on the parenting stress and family quality of life in parents of children who have individuals with intellectual and developmental disabilities (IDD). OBJECTIVE: This paper is to compare the effects of SRS and CRS on parenting stress and family quality of life in parents of individuals with IDD. METHODS: A cross-sectional design was used to examine parenting stress and family quality life in cohorts of 120 fathers and mothers of children…with IDD who had received either SRS or CRS participated in the survey. The outcome measures included the modified Parenting Stress Index (PSI) and the modified Beach Center Family Quality of Life Scale (mBCFQLS). The Mann-Whitney U test was performed at P < 0.05. RESULTS: A significant difference was observed in social stress in PSI between the SRS and CRS groups (P = 0.03). The child rearing, emotional well-being, and physical and material well-being variables in mBCFQLS were different between the SRS and CRS groups (P < 0.05), indicating superior benefits from CRS than SRS. CONCLUSIONS: These findings provide important information and about parenting stress and family quality of life in children with IDD, for developing effective rehabilitation programs and services for these parents.
Keywords: Parenting stress, community-based rehabilitation, quality of life, children with disabilities, developmental disabilities