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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: In this study, we introduce an expert system for intelligent chromosome recognition and classification based on artificial neural networks (ANN) and features obtained by automated image analysis techniques. A microscope equipped with a CCTV camera, integrated with an IBM-PC compatible computerÂů environment including a frame grabber, is used for image data acquisition. Features of the chromosomes are obtained directly from the digital chromosome images. Two new algorithms for automated object detection and object skeletonizing constitute the basis of the feature extraction phase which constructs the components of the input vector to the ANN part of the system. This first version…of our intelligent diagnostic system uses a trained unsupervised neural network structure and an original rule-based classification algorithm to find a karyotyped form of randomly distributed chromosomes over a complete metaphase. We investigate the effects of network parameters on the classification performance and discuss the adaptability and flexibility of the neural system in order to reach a structure giving an output including information about both structural and numerical abnormalities. Moreover, the classification performances of neural and rule-based system are compared for each class of chromosome.
Abstract: In this study an original left ventricular assist device is tested on an open loop modular physical circuit reproducing Starling’s law of the heart to set an optimal control strategy for heart recovery. It is assumed that the goals of the assistance are reduction of oxygen consumption, external work and improvement of cardiac mechanical efficiency. The assistance is evaluated by the position of a working point on the characteristic surfaces of the ventricle defined by peripheral resistance, atrial pressure and selected variables pertaining to energy (pressure-volume area, external work and cardiac mechanical efficiency). In this frame an optimal assistance for…heart recovery is a compromise among different requirements corresponding to a restricted set of control parameters values: driving pressure P Z B = 35 kPa and timing values T1 and T2 (systole beginning and systole ending in relation to QRS complex and cardiac cycle duration T) T 1 = 0.55 · T and T 2 = 0.73 · T .
Abstract: Assessment of the degree of laxity of the distal tibio-fibular joint ligaments is of great importance in the treatment of some ankle pathologies resulting from traumas and when evaluating the effectiveness of re-constructive operations. This can be done by measuring the variation in the intermalleolar distance while loading and flexing the joint in a known way. So far, only X-ray techniques have been applied for this purpose, but they are invasive and do not allow for analysis under dynamic conditions. We have developed a wearable strain gauge device to be positioned directly over the malleoli for measurement of the intermalleolar…distance variation. It has been tested on healthy and injured subjects, in both static and dynamic conditions. Data obtained in the static tests are in agreement with those found in literature. Dynamic analysis allowed for correlation of malleoli diastasis (MD) with the different phases of gait and different injured states.
Abstract: In modern radiotherapy practice, patient mispositionings and movements at therapy units are considered one of the major source of error in the irradiation and, consequently, a decisive factor in relapse rate and in radiation damages occurrence. Movement analysis system ELITE has been used to carry out a new conceived control on patient repositioning procedure and to implement an automatic correction of the detected position errors. Two marker disposition models have been defined for the supine position with reliable and easily identifiable body landmarks. Analytical comparison between current and reference 3D co-ordinates of these points has constituted the core of the…whole method. The detection of patient’s breathing phases has allowed to synchronize the co-ordinates calculation to patient’s FRC, increasing accuracy and reliability of the comparison. Results point out the relative accuracy of the commonly adopted optical laser repositioning systems and confirm the significant role that ELITE can have in radiotherapy, in order to reach a suitable tradeoff between a quick irradiation set-up and a clinically correct patient irradiation.
Keywords: Radiotherapy, Quality control, 3D movement analysis
Abstract: Laparoscopic and thoracoscopic surgery have had a tremendous impact on adult surgery, but are still rarely used in children. In the past 3 years 168 children have been treated endoscopically in the three cooperating institutions. The course of all patients was documented prospectively in order to determine the value and prove the safety of endoscopic surgery in children. The operations performed endoscopically comprised appendectomy (n = 39), diagnostic procedures (24), adhesiolysis (n = 22), cholecystectomy (n = 13), bowel resection (n = 8), pyloromyotomy (n = 6), ovarial resection (n = 6), hiatus hernia repair (n = 22), splenectomy…(n = 6), first stage of Fowler-Stephens operation for kryptorchidism (n = 3) and interruption of persistent botallic ducts (n = 6) in preterm infants. Apart from four wound infections (2.4%) following perforated appendicitis, one of which required laparotomy for perityphlitic abscess there were no serious complications. No patient died, and overall morbidity related to the procedure was 1.8% (i.e. incidence of uneventful minor intraoperative complications). Furthermore endoscopic surgery provides a bcttcr diagnostic survey of the abdomen or thorax so that missing of secondary pathology is unlikely. Pain and reflectory impairment of bowel-function or respiration were diminished, the aesthetic results were excellent and hospitalization could be reduced to a minimum. It is concluded that laparoscopic and thoracoscopic surgery are safe and reliable procedures for children and yield very encouraging results.
Abstract: The utilization of 12 neonatal intensive care technologies was recorded in 193 patients. An index of utilization (Pu ) was adopted to classify these technologies into three sub-groups corresponding to low (Pu < 15%), medium (15% ⩽ Pu ⩽ 85%), and high (Pu > 85%) intensity of use. No models were developed for technologies with high intensity of use (intravenous hydration, warming, micro-haematocrit, heart rate monitoring). Multiple linear regression was used to predict the utilization of technologies with medium intensity of use (gasometry, oxygen hood, CPAP, mechanical ventilation), and multiple logistic regression was used with the same…purpose for technologies with low intensity of use (exchange transfusion, bicarbonate, adrenaline, echocardiography). Both methods yielded significant models (P < 0.05 ) which can be used to improve planning and management of technology in neonatal intensive care units.
Abstract: A new approach in ECG training is presented. The overall approach is based on a combination of the “page-turning architecture”, the “reference model” and AI techniques. A thorough analysis of the training requirements in this field has been carried out; the results determined the educational scenarios and the associated evaluation sessions. The system (CARDIO-LOGOS) is intended to be used mainly by internal medicine physicians and general practitioners, as well as by medical students. The layered structure of the whole CBT application together with the advanced learning strategies and the interactive multimedia technology offer a flexible environment that encourages experimentation and…supports individualised training for a wide variety of users.