Technology and Health Care - Volume Pre-press, issue Pre-press
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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: OBJECTIVES: This paper analyzes ICT diffusion in the biopharmaceutical industry. Since new paradigms emerge in the industry towards precision medicine and fasten the digitalization of health care, it is necessary to measure the changing value system, especially between life science and the IT industry. METHODS: The global value chain (GVC) concept is used and data are extracted from the Trade in Value Added (TiVa) dataset (June 2015) from the GVC-OECD project on interconnectivity of economics and industry. A number of indicators were selected: Foreign value added share of gross exports, % of ICT imported in chemicals…as a final product, either exported or in use in domestic demand. Trade data are analyzed for two industries: chemical industry, including pharmaceuticals, and the ICT industry for a group of countries: USA, Switzerland, France, Germany, UK and Japan. RESULTS: Only 0.5 to 1% of value added embodied in final chemicals and chemical products can be attributed to the ICT industry. An additional analysis shows higher prices of connectivity for services in the USA versus Japan and Germany, on a price index for a basket of broadband services (fixed and wireless, OECD 2013); this may also reflect the open model of US innovation with more transactions. CONCLUSIONS: Fast digitalization of life science requires new measures. TiVa dataset is useful for some IT equipment, but not sufficient for all forms of digital economy. The value chain concept is useful for pricing mobile computing in pharmaceuticals, but needs specific data on connectivity. Complementary datasets (e.g. EU KLEMS) can also track ICT investment in chemicals.
Keywords: Global value chains, pharmaceuticals and chemicals, digitalization, Trade in Added Value (TiVa) database
Abstract: BACKGROUND: Real-time clinical monitoring of cerebral edema (CE) is of great importance and requires continuously improved and optimized measurement hardware. METHODS: A new excitation source with higher frequency stability and wide output power range is presented in this work. The proposed excitation source is small in size and easy to integrate. The output power range of excitation signal used is 1.5 ∼ 33 dBm with a reference signal of 9 ∼ 11 dBm, and the phase shift stability of the excitation signal and reference signal reach 10 - 7…within 20 min. RESULTS: When normal saline (0.9%, 10 mL, 20 mL, 30 mL, 40 mL, and 50 mL) is injected into a human head phantom model, the magnetic induction phase shift (MIPS) changes from 252.78 ± 7.61 degrees to 252.40 ± 7.77 degrees. The MIPS signal shows a downward trend with increasing volume, indicating that MIPS can reflect the volume change of the measured object. Moreover, a more dramatic trend is visible when the solution volume increases from 0 to 10 mL and from 40 to 50 mL. This occurs where the volume increment is closer to the upper and lower sides of the over-ear sensor, where the magnetic field is strongest. CONCLUSION: The phantom simulation experiments illustrate that the proposed MIPS detection system based on a signal source can detect the real-time progress of CE. Advantages of low cost, high precision, and high sensitivity endow this system with excellent application prospects.
Keywords: Excitation source, cerebral edema, phase shift, magnetic induction
Abstract: BACKGROUND AND OBJECTIVE: Although careful clinical examination and medical history are the most important steps towards a diagnostic separation between different tremors, the electro-physiological analysis of the tremor using accelerometry and electromyography (EMG) of the affected limbs are promising tools. METHODS: A soft-decision wavelet-based decomposition technique is applied with 8 decomposition stages to estimate the power spectral density of accelerometer and surface EMG signals (sEMG) sampled at 800 Hz. A discrimination factor between physiological tremor (PH) and pathological tremor, namely, essential tremor (ET) and the tremor caused by Parkinson’s disease (PD), is obtained by summing the…power entropy in band 6 (B6: 7.8125–9.375 Hz) and band 11 (B11: 15.625–17.1875 Hz). RESULTS: A discrimination accuracy of 93.87% is obtained between the PH group and the ET & PD group using a voting between three results obtained from the accelerometer signal and two sEMG signals. CONCLUSION: Biomedical signal processing techniques based on high resolution wavelet spectral analysis of accelerometer and sEMG signals are implemented to efficiently perform classification between physiological tremor and pathological tremor.
Abstract: BACKGROUND: After an operation, the shoulder and wrist might not be able to lift and swing freely, and must be assisted with rehabilitation training. OBJECTIVE: In this paper, Kinect combined with multiple sensors of a Bluetooth ball is proposed to improve the measurement function of the arm’s micro-motion trajectory, rotation amount, and acceleration, which cannot be detected by Kinect alone. METHODS: We designed two virtual scene rehabilitation games for clinical trials. We performed validity analysis with a paired sample t -test. RESULTS: A significance value of P…* < 1 was obtained, and the arm lift angle shows an improvement from 30 ∘ to 60 ∘ , indicating that the range of motion of the hand and shoulder is gradually improving. CONCLUSION: PLEASE ASK AUTHORS TO PROVIDE THIS.
Keywords: Humerus tuberosity, shoulder rehabilitation, Bluetooth ball, Kinect, virtual game
Abstract: BACKGROUND: Missing – please ask authors to provide this. OBJECTIVE: The aim of the study was to evaluate the marginal and internal fit of provisional crowns fabricated using three-dimensional (3D) printing technology and to compare it with that of compression molding and milling methods. METHODS: Ninety study models were fabricated by duplicating metal master models of the maxillary first premolar molar with three different finish line chamfer, rounded shoulder and rounded shoulder with bevel. On each study model, provisional crowns were fabricated using compression molding (Mo. group, n =…30 – by over impression technique), milling (Mi. group, n = 30 – by 5-axis dental milling machine), and 3D printing method (3D-P. group, n = 30 – by 3D printer). Marginal and internal fit of the samples were evaluated by measuring gap using a scanning electron microscope with a magnification of 27 × , at 7 zones A–G on different finish line models. The data were statistically analysed using one-way analysis of variance (ANOVA) at the 0.05 significance level. The p -values were calculated using Dunnett’s test. RESULTS: The marginal gap was minimal for the 3D-P. group for each finish line with lowest for rounded shoulder with bevel at zone A 30.6 ± 5.3 and at zone G 32.8 ± 5.4. In axial area, i.e. zones B and F, the minimum gap was noticed for the Mo. group and in Occlusal area (cusp and fossa), for zones C–E maximum gap was determined in Mi. group followed by Mo. and 3D-P. groups. CONCLUSIONS: 3D printed provisional crowns have better marginal and internal fit compared to milled and molded provisional crowns.
Keywords: Temporary crown, additive manufacturing, internal discrepancy, 3D printing, CAD-CAM
Abstract: BACKGROUND: Fresnel prism shifts the field of view and converts object position in space, but its effect on stroke patients without unilateral neglect has not been examined. OBJECTIVE: We aimed to investigate the effect of Fresnel prism glasses on balance and gait in stroke patients with hemiplegia. METHODS: This study included 17 stroke patients with hemiplegia without unilateral neglect. Balance and gait training were applied in the control group (n = 9), and Fresnel prism glasses were applied with balance and gait training in the experimental group (n…= 8). In all groups, interventions were done for 30 min/day for 5 times/week for 4 weeks. Motor-free visual perception test for visual perception (MVPT), Berg Balance Scale (BBS), and functional reaching test (FRT) for dynamic balance ability, and gait were performed. Measurements were done before and after interventions. RESULTS: MVPT showed no significant difference between the groups (p > 0.05). A significant increase in BBS and FRT results was found before and after interventions in the experimental group (p < 0.05). Gait variables showed significant difference in the experimental group (p < 0.05). CONCLUSION: Fresnel prism glasses may effectively improve dynamic balance and gait functions by shifting body weight to the affected side of stroke patients with hemiplegia without vision loss.
Abstract: BACKGROUND: The rupture of syndesmotic ligaments is treated with a screw fixation as the gold standard. An alternative is the stabilization with a TightRope ® . A couple of studies investigated the different clinical outcome and some even looked at the stability in the joint, but none of them examined the occurring pressure after fixation. OBJECTIVE: Is there a difference in pressure inside the distal tibiofibular joint between a screw fixation and a TightRope ® ? Does the contact area differ in these two treatment options? METHODS:…This biomechanical study aimed to investigate the differences in fixation of the injured syndesmotic ligaments by using a fixation with one quadricortical screw versus singular TightRope ® both implanted 1 cm above the joint. By using 12 adult lower leg cadaveric specimens and pressure recording sensor, we recorded the pressure across the distal tibiofibular joint. Additionally we measured the contact surface area across the joint. RESULTS: The mean of the pressure across the distal tibiofibular joint from the start of the insertion of the fixation device to the complete fixation was 0.05 Pascal for the TightRope ® and 0.1 for the screw (P = 0.016). The mean of the maximum pressure across the joint (after completion of fixation and releasing the reduction clamp) was 1.750 mega Pascal with the screw fixation and 0.540 mega Pascal with TightRope ® (P = 0.008). The mean of the measured contact area of the distal tibiofibular joint after fixation was 250 mm 2 in the TightRope ® group and of 355 mm 2 in the screw fixation (P = 0.123). CONCLUSIONS: The screw fixation is stronger and provides a larger surface contact area, which leads us to the conclusion that it provides a better stability in the joint. While previous clinical studies did not show significant clinical difference between the two methods of fixation, the biomechanical construct varied. Long term clinical studies are required to establish whether this biomechanical distinction will contribute to various clinical outcomes.
Abstract: BACKGROUND: Biological hydrogels provide a conducive three-dimensional extracellular matrix environment for encapsulating and cultivating living cells. Microenvironmental modulus of hydrogels dictates several characteristics of cell functions such as proliferation, adhesion, self-renewal, differentiation, migration, cell morphology and fate. Precise measurement of the mechanical properties of gels is necessary for investigating cellular mechanobiology in a variety of applications in tissue engineering. Elastic properties of gels are strongly influenced by the amount of crosslinking density. OBJECTIVE: The main purpose of the present study was to determine the elastic modulus of two types of well-known biological hydrogels: Agarose and Gelatin…Methacryloyl. METHODS: Mechanical properties such as Young’s modulus, fracture stress and failure strain of the prescribed gels with a wide range of concentrations were determined using tension and compression tests. RESULTS: The elastic modulus, failure stress and strain were found to be strongly influenced when the amount of concentration in the hydrogels was changed. The elastic modulus for a lower level of concentration, not considered in this study, was also predicted using statistical analysis. CONCLUSIONS: Closed matching of the mechanical properties of the gels revealed that the bulk tension and compression tests could be confidently used for assessing mechanical properties of delicate biological hydrogels.
Abstract: OBJECTIVE: To investigate the differences of tumor necrosis factor-α (TNF-α ), interleukin-6 (IL-6) and galectin-3 concentrations in lobar pneumonia and bronchopneumonia induced by mycoplasma pneumoniae (MP) in children and to explore these related factors predicting the severity of MP. METHODS: A total of 148 children with mycoplasma pneumoniae pneumonia (MPP) and 32 healthy controls were analyzed from March 2017 to August 2018 in our province. Clinical information was collected from the hospitalized MP patients. The 148 patients with MPP were divided into two groups: lobar pneumonia group and bronchial pneumonia group.…The 32 healthy children were considered the control group. The concentrations of TNF-α , IL-6 and Gal-3 were examined in the serum of 148 children patients with MPP and 32 healthy children by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: The TNF-α , IL-6 and Gal-3 levels were obviously higher in both the lobar pneumonia and bronchial pneumonia groups, compared to those in the control group. Furthermore, these levels were significantly higher in the lobar pneumonia group, compared to the bronchial pneumonia group. After treatment, the levels of TNF-α , IL-6 and Gal-3 totally descended during the recovery period. CONCLUSION: There are differences in serum TNF-α , IL-6 and Gal-3 concentrations in lobar pneumonia and bronchial pneumonia caused by MP in children. In general, the TNF-α , IL-6 and Gal-3 levels were significantly higher in the lobar pneumonia group, when compared to the bronchial pneumonia group. This was because most lobar pneumonia cases are much more serious than bronchial pneumonia. Moreover, it has been proven that TNF-α , IL-6 and Gal-3 may play an important role in the pathogenesis development of MPP. At the same time, these are important issues in diagnosing MPP.
Abstract: BACKGROUND: The design of Patient Management and Information Systems during outbreaks of highly infectious diseases in low resource environments poses special challenges. Such systems necessitate special functional and design requirements to support patient care under austere conditions. A primary concern is to minimize spread of the disease to caregivers and non-infected individuals. Patient management in these conditions requires the design and development of systems customized for complex patient and caregiver workflows. OBJECTIVE: Design and develop a Patient Management and Information System for healthcare facilities on the frontlines of outbreaks of highly infectious diseases in low resource…environments. METHODS: A team composed of clinicians with experience in Ebola care in affected areas of Africa and informaticians developed detailed hardware, software and functionality requirements. These were translated into hardware designs, software architectures, screen and interface designs and implemented using Common Off-The-Shelf hardware. An experimental app development system was used to develop mHealth software modules. RESULTS: The system was developed and implemented as a proof of concept. Acceptance testing showed that the system met functionality requirements. CONCLUSION: Useful Patient Management and Information systems can be developed and implemented for frontline use in low-resource environments during outbreaks of highly infectious diseases.