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: BACKGROUND: In order to alleviate muscle fatigue and improve ride comfort, many published studies aimed to improve the seat environment or optimize seating posture. However, the effect of lumbar support on the lumbar muscle of seated subjects under whole body vibration is still unclear. OBJECTIVE: This study aimed to investigate the effect of lumbar support magnitude of the seat on lumbar muscle fatigue relief under whole body vibration. METHODS: Twenty healthy volunteers without low back pain participated in the experiment. By measuring surface electromyographic signals of erector spinae muscles under vibration or non-vibration…for 30 minutes, the effect of different lumbar support conditions on muscle fatigue was analyzed. The magnitude of lumbar support d is assigned as d 1 = 0 mm, d 2 = 20 mm and d 3 = 40 mm for no support, small support and large support, respectively. RESULTS: The results showed that lumbar muscle activation levels vary under different support conditions. For the small support case (d 2 = 20 mm), the muscle activation level under vibration and no-vibration was the minimum, 42.3% and 77.7% of that under no support (d 1 = 0 mm). For all support conditions, the muscle activation level under vibration is higher than that under no-vibration. CONCLUSIONS: The results indicate that the small support yields the minimum muscle contraction (low muscle contraction intensity) under vibration, which is more helpful for relieving lumbar muscle fatigue than no support or large support cases. Therefore, an appropriate lumbar support of seats is necessary for alleviating lumbar muscle fatigue.
Keywords: Lumbar support, muscle fatigue, support magnitude, surface electromyographic, vibration
Abstract: BACKGROUND: The use of 3D printed material in the dental field is gaining tremendous attention. However, studies related to 3D printed denture resins are scarce and need consideration before their inclusion in routine clinical practice. OBJECTIVE: This study aimed to assess the surface roughness (Ra) of 3D printed denture resins following aging and mechanical brushing. METHODS: Forty round samples (diameter, 10 mm and thickness, 3 mm) were fabricated from two 3D printed (DentaBASE and Denture 3D+) and one conventional polymethylmethacrylate (PMMA) denture materials. The samples were thermo-cycled, subjected to mechanical brushing, and later…immersed in either artificial saliva (AS), coffee, cola, or lemon juice (n = 10) to simulate one and two years of oral use. Surface roughness (Ra) was determined using a non-contact profilometer and scanning electron microscope was used for qualitative analysis. The data was analyzed using SPSS v.20 (α = 0.05). RESULTS: Denture 3D+ demonstrated highest mean Ra (1.15 ± 0.28 μ m), followed by PMMA (0.99 ± 0.50 μ m) and DentaBASE (0.81 ± 24). The difference in mean Ra between the materials was statistically non-significant (P = 0.08). Amongst the different beverages used, the highest Ra was observed for samples immersed in lemon juice (1.06 ± 0.40 μ m) followed by cola (1.04 ± 0.46 μ m) and coffee (0.98 ± 0.40 μ m), respectively. The lowest Ra was observed for samples immersed in AS (0.85 ± 0.24 μ m). CONCLUSION: The surface roughness of 3D printed denture resins was comparable with that of conventional PMMA resins. Denture 3D+ demonstrated the highest mean roughness, followed by PMMA and DentaBASE.
Abstract: BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent…MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P -values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P < 0.001), mGI (P < 0.001) and PD (P < 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P < 0.001), mGI (P < 0.001) and PD (P < 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.
Abstract: BACKGROUND: Dentine hypersensitivity is one of the most common chief complaints of patients observed by dentists in their practice. However, there is a lack of universal consensus over the selection of reliable treatment modality. OBJECTIVES: To compare the effectiveness between dentine desensitizer and self-etch adhesive in patients complaining of moderate to severe dentine hypersensitivity pain. METHODS: A total of 254 patients with moderate to severe dentine hypersensitivity were randomly divided into Group A (Single Bond Universal Agent) and Group B (Seal & Protect Agent) according to the treatment provided. Sensitivity was assessed by means…of mechanical (probing) and evaporative (air blast) stimuli. Discomfort Internal Scale (DIS) was explained to patients. DIS scores were recorded after one minute and one month following the application of both agents. Descriptive statistics were calculated. Stratification was done to control confounder and post stratification chi-square test was also applied. RESULT: The statistically significant difference (p = 0.000) in effectiveness between the two groups was observed. The mean discomfort internal scale score at baseline, after 1 minute and after 1 month in Group A was 3.65 ± 0.60, 2.33 ± 0.64 and 0.41 ± 0.71 respectively, while in Group B, it was 3.55 ± 0.58, 2.40 ± 0.62 and 0.72 ± 0.92 respectively. Overall, 86.6% patients observed improvement in dentinal sensitivity in Group A while in Group B only 67.7% patients reported reduction in sensitivity. CONCLUSION: Self-etch adhesive significantly reduces dentin hypersensitivity, immediately after one minute of its application and is effective for a period of one month compared to desensitizing agent.
Abstract: BACKGROUND: According to the World Health Organization, one in ten adults will have Type 2 Diabetes Mellitus (T2DM) in the next few years. Autonomic dysfunction is one of the significant complications of T2DM. Autonomic dysfunction is usually assessed by standard Ewing’s test and resting Heart Rate Variability (HRV) indices. OBJECTIVE: Resting HRV has limited use in screening due to its large intra and inter-individual variations. Therefore, a combined approach of resting and orthostatic challenge HRV measurement with a machine learning technique was used in the present study. METHODS: A total of 213 subjects…of both genders between 20 to 70 years of age participated in this study from March 2018 to December 2019 at Smt. Kashibai Navale Medical College and General Hospital (SKNMCGH) in Pune, India. The volunteers were categorized according to their glycemic status as control (n = 51 Euglycemic) and T2DM (n = 162). The short-term ECG signal in the resting and after an orthostatic challenge was recorded. The HRV indices were extracted from the ECG signal as per HRV-Taskforce guidelines. RESULTS: We observed a significant difference in time, frequency, and non-linear resting HRV indices between the control and T2DM groups. A blunted autonomic response to an orthostatic challenge quantified by percentage difference was observed in T2DM compared to the control group. HRV patterns during rest and the orthostatic challenge were extracted by various machine learning algorithms. The classification and regression tree (CART) model has shown better performance among all the machine learning algorithms. It has shown an accuracy of 84.04%, the sensitivity of 89.51%, a specificity of 66.67%, with an Area Under Receiver Operating Characteristic Curve (AUC) of 0.78 compared to resting HRV alone with 75.12% accuracy, 86.42% sensitivity, 39.22% specificity, with an AUC of 0.63 for differentiating autonomic dysfunction in non-diabetic control and T2DM. CONCLUSION: It was possible to develop a Classification and Regression Tree (CART) model to detect autonomic dysfunction. The technique of percentage difference between resting and orthostatic challenge HRV indicates the blunted autonomic response. The developed CART model can differentiate the autonomic dysfunction using both resting and orthostatic challenge HRV data compared to only resting HRV data in T2DM. Thus, monitoring HRV parameters using the CART model during rest and after orthostatic challenge may be a better alternative to detect autonomic dysfunction in T2DM as against only resting HRV.
Keywords: Type 2 diabetes mellitus (T2DM), Heart Rate Variability (HRV), autonomic dysfunction, orthostatic challenge, machine learning, classification, and regression tree (CART)
Abstract: BACKGROUND: The ability to manipulate the upper limbs and fingers of stroke patients is very important for independent daily life. Among the latest approaches for upper limb rehabilitation training, transcranial direct current stimulation (tDCS) is a non-invasive stimulation method that stimulates the cranial nerves by attaching electrodes to the scalp. In addition, virtual reality (VR) is an intervention method that provides an environment similar to reality and can help restore function by performing body movements as if playing a game. In addition, VR is an intervention method that provides an environment similar to reality and helps to recover functions…by performing body movements as if playing a game. OBJECTIVE: This study was conducted to investigate the effect of anodal tDCS applied to the ipsilateral primary motor cortex (M1) during VR training on the upper limb function, cognition, and executive function of stroke patients. METHODS: After 20 patients were randomly assigned to the experimental group and the control group, the experimental group received tDCS and VR, and the control group received sham tDCS and VR for 20 minutes a day, 5 days a week, for a total of 4 weeks. Participants were evaluated for upper limb function using Box and Block Test (BBT) and Jebsen-Taylor Hand Function Test (JTHFT), and cognitive and executive function using the Stroop Test (ST) and Trail Making Test (TMT). RESULTS: In the experimental group, significant differences were found in the pre- and post-test for the all variance (p < 0.05). Control group is significant differences were found in the pre- and post-test for BBT, ST, TMT (p < 0.05). There were significant differences between the two groups in the post test of BBT and ST (p < 0.05). CONCLUSION: The results of this study suggest that anodal tDCS applied to the ipsilateral M1 during VR training is effective for upper limb function, cognitive function, and executive function in stroke patients.
Keywords: Stroke, transcranial direct current stimulation, virtual reality, cognition, executive function, upper limb function
Abstract: BACKGROUND: Physical therapy treatment has gradually become important in hospitals. This paper focused on elbow joint rehabilitation, as this form of rehabilitation is used most often. Moreover, most elbow joint rehabilitation programs could be conducted at home without going to a medical institution, which will economize medical manpower. OBJECTIVE: How to judge the correct rehabilitation motion becomes an issue for elbow joint rehabilitation at home. Therefore, this study proposed a residential elbow joint rehabilitation system (REJRS) by smartphone with a cloud database to address these issues. METHODS: REJRS has the ability to judge…the correct motions and times of rehabilitation in real time. When the rehabilitation motions are incorrect, the number of rehabilitation repetitions is insufficient, or a timed rehabilitation session is insufficient, the patient will receive a warning text and light alert by REJRS. Then, the data of rehabilitation sessions are uploaded to the cloud database immediately. RESULTS: Patients can query their rehabilitation data at all times. Moreover, medical staff can track the status of each patient’s rehabilitation at any time and any place by downloading the data from the cloud database via the Internet. In our experimental results, the rate for detecting the correct elbow joint rehabilitation motion was up to 90%. CONCLUSIONS: The results show that REJRS could be applied for residential elbow joint rehabilitation. In the future, REJRS will be verified by the Institutional Review Board (IRB) for application to clinical treatment.
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: Quantification of melanin pigment release in pigment dispersion syndrome as well as observations of melanin brightness changes can be valuable information in the management of this rare ocular disease. OBJECTIVES: Previous studies have focused on examining the iris pigment epithelium and aqueous humor. Therefore, the aim of this study was to examine the cornea. METHODS: A novel technique was developed for this purpose based on aperture photometry. Slit lamp digital video images of the cornea were recorded. A single frame from each video recording based on the quality was chosen for further…processing and analysis. Aperture photometry was performed with AstroImageJ open source software. Aperture selection was performed automatically. Melanin particles displaying a signal-to-noise ratio above 20 were analyzed. RESULTS: A total of 16 melanin particles from the right eye of the patient participating in the study were detected and a further 9 melanin particles from the left eye. The examined area of the cornea measured 348 × 348 pixels in the image. Brightness differed by as much as 8.98 × among particles in the right eye and 2.03 × in the left eye. CONCLUSIONS: It seems feasible for this new method to be potentially used in the monitoring of patients with pigment dispersion syndrome and pigmentary glaucoma as well as in other ocular diseases.
Abstract: BACKGROUND: Wearable technologies have been developed for healthy aging. The technology for electromyography (EMG)-controlled functional electrical stimulation (FES) systems has been developed, but research on how helpful it is in daily life has been insufficient. OBJECTIVE: The purpose of this study was to investigate the effect of the EMG-controlled FES system on muscle morphology, balance, and gait in older adults. METHODS: Twenty-nine older adults were evaluated under two randomly assigned conditions (non-FES and FES assists). Muscle morphology, balance, gait function, and muscle effort during gait were measured using ultrasonography, a physical test, a…gait analysis system, and EMG. RESULTS: The EMG-controlled FES system improved gait speed by 11.1% and cadence by 15.6% (P < 0.01). The symmetry ratio of the bilateral gastrocnemius was improved by 9.9% in the stance phase and 11.8% in the swing phase (P < 0.05). The degrees of coactivation of the knee and ankle muscles were reduced by 45.1% and 50.5%, respectively (P < 0.05). Balance improved by 6–10.7% (P < 0.01). CONCLUSION: The EMG-controlled FES system is useful for balance and gait function by increasing muscle symmetry and decreasing muscle coactivation during walking in older adults.
Keywords: Aging, wearable technology, muscle symmetry, gait function