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: To evaluate the clinical effects of individual placement of intramedullary nail guided by digital technique in the treatment of tibial fractures. METHODS: Thirty-two cases of unilateral tibial fractures treated with individual placement of intramedullary nail guided by digital technique or conventional surgery were collected from October 2010 to October 2012. In the experimental group, the size of intramedullary nail, as well as the distance between the insertion point of tibial…intramedullary nail and the line perpendicular to the tibial plateau of the tibial tubercle were measured by digital technology preoperatively to select suitable intramedullary nail and appropriate insertion point. RESULTS: The operative time and bone healing time of the experimental group didn't change significantly (P > 0.05). There were statistically significant differences in the number of X-ray examinations and the distance between actual and planned nail placement point between experimental group and control group. The excellent and good rate of functional recovery for the experimental and the control group was 100% and 87.50%, respectively. CONCLUSION: Compared with the conventional surgery, individual placement of intramedullary nail guided by digital technique in tibial fractures might have superior outcomes.
Abstract: Involuntary human tremor due to clinical disorders may inhibit daily activities and can severely restrict lifestyle. Such tremor is associated with rhythmic movement of one or more body parts, where muscles contract and relax, causing twitching or sudden movement. Symptoms are most commonly the result of a psychological illness that causes the muscles to act involuntarily. Medical treatments to human tremor may pose harmful side effects, including hallucinations, and drugs used for treatment have varying degrees of success in reducing the symptoms of the illness. Our research provides a new, assistive technology that minimizes the effects of hand tremor, as…a substitute for drug-related therapy. The device is intended for use in creative art; a paint brush attachment, for application in painting. The engineering solution promises greater application for attachment to a variety of aids, such as for writing, eating or instructional, for device stabilization as used by persons suffering from hand tremor, irrespective of medical cause.
Keywords: Hand tremor, Parkinson's, active cancellation, activity aid, SMA wires, smart device
Abstract: Indoor flight, obstacle avoidance and client-server communication of an Unmanned Aerial Vehicle (UAV) raises several unique research challenges. This paper examines current methods and associated technologies adapted within the literature toward autonomous UAV flight, for consideration in a proposed system for indoor healthcare administration with a quadcopter. We introduce Healthbuddy , a unique research initiative towards overcoming challenges associated with indoor navigation, collision detection and avoidance, stability, wireless drone-server communications and automated decision support for patient care in a GPS-denied environment. To address the identified research deficits, a drone-based solution is presented. The solution is preliminary as we develop and…refine the suggested algorithms and hardware system to achieve the research objectives.
Abstract: BACKGROUND: The acetabular component orientation during total hip arthroplasty (THA) impacts future hip function and early revision. Correcting pelvic obliquity may improve outcomes. OBJECTIVE: To correct pelvic obliquity in the lateral position by applying a gradienter and plumb during THA using fluoroscopy. METHODS: Fifty patients undergoing THA were randomized and divided into 2 groups. In controls, acetabular components were placed using traditional methods. In experimental patients, acetabular components were placed after correcting pelvic obliquity. We measured pelvic obliquity and recorded intra-operative and post-operative abduction angles, comparing abduction angle bias between post-operative measurements and…intra-operation estimations. RESULTS: Before correction, the average pelvic obliquity was - 1.647 ∘ ± 4.512 ∘ in experimental patients. The average abduction angle in experimental patients was 42.685 ∘ ± 3.355 ∘ postoperatively, differing by 1.962 ∘ ± 1.515 ∘ from intra-operative estimates, while in control patients, it was 44.534 ∘ ± 4.844 ∘ postoperatively, differing by 4.244 ∘ ± 3.042 ∘ from intra-operative estimates. The bias of the abduction angle was much greater in control than in experimental patients (P < 0.05). CONCLUSION: The pelvic obliquity in the lateral position affects surgeon judgment during THA. By correcting pelvic obliquity with a gradienter and plumb, the abduction angle bias can be reduced.
Abstract: BACKGROUND/OBJECTIVE: There are two routine pulse-sequences for single voxel spectroscopy (SVS), point resolved spectroscopy (PRESS) and stimulated echo acquisition mode (STEAM). Although STEAM has several advantages in comparison to PRESS, signal/noise ratio (SNR) superiority of PRESS makes it the first choice for SVS. Application of Fast Padé transform (FPT) instead of Fast Furrier transform (FFT) might increase the SNR of the signal produced by STEAM pulse-sequence and therefore allows the benefits of its advantages. We aimed to evaluate and compare the noise root mean square (RMS) and SNR provided by STEAM pulse-sequence using both FPT and FFT.…MATERIALS AND METHOD: A gelatin-based phantom was constructed in a 19-cm acrylic cylinder. The phantom had two normal/tumoral parts. The SVS was performed using a 3T MRI scanner. STEAM pulse-sequence were used with the following parameters: TR = 2000 ms, TM = 10 ms, and three TEs of 20, 135 and 270 ms with two data-points of 1024 and 512 and voxel-size of 1 cm 3 . The raw data were extracted and processed using both FFT and FPT estimators to produce the spectrum. The noise RMS and SNR of Cho and Cr metabolites were assessed. RESULTS: According to the results, noise RMS of spectra provided by FPT were decreased between 3619.01–14252.94% in comparison to FFT (p < 0.00001). The SNR of Cr1 and Cho peaks of the spectra provided by FPT were increased more than 96.80 and 97.18, respectively (0.00006 < p < 0.02). DISCUSSION: The difference of noise RMS’s provided by FPT are thousands percent less than FFT. This enormous decrease in noise provides a good increase of SNR. While the range of Cr1 and Cho SNR by FFT are between 41.55–120.32 the range of SNRs of these peaks provided by FPT are between 1719.99–9744.79, which implies a significant difference between the efficiency of FPT and FFT. CONCLUSION: This study showed that application of FPT in comparison to FFT can increase the spectra SNR and so that its usage can be helpful during the application of STEAM pulse-sequence which results in lower SNR in comparison to PRESS pulse-sequence. Thus, we should make use of the advantages of STEAM pulse-sequence.
Keywords: Magnetic resonance spectroscopy, Fast Padé Transform, Fast Furrier Transform, STEAM pulse sequence, signal to noise ratio
Abstract: BACKGROUND: Passenger comfort is affected by many factors. Patient comfort is even more specific due to its mental and physical health condition. OBJECTIVE: Developing a system for monitoring patient transport conditions with the comfort level classification, which is affected by the patient parameters. METHODS: Smartphone with the developed Android application was installed in an EMS to monitor patient transport between medical institutions. As a result, 10 calculated parameters are generated in addition to the GPS data and the subjective comfort level. Three classifiers are used to classify the transportation. At the end, the…adjustment of classified comfort levels is performed based on the patient’s medical condition, age and gender. RESULTS: Modified SVM classifier provided the best overall classification results with the precision of 90.8%. Furthermore, a model that represents patient sensitivity to transport vibration, based on the patient’s medical condition, is proposed and the final classification results are presented. CONCLUSIONS: The Android application is mobile, simple to install and use. According to the obtained results, SVM and Naive Bayes classifier gave satisfying results while KNN should be avoided. The developed model takes transport comfort and the patient’s medical condition into consideration, so it is suitable for the patient transport comfort classification.
Abstract: BACKGROUND: Previous research regarding the humanistic care ability of Chinese medical professionals was limited to small groups of nurses or students. More systemic analyses involving more general medical professionals are scarce and urgently needed. OBJECTIVE: To survey the sense and ability of humanistic care on medical professionals in China and to identify the potential influencing factors. METHODS: A novel scale of humanistic care indicators was developed. Based on the new scale, a questionnaire was designed, tested and used to survey a total of 928 medical professionals recruited from three hospitals in the Chinese…Western city Chongqing. Chi-square test was used for single factor analyses. For multiple factor analyses, multivariate logistic regression was performed. RESULTS: Our selected group of medical professionals scored nearly 4 or above on a 1–5 scale for all our query items related to the sense and ability of humanistic care. The main factors affecting humanistic care ability of medical professionals in Chongqing include gender, nature of department/division, modes of employment and participation in humanistic care ability training and so on. CONCLUSIONS: In general, the participants in our study group had a humanistic care ability score lower than the aimed value, suggesting that the ability of humanistic care of these medical professional was not satisfactory. The study also shows that one effective way to enhance the humanistic care ability is to provide more targeted training.
Keywords: Humanistic care, sense and ability, influencing factor, medical education
Abstract: This paper introduces a comprehensive fetal Electrocardiogram (fECG) Signal Extraction and Analysis Virtual Instrument that integrates various methods for detecting the R-R Intervals (RRIs) as a means to determine the fetal Heart Rate (fHR) and therefore facilitates fetal Heart Rate Variability (HRV) signal analysis. Moreover, it offers the capability to perform advanced morphological fECG signal analysis called ST segment Analysis (STAN) as it seamlessly allows the determination of the T-wave to QRS complex ratio (also called T/QRS) in the fECG signal. The integration of these signal processing and analytical modules could help clinical researchers and practitioners to noninvasively monitor and…detect the life threatening hypoxic conditions that may arise in different stages of pregnancy and more importantly during delivery and could therefore lead to the reduction of unnecessary C-sections. In our experiments we used real recordings from a Fetal Scalp Electrode (FSE) as well as maternal abdominal electrodes. This Virtual Instrument (Toolbox) not only serves as a desirable platform for comparing various fECG extraction signal processing methods, it also provides an effective means to perform STAN and HRV signal analysis based on proven ECG morphological as well as Autonomic Nervous System (ANS) indices to detect hypoxic conditions.
Abstract: OBJECTIVE: This study aims to explore whether positive end-expiratory pressure (PEEP) guided by esophageal pressure is better than the acute respiratory distress syndrome network (ARDSNet) during the treatment of traumatic acute respiratory distress syndrome (ARDS) patients. SUGGESTIONS: The use of the oxygenation method of inhaled oxygen concentration titration PEEP is suggested. METHODS: This study takes traumatic ARDS patients as the research object. The data of 23 patients were included in this study. The patients were randomly divided into two groups: the esophageal pressure titration PEEP group (n =…12), and the ARDSNet (PEEP-FiO 2 table) titration PEEP group (n = 11). All patients were given mechanical ventilation, and changes in oxygenation index, respiratory mechanics, hemodynamics and inflammatory reaction index were recorded when titrating the best PEEP with the two methods on the current day of grouping and after grouping for 24, 48 and 72 hours. RESULTS: The PEEP titration value in the esophageal pressure group was 12 ± 4 cm H 2 O, and this value was significantly higher than the PEEP titration value in the ARDSNet group (8 ± 3 cm H 2 O) (P < 0.05). The end-expiratory transpulmonary pressure of titrating the best PEEP with the esophageal pressure method and ARDSNet method is 0.5 ± 0.7 cm H 2 O vs. - 1.1 ± 3.3 cm H 2 O (P < 0.05). When titrating the best PEEP with the esophageal pressure method, lung tissue compliance, end-expiratory transpulmonary pressure and the oxygenation index are higher than those obtained through the ARDSNet method (P < 0.05). (2) In the esophageal pressure group, with the extension of treatment time, high-sensitivity C reactive protein (hs-CRP) and procalcitonin (PCT) exhibited a trend of significant decrease (P < 0.05). In the ARDSNet group, with the extension of treatment time, PCT also exhibited a significant decrease (P < 0.05), while the decrease in hs-CRP was not significant (P > 0.05). After comparing these two treatment groups at each monitoring time point, we found that the difference in hs-CRP and PCT was not statistically significant (P > 0.05). During the 72-hour treatment of interleukin-6 (IL-6) and interleukin-8 (IL-8), we found that these two were significantly lower in the esophageal pressure group than in the ARDSNet group (P < 0.05). CONCLUSIONS: The PEEP selection of mechanical ventilation of patients with traumatic ARDS guided by transpulmonary pressure and calculated by measuring intrapleural pressure can realize the individual adjustment of PEEP, identify ARDS patients benefiting from high PEEP, and provide a PEEP setting that can better meet the needs of traumatic patients.
Abstract: The aim of this work was to describe the physical principles behind the reverberation artifacts in ultrasound imaging and list the correct interpretation. This work focuses on the understanding of the principle of reverberation imaging artifacts.