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: Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE: To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS: In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group…underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS: Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P < 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P < 0.025). CONCLUSION: Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.
Abstract: BACKGROUND: Artificial intelligence (AI) technology is a promising diagnostic adjunct in fracture detection. However, few studies describe the improvement of clinicians’ diagnostic accuracy for nasal bone fractures with the aid of AI technology. OBJECTIVE: This study aims to determine the value of the AI model in improving the diagnostic accuracy for nasal bone fractures compared with manual reading. METHODS: A total of 252 consecutive patients who had undergone facial computed tomography (CT) between January 2020 and January 2021 were enrolled in this study. The presence or absence of a nasal bone fracture was…determined by two experienced radiologists. An AI algorithm based on the deep-learning algorithm was engineered, trained and validated to detect fractures on CT images. Twenty readers with various experience were invited to read CT images with or without AI. The accuracy, sensitivity and specificity with the aid of the AI model were calculated by the readers. RESULTS: The deep-learning AI model had 84.78% sensitivity, 86.67% specificity, 0.857 area under the curve (AUC) and a 0.714 Youden index in identifying nasal bone fractures. For all readers, regardless of experience, AI-aided reading had higher sensitivity ([94.00 ± 3.17]% vs [83.52 ± 10.16]%, P < 0.001), specificity ([89.75 ± 6.15]% vs [77.55 ± 11.38]%, P < 0.001) and AUC (0.92 ± 0.04 vs 0.81 ± 0.10, P < 0.001) compared with reading without AI. With the aid of AI, the sensitivity, specificity and AUC were significantly improved in readers with 1–5 years or 6–10 years of experience (all P < 0.05, Table 4 ). For readers with 11–15 years of experience, no evidence suggested that AI could improve sensitivity and AUC (P = 0.124 and 0.152, respectively). CONCLUSION: The AI model might aid less experienced physicians and radiologists in improving their diagnostic performance for the localisation of nasal bone fractures on CT images.
Keywords: Nasal bone fracture, artificial intelligence, sensitivity, specificity, deep learning
Abstract: BACKGROUND: The impact of the current most effective vibration frequency on the balance ability of the elderly needs further verification. OBJECTIVE: To explore the effect of whole-body vibration training (WBVT) at three different frequencies on the balance ability of older women. METHODS: Ninety-three older women were randomly divided into low frequency (15 Hz), intermediate frequency (30 Hz), high-frequency (45 Hz), and control groups. The subjects in the vibration group underwent WBVT of the same amplitude twice a week for approximately 15 min per session. RESULTS: The speed of movement of…the centre of pressure in the left and right directions with eyes closed was 7.9% lower in the static balance ability test in the intermediate frequency group after 36 weeks (P < 0.05). In the high frequency group, after WBVT, the total length of centre of pressure movement and speed of centre of pressure movement in the left and right directions were 9.9% and 8.7% lower, respectively, in the dynamic balance test (P < 0.05), and the speed of closed eye movement in the left and right directions was 12.5% lower in the static balance test (P < 0.05). CONCLUSION: WBVT at 30 and 45 Hz improved static balance in the right and left directions when older women had their eyes closed. WBVT at 45 Hz improved dynamic balance in the right and left directions in older women, and WBVT did not improve static balance in older women when their eyes were open.
Keywords: Whole-body vibration training, different frequencies, older women, balance
Abstract: BACKGROUND: Preeclampsia (PE) has adverse effects on pregnant women, fetuses, and newborns , and accounts for 3%–10% of pregnancy-related diseases globally. OBJECTIVE: This study aimed to screen a series of prenatal markers (pregnancy-associated plasma protein [PAPP-A], β -human chorionic gonadotropin [β -hCG], alpha fetoprotein [AFP], and estriol [uE3]) to establish a risk model and evaluate the diagnostic values of the markers for predicting PE. METHODS: Sixty-five pregnant women were enrolled in this study. They were divided into two groups containing healthy pregnant women (n =…51, the non-PE group) and pregnant women with PE (n = 14, the PE group). According to the stage of pregnancy, the pregnant women in each group were divided into early, middle, and late pregnancy groups for statistical analysis. The levels of PAPPA-A β -hCG, AFP, and uE3 were compared among these groups. Then, a risk model was established, and PE was diagnosed using receiver operating characteristic (ROC) curve results. RESULTS: In the early pregnancy group, the differences in the levels of PAPP-A, AFP, and uE3 between the PE and non-PE groups were statistically significant (P < 0.001, P = 0.029, and P = 0.033, respectively), while the difference in the single remaining marker was not statistically significant. A ROC curve analysis revealed that in early pregnancy, the sensitivity and specificity of PAPP-A were 76.5% and 71.4%, respectively, and the sensitivity and specificity of β -hCG were 82.4% and 57.1%, respectively. The sensitivity and specificity of the combination of the two markers for diagnosing PE were 86.3% and 57.1%, respectively. CONCLUSION: This study demonstrated that the combination of PAPP-A and β -hCG has diagnostic value for PE in pregnant women. Accordingly, we should formulate innovative PE screening strategies to target the prevention of PE and create important conditions for predictive and preventive personalized medical treatments.
Abstract: BACKGROUND: When the jaw bone is subjected to an external force, the stress is transmitted from the force point along the alveolar bone to the skull and skull base. In the case of a dental implant, the stress distribution is mainly dependent on the implant position, type, and mechanical properties. OBJECTIVE: To investigate the dental implant position influence on the stress distribution and transmission in case of facial frontal trauma. Furthermore, the correlation between facial trauma and skull trauma in the case of a dental implant exists. METHODS: In this study, a Finite…Element Method (FEM) model was constructed based on a real skull shape, size, and anatomy. Dental implants were modeled based on imported CAD Data. Five cases were investigated including no dental implant and the replacement of teeth no. 18, 19 20 and 21. Facial trauma was mimicked by applying an external load on the lower frontal jaw. Finally, the stress distribution based on the bone geometry and implant position were evaluated and compared. RESULTS: Results suggested that a dental implant could significantly influence the stress distribution in the skull in case of facial trauma. In addition, the dental position greatly affects stress transmission from the mandible to the skull bones through the zygomatic arch. CONCLUSION: The position of the dental implant could have a significant role in stress transmission and distribution in case of facial or even brain trauma. Thus, increasing the possibility of a correlation between facial and brain trauma.
Keywords: Dental implant, facial trauma, trauma complications, finite element analysis, stress distribution
Abstract: BACKGROUND: An electric bed can easily change posture from a lying position and was effective in preventing pressure ulcer. OBJECTIVE: This study aimed to identify the optimal posture for the prevention of pressure ulcers by analyzing pressure changes applied to the pelvic region. METHODS: Pressure changes resulting from lateral rotations of the body using an electronic adjustable bed and changes in the posture and angles of the trunk and knees were assessed. Twelve conditions with varying angles of the trunk and knees (15–35 ∘ in 5 ∘…increments) and varying lateral angles (20–35 ∘ in 5 ∘ increments) were tested. The pressure (maximum and average) and contact area in the pelvic region of 20 individuals without disabilities were calculated. RESULTS: The conditions in which the average and maximum pressures did not increase according to the increase in angle were 25 ∘ for the upper body and knee angles and 35 ∘ for the side. CONCLUSIONS: The body pressure changed according to the posture rather than according to physical characteristics. Lateral rotation combined with changes in the angles of the trunk and knees effectively prevented pressure ulcers. Changes in the posture at various angles prevented an increased pressure on the body.
Keywords: Pressure ulcer, body posture, positioning bed, body pressure, pressure area
Abstract: BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment. OBJECTIVE: To evaluate the pH variations before and after placement of PMCs. METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one…month after placement. ANOVA and Pearson correlation were performed in SPSS. RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p < 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p = 0.001) and one month (p = 0.002). CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact.
Keywords: Oral health, pediatric dentistry, prefabricated metal crowns, pH
Abstract: BACKGROUND: At present, the clinical diagnosis of white matter change (WMC) patients depends on cranial magnetic resonance imaging (MRI) technology. This diagnostic method is costly and does not allow for large-scale screening, leading to delays in the patient’s condition due to inability to receive timely diagnosis. OBJECTIVE: To evaluate whether the burden of WMC is associated with the degree of invisible hand tremor in humans. METHODS: Previous studies have shown that tremor is associated with WMC, however, tremor does not always have imaging of WMC. Therefore, to confirm that the appearance of WMC…causes tremor, which are sometimes invisible to the naked eye, we achieved an optical-based computer-aided diagnostic device by detecting the invisible hand tremor, and we proposed a calculation method of WMC volume by using the characteristics of MRI images. RESULTS: Statistical analysis results further clarified the relationship between WMC and tremor, and our devices are validated for the detection of tremors with WMC. CONCLUSIONS: The burden of WMC volume is positive factor for degree of invisible hand tremor in the participants without visible hand tremor. Detection technology provides a more convenient and low-cost evaluating method before MRI for tremor diseases.
Keywords: WMC, tremor, segmentation, multiple linear regression, hands
Abstract: BACKGROUND: The continuous decrease of healthcare resources requires hospitals to improve efficiency while striving to improve quality standards that deliver better patient outcomes. OBJECTIVE: The objective of this study was to analyze whether the implementation of digital support systems during orthopedic surgery positively affected clinical processes and quality ratios. METHODS: A retrospective case-control study of 297 knee joint replacement procedures was conducted between 2015 and 2020. Thirty-five patients were allocated to the treatment and control groups after they were identified with exact matching and estimation of the propensity score. Both groups were balanced…regarding the selected covariates. The effect of the surgical procedure manager (SPM) on the incidence of acute haemorrhagic anaemia between the two groups was evaluated with a t -test, and the odds ratio was calculated. RESULTS: SPM-supported surgery has no significant influence on the incidence of acute haemorrhagic anaemia but leads to significantly shorter hospital stay (1.93 days), changeover (4.14 minutes) and recovery room time (20.20 minutes). In addition, it reduces the standard deviation of operation room times. CONCLUSIONS: The study concludes that SPM enhances surgical efficiency and maintains quality outcomes. To overcome their increasing financial pressure hospital management should commercially evaluate the implementation of digital support systems.
Keywords: Quality improvement, efficiency, operating rooms, the standard of care, digital technology, surgical procedure manager
Abstract: BACKGROUND: Aspheric intraocular lens (IOLs) implantation has been widely applied in cataract surgery. However, there is no consensus on the optimal guidance for the operations in IOLs implantation. OBJECTIVE: This study evaluated the visual function of Chinese cataract patients six months after cataract surgery with two different guiding ideologies. METHODS: We evaluated 50 patients (61 eyes) with implantation of different aspheric IOLs (SN60WF IOLs, ZCB00 IOLs, PY-60AD IOLs, AO IOLs) 6 months after cataract surgery. Twenty-four patients (30 eyes) under individual implantation were ascribed to group 1 and 26 patients (31 eyes) with…randomized implantation were ascribed to the control group (group 2). Postoperatively parameters included monocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), total spherical aberration Z (4, 0) at 5 mm pupil size, and patient satisfaction. The quality of life after operation was assessed through the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). RESULTS: Six months after cataract operation, the contrast sensitivity with glare of group 1 at 2.5 ∘ was 0.697 ± 0.027, and 0.532 ± 0.049 in group 2. Besides, there was no significant difference at any other special frequency. The mean spherical aberration Z (4, 0) at 5 mm pupil size in group 1 was 0.015 ± 0.028 um, and in group 2 was 0.043 ± 0.109 um, with a significant difference (p < 0.01). The mean scores obtained from NEI VFQ-25 were not significantly different. CONCLUSION: It is effective to implant aspheric IOLs individually according to preoperative corneal spherical aberration. Patients obtained better contrast sensitivity with glare at 2.5 ∘ , but there was no significant difference in BCVA, contrast sensitivity at other special frequency, and subjective visual function.