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: Acute cerebral infarction (ACI) is a common cerebrovascular disease in clinical practice. OBJECTIVE: The present study aims to investigate the efficacy and safety of alteplase and urokinase in treating ACI. METHODS: A total of 96 patients with ACI, who were treated with alteplase and urokinase, were selected as the main subjects. Among these patients, 45 patients with ultra-early acute cerebral infarction, who received intravenous thrombolysis with RT-PA (alteplase), were included in the treatment group, while 51 patients with acute cerebral infarction, who were treated with urokinase in the same time period, were…included in the control group. RESULTS: The National Institute of Health Stroke Scale (NIHSS) scores were significantly lower in the treatment group and control group (P < 0.05) at two hours, seven days and 14 days after thrombolysis, when compared to those before thrombolysis. The bleeding rate was significantly lower in the control group, when compared to the treatment group (P < 0.05). CONCLUSION: The intravenous thrombolysis with urokinase or alteplase in the ultra-early stage of acute cerebral infarction can reduce the neurological injury symptoms and effectively improve the prognosis of patients with stroke. Urokinase is lower in risk of bleeding, but better in safety, when compared to alteplase.
Abstract: BACKGROUND: The use of fresh-frozen (FF) specimens represents the gold standard for biomechanical investigations. Since FF specimens are often difficult to obtain, chemical-fixed specimens (formalin (FA), Thiel (TH)) are also used. OBJECTIVE: Since fixation methods can alter the mechanical properties of bone tissue, the purpose of this study was to examine their influence on the fracture force of lumbar vertebral bodies (VB). METHODS: First the VB were subdivided into three focus groups: FF, TH, and FA. After removing the soft tissue and the processus transverses of all VB, the endplates were planned with…a thin layer of epoxy resin, in order to apply a constant strain to the surface and sub-surface. The VB were subjected to axial compression tests in order to determine fracture force. Lastly a standardized compression fracture was generated. RESULTS: The mean values of the fracture force of the focus groups were 4529.5 N (FF), 3211.3N (TH) and 2947.9N (FA). Consequently a significant difference between the FF and the other two groups could be demonstrated (p < 0.05). CONCLUSION: The preliminary tests showed that the fraction force of fresh-frozen VB were significantly higher than TH/FA-fixed VB. Therefore, these fixation methods could potentially have an influence on the biomechanical properties of VB. This leads to the assumption that if load-to-failure tests are performed, it is probably recommended to use fresh-frozen specimens.
Abstract: BACKGROUND: Orthodontic force is often statically measured in general, and only the initial force derived from appliances can be assessed. OBJECTIVE: We aimed to investigate a technological method for measuring dynamic force using tooth movement simulation. METHODS: Tooth movement was simulated in a softened wax model. A canine tooth was selected for evaluation and divided into the crown and root. A force transducer was plugged in and fixed between the two parts for measuring force. Forces on this tooth were derived by ordinary nickel-titanium (Ni-Ti) wire, hyperelastic Ni-Ti wire, low-hysteresis (LH) Ti-Ni wire…and self-made glass fibre-reinforced shape memory polyurethane (GFRSMPU) wire. These forces were measured after the tooth movement. RESULTS: The canine tooth moved to the desired location, and only a 0.2 mm deviation remained. The changing trends and magnitudes of forces produced by the wires were consistent with the data reported by other studies. The tooth had a higher moving velocity with ordinary Ni-Ti wires in comparison to the other wires. Force attenuation for the GFRSMPU wire was the lowest (40.17%) at the end of the test, indicating that it provided light but continuous force. CONCLUSIONS: Mimicked tooth movements and dynamic force measurements were successfully determined in tooth movement simulation. These findings could help with estimating treatment effects and optimising the treatment plan.
Keywords: Dynamic measurement, orthodontic force, tooth moveable simulation, wax model
Abstract: BACKGROUND: Ventricular repolarization instabilities have been documented to be closely linked to arrhythmia development. The electrocardiogram (ECG) ST interval can be used to measure ventricular repolarization. Analyzing the duration variation of the ST intervals can provide new information about the arrhythmogenic vulnerability. OBJECTIVE: In this work, we propose a new method based on mean instantaneous frequency (IF) of the ST intervals to quantitatively evaluate the risk of sudden cardiac deaths (SCDs). METHODS: Two spectral bands, i.e. the low-frequency band (LF, 0–0.15 Hz) and the high-frequency band (HF, 0.15–0.5 Hz), are considered in this…paper. Based on IF estimates, the ECG recordings from three MIT-BIH databases that represent different risk levels of SCD occurrence are used, and their mean IFs in the LF and HF bands are calculated. RESULTS: The statistical results show that healthy subjects have a higher mean IF in the HF band and a lower mean IF in the LF band. The experimental results are the opposite for patients with malignant ventricular arrhythmia. CONCLUSION: The proposed mean IF can represent an indirect measure of intrinsic ventricular repolarization instability and can mark cardiac instability associated with SCDs.
Keywords: Ventricular repolarization instabilities, ECG, ST interval, instantaneous frequency
Abstract: BACKGROUND: Estimated continuous cardiac output (esCCO), a non-invasive technique for continuously measuring cardiac output (CO), is based on modified pulse wave transit time, which is determined by pulse oximetry and electrocardiography. OBJECTIVE: We examined the ability of esCCO to detect stroke volume index (SVI) and changes in SVI compared with currently available arterial waveform analysis methods. METHODS: We retrospectively reanalysed 15 of the cases from our previous study on esCCO measurement. SVI was calculated using an esCCO system, measured using the arterial pressure-based CO (APCO) method, and compared with a corresponding intermittent bolus…thermodilution CO (ICO) method. Percentage error measurement and statistical methods, including concordance analysis and polar plot analysis, were performed. RESULTS: The difference in the SVI values between esCCO and ICO was - 3.0 ± 8.8 ml (percentage error, 33.5%). The mean angular bias was 0.8 and the radial limits of agreement were ± 27.3. The difference in the SVI values between APCO and ICO was 0.9 ± 11.2 ml (percentage error, 42.6%). The mean angular bias was - 6.8 and the radial limits of agreement were ± 44.1. CONCLUSION: This study demonstrated that the accuracy, precision, and dynamic trend of esCCO are better than those of APCO.
Abstract: BACKGROUND: The frequencies that can evoke strong steady state visual evoked potentials (SSVEP) are limited, which leads to brain-computer interface (BCI) instruction limitation in the current SSVEP-BCI. To solve this problem, the visual stimulus signal modulated by trinary frequency shift keying was introduced. OBJECTIVE: The main purpose of this paper is to find a more reliable recognition algorithm for SSVEP-BCI based on trinary frequency shift keying modulated stimuli. METHODS: First, the signal modulated by trinary frequency shift keying is simulated by MATLAB. At different noise levels, the empirical mode decomposition, singular value decomposition,…and synchrosqueezing with the short-time Fourier transform are used to extract the characteristic frequency and reconstruct the signal. Then, the coherent method is used to demodulate the reconstructed signal. Second, in the paradigm of BCI using trinary frequency shift keying modulated stimuli, the three methods mentioned above are used to reconstruct EEG signals, and canonical correlation analysis and coherent demodulation are used to recognize the BCI instructions. RESULTS: For simulated signals, it is found that synchrosqueezing with short-time Fourier transform has a better effect on extracting the characteristic frequencies. For the EEG signal, it is found that the method combining synchrosqueezing with short-time Fourier transform and coherent demodulation has a higher accuracy and information translate rate than other methods. CONCLUSION: The method combining synchrosqueezing with short-time Fourier transform and coherent demodulation proposed in this paper can be applied in the SSVEP system based on trinary frequency shift keying modulated stimuli.
Keywords: Steady state visual evoked potentials (SSVEP), trinary frequency shift keying (TFSK), synchrosqueezing with the short-time Fourier transform (SSTFT), canonical correlation analysis (CCA), coherent demodulation
Abstract: BACKGROUND: The prevalence of health information technology (HIT) as an adjunct to increase safety and quality in healthcare applications is well known. There is a relationship between the use of HIT and safer-prescribing practices in long-term care. OBJECTIVE: The objective of this systematic review is to determine an association between the use of HIT and the improvement of prescription administration in long-term care facilities. METHODS: A systematic review was conducted using the MEDLINE and CINAHL databases. With the use of certain key terms, 66 articles were obtained. Each article was then reviewed by…two researchers to determine if the study was germane to the research objective. If both reviewers agreed with using the article, it became a source for our review. The review was conducted and structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: The researchers identified 14 articles to include in a group for analysis from North America, Europe, and Australia. Electronic health records and electronic medication administration records were the two most common forms of technological interventions (6 of 14, 43%). Reduced risk, decreased error, decreased missed dosage, improved documentation, improved clinical process, and stronger clinical focus comprised 92% of the observations. CONCLUSIONS: HIT has shown beneficial effects for many healthcare organizations. Long-term care facilities that implemented health information technologies, have shown reductions in adverse drug events caused by medication errors overall reduced risk to the organization. The implementation of new technologies did not increase the time nurses spent on medication rounds.
Keywords: Long-term care, medication safety, technology diffusion, health information technology
Abstract: BACKGROUND: Evidence on the latest technologies in rehabilitation for reducing pain and altering serum stress hormones in low back pain (LBP) was lacking. OBJECTIVE: To find the clinical and hormonal effects of virtual reality training (VRT) and isokinetic training (IKT) in chronic LBP patients. METHODS: Through the simple random sampling method, 60 university football players with chronic LBP were allocated into three groups: N VRT = 20, N IKT = 20 and N CONTROL = 20.…The three groups underwent different exercises for 4 weeks. Clinical (pain intensity and kinesiophobia) and hormonal (glucose, insulin, HOMA-IR, growth hormone, prolactin, ACTH and cortisol) values were measured at baseline, after 4 weeks and 6 months. RESULTS: Four weeks following training, the VRT and IKT groups showed significant changes in pain intensity and kinesiophobia in comparison to the control group (p < 0.05). Hormonal measures also showed significant improvement in the VRT group in comparison to the other two groups (p < 0.05). CONCLUSION: Training through virtual reality and isokinetic exercise is an effective approach in terms of pain and kinesiophobia. In terms of hormonal analysis, virtual reality shows slightly more improvements than isokinetic training in subjects with chronic LBP.
Abstract: BACKGROUND: A variety of prophylactic materials are used in the dental office for the removal of stains and calculus. OBJECTIVE: To evaluate tooth surface changes caused by the application of air abrasive powders (sodium bicarbonate, SBAP and glycine air powder, GPAP) along with scaling and root planing (SRP), under atomic force microscope (AFM) and to analyze the histological soft tissue changes caused by these agents, using light microscopy. METHODS: This study was conducted in two phases: in vitro and in vivo . In the in vitro phase, hard tissue analysis was…done under AFM following air powder polishing. Eighteen extracted teeth were chosen. SRP and tooth sectioning were carried out. Subsequently, each section of the tooth was mounted on a glass plate with self-cure acrylic resin and air polished using SBAP and GPAP. In the vivo phase, the soft tissue was analyzed under a light microscope for surface roughness. A biopsy specimen was taken from patients who had received phase I therapy, and flap surgery was planned using a modified Widman flap technique. RESULTS: This study compared surface changes in enamel and cementum, under AFM, as indicated by R A after SRP, SRP and SBAP, and SRP and GPAP; comparisons were then drawn across the three groups. The mean AFM values were 108.5 and 144.7, 102.7 and 81.7, and 95.6 and 7.4, at the crown and root, for SRP, SRP and SBAP, and SRP and GPAP interventions, respectively. GPAP was the least rough on soft tissues. CONCLUSION: SBAP and GPAP were better than hand instrumentation as indicated by AFM and histological section analysis.
Keywords: Periodontics, dentistry, tooth surface, atomic force microscope (AFM)