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: Electric cars are increasingly used for public and private transportation and represent possible sources of electromagnetic interference (EMI). Potential implications for patients with cardiac implantable electronic devices (CIED) range from unnecessary driving restrictions to life-threatening device malfunction. This prospective, cross-sectional study was designed to assess the EMI risk of electric cars on CIED function. METHODS: One hundred and eight consecutive patients with CIED presenting for routine follow-up between May 2014 and January 2015 were enrolled in the study. The participants were exposed to electromagnetic fields generated by the four most common electric cars (Nissan Leaf,…Tesla Model S, BMW i3, VW eUp) while roller-bench test-driving at Institute of Automotive Technology, Department of Mechanical Engineering, Technical University, Munich. The primary endpoint was any abnormalities in CIED function (e.g. oversensing with pacing-inhibition, inappropriate therapy or mode-switching) while driving or charging electric cars as assessed by electrocardiographic recordings and device interrogation. RESULTS: No change in device function or programming was seen in this cohort which is representative of contemporary CIED devices. The largest electromagnetic field detected was along the charging cable during high current charging (116.5 μ T). The field strength in the cabin was lower (2.1–3.6 μ T). CONCLUSIONS: Electric cars produce electromagnetic fields; however, they did not affect CIED function or programming in our cohort. Driving and charging of electric cars is likely safe for patients with CIEDs.
Abstract: Body mass index (BMI) is used widely as an indicator in general health. Determination of BMI using non-intrusive measurements are of interest and recent advancements in the availability of digital imaging sensors have paved the way for performing quick and automatic measurements. In this work, we consider automatic computation of BMI using correlation features from face images. We show that using face detection based facial fiducial points analysis provides good BMI prediction. Experimental results on comparing the correlation coefficients of facial ratios along with the colour feature has higher significance in BMI of a person.
Keywords: Body mass index (BMI), facial features, correlation coefficient
Abstract: BACKGROUND: Deep brain stimulation is a method of nerve regulation that uses human body conductance characteristics; signals are diffused and transmitted through human tissues to regulate diseases. OBJECTIVE: We analyzed the distribution and the transmission mechanism of implantable electrical signals from a point source field in the human body using the point source field implanting channel model. METHODS: The model was established using a mathematical modeling method, with reasonable boundary conditions and assumptions. Further, we established an equivalent numerical solution model to verify its accuracy and compared the model to published experimental results to…evaluate its consistency. RESULTS: The analysis results of the two models revealed that both had errors of < 1%. A comparison of the experimental results to published experimental data revealed that the error between the two was < 4 dB, and the model displayed excellent consistency. CONCLUSIONS: Our proposed model is accurate and exhibits good consistency with published experimental results. We therefore conclude that the proposed model is reliable.
Keywords: Deep brain stimulation, body conduction communication, implantable, point source field
Abstract: The present study explored the efficiency of shear wave elastography (SWE) in diagnosing papillary thyroid microcarcinoma (PTMC). This retrospective study constituted of 446 patients with 349 thyroid nodules. SWE values and ultrasound parameters of each nodule were used for comparison and analysis. The ultrasonography findings between malignant and benign nodules differed significantly (P < 0.05). The benign and PTMC nodule groups showed a remarkable difference in the stiffness, i.e., higher SWE values. SWE is useful in diagnosing micro thyroid nodules, and the values were significantly correlated with tumor size and thyroid capsule invasion of PTMC.
Abstract: BACKGROUND: Children with cerebral palsy (CP) have abnormal postures and gait patterns. Many physiotherapists use the Vojta approach as intervention for children with CP. However, its effects remain unclear. OBJECTIVE: This study aimed to investigate the effect of the Vojta approach on abdominal muscles and gait in children with spastic CP. METHODS: Thirteen children with spastic CP were randomly assigned to a general exercise and a Vojta approach group. The interventions were administered in 30 min sessions, 3 times a week for a total of 6 weeks. We used ultrasonography to measure the…thicknesses of the abdominal muscles. The gait and foot pressure were measured by GAITRite. RESULTS: The Vojta approach group showed significant difference in the thicknesses of the rectus abdominis, and external oblique abdominal muscles, which are involved in trunk stability (p < 0.05). There were significant differences in the step width, functional ambulation profile, swing time, stance time, and single support % of cycle as well as foot pressure distribution (p < 0.05). CONCLUSION: The Vojta approach may be considered as an effective treatment method for improving trunk stability and gait functions of children with spastic CP.
Abstract: BACKGROUND: Incorrect cup positioning in primary total hip arthroplasty is known as a risk factor for early implant failure. The use of navigation systems leads to more accurate cup positioning. OBJECTIVE: The aim of this study was to compare the registration accuracy of the anterior pelvic plane and the measurement accuracy of the definite cup position for a pointer computer-assisted orthopaedic navigation system (P-CAOS) and an ultrasound-based navigation tool (US-CAOS) in an intra-individual study design. METHODS: Anterior pelvic plane registration was performed in 44 patients receiving a primary total hip arthroplasty with P-CAOS…and US-CAOS. The cup implantation was performed using US-CAOS. Intraoperatively, the cup position was assessed using P-CAOS and US-CAOS. The postoperative cup position was determined via CT scan. Inclination and anteversion errors were calculated using intraoperative values and CT data. All operations were performed by a single, high-volume surgeon using a minimally invasive anterolateral approach. RESULTS: The mean inclination error was 0.9 ∘ in the US-CAOS group and - 1.1 ∘ in the P-CAOS group. This was not statistically significant. The mean anteversion error was significantly reduced (p < 0.001) in the US-CAOS group (1.4 ∘ ) compared to the P-CAOS group (- 8.0 ∘ ). Significantly more cups (23 of 44; 52%) in the P-CAOS group were outliers regarding to the defined anteversion error range of 15 ∘ ± 10 ∘ . Outliers in the US-CAOS group amounted to two (of 44; 5%) (p < 0.001). The number of outliers regarding the inclination error range of 40 ∘ ± 10 ∘ , did not differ significantly between the P-CAOS (2; 5%) and US-CAOS (1; 2%) group. CONCLUSION: We were able to show a systematic anterior pelvic plane registration error in this intraindividual study design. US-CAOS based APP landmark registration showed to be significantly more precise compared to P-CAOS registration. The anteversion error of the cup using US-CAOS showed to be significantly reduced compared to the P-CAOS method.
Keywords: Primary total hip arthroplasty, ultrasound-based navigation, pointer-based navigation, anterior pelvic plane, registration error, anteversion error, inclination error, orthopaedic navigation system, cup positioning
Abstract: BACKGROUND: Recently, health care and disease prevention are more and more important in people’s daily life. Human body communication (HBC) is an emerging short distance wireless communication mode, which is quite suitable for the communication between the wearable human health care equipment. However, most research on HBC mainly focuses on the electromagnetic model and the circuit model of equivalent human and the in vivo experiment is based on the commercial equipment. OBJECTIVE: The aim of this paper is to design a circuit device for measuring the attenuation of the human body channel based on a floating-ground-electrode…method. METHODS: This paper proposed a new floating-ground-electrode method so as to solve problems of power and high frequencies interference and impedance matching. A circuit module, including signal generator, analog frontend circuit and MCU, was designed to initially replace the spectrum analyzer to measure the attenuation of the human body channel. The floating-ground-electrode added to the receiving end of the human body channel was connected to the ground of the analog frontend circuit, forming an equal potential circuit. The three-electrodes of the receiving terminal can act as a differential probe, since one electrode is connected to the ground and the other two electrodes achieved signal input and output respectively. RESULTS: The results showed that the experimental data of channel attenuation were similar to the measured value of the spectrum analyzer. The maximum absolute error was 1.148 dB and the relative error was 3.55%. In addition, different sizes of the floating-ground-electrode cannot affect the attenuation path of human body channels. Moreover, the common mode rejection ratio (CMRR) was approximated to the value of the commercial differential probe. CONCLUSION: This paper proposed a new floating-ground-electrode method for measuring the attenuation of the human body channel. It could provide the possibility for the dynamic measurement of attenuation and take the place of the spectrum analyzer and make the process of experiments simple and efficient.
Keywords: Human body communication, galvanic coupling, channel attenuation, floating-ground-electrode
Abstract: BACKGROUND: Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours. OBJECTIVE: This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort. METHODS: A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6…weeks postoperatively, and 3, 6, and 12 months postoperatively. RESULTS: Ninety-two patients (mean age, 62.7 ± 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n = 18; 19.6%), lung cancer (n = 16; 17.4%), prostate cancer (n = 14; 15.2%), and breast cancer (n = 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6–7.6) to 3 months (mean, 5.5; 95% CI, 4.8–6.2; p = 0.01) and 12 months (mean, 4.6; 95% CI, 3.7–5.5; p = 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5–57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1–49.6; p = 0.03), 3 months (mean, 37.0; 95% CI, 31.0–42.9) 6 months mean, 40.5; 95% CI, 34.2–46.8; p = 0.01), and 12 months (mean, 31.9; 95% CI, 24.8–39.1; p = 0.005) postoperatively. Improvements in the COMI at 6 weeks (p = 0.05), and 6 months (p = 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38–0.59; p = 0.002), 3 months (mean, 0.50; 95% CI, 0.38–0.61; p = 0.009), and 12 months (mean, 0.61; 95% CI, 0.51–0.71; p = 0.001) postoperatively. After 6 months, the difference was not significant (p = 0.08). CONCLUSION: Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.
Keywords: Spinal metastases, spine, metastatic spine surgery, quality of life, functional outcome, Core Outcome Measures Index
Abstract: BACKGROUND: Stroke combined with Diabetes Mellitus may cause sensibility and vascular alterations. OBJECTIVE: To determine whether sensitivity and plantar cutaneous temperature of clinically controlled patients with stroke and DM are different from those of patients with stroke only. METHODS: This is a cross-sectional case-control study. The volunteers were assessed for sensitivity by monofilament esthesiometry in their plantar region, and for temperature by infrared thermal imaging. The data was presented as means and standard deviations and comparisons were conducted with the Mann-Whitney statistical test, with statistical significance set at p <…0.05. RESULTS: Five cases and 11 controls were included according to the eligibility and pairing criteria. There were no discrepancies between the plegic and contralateral sides regarding temperature and sensibility of both cases and controls. However, in the control group, there was an observable tendency for different temperatures between the plegic and the contralateral sides, with p < 0.05 in most of the comparisons. CONCLUSIONS: There is no evidence that the cases and controls have different plantar sensibility nor different plantar temperature on their plegic and contralateral sides. However, significant temperature discrepancies between both plegic and contralateral sides were observed in the control group.
Keywords: Stroke, cutaneous sensitivity, body temperature, evaluation, esthesiometry, thermography
Abstract: In the last decade, the attention of the scientific community has been focused on bile acids and their salts as systems for the transportation of drugs; specifically their role as carriers and integration into nanomedicine. Bile acids can play a critical role as drug carriers in the form of chemical conjugates, complexation, mixed micelles formation as well as stabilized bile acid liposomes (bilosomes). The unique molecular structure and interaction of these amphiphilic-steroidal compounds make them an interesting subject of research. This review is based on literature research in order to emphasize the importance of bile acids and their salts as…absorption modulators in order to improve therapeutic potentials of low bioavailability drugs.
Keywords: Bile acids, bilosomes, nano-structures, absorption enhancers, drug delivery