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: OBJECTIVE: This study aimed to identify potential key microRNAs (miRNAs) in osteosarcoma and construct miRNA-mRNA negative regulatory networks through analysis of the Gene Expression Omnibus (GEO) database. METHODS: The differentially expressed miRNAs (DE-miRNAs) in GSE28423 were screened, and their prognostic value was assessed with the prognostic data of GSE39058. The target genes of prognostic DE-miRNAs were predicted and underwent Gene Ontology (GO) classification and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. In addition, the expression of all predicted target genes were assessed using the mRNA array data of GSE28424. Finally, the gene-drug interaction network…was constructed. RESULTS: We identified 205 DE-miRNAs between osteosarcoma cells and normal bone. Among them, high expression of miR-411-3p and miR-487b-5p were correlated with prolonged survival. Furthermore, 2659 genes predicted as targets of miR-411-3p or miR-487b-5p were clustered in 42 significant GO categories, including “regulation of neurotransmitter secretion” and “phosphoprotein binding”, as well as 23 significant KEGG pathways, such as “MAPK signaling pathway” and “Ras signaling pathway”. Five of the 75 overlapping target genes of miR-411-3p and miR-487b-5p were downregulated in osteosarcoma, including ZBTB20, ADAMTS4, GLIPR2, CLIC5 and CBX7. CONCLUSIONS: Our findings might help clarify molecular mechanisms underlying the oncogenesis and development, and offer potential targets for osteosarcoma.
Abstract: BACKGROUND: Status epilepticus (SE) as the initial presentation of aortic dissection in the absence of chest pain is very rare. We report a case of aortic dissection (AD), which presented as SE with markedly elevated levels of D-dimer, a reliable and sensitive index of fibrin deposition and stabilization. CASE REPORT: A 74-year-old Asian woman presented to the emergency department (ED) with an altered mental state following three consecutive generalized tonic-clonic seizures at home. Her initial vital signs were normal, and the head CT scan was non-informative. Most of the laboratory results were normal, but the D-dimer…levels were markedly elevated. About 90 minutes after arriving at the ED, the patient developed another tonic-clonic seizure for about three-four minutes. Emergent chest CT revealed type A AD with hemopericardium. During preparation for the emergency operation, the patient suffered a cardiac arrest. Despite performing cardiopulmonary resuscitation (CPR) for 35 minutes, the patient died. CONCLUSIONS: The goal of this case report is to make clinicians aware of the possibility that new-onset SE with elevated D-dimer levels can be an indication of acute AD type A in the absence of typical symptoms.
Keywords: Status epilepticus, type A aortic dissection, D-dimer
Abstract: BACKGROUND: Endothelial cells play an important role in the prevention of cardiovascular disease. OBJECTIVE: In this study, we examined the effects of transient aerobic exercise on peripheral endothelial function. METHODS: Twenty-seven healthy male college students were selected as subjects and randomly divided into two groups: 13 in the control group and 14 in the exercise group. The subjects in the exercise group had a 15-minute supine rest, followed by 30 minutes of cycling exercise at moderate intensity, while measuring the reactive hyperemia index (RHI), an indicator of endothelial function, before and after exercise.…The subjects in the control group had a 40-minute rest, during which RHI was measured with the same timing as in the exercise group. RESULTS: Two-factor analysis of variance revealed a statistically significant interaction effect. In the exercise group, RHI increased significantly after exercise. However, no significant change was observed in the control group. When RHI before exercise was compared between the two groups, no significant difference was found. However, RHI after exercise was significantly higher in the exercise group. CONCLUSIONS: The results of this study suggest that 30 minutes of moderate-intensity exercise may have a favorable impact on peripheral endothelial function.
Abstract: BACKGROUND: The haemodynamics determined by different approaches for studying fluid dynamics – i.e. computational fluid dynamics (CFD), particle image velocimetry (PIV), and phase-contrast magnetic resonance imaging (PC-MRI) – have rarely been thoroughly compared; nor have the factors that affect accuracy and precision in each method. As each method has its own advantages and limitations, this knowledge is important for future studies to be able to achieve valid analyses of fluid flows. OBJECTIVE: To gauge the capacity of these methods for analysing aneurysmal flows, we compared the haemodynamic behaviours determined by each method within a patient-specific aneurysm…model. METHODS: An in vitro silicone aneurysm model was fabricated for PIV and PC-MRI, and an in silico aneurysm model with the same geometry was reconstructed for CFD. With the same fluid model prepared numerically and physically, CFD, PIV and PC-MRI were performed to study aneurysmal haemodynamics. RESULTS: 2D velocity vectors and magnitudes show good agreement between PIV and CFD, and 3D flow patterns show good similarity between PC-MRI and CFD. CONCLUSIONS: These findings give confidence to future haemodynamic studies using CFD technology. For the first time, the morphological inconsistency between the PCMRI model and others is found to affect the measurement of local flow patterns.
Abstract: BACKGROUND: Hip disarticulation prostheses (HDPs) are not routinely seen in clinical practice, and traditional hip prostheses rotate around an axis at the front side of the pelvic socket. OBJECTIVE: This study proposes a mechanism to restore the rotation center to the acetabulum of the amputated side and uses comparative experiments with traditional HDP to verify the validity of the novel design. METHODS: A double parallelogram design of HDP based on a remote center of motion (RCM) mechanism was presented in this paper. Optimization was achieved by a genetic algorithm with the maximal integral…size and minimal driving force of the mechanism. RESULTS: The prototype was developed by final optimal results and tested by a hip disarticulated amputee. Testing results revealed that the RCM-HDP improved the range of motion of the hip prosthesis by 78%. The maximal flexion of the assorted prosthetic knee was closer to the sound side than a traditional HDP by 15%. CONCLUSION: The proposed RCM-HDP promoted the kinematic performance and symmetry of the hip prosthesis compared to the traditional design.
Keywords: Hip disarticulation, prosthesis, remote center of motion, double parallelogram, genetic algorithm
Abstract: BACKGROUND: Pleural Mesothelioma (PM) is an unusual, belligerent tumor that rapidly develops into cancer in the pleura of the lungs. Pleural Mesothelioma is a common type of Mesothelioma that accounts for about 75% of all Mesothelioma diagnosed yearly in the U.S. Diagnosis of Mesothelioma takes several months and is expensive. Given the risk and constraints associated with PM diagnosis, early identification of this ailment is essential for patient health. OBJECTIVE: In this study, we use artificial intelligence algorithms recommending the best fit model for early diagnosis and prognosis of Malignant Pleural Mesothelioma (MPM). METHODS:…We retrospectively retrieved patients’ clinical data collected by Dicle University, Turkey and applied multilayered perceptron (MLP), voted perceptron (VP), Clojure classifier (CC), kernel logistic regression (KLR), stochastic gradient decent (SGD), adaptive boosting (AdaBoost), Hoeffding tree (VFDT), and primal estimated sub-gradient solver for support vector machine (s-Pegasos). We evaluated the models, compared and tested them using paired t -test (corrected) at 0.05 significance based on their respective classification accuracy, f-measure, precision, recall, root mean squared error, receivers’ characteristic curve (ROC), and precision-recall curve (PRC). RESULTS: In phase 1, SGD, AdaBoost.M1, KLR, MLP, VFDT generate optimal results with the highest possible performance measures. In phase 2, AdaBoost, with a classification accuracy of 71.29%, outperformed all other algorithms. C-reactive protein, platelet count, duration of symptoms, gender, and pleural protein were found to be the most relevant predictors that can prognosticate Mesothelioma. CONCLUSION: This study confirms that data obtained from biopsy and imaging tests are strong predictors of Mesothelioma but are associated with a high cost; however, they can identify Mesothelioma with optimal accuracy.
Keywords: Mesothelioma, predictive modeling, decision support system, machine learning, artificial intelligence, lung cancer
Abstract: BACKGROUND: Dental esthetic materials are constantly introduced to meet the increasing esthetic demand in contemporary dental practice. OBJECTIVE: To test the fracture resistance of endodontically treated teeth (ETT) restored with different esthetic post materials like fiber-reinforced composite post (FRC), polyether ether ketone (PEEK), and polymer infiltrated ceramic (PIC). METHODS: Thirty-six human root canal treated single-rooted premolar teeth were decoronated 3 mm above the cemento-enamel junction and prepared to receive the post. They were randomly divided into three groups (n = 12) to be restored with FRC, PEEK, and…PIC. After appropriate surface treatment, they were cemented with self-adhesive luting cement and restored with full veneer crowns. The samples were thermocycled, subjected to a compressive static load at 45 ∘ angulation until fracture. Obtained data were analyzed by one-way ANOVA and Tukey’s HSD post hoc comparison test. RESULTS: The results indicate that the ETT restored with PEEK post had the maximum fracture load (1929.94 N), followed by PIC endodontic post group (1810.65N), and FRC post (1715.68N). Meanwhile, ETT restored with FRC showed a predominantly favorable fracture, whereas PEEK restored teeth had a more unfavorable fracture. CONCLUSION: Of all the esthetic post materials, the group for which PEEK endodontic post was used displayed higher fracture resistance.
Keywords: Root canal treated teeth, PEEK, endodontic post, fiber-reinforced composite post, polymer infiltrated hybrid ceramic, fracture resistance
Abstract: BACKGROUND: A short stem hip arthroplasty can be revised in many cases using a conventional stem. Furthermore, in some cases the implantation of a short stem is intended, but intraoperatively reasons may lead to the decision to implant a conventional stem after previous preparation of a short stem. OBJECTIVE: In both cases it is questionable if the anchorage of a conventional stem is negatively affected by the previous preparation of a short stem. In clinical practice mid- or long-term follow up for these special cases hardly exist. METHODS: The strain patterns for the…conventional Bicontact stem in primary implantation and after preparation of the proximal femur for a METHA short stem were tested biomechanically in three pairs of cadaveric femora. RESULTS: The strain patterns for the conventional Bicontact after preparation of the METHA short stem were similar to conditions after testing the conventional stem in primary conditions. CONCLUSIONS: These data lead to the consequence that in clinical practise the implantation of a conventional stem after preparation of a short stem and even after revision of a short stem is possible without increased risk of loosening or long-term stress-shielding.
Keywords: Short stem hip arthroplasty (METHA), standard stem hip arthroplasty (Bicontact), biomechanical testing, strain gauges, strain pattern
Abstract: BACKGROUND: Trunk control ability has been identified as an important early predictor of functional recovery after stroke. OBJECTIVE: Our study aimed to investigate the effects of three-dimensional active trunk training exercise on trunk control ability, trunk muscle strength, and balance ability in sub-acute stroke patients. METHODS: Twenty-four sub-acute stroke patients were randomly assigned to an experimental (n = 12) or control (n = 12) group. The experimental group (EG) performed three-dimensional active trunk training exercises using the Space Balance 3D system, while the…control group (CG) performed only general trunk training exercises five times per week, for a total of three weeks. The Trunk Impairment Scale (TIS), trunk muscle strength, balance ability using the Space Balance 3D system, and Brunel Balance Assessment (BBA) scores were assessed before and after the intervention. RESULTS: Pre-to-post intervention improvement was noted in all outcome measures for both groups (p < 0.05). Post intervention, the TIS, trunk muscle strength, static balance, and BBA scores were significantly higher in the EG than those in the CG (p < 0.05). CONCLUSION: Our study suggests that the three-dimensional active trunk training exercise may be more effective compared to the general trunk training exercise in improving trunk control ability, trunk muscle strength, and balance ability in sub-acute stroke patients.
Keywords: Exercise therapy, Space Balance 3D system, sub-acute stroke, trunk control, trunk training exercise
Abstract: BACKGROUND: Human facial muscles react differently to different visual stimuli. It is known that the human brain controls and regulates the activity of the muscles. OBJECTIVE: In this research, for the first time, we investigate how facial muscle reaction is related to the reaction of the human brain. METHODS: Since both electromyography (EMG) and electroencephalography (EEG) signals, as the features of muscle and brain activities, contain information, we benefited from the information theory and computed the Shannon entropy of EMG and EEG signals when subjects were exposed to different static visual stimuli with…different Shannon entropies (information content). RESULTS: Based on the obtained results, the variations of the information content of the EMG signal are related to the variations of the information content of the EEG signal and the visual stimuli. Statistical analysis also supported the results indicating that the visual stimuli with greater information content have a greater effect on the variation of the information content of both EEG and EMG signals. CONCLUSION: This investigation can be further continued to analyze the relationship between facial muscle and brain reactions in case of other types of stimuli.