Technology and Health Care - Volume Pre-press, issue Pre-press
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ISSN 0928-7329 (P)
Impact Factor 2023: 1.6
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: Patients’ self-efficacy levels are significantly associated with the process of recovery and creating social support in the inpatient recovery setting can help prevent post-stroke depression and anxiety. OBJECTIVE: To explore the current status of factors influencing chronic disease self-efficacy in patients with ischemic stroke, to provide theoretical basis and clinical data for implementing corresponding nursing interventions. METHODS: The study included 277 patients with ischemic stroke who were hospitalized in the neurology department of a tertiary hospital in Fuyang, Anhui Province, China from January to May 2021. Participants for the study were selected…by convenience sampling method. A questionnaire for general information developed by the researcher and the Chronic Disease Self-Efficacy Scale were used for collecting data. RESULTS: The patients’ total self-efficacy score was (36.79 ± 10.89), which was in the middle to the upper level. Results of our multifactorial analysis showed that history of fall in the previous 12 months, presence of physical dysfunction, and cognitive impairment were all independent risk factors for chronic disease self-efficacy in patients with ischemic stroke (P < 0.05). CONCLUSION: Chronic disease self-efficacy in patients with ischemic stroke was at an intermediate to high level. History of falls in the previous year, physical dysfunction, and cognitive impairment were factors influencing patients’ chronic disease self-efficacy.
Keywords: Chronic disease self-efficacy, current situation, influencing factors, stroke
Abstract: BACKGROUND: Short stems are advantageous for revision as they preserve autogenous bone. At present, the method of short-stem installation is determined based on the surgeon’s experience. OBJECTIVE: To provide the guideline for installing a short stem, we aimed to investigate the alignment effect on the initial fixation of the stem, stress transfer, and the risk of failure numerically. METHODS: Models in which the caput-collum-diaphyseal (CCD) angle and flexion angle were hypothetically changed based on the two clinical cases of hip osteoarthritis were analyzed using the non-linear finite element method. RESULTS:…The medial settlement of the stem increased in the varus model and decreased in the valgus model. With varus alignment, the stresses acting on the femur were high in the distal to the femoral neck. In contrast, the stresses in the proximal to the femoral neck tend to be higher with valgus alignment, although the difference in the femur stress between varus and valgus alignment was slight. CONCLUSION: Both initial fixation and stress transmission are lower when the device was placed in the valgus model than in the actual surgical case. In order to obtain initial fixation and suppress stress shielding, it is essential to extend the contact area between the medial portion of the stem and the femur along the bone axis, and to ensure adequate contact between the lateral portion of the stem tip and the femur.
Keywords: Hip joint, arthroplasty, finite element analysis, hip prosthesis, initial fixation, stress shielding
Abstract: BACKGROUND: A multi-pod catheter (MPC) is a large drainage catheter that can house multiple smaller retractable (MPC-R) and deployable catheters (MPC-D) within the body. OBJECTIVE: The drainage capabilities and resistance to clogging of a novel MPC have been assessed. METHODS: The drainage capabilities are evaluated by placing the MPC in a bag of either a non-clogging (H 2 O) or clogging medium. The results are then compared to matched-size single-lumen catheters with either a close (CTC) or open tip (OTC). The means of five tests runs were used to measure…drainage rate, maximum drained volume (MaxDV), and time to drain the first 200 mL (TTD200). RESULTS: In the non-clogging medium, MPC-D had a slightly higher MaxDV than MPC-R, and higher flow rate than CTC and MPC-R. Moreover, MPC-D needed less TTD200 than MPC-R. In the clogging medium, MPC-D had a higher MaxDV than CTC and OTC, higher flow rate, and faster TTD200 than CTC. However, comparison with MPC-R showed no significant difference. CONCLUSION: The novel catheter may offer superior drainage compared to the single-lumen catheter in a clogging medium, implying various clinical applications, particularly when clogging is a potential risk. Further testing may be required to simulate various clinical scenarios.
Abstract: BACKGROUND: Milling operations of laminae in spinal surgery generate high temperatures, which can lead to thermal injury and osteonecrosis and affect the biomechanical effects of implants, ultimately leading to surgical failure. OBJECTIVE: In this paper, a backpropagation artificial neural network (Bp-ANN) temperature prediction model was developed based on full factorial experimental data of laminae milling to optimize the milling motion parameters and to improve the safety of robot-assisted spine surgery. METHODS: A full factorial experiment design were used to analyze the parameters affecting the milling temperature of laminae. The experimental matrixes were established…by collecting the corresponding cutter temperature T c and bone surface temperature T b for the milling depth, feed speed and different bone densities. The Bp-ANN lamina milling temperature prediction model was constructed from experiment data. RESULTS: Increasing milling depth increases bone surface and cutter temperature. Increasing feed speed had little effect on cutter temperature, but decreased bone surface temperature. Increasing bone density of laminae increased cutter temperature. The Bp-ANN temperature prediction model had best training results in the 10th epoch, and there is no overfitting (training set R = 0.99661, validation set R = 0.85003, testing set R = 0.90421, all temperature data set R = 0.93807). The goodness of fit R of Bp-ANN was close to 1, indicating that the predicted temperature was in good agreement with the experiment measurements. CONCLUSION: This study can help spinal surgery-assisted robot to select appropriate motion parameters at different density bones to improve lamina milling safety.
Abstract: BACKGROUND: The anesthesia machine serves as a vital piece of lifesaving equipment. OBJECTIVE: To analyze incidents of failures in the Primus anesthesia machine and address these malfunctions to reduce recurrence of failure, save maintenance costs, enhance safety, and improve overall efficiency. METHODS: We conducted an analysis on the records pertaining to the maintenance and parts replacement of the Primus anesthesia machines used in the Department of Anaesthesiology of Shanghai Chest Hospital over the past two years to identify the most common causes of failure. This included an assessment of the damaged parts and…degree of damage, as well as a review of factors that caused the fault. RESULTS: The main cause of the faults in the anesthesia machine was found to be air leakage and excessive humidity in the central air supply of the medical crane. The logistics department was instructed to increase inspections to check and ensure the quality of the central gas supply and ensure gas safety. CONCLUSION: Summarizing the methods for dealing with anesthesia machine faults can save hospitals a lot of money, ensure normal hospital and department maintenance, and provide a reference to repair such faults. The use the Internet of Things platform technology can continuously develop the direction of digitalization, automation, and intelligent management in each stage of the “whole life cycle” of anesthesia machine equipment.
Keywords: Internet of things platform, preventive maintenance, Primus anesthesia machine, whole life cycle
Abstract: BACKGROUND: Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year. OBJECTIVE: The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies. METHODS: A total of 202 preterm infants with a gestational age of 26 weeks…to 36 + 6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed. RESULTS: There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy. CONCLUSION: A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants.
Abstract: BACKGROUND: Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE: In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS: We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n = 10) and healthy control group…(n = 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS: We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P < 0.001; control group: P < 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P < 0.01, using independent t -test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P < 0.01, using independent t -test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P < 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION: SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function.
Abstract: BACKGROUND: The emergency rescue ability of firefighters is particularly important in the event of major disasters or accidents. Therefore, assessment of the firefighter-training effectiveness is necessary. OBJECTIVE: This paper aims to achieve a scientific and effective assessment of the firefighter-training effectiveness in China. An assessment method based on human factor parameters and machine learning was proposed. METHOD: The model is constructed by collecting the corresponding human factor parameters such as electrocardiographic signals, electroencephalographic signals, surface electromyographic signals, and photoplethysmographic signals through wireless sensors and using them as constraint indicators. For the problems of…weak human factor parameters and high noise proportion, an improved flexible analytic wavelet transform algorithm is used to denoise and extract the corresponding feature values. To overcome the limitations of traditional assessment methods, improved machine learning algorithms are used to comprehensively assess the training effectiveness of firefighters and provide targeted training suggestions. RESULTS: The effectiveness of this study’s evaluation method is verified by comparing it with the expert scoring method and considering firefighters from a special fire station in Xhongmen, Daxing District, Beijing, as an example. CONCLUSION: This study can effectively guide the scientific training of firefighters and the method is more objective and accurate than the traditional method.
Abstract: BACKGROUND: The Selfit system was developed to improve the mobility and gait-related functions of stroke patients by providing digital exercises and augmented reality training system. OBJECTIVE: To evaluate the effects of a digital exercise and augmented reality training system on mobility, gait-related functions and self-efficacy outcomes in stroke patients. METHODS: A randomized control trial was conducted on 25 men and women diagnosed with an early sub-acute stroke. Patients were randomly assigned to either the intervention (N = 11) or the control groups (N =…14). Patients in the intervention group received a digital exercise and augmented reality training using the Selfit system in addition to the standard physical therapy treatment. Patients in the control group were treated with a conventional physical therapy program. Timed Up and Go (TUG) test, 10-meter walk test, the Dynamic Gait Index (DGI), and the Activity-specific Balance Confidence (ABC) scale were completed before and after the intervention. Feasibility and satisfaction among patients and therapists were also assessed after the completion of the study. RESULTS: The intervention group practiced proportionally more time per session than the control group with a mean change of 19.7% following 6 sessions (p = 0.002). The intervention group showed better improvement in post-TUG score compared to the control group (p = 0.04). ABC, DGI, and the 10-meter walk test scores were not significantly different between the groups. Both therapists and participants demonstrated high satisfaction with the Selfit system. CONCLUSION: The findings suggest that Selfit holds promise as an effective intervention for improving mobility and gait-related functions among patients with an early sub-acute stroke as compared to conventional physical therapy treatments.
Keywords: Stroke, gait, mobility, digital exercise, augmented reality
Abstract: BACKGROUND: Malnutrition is a serious health risk facing older people living in residential aged care facilities. Aged care staff record observations and concerns about older people in electronic health records (EHR), including free-text progress notes. These insights are yet to be unleashed. OBJECTIVE: This study explored the risk factors for malnutrition in structured and unstructured electronic health data. METHODS: Data of weight loss and malnutrition were extracted from the de-identified EHR records of a large aged care organization in Australia. A literature review was conducted to identify causative factors for malnutrition. Natural language…processing (NLP) techniques were applied to progress notes to extract these causative factors. The NLP performance was evaluated by the parameters of sensitivity, specificity and F1-Score. RESULTS: The NLP methods were highly accurate in extracting the key data, values for 46 causative variables, from the free-text client progress notes. Thirty three percent (1,469 out of 4,405) of the clients were malnourished. The structured, tabulated data only recorded 48% of these malnourished clients, far less than that (82%) identified from the progress notes, suggesting the importance of using NLP technology to uncover the information from nursing notes to fully understand the health status of the vulnerable older people in residential aged care. CONCLUSION: This study identified 33% of older people suffered from malnutrition, lower than those reported in the similar setting in previous studies. Our study demonstrates that NLP technology is important for uncovering the key information about health risks for older people in residential aged care. Future research can apply NLP to predict other health risks for older people in this setting.
Keywords: Natural language processing, malnutrition, electronic health records, residential aged care, nursing home