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: The acetabular component orientation during total hip arthroplasty (THA) impacts future hip function and early revision. Correcting pelvic obliquity may improve outcomes. OBJECTIVE: To correct pelvic obliquity in the lateral position by applying a gradienter and plumb during THA using fluoroscopy. METHODS: Fifty patients undergoing THA were randomized and divided into 2 groups. In controls, acetabular components were placed using traditional methods. In experimental patients, acetabular components were placed after correcting pelvic obliquity. We measured pelvic obliquity and recorded intra-operative and post-operative abduction angles, comparing abduction angle bias between post-operative measurements and…intra-operation estimations. RESULTS: Before correction, the average pelvic obliquity was - 1.647 ∘ ± 4.512 ∘ in experimental patients. The average abduction angle in experimental patients was 42.685 ∘ ± 3.355 ∘ postoperatively, differing by 1.962 ∘ ± 1.515 ∘ from intra-operative estimates, while in control patients, it was 44.534 ∘ ± 4.844 ∘ postoperatively, differing by 4.244 ∘ ± 3.042 ∘ from intra-operative estimates. The bias of the abduction angle was much greater in control than in experimental patients (P < 0.05). CONCLUSION: The pelvic obliquity in the lateral position affects surgeon judgment during THA. By correcting pelvic obliquity with a gradienter and plumb, the abduction angle bias can be reduced.
Abstract: BACKGROUND: To evaluate the clinical effects of individual placement of intramedullary nail guided by digital technique in the treatment of tibial fractures. METHODS: Thirty-two cases of unilateral tibial fractures treated with individual placement of intramedullary nail guided by digital technique or conventional surgery were collected from October 2010 to October 2012. In the experimental group, the size of intramedullary nail, as well as the distance between the insertion point of tibial…intramedullary nail and the line perpendicular to the tibial plateau of the tibial tubercle were measured by digital technology preoperatively to select suitable intramedullary nail and appropriate insertion point. RESULTS: The operative time and bone healing time of the experimental group didn't change significantly (P > 0.05). There were statistically significant differences in the number of X-ray examinations and the distance between actual and planned nail placement point between experimental group and control group. The excellent and good rate of functional recovery for the experimental and the control group was 100% and 87.50%, respectively. CONCLUSION: Compared with the conventional surgery, individual placement of intramedullary nail guided by digital technique in tibial fractures might have superior outcomes.
Abstract: Involuntary human tremor due to clinical disorders may inhibit daily activities and can severely restrict lifestyle. Such tremor is associated with rhythmic movement of one or more body parts, where muscles contract and relax, causing twitching or sudden movement. Symptoms are most commonly the result of a psychological illness that causes the muscles to act involuntarily. Medical treatments to human tremor may pose harmful side effects, including hallucinations, and drugs used for treatment have varying degrees of success in reducing the symptoms of the illness. Our research provides a new, assistive technology that minimizes the effects of hand tremor, as…a substitute for drug-related therapy. The device is intended for use in creative art; a paint brush attachment, for application in painting. The engineering solution promises greater application for attachment to a variety of aids, such as for writing, eating or instructional, for device stabilization as used by persons suffering from hand tremor, irrespective of medical cause.
Keywords: Hand tremor, Parkinson's, active cancellation, activity aid, SMA wires, smart device
Abstract: Indoor flight, obstacle avoidance and client-server communication of an Unmanned Aerial Vehicle (UAV) raises several unique research challenges. This paper examines current methods and associated technologies adapted within the literature toward autonomous UAV flight, for consideration in a proposed system for indoor healthcare administration with a quadcopter. We introduce Healthbuddy , a unique research initiative towards overcoming challenges associated with indoor navigation, collision detection and avoidance, stability, wireless drone-server communications and automated decision support for patient care in a GPS-denied environment. To address the identified research deficits, a drone-based solution is presented. The solution is preliminary as we develop and…refine the suggested algorithms and hardware system to achieve the research objectives.
Abstract: BACKGROUND: Many robots can induce passive movements and passive resistance movements to facilitate recovery of upper-extremity function, but it is rare to find robots that can also enable active resistance movements. OBJECTIVE: The purpose of this study was to investigate the effects of robot-assisted therapy on upper-extremity function and the ability to perform activities of daily living (ADL) in patients with stroke-induced hemiplegia. METHODS: Thirty patients with stroke-induced hemiplegia were randomly assigned to the experimental and control groups, with 15 patients in each group. All subjects underwent general occupational therapy consisting of five 30-min…sessions per week for 8 weeks, in addition to 30 min of robot-assisted therapy for the experimental group and 30 additional min of general occupational therapy for the control group for each session. RESULTS: Both the experimental and control groups showed a statistically significant increase in post-treatment Fugl-Meyer assessment and modified Barthel index scores compared to the pre-treatment scores. Intergroup comparisons revealed that the experimental group showed a statistically significant greater increase in scores for all assessments than the control group did (p < 0.05). CONCLUSION: The findings from this study showed that combining robot-assisted therapy with general occupational therapy may enhance upper-extremity function and the ability to perform ADL in patients with stroke-induced hemiplegia compared to those obtained with general occupational therapy alone.
Abstract: BACKGROUND: The study of the brain network based on the basis of the resting-state functional Magnetic Resonance Imaging (fMRI) provided some promising results to investigate changes in connectivity among different brain regions because of Alzheimer’s disease (AD). OBJECTIVE: In addition, the graph theory has been utilized as an efficient tool in diagnosing Alzheimer and in finding the developed differences in the brain as the result of this disease. METHODS: This study considers 16 areas of the brain, which play major role in the development of AD. Accordingly, the time series and the correlation matrix were…yielded for each of these areas. Then, by using threshold we obtain functional connectivity from correlation matrices along with the brain graph parameter for Normal Controls and AD groups were obtained in order to compare the existing differences. RESULTS: The differences of characteristics among healthy individuals and patients suffering from Alzheimer has been investigated in this study through the formation of brain graphs for 16 areas and the utilization of data on Normal Controls (13 persons) and patients suffering from Alzheimer (13 patients). CONCLUSIONS: Some of the properties of the graph are the characteristic path length, the clustering coefficient, the local and global efficiency yield of ability to separate the two groups which may be used to diagnose Alzheimer.
Keywords: Functional Magnetic Resonance Imaging, graph, small world, connectivity, Alzheimer’s disease
Abstract: BACKGROUND: A well-made and properly cemented provisional restoration is essential for the health of abutment teeth and periodontium. Few focused studies are available on the effect of cementation techniques on the fit as well as on the retention of the provisional crowns. OBJECTIVE: To investigate the effect of six cement application techniques on the adaptation and retention of provisional crowns. METHODS: Seventy-two provisional crowns (Bisacryl resin) were fabricated over identical self-cured resin dies and were divided into six groups (N = 72; 6 × n =…12) of cement application techniques (Temp Bond NE, Kerr Corporation). Group-A (Bulk Fill); Group-B (Cement on inner walls); Group-C (Cement on axial walls); Group-D (Cement on crown margin); Group-E (Cement on tooth margin); Group-F (Cement with vent-holes). Adaptation was assessed before and after cementation with digital caliper (0.001 mm). Universal testing machine was used for retention measurement in Mega Pascal’s (MPa). Data was analyzed by SPSS using Paired T-Test and Tukey’s test (p < 0.05). RESULTS: The highest and lowest difference between the two measurements was observed for the Group A (0.095 mm) and Group C (0.030 mm) respectively. Paired T-Test revealed significance (p < 0.05) between before and after cementation. Group-F (0.6094 MPa) and Group-E (0.1858 MPa) showed the highest and lowest retention respectively. Group-E (Cement on tooth margin) with lowest retention significantly differed (Tukey’s Test; p < 0.05) from other groups. CONCLUSIONS: Bulk filling of the provisional crown with luting cement significantly increases the adaptation discrepancies. Discrepancies are more when luting cement is applied on the occlusal surface of the crowns. However, it didn’t influence the retention of the crowns. Cement application on axial walls and cervical third of intaglio surface of crowns was the method of choice with regards to adaptation and retention combined. Addition of vent-holes improved the adaptation with best possible retention.
Abstract: BACKGROUND: Anterior-posterior displacement of center of pressure (AP_CoP) reflects stance limb function. However, AP_CoP’s clinical applicability in post-stroke hemiplegia is unclear. OBJECTIVE: To investigate the clinical usefulness of parameters from AP_CoP in subacute stage post-stroke hemiplegia, their relationships with usage of gait aid, functional ambulatory category, and spatial-temporal parameters were tested. METHODS: Nineteen participants with post-stroke hemiplegia were included in gait with aid group. Twenty one participants were included in gait with independence group. Twenty one participants were included in control group. Insole foot pressure measurement system was used to measure AP_CoP and…spatial-temporal parameters. Effects of gait aid usage and functional ambulatory category on AP_CoP were tested with ANOVA. Relationships between AP_CoP and temporo-spatial parameters were investigated with correlation and linear regression analysis. RESULTS: AP_CoP parameters were shorter in gait with aid group than gait with independence group. With better functional ambulatory category, AP_CoP were longer. AP_CoP showed positive relationship with walking speed. AP_CoP in more affected side showed positive relationship with symmetry of single support phase proportion. AP_CoP showed positive relationship with stride length. CONCLUSIONS: AP_CoP reflects overall gait function, impairments in more affected side and adaptation in less affected side in subacute recovery stage of post-stroke hemiplegia. It can be used as a clinically significant parameter for gait rehabilitation.
Abstract: BACKGROUND: Assessment of asthma outside of the hospital using a patient independent device is highly in demand due to the limitation of existing devices, which are manual and unreliable if patients are not cooperative. OBJECTIVE: The study aims to verify the use of newly developed human respiration, carbon dioxide (CO 2 ) measurement device for the management of asthma outside of the hospital. METHOD: The data were collected from 60 subjects; aged between 18–35 years via convenience sampling method reported in UTM Health Center using the device. Furthermore, the data were normalized…and analyzed using descriptive statistics, t-test, and area (A z ) under receiver operating characteristic curve (ROC). RESULT: Findings revealed that the normalized mean values of end-tidal carbon dioxide (EtCO 2 ), Hjorth activity (HA), and respiratory rate (RR) were lower in asthmatic compared with healthy subjects with minimum deviation from the mean. In addition, each parameter was found to differ statistically significant for asthma and non-asthma with p < 0.05. Furthermore, the A z shows the strong association for the screening of asthma and non-asthma with an average of 0.71 (95% CI: 0.57–0.83), 0.77 (95% CI: 0.64–0.90), and 0.83 (95% CI: 0.73–0.94) for RR, EtCO 2 , and HA, respectively. CONCLUSIONS: This study demonstrates that the newly developed handheld human respiration CO 2 measurement device may possibly be used as an effort-independent asthma management method outside of the hospital.
Keywords: Asthma, capnography, early screening, CO2 measurement
Abstract: BACKGROUND: Total hip arthroplasty (THA) is one of the most common orthopedic procedures in developed countries, and the high volume of surgery and the socioeconomic burden of failures demand continuous optimization. Operative time has been identified as a significant independent factor influencing the clinical outcome of THA. OBJECTIVE: The aim of this study was to analyze factors influencing the operative time for THA in a large, single-center cohort. METHODS: A consecutive series of 7,674 cases undergoing primary THA was identified, and after multiple imputation of missing values, univariable and multivariable linear regression analyses were…performed. RESULTS: In the univariable analysis, all factors showed significant influences on operative time, while multivariable regression analysis revealed that sex, a diagnosis of hip dysplasia and small femoral component size did not reach significance. Younger age, an underlying diagnosis other than osteoarthritis or hip dysplasia, a large stem size, usage of a conventional stem rather than a short stem, a larger cup size and a cemented fixation technique, however, remained significantly influential in terms of a longer operative time. CONCLUSIONS: This study identified risk factors for longer operative time that in turn is associated with a higher rate of periprosthetic joint infection and impaired clinical outcome. Our findings could help to refine scheduling of total hip arthroplasty procedures in times of increasing cost and efficiency pressure.
Keywords: Operative time, total hip arthroplasty, total hip replacement, scheduling