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: Stereotactic radiotherapy (SBRT) is widely used in the treatment of thoracic cancer. OBJECTIVE: To evaluate the efficacy of a non-rebreather mask (NRBM) and high-flow nasal cannula (HFNC) in patients with radiation pneumonia complicated with respiratory failure. METHODS: This was a single-center randomized controlled study. Patients admitted to the EICU of the Fourth Hospital of Hebei Medical University were selected and divided into NRBM and HFNC group. Arterial blood gas analysis, tidal volume, respiratory rates and the cases of patients receiving invasive assisted ventilation were collected at 0, 4, 8, 12, 24, 48,…and 72 h after admission. RESULTS: (1) The PaO2/FiO2, respiratory rates, and tidal volume between the two groups at 0, 4, 8, 12, 24, 48, and 72 h were different, with F values of 258.177, 294.121, and 134.372, all P < 0.01. These indicators were different under two modes of oxygenation, with F values of 40.671, 168.742, and 55.353, all P < 0.01, also varied with time, with an F value of 7.480, 9.115, and 12.165, all P < 0.01. (2) The incidence of trachea intubation within 72 h between HFNC and NRBM groups (23 [37.1%] vs. 34 [54.0%], P < 0.05). The transition time to mechanical ventilation in the HFNC and NRBM groups (55.3 ± 3.2 h vs. 45.9 ± 3.6 h, P < 0.05). (3) The risk of intubation in patients with an APACHE-II score > 23 was 2.557 times than score ⩽ 23, and the risk of intubation in the NRBM group was 1.948 times more than the HFNC group (P < 0.05). CONCLUSION: Compared with the NRBM, HFNC can improve the oxygenation state of patients with radiation pneumonia complicated with respiratory failure in a short time, and reduce the incidence of trachea intubation within 72 h.
Abstract: BACKGROUND: EpidemiXs is an innovative ecosystem of digital tools centralizing official and validated information on COVID-19 for healthcare workers and the general public in a single hub. OBJECTIVE: The vision of EpidemiXs is to foster collaboration between researchers, institutions and individuals to promote “open data” in order to enrich the scientific community and further accelerate science in the fight against COVID-19. METHODS: Through its set of solutions, EpidemiXs Info, EpidemiXs TV and EpidemiXs Studies, this innovative ecosystem contributes to advancing collaborations, data collection and analysis, and helps find funders. RESULTS:…EpidemiXs was launched in March 2020 in Spain with 30 healthcare institutions and rapidly reached close to 1 million users and 2 million views. EpidemiXs gained international recognition when it was awarded the Barcelona Health Hub Awards (BHHAwards) 2020 of the category “Best Startup Initiative to help tackle COVID-19”. CONCLUSION: EpidemiXs has proven the efficiency of the rapid deployment of digital tools in times of COVID-19.
Keywords: COVID-19, infodemic, pandemic, digital health, technology, research, open data, healthcare
Abstract: BACKGROUND: Tracheotomy is one of the first-aid measures for rescuing critically ill patients. OBJECTIVE: This study was designed to observe the clinical effect of using an innovative tracheotomy fixation belt in critically ill patients and to explore the feasibility of using this fixation method. METHODS: Eighty critically ill patients requiring a tracheotomy in Putuo District Central Hospital of Shanghai were enrolled in this study and divided into the observation group and control group (n = 40, each). In the control group, fixation was performed with conventional cotton twill…tape, while in the observation group the fixation was carried out using a tracheotomy fixation belt. The differences in neck skin injury, the occurrence of eczema, and the rate of detachment of the tracheotomy tube in the two groups were compared. RESULTS: The rate of neck skin injury was 7.5% lower in the observation group than in the control group (30%), and the difference was statistically significant (p < 0.05). The incidence of skin eczema was 5% lower in the observation group than in the control group (22.5%), and the difference was statistically significant (p < 0.05). The detachment rate of the tracheotomy tube was 5% lower in the observation group than in the control group (20%), and the difference was statistically significant (p < 0.05). CONCLUSION: The use of an innovative tracheotomy fixation belt can effectively reduce skin damage to the patient’s neck, the incidence of eczema, and the incidence of detachment of the tracheotomy tube.
Abstract: BACKGROUND: Technologies for COVID-19 are in high demand, and supply chains from biotech and pharma industries face critical supply issues. OBJECTIVE: This paper discusses the case on mRNA technologies and quality assurance issues. METHODS: Interviews with managers of biotech companies were performed. These helped to prepare biotech panels at a roundtable on quality of medicine, organized by the Polish Academy of Sciences in Paris (PAN) in 2021. RESULTS: This paper analyzes the new mRNA technology and shows the importance of emerging new biotech firms, especially tool companies providing services in…quality assurance. It highlights research areas and types of survey instruments with academic collaborators, to better understand the economics of mRNA technology platforms. CONCLUSIONS: A future research agenda for collaboration with academic communities is proposed on cost-quality trade-offs and clinical quality attributes for such genomic technologies.
Keywords: Biotech value chain, tool companies, mRNA technology, cost and quality, COVID-19, healthcare
Abstract: BACKGROUND: Gynecological diseases threaten women’s health, and vaginal microecological testing is a common method for detecting gynecological diseases. Efficient and accurate microecological testing methods have always been the goal pursued by gynecologists. OBJECTIVE: In order to automatically identify different types of microbial images in vaginal micromorphology detection, this paper proposes a vaginal microecological image recognition method based on Gabor texture analysis combined with long and short-term memory network (LSTM) model. METHOD: Firstly, we denoise the microecological morphological im-ages, which selects the area of interest and sets the label of the microorganism according to…the doctors label. Secondly, texture analysis is carried out for the region of interest, which uses Gabor filters with 8 directions and 5 scales to filter the region of interest to extract the texture features on the image. Comparing the differences between different microbial image features, and screening suitable features to reduce the number of features. Then, we design an LSTM model to analyze the relationship of image features in different categories of microorganisms. Finally, we use the full connection layer and Softmax function to realize the automatic recognition of different microbial images. RESULTS: The experimental results show that the image classification accuracy of 8 common microorganisms is 81.26%. CONCLUSION: Texture analysis combined with LSTM network strategy can identify different kinds of vaginal micro ecological images. Gabor-LSTM model has better classification effect on imbalanced data sets.
Abstract: BACKGROUND: Catheter jamming is an emerging and possibly underrated complication. OBJECTIVE: To find the criteria for determining if the catheter cannot be removed through the mechanical analysis of fracture tension and fracture strain (ε f) of Peripheral Inserted Central Catheters (PICC). METHOD: We removed 30 pieces of PICC catheters from patients and recorded the indwelling time. Those with an indwelling time shorter than 12 weeks belonged to the short-term group. Those with an indwelling time longer than 12 weeks belonged to the long-term group. The first half of the same catheter…is section A, and the second half is section B. The fraction tension and fracture strain of the catheter were measured, and statistical analysis was conducted. RESULTS: The fracture tension of catheter in sections A and B were 5.8917 ± 1.0095 and 6.0670 ± 0.8066 Newtons respectively (p = 0.393) and the fracture strain of catheter in sections A and B were 6.0611 ± 1.0810 and 6.2543 ± 0.7187 Newtons respectively (p = 0.343). The fracture tension of catheter in short-term and long-term group were 6.0696 ± 0.9414 and 5.9192 ± 0.8972 Newtons respectively (p = 0.535) and the fracture strain of catheter in short-term and long-term group were 6.0067 ± 0.7227 and 6.2584 ± 1.0212 respectively (p = 0.301). CONCLUSION: It is objective and consistent to take the catheter fracture tension as the standard. This standard would be able to accurately define the concept of catheter failure and reduce the risk of catheter fracture and the misdiagnosis of catheter failure. The catheter fracture tension and fracture strain was not affected by the catheter indwelling time. It is recommended to set the tensile force as 5 Newtons and carry it out at a speed of 100 mm/min for the catheter drawing of the PICC single-lumen silicone catheter (4.0F) from Budd Company.
Abstract: BACKGROUND: Essential tremor (ET) and the tremor in Parkinson’s disease (PD) are the two most common pathological tremors with a certain overlap in the clinical presentation. OBJECTIVE: The main purpose of this work is to use an artificial neural network to select the best features and to discriminate between the two types of tremors. The features used are of hybrid type obtained from two different algorithms: the statistical signal characterization (SSC) of the signal describing its morphology, and the soft-decision wavelet-decomposition (SDWD) features extracted from the accelerometer and surface EMG signals. METHODS: The…SSC method is used to obtain morphology-based features of the spectrum of the accelerometer and two surface EMG signals. The SDWD technique is used in this work to obtain the approximate spectral representation of both accelerometer and the two surface EMG signals. Two sets of data (training and test) are used in this paper. The training set consists of 21 ET subjects and 19 PD subjects, while the test set consists of 20 ET and 20 PD subjects. A neural network of the type feed forward back propagation has been used to combine best SSC features and best SDWD features of the accelerometer and EMG signals. RESULTS: Efficiency result of 92.5% was obtained using best hybrid features. CONCLUSIONS: The artificial neural network has been used successfully to combine two types of features in an automatic discrimination system between PD and ET.
Keywords: Artificial neural networks, statistical signal characterization, wavelet-decomposition, hybrid features, discrimination, PD, ET, accelerometer, EMG
Abstract: BACKGROUND: In recent years the global landscape of pharmaceutical development has evolved drastically in order to adapt to innovative products such as immunotherapy, regenerative medicines and cell and gene therapy, all offering the hope to cure numerous untreated diseases. The global COVID-19 pandemic also led competent authorities in charge of approval of new medicines to implement adapted regulatory pathways allowing early access to innovative treatments and vaccines. New challenges are to be overcome, it is the short development time, or the small patient populations, or again drug product features requiring complete new production, testing and distribution strategies. OBJECTIVE:…This paper provides a short overview of the different adaptations required to allow the development of such innovative medicines. METHOD: Several drug development strategies for products under clinical development or recently approved were assessed. RESULTS: Fully integrated strategies encompassing research, non-clinical, clinical and product manufacturing development along with adapted regulatory pathways, anticipation of market access and supported by risk based are important. In such fast pace, the development of relevant manufacturing processes and test methods assessing quality, safety and efficacy of new drugs falls on the critical path and requires particular attention, anticipation and detailed planning as early as possible in order to ensure successful filing and approval. CONCLUSION: Insights within innovative products approved recently reveal the importance of defining a solid chemistry manufacturing and control strategy early on as part of clinical development. Interactions with agencies at key milestones of development are also essential to reduce risks, prioritize development to support safety and allow early access to patients.
Keywords: Chemistry, Manufacturing and control (CMC) – regulatory – innovative drugs – accelerated approval