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: 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: 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: An assessment of needs to develop a system that provides consultations using a telepresence robot and education for health professionals was conducted. The absence of a structured methodology for user-needs analysis has been identified as a problem. OBJECTIVE: To use a telepresence robot for medical consultation in future usability testing, the robot has been developed by analyzing end-user needs in a multifaceted manner. METHODS: In designing the telepresence robot for consultation, required functions and forms were defined based on the results of a user-needs survey. The robot was implemented based on specifications of needs.…The prototype robot was developed and after repeated internal tests, the final version was completed. CONCLUSIONS: The present study holds significance as it systemized user needs, applied them to a new medical technology’s components and functions, and provided a technology development process that could improve usability.
Abstract: BACKGROUND: Falls during transfer to and from a wheelchair are associated with numerous problems. Factors responsible for difficulty in transferring include horizontal/vertical gaps between surfaces; obstacles, such as armrests; and complicated brake/footrests configurations before transferring. Moreover, controlling a wheelchair sufficiently close to the transfer surface within the confined home space is difficult. OBJECTIVE: We described the design of the novel lateral transfer assist robot (LTAR) for solving problems during transfer. Furthermore, the effectiveness and usability of the robot were preliminary examined in healthy adults. METHOD: The transfer problems and basic designs were…organized. The effectiveness of the prototype was measured by three-dimensional motion analysis and questionnaire. RESULTS: The prototype LTAR was developed. With just a push on a button, the footplate lowers to the floor and the seat and armrest lowers to the height of the seating surface to fill the gap between the surfaces. Using these features, users can transfer by simply shifting their buttocks sideways. Additionally, LTAR has omnidirectional wheels that help move it within a narrow space. The LTAR was confirmed to reduce the physical and subjective burden, except for maneuverability. CONCLUSION: The LTAR was found to be effective for home use and reducing burden of transfer.
Keywords: Robotics, activities of daily living, falls, usability, wheeled mobility aids
Abstract: BACKGROUND: A prosthetic knee is the key component of the transfemoral prosthesis. The performance of the prosthetic knee determines the walking ability of transfemoral amputees. OBJECTIVE: This study proposes a microprocessor-controlled prosthetic knee with a novel hydraulic damper and evaluates the performance of the prosthetic knee by gait symmetry index. METHODS: The homotaxial knee joint with electrical-controlled hydraulic cylinder which adjusts knee flexion and extension damping independently and continuously by single motor was designed. Gait symmetry tests under different walking speeds (0.6 m/s, 1.1 m/s and 1.6 m/s) were conducted to evaluate the performance of the…proposed microprocessor-controlled prosthetic knee. RESULTS: The symmetry index values indicated that the stance phase was more asymmetry than swing phase. In the swing phase, the knee angle symmetry was observed in different speeds. The number values of symmetry index were smaller than 15% in swing phase. CONCLUSIONS: The proposed microprocessor-controlled prosthetic knee could meet the demands of walking.
Abstract: BACKGROUND: Radial extracorporeal shock wave therapy (rESWT) is an effective and safe non-invasive therapeutic option for various musculoskeletal pathologies. However, data on possible application of radial extracorporeal shock waves (rESWs) on soft tissue components of fingers is still scarce. OBJECTIVE: We now aimed to analyze the feasibility of applying rESWs to human fingers ex vivo. METHODS: Fresh frozen human cadaveric fingers were exposed to rESWs of varying energy density. The penetration of the rESWs into the soft tissue was determined using pressure sensitive Fuji films that were placed underneath the flexor tendons and…other soft tissue components at the proximal phalanx. Then, rESWs were applied and activation of the Fuji film was recorded. Software based image analysis was performed on all films treated with rESWT under ultrasound gel. RESULTS: Penetration of the rESWs through the soft tissue was detected in all settings. Increasing energy density of the rESWs resulted in increasing film activation. Image analysis of films used under ultrasound showed a significant difference among the groups. CONCLUSION: The results of this study demonstrate that rESWs can penetrate soft tissues including the flexor tendons of human cadaveric fingers. rESWT should be considered as a valuable potential therapeutic option of different finger pathologies. Further studies focusing on the clinical application of rESWT for finger pathologies are required.
Abstract: OBJECTIVE: A high number of stroke survivors experience limitations in balance and gait abilities. Thus, an improvement in gait ability is an important goal in the rehabilitation of hemiplegic stroke survivors. This study aimed to investigate the effect of using the one-arm motorized walker, a hemi-walker developed to assist hemiplegic stroke survivors in gait training and activities of daily living, on the improvement in gait ability in hemiplegic stroke survivors. METHODS: Eleven hemiplegic stroke survivors who met the inclusion criteria were included. The participants were instructed to walk thrice using traditional walking aids on a gait…mat and then to walk thrice using the one-arm motorized walker. During each walk, spatiotemporal gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were evaluated using a gait analysis system. RESULTS: Velocity and cadence significantly increased when the participants walked using the one-arm motorized walker compared to those who used traditional walking aids (p < 0.05), whereas double support time significantly decreased for both the more affected and less affected sides (p < 0.05). However, no significant difference was observed in terms of step length and single support time. CONCLUSION: The one-arm motorized walker may have a positive effect on the improvement of gait ability in hemiplegic stroke survivors. It can be an effective walking aid for hemiplegic stroke survivors who experience difficulties in independent walking.
Abstract: BACKGROUND: Quality control system is one of the hospital information systems. The adoption of quality control system increases the work efficiency; however, to some extent, it also increases the workload for physicians. OBJECTIVE: The purpose of this study is to investigate the impacts of the quality control system on quality of care (e.g., process and outcome performance). METHODS: Our study collected physicians’ behavior information from a large urban hospital in China. We constructed the fixed-effect model to examine the relationship between the quality control system adoption and quality of care. RESULTS:…The quality control system has a significant (p < 0.001) and negative effect on patients’ stay length in the hospital (process performance). Further, the quality control system has a significant (p < 0.001) and positive effect on the trends of cure rate in the hospital (outcome performance). The coefficient of the dependent variable from the patients’ stay length (process performance) is lower than the trends of cure rate (outcome performance). CONCLUSIONS: The controlling system can improve medical quality even though it limits physician behavior to some extent. The controlling system improves both the process performance and outcome performance, and it brings more benefits to outcome performance rather than process performance which means the reflection of the new technology may have more evident on outcome variables.
Keywords: Quality control system, process quality, physician’s behavior change, hospital information system