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: Force Monitoring Devices (FMDs) reported in the literature to monitor applied force during Joint Mobilization Technique (JMT) possess complex design/bulky which alters the execution of treatment, has poor accuracy and is unable to feel the resistance provided by soft tissues limits its usage in the clinical settings. OBJECTIVES: This study aims to develop a highly accurate, portable FMD and to demonstrate real-time monitoring of force applied by health professionals during JMT without altering its execution. METHODS: The FMD was constructed using the FlexiForce sensor, potential divider, ATmega 328 microcontroller, custom-written software, and…liquid crystal display. The calibration, accuracy, and cyclic repeatability of the FMD were tested from 0 to 90 N applied load with a gold standard universal testing machine. For practical demonstration, the FMD was tested for monitoring applied force by a physiotherapist while performing Maitland’s grade I to IV over the 6 th cervical vertebra among 30 healthy subjects. RESULTS: The obtained Bland-Altman plot limits agreement for accuracy, and cyclic repeatability was - 1.57 N to 1.22 N, and - 1.26 N to 1.26 N, respectively with standard deviation and standard error of the mean values of 3.77% and 0.73% and 2.15% and 0.23%, respectively. The test-retest reliability of the FMD tested by the same researcher at an interval of one week showed an excellent intra-class correlation coefficient of r = 1.00. The obtained force readings for grade I to IV among 30 subjects ranged from 10.33 N to 45.24 N. CONCLUSIONS: Appreciable performance of the developed FMD suggested that it may be useful to monitor force applied by clinicians during JMT among neck pain subjects and is a useful educational tool for academicians to teach mobilization skills.
Keywords: Force monitoring device, joint mobilization, neck pain, accuracy, reliability
Abstract: BACKGROUND: The distal biceps brachii tendon rupture is a rare injury of the musculoskeletal system. Multiple surgical techniques have been described for distal biceps brachii tendon repairs including suture anchors. OBJECTIVE: The aim of this study was to evaluate the outcome of anatomical distal biceps tendon refixation using either one or two suture anchors for reattachment and to determine whether there are significant clinically important differences on the number of anchors used for refixation. METHODS: A monocentric, randomized controlled trial was conducted, including 16 male patients with a mean age of 47.4 years (range,…31.0 to 58.0) in Group 1 (two suture anchors for refixation) and 15 male patients with a mean age of 47.4 (range, 35.0 to 59.0) in Group 2 (one suture anchor for refixation). All surgeries were performed through an anterior approach. The outcome was assessed using the Oxford Elbow Score (OES), the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Andrews Carson Score (ACS) and by isokinetic strength measurement for the elbow flexion after six, twelve, 24 and 48 weeks. Radiographic controls were performed after 24 and 48 weeks. RESULTS: No significant differences between both groups were evident at any point during the follow-up period. A continuous improvement in outcome for both groups could be detected, reaching an OES: 46.3 (39.0 to 48.0) vs. 45.5 (30.0 to 48.0), MEPS: 98.0 (85.0 to 100.0) vs. 99.0 (85.0 to 100.0), DASH: 3.1 (0.0 to 16.7) vs. 2.9 (0.0 to 26.7), ACS: 197.0 (175.0 to 200.0) vs. 197.7
Abstract: BACKGROUND: The mucous membrane of the maxillary sinus is sensitivis susceptible to infection or inflammation adjacent to it, which may contribute to mucous membrane thickening (MMT). Residual alveolar bone quality (RABQ) is considered a quality of the remaining bone apical to periodontal defect adjoining to the floor of the maxillary sinus. OBJECTIVE: The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using cone-beam computed tomography (CBCT). METHODS: In this retrospective observational study, 240 sinus exposure CBCT records of 146 patients were evaluated.…Patients with at least one sinus exposure were included. RABQ and MMT were calculated using CBCT inbuilt tools. RABQ was divided into four groups based on gray scale values (GSV). Statistical analysis was performed using one way ANOVA and independent sample t -tests. Correlation was completed applying Pearson’s correlation coefficient. RESULTS: A significant difference (p < 0.05) was observed between the MMT values of the four RABQ groups. Inverse correlation was observed between mean MMT and GSV values. Mean MMT was higher than pathological MMT range (> 2 mm), with significant differences in groups A and B, where mean GSV values are less than 500. Mean GSV greater than 500 in groups C and D show non-pathological MMT. Prevalence of MMT is 91.4% if GSV is < 500 and 7.5% if GSV is > 500. CONCLUSIONS: Our study suggests that MMT is present if RABQ has GSV values < 500. Maxillary sinusitis and its etiology from periodontal pathology can be excluded based on RABQ adjoining periodontal lesion. Early detection and prompt treatment along with appropriate regenerative protocols can be performed to increase the RABQ. Further microbiological investigation is required to support the present results.
Abstract: BACKGROUND: Gait analysis is important for the lower limb prosthesis design. Simulating the natural motion of the human knee in different terrains is useful for the design and performance assessment of the prosthetic knee. OBJECTIVE: This study aimed to propose a four-bar knee joint measurement system which can simulate the natural knee motions to collect the kinetic parameters precisely and analyze the walking characteristics under different terrain conditions. METHODS: A low-cost four-bar knee joint mechanism was proposed and gait characteristics were assessed on level ground, ascending and descending stairs, and ascending and descending…ramp. RESULTS: The initial knee flexion angle during stair ascent at heel strike is obviously larger than in other walking scenes. The stance phase accounts for 53% of a single gait cycle during stair descent, which is slightly lower than other walking scenarios. The period that both the hindfoot and forefoot contact the ground in ramp descent accounts for 18%, which is less than for the others. While the forefoot contacts the ground in ramp ascent, the maximum vertical ground reaction force of the forefoot occurs when the hindfoot and forefoot simultaneously contact the ground, whereas in other scenarios the forefoot contacts the ground solely. CONCLUSIONS: The four-bar knee joint can simulate the natural motion of the human knee accurately. The gait characteristics analysis of different walking scenarios indicated that the low-cost four-bar knee joint exoskeleton was suitable for human knee joint simulation.
Keywords: Gait analysis, knee joint, different terrains, kinetic parameters
Abstract: BACKGROUND: The treatment of adolescent patients with distal femoral cancer has always been a concern. The limb-salvage, regarded as a mainstream treatment, had been developed in recent years, but its application in children still remains challenging. This is because it can lead to potential limb-length discrepancy from the continued normal growth of the contralateral lower body. The extendable prosthesis could solve this problem. The principle is that it can artificially control the length of the prosthesis, making it consistent with the length of the side of the lower limbs. However, this prosthesis has some complications. The extendable prosthesis is classified…into invasive and minimally invasive, which extends the prosthesis with each operation. OBJECTIVE: We designed a new non-invasive prosthesis that can be extended in the body. Based on the non-invasive and extendable characteristics, we need to verify the supporting performance of this prosthesis. METHODS: We carried out a mechanical testing method and finite element analysis simulation. CONCLUSION: The support performance and non-invasively extension of this prosthesis were verified.
Abstract: OBJECTIVES: Autism Spectrum Disorder (ASD) is a complex range of neurodegenerative conditions that impact individuals’ social behaviour and communication skills. However, ASD data often contains far more controls than cases. This poses a serious challenge when creating classification models due to deriving models that favour controls during the classification of individuals. This problem is known as class imbalance, and it may reduce the performance in classification models derived by machine learning (ML) techniques due to individuals may remain undetected. METHODS: ML appears to help in the distressing disorder by improving outcome quality besides speeding up the…access to early diagnosis and consequential treatment. A screening dataset that consists of over 1100 instances was used to perform extensive quantitative analysis using different data resampling techniques and according to specific evaluation metrics. We measure the effect of class imbalance on autism screening performance using different data resampling techniques with a ML classifier and with respect to sensitivity, specificity, and F1-measure. We would like to know which resampling methods work well in balancing autism screening data. RESULTS: The results reveal that data resampling, and especially oversampling, improve results derived by the considered ML classifier. More importantly, there was superiority in terms of sensitivity and specificity for models derived by Naive Bayes classifier when oversampling methods have been used for data pre-processing on the autism data considered. CONCLUSION: The results reported encourages further improvement of the design and implementation of ASD screening systems using intelligent technology.
Keywords: Artificial intelligence, autism screening, classification, class imbalance, data resampling, machine learning
Abstract: BACKGROUND: Motor imagery electroencephalogram (MI-EEG) play an important role in the field of neurorehabilitation, and a fuzzy support vector machine (FSVM) is one of the most used classifiers. Specifically, a fuzzy c-means (FCM) algorithm was used to membership calculation to deal with the classification problems with outliers or noises. However, FCM is sensitive to its initial value and easily falls into local optima. OBJECTIVE: The joint optimization of genetic algorithm (GA) and FCM is proposed to enhance robustness of fuzzy memberships to initial cluster centers, yielding an improved FSVM (GF-FSVM). METHOD: The features…of each channel of MI-EEG are extracted by the improved refined composite multivariate multiscale fuzzy entropy and fused to form a feature vector for a trial. Then, GA is employed to optimize the initial cluster center of FCM, and the fuzzy membership degrees are calculated through an iterative process and further applied to classify two-class MI-EEGs. RESULTS: Extensive experiments are conducted on two publicly available datasets, the average recognition accuracies achieve 99.89% and 98.81% and the corresponding kappa values are 0.9978 and 0.9762, respectively. CONCLUSION: The optimized cluster centers of FCM via GA are almost overlapping, showing great stability, and GF-FSVM obtains higher classification accuracies and higher consistency as well.
Keywords: Motor imagery electroencephalogram, fuzzy c-means, genetic algorithm, fuzzy support vector machine, joint optimization
Abstract: OBJECTIVE: This study aims to accurately measure the range of motion of the sternoclavicular (SC) joint using 3D reconstruction and image registration. The motion of the SC joint is analyzed by means of axial angle representation to identify the kinematical characteristics of this joint. METHODS: A total of 13 healthy volunteers were enrolled in the study. The limit postures of four SC joint movements were scanned by computerized tomography. The images were integrated with reconstruction and registration techniques. The range of motion of the SC joint was measured using 3D modelling. The axial angle was used…to indicate the range of motion of the SC joint. The difference between the dominant side and non-dominant side was compared and the differences in axial angle of the SC joint in different postures were compared. RESULTS: The active axial angle of the SC joint on the dominant side was approximately 1 ∘ higher than that of the non-dominant side when the upper limb moved from a rest position to a posteroinferior position. In the sagittal motion of the upper limbs, the axial angle of the SC joint was greatest when moving from a horizontal position to a posterosuperior position, with an average of 23.55 ∘ . Of the flexion and extension movements of the upper limbs from a rest position to a horizontal position, 13.66% (the smallest proportion) were completed by the SC joint. CONCLUSION: The combination of 3D reconstruction and image registration is a direct and accurate method of measuring the motion of the SC joint. Axial angle representation is an intuitive method of expressing rotation in a 3D space that allows for more convenient comparison; it is also more in line with the characteristics of human anatomy and kinesiology and therefore more accurately reflects the characteristics of joint motion. It is therefore useful for guiding clinical practice. In a physical examination, the extension of the upper limb from the horizontal position to the posterosuperior position and from the rest position to the posteroinferior position can best reflect the rotation function of the SC joint in the combined motion of shoulder joints.
Abstract: BACKGROUND: The definition of rehabilitation training trajectory is of great significance during rehabilitation training, and the dexterity of human-robot interaction motion provides a basis for selecting the trajectory of interaction motion. OBJECTIVE: Aimed at the kinematic dexterity of human-robot interaction, a velocity manipulability ellipsoid intersection volume (VMEIV) index is proposed for analysis, and the dexterity distribution cloud map is obtained with the human-robot cooperation space. METHOD: Firstly, the motion constraint equation of human-robot interaction is established, and the Jacobian matrix is obtained based on the speed of connecting rod. Then, the Monte Carlo…method and the cell body segmentation method are used to obtain the collaborative space of human-robot interaction, and the VMEIV of human-robot interaction is solved in the cooperation space. Finally, taking the upper limb rehabilitation robot as the research object, the dexterity analysis of human-robot interaction is carried out by using the index of the approximate volume of the VMEIV. RESULTS: The results of the simulation and experiment have a certain consistency, which indicates that the VMEIV index is effective as an index of human-robot interaction kinematic dexterity. CONCLUSIONS: The VMEIV index can measure the kinematic dexterity of human-robot interaction, and provide a reference for the training trajectory selection of rehabilitation robot.
Abstract: BACKGROUND: The pulse transit time is an important factor that can be used to estimate the blood pressure indirectly. In many studies, pressures in the artery near and far from the heart are measured or the electrocardiogram and photoplethysmography are used to calculate the pulse transit time. In other words, the so-called contact measurements have been mainly used in these studies. OBJECTIVE: In this paper, a new method based on radar technology to measure the pulse transit time in a non-contact manner is proposed. METHODS: Radar pulses were simultaneously emitted to the chest…and the wrist, and the reflected pulses were accumulated. Heartbeats were extracted by performing principal component analysis on each time series belonging to the accumulated pulses. Then, the matched heartbeat pairs were found among the heartbeats obtained from the chest and wrist and the time delay between them, i.e. the pulse transit time, was obtained. RESULTS: By comparing the pulse transit times obtained by the proposed method with those obtained by conventional methods, it is confirmed that the proposed method using the radar can be used to obtain the pulse transit time in a non-contact manner.
Keywords: Ultra-wide band, impulse radar, pulse transit time, principal component analysis, heartbeat