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: Gait impairment is an essential symptom of Parkinson’s disease (PD). OBJECTIVE: This paper introduces a novel computer-vision framework for automatic classification of the severity of gait impairment using front-view motion analysis. METHODS: Four hundred and fifty-six videos were recorded from 19 PD patients using an RGB camera during clinical gait assessment. Gait performance in each video was rated by a neurologist using the unified Parkinson’s disease rating scale for gait examination (UPDRS-gait). The proposed algorithm detects and tracks the silhouette of the test subject in the video to generate a height signal.…Gait features were extracted from the height signal. Feature analysis was performed using the Kruskal-Wallis rank test. A support vector machine was trained using the features to classify the severity levels according to UPDRS-gait in 10-fold cross-validation. RESULTS: Features significantly (p < 0.05) differentiated between median-ranks of UPDRS-gait levels. The SVM classified the levels with a promising area under the ROC of 80.88%. CONCLUSION: Findings support the feasibility of this model for Parkinson’s gait assessment in the home environment.
Abstract: OBJECTIVE: This study aims to compare and analyze the difference of impact force attenuation according to size and impact location on a Taekwondo body protector. METHODS: Body protectors sized 1 to 5, were impact tested by equipment based on the specifications in the European standard manual (EN 13277-1, 3). The impactor release heights were set to match impact energies of 3 and 15 J. The impactor was made from a 2.5 kg cylindrically cut piece of aluminum. Each body protector was impacted 10 times at the two impact energies and two locations. The differences in performance…for each body protector size were compared using a two-way analysis of variance with a significance level of p < 005. The effect sizes were investigated using a partial eta squared value (η 2 ). RESULTS: The significant mean differences between the body protector size and impact area (p < 005) and the average impact time of impact strengths 3 and 15 J were 0.0017 and 0.0012 s, respectively In addition, when an impact strength of 15 J was applied, the maximum resulting impact force exceeded 2000 N for both locations on all sizes. Furthermore, at an impact strength of 3 J size 3 significantly reduced the impact force more than the other sizes; however, size 1 showed the greatest shock absorption at an impact of 15 J. CONCLUSION: The results of this study show that the shock absorption of body protectors does not increase according to size; i.e., a larger body protector does not reduce the impact load more effectively. To improve safety performance, we recommend a maximum impact force of 2000 N or less for all body protectors.
Abstract: BACKGROUND: As a common secondary pathophysiological process in postischemic stroke (IS), cytotoxic brain edema (CBE) is an independent factor leading to poor prognosis of patients. Near-field coupling (NFC) technology has some advantages such as non-invasive, non-contact, and unimpeded penetration of the skull. In theory, it can reflect the difference between normal and edema tissues through the near-field coupling phase shift (NFCPS) in the electromagnetic wave transmission trait. METHODS: Combining NFC detection principle and computer programming, we established a high-performance real-time monitoring system with functions such as automatic setting of measurement parameters, data acquisition, real-time filtering and…dynamic waveform display. To investigate the feasibility of this system to detect CBE, a saline simulation experiment and a 24-hour real-time monitoring experiment after middle cerebral artery occlusion (MCAO) in rats were carried out. RESULTS: The results of the saline simulation experiment showed that the change of NFCPS was proportional to the increase of the simulated edema solution, and the variation range of NFCPS was more than 9 ∘ after 5 ml injection. In the 24-hour monitoring after MCAO, the NFCPS of the experimental group showed an overall downward trend over time an average change of - 17.7868 ± 1.6325 ∘ and the change rate gradually decreased. The 24-hour NFCPS in the control group fluctuates slightly around the initial value, which has no obvious upward or downward trend. CONCLUSION: The intragroup and intergroup difference statistical analysis shows that NFCPS can effectively distinguish different intracranial pathophysiological states after IS. This work provides sufficient evidence and a technical basis for using NFCPS to monitor CBE in the future.
Abstract: BACKGROUND: Offspring with a genetic predisposition to hypertension may have higher blood pressure (BP) at rest compared with those without a genetic predisposition to hypertension. They are also expected to have a higher sympathetic component in the heart rate variability (HRV) which could be computed with signal processing algorithms. OBJECTIVE: The purpose of this study is to design a wavelet-based system to estimate the heart rate variability that can be used to detect early cardiovascular changes in offspring with a genetic predisposition to hypertension. Early detection will help in the treatment of those young people. In…this work, the relation between the hypertension and the changes in HRV is investigated. METHODS: The frequency domain and time domain analysis of heart rate variability (HRV) are studied to understand their relationship to the autonomic nervous system in offspring with and without a genetic predisposition to hypertension in Oman at resting state. The wavelet-based soft-decision algorithm is used as the spectral analysis tool to obtain different features from the HRV signal and to select the best performing features for detection of hypertension. The main task is to classify between three categories of subjects: 36 subjects with both normotensive parents (ONT), 22 subjects with single hypertensive parent (OHT1), and 11 subjects with both hypertensive parents (OHT2). RESULTS: The summation of the power of bands B4 and B5 of the 32 bands HRV wavelet-based spectrum, which is equivalent to the frequency range (0.046875 Hz-0.078125 Hz), is used as a classification factor among OHT2, OHT1, and ONT groups. The efficiency of classification between ONT and OHT2 is 85.10%, and between OHT1 and OHT2 is 81.81%. The result of classifying between (ONT and OHT1 as one group) and OHT2 is 85.50%. CONCLUSIONS: The work proves that the wavelet-based spectral analysis technique is a successful tool for classifying the three groups of subjects (ONT, OHT1, and OHT2) with different susceptibility for development of hypertension.
Keywords: Heart rate variability, hypertension, classification, wavelet analysis, offspring, hypertensive parents, normotensive parents, oman family study
Abstract: BACKGROUND: Upper limb rehabilitation robots have become an important piece of equipment in stroke rehabilitation. Human-robot coupling (HRC) dynamics play a key role in the control of rehabilitation robots to improve human-robot interaction. OBJECTIVE: This study aims to study the methods of modeling and analysis of HRC dynamics to realize more accurate dynamic control of upper limb rehabilitation robots. METHODS: By the analysis of force interaction between the human arm and the upper limb rehabilitation robot, the HRC torque is achieved by summing up the robot torque and the human arm torque. The…HRC torque and robot torque of a 2-DOF upper limb rehabilitation robot (FLEXO-Arm) are solved by Lagrangian equation and step-by-step dynamic parameters identification method. RESULTS: The root mean square (RMS) is used to evaluate the accuracy of the HRC torque and the robot torque calculated by the parameter identification, and the error of both is about 10%. Moreover, the HRC torque and the robot torque are compared with the actual torque measured by torque sensors. The error of the robot torque is more than twice the HRC. Therefore, the HRC torque is more accurate than the actual torque. CONCLUSIONS: The proposed HRC dynamics effectively achieves more accurate dynamic control of upper limb rehabilitation robots.
Abstract: BACKGROUND: Due to its fast service and high utilization, day surgery is becoming more and more important in the medical system. As a result, an effective day surgery scheduling can reasonably release the supply and demand pressure. OBJECTIVE: This paper aims to investigate the day surgery scheduling problem with patient preferences and limited operation room for the sake of increasing operation efficiency and further decreasing surgery costs. METHODS: A multiple objective stochastic programming model is constructed to seek a satisfactory surgical scheduling for both patients and hospitals under different scenarios. Multi-objective genetic algorithm…is designed to solve the model and different scales of scenarios are utilized to test the effectiveness of the algorithm and modeling process. RESULTS: Results show that the proposed model and algorithm can provide a feasible solution for maximizing individual preference of surgeons with surgery date and operation room utilization as well. CONCLUSIONS: Patient preference is proposed to be incorporated into day surgery scheduling, and the variability of surgery duration considered to seek a satisfactory surgery scheduling scheme for both patients and hospitals is more in line with the actual hospital situation.
Abstract: BACKGROUND: The study of the neural mechanism of human gait control can provide a theoretical basis for the treatment of walking disorders or the improvement of rehabilitation strategies, and further promote the functional rehabilitation of patients with movement disorders. However, the performance and changes of cerebral cortex activity corresponding to gait adjustment intentions are still not clear. OBJECTIVE: The purpose of this study was to detect the blood oxygen activation characterization of the cerebral cortex motor function area when people have the intention to adjust gait during walking. METHODS: Thirty young volunteers (21…± 1 years old) performed normal walking, speed increase, speed reduction, step increase, and step reduction, during which oxygenated hemoglobin (HbO), deoxygenated hemoglobin (HbR), and total oxyhemoglobin (HbT) information in the prefrontal cortex (PFC), premotor cortex (PMC), supplementary motor area (SMA) was continuous monitored using near-infrared brain functional imaging. RESULTS: (1) With the intention to adjust gait, the HbO concentration in the SMA increased significantly, while the HbT concentration in the medial-PFC decreased significantly. (2) In the HbO concentration, step reduction is more activated than the step increase in the left-PMC (p = 0.0130); step adjustment is more activated than speed adjustment in the right-PMC (p = 0.0067). In the HbR concentration, the speed reduction is more activated than the speed increase in the left-PFC (p = 0.0103). CONCLUSIONS: When the intention of gait adjustment occurs, the increase of HbO concentration in the SMA indicates the initial stage of gait adjustment will increase the cognitive-locomotor demand of the brain. The left brain area meets the additional nerve needs of speed adjustment. The preliminary findings of this study can lay an important theoretical foundation for the realization of gait control based on fNIRS-BCI technology.
Abstract: OBJECTIVE: In this study we explore the method to prepare tanshinone self-microemulsifying sustained-release microcapsules using tanshinone self-microemulsion as the core material, and chitosan and alginate as capsule materials. METHODS: The optimal preparation technology of chitosan-alginate tanshinone self-microemulsifying sustained-release microcapsules was determined by using the orthogonal design experiment and single-factor analysis. The drug loading and entrapment rate were used as evaluation indexes to assess the quality of the drug, and the in vitro release rate was used to evaluate the drug release performance. RESULTS: The best technology of chitosan-alginate tanshinone self-microemulsifying sustained-release microcapsules…is as follows: the concentration of alginate is 1.5%, the ratio of tanshinone self-microemulsion volume to alginate volume to chitosan mass is 1:1:0.5 (ml: ml: g), and the best concentration of calcium chloride is 2.0%. To prepare the microcapsules using this technology, the drug loading will be 0.046%, the entrapment rate will be 80.23%, and the 24-hour in vitro cumulative release rate will be 97.4%. CONCLUSION: The release of the microcapsules conforms to the Higuchi equation and the first-order drug release model and has a good sustained-release performance.
Keywords: Tanshinone, chitosan-alginate, self-microemulsifying sustained-release microcapsules, preparation, in vitro release
Abstract: BACKGROUND: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement and robotic therapy which allows many repetitions of movements. OBJECTIVE: Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients. METHODS: Eighteen stroke subjects (onset ⩾ 3 months, age 60.1 ± 15.5) were recruited and randomized to receive an experimental combination of MeCFES…during task-oriented reaching followed by robot therapy (MRG) or same intensity conventional rehabilitation care (CG) aimed at the recovery of the upper limb (20 sessions/45 minutes). Change was evaluated through Fugl-Meyer upperextremity (FMA-UE), Reaching Performance Scale and Box and Block Test. RESULTS: The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P = 0.04), with a 10 point increase following intervention. Effect sizes were moderate in favor of the MRG group on FMA-UE, FMA-UE proximal and RPS (0.37–0.56). CONCLUSIONS: Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke. The mix of motor learning techniques may be important for successful rehabilitation of arm function.
Abstract: BACKGROUND: Tubular structure segmentation in chest CT images can reduce false positives (FPs) dramatically and improve the performance of nodules malignancy levels classification. OBJECTIVE: In this study, we present a framework that can segment the pulmonary tubular structure regions robustly and efficiently. METHODS: Firstly, we formulate a global tubular structure identification model based on Frangi filter. The model can recognize irregular vascular structures including bifurcation, small vessel, and junction, robustly and sensitively in 2D images. In addition, to segment the vessels from JVN, we design a local tubular structure identification model with a sliding window.…Finally, we propose a multi-view voxel discriminating scheme on the basis of the previous two models. This scheme reduces the computational complexity of obtaining high entropy spatial tubular structure information. RESULTS: Experimental results have shown that the proposed framework achieves TPR of 85.79%, FPR of 24.83%, and ACC of 84.47% with the average elapsed time of 162.9 seconds. CONCLUSIONS: The framework provides an automated approach for effectively segmenting tubular structure from the chest CT images.