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: Colposcopy is one of the common methods of cervical cancer screening. The type of cervical transformation zone is considered one of the important factors for grading colposcopic findings and choosing treatment. OBJECTIVE: This study aims to develop a deep learning-based method for automatic classification of cervical transformation zone from colposcopy images. METHODS: We proposed a multiscale feature fusion classification network to classify cervical transformation zone, which can extract features from images and fuse them at multiple scales. Cervical regions were first detected from original colposcopy images and then fed into our multiscale…feature fusion classification network. RESULTS: The results on the test dataset showed that, compared with the state-of-the-art image classification models, the proposed classification network had the highest classification accuracy, reaching 88.49%, and the sensitivity to type 1, type 2 and type 3 were 90.12%, 85.95% and 89.45%, respectively, higher than the comparison methods. CONCLUSIONS: The proposed method can automatically classify cervical transformation zone in colposcopy images, and can be used as an auxiliary tool in cervical cancer screening.
Keywords: Cervical cancer, deep learning, colposcopy, image processing, feature fusion
Abstract: BACKGROUND: The integrity and stability of collagen are crucial for the dentin structure and bonding strength at dentin-resin interface. Natural plant-derived polypehenols have been used as collagen crosslinkers. OBJECTIVE: The aims of the study were to develop novel chitosan oleuropein nanoparticles (CS-OL-NPs), and to investigate the CS-OL-NPs treated dentin’s the resistance to enzymatic degradation and mechanic property. METHODS: CS-OL-NPs were developed using the ionotropic gelation method. Release and biocompatibility of the CS-OL-NPs were tested. Twenty demineralized dentin collage specimens were randomized into four interventions groups: A, Deionized Water (DW); B, 5% glutaraldehyde solution…(GA); C, 1 mg/ml chitosan (CS); and D, 100 mg/L CS-OL-NPs. After 1-min interventions, dentin matrix were evaluated by the micro-Raman spectroscopy for the modulus of elasticity test. Collagen degradation was assessed using hydroxyproline (HYP) assay. RESULTS: CS-OL-NPs were spherical core-shape with a size of 161.29 ± 8.19 nm and Zeta potential of 19.53 ± 0.26 mV. After a burst release of oleuropein in the initial 6 h, there was a long-lasting steady slow release. CS-OL-NPs showed a good biocompatibility for the hPDLSCs. The modulus of elasticity in the crosslinked groups were significantly higher than that in the control group (P < 0.05 for all). The specimens treated with CS-OL-NP showed a greater modulus of elasticity than those treated with GA and CS (P < 0.05 for both). The release of HYP in the crosslinked group was significantly lower than that in the non-crosslinked groups (P < 0.05 for all). CONCLUSION: CS-OL-NPs enhanced the dentin mechanical property and resistance to biodegradation, with biocompatibility and potential for clinical application.
Abstract: BACKGROUND: Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE: To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS: In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group…underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS: Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P < 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P < 0.025). CONCLUSION: Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.
Abstract: BACKGROUND: Total hip replacement (THR) for Crowe type IV developmental dysplasia of the hip (DDH) is still challenging due to specific joint deformities and the high incidence of post-operative complications. OBJECTIVE: This study aimed to evaluate the clinical effect of trochanteric slide osteotomy (TSO) combined with a cementless femoral conical stem in THR for the treatment of Crowe type IV DDH. METHODS: Thirty-one total hip replacements (26 patients) with Crowe type IV DDH were performed using TSO combined with a cementless femoral conical stem. Surgical outcomes were evaluated using leg length discrepancy (LLD),…Harris hip score, and post-operative complications. RESULTS: The average pre-operative LLD was 51 mm (range 46–58 mm), decreasing to an average of 10 mm (range 8–12 mm) post-operatively. As a result, the post-operative incidence of the Trendelenburg sign significantly decreased compared with the pre-operative incidence (P < 0.05). Bony union was identified in 26 hips (83.9%), fibrous union in four (12.9%), and non-union in one (3.2%). No acetabular or femoral component loosening, dislocation, or deep infection around the component was found in any of the patients during the follow-up period (27 to 39 months). The average Harris hip score improved from 63.0 ± 3.0 (range 58–69) to 93.3 ± 2.0 (range 91–96). CONCLUSION: TSO combined with a cementless conical stem in THR is an appropriate option for patients with high congenital hip dislocation.
Keywords: Hip dysplasia, hip replacement, greater trochanter, slide osteotomy, conical stem
Abstract: BACKGROUND: In recent years, arterial stenosis has become one of the serious diseases threatening people’s life and health. OBJECTIVE: The main purpose of the present study is to examine the changes of hemodynamic parameters in different stenosis locations of arteries. METHODS: An arterial stenosis model with fluid-structure interaction and microcirculation as the outlet boundary of seepage is adopted in this paper. Considering the interaction between blood and arterial wall, a numerical simulation is carried out using the finite element method. RESULTS: The results show that hemodynamic parameters are sensitive to…the change of stenosis location. The closer to the microcirculation zone the stenosis location, the lower the blood flow velocity, pressure and the wall shear stress. In addition, the velocity trend is transformed from the gradual increase to decrease with the increasing distance away from inlet when the stenosis location moves to the microcirculation zone. CONCLUSION: This work proves that the stenosis location has a great influence on hemodynamics based on microcirculation function. Microcirculation is an important factor that cannot be ignored in the numerical simulation of arterial hemodynamics. The numerical results could provide the potential of clinical preconditions for disease diagnosis and treatment.
Abstract: BACKGROUND: During neurological rehabilitation training for patients with lower limb dysfunction, active rehabilitation training based on interactive force recognition can effectively improve participation and efficiency in rehabilitation training. OBJECTIVE: This study proposes an active training strategy for lower-limb rehabilitation robots based on a spring damping model. METHODS: The active training strategy included a kinetic model of the human-machine system, calculated and verified using a pull-pressure force sensor We used a dynamic model of the human-machine system and tensile force sensors to identify the human-machine interaction forces exerted by the patient Finally, the spring damping…model is used to convert the active interaction force into the offset angle of each joint, obtaining the active interaction force followed by the active movement of the lower limbs RESULTS: The experimental results showed that the rehabilitation robot could follow the active interaction force of the subject to provide assistance, thus generating the following movement and effectively helping patients improve joint mobility. CONCLUSION: The active flexibility training control strategy based on the virtual spring damping model proposed in this study is feasible, and motion is stable for patients with lower limb dysfunction after stroke Finally, the proposed active training method can be implemented in future work in other rehabilitation equipment and combined virtual reality technology to improve rehabilitation training experience and increase patient participation.
Abstract: BACKGROUND: Grip force estimation is highly required in realizing flexible and accurate prosthetic control. OBJECTIVE: This study presents a method to accurately estimate continuous grip force from surface electromyography (sEMG) under three forearm postures for unilateral amputees. METHODS: Ten able-bodied subjects and a transradial amputee were recruited. sEMG signals were recorded from six forearm muscles on the dominant side of each able-bodied subject and the stump of amputee. Meanwhile, grip force was synchronously measured from the ipsilateral hands of able-bodied subjects and contralateral hand of amputee. Three force profiles (triangle, trapezoid, and fast…triangle) were tested under three forearm postures (supination, neutral and pronation). Two algorithms (Generalized Regression Neural Network (GRNN) and Multilinear Regression Model (MLR)) were compared using several EMG features. The estimation performance was evaluated by coefficient of determination (R 2 ) and mean absolute error (MAE ). RESULTS: The optimal regressor combining TD and GRNN achieved R 2 = 96.33 ± 1.13% and MAE = 2.11 ± 0.52% for the intact subjects, and R 2 = 86.86% and MAE = 2.13% for the amputee. The results indicated that multiple grip force curves under three forearm postures could be accurately estimated for unilateral amputees using mirrored bilateral training. CONCLUSIONS: The proposed method has the potential for precise force control of prosthetic hands.
Abstract: BACKGROUND: Parkinson’s disease (PD) is a long-term neurodegenerative disease of the central nervous system. The current diagnosis is dependent on clinical observation and the abilities and experience of a trained specialist. One of the symptoms that affects most patients is voice impairment. OBJECTIVE: Voice samples are non-invasive data that can be collected remotely for diagnosis and disease progression monitoring. In this study, we analyzed voice recording data from a smartphone as a possible medical self-diagnosis tool by using only one-second voice recording. The data from one of the largest mobile PD studies, the mPower study, was…used. METHODS: A total of 29,798 ten-second voice recordings on smartphone from 4,051 participants were used for the analysis. The voice recordings were from sustained phonation by participants saying /aa/ for ten seconds into an iPhone microphone. A dataset comprising 385,143 short one-second audio samples was generated from the original ten-second voice recordings. The samples were converted to a spectrogram using a short-time Fourier transform. CNN models were then applied to classify the samples. RESULTS: Classification accuracies of the proposed method with LeNet-5, ResNet-50, and VGGNet-16 are 97.7 ± 0.1%, 98.6 ± 0.2%, and 99.3 ± 0.1%, respectively. CONCLUSIONS: We achieve a respectable classification performance using a generalized approach on a dataset with a large number of samples. The result emphasizes that an analysis based on one-second clip recorded on a smartphone could be a promising non-invasive and remotely available PD biomarker.
Keywords: PD voice, audio classification, convolutional neural network, mPower study
Abstract: BACKGROUND: Quality control of magnetic resonance imaging includes image validation, which covers also artefact detection. The daily manual review of magnetic resonance images for possible artefacts can be time-consuming, so automated methods for computer-assisted quality assessment of magnetic resonance imaging need to be developed. OBJECTIVE: The aim of this study was to develop automatic detection of Gibbs artefacts in magnetic resonance imaging using a deep learning method called transfer learning, and to demonstrate the potential of this approach for the development of an automatic quality control tool for the detection of such artefacts in magnetic resonance…imaging. METHODS: The magnetic resonance image dataset of the scanned phantom for quality assurance was created using a turbo spin-echo pulse sequence in the transverse plane. Images were created to include Gibbs artefacts of varying intensities. The images were annotated by two independent reviewers. The annotated dataset was used to develop a method for Gibbs artefact detection using the transfer learning approach. The VGG-16, VGG-19, and ResNet-152 convolutional neural networks were used as pre-trained networks for transfer learning and compared using 5-fold cross-validation. RESULTS: All accuracies of the classification models were above 97%, while the AUC values were all above 0.99, confirming the high quality of the constructed models. CONCLUSION: We show that transfer learning can be successfully used to detect Gibbs artefacts on magnetic resonance images. The main advantages of transfer learning are that it can be applied on small training datasets, the procedures to build the models are not so complicated, and they do not require much computational power. This shows the potential of transfer learning for the more general task of detecting artefacts in magnetic resonance images of patients, which consequently can improve and speed up the process of quality assessment in medical imaging practice.
Keywords: Gibbs artefact, transfer learning, automatic detection, image quality control
Abstract: BACKGROUND: The Ling sound test cannot provide the test of Chinese tone for preschool children with hearing aid and cochlear implants. OBJECTIVE: The paper tries to design a new tone test method composed of the Ling sound test and four Chinese tones to evaluate the hearing level of Chinese hearing-impaired children. METHODS: The tone identification rates of 20 cochlear implant children were statistically analyzed to verify the validity of the Ling sound test in the Chinese tone version. In addition, this paper analyzed the pronunciation characteristics of the Ling sound test in the…Chongqing-accented Mandarin version of 20 subjects. RESULTS: The identification rate of Ling six sounds was more than 97%, the identification rate of tone was more than 81.0%, and the identification rate of vowels was 83.1%, which was higher than that of consonants 79.0%. The Ling sound test in the Chongqing-accented Mandarin version has a narrower frequency range. CONCLUSION: The results verify the effectiveness and feasibility of the Ling sound test in the Chinese tone version in the assessment of frequency range and tone identification for cochlear implant users.
Keywords: Cochlear implants, tone identification, hearing impairment, the Ling sound test, audiologic rehabilitation