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: Medial posterior horn meniscal tear is difficult to be visualized in full view during arthroscopy and is occasionally undetected when the superior surface seems intact. OBJECTIVE: The purpose of this study is to describe a characteristic arthroscopic sign indicating the occult partial-thickness longitudinal medial meniscus tear extending only to the inferior articular surface. METHODS: This study was a retrospective analysis of available arthroscopic knee surgery between January 2016 and December 2017. The videos were studied and data was recorded for the number of cases showing the presence of ‘eyelid-turnup’ sign and coexisting…partial-thickness medial meniscus tear. Sensitivity and positive predictive value of the sign were calculated. RESULTS: Of all the 491 videos of medial meniscal tear available for review, partial-thickness longitudinal medial meniscus was torn in 26 cases. Six out of 26 patients could be diagnosed with partial-thickness longitudinal tear under direct vision. Of the other 20 patients which could not be diagnosed under direct vision during arthroscopy until the tear was pressed by a probe, 17 patients were diagnosed by the positive ‘eyelid-turnup’ sign. The other 3 patients showed negative ‘eyelid-turnup’ sign and were then diagnosed by the hints of preoperative MRI and intra-operative exploration. The sensitivity of the sign was 85%; the positive predictive value was 89.5%. CONCLUSIONS: The ‘eyelid-turnup’ sign of meniscus pressed by a probe at arthroscopy is a characteristic indicator for occult inferior partial-thickness longitudinal tears of midbody and posterior horn. Early identification of this special sign may help reduce the likelihood that the occult partial-thickness longitudinal tear will be missed during arthroscopy.
Abstract: BACKGROUND: Tablet technology is a promising tool for assisting therapeutic strategies in stroke rehabilitation. However, it is not clear whether the basic gestures (e.g. click, double-click) are feasible. OBJECTIVE: This study aimed to assess the successful performance of gestures and associated factors. METHODS: This cross-sectional study was conducted at a rehabilitation center in Austria. The successful tablet use was checked on a Samsung Galaxy Tab 4 (10.1 Wi-Fi 25.6 cm; 10.1 Zoll) with a specifically developed app. To identify factors associated with successful use, impairments in activities of daily living (Barthel index), cognitive…functions (Montreal Cognitive Assessment, MoCA), motor functions (Nine-Hole Peg Test), and grip strength (handgrip dynamometer) were assessed. RESULTS: One hundred and twenty-nine participants were analyzed, whereof 53.5% had a paretic upper limp and 69.2% was able to perform all gestures with at least one hand. Factors associated with successful use were higher Barthel index (OR: 1.06; 95% CI = 1.01–1.11) and MoCA (OR: 1.21; 95% CI = 1.01–1.44), whereas lower age (OR: 0.91; 95% CI = 0.83–0.99) and a paretic hand (OR: 0.12; 95% CI = 0.01–0.99) were associated with a lesser likelihood. Additionally, 18.6% successfully performed all gestures with the paretic hand, whereof 74% could not perform the double-click and 77.0% were not able to zoom. CONCLUSIONS: The majority of stroke patients are able to perform the basic gestures on a tablet with at least one hand, but only few patients with a paresis could do them. Gestures like double-clicking and zooming should be avoided when designing apps for rehabilitation, as especially these were found difficult.
Abstract: BACKGROUND: Prosthetic rehabilitation improves the overall quality of life of patients, despite discomfort and medical complications. No quantitative assessment of prosthesis-patient interaction is used in routine protocols and prosthesis quality still results from the manufacturer’s know-how. OBJECTIVE: Our objective is to investigate whether pressure can be a relevant factor for assessing socket adequacy. METHODS: A total of 8 transtibial amputee volunteers took part in this experimental study. The protocol included static standing and 2 minutes walking tests while the stump-to-socket interface pressures were measured. Questionnaires on comfort and pain were also conducted.…RESULTS: During static standing test, maximum pressures were recorded in the proximal region of the leg, with a peak value reaching 121.1 ± 31.6 kPa. During dynamic tests, maximum pressures of 254.1 ± 61.2 kPa were recorded during the loading phase of the step. A significant correlation was found between the pain score and static maximum recorded pressure (r = 0.81). CONCLUSIONS: The protocol proposed and evaluated in this study is a repeatable, easy-to-set quantified analysis of the patient to socket interaction while standing and walking. This approach is likely to improve feedback for prosthesis manufacturers and consequently the overall design of prostheses.
Abstract: BACKGROUND: Monitoring of temperature changes and accurately determining the moment of electrode removal during open heart operations is not well recognized. OBJECTIVE: We investigated the temperature fields distribution in the biological tissues affected by electrosurgery upon use of an infrared thermograph. METHODS: The dynamics of temperature distribution in the tissue was registered by the thermal imaging camera FLIR i7. Measurement of the temperature between electrode couples was carried out for two operation modes: coagulation (100% power) and coagulation (50% power). RESULTS: The most important result of the applied method of…temperature monitoring is a determination of the moment for electrodes removal that ensures the avoidance of carbonization of the cardiac tissues during their ablation. CONCLUSIONS: Temperature monitoring for connection of soft live biological tissues by welding allows the power to be fed in the amount sufficient for a formation of continuous ablation of the myocardium tissue.
Keywords: IR-imaging, myocardium, electrosurgery, HF welding, ablation, control
Abstract: BACKGROUND: Gait recognition is an emerging biometric technology applied to the mobile environment. With built-in accelerometers, wearable devices are used to recognize user identity according to gait periodic pattern, which shows strong stability and uniqueness property. OBJECTIVE: The purpose of this study is to build analyzing models to find the change of gait normal and pathological function based on gait features. METHODS: This work relies on gait recognition methods. In this paper, the performance of different hybrid filter methods is compared by combining four classical filtering methods. The influence of the abnormal pattern…of gait cycle is estimated by standard deviation. The effectiveness of feature matching methods is evaluated by six classical distance discrimination function. RESULTS: The results highlight the stability and invariance of gait periodic pattern. For analyzing models, the best recognition rate is 96.67% with the combination of MF hybrid filter and Correlation distance function in the small sample, and minimal time consumption is 0.038 s. The effectiveness of analyzing models is further analyzed for different practical applications. CONCLUSIONS: This study provides evidence for future scientific teams to make decisions on selecting filter methods and discrimination functions which can more efficiently extract gait features and suggest ways to analyze clinical gait pattern.
Abstract: We analyzed several QRS detection algorithms in order to build a quality industrial beat detector, intended for a small, wearable, one channel electrocardiogram sensor with a sampling rate of 125 Hz, and analog-to-digital conversion of 10 bits. The research was a lengthy process that included building several hundred rules to cope with the QRS detection problems and finding an optimal threshold value for several parameters. We obtained 99.90% QRS sensitivity and 99.90% QRS positive predictive rate measured on the first channel of rescaled and resampled MIT-BIH Arrhythmia ECG database. Even more so, our solution works better than the algorithms for the…original signals with a sampling rate of 360 Hz and analog-to-digital conversion of 11 bits.
Abstract: BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a major cause of anovulatory infertility. Some studies showed that miRNAs were used as diagnostic/prognostic biomarkers for various diseases. OBJECTIVE: To identify candidate miRNAs in Granulosa Cells (GCs) of PCOS and evaluate their potential values for PCOS diagnosis. METHODS: We screened differentially expressed miRNAs in GCs between PCOS and controls by the microarray data from the GEO database. GCs were collected from 21 controls and 24 PCOS. The candidate miRNAs were verified by qRT-PCR. The correlation was investigated between candidate miRNAs and clinical characteristics in participants. Diagnostic…value of candidate miRNAs was analyzed by receiver operating characteristic (ROC) curve. RESULTS: Seven miRNAs were differentially expressed in PCOS compared with controls. Furthermore, the validation results demonstrated that hsa-miR-3188 and hsa-miR-3135b showed higher levels in GCs with PCOS patients (p < 0.05). In addition, the expressions of hsa-miR-3188 and hsa-miR-3135b were negative correlated with FSH and hsa-miR-3188 was positive correlated with BMI (p < 0.05). ROC analysis indicated that hsa-miR-3188 and hsa-miR-3135b could differentiate PCOS from controls, and the hsa-miR-3188/3135b improved the predictive accuracy for PCOS. CONCLUSIONS: The expressions of hsa-miR-3188 and hsa-miR-3135b in human GCs were significantly associated with PCOS. Moreover, the hsa-miR-3188/3135b has certain diagnostic value for distinguishing PCOS.
Abstract: BACKGROUND: Critically elevated compartment pressures after complicated tibial fractures may result in fibrosis and therefore scarring of muscles with impaired function. Several studies have shown a relationship between angiogenesis and more effective muscle regeneration. Cysteine-rich angiogenic inducer 61 (CYR61) is associated with angiogenesis but it is not clear whether it would restore muscle force, reduce scarring or improve angiogenesis after acute musculoskeletal trauma. OBJECTIVE: We researched whether local application of CYR61 (1) restores muscle force, (2) reduces scar tissue formation, and (3) improves angiogenesis. METHODS: We generated acute soft tissue trauma with temporary ischemia and increased…compartment pressure in 22 rabbits and shortened the limbs to simulate surgical fracture debridement. In the test group, a CYR61-coated collagen matrix was applied locally around the osteotomy site. After 10 days of limb shortening, gradual distraction of 0.5 mm per 12 hours was performed to restore the original length. Muscle force was measured before trauma and on every fifth day after trauma. Forty days after trauma we euthanized the animals and histologically determined the percentage of connective and muscle tissue. Immunohistology was performed to analyze angiogenesis. RESULTS: Recovery of preinjury muscle strength was significantly greater in the CYR61 group (2.8 N; 88%) as compared to the control (1.8 N; 53%) with a moderate reduction of connective tissue (9.9% vs. 8.5%). Immunohistochemical staining showed that blood vessel formation increased significantly (trauma vs. control 38.75 ± 27.45 mm 2 vs. 24.16 ± 19.81 mm 2 ). CONCLUSIONS: Local application of CYR61 may improve restoration of muscle force and accelerate muscle force recovery by improving angiogenesis and moderately reducing connective tissue.
Abstract: BACKGROUND: A new cooling method is proposed for preventing electrode-tissue overheating during cardiac catheter ablation using a vibrating catheter. Previous work has shown that vibration that results from increased flow velocity around the catheter can have a cooling effect on the electrode. OBJECTIVE: Contact force has been shown to be an important factor that affects cooling and lesion formation, because contact force determines the ratio of power delivery between blood and tissue. In this study, the effect of contact force on electrode cooling and tissue heating was investigated during the operation of an electrode cooled by…vibration. METHODS: Using PVA-H or myocardium ablation tissue models under conditions of no flow, electrode and tissue temperatures and lesion sizes were measured at various vibrational frequencies and contact force conditions. RESULTS: The experiments showed that the catheter vibration still decreases the electrode temperature over a contact force range of 2–30 gf. The lesion size was increased with increasing contact force at each vibrational frequency. CONCLUSIONS: Increasing contact force can increase lesion size with cooling by vibration remaining effective.
Abstract: BACKGROUND: Implantable medical sensors for monitoring and transmitting physiological signals like blood glucose, blood oxygen, electrocardiogram, and endoscopic video present a new way for health care and disease prevention. Nevertheless, the signals transmitted by implantable sensors undergo significant attenuation as they propagate through various biological tissue layers. OBJECTIVE: This paper mainly aims to investigate the power loss of an out-to-in body wireless radio frequency link at 2.45 GHz. METHODS: Two simulation models including the single-layer human tissue model and three-layer human tissue model were established, applying the finite element method (FEM). Two experiments using…physiological saline and excised porcine tissue were conducted to measure the power loss of a wireless radio frequency link at 2.45 GHz. Various communication distances and implantation depths were investigated in our study. RESULTS: The results from our measurements show that each 2 cm increase in implantation depth will result in an additional power loss of about 10 dB. The largest difference in values obtained from the measurements and the simulations is within 4 dB, which indicates that the experiments are in good agreement with the simulations. CONCLUSIONS: These results are significant for the estimate of how electromagnetic energy changes after propagating through human tissues, which can be used as a reference for the link budget of transceivers or other implantable medical devices.
Keywords: Implantable medical sensors, power loss, radio frequency link, finite element method