Technology and Health Care - Volume Preprint, issue Preprint
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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: BACKGROUND: Commercially available electroencephalogram devices suitable for brain computer interface research are now widely available for neurofeedback applications. OBJECTIVE: The authors of this study were interested in exploring the usability and acceptance of a commercially available electroencephalogram as a first step in introducing the technology, assessing patient receptivity, and acquiring preliminary clinical outcome data. METHODS: The study was conducted among active duty military service members referred for psychiatric treatment to the Walter Reed…National Military Medical Center's Psychiatry Continuity Service in Bethesda, MD. The investigators used a commercially available single channel dry electrode electroencephalogram device paired with software programs that focused on promoting mediation and attention. A satisfaction survey was completed at the completion of each session. RESULTS: One hundred and one (101) military patients completed a total of 273 brain computer interface sessions from May 2012 through June 2014. Participants overwhelmingly found the single channel electroencephalogram device easy to use (n=265/271, 97.8%). Following completion of the session participants most frequently reported "more focus" (n=85/271, 31.4%) followed by "more relaxed" (n=71/271, 26.2%), and "a sense of accomplishment" (n=44/271, 16.2%). DISCUSSION: Based on survey results gleaned from 273 sessions completed during the two year study, brain computer interface using a single channel electroencephalogram was overwhelming rated as user friendly. Over two-thirds of the individual sessions were rated as improving the person's focus, relaxation, or sense of accomplishment.
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: Survival rates of out-of-hospital cardiac arrest remain poor. Bystander cardiopulmonary resuscitation (CPR) is crucial for survival and feedback devices could improve its quality. OBJECTIVE: We investigated quality of chest compression when using the Cardio First Angel TM (CFA) feedback device compared to standard basic life support (BLS). The analysis focused on laymen. METHODS: Laymen without (n = 43) and with (n = 96) explanation of the device, medical students (n = 128) and…medical staff (n = 27) performed 60 seconds of standard versus assisted chest compression using the CFA on a resuscitation manikin. Compression frequency, depth and position were analyzed according to current guidelines. RESULTS: Laymen showed significantly better success rates regarding correct compression depth when using the CFA (23.3% vs. 55.8%, p = 0.004 and 25.0% vs. 52.1%, p < 0.001, laymen without and with explanation of the device, respectively). Medical students likewise improved (22.7% vs. 42.2%, p = 0.004). Hand positioning was 100% correct in all groups with the device. Improvement in frequency yielded by the CFA was more pronounced for probands with fears of contact (p = 0.02). The benefit of using the device did not differ significantly in laymen with or without explanation. CONCLUSIONS: Chest compression as performed by laymen was significantly improved with regard to compression depth when using the CFA for guidance and feedback. With the device, no cases of incorrect hand positioning occurred in any group.
Abstract: BACKGROUND: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock METHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced. Following trauma, hypothermia of 33 ∘ C was induced for 12 h and intensive care treatment…was evaluated for 48 h. As outcome parameters, we assessed liver function and serum transaminase levels as well as a histopathological analysis of tissue samples. A further 10 animals served as controls. RESULTS: Serum transaminase levels were increased at the end of the observation period following hypothermia without reaching statistical significance compared to normothermic groups. Liver function was preserved (p ⩽ 0.05) after the rewarming period in hypothermic animals but showed no difference at the end of the observation period. In H&E staining, cell death was slightly increased hypothermic animals and caspase-3 staining displayed tendency towards more apoptosis in hypothermic group as well. CONCLUSIONS: Induction of hypothermia could not significantly improve hepatic damage during the first 48 h following major trauma. Further studies focusing on multi-organ failure including a longer observation period are required to illuminate the impact of hypothermia on hepatic function in multiple trauma patients.
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: Information and communications technology has attracted attention as a useful way of sharing care records in community-based care. Such information sharing systems, however, imposed the burden of inputting the same records into different information systems due to a lack of interoperability of the systems. OBJECTIVES: The purpose of this study was to develop a gateway that links information systems and to investigate the functionality and usability of the gateway through an empirical study. METHODS: We developed a gateway with healthcare and welfare professionals in Kashiwa city, Japan. The gateway system consisted of…two sub-systems: a data exchange sub-system and a common sub-system. Regarding the security, we used the transport layer security 1.2 and a public key infrastructure. For document formats, we utilized the health level seven international, extensible markup language, and portable document format. In addition, we performed an empirical study with 11 scenarios of four simulated patients and a questionnaire survey to the professionals. RESULTS: Professionals of eight occupations participated the empirical study and verified the gateway to link information systems of six vendors. For a questionnaire survey, 32 professionals out of 40 reported that the gateway would eliminate the burden of inputting the same records into different information systems.
Keywords: Health information system, electronic health record, community network, home care service, long-term care
Abstract: Low-cost biosensors combined with low-cost portable devices can be very useful in time critical situations of mass casualties, when fast triage procedure must be attained. A methodology that uses ECG to derive the vital parameters (heart rate and respiratory rate) needed for the triage procedure is presented and it is aimed to leverage affordable low-cost equipment that can be easily utilized by urgent medical units or even volunteers in events of considerable number of injured civilians. The methodology relies on selected well-known and published algorithms for heart rate and respiratory rate derivation from a given ECG signal. It consists of…methods for R-wave detection, kurtosis computation, smoothing, and finding peaks. The proposed approach is shown to offer a good trade-off between the accurate measurement of the parameters and their fast derivation. It has been evaluated by using a publicly available database. Its robustness is measured in terms of accuracy estimation, showing a sensitivity of 0.87 for heart rate and 0.74 for respiratory rate, a sensitivity of 0.76 considering the triage process and an average-case execution time of 0.02 seconds, making it suitable for real-time applications.
Abstract: BACKGROUND: The distal radius fracture is one of the common clinical fractures. At present, there are no reports regarding application of the finite element method in studying the mechanism of Colles fracture and the biomechanical behavior when using splint fixation. OBJECTIVE: To explore the mechanism of Colles fracture and the biomechanical behavior when using different fixed splints. METHODS: Based on the CT scanning images of forearm for a young female volunteer, by using model construction technology combined with RPOE and ANSYS software, a 3-D distal radius fracture forearm finite element model with a…real shape and bioactive materials is built. The material tests are performed to obtain the mechanical properties of the paper-based splint, the willow splint and the anatomical splint. The numerical results are compared with the experimental results to verify the correctness of the presented model. Based on the verified model, the stress distribution of different tissues are analyzed. Finally, the clinical tests are performed to observe and verify that the anatomical splint is the best fit for human body. RESULTS: Using the three kinds of splints, the transferred bone stress focus on the distal radius and ulna, which is helpful to maintain the stability of fracture. Also the stress is accumulated in the distal radius which may be attributed to flexion position. Such stress distribution may be helpful to maintain the ulnar declination. By comparing the simulation results with the experimental observations, the anatomical splint has the best fitting to the limb, which can effectively avoid the local compression. CONCLUSION: The anatomical splint is the most effective for fixing and curing the fracture. The presented model can provide theoretical basis and technical guide for further investigating mechanism of distal radius fracture and clinical application of anatomical splint.