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: 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: A lightweight rehabilitation assisting system is required to help the aged and disabled with daily life activities, thereby improving the quality of their lives. OBJECTIVE: This paper discusses the development of a metal-hydride (MH) actuator, with excellent heat transfer performance, for application in a rehabilitative system incorporating an MH module. METHODS: The operating mechanism of MH actuators requires that the mechanical power of the pneumatic actuator only be generated via heat transfer through a Peltier element and the absorption/desorption of a hydrogen-contained MH module. To achieve this aim, a 3D model was…first designed for two MH modules, and a thermal analysis was carried out according to the type of contact with the Peltier elements to fabricate an MH module with improved heat transfer performance. LabVIEW (National Instruments) was used for automatic temperature control of the Peltier element in the MH actuator driving experiment. Zr 0.9 TI 0.1 Cr 0.6 Fe 1.4 , which yields a pressure-composition-temperature (PCT) curve of appropriate pressure and temperature ranges for a rehabilitative system, was selected as the hydrogen-absorbing alloy. RESULTS: In addition, the temperature conditions of the MH actuator driving experiment were restricted by two temperature control ranges (30–40 ∘ C/30–50 ∘ C) of the Peltier element. Within these Peltier element temperature ranges of 30–40 ∘ C and 30–50 ∘ C, results showed that the MH actuator was driven in the ranges of 2–3 atm and 2.5–3.5 atm, respectively. CONCLUSIONS: These findings indicate that the MH actuator proposed in this paper can be utilized to drive a rehabilitative system for elbow and knee joint exoskeletons.
Abstract: OBJECTIVE: The aim of the research is to obtain the relative influences of some critical electro-thermal parameters on the ablation temperature and lesion volume during temperature-controlled radiofrequency ablation (RFA) of liver tumor by parameter sensitivity analysis. METHODS: The finite element method (FEM) has been used to establish the simulation model of RFA temperature field, and the sensitivity of the tissue parameters has been analyzed. The effects of six parameters have been taken into account, including the thermal specific capacity (Cp ), the thermal conductivity (k ), the electrical conductivity (Sigma ), the density (rho ),…the dielectric constant (Epsilon ) and the resistance (R ). The simulation processes based on different parameter values have been accomplished with Comsol Multiphysics software, and the sensitivity parameters have been obtained utilizing the variance contribution rate (SS% ) or the main effects. RESULTS: It was found that the ablation temperature and lesion volume increased with increasing the values of R and Sigma , but was a reverse situation for Cp and rho . Besides, the influence of k on ablation volume was relatively small and Epsilon had a negligible effect on ablation temperature. CONCLUSIONS: It is concluded that these parameter sensitivity results can provide scientific and reliable reference for the specificity analysis of the RF ablation models.
Keywords: Radiofrequency ablation, temperature field simulation, sensitivity analysis
Abstract: BACKGROUND AND OBJECTIVE: To examine the human visual performance (wavefront aberration) and subjective questionnaire (SQ) of visual fatigue when viewing 2-D and 3-D movies. METHODS: Thirty healthy adults observed 2-D and 3-D movies on the same television from a 3m distances during 2D, 3D-A (with better 3D glasses), and 3D-B (with poorer 3D glasses) viewing conditions, visual quality index, including modulation transfer function index (MTFI), higher order aberration root mean square (RMS), vertical coma (VC), horizontal coma (HC) and spherical aberration (SA), were assessed before and after each viewing condition. One-way repeated measures ANOVA was performed to assess…the changes of each test variable before and after movie viewing. RESULTS: Participants watching movies with 3D-B conditions experienced higher change of MTFI, RMS, VC and HC but smaller SQ compared with 2D and 3D-A (P < 0.05). Additionally, higher MTFI but smaller SQ was found for 3D-A compared with 2D viewing condition (P < 0.05). CONCLUSIONS: While prolonged viewing 2-D and 3-D movies would lead to poorer visual performance, 3-D glasses with better quality can play the major role in reducing visual ability for users. The change of human eye wavefront aberration might be useful for the evaluation of visual fatigue in the future.
Abstract: BACKGROUND: Diabetic macular edema (DME) is one of the severe complication of diabetic retinopathy causing severe vision loss and leads to blindness in severe cases if left untreated. OBJECTIVE: To grade the severity of DME in retinal images. METHODS: Firstly, the macular is localized using its anatomical features and the information of the macula location with respect to the optic disc. Secondly, a novel method for the exudates detection is proposed. The possible exudate regions are segmented using vector quantization technique and formulated using a set of feature vectors. A semi-supervised learning with graph based…classifier is employed to identify the true exudates. Thirdly, the disease severity is graded into different stages based on the location of exudates and the macula coordinates. RESULTS: The results are obtained with the mean value of 0.975 and 0.942 for accuracy and F1-scrore, respectively. CONCLUSION: The present work contributes to macula localization, exudate candidate identification with vector quantization and exudate candidate classification with semi-supervised learning. The proposed method and the state-of-the-art approaches are compared in terms of performance, and experimental results show the proposed system overcomes the challenge of the DME grading and demonstrate a promising effectiveness.