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: 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: 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: 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: 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: Prevailing technological solutions that address the problems experienced by the infirm and elderly people, for their locomotion needs, offer limited options when it comes to control mechanism and customization. For more than a decade, joysticks have served the purpose of steering and navigation of autonomous wheelchairs. An alternative gesture-based method, for navigation of wheelchairs by the physically impaired, could very well replace the conventional joystick controls. A prototype system, ’Mudra’ (Sanskrit word for gesture), incorporates a gesture capture module, developed for recognition and identification of hand gestures. Mudra is a no-nonsense user-friendly system that enables control of the navigational platform,…merely by four gestures of the human hand. This paper presents a comprehensive report on implementation of Mudra system’s hardware and software, performance analysis and safety evaluation. Verification tests of the conceptual design show promising results, where 97.8% of the hand gestures were recognized accurately. Furthermore, the response timings of wheelchairs with Mudra controls were noticeably faster than the joystick-based wheelchairs, as affirmed by live testing with wheelchair-users. Pursuant to the positive feedback from the wheelchair-user experience, we conclude that Mudra’s gesture controlled wheelchairs would be preferable alternative to joystick controlled wheelchairs.
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: As an innovative technique without cable connection, targeted drug-delivery capsules improve diagnostic and therapeutic capabilities in the gastrointestinal (GI) tract. OBJECTIVE: To fast track targeted drug-delivery capsules in the GI tract, a tracking method based on the multiple alternating magnetic sources with adaptive adjustment of the excitation intensity has been investigated. METHODS: The functional prototype of the tracking system has been developed. The tracking model between the magnetic field strength and the capsule’s location has been established, which shows a nonlinear equation group with multiple local extremum. Particularly, an improved back-propagation (BP)…neural network by particle swarm optimization (PSO) is investigated to solve the tracking problem in real time. The PSO is introduced at an early stage to optimize the weights and thresholds of the BP neural network to improve the generalizability and global search ability. Consequently, the Levenberg-Marquardt (LM) algorithm is used as the learning rule to obtain a higher accuracy and convergence rate. RESULTS: The performance on the PSO-BP neural network is experimentally analyzed by comparing it with the standard BP network and the LM-BP network. CONCLUSIONS: The tracking experiments show that the PSO-BP neural network can solve the tracking problem successfully. The PSO-BP network can get the solution faster than iterative search algorithms.
Abstract: BACKGROUND: Obstructive Sleep Apnea (OSA) is the cessation of breathing during sleep due to the collapse of the upper airway. Polysomnographic recording is a conventional method for detection of OSA. Although it provides reliable results, it is expensive and cumbersome. Thus, an advanced non-invasive heart rate variability (HRV) signal processing technique other than the standard spectral analysis, which also has efficiency limitations, is needed for identification of OSA and classification of apnea levels. OBJECTIVE: The main purpose of this work was to predict the severity of sleep apnea using an efficient method based on the combination…of time-domain and frequency-domain analysis of the HRV to classify sleep apnea into three different levels (mild, moderate, and severe) according to its severity and to distinguish them from normal subjects. METHODS: The statistical signal characterization of the FFT-based spectrum of the RRI data is used in this work in order to rank patients to full polysomnography. Data of 20 normal subjects, 20 patients with mild apnea, 20 patients with moderate apnea and 20 patients with severe apnea were used in this study. RESULTS: Accuracy result of 100% was obtained between severe and normal subjects, 100% between mild and normal subjects, and 100% between apnea (mild, moderate, severe) and normal subjects. This perfect accuracy is obtained using the parameter mean (mt). The physiological interpretation of the SSC parameters has been derived using a model system. CONCLUSIONS: An efficient method for screening of sleep apnea with 100% efficiency in classification of sleep apnea levels, is investigated in this work.
Keywords: Obstructive sleep apnea, severity of apnea, HRV, statistical signal characterization, FFT spectral
Abstract: Brain activity analysis is an important research area in the field of human neuroscience. Moreover, a subcategory in this field is the classification of brain activity in terms of different brain disorders. Since the Electroencephalography (EEG) signal is, in fact, a non-linear time series, employing techniques to investigate its non-linear structure is rather crucial. In this study, we evaluate the non-linear structure of the EEG signal between healthy and schizophrenic adolescents using fractal theory. The results of our analysis revealed that in terms of all recording channels, the EEG signal of healthy subjects is more complex compared to the ones…suffering from schizophrenia. The statistical analysis also indicated that there is a significant difference in the complex structure of the EEG signal between these two groups of subjects. We also utilized approximate entropy in our analysis in order to verify the obtained results of the fractal analysis. The result of the entropy analysis suggested that EEG signal for healthy subjects is less random compared to the EEG signal in schizophrenic individuals. In addition, the employed methodology in this research can be further investigated in order to classify the brain activity in terms of other brain disorders, where one can explore how the complex structure of the EEG signal alters between them.
Keywords: Electroencephalography (EEG) signal, schizophrenia, fractal, complex, approximate entropy, random