Technology and Health Care - Volume 28, issue S1

Authors: Schwarzacher, Severin P. | Gómez, Carlos

Article Type: Other

DOI: 10.3233/THC-209001

Citation: Technology and Health Care, vol. 28, no. S1, pp. 1-1, 2020

Authors: Chiang, Hsien-Wen | Chiang, Hsien-Jen | Li, Jung-Hui | Tsang, Leo Leung-Chit

Article Type: Research Article

Abstract: BACKGROUND: The air kerma radiation doses have gained much attention since the operating room interventional radiology is a place where medical staff are exposed to a fluoroscopy environment and gain a cumulative dose during the uterine artery embolization procedure. OBJECTIVE: We aimed to evaluate the radiation dose received by medical staff by applying a flat X-ray machine in the surgical room during uterine artery embolization. METHODS: An ATOM humanoid model was laid on the operating table and simulated a patient. The scattered radiation dose received by the radiologist, anesthetist and radiologic technologist was …evaluated. The scintillation detector was adopted. The measurement points were 50 cm, 100 cm and 150 cm above the floor, representing the limbs, abdomen and thyroid level, respectively. We compared the X-rays under different tube voltages of 70, 80, and 90, respectively and frames per second (FPS) of 30, 15, and 7.5, respectively. We configured the dose level per pulse of 40 nGy with a fixed detector. RESULTS: In Section 1, when the tube voltage was 70 kVp and 7.5 FPS, the average radiation doses of limbs, abdomen and thyroid level was 0.48, 1.3 and 1.9 μ Sv/min respectively. When the tube voltage was 80 kVp and the fluoroscopy decreases from 30 FPS to 7.5 FPS, 58% of the radiation dose was reduced. When the tube voltage was 90 kVp, the radiation dose in the lead garment increased 31–177% in comparison to when the tube voltage was 80 kVp. Sections 2 and 3 were far away from the central ray, so the highest radiation dose 100 cm above the floor were 0.05 and 0.02 μ Sv/min. CONCLUSIONS: Lead garment can effectively reduce medical staff from occupational doses with an average attenuation rate of 90%. 80 kVp was most commonly used. Fluoroscopy 7.5 FPS was used 100 cm above the floor in A section and the lowest radiation dose was 1.33 μ Sv/min. The operator should decrease the duration of X-rays or adopt suspended lead shielding to decrease the radiation dose received by the operator. When kVp increases, the penetration increases. Decreasing FPS cannot decrease occupational doses of medical staff. Show more

Keywords: Interventional, uterine artery embolization, scattered radiation, radiation dosimeters

DOI: 10.3233/THC-209002

Citation: Technology and Health Care, vol. 28, no. S1, pp. 3-11, 2020

Authors: Wang, Monan | Sun, Jiangang | Yang, Qiyou

Article Type: Research Article

Abstract: BACKGROUND: The current excitation-contraction coupling model of fast-twitch skeletal muscle fibers cannot completely simulate the excitation-contraction process. OBJECTIVE: To solve this problem, this study proposes an excitation-contraction model of fast-twitch skeletal muscle fibers based on the physiological structure and contractile properties of half-sarcomeres. METHODS: The model includes the action potential model of fast-twitch fiber membranes and transverse tubule membranes, the cycle model of 𝐶𝑎 2 + in myofibril, the cross-bridge cycle model, and the fatigue model of metabolism. RESULTS: Finally, detailed analyses of the results …from the simulation are conducted using the Simulink toolbox in MATLAB. Two conditions, non-coincidence and coincidence, are analyzed for both the thick and thin myofilaments. CONCLUSIONS: The simulation results of two groups of models are the same as the previous research results, which validates the accuracy of models. Show more

Keywords: Skeletal muscles, fast-twitch fiber, excitation-contraction coupling, simulation

DOI: 10.3233/THC-209003

Citation: Technology and Health Care, vol. 28, no. S1, pp. 13-24, 2020

Authors: Lin, Jirui | Xiao, Laiyuan | Wu, Tao

Article Type: Research Article

Abstract: BACKGROUND: Video-based face recognition (VFR) is one of the frontier topics in the domain of computer vision, which aims to automatically track and recognize facial regions of interests (ROIs) in video sequences. OBJECTIVE: In videos with multiple faces, the trajectories of individuals are incredibly complex. This is less studied than videos with a single face per frame. METHODS: In this paper, we present a multi-trajectory incremental learning (MTIL) algorithm, which categorizes trajectories using a Euclidean distance-based greedy algorithm and estimates the most likely labels for each trajectory by incremental learning to correct their …classification and improve the accuracy of recognition. Furthermore, this study proposes an enhanced detection method that combines face detection with a robust tracking-learning-detection (TLD) algorithm to improve the performance of face detection in video. The method can also be extended for medical video recognition applications such as gesture recognition control based medical system. RESULTS: Experiments on Honda/UCSD and BMP (seq_mb) database demonstrate that our method can improve the face detection and face recognition (single or multiple) performance. The method also performs well on the gesture recognition system. CONCLUSION: The proposed MTIL algorithm can significantly improve the performance of the VFR system and the gesture recognition system. Show more

Keywords: Multi-target face recognition, enhanced face detection, multi-trajectory, gesture recognition

DOI: 10.3233/THC-209004

Citation: Technology and Health Care, vol. 28, no. S1, pp. 25-35, 2020

Authors: Li, Jing | Dong, Pengfei | Lai, Yongxin | Qin, Xiansheng | Bai, Jing | Wang, Hongbo | Wan, Zhanxi | Ji, Zhenyu | Shi, Xuetao

Article Type: Research Article

Abstract: BACKGROUND: In hospitals, some problems still exist, such as transfusion reaction that cannot be dealt with in time, medical staff cannot observe the physiological information of the infusion patients in real time, and the infusion speed cannot be controlled smartly. OBJECTIVE: To address these problems, we propose a method for intelligent monitoring and designed a controller for dripping speed regulation. METHODS: A photoelectric sensor was used to obtain the heart rate (HR) information, and a PID parameter self-tuning controller based on the fuzzy control principle was developed to establish a multi-stage adaptive control …method based on HR feedback. By controlling the rotation of the motor to drive the cam to control the drip rate smartly. Also, the infusion and physiological information are transmitted to the nurse station to monitor the possible transfusion reaction. RESULTS: The experiments show that the intelligent infusion controller can achieve HR signal detection with an average accuracy of over 94%, dripping speed detection and adjustment with an average accuracy of above 98% and adjustment time within 35 seconds. CONCLUSION: Our study proved that the intelligent infusion controller can control the infusion process intelligently and effectively, and has excellent reliability, small steady-state error and high practical value. Show more

Keywords: Infusion reaction, intelligent feedback, dripping speed control

DOI: 10.3233/THC-209005

Citation: Technology and Health Care, vol. 28, no. S1, pp. 37-46, 2020

Authors: Liu, Shengnan | Bi, Jiaqi | Zhang, Ying | Song, Qiushi | Yu, Miao | Sun, Xiaowei | Qu, Daofei | Liu, Shaoting

Article Type: Research Article

Abstract: OBJECTIVE: In our study, the influence of PEMF on skeleton morphology and bone metabolism on rats with disuse osteoporosis was investigated, and the possibility of using it for the treatment of disuse osteoporosis was explored. METHODS: The rats in the ALN group were treated with alendronate, and the rats in the PEMF group were exposed to pulsed electromagnetic fields (3.82 mT, 10 Hz) for 40 mind - 1 . Rats were sacrificed by the end of 2, 4, 8 and 12 weeks, and serum and right leg bones were collected. Serum BMP-2, …BGP concentrations and bone metabolism and biomechanical parameters were measured. RESULTS: The bone structural mechanical indices and material mechanical indices of the right femur in all groups of mice during weeks 2 and 4 were decreased. At week 8 the bone structural mechanical index and maximum stress of the right femur in the ALN group were markedly raised compared with the CON group (P < 0.01). Only maximum stress and strain were improved in the ALN group and had a significant difference (P < 0.05) at week 12. The serum BGP and BMP-2 concentration in the PEMF and ALN groups was increased (P < 0.05) at week 2, but this increase was not synchronized. After 8 weeks, BGP and BMP-2 level in the PEMF group was observably elevated (P < 0.01) in contrast to the ALN group. CONCLUSION: From the experimental time interval analysis, PEMF can improve the mechanical stability of bone structure more gently and permanently than alendronate. Show more

Keywords: Pulsed electromagnetic field, osteoporosis, osteocalcin, bone biomechanics, bone morphogenetic protein-2 (BMP-2)

DOI: 10.3233/THC-209006

Citation: Technology and Health Care, vol. 28, no. S1, pp. 47-55, 2020

Authors: Yang, Yanju | Xia, Zhengwu | Xia, Hui | Li, Yanhong | Liu, Guoqiang | Xu, Jianhua

Article Type: Research Article

Abstract: BACKGROUND: The large differences of electrical characteristics can be used to reflect the physiological and pathological changes about biological tissues, and it can provide evidence for the early diagnosis and treatment of cancer in potential applications. OBJECTIVE: This paper describes a method called Applied Current Thermoacoustic Imaging (ACTAI) and explores the theory and demonstrates a low conductivity numerical simulation and fresh pork experimental studies. METHODS: In this paper, firstly, the principle of ACTAI is studied. In ACTAI, a target is applied with a microsecond width Gaussian pulse current. Then the target absorbs Joule …heat and expands instantaneously, sending out thermoacoustic waves. The waves contain the conductivity information of the target. The waves received by sound transducers are processed by the time inversion method to reconstruct the sound source distribution of the target to illustrate the conductivity information of the target. Secondly, a square model with low conductivity was used as a target to conduct numerical simulation of ACTAI. Lastly, a fresh pork experiment study was conducted. RESULTS: The presented experimental results suggest that ACTAI can identify the conductivity changes information of the target with perfect imagery contrast and deep penetration. CONCLUSION: The ACTAI modality would benefit from the noncontact measurement and can be convenient for clinical application. Show more

Keywords: Thermoacoustic imaging, pulse current injection, low conductivity phantoms

DOI: 10.3233/THC-209007

Citation: Technology and Health Care, vol. 28, no. S1, pp. 57-65, 2020

Authors: Fan, Xiaoli | Zhao, Chaoyi | Zhang, Xin | Luo, Hong | Zhang, Wei

Article Type: Research Article

Abstract: BACKGROUND: Mental workload is one of the contributing factors to human errors in road accidents or other potentially adverse incidents. OBJECTIVE: This research probes the effects of mental workload on the electroencephalographic (EEG) and electrocardiogram (ECG) of subjects in visual monitoring tasks, based on which a comprehensive evaluation model for mental workload is established effectively. METHODS: Three degrees of mental workload were obtained by monitoring tasks with different levels of difficulty. 20 healthy subjects were selected to take part in the research. RESULTS: The subjective scores showed a significant increase …with the increase of task difficulty, meanwhile the reaction time (RT) increased and the accuracy decreased significantly, which proved the validity of three degrees of mental workload induced. For the EEG parameters, a significant decrease of θ energy was found in Frontal, Parietal and Occipital with the increase of level of mental workload, as well as a significant decrease of α energy in Frontal, Central and Occipital, meanwhile a significant increase of β energy occurred in Frontal and Occipital. There was a significant decrease of α /θ in Occipital, and significant increases of θ /β and (α + β ) / θ in Frontal, Central and Occipital, meanwhile (α + θ ) / β and WPE decreased significantly in Frontal and Occipital. Among the ECG parameters, it was shown that Mean RR, RMSSD, HF_norm and SampEn decreased significantly with the increase of task difficulty, while LF_norm and LF/HF showed significant increases. These EEG indictors in Occipital and ECG indictors were chosen and constituted a multidimensional original sample. Principal Component Analysis (PCA) was used to extract the principal elements and decreased the dimension of sample space in order to simplify the calculation, based on which an effective classification model with accuracy of 80% was achieved by support vector machine (SVM). CONCLUSION: This study demonstrates that the proposed algorithm can be applied to mental workload monitoring. Show more

Keywords: Mental workload, EEG, ECG, PCA, SVM

DOI: 10.3233/THC-209008

Citation: Technology and Health Care, vol. 28, no. S1, pp. 67-80, 2020

Authors: Cai, Tongbiao | Zhao, Zijian

Article Type: Research Article

Abstract: BACKGROUND: Minimally invasive surgery (MIS), unlike open surgery in which surgeons can perform surgery directly, is performed using miniaturized instruments with indirect but careful observation of the surgical site. OBJECTIVE: Instrument detection is a crucial requirement in conventional and robot-assisted MIS, which can also be very useful during surgical training. In this paper, we propose a novel framework of using two three-layer convolutional neural networks (CNNs) in a series to detect surgical instrument in in-vivo video frames. METHODS: The two convolutional neural networks proposed in this paper have different tasks. (i) The …former CNN is trained to detect the edges points of the instrument shaft directly from images patches. (ii) The latter is trained to locate the instrument tip also from images patches after the former detection finishes. RESULTS: We validated our method on the publicly available EndoVisSub dataset and a standard dataset, and it detected tools with an accuracy of 91.2% and 75% respectively. CONCLUSION: Our two-step detection method achieves better performance than other existing approaches in terms of detection accuracy. Show more

Keywords: Surgical instrument detection, convolutional neural network, edge detection, tip location

DOI: 10.3233/THC-209009

Citation: Technology and Health Care, vol. 28, no. S1, pp. 81-88, 2020

Authors: Wang, Chunbao | Sun, Zhengdi | Long, Jianjun | Wei, Jianjun | Chen, Xiaojiao | Liu, Quanquan | Shen, Yajin | Shang, Wanfeng | Wang, Yulong | Duan, Lihong | Wu, Zhengzhi

Article Type: Research Article

Abstract: BACKGROUND: Traditional Chinese medicine (TCM) massage has a better effect on treating infant diarrhea compared to medical treatment. The TCM doctors need to be trained to master professional massage techniques. Traditional Chinese massage training relies on the students’ understanding ability, and cannot accurately record the students’ operating information. This situation leads to insufficient clinical massage skills of the students. OBJECTIVE: This paper proposes a novel massage training platform to quantitatively perceive the massage techniques of students. METHODS: The paper proposed two types of flexible array sensors, which are arranged and placed into the bionic …baby according to the position of the human acupoints. The massage techniques of the training object can be analyzed and evaluated during the massage process by studying the voltage from pressure sensors when the participants massage the bionic infant. RESULTS: A medical student was invited to conduct the massage training experiment, and the massage information included the operating strength, massage frequency and the massage direction, which were recorded and analyzed through the training platform. CONCLUSION: The platform can perceive the parameters related to the massage technique of students and can be used for medical training. Show more

Keywords: Massage, pressure sensor, medical training

DOI: 10.3233/THC-209010

Citation: Technology and Health Care, vol. 28, no. S1, pp. 89-101, 2020

Authors: Kang, Seung-Rok | Kim, Gi-Wook | Ko, Myoung-Hwan | Han, Kap-Soo | Kwon, Tae-Kyu

Article Type: Research Article

Abstract: BACKGROUND: The amount of patients with muscle imbalance of the left and right side increases rapidly due to an incorrect lifestyle. OBJECTIVE: We investigated the optimal exercise load required to improve muscle imbalance. METHODS: Thirty participants were enrolled in the study. They performed squat exercises according to a whole body vibration (WBV) frequency protocol over a period of eight weeks. The exercises were performed three days a week and comprised five sets of fifteen trials per set per day. We validated muscle imbalance improvement using WBV by comparing and analyzing the results at …different vibration frequencies. The participants were divided into three WBV protocol groups: no WBV, low-frequency WBV (25 Hz and 5 mm amplitude), and high-frequency WBV (50 Hz and 5 mm amplitude). We estimated the isokinetic muscle functions of the hip, knee, and ankle joints using BIODEX system 3. Ultimately, low-frequency WBV improved balance 10.2 ∼ 26.5% more than high-frequency WBV. RESULTS: Continuous load-deviation motions during low-frequency WBV were more effective at improving muscle imbalance than high-frequency WBV. WBV load variation methods improved muscle function and contractility more than external weights or loads by directly transferring kinetic energy into the body. CONCLUSION: In this clinical study, we demonstrated that low-frequency WBV was more effective at improving muscle imbalance. The WBV protocol can be used in rehabilitation programs to improve imbalance without requiring elderly or physically decompensated patients to participate in excessive exercise. Show more

Keywords: Exercise load deviation, frequency, human body, muscle strength imbalance, whole body vibration

DOI: 10.3233/THC-209011

Citation: Technology and Health Care, vol. 28, no. S1, pp. 103-114, 2020

Authors: Shin, Mi Yeon | Chong, Woo Suk | Yu, Chang Ho

Article Type: Research Article

Abstract: BACKGROUND: Hydrogen storage using metal hydride (MH) offers various advantages so the global research and development using MH alloys keeps growing. OBJECTIVE: In this paper, we developed a new actuation system using temperature control of the MH module. METHODS: The actuation system consisted of an MH module, fan, mass flow controller (MFC), solenoid valve, actuator, and a temperature and pressure sensor. The MH module, two fans and temperature sensors were set for heating and cooling the MH power by electricity. Two MFCs and four pneumatic solenoid valves were used for controlling the direction …and measuring hydrogen flow. Two actuators were used to evaluate performance of the MH alloy, and all the results were measured by LabVIEW software. Hydrogen was absorbed by the MH alloy by pressurizing at 1 MPa, and the absorbed hydrogen was desorbed using a vacuum pump. RESULTS: The temperature condition of the driving test was 20–50 ∘ C. As the module was heated, it was confirmed that the actuator connected to the system was driven by the pressure of desorbed hydrogen. CONCLUSION: It is confirmed that the actuation system is suitable for the evaluation of characteristics of MH alloy. Future studies are planned to develop MH alloys and test the actual driving performance using this system. Show more

Keywords: Metal hydride (MH), hydrogen absorption-desorption characteristics, temperature control

DOI: 10.3233/THC-209012

Citation: Technology and Health Care, vol. 28, no. S1, pp. 115-122, 2020

Authors: Jung, Young-Jin | Lee, Yun-Sung | Choi, Ga-Young | Hwang, Han-Jeong

Article Type: Research Article

Abstract: BACKGROUND: Electroencephalography (EEG) measured during transcranial direct current stimulation (tDCS) can help understand the accurate impact of tDCS on the brain, but this has been hindered due to significant inflow of tDCS-induced electrical artifacts. OBJECTIVE: In this study, we introduce a novel tDCS device developed based on current limiter, which can prevent the generation of significant electrical artifacts. METHODS: To verify the feasibility of our developed tDCS device, we performed simultaneous measurement of EEG during tDCS application with five different current intensities (0, 500, 1,000, 1,500, and 2,000 μ A). Changes in EEG power spectral …density (PSD) and correlation between the PSD of non-stimulation and tDCS condition were investigated to see whether our tDCS device can be used for simultaneous EEG recording without significant inflow of tDCS-induced electrical artifacts. RESUTLS: The mean EEG-PSD differences between non-stimulation and tDCS condition were not significant for all stimulation current intensities. Furthermore, EEG-PSDs estimated during non-stimulation and tDCS application showed statistically high correlation for all comparison cases. CONCLUSION: Based on the results, we could demonstrate the feasibility of our tDCS device based on current limiter for simultaneous EEG measurement, which could potentially provide a way to investigate the impact of tDCS on the brain more accurately. Show more

Keywords: Current limiter, transcranial direct current stimulation, simultaneous EEG recording, neuromodulation, precise brain stimulation

DOI: 10.3233/THC-209013

Citation: Technology and Health Care, vol. 28, no. S1, pp. 123-130, 2020

Authors: Shen, Zhen | Xie, Yi | Shang, Xiuqin | Xiong, Gang | Chen, Shi | Yao, Yong | Pan, Zhouxian | Pan, Hui | Dong, Xisong | Li, Yuqing | Guo, Chao | Wang, Fei-Yue

Article Type: Research Article

Abstract: BACKGROUND: Endoscopic endonasal transsphenoidal pituitary surgery is usually difficult and risky. With limited sources of cadaveric skulls, traditional methods of using virtual images to study the surgery are difficult for neurosurgeons and students because the surgery requires spatial imagination and good understanding of the patient’s conditions as well as practical experience. The three-dimensional (3D) printing technique has played an important role in clinical medicine due to its advantages of low cost, high-efficiency and customization. OBJECTIVE: CT images are used as the source data of 3D printing. The data obtained directly from the CT machine has limited …accuracy, which cannot be printed without processing. Some commercial platforms can help build an accurate model but the cost and customization are not satisfactory. In this situation, a tactile, precise and low-cost 3D model is highly desirable. METHODS: Three pieces of computer software are used in the manufacturing of medical 3D models and the processing procedure is easy to understand and operate. RESULTS: This study proposes a practical and cost-effective method to obtain the corrected digital model and produce the 3D printed skull with complete structures of the nasal cavity, sellar region and different levels of pituitary tumors. The model is used for the endoscopic endonasal transsphenoidal pituitary surgery preparation. CONCLUSION: The 3D printed medical model can directly help neurosurgeons and medical students to practice their surgery skills on both general and special cases with customized structures and different levels of tumors. Show more

Keywords: Endoscopic endonasal transsphenoidal pituitary surgery, 3D printing, surgery simulation, pituitary tumor

DOI: 10.3233/THC-209014

Citation: Technology and Health Care, vol. 28, no. S1, pp. 131-150, 2020

Authors: Le, Yingyi | Weng, Jui-Hung | Lee, Tsung-Min | Lee, Yueh-Chun | Kao, Pan-Fu | Pan, Lung-Kwang | Chen, Chien-Yi

Article Type: Research Article

Abstract: OBJECTIVE: Single-photon emission computed tomography (SPECT) as well as dual energy X-ray absorptiometry (DXA) scanners were designed in July 2018 at the Nuclear Medicine Department (NM), of the Taiwan Medical University Hospital. These scanners emit substantial X-rays from the target, which are tungsten, iron. Therefore, patients undergoing SPECT and DXA diagnosis, in addition to medical personnel, are exposed to undesirable photon leakage. METHODS: Following administration of radiopharmaceuticals, patients become radioactive sources; thus, it is necessary to evaluate a possible increase in the environmental gamma exposure rates in the NM as a result of the operation of …the new scanners. A three month evaluation of environmental radiation in the NM was performed using the accurate and sensitive TLD-100H approach, which gives an error rate less than 10%. RESULTS: Detected exposure radiation rates in the NM ranged from 0.12 ± 0.02 to 1.00 ± 0.15 mSv per month, indicating that the imaging room had significantly different radiation rates. The results were compared with previous results, and no significant contribution to the enhancement of environmental gamma radiation was detected, which remained far below the occupational dose recommended by ICRP 60. The minimum detectable dose (MDD) for environmental radiation is also discussed herein to demonstrate the reliability of TLD-100H. CONCLUSION: Recommendations were sent to the authorities of AEC-ROC to implement actions that could reduce doses at these high-dose locations to meet the ALARA principle. Show more

Keywords: Environmental radiation rates, thermoluminescence dosimeter, SPECT, DXA, Nuclear Medicine Department, minimum detectable dose

DOI: 10.3233/THC-209015

Citation: Technology and Health Care, vol. 28, no. S1, pp. 151-160, 2020

Authors: Jiang, Hong-Kun | Liang, Yong

Article Type: Research Article

Abstract: BACKGROUND: DNA methylation is a molecular modification of DNA that is vital and occurs in gene expression. In cancer tissues, the 5’–C–phosphate–G–3’(CpG) rich regions are abnormally hypermethylated or hypomethylated. Therefore, it is useful to find out the diseased CpG sites by employing specific methods. CpG sites are highly correlated with each other within the same gene or the same CpG island. OBJECTIVE: Based on this group effect, we proposed an efficient and accurate method for selecting pathogenic CpG sites. METHODS: Our method aimed to combine a L 1 / 2 …regularized solver and a central node fully connected network to penalize group constrained logistic regression model. Consequently, both sparsity and group effect were brought in with respect to the correlated regression coefficients. RESULTS: Extensive simulation studies were used to compare our proposed approach with existing mainstream regularization in respect of classification accuracy and stability. The simulation results show that a greater predictive accuracy was attained in comparison to previous methods. Furthermore, our method was applied to over 20000 CpG sites and verified using the ovarian cancer data generated from Illumina Infinium HumanMethylation 27K Beadchip. In the result of the real dataset, not only the indicators of predictive accuracy are higher than the previous methods, but also more CpG sites containing genes are confirmed pathogenic. Additionally, the total number of CpG sites chosen is less than other methods and the results show higher accuracy rates in comparison to other methods in simulation and DNA methylation data. CONCLUSION: The proposed method offers an advanced tool to researchers in DNA methylation and can be a powerful tool for recognizing pathogenic CpG sites. Show more

Keywords: DNA methylation, CpG island, L1/2 regularization method, gene regulatory network, variable selection

DOI: 10.3233/THC-209016

Citation: Technology and Health Care, vol. 28, no. S1, pp. 161-171, 2020

Authors: Cao, Lei | Fan, Chunjiang | Wang, Zijian | Hou, Lusong | Wang, Haoran | Li, Gang

Article Type: Research Article

Abstract: BACKGROUND: Mental task-based brain computer interface (BCI) systems are usually developed for neural prostheses technologies and medical rehabilitation. The mental workload was too heavy for the user to manipulate BCI effectively. Fortunately, electroencephalography (EEG) signal is not only used for BCI control but also relates to the changes of mental states. OBJECTIVE: We proposed a novel method for identifying non-effective trials of Steady State Visual Evoked Potential (SSVEP)-based BCI. METHODS: We used the subject-dependent and subject-independent alertness models identifying non-effective trials of SSVEP-BCI systems. RESULTS: The result implied that the …subject-dependent alertness model was most useful for improving the classification accuracy in the task. However, the subject-independent alertness model could enhance the prediction ability of SSVEP-based BCI system. CONCLUSION: In comparison to the conventional canonical correlation analysis (CCA) method without alertness-model filtering, the raise of precision was valuable for the technical development of BCI works. It demonstrated the effectiveness of our proposed subject-dependent and subject-independent methods. Show more

Keywords: Alertness, SSVEP, sleepiness, CCA

DOI: 10.3233/THC-209017

Citation: Technology and Health Care, vol. 28, no. S1, pp. 173-180, 2020

Authors: Yang, Lin | Sun, Ge | Wang, Anran | Jiang, Hongqing | Zhang, Song | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Xu, Mingzhou | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: The risk factors of hypertensive disorders in pregnancy (HDP) could be summarized into three categories: clinical epidemiological factors, hemodynamic factors and biochemical factors. OBJECTIVE: To establish models for early prediction and intervention of HDP. METHODS: This study used the three types of risk factors and support vector machine (SVM) to establish prediction models of HDP at different gestational weeks. RESULTS: The average accuracy of the model was gradually increased when the pregnancy progressed, especially in the late pregnancy 28–34 weeks and ⩾ 35 weeks, it reached more …than 92%. CONCLUSION: Multi-risk factors combined with dynamic gestational weeks’ prediction of HDP based on machine learning was superior to static and single-class conventional prediction methods. Multiple continuous tests could be performed from early pregnancy to late pregnancy. Show more

Keywords: Support vector machine algorithm, machine learning, model research

DOI: 10.3233/THC-209018

Citation: Technology and Health Care, vol. 28, no. S1, pp. 181-186, 2020

Authors: Zhang, Yisong | Zhang, Song | Yang, Lin | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Xu, Mingzhou | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: Fetal electrocardiogram (FECG) can be obtained in a non-invasive manner to monitor fetal growth status. OBJECTIVE: In this study, a fetal heart rate (FHR) calculation system was proposed, which consists of the FECG recorder (MF-HOLTER) and the FECG monitoring software (FECG-MS). The abdomen electrocardiogram (AECG) of pregnant woman is acquired through the MF-HOLTER. The FECG-MS packs the AECG data and calls the FECG separation algorithm to obtain the separated FECG and the fetal QRS (FQRS) position. The FHR is further obtained by calculating the R-R interval value. At the same time, this study proposed a …FQRS position correction algorithm to calculate the correct FHR values. METHOD: In order to verify the accuracy of the FHR calculation, the ECG signal of FLUKE’s PS320 FETAL SIMULATOR and clinical data were simultaneously tested. RESULTS: The accuracy rate is over 98% in processing the simulator’s data. In processing clinical data, the FHR values obtained by both the system proposed in this study and Monica AN24 are very close, and the difference is less than 1 bpm. CONCLUSION: The results show that the FHR calculation system is accurate and stable, and has a positive application value and prospect. Show more

Keywords: Fetal ECG, fetal heart rate, R-R interval, fetal QRS position correction

DOI: 10.3233/THC-209019

Citation: Technology and Health Care, vol. 28, no. S1, pp. 187-195, 2020

Authors: Zhang, Zhihong | Luo, Yingchun | Deng, Xudong | Luo, Weinan

Article Type: Research Article

Abstract: BACKGROUND: Digital image technology has made great progress in the field of foreign body detection and classification, which is of great help to drug purity extraction and impurity analysis and classification. OBJECTIVE: The detection and classification of foreign bodies in lyophilized powder are important. The method which can obtain a higher accuracy of recognition needs to be proposed. METHODS: We used digital image technology to detect and classify foreign bodies in lyophilized powder, and studied the process of image preprocessing, median filtering, Wiener filtering and average filtering balance to better detect and classify …foreign bodies in lyophilized powder. RESULTS: Through industrial small sample data simulation, test results show that in the process of image preprocessing, 3 × 3 median filtering is best. In the aspect of foreign body recognition, the recognition based on principal component analysis (PCA) and support vector machine (SVM) algorithm and the recognition based on PCA and Third-Nearest Neighbor classification algorithm are compared and results show that the PCA+ SVM algorithm is better. CONCLUSION: We demonstrated that integrating PCA and SVM to classify foreign bodies in lyophilized powder. Our proposed method is effective for the prediction of essential proteins. Show more

Keywords: Foreign bodies, median filtering, PCA, SVM

DOI: 10.3233/THC-209020

Citation: Technology and Health Care, vol. 28, no. S1, pp. 197-205, 2020

Authors: Liu, Chengping | Wanyan, Xiaoru | Xiao, Xu | Zhao, Jingquan | Duan, Ya

Article Type: Research Article

Abstract: BACKGROUND: The aircraft cockpit is a highly intensive human-computer interaction system, and its design directly affects flight safety. OBJECTIVE: To optimize the display interface design in complex flight tasks, the present study aimed to propose a dynamic conceptual framework and a timeline task analysis method for the quantization of the dynamic time effect of mental workload and the influencing factors of task types in the mental workload prediction model. METHODS: The multi-factor mental workload prediction model based on attention resource allocation was integrated to establish the dynamic prediction model of mental workload. The …ergonomics simulation experiment was carried out by recording the data on the performance of embedded subtasks, National Aeronautics and Space Administration-Task Load Index (NASA-TLX) subjective evaluation, and eye tracking. RESULTS: The results indicated that the prediction model had a good prediction accuracy and effectiveness under different simulated interfaces and complex tasks, and the real-time monitoring of pilots’ mental workload state was realized. CONCLUSION: In conclusion, the prediction model and the experimental method could be applied to avoid the overload of the pilot throughout the flight phase by optimizing the display interface and adjusting the flight task. Show more

Keywords: Ergonomics, information theory, mental workload, prediction model, timeline analysis

DOI: 10.3233/THC-209021

Citation: Technology and Health Care, vol. 28, no. S1, pp. 207-216, 2020

Authors: Shin, Young-Suk

Article Type: Research Article

Abstract: BACKGROUND: Blood pressure (BP) is currently diagnosed by cuff-based devices, which are inconvenient and provide discontinuous measurements. Photoplethysmography (PPG)-based cuffless techniques have recently been used to accurately estimate both systolic BP (SBP) and diastolic BP (DBP). However, it is difficult to use these SBP and DBP estimations to reflect the personalized traits in the peripheral vascular condition; thus, their accuracy is limited. OBJECTIVE: The purpose of this study is to describe a technique that can be distinguished simply among three BP categories (normotensive, prehypertensive, and hypertensive) and reflect individual traits using PPG only. METHODS: …We measured BP over 120 s using the fingers of 105 subjects. The PPG waveforms varied in size and amplitude over time. Therefore, normalization for uniform features for individual traits was done after the extracted waveforms were divided into multiple windows. The feature is determined by the lowest amplitude in the waveform within each divided window. The features have been applied to distinguish three BP categories using the first-eigenvector (1-EV) and second-eigenvector (2-EV) in linear discriminant analysis. RESULTS: The best decision boundary for each BP category was estimated using 1-EV (- 0.02 to + 0.02) and 2-EV ( > + 0.02) in the hypertensive category, 1-EV (< 0) and 2-EV ( ⩽ + 0.02) in the prehypertensive category, and 1-EV ( ⩾ - 0.02) and 2-EV ( ⩽ + 0.02) in the normotensive category. The overlap range with 1-EV (- 0.02 to 0) and 2-EV ( ⩽ + 0.02) in particular accurately reflected individual traits. CONCLUSION: Discrimination among the three BP categories reflecting individual traits was successfully achieved using PPG. This method could improve limitations of cuff-based techniques. Show more

Keywords: Blood pressure, photoplethysmography, personalized trait, maximum low amplitudes, linear discriminant analysis

DOI: 10.3233/THC-209022

Citation: Technology and Health Care, vol. 28, no. S1, pp. 217-227, 2020

Authors: Han, Kap-Soo | Kim, Gi-Wook | Kang, Seung-Rok | Ko, Myoung-Hwan | Seo, Jeong-Hwan

Article Type: Research Article

Abstract: BACKGROUND: Bracing is one of the oldest non-operative treatments for patients with scoliosis. However, a wide variety of braces is used, and some show no effect, while others show conflicting results. OBJECTIVE: We aimed to evaluate the effectiveness of a new orthotic device for the treatment of adult scoliosis. METHODS: Twenty adult patients who were diagnosed with scoliosis and qualified for the study were selected and all participants were treated for 12 hours/day for 12 weeks using a new orthotic device. Various efficacy assessments (Cobb’s angle, spine length, pelvic angle, shoulder angle, thoracic …angle, lumbar angle, pelvic sacral angle) were performed before and after the 12-week treatment. The values at each time point were compared. RESULTS: There were significant treatment effects in a time-dependent manner on every efficacy assessment (p < 0.05) after 12 weeks of bracing. CONCLUSION: In this clinical study, it was demonstrated that a new brace that is more comfortable for the wearer reduced scoliosis and may be a useful option for non-operative treatment of scoliosis. Show more

Keywords: Scoliosis, orthotic device, non-operative treatment, spine, rehabilitation

DOI: 10.3233/THC-209023

Citation: Technology and Health Care, vol. 28, no. S1, pp. 229-236, 2020

Authors: Peng, Yangzhi | Su, Yue | Jiang, Yong

Article Type: Research Article

Abstract: OBJECTIVE: To study the molecular mechanism of warming and tonifying kidney-yang recipe (WTKYR) in the treatment of depression. METHODS: SD rats were divided into a control group, model group, WTKYR group, and fluoxetine group. Each group consisted of 21 rats. The chronic unpredictable mild stress model was used. Body weighing and SPT were performed regularly. After treatment, histopathology of the brain tissue was performed, and concentrations of 5-HT (5-hydroxytryptamine), NE (norepinephrine), and DA (dopamine) in the hippocampus were determined. RESULTS: The WTKYR group showed higher body weight and sucrose consumption than the control …groups. Moreover, the concentrations of 5-HT, NE, and DA in the hippocampus were significantly different in the WTKYR group in comparison to those in the other groups. The hippocampus histomorphology of the WTKYR group exhibited less dematous pyramidal cells and mild inflammatory cell infiltration. CONCLUSION: The treatment effect of WTKYR in depression may be based on improvement in the content of 5-HT, NE, and DA in the hippocampus, extenuating edema of the cortical surface and pyramidal cells and decreasing the infiltration of inflammatory cells into hippocampus tissue. Show more

Keywords: WTKYR, depression, kidney-yang, brain histopathology, monoamine neurotransmitters

DOI: 10.3233/THC-209024

Citation: Technology and Health Care, vol. 28, no. S1, pp. 237-244, 2020

Authors: Hu, Bing | Wang, Dingjiang | Shi, Qianqian

Article Type: Research Article

Abstract: BACKGROUND: Absence epilepsy (AE) is a systemic disease of the brain, which mainly occurs during childhood and adolescence. The control mechanism is still unclear, and few theoretical studies have been conducted to investigate this. OBJECTIVE: In this paper, we employed external direct voltage stimulation in the subthalamic nucleus to explore mechanisms that inhibit absence seizures. METHODS: All simulation results are obtained by the four-order Runge-Kutta method in the MATLAB environment. The inhibition mechanism can be inferred from the results. RESULTS: We found that the seizures may be inhibited by tuning …the strength of the voltage to suitable ranges. This regulation may be achieved through the competition between the inhibitory projections from the basal ganglia to the thalamus. CONCLUSION: Because the mechanism underlying the treatment of epilepsy with a uniform direct current electric field is unclear, we hope that these results can inspire further experimental studies. Show more

Keywords: Absence seizure, subthalamic nucleus, voltage, control, network

DOI: 10.3233/THC-209025

Citation: Technology and Health Care, vol. 28, no. S1, pp. 245-251, 2020

Authors: Kim, Kyong | Kim, Tae-Won | Kim, Seong Hyun

Article Type: Research Article

Abstract: BACKGROUND: Analysis of the change pattern of a user’s physiological signals collected over a long time and user health information prediction technology based on personal history data can provide the user with accurate health information. OBJECTIVE: In this study, we analyzed the change pattern of health information that was altered by performing personal training (PT) at the beginning of the study and subsequently quitting exercise and only performing activities of daily living (ADL). METHODS: The subject performed PT for 75 days, and then consistently performed relatively simple ADL, such as standing, sitting, and …walking, for 325 days that followed. After 400 days, the health information was analyzed through the change patterns of various physiological signals. Personal exercise information and heart rate data were collected through a smart watch (Apple watch Nike+ , Apple Inc.) and the obesity parameters (i.e. information on the weight, body fat fate, and body muscle rate) were measured using a smart scale (PICOOC S1 Pro, EasySolar). RESULTS: We found that the weight and body fat rate linearly decreased and the body muscle rate increased for the first 75 days when hard training was performed whereas they repeatedly increased or decreased when only ADL were performed. As the daily exercise distance increased, weight and body fat rate tended to decrease while body muscle rate tended to increase. There was no significant change in the weight, body fat rate, and body muscle rate while daily activities were performed, but continuous exercise is expected to improve cardiac function by increasing the cardiac output of the heart. CONCLUSION: We expected that the simple physiological data measured with smart watches and smart scales can be used for the health management of the elderly living in rural areas in the future. Show more

Keywords: Health management, personal health pattern, long-term physiological signals, heart rate, daily activities

DOI: 10.3233/THC-209026

Citation: Technology and Health Care, vol. 28, no. S1, pp. 253-262, 2020

Authors: Shao, Zeguo | Xiang, Yuhong | Yan, Mina | Chen, Wei

Article Type: Research Article

Abstract: BACKGROUND: With the gradual aging of China’s population development, the number of disabled elderly has increased significantly. OBJECTIVE: In order to better solve the problem of life care for these elderly people, it is necessary to conduct in-depth and detailed research on the specific conditions of disabled elderly people, in order to differentiate different conditions for care and set appropriate insurance provisions. METHODS: Based on the detailed analysis of the basic behavioral ability of the elderly, and referring to the International Disability standards, this paper refines the three basic living ability indicators of …physiological behavior, cognitive behavior and interpersonal behavior, and integrates the cultural elements of assimilation, continuity, fusion and cohesion with Chinese characteristics. A more systematic and perfect five-level disability scale which conforms to the national conditions of China is designed. RESULTS: The disability of the elderly in Shanghai was investigated with the newly constructed scale, and a detailed analysis and five-level division were made. CONCLUSION: Experiments show that the results of this study can more effectively establish the disability level of the elderly in China. Show more

Keywords: Behavioral ability, disabled elderly, disability level

DOI: 10.3233/THC-209027

Citation: Technology and Health Care, vol. 28, no. S1, pp. 263-271, 2020

Authors: Chou, Ryan | Chi, Hung-Yi | Lin, Yi-Hung | Ying, Liu-Kuo | Chao, Yu-Ju | Lin, Cheng-Hsun

Article Type: Research Article

Abstract: BACKGROUND: Metal artifact reduction (MAR) techniques can improve metal artifacts of computed tomography (CT) images. OBJECTIVE: This work focused on conducting a quantitative analysis to compare the effectiveness of four commercial MAR techniques on three types of metal implants (hip implant, spinal implant, and dental filling) with a self-made acrylic phantom. METHODS: A cylindrical phantom was made from acrylic with a groove in the middle, and then three types of metal implants were placed in the groove. The phantom was scanned by four CT scanners and four commercialized MAR techniques were used to …analyze the images. The techniques used were single-energy metal artifact reduction (SEMAR, Canon), smart metal artifact reduction software (Smart-MAR, GE), iterative metal artifact reduction (IMAR, Siemens), and metal artifact reduction for orthopedic implants (OMAR, Philips). Quantitative analysis methods included objective and subjective analysis. RESULTS: The expected value of SEMAR, Smart-MAR, IMAR, and OMAR were 36.6, 37.8, 5.0, and 2.3, respectively. SEMAR and Smart-MAR achieved optimal results. CONCLUSION: This study successfully evaluated the effects of four commercial MAR techniques on three types of metal implants in a phantom. All MAR techniques effectively reduced metal artifacts, but the effect was not significant with dental fillings due to high-density material. Show more

Keywords: Computed tomography, metal artifact reduction, quantitative analysis

DOI: 10.3233/THC-209028

Citation: Technology and Health Care, vol. 28, no. S1, pp. 273-287, 2020

Authors: Wang, Feng | Zhang, Haisheng | Bao, Junlin | Li, Huaiqiang | Peng, Weihao | Xu, Jia | Yang, Jun | Zhuang, Wei | Ning, Xu | Xu, Lin | Qiao, Liang | Qin, Mingxin | Chen, Mingsheng

Article Type: Research Article

Abstract: BACKGROUND: Hemorrhagic stroke and ischemic stroke have similar symptoms at the onset of the disease, but their clinical treatment is completely different. The early, effective identification of stroke types can effectively improve the cure rate. OBJECTIVE: In this study, an early, noncontact identification of the stroke type, i.e., hemorrhagic or ischemic, based on a microwave measurement technique was investigated. METHODS: This study was based on animal models of cerebral hemorrhage and cerebral ischemia and the design of a microwave scattering parameter measurement system. RESULTS: The accuracy of the cerebral hemorrhage …model with a blood loss interval of 2 ml reached 93.75%. While the accuracy of the cerebral ischemia model with an ischemic interval of 42 minutes reached 91.7%. CONCLUSION: The experimental results show that the system for identifying cerebral stroke based on microwaves can distinguish between cerebral hemorrhage and cerebral ischemia models and effectively distinguish between different degrees of cerebral hemorrhage or different durations of cerebral ischemia. This experimental system is inexpensive, portable, noninvasive, simple, and rapid and thus has good potential as a method for identifying the stroke type prior to hospitalization. Show more

Keywords: Stroke type diagnosis, cerebral hemorrhage, cerebral ischemia, microwave detection, noncontact diagnosis

DOI: 10.3233/THC-209029

Citation: Technology and Health Care, vol. 28, no. S1, pp. 289-301, 2020

Authors: Zhang, Jianfeng | Lu, Zhiying | Li, Min

Article Type: Research Article

Abstract: BACKGROUND: The chaotic system with low dimensions has a low security compared to the high-dimensional chaotic system. Furthermore, major pixel-level permutations merely transform the pixel position and cannot change the intensity distribution of the original image. Bit-level permutation could change the intensity distribution, as it devotes more time to conduct bit-level computation. OBJECTIVE: In this study, we present a more efficient image encryption approach based on hyper-chaos and a global bit cycle shift (HC-GBCS). METHODS: According to the input image we adopted the SHA-256 secure hash algorithm to obtain the initial key, which …served as the premier parameter of the chaotic system. Then we employed a 4D hyper-chaotic system for generating the chaotic series, on which we utilized global bit permutation to enhance the security of the encryption system. Finally, the diffusion process was conducted by using the generated chaotic series extended with a logistic map. RESULTS: Experimental results and analysis reveal that the presented approach encrypts plain images effectively and achieves high security and stability. CONCLUSION: The proposed method can deal with the problems inherently existing in encryption methods utilizing low-dimensional chaotic map. Furthermore, global bit permutation can transform the pixel distribution of plain images and enhance the cryptosystem security. Show more

Keywords: Hyper-chaos, global bit cycle shift, SHA-256, encryption

DOI: 10.3233/THC-209030

Citation: Technology and Health Care, vol. 28, no. S1, pp. 303-309, 2020

Authors: Lee, Gihyoun | Park, Ji-Su | Cho, Hong-Sig | Lee, Bong-Choon | Jung, Young-Jin

Article Type: Research Article

Abstract: BACKGROUND: Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that can help modulate cortical excitability by transmitting direct current (DC) between a pair of scalp electrodes. To date, most studies on tDCS have been relatively short-lived, and the DC stimulations only lasted a few minutes. Conventional tDCS devices usually have some problems such as needing a lot of patches and lead lines. OBJECTIVE: Since conventional tDCS devices are unsuitable for use in long-term stimulations, we developed a new tDCS which can easily be used by unskilled persons. METHODS: We developed …a new tDCS device that does not have lead lines for tDCS electrodes and has a simple structure. RESULT: This device can achieve stimulation with polarity interchangeable DC without physically swapping the anode and cathode. The performance of the proposed device was verified through an experiment. CONCLUSION: The developed tDCS device can contribute to long-term research as it uses neuroelectric stimulation. Show more

Keywords: Transcranial direct current stimulation (tDCS), interchangeable electrodes

DOI: 10.3233/THC-209031

Citation: Technology and Health Care, vol. 28, no. S1, pp. 311-319, 2020

Authors: Choi, Mi-Hyun | Kim, Hyung-Sik | Lee, Beob-Yi | Chung, Soon-Cheol

Article Type: Research Article

Abstract: BACKGROUND: Variations or malformation of the internal carotid artery (ICA) and basilar artery (BA) can be risk factors during simple surgery. So medically the focus has been on information about the positional relationship between the blood vessels based on the distance and angle between the ICA and BA. OBJECTIVE: This study measured the distance and angle between the ICA and BA in 188 healthy Korean male and female subjects in their 20s and 40s and analyzed the differences in terms of age and gender. METHODS: Magnetic resonance images were obtained; the distance between …the right ICA and BA was defined as R1 [cm], the distance between the left ICA and BA was defined as L2 [cm], and the distance between the right ICA and left ICA was defined as M3 [cm]. The angles between the right and left ICA and BA were defined as AR1 [degree] and AR2 [degree], respectively. RESULTS: With increasing age, R1 and M3 became shorter in both men and women, and L2 became shorter only in women. CONCLUSION: The results of this study provide data on the average distance and angle between the ICA and BA of healthy Korean men and women in their 20s and 40s, which may later be used to support the diagnosis of relevant brain diseases and simple routine surgical procedures. Show more

Keywords: Internal carotid artery (ICA), basilar artery (BA), distance and angle, age and gender

DOI: 10.3233/THC-209032

Citation: Technology and Health Care, vol. 28, no. S1, pp. 321-326, 2020

Authors: Yi, Jeong-Han | Kim, Ki-Han | Ahn, Jin-Su | Kim, Hyung-Sik

Article Type: Research Article

Abstract: BACKGROUND: The defibrillator is a device that instantaneously discharges the high energy stored in the capacitor to the human body to help revitalize the heart. The circuit for charging the capacitor uses the same power source as the biosignal measurement unit. Therefore, variation in main power supply voltage, ground noise, and electromagnetic interference from the charging circuit can induce distortion into the biosignal at the initial stage of charging. OBJECTIVE: In this study, a simple method is proposed for removing the initial irregularity of an electrocardiogram due to the transient state of a power supply. …METHODS: To evaluate the method, a 1-channel electrocardiogram measurement unit and peripheral units were separated from the main control module using galvanic isolation. An isolated push-pull converter was designed to power the secondary side. The method was tested under steady-state and transient conditions. RESULTS: The obtained results proved that biosignal distortion can be significantly reduced. CONCLUSION: This method could be another simple implementation approach for solving signal distortions due to the transient status of power supplies used in medical devices. Show more

Keywords: Defibrillator, electrocardiogram, irregularity, transient state, galvanic isolation

DOI: 10.3233/THC-209033

Citation: Technology and Health Care, vol. 28, no. S1, pp. 327-334, 2020

Authors: Kim, Hyung-Sik | Mun, Kyung-Ryoul | Choi, Mi-Hyun | Chung, Soon-Cheol

Article Type: Research Article

Abstract: BACKGROUND: A system that comprehensively analyzes a complex perceptual-motor behavior such as driving, by measuring changes in the central and autonomic nervous systems integrated with measurement of changes in vehicle operation, is lacking. OBJECTIVE: We aimed to develop a functional magnetic resonance imaging (fMRI)-compatible driving simulator to enable simultaneous measurement of physiological, kinematic, and brain activations. METHODS: The system mainly comprises a driving simulator and physiological/kinematic measurement. The driving simulator comprises a steering wheel, an accelerator, a brake pedal, and a virtual-reality optical system. The physiological system comprises a skin-conductance-level and a photoplethysmographic …meter. The kinematic system comprises a 3-axis accelerometer and a 2-axis gyroscope attached to the accelerator foot. To evaluate the influence of the MR system on the MMSD, physiological and kinematic signals were measured. RESULTS: The system did not blur or deform the MR image. Moreover, the main magnetic field, the gradient magnetic field, and the RF pulse of the MR system did not introduce noise into the physiological or kinematic signals. CONCLUSION: This system can enable a comprehensive evaluation of cognitively complex behaviors such as driving, by quantitatively measuring and analyzing concurrent brain activity, autonomic nervous system activity, and human movement during simulated driving. Show more

Keywords: fMRI-compatibility, driving simulator, physiological signal, kinematic signal, multi-biosignal measurement system

DOI: 10.3233/THC-209034

Citation: Technology and Health Care, vol. 28, no. S1, pp. 335-345, 2020

Authors: Chen, Jinliang | Lv, Xuedong | He, Haiyan | Qi, Feng | Chen, Jianrong

Article Type: Research Article

Abstract: OBJECTIVE: We aimed to observe and investigate the clinical significance of vascular endothelium growth factor (VEGF) levels in exhaled breath condensate (EBC) from patients with acute respiratory distress syndrome (ARDS). METHODS: An improved EcoScreen condenser was used to collect EBC from 31 ARDS patients on mechanical ventilation and from 22 healthy subjects. Serum and EBC VEGF levels were analyzed with ELISA. VEGF levels in the EBC of patients with different grades of lung injuries were analyzed. The correlation between VEGF levels and clinical indicators was analyzed. RESULTS: Serum and EBC VEGF levels were …linearly and positively correlated with a correlation coefficient of 0.694 (P < 0.01). The VEGF level in the EBC of ARDS patients was significantly lower than that in the control group (P < 0.01). The VEGF level in the EBC of the mild ARDS group was higher than that in the moderate-severe ARDS group (P < 0.01). The VEGF level in the EBC of the survival group was higher than that in the mortality group. The VEGF level in the EBC of ARDS patients was positively correlated with PaO 2 /FiO 2 and PaO 2 and was negatively correlated with lung injury score (LIS) and A-aDO 2 /PaO 2 . CONCLUSION: The changes in VEGF levels in the EBC of ARDS patients can Respiratory Medicine, reflect the severity of lung injury. Therefore, VEGF level in EBC can be used as an auxiliary index for judging the severity and prognosis of ARDS patients. Show more

Keywords: Vascular endothelium growth factor, exhaled breath condensate, acute respiratory distress syndrome, mechanical ventilation, ELISA, PaO2/FiO2, lung injury score

DOI: 10.3233/THC-209035

Citation: Technology and Health Care, vol. 28, no. S1, pp. 347-354, 2020

Authors: Hu, Fan | Jing, Limei | Shi, Rong

Article Type: Research Article

Abstract: BACKGROUND: In recent years, air pollution and the number of children with respiratory tract infections increased. This also increased the burden related to the treatment of disease, so the government and relevant departments need to strengthen their management. OBJECTIVE: The aim of the present study was to quantitatively analyze the relationship between respiratory infection and air quality in children and gain insight into the burden of related diseases. METHODS: Data regarding outpatient and emergency department visits in children of 14 years or younger in 16 public and private medical institutions were collected for …four months. Routine air quality monitoring data in Shanghai from the same period were correlated with these medical data by descriptive statistics, Pearson’s correlation analysis and multivariate linear regression analysis. RESULTS: There was a positive correlation between respiratory tract infections in 73376 children and Air Quality Index (AQI), PM2.5, SO 2 and NO 2 levels. The total medical expense per patient was 80.22 yuan, and the average compensation ratio of medical insurance per patient was 18.95%. The increase in AQI and the concentration of major air pollutants will lead to increased medical treatment for children with respiratory diseases. CONCLUSION: It is suggested that the intensity of air pollution control should be increased, so that the special period of childhood respiratory protection is strengthened. Moreover, child medical insurance coverage should also be moderately increased to safeguard the rights and interests of children’s health. Show more

Keywords: Air Quality Index, pollutant concentration, children, respiratory tract infection, outpatient emergency treatment visits, medical expenses, medical insurance

DOI: 10.3233/THC-209036

Citation: Technology and Health Care, vol. 28, no. S1, pp. 355-360, 2020

Authors: Lu, Haidan | Zhang, Kaili | Liu, Qiaoyun

Article Type: Research Article

Abstract: BACKGROUND: Pitch perception and pitch matching may link to individual reading skills. OBJECTIVE: In this study, we examined pitch perception and pitch matching tasks in children with learning disabilities to determine whether there was any connection between these tests and the reading fluency in these children. METHOD: The study used different types of pitch discrimination tests and reading fluency tests to compare the two groups. RESULTS: Results indicated that the accuracy of pitch discrimination and reading fluency was significantly different in these children with learning disabilities relative to typically developing …children. This study also indicated that they exhibit impaired pitch matching, which linked to their reading skills. CONCLUSION: The results indicate that processing and production of speech may be impacted by individuals’ musical pitch perception and matching ability. The results may also give us a piece of evidence that we need further research on how these deficits in musical pitch perception affect our speech and language production in children and adults. Show more

Keywords: Learning disabilities, pitch perception, pitch matching, reading fluency

DOI: 10.3233/THC-209037

Citation: Technology and Health Care, vol. 28, no. S1, pp. 361-370, 2020

Authors: Jiang, Zhongting | Wang, Dong | Shang, Huijie | Chen, Yuehui

Article Type: Research Article

Abstract: BACKGROUND: The nervous system senses and transmits information through the firing behavior of neurons, and this process is affected by various noises. However, in the previous study of the influence of noise on nerve discharge, the channel of some noise effects is not clear, and the difference from other noises was not examined. OBJECTIVE: To construct ion channel noise which is more biologically significant, and to clarify the basic characteristics of the random firing rhythm of neurons generated by different types of noise acting on ion channels. Method: Based on the dynamics of …the ion channel, we constructed ion channel noise. We simulated the nerve discharge based on the Chay model of potassium ion channel noise, and used the nonlinear time series analysis method to measure the certainty and randomness of nerve discharge. RESULTS: In the Chay model with potassium ion noise, the chaotic rhythm defined by the original model could be effectively unified with the random rhythm simulated by the previous random Chay model into a periodic bifurcation process. CONCLUSION: This method clarified the influence of ion channel noise on nerve discharge, better understood the randomness of nerve discharge and provided a more reasonable explanation for the mechanism of nerve discharge. Show more

Keywords: Nerve discharge, ion channel, noise, periodic bifurcation process, Chay model

DOI: 10.3233/THC-209038

Citation: Technology and Health Care, vol. 28, no. S1, pp. 371-381, 2020

Authors: Choi, Jin-Seung | Seo, Jeong-Woo | Lee, Jin-Soo | Kim, Jung-Gil | Cho, Jun-Hyeong | Tack, Gye-Rae

Article Type: Research Article

Abstract: BACKGROUND: Gait variability and fractal dynamics may be affected by the walking duration. OBJECTIVE: The purpose of this study is to examine the reproducibility of stride time while walking on a self-paced treadmill. METHODS: Fifteen young and healthy subjects walked on the treadmill for 10 minutes. Three to eight minutes duration of the data were used to compare the trial-to-trial and day-to-day reproducibility of the average, variability, and fractal dynamics of stride time. RESULTS: The results show that all variables had high trial-to-trial reproducibility. In the day-to-day results, the average …walking speed and mean stride time showed reproducibility without regard for duration, but the variability and gait fractal dynamics showed differences in reproducibility according to duration. The variability and fractal dynamics showed better reproducibility in less than 5 minutes and over time, respectively. However, both variables generally showed improved reproducibility when average data from two to three rounds were used. CONCLUSION: Based on the results of this study, it is proposed that variability should be examined using data of 5 min or less, and fractal dynamics should be examined using 5 min or more of repeated data when performing walking tests from a gait dynamics perspective. Show more

Keywords: Reproducibility, self-paced treadmill, walking duration, fractal dynamics, variability

DOI: 10.3233/THC-209039

Citation: Technology and Health Care, vol. 28, no. S1, pp. 383-390, 2020

Authors: Yu, Shuchun | Wang, Qi | Ru, Changhai | Pang, Ming

Article Type: Research Article

Abstract: BACKGROUND: Key area location is an important content of medical image processing and an important detail of auxiliary medical diagnosis. OBJECTIVE: In this paper, a prior knowledge fusion method based on Haar-like feature and contour feature is proposed to locate and detect key areas in medical images. METHOD: For the image to be processed, six Haar-like features and five contour features are extracted respectively. The improvement of Haar-like feature extraction template better adapts to the complexity of regional structure of medical images. The design of the contour feature extraction process fully reflects the …consideration of feature invariance. The two features, together with prior knowledge, are fed into their respective decision makers and final fusers as the basis for determining and locating key regions. RESULTS: The experimental results show that the proposed method has excellent performance in locating key regions of medical images on MRI. When the capacity of the database increases from 10 to 200, the accuracy of locating the key areas of the image to be processed still reaches more than 90%. CONCLUSION: The proposed method realizes the accurate location of the key areas of medical images, which is of great significance for the auxiliary medical diagnosis. Show more

Keywords: Haar-like features, contour features, prior knowledge, location

DOI: 10.3233/THC-209040

Citation: Technology and Health Care, vol. 28, no. S1, pp. 391-399, 2020

Authors: Kang, Hyun-Kyu | Kim, Ki-Han | Ahn, Jin-Su | Kim, Hong-Bae | Yi, Jeong-Han | Kim, Hyung-Sik

Article Type: Research Article

Abstract: BACKGROUND: Microscopic image analysis based on image processing is required for quantitative evaluation of decellularization. Existing methods are not widely used because of expensive commercial software, and machine learning-based techniques lack generality for decellularization because many high-resolution image data has to be processed. OBJECTIVE: In this study, we developed an image processing algorithm for quantitative analysis of tissues and cells in a general microscopic image. METHODS: The proposed method extracts the color images obtained by the microscope into reference images consisting of grayscale, red (R), green (G), and blue (B) information and transforms each into a …binary image. The transformed images were extracted by separating the cells and tissues through outlier noise elimination, logical multiplication and labeling. In order to verify the method, decellularization of porcine arotic valve was performed by the electrical method. Slice samples were obtained by time and the proposed method was applied. RESULTS: The experimental results show that the segmentation of cells and tissues, and quantitative analysis of the number of cells and changes in tissue area during the decellularization process was possible. CONCLUSIONS: The proposed method shows that cell and tissue extraction and quantitative numerical analysis were possible in different brightness of microscopic images. Show more

Keywords: Segmentation, microscope image, image process, decellularization

DOI: 10.3233/THC-209041

Citation: Technology and Health Care, vol. 28, no. S1, pp. 401-410, 2020

Authors: Song, Seong-Mi | Heo, Min | Oh, Seung-Yong | Kim, Kyong | Kwon, Tae-Kyu

Article Type: Research Article

Abstract: BACKGROUND: Mobile rehabilitation systems for patients with gait disorder are being developed. Safety functions to prevent patients from falling are considered during product development; however, few studies have been conducted on systems that have been prevalidated for healthy adults prior to application to patients. OBJECTIVE: This study analyzed the characteristics of lower extremity muscles and foot pressure in healthy adults during unbalanced walking with differences in the speed of left and right speed using a two-belt treadmill. METHODS: Twenty subjects performed gait motions with a difference in the weight support conditions (0% and 30%) …and the left and right lower limb speeds (1–3 km/h). Each subject’s muscular activities and foot pressure signals were collected. The gait patterns of the faster side exhibit similar characteristics to the paralyzed leg, and the slower side is similar to the non-paralyzed leg. RESULTS: Weight-supporting healthy subjects showed asymmetric gait patterns, similar to hemiplegic patients, because of the difference in the speed of the left and right side. CONCLUSIONS: The quantitative results can be used to develop a training protocol for two-belt treadmills with differently controlled left and right speeds for gait rehabilitation in hemiplegic patients. Show more

Keywords: Hemiplegic gait, two-belt treadmill, body weight support, EMG, foot pressure

DOI: 10.3233/THC-209042

Citation: Technology and Health Care, vol. 28, no. S1, pp. 411-419, 2020

Authors: Zhang, Shunqi | Ma, Ren | Zhou, Xiaoqing | Yin, Tao | Liu, Zhipeng

Article Type: Research Article

Abstract: BACKGROUND: Stimulating current distribution in the tissue is unknown due to the complex distribution. OBJECTIVE: A preliminary in vivo measurement of the magneto-acoustic (MA) signal of the human finger is performed in this study. The approach for locating the magneto-acoustic source of the stimulating current is studied. METHODS: We use a lock-in amplifier to measure the MA signal under continuous wave electrical stimulation. The phase of the MA signal is used to extract the location of the sonic source. The experimental system is designed to measure the MA signal under electrical stimulation. …RESULTS: Preliminary experiments results show that the amplitude precision is improved to less than 1 μ Pa. The sonic source is located with millimetre precision. CONCLUSIONS: We propose a new MA source-locating method with high measurement and location precision. This method will be significant to the study of the imaging and monitoring of the current distribution of electrical stimulation with high precision. Show more

Keywords: In vivo measurement, magneto-acoustic source, electrical stimulation, current distribution, lock-in amplifier

DOI: 10.3233/THC-209043

Citation: Technology and Health Care, vol. 28, no. S1, pp. 421-432, 2020

Authors: Yao, Huan-Chung | Chen, Pei-Jarn | Kuo, Yu-Ting | Shih, Chun-Chin | Wang, Xuan-Yin | Chen, Ping-Shun

Article Type: Research Article

Abstract: BACKGROUND: A two-hospital patient referral problem intends to calculate an optimal value of referral patients between two hospitals and to evaluate whether or not the current number of referral patients is too low. OBJECTIVE: The goal of this study is to develop a simulation-based optimization algorithm to find the optimal referral between two hospitals with the unfixed daily patient referral policy. METHODS: This study applied system simulation and a bat algorithm (BA) to build a simulation model in accordance with the status of the two hospitals case and to calculate an optimal value of …daily referral patients. RESULTS: Based on the 20 test instances, we verified the stability of this algorithm. The results show that the average magnetic resonance imaging (MRI) patient wait time reduced from 16 days to eight days. The hospital should increase the average total monthly MRI referral patients to 370 under the limitation of the daily referral patients to 25. CONCLUSIONS: This research investigated the two-hospital patient referral problems. We conducted and analyzed a simulation model and improved the case hospital’s conditions, enhancing the quality of its medical care. The findings of this study can extend to other departments or hospitals. Show more

Keywords: Patient referral problem, simulation optimization, bat algorithm

DOI: 10.3233/THC-209044

Citation: Technology and Health Care, vol. 28, no. S1, pp. 433-442, 2020

Authors: Kim, Kyong | Chong, Woo Suk | Yu, Chang Ho

Article Type: Research Article

Abstract: BACKGROUND: Accurate detection of the intended movement direction of a patient plays an important role in the development of a training system for gait rehabilitation and enables to increase the effect of gait rehabilitation training. OBJECTIVE: This study investigated the detection of the intended movement of a user to operate a ceiling rail-based rehabilitative training system with accurate timing. METHODS: To detect the movement direction intention of a user, two potentiometers were used to measure the movement direction in the anterior, posterior, and left and right directions of the user when operating the driving …motor of the rehabilitative training system. A simple test mock-up with two potentiometers was fabricated, and the experiments were conducted to determine the effect of the direction of movement on the measured values of potentiometers. A direction measurement algorithm was developed to control the driving motor of the rail-based gait rehabilitative training system. RESULTS: The intended movement direction of the user could be predicted for eight directions by combining the “positive value, 0, negative value” of each measured value of the two potentiometers. Further, the developed algorithm was effectively used to control the driving function to assist the walking, sitting–standing, and climbing up–down the step activities in daily life. CONCLUSIONS: The movement intention detection function for users developed in this paper can be used to effectively control a rehabilitative training system for patients with hemiplegia to improve gait movement and posture balance, thereby improving their function of activities of daily living. Show more

Keywords: Intended motion direction, rail-based rehabilitative training system, gait rehabilitation

DOI: 10.3233/THC-209045

Citation: Technology and Health Care, vol. 28, no. S1, pp. 443-452, 2020

Authors: Lin, Zhenkun | Zang, Xizhe | Zhang, Xuehe | Liu, Yubin | Heng, Shuai

Article Type: Research Article

Abstract: BACKGROUND: Biped robot locomotion is an active topic of research, and the walking stability is one of the research objectives. OBJECTIVE: This paper discusses the variable stiffness ankle joint and the walking control of a biped robot. METHODS: A design is introduced that achieves the ankle joint variable stiffness by using a pneumatic unit. The actuation system of the biped robot is based on the hybrid use of electric and pneumatic. The locomotion control architecture has been proposed to exploit natural leg dynamics in order to improve the biped robot walking stability. We also …present a dynamic simulation which matches the biped robot and experiments with the real biped robot. RESULTS: The simulation and experiments result that introducing the variable stiffness ankle joint and the controller achieve a significant improvement in foot-ground impact and walking stability of the biped robot. CONCLUSION: The biped robot with variable stiffness ankle joints has a better walking performance under the control method. Show more

Keywords: Biped robot, variable stiffness ankle joint, foot-ground impact, locomotion control

DOI: 10.3233/THC-209046

Citation: Technology and Health Care, vol. 28, no. S1, pp. 453-462, 2020

Authors: Ma, Guangkun | Yang, Jinzhu | Zhao, Hong

Article Type: Research Article

Abstract: BACKGROUND: Coronary artery image segmentation is an important auxiliary method for coronary artery disease diagnosis. OBJECTIVE: The classical region growing algorithms, which only consider the intensity of pixels, are noise-sensitive and require manual interaction. To this end, recent methods simultaneously consider the intensity of pixels and multi-scale analysis with the region growing. Nevertheless, these methods are not fully optimized and they suffer from the drawbacks of over- or under-segmentation in many cases. METHODS: In this paper, we propose a region growing based coronary artery segmentation method. Different from the existing methods, the variable …sector search area is considered in the region growing technique. A growing rule is proposed to segment the vessel, which combines the Hessian vector and the region growing with the variable sector search area. To further improve the quality of segmentation, we propose an optimization of removing some small disconnected regions. RESULTS: Our proposed method can search more branches while segmenting the vessel, even the small ones. It keeps an acceptable performance when dealing with stenosis and large curvature of blood vessels. CONCLUSIONS: Quantitative evaluations are conducted on coronary angiography and the results show that the proposed method achieves a higher DSC ratio and a more reliable sensitivity ratio. Show more

Keywords: Coronary artery, variable sector search area, region growing, coronary angiography

DOI: 10.3233/THC-209047

Citation: Technology and Health Care, vol. 28, no. S1, pp. 463-472, 2020

Authors: Shin, Mi Yeon | Chong, Woo Suk | Kim, Kyong | Yu, Chang Ho

Article Type: Research Article

Abstract: BACKGROUND: With the improvement in the standard of living, there has been increasing interest in facial skin care. In particular, it has been observed that people pay extra attention to eye-skin when they visit skin care parlors for special treatment and care. OBJECTIVE: There is a need for skin care devices that would enable convenient skin care anywhere, including at home and on the move. In this research, we developed a prototype of a glasses-type skin care device with a LED (Light-Emitting Diode) irradiation function and performed injection molding analysis of the skin care device model …for mass production. METHODS: First, the product was designed using a universal design to improve the wearability of the glasses-type skin care device. The first prototype of the skin care device was produced using an integrated LED optical module capable of irradiating at three LED wavelengths to investigate the structural function of the product. The prototype was classified into three mechanisms and injection molding analysis was performed. The fill time, temperature at flow front, injection pressure, clamp force, and deflection values were analyzed according to the appropriate number and location of gates into which the PC + PBT (Polycarbonate + Polybutylene terephthalate) resin was introduced. RESULTS: We found that all the other parts except the temple section of the device were inferior in moldability. CONCLUSION: In further studies, the 3D prototype will be modified to enhance moldability, and injection molding analysis with other materials as well as with PC + PBT resin will be performed. Show more

Keywords: Glasses-type skin care device, LED, injection molding analysis, wearability, universal design

DOI: 10.3233/THC-209048

Citation: Technology and Health Care, vol. 28, no. S1, pp. 473-485, 2020

Authors: Kim, Young-Kyu | Jang, Young-Jong | Kim, Dong-Sun | Wei, Qun

Article Type: Research Article

Abstract: BACKGROUND: Biomedical engineers in particular require fast and powerful data processing systems to process computerized tomography and magnetic resonance imaging scans and other medical imaging technologies. However, current computer data processing technologies are unable to satisfy such requirements. A promising approach to addressing these limitations is processing in memory (PIM). Unfortunately, several issues, such as the compatibility and interconnection of PIM with legacy systems, still remain. OBJECTIVE: This paper proposes a standard memory bus-based PIM interface for medical image processing and a PIM platform. The proposed PIM interface can overcome problems of compatibility with legacy systems. …METHODS: We will adapt an embedded system based on a commercial application processor (AP) to a medical image system to verify the functions and the performance of the proposed PIM interface. Using the PIM platform, we apply the proposed PIM interface and the AP to execute an image processing program, measure the image processing times, and compare the results of the measurements. RESULTS: Experimental results show that while the functions of the proposed PIM interface are normal, the processing time of PIM is more than 81% faster than that of the AP. CONCLUSION: The experimental results prove that the proposed PIM interface is able to solve problems of compatibility with legacy systems. We foresee that not only the medical image processing field but also a number of academic fields and professional sectors will use PIM in their data-intensive applications. Show more

Keywords: Processing in memory, memory centric computing, near data processing, medical image processing

DOI: 10.3233/THC-209049

Citation: Technology and Health Care, vol. 28, no. S1, pp. 487-497, 2020

Authors: Kwon, Do-Young | Kwon, Yu-Ri | Choi, Yoon-Hyeok | Eom, Gwang-Moon | Ko, Junghyuk | Kim, Ji-Won

Article Type: Research Article

Abstract: BACKGROUND: It is important to quantitatively assess tremor for accurate diagnosis and evaluation of the response to interventions in patients with essential tremor (ET). OBJECTIVE: The purpose of this study was to investigate the relationship between quantitative measures of postural tremor and clinical rating scale in patients with ET. METHODS: 18 ET patients performed a postural tremor task that required them to hold their arms outstretched parallel to the floor while wearing a gyro sensor based measurement system. The time domain variables were derived from the sensor signals. Additionally, the frequency domain variables …were derived from the power spectrum of the angular velocity signal. Spearman correlation analysis was employed in the relationship between the variables and clinical score. RESULTS: The RMS angular velocity of roll and yaw directions at the hand joint were strongly correlated with the clinical rating scale (r = 0.7, p < 0.01). Similarly, the peak power of roll and yaw directions at the hand joint were moderately correlated with the clinical rating scale (r = 0.61 and r = 0.67, p < 0.01). In contrast, no significant correlation coefficients were observed in the peak frequency (p > 0.05). CONCLUSION: These results indicate that hand tremor of roll and yaw directions are more associated with assessment of severity of ET compared to other joints. This study suggests that quantitative measurements of postural tremor should be considered as tremor directionality as well as attachment location. Show more

Keywords: Quantification, essential tremor, gyro sensor, postural tremor, directionality, joint

DOI: 10.3233/THC-209050

Citation: Technology and Health Care, vol. 28, no. S1, pp. 499-507, 2020

Authors: Son, Ji Eun | Choi, Hyoseon | Lim, Hyunmi | Ku, Jeonghun

Article Type: Research Article

Abstract: BACKGROUND: This study focused on developing an upper limb rehabilitation program. In this regard, a steady state visual evoked potential (SSVEP) triggered brain computer interface (BCI)-functional electrical stimulation (FES) based action observation game featuring a flickering action video was designed. OBJECTIVE: In particular, the synergetic effect of the game was investigated by combining the action observation paradigm with BCI based FES. METHODS: The BCI-FES system was contrasted under two conditions: with flickering action video and flickering noise video. In this regard, 11 right-handed subjects aged between 22–27 years were recruited. The differences in brain …activation in response to the two conditions were examined. RESULTS: The results indicate that T3 and P3 channels exhibited greater Mu suppression in 8–13 Hz for the action video than the noise video. Furthermore, T4, C4, and P4 channels indicated augmented high beta (21–30 Hz) for the action in contrast to the noise video. Finally, T4 indicated suppressed low beta (14–20 Hz) for the action video in contrast to the noise video. CONCLUSION: The flickering action video based BCI-FES system induced a more synergetic effect on cortical activation than the flickering noise based system. Show more

Keywords: Brain computer interface (BCI), functional electrical stimulation (FES), flickering action video, steady state visual evoked potential (SSVEP), action observation, rehabilitation, upper limb, mirror neuron system (MNS)

DOI: 10.3233/THC-209051

Citation: Technology and Health Care, vol. 28, no. S1, pp. 509-519, 2020