Technology and Health Care - Volume 30, issue 5

Authors: Yin, Meng | Huang, Binhua | Yi, Zhengkun | Cai, Shibo

Article Type: Research Article

Abstract: BACKGROUND: The complex in-hand manipulation puts forward higher requirements for the dexterity and joint control accuracy of the prosthetic hand. The tendon-sheath drive has important application potential in the fields of prosthetic hand to obtain higher dexterity. However, the existing control methods of tendon-sheath driven joint are mainly open-loop compensation based on friction model, which makes it difficult to achieve high-precision joint control. OBJECTIVE: The purpose of this work is to improve the position control accuracy of the tendon-sheath driven joint for the prosthetic hand. METHODS: The structure of the prosthetic hand is …introduced, and the encoder and potentiometer are mounted on the driving motor and joint respectively. Then, the transfer function of the joint is established based on the dynamic model. The adaptive sliding mode control strategy based on RBF network is applied to realize the closed-loop feedback position control of the prosthetic hand joint. The stability of the system is demonstrated by Lyapunov theorem. RESULTS: Under the condition of constant and variable sheath curvature, the effectiveness of the controller is demonstrated by simulation and joint motion experiments, respectively. The results show that the closed-loop control has better position tracking ability than the open-loop control, and the designed controller can reduce the tracking error more obviously than the traditional algorithm. The high-precision position control can be realized by designing the controller based on the joint angle feedback. CONCLUSIONS: The research content has certain theoretical and practical significance for the development of joint high-precision control of tendon-sheath driven prosthetic hand. This is beneficial to the implementation of complex in-hand manipulation for prosthetic hand. Show more

Keywords: Prosthetic hand, tendon-sheath driven joint, RBF network, adaptive sliding mode

DOI: 10.3233/THC-213242

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1155-1165, 2022

Authors: Meng, Qiaoling | Fei, Cuizhi | Jiao, Zongqi | Xie, Qiaolian | Dai, Yue | Fan, Yuanjie | Shen, Zhijia | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: Upper-limb rehabilitation robots have become an important piece of equipment in stroke rehabilitation. The design of exoskeleton mechanisms plays a key role to improve human-robot interface in the upper-limb movements under passive and active rehabilitation training. OBJECTIVE: This paper proposes a novel of the 7-DOF (RR-RR-PRR) under-actuated exoskeleton mechanism based on the characteristics of the upper-limb movements in both of active and passive training. This aim of the proposed work is to improve human-robot interface in rehabilitation training with robots. METHODS: Firstly, the characteristics of active and passive movement training are analyzed …depending on the human upper-limb model. Then, a novel 7-DOF (RR-RR-PRR) exoskeleton mechanism is proposed based on the analyzed characteristics. After that, kinematical performances of the proposed exoskeleton are analyzed on the workspace, manipulability and manipulability ellipsoid by compared with the common exoskeleton configuration of the 7 DOFs (RRR-R-PRR) mechanism. In the end, the prototype is manufactured and tested by undergoing the experiments of single-joint passive movement training and multi-joint active movement training. The human-robot interface of the proposed exoskeleton is demonstrated by root mean square error, Pearson correlation coefficient, and the time-delay difference. RESULTS: The results of the kinematical performance show that the effective workspace and the flexibility of the exoskeleton with the proposed configuration are increased by 10.44% and 1.7%. In the single-joint passive movement training experiment, the root mean square errors are 6.986, 7.568, 5.846, and Pearson correlation coefficients are 0.989, 0.984, 0.988 at the shoulder joint and the elbow joint, respectively. The time-delay differences are not beyond 3.1%. In the multi-joint active movement training experiment, the root mean square errors are 9.312 and 7.677, and Pearson correlation coefficients are 0.906 and 0.968 at the shoulder joint and the elbow joint, respectively. The time-delay differences are not beyond 3.28%. CONCLUSIONS: The proposed 7 DOFs exoskeleton mechanism shows uniformity with that of the common exoskeleton on the same rehabilitation trajectory which is effective to improve human-robot interface under passive and active rehabilitation training. Show more

Keywords: Upper-limb rehabilitation exoskeleton, active and passive movement training, kinematical performance, workspace, manipulability

DOI: 10.3233/THC-213573

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1167-1182, 2022

Authors: Chrif, Farouk | van Hedel, Hubertus J.A. | Vivian, Mauro | Nef, Tobias | Hunt, Kenneth J.

Article Type: Research Article

Abstract: BACKGROUND: The use of robotic technology for neurorehabilitative applications has become increasingly important for adults and children with different motor impairments. OBJECTIVE: The aim of this study was to evaluate the technical feasibility and usability of a new interactive leg-press training robot that was developed to train leg muscle strength and control, suitable for children with neuromuscular impairments. METHODS: An interactive robotic training system was designed and constructed with various control strategies, actuators and force/position sensors to enable the performance of different training modes (passive, active resistance, and exergames). Five paediatric patients, aged …between 7 and 16 years (one girl, age 13.0 ± 3.7 years, [mean ± SD]), with different neuromuscular impairments were recruited to participate in this study. Patients evaluated the device based on a user satisfaction questionnaire and Visual Analog Scale (VAS) scores, and therapists evaluated the device with the modified System Usability Scale (SUS). RESULTS: One patient could not perform the training session because of his small knee range of motion. Visual Analog Scale scores were given by the 4 patients who performed the training sessions. All the patients adjudged the training with the interactive device as satisfactory. The average SUS score given by the therapists was 61.2 ± 18.4. CONCLUSION: This study proposed an interactive lower limb training device for children with different neuromuscular impairments. The device is deemed feasible for paediatric rehabilitation applications, both in terms of technical feasibility and usability acceptance. Both patients and therapists provided positive feedback regarding the training with the device. Show more

Keywords: Neurorehabilitation, leg press, paediatric rehabilitation

DOI: 10.3233/THC-213629

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1183-1197, 2022

Authors: Guduk, Omer Faruk | Sivrikaya, Efe Can | Yilmaz, Nagehan | Baygin, Ozgul | Tuzuner, Tamer

Article Type: Research Article

Abstract: BACKGROUND: Stainless steel crowns (SSCs), which have been used frequently in the treatment of first permanent molars in children until now, has become less applicable due to its poor aesthetic appearance. Zirconia crowns (ZCs) have become more popular due to their aesthetic advantage. However, stress transmission of ZCs to dental tissues under occlusal forces in endodontically treated teeth has not been described. OBJECTIVE: The aim of this study was to compare the stress distribution of different crown materials (ZCS, SSCs) and adhesive materials on dentin in endodontically treated permanent teeth and to specify the crown-adhesive model …with lower stress. METHODS: Finite element analysis (FEA) was used to apply a force of 300 N from the inner part of the buccal tubercles (vertical loading) and a lingo-buccal at an angle of 30 degrees (oblique loading) of the first permanent molars (FPM) with different crown (ZCS, SSCs) and adhesive (Glass ionomer cement, Resin modified glass ionomer cement, Resin cement) materials in twelve separate models. The von Mises values obtained from the models were compared and the optimal stress values were determined by FEA. RESULTS: The lowest stress values of dentin were found in zirconia crown model with glass ionomer cement (GIC) adhesive under vertical loading (26,793 Mpa). In the zircon crown and GIC adhesive model, less von Mises stress occurred on the dentin under all conditions. CONCLUSIONS: ZCs and GIC adhesive may be recommended for teeth with a high probability of dentin fracture. Show more

Keywords: Endodontically treated teeth, FEA, stainless steel crown, zirconium crown

DOI: 10.3233/THC-213505

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1199-1207, 2022

Authors: Ji, Juanjuan | Li, Xudong | Zhu, Yaling | Wang, Rui | Yang, Shuang | Peng, Bei | Zhou, Zhi

Article Type: Research Article

Abstract: BACKGROUND: Periodontitis is a common oral immune inflammatory disease and early detection plays an important role in its prevention and progression. However, there are no accurate biomarkers for early diagnosis. OBJECTIVE: This study screened periodontitis-related diagnostic biomarkers based on weighted gene correlation network analysis and machine algorithms. METHODS: Transcriptome data and sample information of periodontitis and normal samples were obtained from the Gene Expression Omnibus (GEO) database, and key genes of disease-related modules were obtained by bioinformatics. The key genes were subjected to Gene Ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and …Genomes (KEGG) enrichment analysis and 5 machine algorithms: Logistic Regression (LR), Random Forest (RF), Gradient Boosting Decisio Tree (GBDT), Extreme Gradient Boosting (XGBoost), and Support Vector Machine (SVM). Expression and correlation analysis were performed after screening the optimal model and diagnostic biomarkers. RESULTS: A total of 47 candidate genes were obtained, and the LR model had the best diagnostic efficiency. The COL15A1, ICAM2, SLC15A2, and PIP5K1B were diagnostic biomarkers for periodontitis, and all of which were upregulated in periodontitis samples. In addition, the high expression of periodontitis biomarkers promotes positive function with immune cells. CONCLUSION: COL15A1, ICAM2, SLC15A2 and PIP5K1B are potential diagnostic biomarkers of periodontitis. Show more

Keywords: Periodontitis, WGCNA, machine algorithms, diagnostic biomarkers

DOI: 10.3233/THC-THC213662

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1209-1221, 2022

Authors: Ou, Tzu-Ming | Hu, Wei-Wen | Chang, Chia-Hung | Hsu, Chia-Chin | Wang, Chih-Hsuan

Article Type: Research Article

Abstract: BACKGROUD: Recently, monitoring the vital-sign with the noncontact method is a popular technology. OBJECTIVE: In this work, we present a fully pulse radar system including front-end sensing and back-end data processing. A series of ultra-wide band sensing pulses is generated and radiated to detect the subject’s chest vibration which in turn obtains the required vital-sign signals. METHODS: An artificial plywood with 3 centimeter thickness is placed between a transmitting/receiving antenna of the radar and subject to demonstrate the characteristic of noncontact sensing. The firmware and digital signal processing are also presented in this paper to …optimize physiological data quality. RESULTS: The experimental results show that the continuous heart rate and breathing rate can be monitored by this customized system radar module. CONCLUSION: A fully customized ultra-wide band radar for vital-sign application is presented. The radar system plan with wall parameter is also incorporated into the design consideration to meet the FCC requirement and SNR. Show more

Keywords: Radar, UWB, noncontact, real time, vital signs

DOI: 10.3233/THC-THC220022

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1223-1231, 2022

Authors: Luo, Guiyuan | Liao, Dan | Lin, Wenjin | Chen, Liuyun | Chen, Xiaojun | Yao, Dianye

Article Type: Research Article

Abstract: BACKGROUND: Da Vinci surgery is used extensively, but the high costs of the surgical instrument are a serious clinical and management problem. OBJECTIVE: To reduce the cost of the Da Vinci robotic surgical instrument supply chain. METHODS: Patients were selected from the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Control group patients underwent Da Vinci robot-assisted surgery between January 2019 and June 2019 (control group). Patients who were operated with the same robot from July 2019 to December 2019 were selected as the experimental group (SCM group). The cost analysis and …comparison were carried out to integrate instrument sets, working hours, workforce expenditure, and direct and indirect expenses. RESULTS: Compared with the control group, the number of instrument packages was lower (4.5 ± 1.4 vs. 11.5 ± 1.6, P < 0.001) and the personnel’s awareness of the instruments was higher (92.3 ± 4.2 vs. 83.4 ± 3.7, P < 0.001) in the SCM group. The SCM group showed lower processing time per device (8.1 ± 1.6 vs. 44.2 ± 5.6 min, P < 0.001) and lower costs per surgical instrument (RMB 11.5 ± 2.3 vs. 60.3 ± 10.2, P < 0.001). CONCLUSION: The application of the supply chain management can reduce the costs of robotic surgery, improve work efficiency and decrease the failure rate of instruments. Show more

Keywords: Supply chain management, Da Vinci’s surgical instruments, robotic surgery, management, cost analysis

DOI: 10.3233/THC-213563

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1233-1241, 2022

Authors: Dong, Qi | Cao, Miao | Gu, Feng | Gong, Weifang | Cai, Qingwu

Article Type: Research Article

Abstract: BACKGROUND: Thermal ablation of liver tumors is a conventional mode for treating liver tumors. In order to reduce the damage to normal tissue endangered by thermal ablation, the physician needs to plan the puncture path before surgery. OBJECTIVE: In this paper, a puncture trajectory planning method for thermal ablation of liver tumor based on NSGA-III is proposed. This method takes the clinical hard constraints and soft constraints into account. METHOD: The feasible puncture region is solved by the hard constraints, and after that the pareto front points are obtained under the soft constraints. …When accessing the feasible puncture region, an adaptive morphological closing operation method based on K-means algorithm is adopted to process the spherical angle binary image of obstacles that might be encountered in the puncture process. RANSAC is performed to fit the tangent plane of liver surface when calculating the angle between the puncture trajectory and liver surface. In order to evaluate the puncture path obtained by this method, 6 tumors are selected as experimental subjects, and Hausdorff distance and Overlap Rate of Pareto front points with manually recommend points are calculated respectively. RESULTS: The average value of Hausdorff distance is 24.91 mm, and the mean value of the overlap rate is 86.43%. CONCLUSION: The proposed method can provide high safety and clinical practice of the puncture route. Show more

Keywords: Liver tumor puncture ablation planning, multi-objective optimization, K-means, Random Sampling Consistent algorithm, NSGA-III

DOI: 10.3233/THC-213592

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1243-1256, 2022

Authors: Wang, Yonggang | Zhou, Min | Ding, Yong | Li, Xu | Zhou, Zhenyu | Xie, Tianchen | Shi, Zhenyu | Fu, Weiguo

Article Type: Research Article

Abstract: BACKGROUND: Endovascular aortic aneurysm repair (EVAR) is currently established as the first-line treatment for anatomically suitable abdominal aortic aneurysm (AAA). OBJECTIVE: To establish a deep convolutional neural networks (DCNN) model for fully automatic segmentation intraluminal thrombosis (ILT) of abdominal aortic aneurysm (AAA) in pre-operative computed tomography angiography (CTA) images. METHODS: We retrospectively reviewed 340 patients of AAA with ILT at our single center. The software ITKSNAP was used to draw AAA and ILT region of interests (ROIs), respectively. Image preprocessing and DCNN model build using MATLAB. Randomly divided, 80% of patients was classified …as training set, 20% of patients was classified as test set. Accuracy, intersection over union (IOU), Boundary F1 (BF) Score were used to evaluate the predictive effect of the model. RESULTS: By training in 34760–35652 CTA images (n = 204) and validation in 6968–7860 CTA images (n = 68), the DCNN model achieved encouraging predictive performance in test set (n = 68, 6898 slices): Global accuracy 0.9988 ± 5.7735E-05, mean accuracy 0.9546 ± 0.0054, ILT IOU 0.8650 ± 0.0033, aortic lumen IOU 0.8595 ± 0.0085, ILT weighted IOU 0.9976 ± 0.0001, mean IOU 0.9078 ± 0.0029, mean BF Score 0.9829 ± 0.0011. Our DCNN model achieved a mean IOU of more than 90.78% for segmentation of ILT and aortic lumen. It provides a mean relative volume difference between automatic segmentation and ground truth (P > 0.05). CONCLUSION: An end-to-end DCNN model could be used as an efficient and adjunctive tool for fully automatic segmentation of abdominal aortic thrombus in pre-operative CTA image. Show more

Keywords: Abdominal aortic aneurysm, intraluminal thrombosis, computed tomography angiography, convolutional neural networks, deep learning

DOI: 10.3233/THC-THC213630

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1257-1266, 2022

Authors: Yi, Shuai | Li, Wenzhao | Ding, Muliang | Ni, Jiangdong | Wang, Junjie

Article Type: Case Report

Abstract: BACKGROUND: Congenital pseudarthrosis of the clavicle (CPC) is a rare congenital entity with unresolved aetiology and pathogenesis. Nearly 250 cases have been reported to date. CPC is characterized by a definite defect in the mid-clavicle at birth and is usually diagnosed when the deformity becomes evident in late childhood or adolescence. Surgical management is controversial, especially in asymptomatic children, with various techniques reported in the literature. CASE REPORT: We report a case of a 6-year-old boy who was diagnosed with CPC during a medical examination for primary school enrollment. Operative treatment included debridement of pseudoarthrosis, internal …fixation with third tube plate, and barrel-shaped mono-cortical iliac crest autograft. RESULTS: A complete bone union was obtained 9 months after the operation, and satisfactory function and cosmetic appearance were observed 4 years and 3 months postoperatively. CONCLUSION: In our opinion, reconstruction with barrel-shaped mono-cortical iliac crest autograft was an effective and reproducible surgical technique to treat CPC. Show more

Keywords: Congenital pseudarthrosis of the clavicle, operative treatment, iliac crest autograft, osteosynthesis

DOI: 10.3233/THC-213658

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1267-1272, 2022