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ISSN 0928-7329 (P)
Impact Factor 2023: 1.6
Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: Cardiac output (CO) decreases on reversing the patient’s position to the prone position. Estimated continuous cardiac output (esCCO) systems can noninvasively and continuously monitor CO calibrated by patient information or transesophageal echocardiogram (TEE). OBJECTIVE: To compare the accuracy, precision, and trending ability of two calibration methods of CO estimation in patients in prone position. METHODS: The CO estimates calibrated by TEE (esT) and patient information (esP) of 26 participants were included. CO was collected at four time points. The accuracy and precision of agreement were evaluated using the Bland-Altman method. A four-quadrant…plot was used for trending ability analysis. RESULTS: The bias between esP and TEE and between esT and TEE was 0.2594 L/min (95% limits of agreement (LoA): - 1.8374 L/min to 2.3562 L/min) and 0.0337 L/min (95% LoA: - 0.7381 L/min to 0.8055 L/min), respectively. A strong correlation was found between Δ esP and Δ TEE (p < 0.001, CCC = 0.700) and between Δ esT and Δ TEE (p < 0.001, CCC = 0.794). The concordance rates between Δ esP and Δ TEE and between Δ esT and Δ TEE were 91.9% and 97.1%, respectively. CONCLUSION: Despite limited accuracy and precision, esP showed acceptable trending ability. The trending ability of esCCO calibrated by the reference TEE value was comparable with that of TEE.
Abstract: BACKGROUND: Various methods exist to intervene with and control myopia, including bifocal lenses, multifocal lenses, pirenzepine, atropine, soft gas-permeable contact lenses and aberration control frame lenses, each with its own advantages and disadvantages. OBJECTIVE: To compare the clinical effectiveness of digital keratoplasty lenses and traditional orthokeratology (OK) lenses in correcting juvenile myopia. METHODS: Sixty-one patients (122 eyes) with an average age of 10.43 ± 1.71 years and with myopia were enrolled from January 2021 to January 2022 in the treatment centre of our hospital. The patients were randomly divided into…two groups. Group I (the experimental group) consisted of 30 patients who were treated with digital corneal shaping (MCT) lenses, while group II (the control group) consisted of 31 patients who were treated with traditional OK lenses. Clinical indicators, such as visual acuity, ocular axis, intraocular pressure, degree of central positioning, naked visual acuity and first-order spotting, were statistically analysed before and after fitting. RESULTS: The naked eye vision of patients using MCT lenses was significantly improved compared with patients who used traditional OK lenses (0.95 ± 0.28 > 0.58 ± 0.25; p < 0.05). Moreover, the risk of primary spot staining was reduced (p < 0.05), intraocular pressure was lower (p < 0.05) and the centre position reached 100% in patients wearing MCT lenses, suggesting that wearing MCT lenses may be more beneficial than wearing traditional OK lenses. CONCLUSION: Compared with traditional OK lenses, MCT lenses reduce the degree of myopia, have significant effects and have the added advantages of safety and reliability.
Keywords: Centre positioning, primary spot staining, orthokeratology contact lens, vision
Abstract: BACKGROUND: Monitoring the vital signs of chronic patients with hypertension, asthma, and chronic obstructive pulmonary disease (COPD) aids in disease prevention. OBJECTIVE: This study enhances the patient quality of life while adding to the corpus of information about electronic medical devices. METHOD: The requirements for both the functional and non-functional system architecture were determined and designs were made. Diagrams were used to describe the system’s parts, behaviour, and connections before implementation. RESULTS: Although the project’s development produced a remote monitoring system prototype with outcomes comparable to those of patented and…regarded as reliable devices, CCFHAC is not yet prepared to be considered a fully finished good that can be used to define a person’s health status with absolute certainty. CONCLUSION: This endeavour marks a step in investigating how the Internet of Things might improve the quality of life for Jordanian patients.
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) causes organic damage as well as anxiety, depression, fear, and other psychological disorders, which seriously affect the quality of life and prognosis of patients and cause a huge economic burden to the family and society. OBJECTIVE: The aim of this study was to investigate the correlation between an imbalance of serum Th1/Th2 indicators and psychiatric depression in elderly patients with COPD and analyze its implications for clinical management. METHODS: From January 2018 to May 2022, 120 elderly patients with COPD treated at our hospital were categorized into…two groups based on the self-rating depression scale (SDS): COPD with depression (SDS score ⩾ 50) and COPD alone (SDS score < 50). Blood gas analysis, pulmonary function, and serum Th1/Th2 index were determined. Receiver operating characteristic (ROC) curves were analyzed to explore the diagnostic value of serum Th1/Th2 ratios for COPD complicated by depression. RESULTS: Compared with the group without depression, the partial pressure of carbon dioxide and COPD assessment test scores were significantly higher, and the oxygenation index, forced expiratory volume in one second (FEV1), and percent predicted FEV1 were significantly lower in the COPD with depression group (P < 0.05). Interleukin (IL)-1β , IL-2, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α ) were significantly higher in the COPD with depression group than in the group without depression (P < 0.05). Logistic regression analysis indicated that the imbalance of serum IL-1β , IL-2, IL-6, IL-8, IL-10, and TNF-α was a risk factor for mental depression in elderly patients with COPD. When comparing prognostic indices, the interval before the first onset of clinically noticeable deterioration (CID-C) in the COPD with depression group was noticeably shorter than that in the COPD without depression group; the incidence of CID-C within 6 months was noticeably higher in the COPD with depression group than in the group without depression. CONCLUSION: Elderly patients with COPD and depression had reduced pulmonary function and higher serum Th1/Th2 levels, and an imbalance in serum Th1/Th2 indicators was a potential risk factor for depression. Moreover, elderly patients with COPD and depression were at a higher risk of disease progression and had a worse prognosis. Thus, an imbalance in serum Th1/Th2 indicators is a potential prognostic factor for evaluating depression in patients with COPD.
Abstract: BACKGROUND: At present, there is no consensus on the required duration of neoadjuvant endocrine therapy (NET), yet there is no consistent conclusion on the factors influencing the efficacy of treatment with breast cancer after prolonged treatment. OBJECTIVE: To explore the effect of prolonged NET on the efficacy of patients with breast cancer and analyze the factors influencing the efficacy of treatment with breast cancer after the treatment duration is prolonged. METHODS: The case histories of 51 patients who were diagnosed with breast cancer and received NET in our hospital from September 2017 to…December 2021 were retrospectively analyzed. All patients received NET for over 12 months. The clinical efficacy and tumor size changes after treatment for six months and 12 months were compared, and the factors influencing the efficacy of treatment with breast cancer after patients’ treatment duration was prolonged were analyzed. RESULTS: (1) Among the 51 patients, the objective remission rate (ORR) of NET, at T = 6 months was 21.6%, and the average tumor size was 15.52 ± 7.30 mm. The ORR of the NET at T = 12 months was 52.9%, and the average tumor size was 13.79 ± 7.43 mm. (2) After the treatment duration was prolonged, the clinical ORRs of patients with estrogen receptor (ER) (+) and progesterone receptor (PR) (+) were significantly higher than that of patients with ER (+) and PR (-) and patients with ER (-) and PR (+), which was (P < 0.05). (3) There was no significant difference between the patients’ axillary lymph node status and the Ki67 expression before treatment and the clinical ORR after prolonged treatment, which was (P > 0.05). CONCLUSIONS: (1) Prolonging the NET duration for patients with breast cancer can improve their clinical ORR and further reduce the tumor size, but patients’ conditions should be closely monitored during the treatment process to prevent the progression of disease due to drug resistance. (2) The expression state of ER or PR may be used as a factor influencing the efficacy of treatment with breast cancer after prolonged treatment. (3) There was no significant effect on the patients’ axillary lymph node status and the Ki67 expression before treatment on the clinical efficacy after prolonged treatment.
Keywords: Breast cancer, hormone receptor-positive, neoadjuvant endocrine therapy (NET), anastrozole
Abstract: BACKGROUND: Protection of wireless technology-enabled e-healthcare data transfer over constrained devices of body sensor networks using lightweight security mechanisms is the demand of health sector nowadays. OBJECTIVE: A new secure wireless body sensor network architecture (S-WBSN) with reduced CPU cycles and computational cost is proposed. S-WBSN uses OTP-Q (One-Time Pad-Quasi) and Diffie-Hellman key exchange algorithms for encryption and mutual authentication, respectively. METHODS: To ensure mutual authentication among < WBSN, Local Processing Center (LPC)> and < WBSN, Data Server> components, the Diffie-Hellman key exchange…algorithm is used. Using the S-WBSN architecture, security requirements such as mutual authentication, and privacy preservation thwarting security attacks are perfectly met comparing other security-based research works on healthcare data monitoring. RESULTS: The one-time pad-based quasi-group algorithm is a stream block cipher that operates on the data observed from the sensors of the WBSN. Before transmitting encrypted data, authentication is to be established. CONCLUSION: The proposed system methodology proves to be efficient and consumes fewer CPU cycles. The encryption and decryption processing times are comparatively less than the state-of-the-art approaches.
Keywords: Body area network, secure wireless body sensor networks, one-time pad, quasi-group encryption, Diffie-Hellman key exchange algorithm, Local Processing Centre (LPC)
Abstract: BACKGROUND: The Healthy China strategy is an important development objective of the 14th Five-Year Plan and Vision 2035 in China, while health service use in rural China has been a weak link in this strategy. OBJECTIVE: Nowadays, people’s health service use will be influenced by digital technology due to the arrival of the Digital Age, and that is the reason why our interest is to discuss the effect of digital life on health service use among rural residents. METHODS: We use the data from the China Family Panel Studies (CFPS) 2020 to examine…the effect of digital life on health service use among rural residents, and we use Instrumental Variables method to control the endogenous problem and use KHB model to discuss the mechanism of this effect. RESULTS: It was found that digital life has increased the health service use among rural residents significantly, and this result has been verified by robust test and Instrumental Variables method. Besides, digital life can increase health service use through the information channel effect and the health literacy effect indirectly. Moreover, digital life has a more significant impact on the residents with low social capital, low physical capital and low social trust, which represents the inclusivity of digital life. CONCLUSION: The results of our paper will be helpful to examine the effect of the digital policy on promoting the health service use in rural China, and our findings will provide evidence of how to use digital life to enhance health service use among rural residents. Based on this, the government should take measures to eliminate the digital divide between urban and rural areas by promoting the level of digital life among rural residents, paying more attention to the digital literacy development among them, and forging ahead toward the great goal of the Healthy China under the Digital Age.
Keywords: Digital life, health service use, health literacy, inclusivity
Abstract: BACKGROUND: Evaluation of the working postures and development of new techniques are paramount in reducing the awkward postures and occurrence of musculoskeletal disorders (MSDs). The Kinect sensor, a portable and cost-effective device, appears to be a promising alternative to study work postures. OBJECTIVE: The current study aimed to evaluate the validity of Kinect against the gold-standard instrument (electro-goniometers) for body joint angle measurements. METHODS: A unique software application was developed to measure the critical body joint angles for postural evaluation by using the Kinect’s skeletal tracking feature. The body joint angle data of…ten volunteers were measured simultaneously by both Kinect and electro-goniometers. The validation analysis was conducted in both static and dynamic domains of application. RESULTS: Minimal variation was observed between the two techniques, and the Kinect correlated well for upper-arm joint angles of 45 ∘ , 60 ∘ and 90 ∘ ; lower-arm joint angles of 30 ∘ , 45 ∘ , 60 ∘ , and 90 ∘ ; straight neck position, neck joint angle at maximum possible flexion; straight trunk position, trunk bend angle at full flexion. In dynamic analysis, four out of five ICC values were > 0.75 except for the upper arm. Discrepancies in the results indicated the disapproval of Kinect for only wrist measurements. CONCLUSION: The results of the static and dynamic studies gave a sufficient basis to consider the Kinect tool as an alternative to contemporary posture-based ergonomic evaluation methods.
Abstract: BACKGROUND: Pacing is the most effective and dependable method for treating complete atrioventricular block (AVB). OBJECTIVE: The purpose of this study is to investigate the use of His bundle pacing (HBP) in patients with atrioventricular block. METHODS: Patients who underwent HBP or right ventricular pacing (RVP) were enrolled and divided into two groups: the HBP group and the RVP group, respectively. We compared baseline clinical data, fluoroscopy duration, operation duration, pacing electrode parameters during the operation or follow-up, baseline QRS duration, and pacing QRS duration. RESULTS: HBP was attempted in…48 patients and was successful in 34 patients who were included in the HBP group. In addition, 30 RVP patients were included in the RVP group. Fluoroscopy duration and operation duration were significantly longer in the HBP group compared to the RVP group. Compared to the RVP group, the HBP group had a higher pacing threshold, a lower R wave amplitude, and a shorter pacing QRS duration. At 6 months of follow-up, the pacing threshold remained higher, the R wave amplitude was significantly lower, and the end-diastolic diameter of the left ventricle was smaller in the HBP group. CONCLUSION: HBP was safe and effective for atrioventricular block despite the longer fluoroscopy and operation duration in the HBP group when compared to the RVP group.
Keywords: Atrioventricular block, his bundle pacing, left ventricular remodeling, right ventricular pacing
Abstract: BACKGROUND: Early postoperative activity, an important part of enhanced recovery after surgery (ERAS) in clinical practice, is considered to be a significant component of postoperative quality care. OBJECTIVE: To evaluate the effect of a standardized early activity program on ERAS in patients after surgery for pulmonary nodules. METHODS: A total of 100 patients with pulmonary nodules who underwent a single-port thoracoscopic segmental resection or a wedge resection of the lung were selected for the present study. These patients were divided into a control group (n = 50) and…an intervention group (n = 50) by a digital random method. The patients in the control group received routine perioperative nursing intervention for thoracic surgery due to lung cancer, and those in the intervention group received an intervention using a standardized early activity program along with routine nursing care. The evaluation indexes in both groups included postoperative indwelling time of the closed chest drainage tube, the time to the first off-bed activity after surgery, the incidence of postoperative pulmonary complications, the length of postoperative hospital stay, and patient satisfaction. RESULTS: The postoperative indwelling time of the closed chest drainage tube and the time to the first off-bed activity in the intervention group were less than in the control group. The length of the postoperative hospital stay in the intervention group was shorter than in the control group, and the patient satisfaction in the intervention group was higher than in the control group. The difference for these evaluation indexes were statistically significant (P < 0.05). The number of cases of postoperative complications was four and eight in the intervention group and the control group, respectively, and the difference was not statistically significant (P > 0.05). CONCLUSION: A standardized early activity program is a safe and effective nursing measure for ERAS for patients after surgery for pulmonary nodules, which can promote earlier off-bed activity, shorten the postoperative indwelling time of the closed chest drainage tube, shorten the postoperative hospital stay, improve patient satisfaction, and promote rapid recovery.
Keywords: Early activity program, pulmonary nodules, postoperative, enhanced recovery after surgery, single-port thoracoscopy