Technology and Health Care - Volume Pre-press, issue Pre-press
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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: Short stems are advantageous for revision as they preserve autogenous bone. At present, the method of short-stem installation is determined based on the surgeon’s experience. OBJECTIVE: To provide the guideline for installing a short stem, we aimed to investigate the alignment effect on the initial fixation of the stem, stress transfer, and the risk of failure numerically. METHODS: Models in which the caput-collum-diaphyseal (CCD) angle and flexion angle were hypothetically changed based on the two clinical cases of hip osteoarthritis were analyzed using the non-linear finite element method. RESULTS:…The medial settlement of the stem increased in the varus model and decreased in the valgus model. With varus alignment, the stresses acting on the femur were high in the distal to the femoral neck. In contrast, the stresses in the proximal to the femoral neck tend to be higher with valgus alignment, although the difference in the femur stress between varus and valgus alignment was slight. CONCLUSION: Both initial fixation and stress transmission are lower when the device was placed in the valgus model than in the actual surgical case. In order to obtain initial fixation and suppress stress shielding, it is essential to extend the contact area between the medial portion of the stem and the femur along the bone axis, and to ensure adequate contact between the lateral portion of the stem tip and the femur.
Keywords: Hip joint, arthroplasty, finite element analysis, hip prosthesis, initial fixation, stress shielding
Abstract: BACKGROUND: Milling operations of laminae in spinal surgery generate high temperatures, which can lead to thermal injury and osteonecrosis and affect the biomechanical effects of implants, ultimately leading to surgical failure. OBJECTIVE: In this paper, a backpropagation artificial neural network (Bp-ANN) temperature prediction model was developed based on full factorial experimental data of laminae milling to optimize the milling motion parameters and to improve the safety of robot-assisted spine surgery. METHODS: A full factorial experiment design were used to analyze the parameters affecting the milling temperature of laminae. The experimental matrixes were established…by collecting the corresponding cutter temperature T c and bone surface temperature T b for the milling depth, feed speed and different bone densities. The Bp-ANN lamina milling temperature prediction model was constructed from experiment data. RESULTS: Increasing milling depth increases bone surface and cutter temperature. Increasing feed speed had little effect on cutter temperature, but decreased bone surface temperature. Increasing bone density of laminae increased cutter temperature. The Bp-ANN temperature prediction model had best training results in the 10th epoch, and there is no overfitting (training set R = 0.99661, validation set R = 0.85003, testing set R = 0.90421, all temperature data set R = 0.93807). The goodness of fit R of Bp-ANN was close to 1, indicating that the predicted temperature was in good agreement with the experiment measurements. CONCLUSION: This study can help spinal surgery-assisted robot to select appropriate motion parameters at different density bones to improve lamina milling safety.
Abstract: BACKGROUND: Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year. OBJECTIVE: The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies. METHODS: A total of 202 preterm infants with a gestational age of 26 weeks…to 36 + 6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed. RESULTS: There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy. CONCLUSION: A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants.
Abstract: BACKGROUND: Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE: In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS: We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n = 10) and healthy control group…(n = 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS: We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P < 0.001; control group: P < 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P < 0.01, using independent t -test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P < 0.01, using independent t -test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P < 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION: SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function.
Abstract: BACKGROUND: The Selfit system was developed to improve the mobility and gait-related functions of stroke patients by providing digital exercises and augmented reality training system. OBJECTIVE: To evaluate the effects of a digital exercise and augmented reality training system on mobility, gait-related functions and self-efficacy outcomes in stroke patients. METHODS: A randomized control trial was conducted on 25 men and women diagnosed with an early sub-acute stroke. Patients were randomly assigned to either the intervention (N = 11) or the control groups (N =…14). Patients in the intervention group received a digital exercise and augmented reality training using the Selfit system in addition to the standard physical therapy treatment. Patients in the control group were treated with a conventional physical therapy program. Timed Up and Go (TUG) test, 10-meter walk test, the Dynamic Gait Index (DGI), and the Activity-specific Balance Confidence (ABC) scale were completed before and after the intervention. Feasibility and satisfaction among patients and therapists were also assessed after the completion of the study. RESULTS: The intervention group practiced proportionally more time per session than the control group with a mean change of 19.7% following 6 sessions (p = 0.002). The intervention group showed better improvement in post-TUG score compared to the control group (p = 0.04). ABC, DGI, and the 10-meter walk test scores were not significantly different between the groups. Both therapists and participants demonstrated high satisfaction with the Selfit system. CONCLUSION: The findings suggest that Selfit holds promise as an effective intervention for improving mobility and gait-related functions among patients with an early sub-acute stroke as compared to conventional physical therapy treatments.
Keywords: Stroke, gait, mobility, digital exercise, augmented reality
Abstract: BACKGROUND: Cells adherence provides specific information about physiology and pathology, the adhesion measurement between living cells and nanostructures can be measured by atomic force microscopy, but this detection technique is difficult to operate and costly. The adhesion height and effective contact area between cells and substrates are also the key factors affecting measurement value of the overall impedance. These factors change with structural parameters of the substrates, so the adhesion measurement between living cells and substrate can be indirectly reflected by the impedance value. OBJECTIVE: To establish a mapping relationship between the impedance measurement and the…adhesion measurement of living cells. The possibility of dynamic measurement of adhesion is realized by this method, and the experimental process is simplified. METHODS: Laser interference technology was used to prepare nanoarray structures with different periods on the surface of silicon wafers for cells culture. Under the same experimental conditions, the impedance of living cells on the substrates of different cycle sizes were measured. The adhesion between cells and different substrates were analyzed by measuring impedance after the interaction between cells and substrate. RESULTS: The adhesion of living cells on the substrates of different sizes be analyzed, and the mapping relationship between the impedance and the adhesion measurement was established. The results showed that, the larger the impedance value between cells and substrate, the larger the effective contact area and the smaller the gap between them. CONCLUSION: The difference of adhesion height and effective adhesion area between living cells and substrates were obtained. This paper, a new method to measure the adhesion properties of living cells is presented, which provides theoretical basis for the related research.
Keywords: Living cells, nanostructure, impedance, adhesion, effective adhesion areas
Abstract: BACKGROUND: Hepatitis B Virus (HBV) reactivation is the most common complication for patients with primary liver cancer (PLC) after radiotherapy. How to reduce the reactivation of HBV has been a hot topic in the study of postoperative radiotherapy for liver cancer. OBJECTIVE: To find out the inducement of HBV reactivation, a feature selection algorithm (MIC-CS) using maximum information coefficient (MIC) combined with cosine similarity (CS) was proposed to screen the risk factors that may affect HBV reactivation. METHOD: Firstly, different factors were coded and MIC between patients was calculated to acquire the association…between different factors and HBV reactivation. Secondly, a cosine similarity algorithm was constructed to calculate the similarity relationship between different factors, thus removing redundant information. Finally, combined with the weight of the two, the potential risk factors were sorted and the key factors leading to HBV reactivation were selected. RESULTS: The results indicated that HBV baseline, external boundary, TNM, KPS score, VD, AFP, and Child-Pugh could lead to HBV reactivation after radiotherapy. The classification model was constructed for the above factors, with the highest classification accuracy of 84% and the AUC value of 0.71. CONCLUSION: Comparing multiple feature selection methods, the results showed that the effect of the MIC-CS was significantly better than MIM, CMIM, and mRMR, so it has a very broad application prospect.
Abstract: BACKGROUND: Cognitive neuroscience experiments require accurate and traceable methods of measuring cognitive phenomena, analyzing and processing data, and validating results, including measurement of impact of such phenomena on brain activity and consciousness. EEG measurement is the most widely used tool for evaluation of the experiment’s progress. To extract more information from the EEG signal, continuous innovation is necessary to provide a broader range of information. OBJECTIVE: This paper presents a new tool for measuring and mapping cognitive phenomena using time window-based multispectral brain mapping of electroencephalography (EEG) signals. METHODS: The tool was developed…using Python programming language and enables users to create brain maps images for six spectra (Delta, Theta, Alpha, Beta, Gamma, and Mu) of EEG signal. The system can accept an arbitrary number of EEG channels with standardized labels based on the 10–20 system, and users can select the channels, frequency bandwidth, type of signal processing, and time window length to perform the mapping. RESULTS: The key advantage of this tool is its ability to perform short-time brain mapping, which allows for the exploration and measurement of cognitive phenomena. The tool’s performance was evaluated through testing on real EEG signals, and results demonstrated its effectiveness in accurately mapping cognitive phenomena. CONCLUSION: The developed tool can be used in various applications, including cognitive neuroscience research and clinical studies. Future work involves optimizing the tool’s performance and expanding its capabilities.
Abstract: BACKGROUND: The existing patient clothing is not suitable for patients that have to maintain a prone position for a long time after vitrectomy. OBJECTIVE: To investigate the effect of a new design of patient gowns for prone position patients after vitrectomy. METHOD: This study designed a kind of patient’s gown for prone position patients. A non-randomized, concurrent, controlled study was conducted on 212 patients who met the inclusion criteria for the prone position after vitrectomy in Grade III at a Class A hospital department of ophthalmology in Zhejiang Province from April to August…2020. The experimental group (106 patients in prone position) and the control group (106 patients in common position) were managed by the same group of nurses. The study recorded and compared the comfort degree of patients’ clothing used in the course of operation rehabilitation between the two groups and the satisfaction degree of doctors with nurses to patients’ clothing used in the prone position. RESULTS: The satisfaction degree and comfort degree of patients and the health care providers in the experiment group were significantly higher than those in the control group (p < 0.001). CONCLUSION: The process of making patient gowns for prone position patients is simple, which can improve the safety and comfort of patients when they were in the prone position. The new design also facilitated the treatment and nursing procedures of the medical staff and improved satisfaction among patients and medical staff.
Keywords: Prone position patient, vitrectomy, gown, satisfaction, comfort
Abstract: BACKGROUND: Chronic heart failure (CHF) is the terminal stage of cardiovascular disease. OBJECTIVE: In this study, the “hospital-to-home + online-to-offline” (H2H + O2O) care scheme was implemented for patients with CHF during vulnerable periods, and its effect was evaluated. METHODS: Patients with CHF in the cardiovascular department of a Class III/Grade A hospital in Jiangxi Province from January to December 2020 were selected using a convenience sampling method and randomly divided into a control and intervention group (n = 100 each). The…patients in the control group received routine in-hospital treatment and out-of-hospital follow-up, while in the intervention group, a multi-disciplinary cooperation team with CHF specialist nurses evaluated and stratified the patients before discharge and formulated individualized prescriptions and care plans. Based on the “Health & Happiness” chronic disease follow-up application designed for this study, the specialist nurses provided patients with one-to-one guidance. After three months, the cardiac function, heart failure knowledge, self-care behavior, and re-hospitalization rate of the patients were compared between the two groups. Cardiac function was evaluated by the serum B-type natriuretic peptide (BNP), the left ventricular ejection fraction (LVEF), and a six-minute walking test (6MWT). Heart failure knowledge and self-care behavior was assessed using specific questionaries. RESULTS: The level of cardiac function in the intervention group was significantly higher than that in the control group, and the difference was statistically significant (P < 0.001). The mastery of heart failure knowledge and self-care behavior in the intervention group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05). The re-hospitalization rate due to CHF in the intervention group was 21.0%, which was lower than that in the control group (35.0%), and the difference was statistically significant (P < 0.05). CONCLUSION: The H2H + O2O care scheme can be used for the transition of vulnerable patients with CHF from the hospital to family care to improve the patients’ level of cardiac function, elevate their knowledge level and self-care abilities, and improve their overall health outcomes.
Keywords: Chronic heart failure, vulnerable period, hospital-family, online and offline