Technology and health care : official journal of the European Society for Engineering and Medicine
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Technol Health Care · Jan 2013
Prediction of different types of liver diseases using rule based classification model.
Diagnosing different types of liver diseases clinically is a quite hectic process because patients have to undergo large numbers of independent laboratory tests. On the basis of results and analysis of laboratory test, different liver diseases are classified. Hence to simplify this complex process, we have developed a Rule Base Classification Model (RBCM) to predict different types of liver diseases. The proposed model is the combination of rules and different data mining techniques. ⋯ This study demonstrates that there is a significant difference between the proposed rules based classification model and the model without rules for the liver diseases prediction and the rule based classification model with decision tree (DT) technique provides most accurate result. This model can be used as a valuable tool for medical decision making.
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Technol Health Care · Jan 2013
Hip resurfacing using a modified lateral approach with limited splitting of the gluteus medius muscle results in significant impairment of hip abductor strength.
A lateral, transgluteal approach for hip resurfacing carries the risk of approach-related weakening of the hip abductors due to unsuccessful re-adaptation of the gluteal muscles to the greater trochanter or to injury to the inferior nerve branch of the superior gluteal nerve. ⋯ Even a limited incision of the gluteus medius muscle resulted in significant impairment of hip abductor strength 2.5 years after surgery.
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Technol Health Care · Jan 2012
ReviewOn the efficiency of FES cycling: a framework and systematic review.
Research and development in the art of cycling using functional electrical stimulation (FES) of the paralysed leg muscles has been going on for around thirty years. A range of physiological benefits has been observed in clinical studies but an outstanding problem with FES-cycling is that efficiency and power output are very low. The present work had the following aims: (i) to provide a tutorial introduction to a novel framework and methods of estimation of metabolic efficiency using example data sets, and to propose benchmark measures for evaluating FES-cycling performance; (ii) to systematically review the literature pertaining specifically to the metabolic efficiency of FES-cycling, to analyse the observations and possible explanations for the low efficiency, and to pose hypotheses for future studies which aim to improve performance. ⋯ Performance assessments should be carried out at a well-defined operating point, i.e. under conditions of well controlled work rate and cadence, because these variables have a strong effect on energy expenditure. Future work should focus on the two main factors which affect FES-cycling performance, namely: (i) unfavourable biomechanics, i.e. crude recruitment of muscle groups, non-optimal timing of muscle activation, and lack of synergistic and antagonistic joint control; (ii) non-physiological recruitment of muscle fibres, i.e. mixed recruitment of fibres of different type and deterministic constant-frequency stimulation. We hypothesise that the following areas may bring better FES-cycling performance: (i) study of alternative stimulation strategies for muscle activation including irregular stimulation patterns (e.g. doublets, triplets, stochastic patterns) and variable frequency stimulation trains, where it appears that increasing frequency over time may be profitable; (ii) study of better timing parameters for the stimulated muscle groups, and addition of more muscle groups: this path may be approached using EMG studies and constrained numerical optimisation employing dynamic models; (iii) development of optimal stimulation protocols for muscle reconditioning and FES-cycle training.
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Technol Health Care · Jan 2012
Comparative StudyComparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base.
In consideration of rising cost pressure in the German health care system, the usefulness of helicopter emergency medical service (HEMS) in terms of time- and cost-effectiveness is controversially discussed. The aim of the present study was to investigate whether HEMS is associated with significantly decreased arrival and transportation times compared to ground EMS. ⋯ The results of the present study indicate the time-effectiveness of German air ambulance services with significantly decreased transportation times.
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Technol Health Care · Jan 2012
Impact of enterococcus on immunocompetent and immunosuppressed patients with perforation of the small or large bowel.
The role of enterococcus in intraabdominal infection remains controversial. A retrospective study of 473 patients with bowel perforation was conducted to assess the impact of enterococci on outcome of patients with perforation of the small and large bowel. ⋯ Enterococci seem to play a minor role in uncomplicated intraabdominal infections. Our results suggest that enterococci play a role in the severity of postoperative complications. In particular, detection of enterococci in patients with anastomotic leakage are suggested to be an indicator of severe illness. We found significantly higher rates of E. faecium than described before, but no significant differences in clinical outcome between E. faecalis and E. faecium. When empirical therapy against enterococci is recommended, E. faecalis and E. faecium should both be covered.