Technology and Health Care - Volume 29, issue S1

Authors: Gómez, Carlos | Liu, Feng

Article Type: Research Article

DOI: 10.3233/THC-218000

Citation: Technology and Health Care, vol. 29, no. S1, pp. 1-1, 2021

Authors: Song, Zhijun | Chen, Xiaolei | Sun, Zhenghui | Li, Fangye | Xue, Zhe | Liang, Yongping | Zhou, Dingbiao

Article Type: Research Article

Abstract: BACKGROUND: Ventriculo-peritoneal shunt (VPS) is one of the routine methods used to treat communicating hydrocephalus. OBJECTIVE: To sum up the clinical effectiveness of ventriculo-peritoneal shunt (VPS), assisted with neuroendoscopy and laparoscopy, for the treatment of patients with communicating hydrocephalus. METHODS: From January 2010 to 2014, we performed VPS surgery on 209 patients with communicating hydrocephalus, using neuroendoscopy and laparoscopy, which helped to implant the shunt catheter in a suitable position in the ventricles and abdominal cavity, respectively. The subsequent survival following the surgery was analyzed using Kaplan-Meier analysis. RESULTS: A …total of 209 patients received 255 VPSs or revisions and all the operations were successfully completed. Open operation or oraniotomy was not needed for any technical complications, while 46 revisions were performed. After the operations, 203 patients with communicating hydrocephalus exhibited improvement of symptoms following surgery. The follow-up period ranged from one month to four years; the shunt surgery efficiencies were 91.0%, 86.7%, 83.9%, and 82.0% in the first, second, third, and fourth years, respectively. CONCLUSION: For ventriculo-peritoneal shunt, laparoscopy and neuroendoscopy can help to implant shunt catheter in a suitable position, in the ventricles or abdominal cavity, respectively. Hence, the combination of the two techniques can reduce the failure rate of VPS, and has an obvious impact on survival following the surgery. Show more

Keywords: Hydrocephalus, neuroendoscopy, laparoscopy, ventriculo-peritoneal shunt

DOI: 10.3233/THC-218001

Citation: Technology and Health Care, vol. 29, no. S1, pp. 3-10, 2021

Authors: Zhong, Xingming | Jin, Fenpin | Huang, Chuican | Du, Mengxuan | Gao, Mengge | Wei, Xiangcai

Article Type: Research Article

Abstract: BACKGROUND: Polycystic ovary syndrome (PCOS) is a common gynecologic endocrinopathy, characterized by menstrual disorders, ovulation disorders, polycystic ovary, hyperandrogen syndrome and insulin resistance. At present, the etiology and exact pathogenesis of PCOS are still unclear. Anti-Müllerian hormone is a local regulator secreted by ovarian granulosa cells, and participates in regulating the occurrence and development of PCOS. Insulin resistance is another important pathophysiological feature of PCOS. Although the expression of anti-müllerian hormone receptor (AMHR) and insulin receptor (INSR) in PCOS have been previously reported, the DNA methylation of the genes have not been well characterized. OBJECTIVE: To …study AMHR II/INSR and its role in gene methylation in Ovarian and endometrial pathology of PCOS subjects. METHODS: We recruited seventy-five women with PCOS as cases and twenty healthy women as controls, using immunohistochemical method, study localization, distribution and expression of MHRII/INSR in ovary and endometrium and then discover the correlation of AMHRII/INSR gene methylation. RESULTS: Different clinical features in PCOS group AMHRII gene methylation level and insulin resistance relations have significant differences (r = 0.532, P = 0.000); INSR gene methylation level and insulin resistance relations have significant differences (r = 0.281, P = 0.03). CONCLUSIONS: The analysis of DNA methylation suggested that methylation of AMHRII and INSR genes was associated with basic clinical characteristics and insulin resistance of PCOS. These results provide evidence for AMHRII and INSR genes, and their methylation levels are intimately associated with the pathogenesis of PCOS. Show more

Keywords: Anti-müllerian hormone (AMH), anti-müllerian hormone receptor (AMHR), insulin receptor (INSR), DNA methylation, polycystic ovary syndrome (PCOS)

DOI: 10.3233/THC-218002

Citation: Technology and Health Care, vol. 29, no. S1, pp. 11-25, 2021

Authors: Kim, Jung-Hun | Park, Chun-Kyu | Park, Ji-Eun | Lee, Jong-Min

Article Type: Research Article

Abstract: BACKGROUND: Three-dimensional (3D) printing technology for heart simulation can be represented as complex anatomical structures, and objective information can be provided. OBJECTIVE: We studied 3D print material to find a material with the same elastic coefficient as pig elastic coefficient. METHODS: Pig heart sample, Agilus sample, Tango sample, TPU sample, and silicone sample were studied. The elastic coefficient of each specimen was measured using an elastic coefficient measuring instrument. The analysis was performed using the average value of ten specimens of the same size. We suggested an equation to find the elastic coefficient …of material by the thickness using the elastic coefficient of Agilus, Tango, and silicone. RESULTS: The sample with similar elasticity to the pig sample did not show the same coefficient of elasticity at the same sample size. In Tango, the 0.5 mm high elastic force was about 3 times higher than the pig sample 7 mm elastic force. CONCLUSIONS: The study was conducted using 3D print material and silicone which can reproduce the elasticity of pig heart. However, no material is currently available to reproduce pig heart sample of the same size. However, if the heart is developed considering only elasticity, it can be sufficiently reproduced using the research results. Show more

Keywords: Agilus elastic material, Tango elastic material, pig heart, elastic force, elastic coefficient

DOI: 10.3233/THC-218003

Citation: Technology and Health Care, vol. 29, no. S1, pp. 27-34, 2021

Authors: Park, Eunhee | Park, Jang Woo | Min, Yu-Sun | Lee, Yang-Soo | Kim, Byung-Soo | Kim, Ju-Hyun | Lee, Hui Joong | Lee, Jongmin | Chang, Yongmin | Jung, Tae-Du

Article Type: Research Article

Abstract: BACKGROUND: Post-stroke depression (PSD) is a consequential neuropsychiatric sequela that occurs after stroke. However, the pathophysiology of PSD are not well understood yet. OBJECTIVE: To explore alterations in functional connectivity (FC) between anterior insula and fronto-cortical and other subcortical regions in the non-affected hemisphere in patients with PSD compared to without PSD and healthy control. METHODS: Resting-state FC was estimated between the anterior insula and cortical and subcortical brain regions in the non-affected hemisphere in 13 patients with PSD, 12 patients without PSD, and 13 healthy controls. The severity of depressive mood was …measured by the Beck Depression Inventory (BDI)-II. RESULTS: Patients with PSD showed significant differences in FC scores between the anterior insula and the superior frontal, middle frontal, and orbitofrontal gyrus in the non-affected hemisphere than healthy control or patients without PSD (P < 0.05). In post-hoc, patients with PSD showed higher FC scores between the anterior insula and the superior frontal region than patients without PSD (P < 0.05). Furthermore, alterations in FC of the superior frontal, middle frontal, and orbitofrontal gyrus were positively correlated with depression severity, as measured with the BDI-II (P < 0.001). Show more

DOI: 10.3233/THC-218004

Citation: Technology and Health Care, vol. 29, no. S1, pp. 35-48, 2021

Authors: Kim, Jong Hoon | Park, Min Gyu | Wei, Qun | Seong, Ki Woong | Lee, Jyung Hyun

Article Type: Research Article

Abstract: BACKGROUND: Sound normally enters the ear canal, passes through the middle ear, and stimulates the cochlea through the oval window. Alternatively, the cochlea can be stimulated in a reverse manner, namely round window stimulation. The reverse stimulation is not well understood, partly because in classic lumped-parameter models the path of reverse drive during the round window stimulation is usually not considered. OBJECTIVE: The study goal is to gain a better understanding of the hearing mechanism during round window stimulation. METHODS: A piezo actuator was coupled to the oval and round window of the …guinea pigs. The auditory brainstem response produced by the forward and reverse stimulation at four frequencies was recorded. RESULTS: The results show that the input voltage of the actuator required at the hearing threshold in the round window drive was higher than that in the oval window drive. In order to understand the data, we designed a lumped-parameter cochlear model that can simulate both forward and reverse drive. The model-predicted results were consistent with the experimental results. CONCLUSIONS: The response of the auditory system to stimulus of oval window and round window was quantified through animal experimentation, and guinea pigs were used as experimental animals. When the same stimulus was applied to the oval window and round window of the cochlea, the ABR signals were compared. A lumped parameter model was designed to incorporate the sound transmission paths in both oval and round window stimulation. The simulated results are consistent with those of animal experiments. This model will be useful in understanding the inner-ear response in round window. Show more

Keywords: Middle ear implantable hearing devices, auditory brainstem response, round window stimulation, oval window stimulation

DOI: 10.3233/THC-218005

Citation: Technology and Health Care, vol. 29, no. S1, pp. 49-56, 2021

Authors: Lu, Jiayu | Zhang, Song | Jiang, Hongqing | Yang, Lin | Hao, Dongmei | Yang, Yimin | Li, Xuwen | Chen, Aiqing | Shao, Jing | Liu, Xiaohong

Article Type: Research Article

Abstract: BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, …respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance. Show more

Keywords: Prediction model, gestational diabetes mellitus, rest energy metabolism

DOI: 10.3233/THC-218006

Citation: Technology and Health Care, vol. 29, no. S1, pp. 57-63, 2021

Authors: Meng, Hong | Lin, Weixuan | Dong, Yinmao | Li, Li | Yi, Fan | Meng, Qingyang | Li, Yue | He, Yifan

Article Type: Research Article

Abstract: BACKGROUND: Due to the increasing interest in human anti-aging, demand for a higher quality of life, and technological advancement, the development of anti-aging skincare has great market prospects. Most cosmetic companies develop products driven by the market or focus on the mechanism of action of substances and the behavior of skin; however, little research utilizes skin parameters and large data methodology to develop skincare products. OBJECTIVE: To instruct consumers to purchase skincare products and to guide skincare research toward the development of customer-targeted products. METHODS: A total of 815 Chinese subjects (83 male; …732 female) from five different cities were included. We measured 14 indices in each subject, including moisture, transepidermal water loss (TEWL), and sebum levels. We performed multiple regression analysis to understand the relationship between skin indices and aging; a novel approach is shown using the R software. RESULTS: The exact age at which changes in each skin index occurred could be demonstrated by this method of analysis: 39, 38, 48, 46, and 56 years old with respect to the L value, Melanin, Rt, Rm, and Rz, respectively. CONCLUSION: With the use of statistical analysis, consumers can be more efficiently targeted and choose suitable products considering particular skin parameter changing points; thus, skincare companies will not only meet customer requirements but also better control budgets. Show more

Keywords: Multiple regression analysis, R software, skin aging, skin parameters, changing point

DOI: 10.3233/THC-218007

Citation: Technology and Health Care, vol. 29, no. S1, pp. 65-76, 2021

Authors: Kim, Jungsuk | Kim, Kwang Soo | Choi, Hojong

Article Type: Research Article

Abstract: BACKGROUND: The pulse-echo test is used to evaluate the performance of ultrasonic probes before manufacturing ultrasonic systems. However, commercial alignment instruments are very large and use complex programs with long operation times. OBJECTIVE: To develop a low-cost alignment instrument used in the pulse-echo test for evaluating the performance of various 2D and 3D ultrasonic probes. METHODS: The developed alignment instrument can be aligned with the X, Y, Z, azimuth, elevation, and tilt axes with manual structure to support mounting fixtures that hold 2D and 3D ultrasonic probes. Each axis has a manual lever …and is designed to have no movement when fixed. In particular, tilt and azimuth directions are designed to move more than 5 ∘ left and right. RESULTS: The probe mounted in the X, Y, and Z axes can move at above 50 mm. The probe mounted in the azimuth, elevation, and tilt axes can move more than 5 ∘ in the left and right directions. The pulse-echo test using commercial ultrasonic probes showed maximum error rate of less than 5%. CONCLUSIONS: Our developed alignment instrument can reduce costs by eliminating the need for shortening inspection times for probe manufacturers. Show more

Keywords: Ultrasonic probes, alignment instruments, water tank, ultrasonic transducers

DOI: 10.3233/THC-218008

Citation: Technology and Health Care, vol. 29, no. S1, pp. 77-84, 2021

Authors: Kim, Mikyoung | Park, Chanhee | Park, Myungsook | You, Joshua (Sung) H.

Article Type: Research Article

Abstract: BACKGROUND: There is a dearth of information on the effects of different types (Segmental rehabilitation service (SRS) vs Community-based rehabilitation service (CRS)) on the parenting stress and family quality of life in parents of children who have individuals with intellectual and developmental disabilities (IDD). OBJECTIVE: This paper is to compare the effects of SRS and CRS on parenting stress and family quality of life in parents of individuals with IDD. METHODS: A cross-sectional design was used to examine parenting stress and family quality life in cohorts of 120 fathers and mothers of children …with IDD who had received either SRS or CRS participated in the survey. The outcome measures included the modified Parenting Stress Index (PSI) and the modified Beach Center Family Quality of Life Scale (mBCFQLS). The Mann-Whitney U test was performed at P < 0.05. RESULTS: A significant difference was observed in social stress in PSI between the SRS and CRS groups (P = 0.03). The child rearing, emotional well-being, and physical and material well-being variables in mBCFQLS were different between the SRS and CRS groups (P < 0.05), indicating superior benefits from CRS than SRS. CONCLUSIONS: These findings provide important information and about parenting stress and family quality of life in children with IDD, for developing effective rehabilitation programs and services for these parents. Show more

Keywords: Parenting stress, community-based rehabilitation, quality of life, children with disabilities, developmental disabilities

DOI: 10.3233/THC-218009

Citation: Technology and Health Care, vol. 29, no. S1, pp. 85-89, 2021

Authors: Dou, Bo | Chen, Tianrui | Chu, Qiubo | Zhang, Guirong | Meng, Zhaoli

Article Type: Research Article

Abstract: BACKGROUND: Giant cell tumor of bone (GC), osteosarcoma (OS) and Ewing’s sarcoma (ES) are three different types of bone cancer with common and specific pathology features. OBJECTIVE: The purpose of the study was to examine the relationship and differences of the three bone tumors using clinical samples. METHODS: Through screening the profiles of clinical samples from GC, OS and ES patients using a humanoncology array, we found 26, 25 and 15 tumorigenesis factors significantly increased in GS, OS and ES tissues compared to normal individuals. eNOS, endostatin, HIF-1α , IL-6, CCL2/MCP-1, …CCL8/MCP-2, CCL7/MCP-3, Tie and VEGF directly or indirectly involve in the metastasis Therefore, expression levels of the 6 factors were further determined by Western blot. RESULTS: The results showed levels of MCP1, MCP2, MCP3 or IL-6 in the GS, OS and ES significantly increased, and the expression levels of angiogenesis and anti-angiogenesis factors containing eNOS, endostatin, HIF-1α , Tie or VEGF were enhanced. CONCLUSIONS: Our results suggest that eNOS, endostatin, HIF-1α , IL-6, CCL2/MCP-1, CCL8/MCP-2, CCL7/MCP-3, Tie and VEGF may play important roles in tumorigenesis, reveal the expression differences of tumor-associated cytokines and angiogenesis related factors, and provide clinical evidence for studying the mechanisms on the metastasis in GC, OS and ES. Show more

Keywords: Giant cell tumor of bone, osteosarcoma, Ewing’s sarcoma, metastasis

DOI: 10.3233/THC-218010

Citation: Technology and Health Care, vol. 29, no. S1, pp. 91-101, 2021

Authors: Li, Haiyan | Cao, Zanxia | Hu, Guodong | Zhao, Liling | Wang, Chunling | Wang, Jihua

Article Type: Research Article

Abstract: BACKGROUND: The ribose-binding protein (RBP) from Escherichia coli is one of the representative structures of periplasmic binding proteins. Binding of ribose at the cleft between two domains causes a conformational change corresponding to a closure of two domains around the ligand. The RBP has been crystallized in the open and closed conformations. OBJECTIVE: With the complex trajectory as a control, our goal was to study the conformation changes induced by the detachment of the ligand, and the results have been revealed from two computational tools, MD simulations and elastic network models. METHODS: Molecular …dynamics (MD) simulations were performed to study the conformation changes of RBP starting from the open-apo, closed-holo and closed-apo conformations. RESULTS: The evolution of the domain opening angle θ clearly indicates large structural changes. The simulations indicate that the closed states in the absence of ribose are inclined to transition to the open states and that ribose-free RBP exists in a wide range of conformations. The first three dominant principal motions derived from the closed-apo trajectories, consisting of rotating, bending and twisting motions, account for the major rearrangement of the domains from the closed to the open conformation. CONCLUSIONS: The motions showed a strong one-to-one correspondence with the slowest modes from our previous study of RBP with the anisotropic network model (ANM). The results obtained for RBP contribute to the generalization of robustness for protein domain motion studies using either the ANM or PCA for trajectories obtained from MD. Show more

Keywords: Ribose-binding protein, molecular dynamics simulation, conformational change, elastic network model

DOI: 10.3233/THC-218011

Citation: Technology and Health Care, vol. 29, no. S1, pp. 103-114, 2021

Authors: Wang, Xinlu | Saif, Ahmed A.F. | Liu, Dayou | Zhu, Yungang | Benediktsson, Jon Atli

Article Type: Research Article

Abstract: BACKGROUND: DNA sequence alignment is one of the most fundamental and important operation to identify which gene family may contain this sequence, pattern matching for DNA sequence has been a fundamental issue in biomedical engineering, biotechnology and health informatics. OBJECTIVE: To solve this problem, this study proposes an optimal multi pattern matching with wildcards for DNA sequence. METHODS: This proposed method packs the patterns and a sliding window of texts, and the window slides along the given packed text, matching against stored packed patterns. RESULTS: Three data sets are used …to test the performance of the proposed algorithm, and the algorithm was seen to be more efficient than the competitors because its operation is close to machine language. CONCLUSIONS: Theoretical analysis and experimental results both demonstrate that the proposed method outperforms the state-of-the-art methods and is especially effective for the DNA sequence. Show more

Keywords: DNA sequence, multi-pattern matching, wildcards, packed string matching

DOI: 10.3233/THC-218012

Citation: Technology and Health Care, vol. 29, no. S1, pp. 115-124, 2021

Authors: Kim, Tae-Hoon

Article Type: Research Article

Abstract: BACKGROUND: Mastication improves cognitive function by activating cerebral cortical activity, and it is important to demonstrate the cognitive effects of masticatory training using a variety of different interventions. OBJECTIVE: This study aimed to evaluate the effects of masticatory exercise on cognitive function in healthy older adults living in the community. METHODS: For six weeks, twelve participants performed a masticatory exercise using a NOSICK exerciser device, and thirteen subjects performed daily life without masticatory exercises. Trail Making Test, Digit Span Test, and Stroop test were used to measure the cognitive function. RESULTS: …The participants in the experimental group showed significant improvements in TMT-A/B (p = 0.001 and 0.004), DST-forward (p = 0.001), and ST-word (p = 0.001). The effect sizes after the intervention were calculated as (1.2 and 0.8) for TMT-A/B, (0.8 and 0.2) for Digit Span Test forward/backward, and (0.6 and 0.2) for Stroop test color/word. CONCLUSIONS: We suggest that the masticatory exercises improve cognitive function in healthy older adults. Therefore, masticatory exercises can be used as a therapeutic exercise during cognitive rehabilitation. Show more

Keywords: Cognitive function, masticatory exercise, older adults

DOI: 10.3233/THC-218013

Citation: Technology and Health Care, vol. 29, no. S1, pp. 125-131, 2021

Authors: Liu, Bin | Liu, Shujun | Shang, Guanning | Chen, Yanjie | Wang, Qifeng | Niu, Xiaolei | Yang, Liang | Zhang, Jianxin

Article Type: Research Article

Abstract: BACKGROUND: There is a great demand for the extraction of organ models from three-dimensional (3D) medical images in clinical medicine diagnosis and treatment. OBJECTIVE: We aimed to aid doctors in seeing the real shape of human organs more clearly and vividly. METHODS: The method uses the minimum eigenvectors of Laplacian matrix to automatically calculate a group of basic matting components that can properly define the volume image. These matting components can then be used to build foreground images with the help of a few user marks. RESULTS: We propose a …direct 3D model segmentation method for volume images. This is a process of extracting foreground objects from volume images and estimating the opacity of the voxels covered by the objects. CONCLUSIONS: The results of segmentation experiments on different parts of human body prove the applicability of this method. Show more

Keywords: Virtual human, 3D organ models, volume data segmentation, matting components

DOI: 10.3233/THC-218014

Citation: Technology and Health Care, vol. 29, no. S1, pp. 133-140, 2021

Authors: Kang, Ha Lim | Na, Sung Dae | Kim, Myoung Nam

Article Type: Research Article

Abstract: BACKGROUND: Digital hearing aids are based on technology that amplifies sound and removes noise according to the frequency of hearing loss in hearing loss patients. However, within the noise removed is a warning sound that alert the listener; the listener may be exposed to danger because the warning sound is not recognized. OBJECTIVE: In this paper, a deep learning model was used to improve these limits and propose a method to distinguish the warning sound in speech signals mixed with noise. In addition, the improved speech and warning sound were derived by removing noise present in …the classification sound signals. METHODS: To classify the sound dataset, an adaptive convolution filter that changes according to two signals is proposed. The proposed convolution filter is applied to the PCNNs model to analyze the characteristics of the time and frequency domains of the dataset and classify the presence or absence of warning sound. In addition, the CEDN model was used to improve the intelligibility of the warning and the speech in the signal based on the warning sound classification from the proposed PCNNs model. RESULTS: Experimental results show that the PCNNs model using the proposed multiplicative filters is efficient for analyzing sound signals with complex frequencies. In addition, the CEDN model was used to improve the intelligibility of the warning and the speech in the signal based on the warning sound classification from the proposed PCNNs model. CONVLUSION: We confirmed that the PCNN model with the proposed filter showed the highest training rate, lowest error rate, and the most stable results. In addition, the CEDN model confirmed that speech and warning sounds were recognized, but it was confirmed that there was a limitation in clearly recognizing speech as the noise ratio increased. Show more

Keywords: Warning sound classification, parallel convolutional neural networks, sound enhancement, convolutional encoder-decoder network

DOI: 10.3233/THC-218015

Citation: Technology and Health Care, vol. 29, no. S1, pp. 141-152, 2021

Authors: Ye, Yingjian | Wu, Xiaxia | Li, Xiumei | Xu, Chunmei | Wang, Qingpeng | Yuan, Wenhuan | Zhang, Li | Li, Huan | Zheng, Lishi | Li, Qiongxia | He, Zhibing | Liu, Bo

Article Type: Research Article

Abstract: BACKGROUND: The SARS-CoV-2 pneumonia infection is associated with high rates of hospitalization and mortality and this has placed healthcare systems under strain. Our study provides a novel method for the progress prediction, clinical treatment and prognosis of NCP, and has important clinical value for timely treatment of severe NCP patients. OBJECTIVE: To summarize the clinical features and severe illness risk factors of the patients with novel coronavirus pneumonia (NCP), in order to provide support for the progression prediction, clinical treatment and prognosis of NCP patients. MATERIALS AND METHODS: A total of 196 NCP …patients treated in our hospital from January 25, 2020 to June 21, 2020 were divided into the severe group and the mild group. The clinical features of the two groups were analyzed and compared. The risk factors were explored by using multivariate logistic regression, and the receiver operating characteristic (ROC) curve was obtained. The correlations of the risk factors with the prognosis of NCP were investigated combined with the lung function test. RESULTS: The primary clinical symptoms of 196 cases of NCP included fever in 167 cases (85.2%) and cough in 121 cases (61.73%). The chest computed tomography (CT) scans of the 178 cases (90.81%) showed a typical ground-glass opacification. In 149 cases, the lymphocyte count was decreased, while the levels of creatine kinase (CK), lactate dehydrogenase (LDH), c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and D-dimer (D-D) increased. 44 cases (22.45%) were found to be severely ill. The multivariate logistic regression analysis demonstrated that age, underlying disease, length of hospital stay, body mass index (BMI), LDH, chest CT visual score, absolute lymphocyte count (ALC) and CRP were risk factors for severe Show more

DOI: 10.3233/THC-218016

Citation: Technology and Health Care, vol. 29, no. S1, pp. 153-164, 2021

Authors: Xu, Qi | Sun, Ge | Zhang, Song | Liu, Guoli | Yang, Lin | Meng, Yu | Chen, Aiqing | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Liu, Xiaohong | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: The prediction of hypertensive disorders in pregnancy (HDP) mainly involves various aspects such as maternal characteristics and biomarkers. OBJECTIVE: We aimed to study the effect of the HDP prediction model with or without placental growth factor (PlGF). METHODS: This study used maternal factors and PlGF, and standardized the data uniformly. At 12–20 weeks, the comprehensive comparison of model quality with or without PlGF was conducted by logistic regression. RESULTS: The area under curve and the model accuracy of the model with PlGF were higher than those of the model …without PlGF. The accuracy of the model with PlGF was above 90%. CONCLUSIONS: Adding PlGF to the model for predicting HDP improved the accuracy and effectiveness of the model. This study confirmed the predictive performance of PlGF. Show more

Keywords: Model accuracy, placental growth factor, logistic regression

DOI: 10.3233/THC-218017

Citation: Technology and Health Care, vol. 29, no. S1, pp. 165-170, 2021

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

Article Type: Research Article

Abstract: BACKGROUND: Hydrogen has advantages that can be used as energy, but research on safe use is needed. OBJECTIVE: In this study, an actuation system for rehabilitation is developed to drive the actuator using hydrogen storage alloy and to analyze the hydrogen release characteristics of the alloy. METHODS: The system is automatically control and report the pressure, temperature and hydrogen flow using LabVIEW-based modules and LabVIEW software. Zr 0.9 Ti 0.1 Cr 0.6 Fe 1.4 alloy was selected as hydrogen storage …alloy. 5 MPa of hydrogen pressure was applied at 8.56 g of alloy powder for activation process and the temperature outside was maintained at 19 ∘ C to 21 ∘ C. The amount of hydrogen absorption was measured about 1.47 wt%. The actuation test was conducted at the temperature from 25 ∘ C to 80 ∘ C, increased by every 5 ∘ C. The actuation height was measured at each load of 5, 10, 15, and 20 kg. The voltage and current which is applied to peltier elements were set to 5.0 V and 2.5 A. The pressure changing in the system was checked for 5 min for each temperature, however, if the temperature at which the pressure inside the system changed, the time to heat the module was increased to 20 min. Hydrogen was first released at 70 ∘ C. RESULTS: The loads of 5 and 10 kg were raised by 87 and 19 mm at 70 ∘ C, respectively. At 75 ∘ C, loads of 5, 10 and 15 kg were raised by 131, 70, and 15 mm, respectively. At 80 ∘ C, 5, 10, 15, and 20 kg were raised by 150, the end of the actuator, 83, 55, and 28 mm, respectively. CONCLUSIONS: The actuation system in this paper can be applied to assistive device and rehabilitation system for assisting the movement of daily life of the elderly or people with disability. Show more

Keywords: Hydrogen storage alloy, actuation system, rehabilitative system, Zr0.9Ti0.1Cr0.6Fe1.4

DOI: 10.3233/THC-218018

Citation: Technology and Health Care, vol. 29, no. S1, pp. 171-184, 2021

Authors: Liu, Shuang | Liu, Li | Pang, Ming

Article Type: Research Article

Abstract: BACKGROUND: Medical image security has been paid more attention in the medical field. OBJECTIVE: In order to achieve a higher security level of medical image encryption, this paper proposes a stream cipher enhanced logic mapping encryption method. METHODS: According to the theory of stream cipher, this method uses Chebyshev map to form encryption key. A series of coding operations are used to set the initial value before image chaos processing. Combining with logical mapping, the original image information is encrypted by chaos from X and Y dimensions. RESULTS: The experimental …results show that the NPCR value of the encrypted image is 0.9874 after the blood cells are encrypted. CONCLUSIONS: All four evaluation methods fully prove that this method has excellent encryption performance. Show more

Keywords: Medical image, image encryption, stream cipher, logical mapping

DOI: 10.3233/THC-218019

Citation: Technology and Health Care, vol. 29, no. S1, pp. 185-193, 2021

Authors: Li, Yaling | Chandra, Thakur Prakash | Song, Xiong | Nie, Liangui | Liu, Maojun | Yi, Jiali | Zheng, Xia | Chu, Chun | Yang, Jun

Article Type: Research Article

Abstract: OBJECTIVE: We waimed to investigate whether H 2 S can relieve the myocardial fibrosis caused by doxorubicin through Keap1-Nrf2. METHODS: Sprague-Dawley (SD) rats were randomly divided into four groups: normal control group (Control); DOX model group (DOX); H 2 S intervention model group (DOX+H 2 S); H 2 S control group (H 2 S). DOX and DOX+H 2 S group were injected with doxorubicin (3.0 mg/kg/time) intraperitoneally. Both of the Control group and H 2 …S groups were given normal saline in equal volume, 2 weeks later, DOX+H 2 S and H 2 S group were controlled with NaHS (56 μ mol/kg/d) through the abdominal cavity, while the Control and DOX group were injected with normal saline of the same dosage intraperitoneally. RESULTS: Myocardial injury and myocardial cell apoptosis were significantly increased, the H 2 S content in myocardial tissue was remarkably down-regulated, the expression levels of MDA, Keap1, caspase-3, caspase-9, TNF-α , IL1β , MMPs and TIMP-1 in rat myocardial tissue was significantly up-regulated (P < 0.05), and the expression levels of GSH, NQO1, Bcl-2 were down-regulated compared with those of control group. The above results can be reversed by the DOX+H 2 S group. There is no statistically significant difference between the Control group and the H 2 S control group. CONCLUSIONS: These results suggest that H 2 S can improve DOX-induced myocardial fibrosis in rats, and the keap1/Nrf2 signaling pathway, oxidative stress, inflammation, and apoptosis may be involved in the mechanism. Show more

Keywords: Hydrogen sulfide, doxorubicin, myocardial fibrosis, keap1/Nrf2, apoptosis

DOI: 10.3233/THC-218020

Citation: Technology and Health Care, vol. 29, no. S1, pp. 195-209, 2021

Authors: Chiang, Hsien-Wen | Wu, Re-Wen | Yin, Tsung-Cheng | Li, Jung-Hui | Wang, Yue-Sheng | Lin, Li-Han

Article Type: Research Article

Abstract: BACKGROUND: The purpose of this work was to evaluate orthopedic surgeons’ exposure to occupational radiation doses from scattering using a mobile flat panel C-arm X-ray machine at different standing positions during an intraoperative pedicle screw implantation. OBJECTIVE: Evaluate the radiation dose received by medical staff, by applying flat X-ray machine in surgical room during an intraoperative pedicle screw implantation. METHODS: A mobile flat-panel C-arm X-ray machine at a dedicated orthopedic operating room was used to image an anthropomorphic female phantom which was set in a prone position on the operating table. The X-ray …was projected horizontally, and 1 minute continuous fluoroscopy was used for lumbar spine and thoracolumbar spine during pedicle screw implantation. Scattering radiation doses to orthopedic surgeons were measured at different standing positions and body heights (50, 100, 150 cm above the ground) with and without limited collimations. RESULTS: The dose area product (DAP) in this experiment is normalized as 343 μ Gy⋅ m 2 . In the four areas, the lowest scattered radiation measured by DF is 11.2 vs. 0.7 μ Sv, outside and inside the lead suit, respectively, with or without restricted field, 150 cm above the ground, and the lowest scattered radiation dose inside the lead suit. It is 1.3 vs. 0.5 μ Sv. Comparing the highest dose of the TF at with the lowest dose of the DF, the average result is 73.7 vs. 11.1 μ Sv, P < 0.05. CONCLUSIONS: Using a mobile flat-panel C-arm X-ray machine during a pedicle screw implantation, the minimum scattering radiation to surgeons was found to be at the terminal DF area based on the analysis of the scattering doses orthopedic surgeons were exposed to. Show more

Keywords: Fluoroscopy, pedicle screw insertion, effective dose, scattered radiation

DOI: 10.3233/THC-218021

Citation: Technology and Health Care, vol. 29, no. S1, pp. 211-219, 2021

Authors: Niu, Junlong | Qin, Xiansheng | Bai, Jing | Li, Haiyan

Article Type: Research Article

Abstract: BACKGROUND: Nowadays, the total knee arthroplasty (TKA) technique plays an important role in surgical treatment for patients with severe knee osteoarthritis (OA). However, there are still several key issues such as promotion of osteotomy accuracy and prosthesis matching degree that need to be addressed. OBJECTIVE: It is significant to construct an accurate three-dimensional (3D) geometric anatomy structure model of subject-specific human knee joint with major bone and soft tissue structures, which greatly contributes to obtaining personalized osteotomy guide plate and suitable size of prosthesis. METHODS: Considering different soft tissue structures, magnetic resonance imaging …(MRI) scanning sequences involving two-dimensional (2D) spin echo (SE) sequence T1 weighted image (T1WI) and 3D SE sequence T2 weighted image (T2WI) fat suppression (FS) are selected. A 3D modeling methodology based on computed tomography (CT) and two sets of MRI images is proposed. RESULTS: According to the proposed methods of image segmentation and 3D model registration, a novel 3D knee joint model with high accuracy is finally constructed. Furthermore, remeshing is used to optimize the established model by adjusting the relevant parameters. CONCLUSIONS: The modeling results demonstrate that reconstruction and optimization model of 3D knee joint can clearly and accurately reflect the key characteristics, including anatomical structure and geometric morphology for each component. Show more

Keywords: 3D model reconstruction, human knee joint, 3D model registration, geometric model optimization, CT and MRI images

DOI: 10.3233/THC-218022

Citation: Technology and Health Care, vol. 29, no. S1, pp. 221-238, 2021

Authors: Wang, Qian | Du, Lijing | Hong, Jiana | Chen, Zhenlin | Liu, Huijian | Li, Shasha | Xiao, Xue | Yan, Shikai

Article Type: Research Article

Abstract: BACKGROUND: Shanmei Capsule is a famous preparation in China. However, the related mechanism of Shanmei Capsule against hyperlipidemia has yet to be revealed. OBJECTIVE: To elucidate underlying mechanism of Shanmei Capsule against hyperlipidemia through network pharmacology approach and molecular docking. METHODS: Active ingredients, targets of Shanmei Capsule as well as targets for hyperlipidemia were screened based on database. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed via Database for Annotation, Visualization, and Integrated Discovery (DAVID) 6.8 database. Ingredient-target-disease-pathway network was visualized utilizing Cytoscape …software and molecular docking was performed by Autodock Vina. RESULTS: Seventeen active ingredients in Shanmei Capsule were screened out with a closely connection with 34 hyperlipidemia-related targets. GO analysis revealed 40 biological processes, 5 cellular components and 29 molecular functions. A total of 15 signal pathways were enriched by KEGG pathway enrichment analysis. The docking results indicated that the binding activities of key ingredients for PPAR-α are equivalent to that of the positive drug lifibrate. CONCLUSIONS: The possible molecular mechanism mainly involved PPAR signaling pathway, Bile secretion and TNF signaling pathway via acting on MAPK8, PPARγ , MMP9, PPARα , FABP4 and NOS2 targets. Show more

Keywords: Shanmei Capsule, hyperlipidemia, network pharmacology, molecular docking

DOI: 10.3233/THC-218023

Citation: Technology and Health Care, vol. 29, no. S1, pp. 239-256, 2021

Authors: Wang, Panpan | Jing, Chenxi | Yu, Pei | Lu, Meng | Xu, Xiaobo | Pei, Qinglan | Yan, Fengmei

Article Type: Research Article

Abstract: BACKGROUND: Bupropion, one of the dual norepinephrine and dopamine reuptake inhibitors (NDRIs), is an aminoketone derivative performed effect in improving cognitive function for depression. However, its therapeutic effect is unsatisfactory due to poor clinical response, and there are only few derivatives in pre-clinical settings. OBJECTIVE: This work attempted to elucidate the essential structural features for the activity and designed a series of novel derivatives with good inhibitive ability, pharmacokinetic and medicinal chemistry properties. METHODS: The field-based QSAR of aminoketone derivatives of two targets were established based on docking poses, and the essential structural …properties for designing novel compounds were supplied by comparing contour maps. RESULTS: The selected two models performed good predictability and reliability with R 2 of 0.8479 and 0.8040 for training set, Q 2 of 0.7352 and 0.6266 for test set respectively, and the designed 29 novel derivatives performed no less than the highest active compound with good ADME/T pharmacokinetic properties and medicinal chemistry friendliness. CONCLUSIONS: Bulky groups in R 1 , bulky groups with weak hydrophobicity in R 3 , and potent hydrophobic substituted group with electronegative in R 2 from contour maps provided important insights for assessing and designing 29 novel NDRIs, which were considered as candidates for cognitive dysfunction with depression or other related neurodegenerative disorders. Show more

Keywords: Cognitive dysfunctions, field-based QSAR, drug design, pharmacokinetic properties

DOI: 10.3233/THC-218024

Citation: Technology and Health Care, vol. 29, no. S1, pp. 257-273, 2021

Authors: Li, Yantao

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Orienteering, which is one of the popular physical educations in the world, is an emerging sport integrating knowledge, competition, fun, and collaborative attributes. Although it started late in China, it has developed rapidly in recent years in most places except the northeast and northwest parts of the country. METHODS: In order to accelerate the development of orienteering in the northeast, given the climate and social characteristics of this area, we built a four-in-one orienteering development model including a theory course, a social component, a team, and events based on the longtime practice of …Harbin Engineering University. RESULTS: The research results have practical reference significance for orienteering at universities in China, as well as at universities and commercial clubs in other areas of the world. Show more

Keywords: Orienteering, physical education, practical research, universities of northeast China

DOI: 10.3233/THC-218025

Citation: Technology and Health Care, vol. 29, no. S1, pp. 275-286, 2021

Authors: Zhou, Zhiming | Huang, Haihui | Liang, Yong

Article Type: Research Article

Abstract: BACKGROUND: In genome research, it is particularly important to identify molecular biomarkers or signaling pathways related to phenotypes. Logistic regression model is a powerful discrimination method that can offer a clear statistical explanation and obtain the classification probability of classification label information. However, it is unable to fulfill biomarker selection. OBJECTIVE: The aim of this paper is to give the model efficient gene selection capability. METHODS: In this paper, we propose a new penalized logsum network-based regularization logistic regression model for gene selection and cancer classification. RESULTS: Experimental results on …simulated data sets show that our method is effective in the analysis of high-dimensional data. For a large data set, the proposed method has achieved 89.66% (training) and 90.02% (testing) AUC performances, which are, on average, 5.17% (training) and 4.49% (testing) better than mainstream methods. CONCLUSIONS: The proposed method can be considered a promising tool for gene selection and cancer classification of high-dimensional biological data. Show more

Keywords: Regularization, gene selection, log-sum penalty, network-based knowledge

DOI: 10.3233/THC-218026

Citation: Technology and Health Care, vol. 29, no. S1, pp. 287-295, 2021

Authors: Chen, Xiaohui | Sun, Wenbo | Xu, Dan | Ma, Jiaojiao | Xiao, Feng | Xu, Haibo

Article Type: Research Article

Abstract: BACKGROUND: Computed tomography (CT) imaging combined with artificial intelligence is important in the diagnosis and prognosis of lung diseases. OBJECTIVE: This study aimed to investigate temporal changes of quantitative CT findings in patients with COVID-19 in three clinic types, including moderate, severe, and non-survivors, and to predict severe cases in the early stage from the results. METHODS: One hundred and two patients with confirmed COVID-19 were included in this study. Based on the time interval between onset of symptoms and the CT scan, four stages were defined in this study: Stage-1 (0 ∼ …7 days); Stage-2 (8 ∼ 14 days); Stage-3 (15 ∼ 21days); Stage-4 (> 21 days). Eight parameters, the infection volume and percentage of the whole lung in four different Hounsfield (HU) ranges, ((- , - 750), [- 750, - 300), [- 300, 50) and [50, + )), were calculated and compared between different groups. RESULTS: The infection volume and percentage of four HU ranges peaked in Stage-2. The highest proportion of HU [- 750, 50) was found in the infected regions in non-survivors among three groups. CONCLUSIONS: The findings indicate rapid deterioration in the first week since the onset of symptoms in non-survivors. H higher proportion of HU [- 750, 50) in the lesion area might be a potential bio-marker for poor prognosis in patients with COVID-19. Show more

Keywords: COVID-19, quantitative CT parameters, temporal changes, early detection

DOI: 10.3233/THC-218027

Citation: Technology and Health Care, vol. 29, no. S1, pp. 297-309, 2021

Authors: Bao, Xinyu | Wang, Yan | Zhang, Song | Yang, Lin | Liu, Guoli | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Chen, Aiqing | Liu, Xiaohong | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: Fetal weight is one of the important indicators for judging whether fetal growth and development are normal. Fetal weight exceeding the normal range may lead to poor delivery outcomes. OBJECTIVE: We aimed to establish a personalized fetal growth curve in order to effectively monitor fetal growth during pregnancy. Fetal weight can be monitored while fetal growth and development are assessed. METHODS: This study retrospectively analyzed the birth weight and ultrasound database of 3,093 newborns delivered at normal term. The personalized fetal growth curve model was generated based on the birth weight formula …established by Gardosi combined with the proportional weight equation. RESULTS: (1) The average birth weight of the single fetus at normal term was 3,457g. (2) According to the regression results of the proportion of fetal weight in full-term pregnancy and gestational week, the proportional weight equation is Weight% = 500.9 - 51.60GA + 1.727GA 2 - 0.01718GA 3 (GA is gestational week), R 2 is 98%, P < 0.001. CONCLUSIONS: In this study, the normal birth weight of newborns and normal range of fetal weight can be estimated by using the personalized fetal growth curve model. Show more

Keywords: Fetal weight, fetal growth curve, birth weight, proportional weight equation, normal range

DOI: 10.3233/THC-218028

Citation: Technology and Health Care, vol. 29, no. S1, pp. 311-317, 2021

Authors: Bang, Sang Kwang | Seong, Ki Woong | Kim, Myoung Nam | Lee, Jyung Hyun

Article Type: Research Article

Abstract: BACKGOROUND AND OBJECTIVE: Cardiovascular disorders are increasing because of poor eating habits, excessive drinking, and lack of exercise. Some of the typical cardiovascular surgical procedures utilize catheters. Catheter-based procedures require the surgeons to have extensive experience and high proficiency at performing vascular interventions. However, the learning period to acquire such proficiency is lengthy and the opportunities for practical training and mastery are insufficient. Therefore, due to insufficient skill, dangerous situations with damage or rupture of the patient’s blood vessels may occur, thereby increasing the risk of medical accidents. Hence, it is necessary to have experience and proficiency for performing …vascular interventions. Thus, it is necessary to develop a simulator to shorten learning time and reduce medical accidents. METHODS: In this study, we developed a position detection system for the simulator to use physical models to learn cardiovascular surgical intervention techniques. The developed system uses changes in the output values of a Hall sensor based on the position of a permanent magnet. RESULTS AND CONCLUSIONS: From the changing output values, the distance calculation equation is derived, and the position of the permanent magnet is effectively estimated from the calculations. The performance of the position detecting system was tested, and the results proved that the system could be sufficiently used as a simulator. Show more

Keywords: Permanent magnet, hall sensor, hall effect, position detection, medical simulator

DOI: 10.3233/THC-218029

Citation: Technology and Health Care, vol. 29, no. S1, pp. 319-326, 2021

Authors: Meng, Hong | Yin, Yating | Wu, Wenhai | Liu, Yuhong | Li, Li | Dong, Yinmao | Fan, Yi | Li, Yue | He, Yifan

Article Type: Research Article

Abstract: BACKGROUND: The stratum corneum (SC) is the outermost layer of human skin and deemed as barrier against chemical exposure and water loss. Moisturizers have beneficial effects in treating dry skin, especially the SC. Confocal Raman spectroscopy (CRS) was used to evaluate the efficacy of moisturizers on skin hydration and penetration, with such agents posing inherent characteristics of being noninvasive, nondestructive, timesaving, and cost effective. Bionics vernix caseosa (BVC) cream mimics the composition of vernix caseosa (VC), which could protect the newborn skin. METHODS: This research applied CRS to evaluate the penetration depth and water content variation …during the intervention with two moisturizers, BVC cream and Vaseline. Volunteers received the 2 h application of BVC cream and Vaseline on the forearms. The evaluations on 0 h, 2 h, 4 h and 6 h were performed clinical assessment. Experimental data was processed by least square method and analysis of variance (ANOVA). RESULTS: The penetration depth of Vaseline was deeper than that of Bionics vernix caseosa cream. Specifically, BVC cream penetrated 18 μ m into human skin, while Vaseline penetrated at least 20 μ m. Compared with Vaseline, only BVC cream increased skin hydration, with a moisturizing effect lasting for 4 h. At 6 h, the Vaseline moisturizing effect decreased significantly. Show more

Keywords: Bionics vernix caseosa cream, Vaseline, confocal Raman spectroscopy, hydration, penetration

DOI: 10.3233/THC-218030

Citation: Technology and Health Care, vol. 29, no. S1, pp. 327-334, 2021

Authors: Zhang, Xiaoli | Zhang, Kuixing | Jiang, Mei | Yang, Lin

Article Type: Research Article

Abstract: BACKGROUND: Malignant lymphoma is a type of tumor that originated from the lymphohematopoietic system, with complex etiology, diverse pathological morphology, and classification. It takes a lot of time and energy for doctors to accurately determine the type of lymphoma by observing pathological images. OBJECTIVE: At present, an automatic classification technology is urgently needed to assist doctors in analyzing the type of lymphoma. METHODS: In this paper, by comparing the training results of the BP neural network and BP neural network optimized by genetic algorithm (GA-BP), adopts a deep residual neural network model (ResNet-50), …with 374 lymphoma pathology images as the experimental data set. After preprocessing the dataset by image flipping, color transformation, and other data enhancement methods, the data set is input into the ResNet-50 network model, and finally classified by the softmax layer. RESULTS: The training results showed that the classification accuracy was 98.63%. By comparing the classification effect of GA-BP and BP neural network, the accuracy of the network model proposed in this paper is improved. CONCLUSIONS: The network model can provide an objective basis for doctors to diagnose lymphoma types. Show more

Keywords: Lymphoma, pathological images, deep learning, Resnet-50, automatic classification

DOI: 10.3233/THC-218031

Citation: Technology and Health Care, vol. 29, no. S1, pp. 335-344, 2021

Authors: Wang, Yan | Bao, Xinyu | Zhang, Song | Yang, Lin | Liu, Guoli | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Chen, Aiqing | Liu, Xiaohong | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: Monitoring fetal weight during pregnancy has a guiding role in prenatal care. OBJECTIVE: To establish a personalized fetal growth curve for effectively monitoring fetal growth during pregnancy. METHODS: (1) This study retrospectively analyzed the birth weight database of 2,474 singleton newborns delivered normally at term. The personalized fetal growth curve model was formed by combining the estimating birth weight of newborns with the proportional weight formula. (2) Multiple linear stepwise regression method was used to estimate the birth weight of newborns. RESULTS: (1) Delivery gestational age, weight at first …visit, maternal height, pre-pregnancy body mass index, fetal sex, parity had significant effects on birth weight. Based on these parameters, the formula for calculating term optimal weight was obtained (R 2 = 22.8%, P < 0.001). (2) The personalized fetal growth curve was obtained according to the epidemiological factors input model of each pregnant woman. CONCLUSIONS: A model of personalized fetal growth curve can be established, and be used to evaluate fetal growth and development through estimated fetal weight monitoring. Show more

Keywords: Fetal weight, growth charts, personal health services

DOI: 10.3233/THC-218032

Citation: Technology and Health Care, vol. 29, no. S1, pp. 345-350, 2021

Authors: Li, Chunrui | Liu, Manjiao | An, Yunhe | Tian, Yanjie | Guan, Di | Wu, Huijuan | Pei, Zhiyong

Article Type: Research Article

Abstract: BACKGROUND: Type 2 diabetes mellitus (T2DM) is a complex disease with high incidence and serious harm associated with polygenic determination. This study aimed to develop a predictive model so as to assess the risk of T2DM and apply it to health care and disease prevention in northern China. OBJECTIVE: Based on genotyping results, a risk warning model for type 2 diabetes was established. METHODS: Blood samples of 1042 patients with T2DM in northern China were collected. Multiplex polymerase chain reaction and high-throughput sequencing (NGS) techniques were used to design the amplification-based targeted sequencing …panel to sequence the 21 T2DM susceptibility genes. RESULT: The related key gene KQT-like subfamily member 1 played an important role in the T2DM risk model, and single-nucleotide polymorphism rs2237892 was highly significant, with a P value of 1.2 × 10 - 5 . CONCLUSIONS: Susceptibility genes in different populations were examined, and a model was developed to assess the risk-based genetic analysis. The performance of the model reached 92.8%. Show more

Keywords: Gene, health care, logistic regression, risk model, type 2 diabetes mellitus

DOI: 10.3233/THC-218033

Citation: Technology and Health Care, vol. 29, no. S1, pp. 351-358, 2021

Authors: Jung, Gihoon | Park, Chanhee | Hwang, Jongseok | You, Joshua (Sung) H. | Yi, Chunghwi | Choi, Woochol Joseph

Article Type: Research Article

Abstract: BACKGROUND: While respiratory and core-postural stabilisation has recently gained a widespread acceptance to improve pulmonary function and dyspena, the therapeutic effects of and rationale underlying the use of respiratory and core-postural stabilisation in the management of patients with chronic obstructive pulmonary disease have not been investigated. OBJECTIVE: This study aimed to compare the effects of abdominal breathing and respiratory and core-postural stabilisation on diaphragmatic movement and pulmonary function. METHODS: Fourteen patients with moderate chronic obstructive pulmonary disease were randomly assigned to either the respiratory and core-postural stabilisation or abdominal breathing group. All patients …underwent fluoroscopy-guided chest X-ray imaging and pulmonary function tests before and after the interventions; the modified Medical Research Council questionnaire was also administered before and after the interventions. Six sessions of either intervention were consistently provided. The obtained data were assessed using independent t -tests and Wilcoxon signed-rank test with a significance threshold of P < 0.05. RESULTS: Respiratory and core-postural stabilisation was more effective in increasing diaphragmatic movements than abdominal breathing (P < 0.05). Pulmonary function tests revealed more significant differences in the forced vital capacity (FVC(%) predicted ) only after respiratory and core-postural stabilisation (P = 0.004). The Medical Research Council questionnaire score was significantly different within the Respiratory and core-postural stabilisation group (P = 0.014). CONCLUSIONS: Our novel results suggest that the effects of respiratory and core-postural stabilisation breathing on diaphragmatic movement and pulmonary function were superior to those of abdominal breathing in patients with chronic obstructive pulmonary disease. Show more

Keywords: Chronic obstructive pulmonary disease, dyspnea, breathing training, core stabilisation, pulmonary function

DOI: 10.3233/THC-218034

Citation: Technology and Health Care, vol. 29, no. S1, pp. 359-366, 2021

Authors: Wu, Liang | Shi, Ping | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: The delayed blood pressure recovery (BPR) at post-exercise has been in association with a major risk of cardiovascular disease and death. OBJECTIVE: The study focused on evaluating the systolic and diastolic blood pressure recovery (SBPR, DBPR) and the autonomic modulation following treadmill exercise in healthy young adults. Although considerable literature had been published about BPR and HRV, the association between BPR and ultra-short-term HRV has not yet been completely described. METHODS: Fifteen subjects performed exercise with three different intensities on a treadmill, the speed was 6 km/h, 9 km/h, 12 km/h, respectively. SBP and DBP …was measured per 30 s in each trial. The synchronous 5-min electrocardiogram (ECG) signals were recorded and HRV 30s parameters including SDNN 30s , RMSSD 30s , SDNN 30s /RMSSD 30s , SD1 30s , SD2 30s and SD1 30s /SD2 30s were calculated every 30 s periods in 5 min ECG signals to match the corresponding BPR. RESULTS: The intraclass correlation coefficient (ICC) values and the Bland-Altman plots indicated good consistency and repeatability between HRV 30s and HRV 5min at three post-exercise trials, with most ICC values > 0.75. Besides, SBPR and DBPR generally decreased and returned to the Rest level in 5 mins. The Spearman correlation coefficients showed strong relationships between BPR and HRV 30s sympathetic-vagal balance parameters, i.e., ratio SDNN/RMSSD and ratio SD1/SD2. CONCLUSIONS: These observations represented a new insight into the cardiovascular regulation at post-exercise, which could contribute to physical exercise areas in the future. Show more

Keywords: Blood pressure recovery, autonomic modulation, heart rate variability, electrocardiogram

DOI: 10.3233/THC-218035

Citation: Technology and Health Care, vol. 29, no. S1, pp. 367-376, 2021

Authors: Yoon, Hyunsik | Park, Chanhee | Park, Ilbong | Kim, Kyoungtae | Cha, Youngjoo

Article Type: Research Article

Abstract: BACKGROUND: Impaired sensory in acute stroke patients results in dynamic balance, gait and activities of daily living (ADL) impairment. OBJECTIVE: The aim of present study was to examine the correlation between somatosensory-evoked potential (SSEP) parameters and motor recovery in balance, gait and ADL performance in hemiparetic stroke survivors. METHODS: One hundred and one participants with hemiparetic stroke (43 males, 58 females; mean age, 6538 ± 1222 years; post-stroke duration, 199 ± 0.74 month) participated in this study. The Electro Synergy system (Viasys Healthcare; San Diego, CA, USA) …was applied to measure SSEP measurement. The 101 stroke survivors were divided into three groups consistent with their SSEP results: sensory normal group; sensory impaired group; sensory absent group. All the subject participated the inpatient rehabilitation intervention for 4 weeks. Analyses of variance (ANOVA) were used to verify the group difference among the three groups after the treatment. RESULTS: ANOVA revealed the significant difference (p < 0.01). The Scheffe test demonstrated that the sensory normal group showed greater increasement in Modified Barthel Index (MBI), Fugl-Myer Assessment (FMA), Trunk Impairment Scale (TIS), Berg Balance Scale (BBS) and Functional Ambulation Category (FAC) scores than the sensory impaired and absent group (p < 0.05). CONCLUSIONS: Our research provides therapeutic evidence that correlation of somatosensory functions on motor recovery, balance, gait, and ADL in patients with hemiplegic stroke. Show more

Keywords: Somatosensory-evoked potential, neurorehabilitation, balance, gait, ADL

DOI: 10.3233/THC-218036

Citation: Technology and Health Care, vol. 29, no. S1, pp. 377-383, 2021

Authors: Sun, Shenshen | Ren, Huizhi | Dan, Tian | Wei, Wu

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: At present, there are many methods for pathological lung segmentation. However, there are still two unresolved problems. (1) The search steps in traditional ASM is a least square optimization method, which is sensitive to outlier marker points, and it makes the profile update to the transition area in the middle of normal lung tissue and tumor rather than a true lung contour. (2) If the noise images exist in the training dataset, the corrected shape model cannot be constructed. METHODS: To solve the first problem, we proposed a new ASM algorithm. Firstly, we …detected these outlier marker points by a distance method, and then the different searching functions to the abnormal and normal marker points are applied. To solve the second problem, robust principal component analysis (RPCA) of low rank theory can remove noise, so the proposed method combines RPCA instead of PCA with ASM to solve this problem. Low rank decompose for marker points matrix of training dataset and covariance matrix of PCA will be done before segmentation using ASM. RESULTS: Using the proposed method to segment 122 lung images with juxta-pleural tumors of EMPIRE10 database, got the overlap rate with the gold standard as 94.5%. While the accuracy of ASM based on PCA is only 69.5%. CONCLUSIONS: The results showed that when the noise sample is contained in the training sample set, a good segmentation result for the lungs with juxta-pleural tumors can be obtained by the ASM based on RPCA. Show more

Keywords: Abnormal lung regions, active shape model, segmentation, outlier marker point, search function, low rank, robust principal component analysis

DOI: 10.3233/THC-218037

Citation: Technology and Health Care, vol. 29, no. S1, pp. 385-398, 2021

Authors: Lee, Jyung Hyun | Kim, Dong Wook | Seong, Ki Woong | Kim, Myoung Nam | Cho, Jin-Ho

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Recently, with the increase in the population of hearing impaired people, various types of hearing aids have been rapidly developed. In particular, a fully implantable middle ear hearing device (F-IMEHD) is developed for people with sensorineural hearing loss. The F-IMEHD system comprises an implantable microphone, a transducer, and a signal processor. The signal processor should have a small size and consume less power for implantation in a human body. METHODS: In this study, we designed and fabricated a signal-processing chip using the modified FFT algorithm. This algorithm was developed focusing on eliminating time delay and …system complexity in the transform process. The designed signal-processing chip comprises a 4-channel WDRC, a fitting memory, a communication 1control part, and a pulse density modulator. Each channel is separated using a 64-point fast Fourier transform (FFT) method and the gain value is matched using the fitting table in the fitting memory. RESULTS AND CONCLUSION: The chip was designed by Verilog-HDL and the designed HDL codes were verified by Modelsim-PE 10.3 (Mentor graphics, USA). The chip was fabricated using a 0.18 μ m CMOS process (SMIC, China). Experiments were performed on a cadaver to verify the performance of the fabricated chip. Show more

Keywords: Fully implantable middle ear hearing device, wide dynamic range, CMOS process, Verilog-HDL, Cadaver experiment

DOI: 10.3233/THC-218038

Citation: Technology and Health Care, vol. 29, no. S1, pp. 399-413, 2021

Authors: Wang, Ling | Zhi, Xu | Ke, Haokun | Lv, Sainan | He, Ning | Zhou, Hong | Hao, Hongxia

Article Type: Research Article

Abstract: BACKGROUND: In recent decades, illicit drug testing has become a high priority area in law enforcement and forensic analysis. OBJECTIVE: Since patents are the largest source of technical information in the world, patent database analysis for illicit drug testing is extremely important to effectively promote the development and protection of the related intellectual property rights. METHODS: In the present study, we first retrieve a database of 1732 drug detection patents using keywords and logical expressions related to the title, abstract, and claims, and subsequently discuss the current global patent statistics in detail. RESULTS: …The relevant patent information is presented, including patent application quantity, filing country, ownership, and technical field. CONCLUSIONS: Finally, we summarize the current development trend in drug testing and propose several suggestions focused on the bottleneck of analytical techniques. Show more

Keywords: Drug detection, patent statistics, patent analysis, development trend

DOI: 10.3233/THC-218039

Citation: Technology and Health Care, vol. 29, no. S1, pp. 415-425, 2021

Authors: Sun, Ge | Xu, Qi | Zhang, Song | Yang, Lin | Liu, Guoli | Meng, Yu | Chen, Aiqing | Yang, Yimin | Li, Xuwen | Hao, Dongmei | Liu, Xiaohong | Shao, Jing

Article Type: Research Article

Abstract: BACKGROUND: Placental growth factor (PlGF), one of the biomarkers, has a certain predictive effect on hypertensive disorders in pregnancy (HDP). OBJECTIVE: To study the HDP prediction effect of different methods for variable selection and modeling for models containing PlGF. METHODS: For the model containing PlGF, the appropriate range of PlGF parameters needed to be selected. Step-logistic regression and lasso were used to compare the model effect of twice range selection. The PlGF model with good predictive effect and appropriate detecting gestational age was selected for the final prediction. RESULTS: The effect of the …model containing PlGF tested at 15–16 weeks was better than the PlGF value without comprehensive screening. The sensitivity of both methods was over 92%. By comprehensive comparison, the final model of lasso method in this study was more effective. CONCLUSIONS: In this study, a variety of methods were used to screen models containing PlGF parameters. According to clinical needs and model effects, the optimal HDP prediction model with PlGF parameters in the second trimester of 15–26 weeks of pregnancy was finally selected. Show more

Keywords: Placental growth factor, model parameters, variable selection

DOI: 10.3233/THC-218040

Citation: Technology and Health Care, vol. 29, no. S1, pp. 427-432, 2021

Authors: Jeon, Hyeong-Min | Lee, Ki-Kwang | Lee, Jun-Young | Shin, Ju-Hwan | Eom, Gwang-Moon

Article Type: Research Article

Abstract: BACKGROUND: Joint loads in different walking strategies during stair descent have been investigated in terms of the joint moment in association with the risk of osteoarthritis. However, the absorption mechanisms of the potential energy loss are not known. OBJECTIVE: This study aims to compare the mechanical energy absorptions in lower limb joints in different initial foot contact strategies. METHODS: Nineteen young subjects walked down on instrumented stairs with two different strategies, i.e., forefoot and rearfoot strike. Power and energy at lower limb joints during stance phase were compared between strategies. RESULTS: …Lower limb joints absorbed 73 ± 11% of the potential energy released by descending stairs and there was no difference between strategies. Rearfoot strategy absorbed less energy than forefoot strategy at the ankle joint in the 1st phase, which was compensated mainly by more energy absorption at the knee in the 2nd phase and less energy generation at the hip joints in the 3rd phase. CONCLUSION: The results suggest that a leg absorbs most of the potential energy while descending stairs irrespective of the walking strategies and that any reduction of energy absorption at one joint is compensated by other joints. Greater energy absorption at the knee joint compared to the other joints suggests high burden of knee joint muscles and connective tissues during stair-descent, which is even more significant for the rearfoot strike strategy. Show more

Keywords: Energy absorption, mechanism, stair descent, foot strike strategy, osteoarthritis

DOI: 10.3233/THC-218041

Citation: Technology and Health Care, vol. 29, no. S1, pp. 433-440, 2021

Authors: Ding, Hongjun | Li, Yanju | Zhang, Yanlong | Meng, Huipeng | Wang, Keqiang | Sun, Qian | Li, Xichuan | Dong, Huajiang | Chen, Long | He, Feng

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: We aimed to further study the role of Myelin Transcription Factor 1(MyT1) in tumor and other diseases and epigenetic regulation, and better understand the regulatory mechanism of MyT1. METHODS: Using bioinformatics analysis, the structure and function of MyT1sequence were predicted and analyzed using bioinformatics analysis, and providing a theoretical basis for further experimental verification and understanding the regulatory mechanism of MyT1. The first, second and third-level structures of MyT1 were predicted and analyzed by bioinformatics analysis tools. RESULTS: MyT1 is found to be an unstable hydrophilic protein, rather than a secretory …protein, with no signal peptide or trans-membrane domain; total amino acids located on the surface of the cell membrane. It contains seven zinc finger domains structurally. At sub-cellular level, MyT1 is localized in the nucleus. The phosphorylation site mainly exists in serine, and its secondary structure is mainly composed of random coils and alpha helices; the three-dimensional structure is analyzed by modeling. CONCLUSIONS: In this study, the structure and function of MyT1 protein were predicted, thereby providing a basis for subsequent expression analysis and functional research; it laid the foundation for further investigation of the molecular mechanism involved in the development of diseases. Show more

Keywords: Transcription Factor 1, MyT1, structure, function, bioinformatics

DOI: 10.3233/THC-218042

Citation: Technology and Health Care, vol. 29, no. S1, pp. 441-453, 2021

Authors: Hu, Bing | Wang, Zhizhi | Xu, Minbo | Zhu, Luyao | Wang, Dingjiang

Article Type: Research Article

Abstract: BACKGROUND: The selection of optimal target areas in the surgical treatment of epilepsy is always a difficult problem in medicine. OBJECTIVE: We employed a theoretical calculation model to explore the control mechanism of seizures by an external voltage stimulus acting in different nerve nuclei. METHODS: Theoretical analysis and numerical simulation were combined. RESULTS: The globus pallidus, excitatory pyramidal neurons, striatal D1 neurons, thalamic reticular nucleus and specific relay nuclei were selected, we analyzed that the electrical stimulation has different effects in these target areas. CONCLUSIONS: The data selected were reasonable …in study, the results may give a theoretical support for similar studies in clinical. Show more

Keywords: Epilepsy, a computing network, voltage stimulation, nerve nuclei

DOI: 10.3233/THC-218043

Citation: Technology and Health Care, vol. 29, no. S1, pp. 455-461, 2021

Authors: Zhang, Liang | Ji, Zhenyu

Article Type: Research Article

Abstract: BACKGROUND: Wound monitoring is very meaningful for the clinical research, diagnosis and treatment. But the existing wound monitoring technology is hard to meet the needs of modern medical care in terms of real-time, non-invasive and anti-interference. OBJECTIVE: To solve this problem, this paper proposed a new kind of monitoring technology based on the co-planar waveguide transmission line theory and assessed the application value of this method as a wound monitoring technology. METHODS: The simplified wound model included the skin, fat, muscle, tissue fluid and bandage and a new co-planar waveguide sensor were designed and …established. All of the simulation was achieved in the electromagnetic special software. The data processing method was based on the transmission line theory. RESULTS: Detailed analyses of the results from the simulation were conducted. The sensor has a good monitoring effect in the low frequency band. The monitoring results could be influenced by the thickness of the bandage outside the wound. The thickness of the bandage should not be larger than 10 mm. The effective monitoring area of the sensor is 30 × 20 mm 2 . CONCLUSIONS: The proposed sensor based on the CPW transmission principle in this paper has good wound monitoring potential. Show more

Keywords: CPW, electromagnetic field, impedance, monitoring technology, wound healing

DOI: 10.3233/THC-218044

Citation: Technology and Health Care, vol. 29, no. S1, pp. 463-473, 2021

Authors: Petryshak, Bohdan | Kachko, Illia | Maksymenko, Mykola | Dobosevych, Oles

Article Type: Research Article

Abstract: BACKGROUND: Premature ventricular contraction (PVC) is among the most frequently occurring types of arrhythmias. Existing approaches for automated PVC identification suffer from a range of disadvantages related to hand-crafted features and benchmarking on datasets with a tiny sample of PVC beats. OBJECTIVE: The main objective is to address the drawbacks described above in the proposed framework, which takes a raw ECG signal as an input and localizes R peaks of the PVC beats. METHODS: Our method consists of two neural networks. First, an encoder-decoder architecture trained on PVC-rich dataset localizes the R peak …of both Normal and anomalous heartbeats. Provided R peaks positions, our CardioIncNet model does the delineation of healthy versus PVC beats. RESULTS: We have performed an extensive evaluation of our pipeline with both single- and cross-dataset paradigms on three public datasets. Our approach results in over 0.99 and 0.979 F1-measure on both single- and cross-dataset paradigms for R peaks localization task and above 0.96 and 0.85 F1 score for the PVC beats classification task. CONCLUSIONS: We have shown a method that provides robust performance beyond the beats of Normal nature and clearly outperforms classical algorithms both in the case of a single and cross-dataset evaluation. We provide a Github 1 repository for the reproduction of the results. Show more

Keywords: Electrocardiography, PVC identification, ECG segmentation, ECG classification

DOI: 10.3233/THC-218045

Citation: Technology and Health Care, vol. 29, no. S1, pp. 475-486, 2021

Authors: Wen, Junling | Jiang, Miao | Wang, Yihui | Huang, Na | Gao, Ming

Article Type: Research Article

Abstract: BACKGROUND: Auricular acupuncture point (AAP) therapy is an important part of traditional Chinese medicine and is featured with a sophisticated location method based on the division of auricular subzones. OBJECTIVE: This study aimed to realize the automatic computerized division on the relatively small area of the research object which has long been considered difficult. METHOD: We propose a novel method based on the active shape model algorithm and the “Name and location of AAPs” issued by the World Federation of Acupuncture-Moxibustion Societies (WFAS STANDARD-002:2013). RESULTS: The experimental results showed that the subzones of the …auricle could be divided for the location of AAPs using the proposed method automatically and efficiently. The average Hausdorff distance and Euclid distance of landmarks between the machine and the manual positioning were 6.28 ± 0.50 and 6.67 ± 0.59, respectively. CONCLUSIONS: The proposed method might provide benefits for further development of therapeutic and educational applications of AAPs. Show more

Keywords: Active shape model, auricular division, auricular acupuncture point, image processing, Traditional Chinese medicine

DOI: 10.3233/THC-218046

Citation: Technology and Health Care, vol. 29, no. S1, pp. 487-495, 2021

Authors: Wang, Mengjie | Chen, Weiyang

Article Type: Research Article

Abstract: BACKGROUND: Age is an essential feature of people, so the study of facial aging should have particular significance. OBJECTIVE: The purpose of this study is to improve the performance of age prediction by combining facial landmarks and texture features. METHODS: We first measure the distribution of each texture feature. From a geometric point of view, facial feature points will change with age, so it is essential to study facial feature points. We annotate the facial feature points, label the corresponding feature point coordinates, and then use the coordinates of feature points and texture features to predict …the age. RESULTS: We use the Support Vector Machine regression prediction method to predict the age based on the extracted texture features and landmarks. Compared with facial texture features, the prediction results based on facial landmarks are better. This suggests that the facial morphological features contained in facial landmarks can reflect facial age better than facial texture features. Combined with facial landmarks and texture features, the performance of age prediction can be improved. CONCLUSIONS: According to the experimental results, we can conclude that texture features combined with facial landmarks are useful for age prediction. Show more

Keywords: Facial aging, texture features, age estimation, facial landmarks, regression analysis

DOI: 10.3233/THC-218047

Citation: Technology and Health Care, vol. 29, no. S1, pp. 497-507, 2021

Authors: Yan, Gen | Yi, Meizhi | Li, Shengkai | Yang, Lin | Dai, Zhuozhi | Xuan, Yinghua | Wu, Renhua

Article Type: Research Article

Abstract: BACKGROUND: The determination of tumor peripheral is of great significance in clinical diagnosis and treatment. OBJECTIVE: In this study, we aim to obtain the metabolic condition in tumor peripheral of gliomas in vivo at 7T. METHODS: C6 glioma cells were implanted into the right basal ganglia of Sprague-Dawley (SD) rats under stereotactic guided to create the glioma models. The models were sequentially undergone MRI and MRS examination on an 7T MR scanner designed for animals 7 days after the operation. Neuro metabolites were investigated from the center of the tumor, solid part of the …tumor, peritumoral region, and contralateral white matter, and be quantified using the LCmodel software. Glial fibrillary acidic protein (GFAP) immunohistochemistry and conventional hematoxylin and eosin (HE) staining were performed after the imaging protocol. RESULTS: Our results found that the inositol (Ins) and taurine (Tau) significantly defected in tumor peripheral compared to both tumor solid and normal tissues (P < 0.05). In contrast, the glutamate and glutamine (Glx) escalated and peaked at the tumor peripheral (P < 0.05). CONCLUSIONS: This study revealed that Ins, Tau, and Glx have the potential to provide specific biomarkers for the location of tumor peripheral of glioma. Show more

Keywords: Glioma, tumor metabolism, Magnetic resonance imaging, Magnetic resonance spectroscopy (MRS)

DOI: 10.3233/THC-218048

Citation: Technology and Health Care, vol. 29, no. S1, pp. 509-517, 2021

Authors: Lee, Sang-Hong

Article Type: Research Article

Abstract: BACKGROUND: Feature selection is a technology that improves the performance result by eliminating overlapping or unrelated features. OBJECTIVE: To improve the performance result, this study proposes a new feature selection that uses the distance between the centers. METHODS: This study uses the distance between the centers of gravity (DBCG) of the bounded sum of the weighted fuzzy memberships (BSWFMs) supported by a neural network with weighted fuzzy membership (NEWFM). RESULTS: Using distance-based feature selection, 22 minimum features with a high performance result are selected, with the shortest DBCG of BSWFMs …removed individually from the initial 24 features. The NEWFM used 22 minimum features as inputs to obtain a sensitivity, accuracy, and specificity of 99.3%, 99.5%, and 99.7%, respectively. CONCLUSIONS: In this study, only the mean DBCG is used to select the features; in the future, however, it will be necessary to incorporate statistical methods such as the standard deviation, maximum, and normal distribution. Show more

Keywords: Feature selection, neuro fuzzy networks, EEG signal, epileptic seizure, wavelet transforms

DOI: 10.3233/THC-218049

Citation: Technology and Health Care, vol. 29, no. S1, pp. 519-529, 2021