Technology and Health Care - Volume 31, issue 1

Authors: Zhang, Wenjuan | Guan, Ning | Zhang, Xiumei | Liu, Yizhen | Gao, Xiuqiu | Wang, Linyuan

Article Type: Research Article

Abstract: BACKGROUND: Macrophages commonly exist in two distinct subsets in different microenvironments: classically activated macrophages (M1) and alternatively activated macrophages (M2). The imbalance of M1-M2 macrophage polarization is often related to various diseases or inflammatory states. OBJECTIVE: The purpose of this study was to determine whether there is an imbalance in the expression of M1 and M2 macrophage-related cytokines in severe chronic periodontitis. METHODS: A total of 30 clinical specimens, including severe chronic periodontitis tissues (n = 15) and healthy control tissues (n = …15), were used in this study. Reverse transcription polymerase chain reaction (RT-PCR) and Western blot methods were used to detect the mRNA and protein expression levels of M1 macrophage-related cytokines (inducible nitric oxide synthase (iNOS) and signal transducer and activator of transcription 1 (STAT1)) and M2 macrophage-related cytokines (arginase-1 (Arg-1) and STAT6), respectively. RESULTS: The mRNA and protein expression levels of M1 macrophage-related cytokines (iNOS and STAT1) and M2 macrophage-related cytokines (Arg-1 and STAT6) were significantly increased in severe chronic periodontitis patients. In addition, the ratios of iNOS/Arg-1 and STAT1/STAT6 in the severe chronic periodontitis group were also significantly increased (P < 0.01). CONCLUSION: The imbalance of M1/M2 macrophages exists in the pathogenesis of severe chronic periodontitis, and has a tendency towards M1 polarization. Therefore, maintaining the immune balance of M1/M2 macrophages may be a novel therapeutic alternative for the management of severe chronic periodontitis. Show more

Keywords: Severe chronic periodontitis, macrophages, cytokine, M1, M2

DOI: 10.3233/THC-220092

Citation: Technology and Health Care, vol. 31, no. 1, pp. 117-124, 2023

Authors: Guo, Xinwei | Zhao, Hongyan | Zhang, Zhimin

Article Type: Research Article

Abstract: BACKGROUND: The similar elastic modulus of resin-matrix ceramics to dentin has resulted in their recent widespread application clinically. Nevertheless, the bacterial environment of oral cavity can degrade the resin composite. OBJECTIVE: The objective was to analyse the effect of S. mutans and its fluoride-resistant strains on the adhesion of three CAD/CAM ceramics. METHODS: S. mutans UA159 (UA) was identified, and its fluoride-resistant strain (FR) was induced. For crack observation, three kinds of CAD/CAM ceramics (IPS Empress, Lava Ultimate and Vita Enamic) were bonded with tooth complex (enamel, dentin and flowable resin) through adhesive. …For micro-tensile test, ceramics were bonded with flowable resin, and cut into strip test pieces. Then specimens were immersed into the UA, FR and the control solution (BHI) separately for 14 d. Ceramic-adhesive interface and adhesive-tooth complex interface were observed and analyzed through electron microscope and stereomicroscope. Micro-tensile test was conducted. RESULTS: Specimens in bacterial solutions had more cracks and comparatively weaker micro-tensile strength than those in BHI. In ceramic-adhesive interface, Lava Ultimate produced the most cracks. In adhesive-tooth complex interface, adhesive-dentin produced the most cracks. Meanwhile, IPS Empress had the strongest micro-tensile strength when bonded with resin. CONCLUSIONS: S. mutans and its fluoride resistant strain can cause cracks in the bonding of ceramics and dental tissue, especially resin-matrix ceramic and dentin, and weaken the bonding strength between ceramics and resin. Show more

Keywords: Computer-aided design, resin, ceramic, Streptococcus mutans, fluoride, tensile strength

DOI: 10.3233/THC-220117

Citation: Technology and Health Care, vol. 31, no. 1, pp. 125-139, 2023

Authors: Wu, Zhongping | Huang, Ruibo | Zhong, Liping | Zheng, Jinping | Gao, Yi

Article Type: Research Article

Abstract: BACKGROUND: Peak expiratory flow meters (PEFMs) have emerged as primary tools used for diagnosing and monitoring a range of respiratory diseases including asthma and chronic obstructive pulmonary disease, and the performance of these meters will thus impact disease evaluation. OBJECTIVE: The aim of this study was therefore to assess the technical performance of mechanical and electronic PEFMs commonly used in clinical practice. METHODS: The accuracy, repeatability, airflow resistance, frequency response, and linearity of five electronic and seven mechanical PEFMs were measured using a standard flow/volume simulator in accordance with nine A-waveforms and three …B-waveforms defined in ISO 23747:2015 issued by the International Standards Organization (ISO). RESULTS: The accuracy, repeatability, linearity, airflow resistance, and frequency response pass rates for these 12 different PEFM brands were 41.67%, 75.00%, 50.00%, 75.00%, and 25.00%, respectively. Just 16.67% (2/12) of the tested PEFMs met all evaluated criteria, whereas the remaining PEFMs partially met these criteria. There were no significant differences between the two tested PEFM types in the low flow rate waveform test (P > 0.05), although there were significant differences in the medium and high flow rate waveform test (P < 0.05). In addition, the overall PEFMs test had poor accuracy and good repeatability, although most of the repeatability errors occurred in the BTPS state. CONCLUSION: PEFMs commonly used in clinical settings exhibit variable technical performance, and relevant departments need to strengthen PEFM quality control and management in China. Show more

Keywords: Peak expiratory flow meter, standard flow/volume simulator, quality control, ISO 23747:2015

DOI: 10.3233/THC-220122

Citation: Technology and Health Care, vol. 31, no. 1, pp. 141-149, 2023

Authors: Mei, Hai-Long | Yao, Yao | Huang, Ying | Zhou, Ke | Wang, Zhi-Lie | Chen, Hou-Qiong

Article Type: Research Article

Abstract: BACKGROUND: Patellar fractures are common intra-articular fractures. Arthroscopically assisted reduction and fixation has been shown to advantageous in the treatment of patellar fractures. OBJECTIVE: This study aimed to investigate the effect of arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation on the treatment of patellar fractures. METHODS: Thirty-four patients with acute closed patellar fractures enrolled in the study and were managed by arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation under epidural anesthesia. Among these patients, 24 were males, and ten were females. The mean age of these patients …was 38 ± 0.8 years (range: 25–62 years). Of these patients, 20 had transverse fractures, five had longitudinal fractures, four had marginal oblique fractures, and five had multifragmentary upper and lower pole. Fracture causes: 25 were caused by falls, and nine were caused by traffic accidents. The time from injury to operation was 6–48 hours, with an average of 23 hours. The average post-operative follow-up was 12.8 months, and at the end of follow-up, the Boestman scoring system was used to evaluate knee joint function. RESULTS: All the wounds healed by first intention, and no infections, skin necrosis, joint stiffness, or other complications occurred. Three months after operation, the tension band wire had broken in one patient, but the fracture had united, and this did not affect the prognosis. In eight patients, the average circumference at 10 cm above the patella was 0.6 cm less on the injured side than on the contralateral side. The average Boestman score was 27.5. The final result was excellent in 25 patients, good in eight patients, and acceptable in one patient. CONCLUSION: Arthroscopic management of simple patellar fracture with percutaneous minimally invasive Kirschner wire tension band fixation is less invasive than open operation, while still leading to firm fixation, and is conducive to early functional training and functional recovery, and thus is an effective method of management for patellar fractures. Show more

Keywords: Patellar fracture, arthroscopy, percutaneous, tension band, internal fixation

DOI: 10.3233/THC-220133

Citation: Technology and Health Care, vol. 31, no. 1, pp. 151-156, 2023

Authors: Seemann, R.J. | Mielke, A.M. | Glauert, D.L. | Gehlen, T. | Poncette, A.S. | Mosch, L.K. | Back, D.A.

Article Type: Research Article

Abstract: BACKGROUND: Digital competencies are more and more required in everyday work, and training future healthcare professionals in digital health is highly important. OBJECTIVE: Aim of this study was to assess medical students’ gain of knowledge by participation in a teaching module “Digital Health”, and to evaluate their attitudes towards digital health and its role in medical education. METHODS: Students of the module were asked to complete a questionnaire and a multiple-choice-test before and after completing the classes. Students of the same educational level in different modules served as reference group. RESULTS: …34 students took part (n = 17 “Digital Health group”; n = 17 “reference group”). There was no significant difference in pre-existing knowledge between the groups. After having completed the module, participants reached significantly higher scores, compared to their preexisting knowledge (p < 0.05) and the reference group (p < 0.05). Most students found that digital medicine is not sufficiently represented in undergraduate medical education, but will influence everyday work of physicians in the next five years. CONCLUSIONS: Students showed a high awareness for the impact of digital health on physicians’ work. The results suggest that the format can sufficiently transfer knowledge about digital health. Teaching of digital knowledge and competencies should be firmly implemented into medical education to form digitally competent future doctors. Show more

Keywords: Digital health, Undergraduate Medical Education, digital competencies, medical students, data literacy

DOI: 10.3233/THC-220138

Citation: Technology and Health Care, vol. 31, no. 1, pp. 157-164, 2023

Authors: Deng, Chengliang | Adu, Jianhua | Xie, Shenghua | Li, Zhaohuan | Meng, Qingguo | Zhang, Qingfeng | Yin, Lixue | Peng, Bo

Article Type: Research Article

Abstract: BACKGROUND: Carotid atherosclerosis plaque rupture is an important cause of myocardial infarction and stroke. The effective segmentation of ultrasound images of carotid atherosclerotic plaques aids clinicians to accurately assess plaque stability. At present, this procedure relies mainly on the experience of the medical practitioner to manually segment the ultrasound image of the carotid atherosclerotic plaque. This method is also time-consuming. OBJECTIVE: This study intends to establish an automatic intelligent segmentation method of ultrasound images of carotid plaque. METHODS: The present study combined the U-Net and DenseNet networks, to automatically segment the ultrasound images …of carotid atherosclerotic plaques. The same test set was selected and segmented using the traditional U-Net network and the ResUNet network. The prediction results of the three network models were compared using Dice (Dice similarity coefficient), and VOE (volumetric overlap error) coefficients. RESULTS: Compared with the existing U-Net network and ResUNet network, the Dense-UNet network exhibited an optimal effect on the automated segmentation of the ultrasound images. CONCLUSION: The Dense-UNet network could realize the automatic segmentation of atherosclerotic plaque ultrasound images, and it could assist medical practitioners in plaque evaluation. Show more

Keywords: Carotid atherosclerotic plaque, ultrasound image, Dense-UNet network, fully automatic segmentation

DOI: 10.3233/THC-220152

Citation: Technology and Health Care, vol. 31, no. 1, pp. 165-179, 2023

Authors: Wang, Yongtao | Tian, Shengwei | Yu, Long | Wu, Weidong | Zhang, Dezhi | Wang, Junwen | Cheng, Junlong

Article Type: Research Article

Abstract: BACKGROUND: The results of medical image segmentation can provide reliable evidence for clinical diagnosis and treatment. The U-Net proposed previously has been widely used in the field of medical image segmentation. Its encoder extracts semantic features of different scales at different stages, but does not carry out special processing for semantic features of each scale. OBJECTIVE: To improve the feature expression ability and segmentation performance of U-Net, we proposed a feature supplement and optimization U-Net (FSOU-Net). METHODS: First, we put forward the view that semantic features of different scales should be treated differently. …Based on this view, we classify the semantic features automatically extracted by encoders into two categories: shallow semantic features and deep semantic features. Then, we propose the shallow feature supplement module (SFSM), which obtains fine-grained semantic features through up-sampling to supplement the shallow semantic information. Finally, we propose the deep feature optimization module (DFOM), which uses the expansive convolution of different receptive fields to obtain multi-scale features and then performs multi-scale feature fusion to optimize the deep semantic information. RESULTS: The proposed model is experimented on three medical image segmentation public datasets, and the experimental results prove the correctness of the proposed idea. The segmentation performance of the model is higher than the advanced models for medical image segmentation. Compared with baseline network U-NET, the main index of Dice index is 0.75% higher on the RITE dataset, 2.3% higher on the Kvasir-SEG dataset, and 0.24% higher on the GlaS dataset. CONCLUSIONS: The proposed method can greatly improve the feature representation ability and segmentation performance of the model. Show more

Keywords: Deep learning algorithm, medical image analysis, semantic segmentation, multi-scale, convolutional neural networks

DOI: 10.3233/THC-220174

Citation: Technology and Health Care, vol. 31, no. 1, pp. 181-195, 2023

Authors: Yang, Jiantao | Wang, Zekai | Sun, Tairen

Article Type: Research Article

Abstract: BACKGROUND: Human gait involves activities in nervous and musculoskeletal dynamics to modulate joint torques with time continuously for adapting to varieties of walking conditions. OBJECTIVE: The goal of this paper is to estimate the joint torques of lower limbs in human gait based on Gaussian process. METHOD: The potential uses of this study include optimization of exoskeleton assistance, control of the active prostheses, and modulating the joint torque for human-like robots. To achieve this, Gaussian process (GP) based data fusion algorithm is established with joint angles as the inputs. RESULTS: …The statistic nature of the proposed model can explore the correlations between joint angles and joint torques, and enable accurate joint-torque estimations. Experiments were conducted for 5 subjects at three walking speed (0.8 m/s, 1.2 m/s, 1.6 m/s). CONCLUSION: The results show that it is possible to estimate the joint torques at different scenarios. Show more

Keywords: GP, human gait, joint torque, prostheses, robots, mechanics

DOI: 10.3233/THC-220190

Citation: Technology and Health Care, vol. 31, no. 1, pp. 197-204, 2023

Authors: Kamal, Shahul Mujib | Babini, Mohammad Hossein | Tee, Rui | Krejcar, Ondrej | Namazi, Hamidreza

Article Type: Research Article

Abstract: BACKGROND: One of the important areas of heart research is to analyze heart rate variability during (HRV) walking. OBJECTIVE: In this research, we investigated the correction between heart activation and the variations of walking paths. METHOD: We employed Shannon entropy to analyze how the information content of walking paths affects the information content of HRV. Eight healthy students walked on three designed walking paths with different information contents while we recorded their ECG signals. We computed and analyzed the Shannon entropy of the R-R interval time series (as an indicator of HRV) versus …the Shannon entropy of different walking paths and accordingly evaluated their relation. RESULTS: According to the obtained results, walking on the path that contains more information leads to less information in the R-R time series. CONCLUSION: The analysis method employed in this research can be extended to analyze the relation between other physiological signals (such as brain or muscle reactions) and the walking path. Show more

Keywords: Heart Rate Variability (HRV), walking path, Shannon entropy, information content, R-R interval time series

DOI: 10.3233/THC-220191

Citation: Technology and Health Care, vol. 31, no. 1, pp. 205-215, 2023

Authors: Pan, Jingwen | Zhang, Chaoxue | Peng, Hu | Wang, Yadan | Wang, Yuanguo | Han, Zhihui

Article Type: Research Article

Abstract: BACKGROUND: A fundamental challenge in medical ultrasound imaging is to improve the resolution accurately. Adaptive beamforming is often used to improve lateral resolution, such as minimum variance (MV) and phase coherence factor (PCF). However, it is difficult to improve the axial resolution due to the limitation of the spatial pulse length (SPL) of the transmitted signal. OBJECTIVE: A deconvolution recovery method combines two adaptive weighting techniques to improve axial resolution. METHODS: A deconvolution recovery (DR) technique is used to improve axial resolution with a shorter SPL. Then, the DR is combined with MV …and PCF (DR-MVPCF) to suppress the sidelobe. The influence of different transmission modes, regularization parameters, and the estimation of point spread function are discussed on the proposed algorithm. RESULTS: In simulation, DR-MVPCF improved axial resolution from 0.41 mm (0.98 λ ) to 0.09 mm (0.21 λ ) compared with MV-PCF. In the water bath experiment, DR-MVPCF provided improvement of axial resolution from 0.39 mm (0.93 λ ) to 0.07 mm (0.17 λ ) compared with MV-PCF. In-vivo data experiment, the DR-MVPCF method increased the speckle signal-to-noise ratio and visibility of the structure while the contrast ratio and contrast-noise ratio decreased. CONCLUSIONS: The proposed method can improve the axial resolution significantly. Show more

Keywords: Ultrasound imaging, axial resolution, deconvolution recovery, adaptive beamforming

DOI: 10.3233/THC-220198

Citation: Technology and Health Care, vol. 31, no. 1, pp. 217-237, 2023