Technology and Health Care - Volume 31, issue 1

Authors: Dewan, Harisha | Robaian, Ali | Divakar, Darshan Devang | Hegde, Samrat Megaravalli Ramappa | Shankar, Shrinidhi Maji | Poojary, Bharathi

Article Type: Research Article

Abstract: BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) and tumor necrosis factor-alpha (TNF-α ) are inflammatory biomarkers. No studies have yet assessed the suPAR levels in relation with TNF-α in the peri-implant sulcular fluid (PISF) among cigarette smokers and non-smokers with peri-implantitis. OBJECTIVE: The aim was to evaluate PISF levels of suPAR, and TNF-α among cigarette smokers and non-smokers with and without peri-implantitis. METHODS: Sixty male patients with peri-implantitis were included. There were 20 cigarette smokers and 20 and non-smokers with peri-implantitis (Groups 1 and 2), …and 20 non-smokers without peri-implantitis (Group 3). Demographic data and information related to cigarette smoking was recorded. Peri-implant clinicoradiographic parameters (plaque index [PI], gingival index [GI], probing depth [PD] and crestal bone loss [CBL]) were assessed. The PISF samples were collected and levels of suPAR and TNF-α were measured. Sample-size estimation was performed and all parameters were statistically assessed. Level of significance was set at P < 0.05. RESULTS: Sixty individuals were included in Groups 1, 2 and 3 (20 in each). Peri-implant PI (P < 0.01), PD (P < 0.01) and mesial (P < 0.01) and distal (P < 0.01) CBL were significantly higher in Group 1 than in Groups 2 and 3. The PISF volume (P < 0.01) and suPAR (P < 0.01) and TNF-α levels (P < 0.01) were significantly higher in Groups 1 and 2 than in Group 3. There was no difference in PISF volume and suPAR and TNF-α levels between patients in Groups 1 and 2. In Group 2, there was a statistically significant correlation between peri-implant PD and PISF suPAR and TNF-α levels (P < 0.01). The suPAR and TNF-α levels are expressed in high concentrations in the PISF of smokers and non-smokers with peri-implantitis compared with non-smokers without peri-implantitis. CONCLUSION: In non-smokers, PISF suPAR and TNF-α levels are correlated with peri-implant PD. Show more

Keywords: Cigarette smoking, peri-implantitis, peri-implant sulcular fluid, soluble urokinase plasminogen activator receptor, tumor necrosis factor-alpha

DOI: 10.3233/THC-213123

Citation: Technology and Health Care, vol. 31, no. 1, pp. 1-9, 2023

Authors: Li, Hao | Zhao, Long | Yuan, Xiaokai | Zhang, Qingjuan | Pang, Yatao | Li, Hongling

Article Type: Research Article

Abstract: BACKGROUND: Transcranial direct current stimulation (tDCS) has a considerable advantage in the rehabilitation treatment of dysphagia. OBJECTIVE: The purpose of this study was to explore the effect of tDCS combined with respiratory training on dysphagia in post-stroke patients. METHODS: From December 2017 to January 2019, 64 post-stroke patients who were hospitalized in the Department of Neurology of the Second Hospital of Hebei Medical University were enrolled in this study. They were randomly divided into control and treatment groups (n = 32). Patients in the two groups received routine …swallowing rehabilitation training and respiratory training. On this basis, the patients in the treatment group received tDCS. The anode was placed in the movement area of the pharyngeal cortex on the unaffected side of the patients’ bodies, and the cathode was placed in the upper orbital orbit on the opposite side. The current intensity was 1.5 mA, 20 min/time, 1 time/d, and 6 d/w. Before and after the treatment, the water swallow text, functional oral intake scale (FOIS), forced vital capacity (FVC) and peak expiratory flow (PEF) were assessed, and the correlation among them was evaluated. RESULTS: There were no differences in all indexes before and after treatment. After treatment, water swallow text, FOIS, FVC and PEF were all better than before treatment, and the clinical efficacy in the treatment group was significantly better than that in the control group. FVC and PEF were positively correlated with water swallow text and FOIS. CONCLUSION: tDCS combined with respiratory training may have a significant therapeutic effect on dysphagia in post-stroke patients. Show more

Keywords: Transcranial direct current stimulation, respiratory training, dysphagia, stroke

DOI: 10.3233/THC-213234

Citation: Technology and Health Care, vol. 31, no. 1, pp. 11-19, 2023

Authors: Shi, Ping | Fang, Kaixin | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: At present, the popular control method for intelligent bionic prosthetic hands is EMG control. However, the control accuracy of this method is low. It is a trend to integrate computer vision into the prosthetic hand. OBJECTIVE: The purpose of this paper is to design an intelligent prosthetic hand based on image recognition, improve the control accuracy and the quality of life of the disabled. METHODS: Convolutional neural network is used to recognize the object to be grasped, and the recognition result is used as a trigger signal to control our intelligent prosthetic …hand. We have designed a four-bar linkage mechanism and a side swing mechanism in the structure, which can not only achieve the flexion and extension of fingers but also realize the adduction and abduction of the four fingers and the lateral swing of the thumb. RESULTS: Through the method of image recognition, the new intelligent bionic hand can achieve five kinds of Human action. Including grasp, side pinch, three-finger pinch, two-finger pinch, and pinch between fingers. CONCLUSIONS: The experiment result proves that the precision of image recognition control is very excellent, the intelligent prosthetic hand can be completed the corresponding task. Show more

Keywords: Deformable convolution, image recognition, prosthetic hand

DOI: 10.3233/THC-213320

Citation: Technology and Health Care, vol. 31, no. 1, pp. 21-35, 2023

Authors: Ramalingam, Vinodhkumar | Cheong, Soon Keng | Lee, Poh Foong

Article Type: Research Article

Abstract: BACKGROUND: Athletes with chronic ankle pain (CAP) are more inclined to suffer from physical and psychological pain depending on the severity of the injuries, which might trigger the powerless feeling on future sports participation. Therefore, an efficient and simple method is useful to integrate into conventional physiotherapy (CP) for maintaining mental wellness. OBJECTIVE: This research aimed to verify the effects and progress of video-guided deep breathing (DB) integrated into CP through study on the changes of alpha waves and pain scale. METHODS: Alpha waves were recorded using an electroencephalogram (EEG) and a visual …analogue scale (VAS) to assess pain intensity before and after the intervention (6 weeks). Thirty CAP participants were recruited and randomly assigned to two groups: group A for video-guided DB integration into their CP and group B for CP. The effects of pre and post intervention were analyzed using a paired t-test with statistical significance set at p < 0.05. RESULTS: Profound results from the research have shown that the participants who received both the DB+CP revealed a significant increase in alpha wave (p < 0.05) at occipital region. CONCLUSION: The significant result reveals an increase in alpha waves in the occipital region after 6 weeks and indicates that the video-guided DB with a smartphone application is able to produce a change in CAP participants. This supports the DB integration to the CP for altering the pain perception. Show more

Keywords: Brain waves, chronic pain, EEG, breathing exercises, mobile applications, physiotherapy (techniques)

DOI: 10.3233/THC-213531

Citation: Technology and Health Care, vol. 31, no. 1, pp. 37-46, 2023

Authors: Wang, Lan | Wu, Yanqi | Zhu, Min | Zhao, Cuilian

Article Type: Research Article

Abstract: BACKGROUND: Lip incompetence resulting from mouth breathing is a common clinical manifestation, while there are no definite indicators of amplitude and intensity of muscle functional training in clinical practice, which leads to unsatisfactory training results. OBJECTIVE: The aim was to quantify the relationship between electromyography (EMG) and force in orbicularis oris muscle, so that the indicators of muscle functional training can be evaluated using EMG signals, so as to improve the training effects. METHODS: The EMG and the force signals of orbicularis oris muscle from 0% to 100% MVC within 5 s in …twelve healthy subjects (six males and six females; age, 25 ± 2 years; mass, 60 ± 15 kg) were recorded simultaneously for three trials. Four EMG features consisting of RMS, WAMP, SampEn and FuzzyEn were analyzed. The regression analyses were performed using first-order and third-order polynomial model. RESULTS: There were high correlations between the four EMG features and muscle force with the two models. The third-order model yielded a higher coefficient of determination (R 2 ) than the linear model (p < 0.001) and the result of FuzzyEn (R 2 : 0.884 ± 0.059) was the highest in the four features. CONCLUSION: The third-order model with FuzzyEn of EMG signals may be used to guide the muscle functional training. Show more

Keywords: Orbicularis oris muscle, surface electromyography, muscle force, FuzzyEn

DOI: 10.3233/THC-213545

Citation: Technology and Health Care, vol. 31, no. 1, pp. 47-56, 2023

Authors: Sadasivam, S. | V, Thulasi Bai

Article Type: Research Article

Abstract: BACKGROUND: Antennas for the microwave imaging system are large which results in higher radiation, manufacturing cost, poor radiation characteristics and it will be difficult to locate on breast tissues. OBJECTIVE: We propose a wearable ultra-wide band antenna for use in the diagnosis of breast cancer bio-medical applications. METHODS: The antenna has been fabricated on 1.6 mm FR4 substrate with a dimension of 28 × 14.4 mm 2 and can operate between 2 GHz–12 GHz with S 11 < - 10 dB with …best radiation characteristics. The prototype of the proposed antenna was fabricated and practically tested and the results were found to be consistent with the simulated results. The proposed UWB antenna is intended to radiate and receive information covering the entire spectrum from 3 GHz to 13 GHz. For good impendence matching throughout the larger spectrum, the defected ground structure (diamond shape) was exploited. All the dimensions of the proposed design are confirmed by parametric study and optimization. RESULTS: The maximum simulated efficiency was ranging from 80 to 84% in the desired operating frequency. The maximum Specific Absorption Rate of the proposed antenna was 0.98 W/Kg. Therefore, the proposed UWB antenna could be the right structure for breast cancer diagnosis in terms of SAR. The antenna was found to have a substantial radiation efficiency of around 78%–84% in the desired operating bandwidth. The overall realized gain of the proposed UWB antenna was seen ranging from 1.8–4.2 dB which is sufficient for bio-medical applications. CONCLUSION: The breast phantom was modeled for the validation of the performance of the antenna and SAR was analyzed. The value of SAR of the designed antenna was observed at about 0.98 W/Kg, which is suitable for medical applications. Show more

Keywords: Antenna, breast tumor, medical, radiation pattern, SAR

DOI: 10.3233/THC-220030

Citation: Technology and Health Care, vol. 31, no. 1, pp. 57-68, 2023

Authors: He, Siqi | Xiao, Bo | Wei, Huajiang | Huang, Shenjiao | Chen, Tongsheng

Article Type: Research Article

Abstract: BACKGROUND: Cervical histopathology image classification is a crucial indicator in cervical biopsy results. OBJECTIVE: The objective of this study is to identify histopathology images of cervical cancer at an early stage by extracting texture and morphological features for the Support Vector Machine (SVM) classifier. METHODS: We extract three different texture features and one morphological feature of cervical histopathology images: first-order histogram, K-means clustering, Gray Level Co-occurrence Matrix (GLCM) and nucleus feature. The original dataset used in our experiment is obtained from 20 patients diagnosed with cervical cancer, including 135 whole slide images (WSIs). …Given an entire WSI, the patches on its tissue region are extracted randomly. RESULTS: We finally obtain 3,000 patches, including 1,000 normal, 1,000 hysteromyoma and 1,000 cancer images. Among them, 80% of the entire data set is randomly selected as training set and the remaining 20% as test set. The accuracy of SVM classification using first-order histogram, K-means clustering, GLAM and nucleus feature for extracting features are respectively 87.4%, 90.6%, 91.6% and 93.5%. CONCLUSIONS: The classification accuracy of the SVM combining the four features is 96.8%, and the proposed nucleus feature plays a key role in the SVM classification of cervical histopathology images. Show more

Keywords: First-order histogram, GLCM, K-means clustering, morphological, nucleus, SVM, texture

DOI: 10.3233/THC-220031

Citation: Technology and Health Care, vol. 31, no. 1, pp. 69-80, 2023

Authors: Vomer, Rock P. | Pujalte, George G.A. | Waller, Thomas A. | Abadin, Andre | York, Emma R. | Albano-Aluquin, Shirley

Article Type: Research Article

Abstract: BACKGROUND: Telehealth evaluations of musculoskeletal conditions have increased due to the stay-at-home policies enacted during the COVID-19 pandemic. Back pain is one of the most common complaints in primary care. While telehealth may never supplant in-person evaluation of back pain, it is imperative in a changing world to learn to perform this evaluation via telephone or video. Virtual visits rely on history-taking and patient self-reported descriptions of pain elicited from self-palpation or specific movements while on the telephone with the clinician. Video examinations provide a unique way of evaluating the lower back compared to telephone because of the ability …to visualize the actions of the patient. OBJECTIVE: To create an evaluation pathway for examination of the lumbar spine via telehealth. METHODS: Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical lumbar examination elements, including inspection, palpation, range of motion, and strength, special, and functional testing. RESULTS: We have developed a table of questions and instructions and a glossary of images of each maneuver to facilitate lumbar spine examination via telemedicine. CONCLUSIONS: This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the lumbar spine. Show more

Keywords: Lumbar, back pain, telehealth, virtual encounter, exam guide

DOI: 10.3233/THC-220041

Citation: Technology and Health Care, vol. 31, no. 1, pp. 81-93, 2023

Authors: Ceballos-Juárez, Rosselin Gabriela | Pichardo-Carmona, Elias Yojairi | Mendieta-Zerón, Hugo | Echeverría, Juan Carlos | Reyes-Lagos, José Javier

Article Type: Research Article

Abstract: BACKGROUND: It is known that acceleration and deceleration patterns in heart rate variability (HRV) are asymmetrically distributed in healthy subjects. Accordingly, novel approaches for assessing the asymmetrical properties of HRV, such as the multiscale asymmetry (MSA), have been applied in the perinatal field. OBJECTIVE: To study the asymmetry of accelerations and decelerations of maternal short-term cardiac dynamics of thirty-six normotensive and preeclamptic women during labor/nonlabor by MSA analysis. METHODS: The RR interval time series obtained from these participants were classified into four groups: normotensive (control) without labor C-NL, n = …10; control with labor C-L, n = 10; and two preeclamptic groups with absence or presence of labor P-NL, n = 6; and P-L, n = 10, respectively. Multiscale indices of heart rate asymmetry (HRA) such as Porta (P%), Guzik (G%) and Ehlers (E) were used to explore the changes of HRA in the normotensive and preeclamptic groups in the presence or absence of labor. RESULTS: The main result of this study shows that preeclamptic women manifest decreased magnitude of decelerations of heart rate dynamics compared to normotensive women indicated by G% and E. We speculate that a lower cardiac parasympathetic response may be manifested in preeclamptic women during labor/nonlabor compared to normotensive women. CONCLUSIONS: These observations represented a new insight into the autonomic cardiovascular regulation in preeclampsia, which could contribute to the perinatal field in the future. Show more

Keywords: Pre-Eclampsia, Autonomic regulation, Asymmetry, Labor, HRV

DOI: 10.3233/THC-220042

Citation: Technology and Health Care, vol. 31, no. 1, pp. 95-101, 2023

Authors: Wang, Wanxiang | He, Yong | Li, Feng | Li, Jinke | Liu, Jingshuai | Wu, Xinyu

Article Type: Research Article

Abstract: BACKGROUND: The digital twin concept is the virtual model based on entity design measures, which is used in many enterprises’ virtual workshop design models for workshop production scheduling and optimization. However, in the field of medical rehabilitation, the integration of digital twin technology started late compared to traditional industrial manufacturing. Many current digital models are not well suited for information interaction between patients and devices. OBJECTIVE: In order to address the lack of interaction between patients and devices in the field of medical rehabilitation, this paper proposes an automatic gait data control system (AGDCS) for fully …actuated lower limb exoskeleton digital twinning. This system improves the integration of digital twinning system with the medical rehabilitation field and analyzes the patient’s gait data through simulation experiments. METHODS: The digital twin system was designed in several steps. Firstly, the upper computer function module was designed and developed according to the rehabilitation treatment needs. After that, the combination of exoskeleton robot and software was carried out, and finally the real rehabilitation treatment environment of patients was simulated through experiments. RESULTS: The proposed system was very reliable in the experimental tests of the host computer and exoskeleton robot. In the upper computer test, the patient specific gait can be generated, and the motion of the exoskeleton robot can be observed in real-time. During the walking test of the exoskeleton robot, the exoskeleton robot completed the specified gait. The result verified the superiority and effectiveness of the digital twin system AGDCS in the field of rehabilitation. CONCLUSIONS: The digital twin system proposed in this paper improves the interaction between self-balancing exoskeleton robot and patients, and improves the autonomy and safety of patients in rehabilitation treatment. Show more

Keywords: Digital twin system, walking rehabilitation, lower extremity exoskeleton, robotics

DOI: 10.3233/THC-220087

Citation: Technology and Health Care, vol. 31, no. 1, pp. 103-115, 2023