Technology and Health Care - Volume 31, issue 2

Authors: Okawa, Ryuya | Yasui, Go | Mihara, Ban | Hayashi, Norio

Article Type: Research Article

Abstract: BACKGROUND: The failure of cerebrospinal fluid (CSF) signal suppression in postmortem fluid-attenuated inversion recovery (FLAIR) of the brain is a problem. OBJECTIVE: The present study was to clarify the relationship between the temperature of deceased persons and CSF T 1 , and to optimize the postmortem brain FLAIR imaging method using synthetic MRI. METHODS: Forehead temperature was measured in 15 deceased persons. Next, synthetic MRI of the brain was performed, the CSF T 1 was measured, and the optimal TI was calculated. Two types of FLAIR …images were obtained with the clinical and optimal TI. The relationship between forehead temperature and the CSF T 1 and optimal TI was evaluated. The optimized FLAIR images were physically and visually evaluated. RESULTS: The CSF T 1 and optimal TI were strongly correlated with forehead temperature. Comparing the average SNR and CNR ratios and visual evaluation scores of the two FLAIR images, those captured with the optimal TI showed statistically lower SNR, higher CNR, and higher visual evaluation scores (p < 0.01). CONCLUSIONS: Synthetic MRI enables the quantification of the CSF T 1 resulting from postmortem temperature decreases and calculation of the optimal TI, which could aid in improving the failure of CSF signal suppression and in optimizing postmortem brain FLAIR imaging. Show more

Keywords: Synthetic magnetic resonance imaging, autopsy imaging, inversion time, cerebrospinal fluid, fluid-attenuated inversion recovery

DOI: 10.3233/THC-220230

Citation: Technology and Health Care, vol. 31, no. 2, pp. 661-674, 2023

Authors: Mao, He | Fang, Peng | Zheng, Yue | Tian, Lan | Li, Xiangxin | Wang, Pu | Peng, Liang | Li, Guanglin

Article Type: Research Article

Abstract: BACKGROUND: Grip force estimation is highly required in realizing flexible and accurate prosthetic control. OBJECTIVE: This study presents a method to accurately estimate continuous grip force from surface electromyography (sEMG) under three forearm postures for unilateral amputees. METHODS: Ten able-bodied subjects and a transradial amputee were recruited. sEMG signals were recorded from six forearm muscles on the dominant side of each able-bodied subject and the stump of amputee. Meanwhile, grip force was synchronously measured from the ipsilateral hands of able-bodied subjects and contralateral hand of amputee. Three force profiles (triangle, trapezoid, and fast …triangle) were tested under three forearm postures (supination, neutral and pronation). Two algorithms (Generalized Regression Neural Network (GRNN) and Multilinear Regression Model (MLR)) were compared using several EMG features. The estimation performance was evaluated by coefficient of determination (R 2 ) and mean absolute error (MAE ). RESULTS: The optimal regressor combining TD and GRNN achieved R 2 = 96.33 ± 1.13% and MAE = 2.11 ± 0.52% for the intact subjects, and R 2 = 86.86% and MAE = 2.13% for the amputee. The results indicated that multiple grip force curves under three forearm postures could be accurately estimated for unilateral amputees using mirrored bilateral training. CONCLUSIONS: The proposed method has the potential for precise force control of prosthetic hands. Show more

Keywords: Electromyography, amputees, rehabilitation, machine learning

DOI: 10.3233/THC-220283

Citation: Technology and Health Care, vol. 31, no. 2, pp. 675-689, 2023

Authors: Lu, Jinmiao | Wang, Guangfei | Ying, Xiaohua | Li, Zhiping

Article Type: Research Article

Abstract: BACKGROUND: The medicine selection method is a critical and challenging issue in medical insurance decision-making. OBJECTIVES: This study proposed a real-world data-based multi-criteria decision analysis (MCDA) model with a hybrid entropic weight Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) algorithms to select satisfactory drugs. METHODS: The evaluation index includes two levels: primary criteria and sub-criteria. Firstly, we proposed six primary criteria to form the value health framework. The primary criteria’s weights were derived from the policymakers’ questionnaire. Meanwhile, clinically relevant sub-criteria were derived from high-quality (screened by GRADE scores) …clinical-research literature. Their weights are determined by the entropy weight (EW) algorithm. Secondly, we split the primary criteria into six mini-EW-TOPSIS models. Then, we obtained six ideal closeness degree scores (ICDS) for each candidate drug. Thirdly, we get the total utility score by linear weighting the ICDS. The higher the utility score, the higher the ranking. RESULTS: A national multicenter real-world case study of the ranking of four generic antibiotics validated the proposed model. This model is verified by comparative experiments and sensitivity analysis. The whole ranking model was consistent and reliable. Based on these results, medical policymakers can intuitively and easily understand the characteristics of each drug to facilitate follow-up drug policy-making. CONCLUSION: The ranking algorithm combines the objective characteristics of medicine and policy makers’ opinions, which can improve the applicability of the results. This model can help decision-makers, clinicians, and related researchers better understand the drug assessment process. Show more

Keywords: Medicine, evaluation, multicriteria, ranking, model, analysis

DOI: 10.3233/THC-220355

Citation: Technology and Health Care, vol. 31, no. 2, pp. 691-703, 2023

Authors: Worasawate, Denchai | Asawaponwiput, Warisara | Yoshimura, Natsue | Intarapanich, Apichart | Surangsrirat, Decho

Article Type: Research Article

Abstract: BACKGROUND: Parkinson’s disease (PD) is a long-term neurodegenerative disease of the central nervous system. The current diagnosis is dependent on clinical observation and the abilities and experience of a trained specialist. One of the symptoms that affects most patients is voice impairment. OBJECTIVE: Voice samples are non-invasive data that can be collected remotely for diagnosis and disease progression monitoring. In this study, we analyzed voice recording data from a smartphone as a possible medical self-diagnosis tool by using only one-second voice recording. The data from one of the largest mobile PD studies, the mPower study, was …used. METHODS: A total of 29,798 ten-second voice recordings on smartphone from 4,051 participants were used for the analysis. The voice recordings were from sustained phonation by participants saying /aa/ for ten seconds into an iPhone microphone. A dataset comprising 385,143 short one-second audio samples was generated from the original ten-second voice recordings. The samples were converted to a spectrogram using a short-time Fourier transform. CNN models were then applied to classify the samples. RESULTS: Classification accuracies of the proposed method with LeNet-5, ResNet-50, and VGGNet-16 are 97.7 ± 0.1%, 98.6 ± 0.2%, and 99.3 ± 0.1%, respectively. CONCLUSIONS: We achieve a respectable classification performance using a generalized approach on a dataset with a large number of samples. The result emphasizes that an analysis based on one-second clip recorded on a smartphone could be a promising non-invasive and remotely available PD biomarker. Show more

Keywords: PD voice, audio classification, convolutional neural network, mPower study

DOI: 10.3233/THC-220386

Citation: Technology and Health Care, vol. 31, no. 2, pp. 705-718, 2023

Authors: Simic, Vladimir | Milosevic, Miljan | Milicevic, Vladimir | Filipovic, Nenad | Kojic, Milos

Article Type: Research Article

Abstract: BACKGROUND: Mechanical forces at the micro-scale level have been recognized as an important factor determining various biological functions. The study of cell or tissue mechanics is critical to understand problems in physiology and disease development. OBJECTIVE: The complexity of computational models and efforts made for their development in the past required significant robustness and different approaches in the modeling process. METHOD: For the purpose of modeling process simplifications, the smeared mechanics concept was introduced by M. Kojic as a general concept for modeling the deformation of composite continua. A composite smeared finite element …for mechanics (CSFEM) was formulated which consists of the supporting medium and immersed subdomains of deformable continua with mutual interactions. Interaction is modeled using 1D contact elements (for both tangential and normal directions), where the interaction takes into account appropriate material parameters as well as the contact areas. RESULTS: In this paper we have presented verification examples with applications of the CSFEMs that include the pancreatic tumor tissue, nano-indentation model and tumor growth model. CONCLUSION: We have described CSFEM and contact elements between compartments that can interact. Accuracy and applicability are determined on two verification and tumor growth examples. Show more

Keywords: Smeared mechanics, tissue mechanics, composite smeared finite element, tumor growth

DOI: 10.3233/THC-220414

Citation: Technology and Health Care, vol. 31, no. 2, pp. 719-733, 2023

Authors: O’Connor, Matthew | Kolb, Christof | Klein, Norbert | Rauwolf, Thomas | Kuster, Stefan | Kääb, Stefan | Tilz, Roland Richard | Bänsch, Dietmar | Ince, Hüseyin | Belke, Roberto | Hauser, Tino | Rietsch, Katrin | Krämer, Jan F. | Wessel, Niels | Lennerz, Carsten

Article Type: Research Article

Abstract: BACKGROUND: Atrial fibrillation (AF) is associated with significant morbidity and is predicted by atrial high rate events. The early detection of AF is paramount to timely interventions to reduce the morbidity of AF. The DX ICD system combined with Home Monitoring ® allows for continuous atrial rhythm monitoring without the need for a dedicated atrial lead. OBJECTIVE: To establish the reaction to and timing of reactions to the detection of atrial high rate episodes (AHRE). METHODS: A prospective cohort of DX ICD systems was followed up and the response …to AHREs was collected and evaluated. RESULTS: A total of 234 patients were enrolled; an AHRE ⩾ 6 min was detected in 13.7% of patients (n = 32) within a mean follow-up duration of 16 months. A high rate of oral anticoagulation (OAC) prescription was seen with the detection of AHREs in patients with a not-low risk CHA 2 DS 2 -VASc score. There was a delay in this prescription highlighting the potential to improve the timeliness of patient care in this group of patients. CONCLUSIONS: The DX ICD system provides rapid and ongoing atrial rhythm monitoring such that physicians are rapidly aware of AHRE without the need for a dedicated atrial lead, but local protocols are needed to improve the response time of anti-coagulation prescription. Show more

Keywords: DX technology, home monitoring, atrial high rate events, atrial fibrillation, oral anticoagulation

DOI: 10.3233/THC-220432

Citation: Technology and Health Care, vol. 31, no. 2, pp. 735-746, 2023

Authors: Wang, Yadan | Zheng, Chichao | Wang, Yuanguo | Feng, Shuai | Liu, Mingzhou | Peng, Hu

Article Type: Research Article

Abstract: BACKGROUND: Pixel-based beamforming realizes dynamic focusing at the pixel level with a focused beam by assuming that the received signals are composed of spherical pulses. Far-focused pixel-based (FPB) imaging was proposed to avoid artifacts around the focal depth. However, the contrast improvement is limited. OBJECTIVE: We propose an adaptive weighting method based on dynamic phase coherence factor (DPCF) to improve the image contrast while preserving the speckle pattern. METHODS: The phase variation is dynamically estimated based on the noise energy proportion of echo signals and it is used to calculate phase coherence weights …for suppressing interference and preserving desired signals. A depth-dependent parameter is designed for DPCF to enhance the performance of noise and clutter suppression in the far-field region. We further use the subarray averaging technique to smooth the speckle texture. RESULTS: The proposed method was evaluated on simulated, phantom experimental, and in vivo data. Results show that, compared with the phase coherence factor (PCF) based method, DPCF respectively leads to average CR improvements by more than 60% and 24% in simulation and experiment, while obtaining an improved speckle signal-to-noise ratio. CONCLUSIONS: The proposed method is a potentially valuable approach to obtaining high-quality ultrasound images in clinical applications. Show more

Keywords: Ultrasound imaging, far-focused pixel-based imaging, adaptive beamforming, phase coherence factor

DOI: 10.3233/THC-220450

Citation: Technology and Health Care, vol. 31, no. 2, pp. 747-770, 2023

Authors: Arslan, Tuğba | Gültekin, Muhammet Zeki

Article Type: Research Article

Abstract: BACKGROUND: Patellofemoral pain syndrome (PFPS) is one of the musculoskeletal system pathologies frequently encountered especially in women. OBJECTIVE: The aim of the current study was to compare the efficacy of an online exercise program with a home exercise program including the same exercises, and a control group planned for females with PFPS. METHODS: The study included 60 females with PFPS aged 33.17 ± 6.84. Participants were randomly divided into 3 groups. One of the groups was given a 6-week home program consisting of evidence-based exercises. Exercises consisting of the same …exercises were supervised online to another group. The third group did not receive any intervention. Pain, knee joint range of motion, muscle strength in flexion and extension and hip posterolateral muscle group, patellofemoral joint functionality, quality of life, recurrence of injury and fear of movement were measured at preintervention and postintervention. RESULTS: Participation in the online supervised exercise group was seen to result in a greater decrease in pain during activity and kinesiophobia, and a greater increase in the quality of life mental health sub-dimension compared to the home exercise group. CONCLUSION: Online supervised exercise groups could be an alternative telerehabilitation method for exercise programs established for women with PFPS. Show more

Keywords: Anterior knee pain, muscle strength, physiotherapy, quality of life, telemedicine

DOI: 10.3233/THC-220533

Citation: Technology and Health Care, vol. 31, no. 2, pp. 771-782, 2023

Authors: Qi, Bao-Chang | Gao, Long | Wang, Jian | Ran, Jian

Article Type: Case Report

Abstract: BACKGROUND: Although tibial shaft fractures are the third most common long bone fractures in children after the forearm and femur, nonunion of these fractures are rare in the pediatric population. CASE REPORT: Despite seldom seen, tibial nonunion is very complex and it is also a devastating complication of tibial fracture especially when infected. Numerous methods have been employed to treat pediatric tibial nonunion, but there is no consensus. Here, we present a case of a child with right tibial shaft fracture nonunion. We treated this patient with ipsilateral free non-vascularized fibular graft. RESULTS: …Both the nonunion site and fibular donor site united well with good function in the injured extremity and no adverse events. CONCLUSION: We recommend the use of ipsilateral free non-vascularized fibular graft for the treatment of pediatric tibial shaft nonunion. Show more

Keywords: Pediatric tibial shaft nonunion, ipsilateral free non-vascularized fibular graft

DOI: 10.3233/THC-220126

Citation: Technology and Health Care, vol. 31, no. 2, pp. 783-787, 2023

Article Type: Research Article

DOI: 10.3233/THC-229019

Citation: Technology and Health Care, vol. 31, no. 2, pp. 789-789, 2023