Technology and Health Care - Volume 31, issue 4

Authors: Zhou, Shuguang | Jin, Qinqin | Jiang, Xiya | Wang, Rui | Wang, Bingbing | Li, Jin | Yao, Hui | Yang, Yinting | Gao, Wei | Zhang, Weiyu | Cao, Wujun

Article Type: Research Article

Abstract: BACKGROUND: Internet-related technologies have rapidly developed and started to impact the traditional medical practices, which combined wireless communication technology as well as “cloud service” technology with electronic fetal heart monitoring have become a mainstream tendency. OBJECTIVE: To investigate the clinical application value of remote fetal heart rate monitoring mode (RFHRM) on late pregnancy during the coronavirus disease (COVID-19) pandemic. METHODS: From March 2021 to February 2022, we recruited 800 cases of pregnant women received prenatal examination at the Anhui Province Maternity and Child Healthcare Hospital. These pregnant women were randomly divided into two …groups: the control group (n = 400), which was given traditional management, and the observation group (n = 400), which received remote monitoring technology on this basis. The two groups were compared with neonatal asphyxia, pregnancy outcomes, Edinburgh postnatal depression scale scores (EPDS), prenatal examination expenses and total time consumption. RESULTS: There were no statistically significant differences between the groups in pregnancy outcome and neonatal outcome (P > 0.05). However, total EPDS score of 12.5% pregnant women in the observation group were higher than 12. The TPE group had significantly higher mean EPDS scores compared with the RFHRM group (7.79 ± 3.58 vs 5.10 ± 3.07; P < 0.05). The results showed a significant difference in maternity expenses (2949.83 ± 456.07 vs 2455.37 ± 506.67; P < 0.05) and total time consumption (42.81 ± 7.60 vs 20.43 ± 4.16; P < 0.05) between the groups. CONCLUSION: Remote fetal heart rate monitoring via internet served as an innovative, acceptable, safe and effective reduced-frequency prenatal examination model without affecting the outcome of perinatology of pregnant women with different risk factors. Show more

Keywords: COVID-19, prenatal examination, late trimester of pregnancy, fetal monitoring, remote monitoring technology, perinatal outcome

DOI: 10.3233/THC-220700

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1105-1117, 2023

Authors: Jiang, Sheng Li | Jiang, Xiu Min | Zheng, Qing Xiang | Liu, Xiu Wu

Article Type: Research Article

Abstract: BACKGROUND: Acupoint buried beans on the auricle is a feasible method to prevent and treat postpartum urinary retention. OBJECTIVE: This study investigated the effect of auricular acupoint buried beans on postpartum urination and maternal and fetal outcomes following epidural analgesia for labor. METHODS: Two hundred forty primiparas underwent vaginal trial labor analgesia from May 2020 to January 2021 and were randomly placed into the intervention and control groups. Both groups received epidural labor analgesia. Maternal urination during labor, 2 h postpartum, and the time for first postpartum urination were recorded as primary outcomes, …with maternal and infant outcomes documented as secondary results. Statistical analysis was performed using the independent sample t -test, non-parametric rank-sum, or chi-square test using the SPSS Statistics 25.0 software. RESULTS: Two hundred eight study participants were subsequently included in the results, i.e., 105 patients in the intervention group and 103 in the control group. The intervention group comprised a significantly lower number of patients with excessive residual urine volume at cervical dilatation of 5–6 cm (P < 0.05). The total postpartum score of the intervention group was lower than in the control group (P < 0.01), and the time to first urination was shorter compared with the control group (P < 0.05). In the intervention group, the time of labor analgesia, the duration of the first stage of labor, and the total labor time were shorter compared with the control group (P < 0.01). CONCLUSION: Auricular acupoint embedded beans can improve the urination status at cervical dilatation of 5–6 cm and 2 h postpartum, as well as significantly shorten the duration of labor. Show more

Keywords: Ear-point buried beans, maternal outcome, epidural labor analgesia, urinary retention, labor

DOI: 10.3233/THC-220660

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1119-1127, 2023

Authors: Ghaffar, Asim | Dehghani-Sanij, Abbas A. | Xie, Sheng Quan

Article Type: Research Article

Abstract: BACKGROUND: The aim of a robotic exoskeleton is to match the torque and angular profile of a healthy human subject in performing activities of daily living. Power and mass are the main requirements considered in the robotic exoskeletons that need to be reduced so that portable designs to perform independent activities by the elderly users could be adopted. OBJECTIVE: This paper evaluates a systematic approach for the design optimization strategies of elastic elements and implements an actuator design solution for an ideal combination of components of an elastic actuation system while providing the same level of …support to the elderly. METHODS: A multi-factor optimization technique was used to determine the optimum stiffness and engagement angle of the spring within its elastic limits at the hip, knee and ankle joints. An actuator design framework was developed for the elderly users to match the torque-angle characteristics of the healthy human with the best motor and transmission system combined with series or parallel elasticity in an elastic actuator. RESULTS: With the optimized spring stiffness, a parallel elastic element significantly reduced the torque and power requirements up to 90% for some manoeuvres for the users to perform ADL. When compared with the rigid actuation system, the optimized robotic exoskeleton actuation system reduced the power consumption of up to 52% using elastic elements. CONCLUSION: A lightweight, smaller design of an elastic actuation system consuming less power as compared to a rigid system was realized using this approach. This will help to reduce the battery size and hence the portability of the system could be better adopted to support elderly users in performing daily living activities. It was established that parallel elastic actuators (PEA) can reduce the torque and power better than series elastic actuators (SEA) in performing everyday tasks for the elderly. Show more

Keywords: Wearable electronic devices, exoskeleton device, robotics, actuators

DOI: 10.3233/THC-220145

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1129-1151, 2023

Authors: Temporiti, Federico | Adamo, Paola | Mandelli, Andrea | Buccolini, Fabio | Viola, Erika | Aguzzi, Damiano | Gatti, Roberto | Barajon, Isabella

Article Type: Research Article

Abstract: BACKGROUND: The BHOHB system (Bhohb S.r.l., Italy) is a portable non-invasive photographic marker-based device for postural examination. OBJECTIVE: To assess the test-retest reliability of the BHOHB system and compare its reliability with an optoelectronic system (SMART-DX 700, BTS, Italy). METHODS: Thirty volunteers were instructed to stand upright with five markers on the spinous processes of C7, T6, T12, L3 and S1 vertebrae to define the dorsal kyphosis and lumbar lordosis (sagittal plane) angles. Three markers were placed on the great trochanter, apex of iliac crest and lateral condyle of the femur to detect …pelvic tilt. Finally, to define angles between the acromion and the spinous processes (frontal plane), two markers were placed on the right and left acromion. Postural angles were recoded simultaneously with BHOHB and optoelectronic systems during two consecutive recording sessions. RESULTS: The BHOHB system revealed excellent reliability for all the angles (ICCs: 0.92–0.99, SEM: 0.78 ∘ –3.33 ∘ ) as well as a shorter processing time compared to the optoelectronic system. Excellent reliability was also found for all the angles detected through the optoelectronic system (ICCs: 0.91–0.99, SEM: 0.84 ∘ –2.80 ∘ ). CONCLUSION: The BHOHB system resulted as a reliable non-invasive and user-friendly device to monitor spinal posture, especially in subjects requiring repeat examinations. Show more

Keywords: Posture, postural assessment, photographic system, optoelectronic system

DOI: 10.3233/THC-220155

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1153-1160, 2023

Authors: Nan, Chong | Li, Yanjun | Liu, Yuxiu | Ma, Liang | Ma, Zhanbei

Article Type: Research Article

Abstract: BACKGROUND: The femoral neck system (FNS) has been considered as a novel strategy for femoral neck fracture. The diversity of internal fixation creates difficulties in choosing an effective option for Pauwels III type femoral neck fractures. Therefore, it is significant to investigate the biomechanical effects of FNS versus conventional approaches on bones. OBJECTIVE: To evaluate the biomechanical characteristics of FNS versus cannulated screws coupled with medial plate (CSS+ MP) for the treatment of Pauwels III type femoral neck fractures. METHODS: Through three-dimensional computer software (Minics, Geomagic – Warp), the proximal femur …model was rebuilt. Based on the present clinical characteristics, models of internal fixation were reconstructed in SolidWorks, including cannulated screws (CSS), medial plate (MP) and FNS. After parameter setting and meshing, boundary conditions and loads were set up for the final mechanical calculation in Ansys Software. Under identical experimental conditions, such as the same Pauwels angle and force loading, the peak values of displacement, shear stress and equivalent (von Mises) stress were recorded. RESULTS: This study showed that the displacement of the models was CSS, CSS+ MP, and FNS in descending order of magnitude. The shear stress and equivalent stress of the models was CSS+ MP, FNS, and CSS in descending order. The principal shear stress of CSS+ MP was concentrated on the medial plate. The equivalent stress of FNS was more dispersed and distributed from the proximal main nail to the distal locking screw. CONCLUSION: CSS+ MP and FNS exhibited better initial stability compared to CSS. However, the MP was subjected to more shear stress, which could increase the risk of internal fixation failure. Due to its unique design, FNS may be a good choice for the treatment of Pauwels III type femoral neck fractures. Show more

Keywords: Femoral neck system, femoral neck fractures, finite element analysis, biomechanics

DOI: 10.3233/THC-220267

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1161-1170, 2023

Authors: Liu, Shuai | Chen, Ruili | Gu, Yun | Yu, Qiong | Su, Guoxiong | Ren, Yanjiao | Huang, Lan | Zhou, Fengfeng

Article Type: Research Article

Abstract: BACKGROUND: Acne is a skin lesion type widely existing in adolescents, and poses computational challenges for automatic diagnosis. Computer vision algorithms are utilized to detect and determine different subtypes of acne. Most of the existing acne detection algorithms are based on the facial natural images, which carry noisy factors like illuminations. OBJECTIVE: In order to tackle this issue, this study collected a dataset ACNEDer of dermoscopic acne images with annotations. Deep learning methods have demonstrated powerful capabilities in automatic acne diagnosis, and they usually release the training epoch with the best performance as the delivered model. …METHODS: This study proposes a novel self-ensemble and stacking-based framework AcneTyper for diagnosing the acne subtypes. Instead of delivering the best epoch, AcneTyper consolidates the prediction results of all training epochs as the latent features and stacks the best subset of these latent features for distinguishing different acne subtypes. RESULTS: The proposed AcneTyper framework achieves a promising detection performance of acne subtypes and even outperforms a clinical dermatologist with two-year experiences by 6.8% in accuracy. CONCLUSION: The method we proposed is used to determine different subtypes of acne and outperforms inexperienced dermatologists and contributes to reducing the probability of misdiagnosis. Show more

Keywords: Acne subtype, deep learning, self-ensemble, stacking, classification

DOI: 10.3233/THC-220295

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1171-1187, 2023

Authors: Heo, Min | Kang, Seung-Rok | Yu, Mi | Kwon, Tae-Kyu

Article Type: Research Article

Abstract: BACKGROUND: The weakening of the ability of the elderly to perform gait is becoming a major cause of the increase in the frequency of falls. OBJECTIVE: In this study, we designed and manufactured a treadmill capable of restraining walking by providing a sudden repulsive force on the left and right legs of a pedestrian when walking for the fall prevention training of the elderly. Through this, it is possible for the elderly person to strengthen the lower extremity muscles to prevent and prepare for falling through the fall prevention training similar to the fall environment that …may occur in daily life. METHOD: The development system includes a motor for generating a driving force in the form of a left and a right driving system and a belt separated from each other, an electromagnetic clutch for rapidly stopping the running belt of the motor transmitted to the running belt to stop the running belt, and a controller for controlling the driver. RESULTS: In order to evaluate the development system, the motor driving ability test and the power transmission, connection and shut-off performance of the electromagnetic clutch were carried out. The subject’s muscle activity of the lower extremity muscles was evaluated when the running belt stopped at the beginning of the right folding. CONCLUSION: It is expected that the developed dual function system would be helpful for the fall prevention exercise as well as the rehabilitation exercise for patients who have recovered from surgery or hemiplegic patients. Show more

Keywords: People with gait disability, fall prevention training, power train and control, split-treadmill, smart medical device

DOI: 10.3233/THC-220392

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1189-1201, 2023

Authors: Jin, Qianheng | Yu, Chenghao | Xu, Lei | Zhang, Guangliang | Ju, Jihui | Hou, Ruixing

Article Type: Research Article

Abstract: BACKGROUND: Bionic grafts can replace autologous tissue through tissue engineering in cases of cardiovascular disease. However, small-diameter vessel grafts remain challenging to precellularize. OBJECTIVE: Bionic small-diameter vessels with endothelial and smooth muscle cells (SMCs) manufactured with a novel approach. METHODS: A 1-mm-diameter bionic blood vessel was constructed by combining light-cured hydrogel gelatin-methacryloyl (GelMA) with sacrificial hydrogel Pluronic F127. Mechanical properties of GelMA (Young’s modulus and tensile stress) were tested. Cell viability and proliferation were detected using Live/dead staining and CCK-8 assays, respectively. The histology and function of the vessels were observed using hematoxylin …and eosin and immunofluorescence staining. RESULTS: GelMA and Pluronic were printed together using extrusion. The temporary Pluronic support was removed by cooling during GelMA crosslinking, yielding a hollow tubular construct. A bionic bilayer vascular structure was fabricated by loading SMCs into the GelMA bioink, followed by perfusion with endothelial cells. In the structure, both cell types maintained good cell viability. The vessel showed good histological morphology and function. CONCLUSION: Using light-cured and sacrificial hydrogels, we formed a small ca bionic vessel with a small caliber containing SMCs and endothelial cells, demonstrating an innovative approach for construction of bionic vascular tissues. Show more

Keywords: 3D bioprinting, tissue-engineered vascular, cardiovascular disease, endothelium, smooth muscle

DOI: 10.3233/THC-220393

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1203-1213, 2023

Authors: Abgeena, Abgeena | Garg, Shruti

Article Type: Research Article

Abstract: BACKGROUND: Recognising emotions in humans is a great challenge in the present era and has several applications under affective computing. Deep learning (DL) is found as a successful tool for prediction of human emotions in different modalities. OBJECTIVE: To predict 3D emotions with high accuracy in multichannel physiological signals, i.e. electroencephalogram (EEG). METHODS: A hybrid DL model consisting of convolutional neural network (CNN) and gated recurrent units (GRU) is proposed in this work for emotion recognition in EEG data. CNN has the capability of learning abstract representation, whereas GRU can explore temporal correlation. …A bi-directional variation of GRU is used here to learn features in both directions. Discrete and dimensional emotion indices are recognised in two publicly available datasets SEED and DREAMER, respectively. A fused feature of energy and Shannon entropy ( 𝐸𝑛𝑆𝐸 → ) and energy and differential entropy ( 𝐸𝑛𝐷𝐸 → ) are fed in the proposed classifier to improve the efficiency of the model. RESULTS: The performance of the presented model is measured in terms of average accuracy, which is obtained as 86.9% and 93.9% for SEED and DREAMER datasets, respectively. CONCLUSION: The proposed convolution bi-directional gated recurrent unit neural network (CNN-BiGRU) model outperforms most of the state-of-the-art and competitive hybrid DL models, which indicates the effectiveness of emotion recognition using EEG signals and provides a scientific base for the implementation in human-computer interaction (HCI). Show more

Keywords: EEG, hybrid deep learning, CNN, BiGRU, emotion recognition

DOI: 10.3233/THC-220458

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1215-1234, 2023

Authors: Jiang, Runxue | Li, Zhi | Wang, Xia | Cai, Haifeng | Wu, Shouling | Chen, Shuohua | Hu, Hailong

Article Type: Research Article

Abstract: BACKGROUND: Metabolic syndrome increases the risk of developing several types of cancer in humans; however, its effect on the development of kidney cancer is not uniform. OBJECTIVE: To investigate the association between metabolic syndrome (MetS) and its components and the risk of developing kidney cancer. METHODS: We conducted a cohort-based case-control study. The case group included 217 patients with new kidney cancer in the Kailuan cohort. A total of 868 subjects who were matched for age and sex with those in the case group age (± 1 year) at 1:4 …as the control group were selected from baseline survey participants without malignant tumours at the same time as the case group. Biennial baseline survey data of the cases and controls were collected, and the baseline data nearest to the onset time of cases were used for statistical analyses. Logistic proportional risk regression models were used to analyse the association between MetS and its components and the risk of developing kidney cancer. RESULTS: The proportion of MetS patients in the case group was significantly higher than that in the control group (P < 0.01). The risk of developing kidney cancer was significantly higher in the MetS group than in the non-MetS group [odds ratio (OR) (95% confidence interval, CI) = 1.63 (1.20–2.21)], and the risk of kidney cancer increased as the number of MetS components increased compared with subjects without any MetS components (p 𝑡𝑟𝑒𝑛𝑑 < 0.01). Elevated blood pressure and low high-density lipoprotein cholesterol levels were associated with the risk of kidney cancer [OR (95% CI) = 1.49 (1.02–2.17) and 1.55 (1.13–2.13), respectively]. CONCLUSION: Our findings suggest that the risk of developing kidney cancer is correlated with MetS. Show more

Keywords: Kidney cancer, metabolic syndrome, case-control study, Kailuan Study

DOI: 10.3233/THC-220482

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1235-1244, 2023

Authors: Lin, Xiaoxiao | Sun, Haoyue | Lin, Xizhou | Liu, Ya | Hu, Sisi | Yu, Yingcong | Song, Caiyun

Article Type: Research Article

Abstract: BACKGROUND: Studies have reported that certain adverse reactions can occur during painless gastroscopy examination. Knowing how to decrease the risks and incidence of adverse reactions is of great importance. OBJECTIVE: To investigate whether topical pharyngeal anesthesia combined with intravenous anesthesia is superior to intravenous anesthesia alone in patients undergoing painless gastroscopy and to determine whether this combined approach had any additional benefits. METHODS: Three hundred patients undergoing painless gastroscopy were randomly assigned to either the control group or the experimental group. In the control group, patients were anesthetized with propofol, while patients in …the experimental group received propofol combined with 2% lidocaine spray for topical pharyngeal anesthesia. Hemodynamic parameters before and after the procedure, including the heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SPO 2 ) were recorded. Any adverse reactions experienced by the patient, including choking and respiratory depression, and the total dosage of propofol required during each procedure were also documented. RESULTS: Compared with pre-anesthetic data, the HR, MAP, and SPO 2 were reduced after the completion of the painless gastroscopy procedure in both groups. However, the HR, MAP, and SPO 2 measurements taken after the gastroscopy were significantly lower in the control group than those of the experimental group (P < 0.05); thus, the hemodynamic parameters of the experimental group were more stable. Compared with the control group, there was significant reduction in the total amount of propofol administered in the experimental group (P < 0.05). The incidence of adverse reactions, including choking and respiratory depression, was significantly lower in the experimental group (P < 0.05). CONCLUSION: The results demonstrated that the application of topical pharyngeal anesthesia in painless gastroscopy can significantly reduce the incidence of adverse reactions. Thus, the combination of topical pharyngeal and intravenous anesthesia is worthy of clinical application and promotion. Show more

Keywords: Topical pharyngeal anesthesia, adverse reactions, painless gastroscopy, intravenous anesthesia

DOI: 10.3233/THC-220516

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1245-1251, 2023

Authors: Lallement, Alex | Noblet, Vincent | Antoni, Delphine | Meyer, Philippe

Article Type: Research Article

Abstract: BACKGROUND: Adaptive radiotherapy (ART) aims to address anatomical modifications appearing during the treatment of patients by modifying the planning treatment according to the daily positioning image. Clinical implementation of ART relies on the quality of the deformable image registration (DIR) algorithms included in the ART workflow. To translate ART into clinical practice, automatic DIR assessment is needed. OBJECTIVE: This article aims to estimate spatial misalignment between two head and neck kilovoltage computed tomography (kVCT) images by using two convolutional neural networks (CNNs). METHODS: The first CNN quantifies misalignments between 0 mm and 15 …mm and the second CNN detects and classifies misalignments into two classes (poor alignment and good alignment). Both networks take pairs of patches of 33x33x33 mm 3 as inputs and use only the image intensity information. The training dataset was built by deforming kVCT images with basis splines (B-splines) to simulate DIR error maps. The test dataset was built using 2500 landmarks, consisting of hard and soft landmark tissues annotated by 6 clinicians at 10 locations. RESULTS: The quantification CNN reaches a mean error of 1.26 mm (± 1.75 mm) on the landmark set which, depending on the location, has annotation errors between 1 mm and 2 mm. The errors obtained for the quantification network fit the computed interoperator error. The classification network achieves an overall accuracy of 79.32%, and although the classification network overdetects poor alignments, it performs well (i.e., it achieves a rate of 90.4%) in detecting poor alignments when given one. CONCLUSION: The performances of the networks indicate the feasibility of using CNNs for an agnostic and generic approach to misalignment quantification and detection. Show more

Keywords: Registration error, DIR validation, DIR in radiotherapy, adaptive radiotherapy, supervised learning, convolutional neural networks, deep learning

DOI: 10.3233/THC-220519

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1253-1266, 2023

Authors: Li, Zhennan | Liu, Chunbao | Han, Yang | Wang, Tongjian | Lei, Ren

Article Type: Research Article

Abstract: BACKGROUND: Due to low friction, passive mechanical prostheses move compliantly followed by the stump and are used widely. Advanced semi-active prostheses can both move passively like passive prostheses and provide active torque under specific conditions. However, the current mechanical-hydraulic coupling driven semi-active prostheses, in order to meet the low passive friction requirements with a low active transmission ratio, lead to a significant problem of insufficient active torque. OBJECTIVE: A hybrid active and passive prosthesis was developed to solve the incompatibility problem of low passive friction and high active driving torque of semi-active prostheses. METHODS: …The mechanical structure and control strategy of the prosthesis were demonstrated. The performance of the prosthesis was tested by bench and human tests. RESULTS: Passive subsystem damping adjustment ranges from 0.4 N⋅ (mm/s) - 1 to 300 N⋅ (mm/s) - 1 . The switching time between the damping and the active subsystem is 32 ± 2 ms. The continuous active torque output is more than 24 Nm. In level walking, the peak torque is about 28 Nm. CONCLUSION: The proposed active-passive hybrid hydraulic prosthesis could satisfy both low passive friction and high active actuation. Show more

Keywords: Knee prosthesis, hydraulic, active-passive hybrid drive, low passive friction, high transmission ratio

DOI: 10.3233/THC-220522

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1267-1277, 2023

Authors: Shimpi, Neel | Glurich, Ingrid | Hegde, Harshad | Steinmetz, Annie | Kuester, Robbyn | Crespin, Matthew | Acharya, Amit

Article Type: Research Article

Abstract: BACKGROUND: The evidence base supports effectiveness of dental sealants for prevention of childhood caries in school-aged children. OBJECTIVE: This study describes planning, development, usability testing and outcomes following implementation of DentaSeal, a web-based application designed to accurately track unique student data and generate reports for all Wisconsin school-based sealant placement (SP) programs. METHODS: Application software development was informed by a steering committee of representative stakeholders who were interviewed to inform design and provide feedback for design of DentaSeal during development and evaluation. Software development proceeded based on wireframes developed to build architectural design. …Usability testing followed and informed any required adjustments to the application. The DentaSeal prototype was beta tested and fully implemented subsequently in the public health sector. RESULTS: The DentaSeal application demonstrated capacity to: 1) track unique student SP data and longitudinal encounter history, 2) generate reports and 3) support administrative tracking. In 2019, DentaSeal captured SP data of 47 school-based programs in Wisconsin that sponsored > 7,000 program visits for 184,000 children from 62 counties. Delivery of > 548,000 SP services were catalogued. CONCLUSIONS: For public health initiatives targeting reduction in caries incidence, web-based applications such as DentaSeal represent useful longitudinal tracking tools for cataloguing SP in school-based program participants. Show more

Keywords: Dental sealants, school health services, registries, user-computer interface, computer software, dental caries resistance

DOI: 10.3233/THC-220568

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1279-1291, 2023

Authors: Li, Ling | Mkangala, Abdala | Geng, Zhiqi | Fan, Wenliang | Ren, Yanqiao | Wang, Zhongmin | Zheng, Chuansheng | Xiao, Shuping

Article Type: Research Article

Abstract: BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is an accepted minimal invasive procedure for the management of complications of portal hypertension. OBJECTIVE: This study aims to investigate the value of the preemptive administration of morphine, when compared with on-demand morphine, during TIPS. METHODS: The present study was a randomized control trial. A total of 49 patients were selected to receive 10 mg of morphine either before the TIPS procedure (group B, n = 26), or on demand when needed during the TIPS procedure (group A, n = …23). The patient’s pain was scored using the visual analog scale (VAS) during the procedure. VAS, pain performance, HR, systolic pressure, diastolic pressure and SPO 2 were recorded at four-time points: before the operation (T0), during the trans-hepatic puncture of the portal vein (T1), during the intrahepatic channel expansion (T2), and when the operation was finished (T3). The duration of the operation was also recorded. RESULTS: In group A, the proportion of severe pain at T1 was 4.3% (one case), two cases were combined with vagus reflex, and the proportion of severe pain at T2 was 65.2% (15 cases). No severe pain occurred in group B. The VAS score significantly decreased at T1, T2 and T3 in group B, when compared to group A (P < 0.05). HR, systolic pressure and diastolic pressure significantly decreased at T2 and T3 in group B, when compared to group A (P < 0.05). There was no significant difference between the two groups in terms of SPO 2 (P > 0.05). CONCLUSION: Preemptive analgesia can effectively relieve severe pain during TIPS, improve patient comfort and compliance, ensure a routine procedure, and offer excellent safety, and is simple and effective. Show more

Keywords: Preemptive analgesia, morphine, TIPS, pain, visual analogue scale

DOI: 10.3233/THC-220572

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1293-1300, 2023

Authors: Tian, Qiu-Si | Zhang, Qun | Huang, Wei

Article Type: Research Article

Abstract: BACKGROUND: Gliomas are one of the most common malignancies in the central nervous system (CNS). Members of the minichromosomal maintenance protein (MCM) family play an essential role in diagnosing and prognosis of malignant tumors. MCM10 is found in gliomas, but the prognosis and immune infiltration of gliomas has not been elucidated. OBJECTIVE: To explore the biological function and immune infiltration of MCM10 in gliomas and provide a reference for the diagnosis, treatment, and prognostic evaluation. METHODS: The MCM10 expression profile and the clinical information database of glioma patients were obtained from the China …Glioma Genome Atlas (CGGA) and Cancer Genome Atlas (TCGA) glioma data. We analyzed the MCM10 expression levels in various cancers from The TCGA.RNA sequencing data were analyzed using the R packages to determine differentially expressed genes (DEGs) between high- and low MCM10 expressing GBM tissues from the TCGA-GBM database. The Wilcoxon rank sum test was used to compare MCM10 expression levels in glioma and normal brain tissue. To evaluate the value of MCM10 expressions in the prognosis of glioma patients by the Kaplan-Meier survival analysis, a univariate Cox analysis, multivariate Cox analysis, and a ROC curve analysis were used to analyze the correlation of MCM10 expression and the clinicopathological features of glioma patients using the TCGA database data. Subsequently, a functional enrichment analysis was performed to explore its potential signaling pathways and biological functions. Moreover, a single-sample gene set enrichment analysis was used to assess the extent of immune cell infiltration. Lastly, the authors constructed a nomogram to predict the overall survival rate (OS) of gliomas at 1, 3 and 5 years after diagnosis. RESULTS: MCM10 is highly expressed in 20 cancer types including gliomas, and MCM10 expression was an independent adverse prognostic factor in glioma patients. Similarly, high expression of MCM10 was associated with advanced age (60 years), increased tumor grade, tumor recurrence or development of a secondary tumor, IDH wild-type, and non-codeletion of 1p19q (p < 0.01). The OS nomogram generated a consistency index of 0.821. The results of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and Gene Ontology (GO) functional analysis showed that the cell-cycle-related and tumor-related signaling pathways were significantly enriched in the MCM10 high expression phenotype. Moreover, signaling pathways were significantly enriched in Gene Set Enrichment Analysis (GSEA), including Rho GTPases, M phase, DNA repair, extracellular matrix organization, and nuclear receptors. Furthermore, MCM10 over expression was negatively correlated with the level of immune cell infiltration in natural killer CD56 bright cells, follicular helper T cells, plasmacytoma dendritic cells, and dendritic cells. CONCLUSION: MCM10 is an independent prognostic index of glioma patients, and the high expression of MCM10 suggests a poor prognosis; MCM10 expression is closely related to the immune cell infiltration of gliomas, and MCM10 may be related to drug resistance and development of gliomas. Show more

Keywords: Gliomas, minichromosomal maintenance protein 10, immune infiltration, biomarker, prognosis

DOI: 10.3233/THC-220576

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1301-1317, 2023

Authors: Chen, Huan | Zhao, Dechun | Luo, Zixin | Shen, Lihao | Shu, Yang | Li, Ling

Article Type: Research Article

Abstract: BACKGROUND: Closed-loop deep brain stimulation (DBS) is a research hotspot in the treatment of Parkinson’s disease. However, a variety of stimulation strategies will increase the selection time and cost in animal experiments and clinical studies. Moreover, the stimulation effect is little difference between similar strategies, so the selection process will be redundant. OBJECTIVE: The objective was to propose a comprehensive evaluation model based on analytic hierarchy process (AHP) to select the best one among similar strategies. METHODS: Two similar strategies, namely, threshold stimulation (CDBS) and threshold stimulus after EMD feature extraction (EDBS), were …used for analysis and screening. The values of Similar to Unified Parkinson’s Disease Rating Scale estimates (SUE), β power and energy consumption were calculated and analysed. The stimulation threshold with the best improvement effect was selected. The weights of the indices were allocated by AHP. Finally, the weights and index values were combined, and the comprehensive scores of the two strategies were calculated using the evaluation model. RESULTS: The optimal stimulation threshold for CDBS was 52% and for EDBS was 62%. The weights of the indices were 0.45, 0.45 and 0.1, respectively. According to comprehensive scores, different from the situation where either EDBS or CDBS can be called optimal stimulation strategies. But under the same threshold stimulation, the EDBS was better than the CDBS under the optimal level. CONCLUSION: The evaluation model based on AHP under the optimal stimulation conditions satisfied the screening conditions between the two strategies. Show more

Keywords: Optimal level, comprehensive evaluation model, closed-loop deep brain stimulation strategy, analytic hierarchy process, Parkinson’s disease

DOI: 10.3233/THC-220587

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1319-1331, 2023

Authors: Wang, Ping | Song, Guo-Dong | Xie, Wang-Cheng | Song, Zhen-Shun

Article Type: Research Article

Abstract: BACKGROUND: There are two minimally invasive ways of treating cholecystolithiasis combined with choledocholithiasis, but there remains some controversy regarding which technique is better, since they both have advantages and disadvantages. The one-step method involves laparoscopic cholecystectomy, laparoscopic common bile duct exploration, and primary close (LC + LCBDE + PC), while the two-step procedure consists of endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, and laparoscopic cholecystectomy (ERCP + EST + LC). OBJECTIVE: This multicenter retrospective study aimed to analyze and compare the effects of the two techniques. …METHODS: The data of patients who underwent either one-step LCBDE + LC + PC or two-step ERCP + EST + LC treatment for gallstones in the gallbladder and bile duct at the Shanghai Tenth People’s Hospital, Shanghai Tongren Hospital, and Taizhou Fourth People’s Hospital between January 1, 2015 and December 31, 2019 were collected, and the preoperative indicators of the two groups were compared. RESULTS: The surgical success rate of the one-step laparoscopic group was 96.23% (664/690), the transit abdominal opening rate was 2.03% (14/690), and there were 21 cases of postoperative bile leakage. The success rate of the two-step endolaparoscopic surgery was 78.95% (225/285), the transit opening rate was 2.46% (7/285), and there were 43 postoperative cases of pancreatitis and five of cholangitis. Postoperative cholangitis, pancreatitis, postoperative stone recurrence, postoperative hospitalization, and treatment costs were significantly lower (P < 0.05) in the one-step laparoscopic group than in the two-step endolaparoscopic group. However, the amount of intraoperative bleeding, the postoperative extraction time of the abdominal drainage tube, and the incidence of bile leakage were higher (P < 0.05) in the one-step laparoscopic group than in the two-step endolaparoscopic group. CONCLUSION: The two methods of treating choledocholithiasis combined with choledocholithiasis that were analyzed in this study were safe and effective, and each method had its own advantages. Show more

Keywords: Laparoscopic cholecystectomy, laparoscopic common bile duct exploration, endoscopic sphincterotomy, secondary choledocholithiasis, multicenter retrospective clinical study

DOI: 10.3233/THC-220610

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1333-1342, 2023

Authors: Popović, Tamara | Matavulj, Milica | Nežić, Lana | Radulović, Tatjana Nožica | Škrbić, Ranko

Article Type: Research Article

Abstract: BACKGROUND: The pulsed electromagnetic fields (PEMFs) seem effective in increasing bone mineral density and promoting osteogenesis and bone healing. OBJECTIVE: To examine the effect of two different modalities of PEMFs therapy in comparison with the recommended pharmacological treatment on experimental osteoporosis in rats. METHODS: The experimental model of estrogen-deficient osteoporosis induced by ovariectomy was used in this study. The animals were exposed to PEMFs of various frequencies (40 Hz and 25 Hzk), intensities (10 mT and 36.4 μ T), lengths of exposure, and the effects were compared with the standard treatment …with pamidronate, vitamin D, and calcium supplementation. RESULTS: The application of PEMF 40Hz , significantly reduced the osteoporotic bone loss in female rats that were confirmed with biochemical, biomechanical, and histological analyses. These effects were more pronounced than in osteoporotic animals treated with pamidronate, vitamin D, and calcium supplementation. On the contrary, the exposure to PEMF 25Hz did not show restorative effects but led to further progression of osteoporosis. CONCLUSION: The exposure to PEMF 40Hz , significantly restored osteoporosis and attenuated bone fragility in comparison to the rats exposed to PEMF 25Hz or those treated with pamidronate, vitamin D, and calcium supplementation. Show more

Keywords: Estrogen deficient osteoporosis, pulsed electromagnetic fields, pamidronate, vitamin D, calcium

DOI: 10.3233/THC-220642

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1343-1353, 2023

Authors: Zhang, Yanhua | Teng, Libao | Wang, Chunying

Article Type: Research Article

Abstract: BACKGROUND: In order to prevent the occurrence of high-cost cases, it is necessary to know the proportion of high-rate cases and the hospitalization cost of patients. OBJECTIVE: Through the analysis of the high-rate cases of various specialties in a first-class hospital in a province, the profit and loss situation of medical institutions under the diagnosis-intervention packets (DIP) payment reform was discussed to seek a more effective way of medical insurance payment reform. METHODS: Data of 1955 inpatients who participated in DIP settlement in January 2022 were retrospectively selected. The Pareto chart was used …to analyze the distribution trend of high-cost cases and the composition of hospitalization expenses in each specialty. RESULTS: The high-cost cases are the main reason for the loss of medical institutions at the time of DIP settlement. Neurology, respiratory medicine and other specialties are the focus of high-cost cases. CONCLUSION: The cost composition of inpatients with high-cost cases is in urgent need of optimization and adjustment. DIP payment method can control the use of medical insurance funds more effectively, which is the guarantee for the refined management of medical institutions. Show more

Keywords: High-cost cases, diagnosis-intervention packet, hospitalization expenses, Pareto chart analysis

DOI: 10.3233/THC-220647

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1355-1364, 2023

Authors: Wang, Yong Feng | He, Rui Jing | Yuan, Xiao Juan | Wang, Xiao Min | Liang, Tao | Cui, Zhi Qiang | Liu, Jian Xia

Article Type: Research Article

Abstract: BACKGROUND: Standardized chemotherapy for breast cancer can improve the survival of patients, but during the process, it is accompanied by a variety of symptoms. OBJECTIVE: To explore the dynamic changes of symptoms and quality of life in breast cancer patients at different time points during chemotherapy, and to explore the correlation with quality of life. METHOD: A prospective study method was used to collect 120 breast cancer patients undergoing chemotherapy as the research objects. The general information questionnaire, the Chinese version of the M.D. Anderson Symptom inventory (MDASI-C), and the European Organization for …Cancer Research and Treatment (EORTC) Quality of Life questionnaire were used in the first week (T1), first month (T2), three month (T3) and 6 months after chemotherapy (T4) to conduct dynamic investigation. RESULTS: The symptoms of breast cancer patients at four time points during chemotherapy period were: psychological symptoms, pain-related symptoms, perimenopausal symptoms, impaired self-image, and neurological related symptoms etc. At T1, it exhibited 2 symptoms, however as moving along the chemotherapy process, the symptoms are increasing. The severity is (F = 76.32, P < 0.001), life of quality (F = 117.64, P < 0.001) vary. At T3, there were 5 symptoms, and at T4 symptom number increased to 6 with worsening quality of life. It exhibited positive correlation with scores in multiple domains of quality of life (P < 0.05), and the above symptoms showed positive correlation with multiple domains of QLQ-C30 (P < 0.05). CONCLUSION: After T1-T3 of chemotherapy in breast cancer patients, the symptoms become more serious and the quality of life reduced. Therefore, medical staff should pay attention to the occurrence and development of patient’s symptoms, create a reasonable plan from the perspective of symptom management and carry out personalized interventions to improve patient’s quality of life. Show more

Keywords: Breast cancer patients, chemotherapy, symptom clusters, dynamic changes, quality of life

DOI: 10.3233/THC-220657

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1365-1373, 2023

Authors: Lv, Yin-Jiang | Liang, Xiu-Feng | Wu, Yi-Ping

Article Type: Research Article

Abstract: BACKGROUND: The ABO blood group is closely related to clinical blood transfusion, transplantation, and neonatal hemolytic disease. It is also the most clinically significant blood group system in clinical blood transfusion. OBJECTIVE: The purpose of this paper is to review and analyze the clinical application of the ABO blood group. METHODS: The most common ABO blood group typing methods in clinical laboratories are hemagglutination test and microcolumn gel test, while genotype detection is mainly adopted in clinical identification of suspicious blood types. However, in some cases, the expression variation or absence of blood …type antigens or antibodies, experimental techniques, physiology, disease, and other factors affect the accurate determination of blood types, which may lead to serious transfusion reactions. RESULTS: The mistakes could be reduced or even eliminated by strengthening training, selecting reasonable identification methods, and optimizing processes, thereby improving the overall identification level of the ABO blood group. ABO blood groups are also correlated with many diseases, such as COVID-19 and malignant tumors. Rh blood groups are determined by the RHD and RHCE homologous genes on chromosome 1 and are classified as Rh negative or positive according to the D antigen., the agglutination method is often used in clinical settings, while genetic and sequencing methods are often used in scientific research. CONCLUSION: Accurate ABO blood typing is a critical requirement for the safety and effectiveness of blood transfusion in clinical practice. Most studies were designed for investigating rare Rh blood group family, and there is a lack of research on the relationship between Rh blood groups and common diseases. Show more

Keywords: ABO blood type, Rh blood type, blood group system, forward and reverse typing, influencing factors, diseases

DOI: 10.3233/THC-220659

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1375-1383, 2023

Authors: Yang, Mo | Yang, Na | Yan, Zhanqiu | Tong, Yan | Zhao, Xiumei | Gu, Chengmin | Gao, Caiyun | Yang, Qing

Article Type: Research Article

Abstract: BACKGROUND: Effective analgesia is required to ensure maternal and neonatal safety. OBJECTIVE: To compare the therapeutic effects of analgesia applied throughout labor and analgesia applied during the first stage of labor in women with pregnancy-induced hypertension (PIH). METHODS: In this study, 120 puerperae with PIH who gave birth in our hospital were enrolled as the study participants and were randomized into two groups (n = 60 in each group) using a coin flip. Those who received analgesia throughout labor were enrolled in the observation group, and those administered …analgesia during the first stage of labor were enrolled in the control group. The analgesic effects, changes in blood pressure during labor, and neonatal health were compared between the two groups. RESULTS: Differences in visual analog scale (VAS) scores before analgesia, 10 min after analgesia, and full cervical dilation between the two groups were not statistically significant (P > 0.05 in all). The VAS scores of the puerperae in the observation group during forced breathing in the second stage of labor and fetal head expulsion were lower than those in the control group (P < 0.05 for both). The incidence of postpartum hemorrhage, forceps delivery, and antihypertensive treatment in the observation group was slightly lower than in the control group, but the differences were not statistically significant (P > 0.05). The rate of oxytocin treatment in puerperae in the observation group was significantly lower than in the control group (P < 0.05). The differences in base excess, arterial partial pressure of oxygen, partial pressure of carbon dioxide, and pH between the two groups of newborns were not statistically significant (P > 0.05 for all). Differences in changes in systolic and diastolic blood pressure between the two groups of puerperae were not statistically significant (P > 0.05 for both). Eclampsia did not occur during labor in either group. CONCLUSION: For patients with PIH, the application of analgesia throughout labor had a positive analgesic effect, effectively controlling the changes in blood pressure and ensuring the health of newborns. This is worthy of widespread clinical application. Show more

Keywords: Analgesia throughout labor, analgesia during the first stage of labor, pregnancy-induced hypertension, analgesic effect

DOI: 10.3233/THC-220680

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1385-1391, 2023

Authors: Li, Changzhong | Ma, Ya

Article Type: Research Article

Abstract: BACKGROUND: To effectively circumvent foetal structural abnormalities and serious newborn sequelae, antenatal ultrasound evaluation can support making an early diagnosis for potential prenatal management or the termination of pregnancy. OBJECTIVE: This study systematically evaluated a meta-analysis of different pregnancy outcomes in the diagnosis of isolated foetal renal parenchymal echogenicity (IHEK) by prenatal ultrasonography. METHODS: Two researchers conducted a literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were included in the search: China National Knowledge Infrastructure, Wanfang Medical Network, China Academic Journals Full-text Database, PubMed, …Web Of Science and Springer Link; additional library websites were also included, and the search reviewed different pregnancies among patients with IHEK. The outcome indicators were the live birth rate, the incidence of polycystic renal dysplasia and the incidence of pregnancy termination/neonatal death. The meta-analysis was performed using the Stata/SE 12.0 software. RESULTS: A total of 14 studies were included in the meta-analysis (total sample content, 1,115 cases). The combined effect size of prenatal ultrasound diagnosis of pregnancy termination/neonatal mortality in patients with IHEK was 0.289 (confidence interval (CI) 95%; range, 0.102–0.397). The combined effect size of the live birth rate of pregnancy outcomes was 0.742 (CI 95%; range, 0.634–0.850. The combined effect size of the polycystic kidney dysplasia rate was 0.066 (CI 95%; range, 0.030–0.102). The heterogeneity of all three results was > 50%; accordingly, a random-effects model was used. CONCLUSION: The indications for eugenic labour should not be included in a prenatal ultrasound diagnosis of patients with IHEK. In the results of this meta-analysis, the live birth and polycystic dysplasia rates were optimistic in terms of pregnancy outcomes. Therefore, under the condition of excluding other unfavourable factors, it is necessary to A thorough technical inspection is required to make an accurate judgment. Show more

Keywords: IHEK, pregnancy outcomes, eugenic labour

DOI: 10.3233/THC-220690

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1393-1405, 2023

Authors: Li, Jiaxin | Liu, Xiaonan | Li, Jiaxin | Han, Dongwei | Li, Yu | Ge, Pengling

Article Type: Research Article

Abstract: BACKGROUND: Traditional Chinese medicine (TCM) has been widely recognized and accepted worldwide to provide favorable therapeutic effects for cancer patients. As Andrographis paniculata has an anti-tumor effect, it might inhibit lung cancer. OBJECTIVE: The drug targets and related pathways involved in the action of Andrographis paniculata against lung cancer were predicted using network pharmacology, and its mechanism was further explored at the molecular level. METHODS: This work selected the effective components and targets of Andrographis paniculata against the Traditional Chinese Medicine System Pharmacology (TCMSP) database. Targets related to lung cancer …were searched for in the GEO database (accession number GSE136043). The volcanic and thermal maps of differential expression genes were produced using the software R. Then, the target genes were analyzed by GO and KEGG analysis using the software R. This also utilized the AutoDock tool to study the molecular docking of the active component structures downloaded from the PubChem database and the key target structures downloaded from the PDB database, and the docking results were visualized using the software PyMol. RESULTS: The results of molecular docking show that wogonin, Mono-O-methylwightin, Deoxycamptothecine, andrographidine F_qt, Quercetin tetramethyl (3’,4’,5,7) ether, 14-deoxyandrographolide, andrographolide-19-β -D-glucoside_qt and 14-deoxy-11-oxo-andrographolide were potential active components, while AKT1, MAPK14, RELA and NCOA1 were key targets. CONCLUSION: This study showed the main candidate components, targets, and pathways involved in the action of Andrographis paniculata against lung cancer. Show more

Keywords: Andrographis paniculata, lung cancer, pharmacology, molecular docking, mechanism

DOI: 10.3233/THC-220698

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1407-1427, 2023

Authors: Feng, Shengchun | Yang, Chunyan | Wang, Jun | Fan, Xiaopeng | Ying, Xiaowei

Article Type: Research Article

Abstract: BACKGROUND: Due to the complexity and heterogeneity of hepatocellular carcinoma, the existing clinical staging criterias are insufficient to accurately reflect the tumor microenvironment and predict the prognosis of HCC patients. Aggrephagy, as a type of selective autophagy, is associated with various phenotypes of malignant tumors. OBJECTIVE: This study aimed to identify and validate a prognostic model based on aggrephagy-related LncRNAs to assess the prognosis and immunotherapeutic response of HCC patients. METHODS: Based on the TCGA-LIHC cohort, aggrephagy-related LncRNAs were identified. Univariate Cox regression analysis and lasso and multivariate Cox regression were used to …construct a risk-scoring system based on eight ARLs. CIBERSORT, ssGSEA, and other algorithms were used to evaluate and present the immune landscape of tumor microenvironment. RESULTS: The high-risk group had a worse overall survival (OS) than the low-risk group. Patients in the high-risk group are more likely to benefit from immunotherapy because of their high infiltration level and high immune checkpoint expression. CONCLUSION: The ARLs signature is a powerful predictor of prognosis for HCC patients, and the nomogram based on this model can help clinicians accurately determine the prognosis of HCC patients and screen for specific subgroups of patients who are more sensitive to immunotherapy and chemotherapy. Show more

Keywords: Hepatocellular carcinoma, aggrephagy, prognostic signature, tumor microenvironment, immunotherapy

DOI: 10.3233/THC-220738

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1429-1449, 2023

Authors: Zhou, Tao-Cheng | Yin, Chuan-Gao | Wang, Chang | Shi, Zi-Feng | Tong, Guang-Lei

Article Type: Research Article

Abstract: BACKGROUND: Autism spectrum disorder (ASD) is a severe neurodevelopmental disorder that begins in early infancy and childhood and is characterized by impaired social communication and repetitive stereotyped behaviors. OBJECTIVE: The purpose of this study was to examine the development of the corpus callosum and its relationship to neurobehavior in young children with high-risk (HR) ASD using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). METHODS: Twenty-one children with HR-ASD who visited Anhui Children’s Hospital between January 2020 and December 2021 were selected as the study group, while 19 matched children with normal …development during the same time were adopted as the control group. Cranial MRI+ DTI were performed for all of the enrolled children and fractional anisotropy (FA) measurements were taken in each region of the corpus callosum. RESULTS: The FA values in all regions of the corpus callosum were higher in the study group than in the control group (0.417 ± 0.016 vs. 0.412 ± 0.02 in the corpus callosum knee, 0.439 ± 0.018 vs. 0.431 ± 0.023 in the corpus callosum body, and 0.446 ± 0.017 vs. 0.434 ± 0.019 in the splenium of corpus callosum [SCC]), where the difference in the FA in the SCC was statistically significant between the two groups (P < 0.05). There was a positive correlation between the FA in the corpus callosum knee and speech scores in the neuropsychological development of the study group (P < 0.05). CONCLUSION: There was a premature development tendency for corpus callosum myelination in young children with HR-ASD, and the developmental tendency was visible in the SCC. There was also a positive relationship between corpus callosum knee development and language function. Show more

Keywords: Autism spectrum disorder, diffusion tensor imaging, corpus callosum, fractional anisotropy, developmental quotients

DOI: 10.3233/THC-220777

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1451-1456, 2023

Authors: Begić, Edin | Aziri, Buena | Omeragić, Elma | Medjedović, Edin | Iglica, Amer | Stanetić, Bojan | Kovačević-Preradović, Tamara | Živanović, Željko | Begić, Amra | Janković, Slobodan | Mlačo, Nejra | Mladenović, Zorica | Badnjević, Almir

Article Type: Review Article

Abstract: BACKGROUND: Heat-not-burn (HNB) technology by the U.S. Food and Drug Administration has been classified as a modified risk tobacco product, which can be a better option for those populations who cannot give up the habit of smoking. The outlook on the effects of these products is quite controversial in the scientific world. OBJECTIVE: To present the effect of HNB tobacco products on the cardiovascular system, with reference to the existence of possible benefits of the technology. METHODS: The literature search was conducted in PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), and …ClinicalTrials.gov databases, with reliance on a well-defined guiding research statement. Quality appraisal was performed using the CASP checklist for randomized controlled trials. RESULTS: The search of three databases identified 167 records, and after selection process, 25 randomized controlled trials were eligible for our study’s criteria. Twenty studies investigated the effects of HNB products on biomarkers of clinical relevance. Five studies evaluated other functional heart parameters rather than biomarkers. CONCLUSION: With HNB tobacco products, significant reductions were found in biomarkers of exposure and biological effect related to pathways involved in cardiovascular disease, including inflammation, oxidative stress, lipid metabolism, platelet function, and endothelial dysfunction. Show more

Keywords: Tobacco products, nicotine delivery devices, cardiovascular system, risk, parameters

DOI: 10.3233/THC-220677

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1457-1491, 2023

Authors: Du, Jie | Wei, Liang

Article Type: Case Report

Abstract: BACKGROUND: The clinical manifestations of Parkinson’s disease (PD) are bradykinesia and abnormal walking postures. Patients with PD are prone to complications such as drug addiction, which may not only lead to cognitive, behavioral, and affective disorders but also have irreversible impacts on patients’ body indexes. CASE DESCRIPTION: In this study, the treatment regimen for a patient with dopamine dysregulation syndrome was adjusted to allow for the withdrawal of Trastal, gradual decrease of Madopar, and the addition of Comtan and clozapine. While the body indexes effectively improved, the patient did not experience negative side effects. …CONCLUSION: Reducing the dosage of Madopar and reasonably applying the treatment regimen can improve the clinical treatment effect and improve the quality of life of patients. Show more

Keywords: Dopamine dysregulation syndrome, Madopar, clozapine, Comtan

DOI: 10.3233/THC-220719

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1493-1496, 2023

Authors: Huttin, Christine C.

Article Type: Short Communication

Abstract: BACKGROUND: At a time when welfare contracts are in crisis, it is timely to discuss different forms of disruptive innovation and responses of medical finance and economic systems, especially adjusting with new instruments for recovery and innovative solutions for health reforms. OBJECTIVE: The objective of this paper is to propose some ways to develop a framework for policy changes affecting life science sectors and healthcare. It aims to analyze the types of relationships between health or medical systems and the economic systems. METHOD: Medical systems used to be generally closed systems, but the new forms of …delivery, especially with increase of telehealth and Mobile health (Mhealth) solutions (boosted by the COVID-19 pandemic, such as online consultations), have open traditional boundaries and generate more interactions with economic systems. It also led to new institutional arrangements at federal, national, or local levels, with different power games according to the history of institutions and cultural differences between countries. RESULTS: Which system dynamics prevail will also depend on the political systems in place, for instance very innovative open innovation systems dominated by private players such as the USA empower individuals and favor intuitive and entrepreneurial states. On the other hand, systems historically dominated by socialized insurance or former communist countries, have investigated “attunements” or adaptation mechanisms in system intelligence. However, systemic changes are not only implemented by traditional rulers (government agencies, federal reserve banks) but also face the emergence of systemic platforms dominated by Big Tech players. The new agendas expressed for instance in the United Nation (UN) framework and the set of Sustainable Development Goals (SDGs) for climate change and sustainable growth, also require global adjustment of supply and demand, in a context where the traditional drug/vaccine split is challenged by the new technologies (e.g., mRNA technologies). Investment for drug research led to the development of COVID-19 vaccines, but also potential cancer vaccines. Finally, welfare economics is increasingly criticized among economist circles; it requires new design for global value assessment framework, facing growing inequalities and inter-generational challenges in aging populations. CONCLUSION: This paper contributes to new models of developments and different frameworks for multiple stakeholders with major technological changes. Show more

Keywords: Welfare economics, economics of innovation, value assessment, life science, medical systems

DOI: 10.3233/THC-220609

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1497-1504, 2023

Authors: Lewandowski, Natalie | Koller, Bastian

Article Type: Editorial

Abstract: The advance of high-performance computing (HPC), high-performance data analytics (HPDA) and AI and their synergetic integration into workflows has revolutionized numerous industries, amongst others the medical and pharmaceutical sectors. In this special section of Technology and Health Care , we delve into the remarkable advancements and potential of HPC, HPDA and AI (together termed HPC+ ) in driving innovation, improving patient outcomes, and accelerating drug discovery. The articles in this issue shed light onto the potential of HPC+ in addressing several critical areas, including medical imaging, personalized medicine, drug discovery, and clinical as well as political decision support.

Keywords: Computer simulation, big data, image processing, computer-assisted diagnosis, drug development, computer-assisted decision making, precision medicine

DOI: 10.3233/THC-237000

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1505-1507, 2023

Authors: Koch, Miriam | Arlandini, Claudio | Antonopoulos, Gregory | Baretta, Alessia | Beaujean, Pierre | Bex, Geert Jan | Biancolini, Marco Evangelos | Celi, Simona | Costa, Emiliano | Drescher, Lukas | Eleftheriadis, Vasileios | Fadel, Nur A. | Fink, Andreas | Galbiati, Federica | Hatzakis, Ilias | Hompis, Georgios | Lewandowski, Natalie | Memmolo, Antonio | Mensch, Carl | Obrist, Dominik | Paneta, Valentina | Papadimitroulas, Panagiotis | Petropoulos, Konstantinos | Porziani, Stefano | Savvidis, Georgios | Sethia, Khyati | Strakos, Petr | Svobodova, Petra | Vignali, Emanuele

Article Type: Research Article

Abstract: BACKGROUND: To say data is revolutionising the medical sector would be a vast understatement. The amount of medical data available today is unprecedented and has the potential to enable to date unseen forms of healthcare. To process this huge amount of data, an equally huge amount of computing power is required, which cannot be provided by regular desktop computers. These areas can be (and already are) supported by High-Performance-Computing (HPC), High-Performance Data Analytics (HPDA), and AI (together “HPC+ ”). OBJECTIVE: This overview article aims to show state-of-the-art examples of studies supported by the National …Competence Centres (NCCs) in HPC+ within the EuroCC project, employing HPC, HPDA and AI for medical applications. METHOD: The included studies on different applications of HPC in the medical sector were sourced from the National Competence Centres in HPC and compiled into an overview article. Methods include the application of HPC+ for medical image processing, high-performance medical and pharmaceutical data analytics, an application for pediatric dosimetry, and a cloud-based HPC platform to support systemic pulmonary shunting procedures. RESULTS: This article showcases state-of-the-art applications and large-scale data analytics in the medical sector employing HPC+ within surgery, medical image processing in diagnostics, nutritional support of patients in hospitals, treating congenital heart diseases in children, and within basic research. CONCLUSION: HPC+ support scientific fields from research to industrial applications in the medical area, enabling researchers to run faster and more complex calculations, simulations and data analyses for the direct benefit of patients, doctors, clinicians and as an accelerator for medical research. Show more

Keywords: Computer simulation, computational modeling, data analysis, AI (artificial intelligence), medicine, therapeutics, diagnosis

DOI: 10.3233/THC-229015

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1509-1523, 2023

Authors: Zečević, Aleksandar | Filipović, Luka | Marčev, Angel

Article Type: Research Article

Abstract: BACKGROUND: The necessity of setting up high-resolution models is essential to timely forecast dangerous meteorological phenomena. OBJECTIVE: This study presents a verification of the numerical Weather Research and Forecasting non-hydrostatic Mesoscale Model (WRF NMM) for weather prediction using the High-Performance Computing (HPC) cluster over the complex relief of Montenegro. METHODS: Verification was performed comparing WRF NMM predicted values and measured values for temperature, wind and precipitation for six Montenegrin weather stations in a five-year period using statistical parameters. The difficult task of adjusting the model over the complex Montenegrin terrain is caused by …a rapid altitude change in in the coastal area, numerous karst fields, basins, river valleys and canyons, large areas of artificial lakes on a relatively small terrain. RESULTS: Based on the obtained verification results, the results of the model vary during time of day, the season of the year, the altitude of the station for which the model results were verified, as well as the surrounding relief for them. The results show the best performance in the central region and show deviations for some metrological measures in some periods of the year. CONCLUSION: This study can give recommendations on how to adapt a numerical model to a real situation in order to produce better weather forecast for the public. Show more

Keywords: Weather forecast, Montenegro, WRF NMM model, meteorology

DOI: 10.3233/THC-229016

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1525-1539, 2023

Authors: Malisic, Bojana | Tinaj, Sandra

Article Type: Research Article

Abstract: BACKGROUND: Absorptive capacity is the ability to absorb new knowledge and adopt new technologies. This capacity of an economy is measured through a series of indicators, however, the most important among them are precisely those elements related to the competences required for the adoption of new technologies, as well as their structure. OBJECTIVE: This paper provides an overview of the concepts and systems needed to develop the competencies needed to implement modern technology such as High-Performance Computing (HPC) in Montenegro. METHOD: In this research paper competencies are viewed holistically. This paper will elaborate …the defined competencies related to the HPC technology environment, identified during the implementation of the EuroCC project in Montenegro, but also based on market analyses, combined with the identified indicators of absorption capacity, generally at the national level. RESULT: By identifying the innovative and business potential of representatives of the public, academic and economic sectors, with special reference to small and medium-sized companies and the IT cluster that make up the dominant segments in the structure of the market sample, as generators and accelerators of innovation, smart growth and the digital economy, we got a clear picture regarding the development of necessary competencies within the NCC team but also at the national level. CONCLUSION: There must be a systemic approach and sustainable, dynamic projects and tools for the development of human resources in the development of competences. Show more

Keywords: Competencies, absorption capacity, HPC new technology, knowledge environment

DOI: 10.3233/THC-229017

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1541-1549, 2023

Authors: Lena, Martensson

Article Type: Research Article

Abstract: Luxembourg’s supercomputer MeluXina is open to cooperation with companies that need to process huge quantities of data. Diem Bui, Solution Engineer at LuxProvide that manages MeluXina, explains how healthtech companies can benefit from supercomputing to develop and implement innovative health technology applications.

Keywords: Supercomputing, companies, dataprotection, healthtech, Luxembourg

DOI: 10.3233/THC-229018

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1551-1553, 2023

Authors: Schnabel, Benjamin | Gebert, Johannes | Schneider, Ralf | Helwig, Peter

Article Type: Research Article

Abstract: BACKGROUND: The clinical performance of medical devices is becoming increasingly important for the requirements of modern development processes and the associated regulations. However, the evidence for this performance can often only be obtained very late in the development process via clinical trials or studies. OBJECTIVE: The purpose of the presented work is to show that the simulation of bone-implant systems has advanced in various aspects, including cloud-based execution, Virtual Clinical Trials, and material modeling towards a point where and widespread utilization in healthcare for procedure planning and enhancing practices seems feasible. But this will only hold …true if the virtual cohort data build from clinical Computer Tomography data are collected and analysed with care. METHODS: An overview of the principal steps necessary to perform Finite Element Method based structural mechanical simulations of bone-implant systems based on clinical imaging data is presented. Since these data form the baseline for virtual cohort construction, we present an enhancement method to make them more accurate and reliable. RESULTS: The findings of our work comprise the initial step towards a virtual cohort for the evaluation of proximal femur implants. In addition, results of our proposed enhancement methodology for clinical Computer Tomography data that demonstrate the necessity for the usage of multiple image reconstructions are presented. CONCLUSION: Simulation methodologies and pipelines nowadays are mature and have turnaround times that allow for a day-to-day use. However, small changes in the imaging and the preprocessing of data can have a significant impact on the obtaind results. Consequently, first steps towards virtual clinical trials, like collecting bone samples, are done, but the reliability of the input data remains subject to further research and development. Show more

Keywords: Simulation, bone-implant systems, computed tomography, in silicio, finite element method, virtual clinical trials, high-performance computing

DOI: 10.3233/THC-237001

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1555-1566, 2023