Technology and Health Care - Volume 31, issue 5

Authors: Li, Zishuo | Long, Yanli | Yang, Qing | Liu, Jing | Wang, Yahong

Article Type: Research Article

Abstract: BACKGROUND: A variety of reviews have indicated the effectiveness of smartphone-based interventions in preventing secondary cardiovascular disease (CVD). However, few studies have focused on clinical outcomes. OBJECTIVE: This meta-analysis aimed to evaluate the potential benefits of application interventions and short message service (SMS) interventions on CVD outcomes. METHODS: Electronic databases were searched to identify randomized controlled trials (RCT) investigating an application or SMS intervention for secondary CVD prevention. Primary outcomes included major adverse cardiovascular events (MACE), cardiovascular death, and cardiac hospitalization. Secondary outcomes were cardiovascular risk factors (BMI, blood pressure, and cholesterol). …RESULTS: A total of 26 RCTs were included, with 16 investigating applications and 10 assessing SMS. Overall, there was no significant difference in MACE, cardiovascular death, and cardiac hospitalization when comparing application interventions with usual care, as well as comparing SMS with usual care. Subgroup analysis revealed that patients who received applications without a medical interface had a significantly lower incidence of MACE (OR = 0.56; 95% CI: 0.33, 0.98). Participants who received applications with a medical interface showed a tendency towards higher rates of cardiac hospitalization (OR = 2.03; 95% CI: 0.85, 4.87). Significant reduction in waist circumference (SMD = - 0.80; 95% CI: - 1.58, - 0.03) was found in application interventions compared to usual care; while significant reductions in SBP (SMD = - 0.08; 95% CI: - 0.15, - 0.01) and TC (SMD = - 0.31; 95% CI: - 0.57, - 0.08) were found in SMS interventions compared to usual care. CONCLUSION: Smartphone-based interventions, including applications and SMS, have the potential to benefit the secondary prevention of CVD. Applications may reduce the incidence of cardiovascular-related adverse events, while SMS interventions may improve cardiovascular risk factors. Show more

Keywords: mHealth, mobile applications, text messaging, cardiovascular disease, mobile phone

DOI: 10.3233/THC-230022

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1935-1948, 2023

Authors: Kovacevic, Pedja | Djajic, Vlado | Skrbic, Ranko | Milivojevic, Natasa | Jereb, Matjaz | Gradisek, Primoz | Gorjup, Vojka

Article Type: Review Article

Abstract: BACKGROUND: Critical care medicine is a young branch of medicine, of which the development was much faster in High Income Countries (HICs) than in Low Resources Settings (LRS). Slovenia, as one of the successor states of former Yugoslavia, passed the process of transition and joined the European Union successfully. On the contrary, Bosnia and Herzegovina (B&H) went through the extremely difficult process of transition (four years of civil war), which left a deep scar to the healthcare system, including critical care medicine. OBJECTIVE: To examine the impact of HICs on the development of critical care in …LRS. METHOD: This review examined the process of growing up the first modern Medical Intensive Care Unit (MICU) in the Republic of Srpska. RESULTS: The five-year process of transferring critical care knowledge from Slovenia to the health care system of Republic of Srpska has contributed to the existence of modern and state of the art MICU with tremendous social effects. CONCLUSION: The model of using the impact of HICs for improving critical care in LRS can be extrapolated to other similar settings. Show more

Keywords: Critical care, low resources settings, high-income countries, translation

DOI: 10.3233/THC-230117

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1949-1955, 2023

Authors: Alobaid, Mohammed A. | Chaturvedi, Saurabh | Alshahrani, Ebtihal Mobarak S. | Alshehri, Ebtsam M. | Shaiban, Amal S. | Addas, Mohamed Khaled | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Cone-beam computed tomography (CBCT) could be more beneficial in clinical situations that involve the determination of root canal morphology. AIM: The aim of the study was to ascertain the prevalence of radix molaris (paramolaris-RP and entomolaris-RE) in a subpopulation of Saudi Arabia using CBCT. METHOD: A total of 700 CBCT scans of mandibular permanent first molars were included in this study. All CBCT scans were interpreted by two trained dentists and an endodontist. Mandibular permanent first molars with fully developed roots and closed apices were only included. Computed Tomography scans were obtained …from the dental college record. The anatomic characteristics which were checked included: the prevalence of radix molaris in both RE and RP and the prevalence of radix molaris according to the patient’s gender and age. All CBCT images were processed and reconstructed using OnDemand3D TM imaging software. RESULTS: Of the 700 patients included, 651 (93.0%) did not have radix molaris, 46 (6.6%) had radix entomolaris and 3 (0.4%) had radix paramolaris in the study group. There was no statistically significant difference between the genders and age in the incidence of RE and RP (P -value < 0.05). CONCLUSION: The study showed that RE prevalence is more compared to RP in the first lower molars in the population studied. It is important to identify extra roots and associated canals to perform successful root canal treatment and avoid failure. Show more

Keywords: Cone-beam computed tomography, mandibular first molars, radix molaris, radix entomolaris, radix paramolaris, root canal morphology

DOI: 10.3233/THC-230300

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1957-1968, 2023

Authors: Chen, Wei-Ling | Lin, Chia-Hung | Yang, Tsung-Lung | Lin, Che-Wei | Kan, Chung-Dann

Article Type: Research Article

Abstract: BACKGROUND: The increasing prevalence of end-stage renal disease (ESRD) imposes a substantial economic burden on public health-care systems. Hemodialysis (HD) is a pivotal treatment modality for patients with ESRD. However, prolonged use of HD vessels may result in stenosis, thrombosis, and occlusion due to repeated daily punctures. Thus, early detection and prevention of the dysfunction of dialysis routes are crucial. OBJECTIVE: In this study, we designed a wearable device for the early and accurate detection of arteriovenous access (AVA) stenosis in HD patients. METHODS: A personalized three-dimensional (3D) printed wearable device was designed …by combining the phonoangiography (PAG) and photoplethysmography (PPG) techniques. The capability of this device to monitor AVA dysfunction before and after percutaneous transluminal angioplasty (PTA) was evaluated. RESULTS: After PTA, the amplitudes of both PAG and PPG signals increased in patients with arteriovenous fistulas and those with arteriovenous grafts; this might be due to increased blood flow. CONCLUSION: Our designed multi-sensor wearable medical device using PAG, PPG, and 3D printing appears suitable for early and accurate detection of AVA stenosis in HD patients. Show more

Keywords: Hemodialysis, personalized 3D printed device, phonoangiography

DOI: 10.3233/THC-235000

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1969-1979, 2023

Authors: Han, Seungju | Kim, Changhee | Kim, Kangil | Lee, Sangmin

Article Type: Research Article

Abstract: BACKGROUND: In retinal prosthetic systems on multi-channel microelectrodes to effectively stimulate retinal neurons, the electrode-electrolyte interface impedance of a microelectrode should be minimized to drive sufficiently large current at a given supply voltage. OBJECTIVE: This paper presents the fabrication of the nanostructured microelectrode array with simplified fabrication and its characteristic evaluation using biphasic current stimulator. METHODS: The nanostructured microelectrodes with the base diameter of 25 μ m, 50 μ m, 75 μ m are fabricated, and the maximum allowable current injection limits are measured to verify the …estimated injection limit. Also, a biphasic stimulator has been fabricated using the 2-stage amplifier and 4 switches based on a stimulator cell. The adjustable load resistance is adopted to control between 5 kΩ to 20 kΩ , and the biphasic stimulator can drive the stimulation current between 50 uA and 200 uA. RESULTS: The proposed electrode-electrolyte interface impedance of the fabricated nanostructured microelectrode is 3178 Ω , 1218 Ω and 798.8 Ω for electrodes with diameter of 25 μ m, 50 μ m, 75 μ m, respectively. CONCLUSION: This paper shows the advantages of the nanostructured microelectrode arrays for high resolution retinal prostheses, which could be a basic experiment for artificial retina research. Show more

Keywords: Retinal prosthetic system, nanostructured microelectrode, microelectrode array

DOI: 10.3233/THC-235001

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1981-1995, 2023

Authors: Sa-nguannarm, Phataratah | Elbasani, Ermal | Kim, Jeong-Dong

Article Type: Research Article

Abstract: BACKGROUND: Stress is one of the critical health factors that could be detected by Human Activity Recognition (HAR) which consists of physical and mental health. HAR can raise awareness of self-care and prevent critical situations. Recently, HAR used non-invasive wearable physiological sensors. Moreover, deep learning techniques are becoming a significant tool for analyzing health data. OBJECTIVE: In this paper, we propose a human lifelog monitoring model for stress behavior recognition based on deep learning, which analyses stress levels during activity. The proposed approach considers activity and physiological data for recognizing physical activity and stress levels. …METHODS: To tackle these issues, we proposed a model that utilizes hand-crafted feature generation techniques compatible with a Bidirectional Long Short-Term Memory (Bi-LSTM) based method for physical activity and stress level recognition. We have used a dataset called WESAD, collected using wearable sensors for model evaluation. This dataset presented four levels of stress emotion, including baseline, amusement, stress, and meditation. RESULTS: The following results are from the hand-crafted feature approaches compatible with the bidirectional LSTM model. The proposed model achieves an accuracy of 95.6% and an F1-score of 96.6%. CONCLUSION: The proposed HAR model efficiently recognizes stress levels and contributes to maintaining physical and mental well-being. Show more

Keywords: Human activity recognition, stress behavior recognition, bidirectional long short-term memory, recurrent neural network, deep learning

DOI: 10.3233/THC-235002

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1997-2007, 2023