Technology and Health Care - Volume 31, issue 6

Authors: Ademović, Enisa | Čakarić, Mirza | Durak-Nalbantić, Azra | Džubur, Alen | Hodzić, Enisa | Mahmutović, Sabina | Aganović, Izeta | Dilić, Mirza | Begić, Alden | Jahić, Elmedina | Begić, Edin | Hamzić-Mehmedbašić, Aida | Rebić, Damir | Gojak, Refet | Badnjevic, Almir | Čavaljuga, Semra

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerotic cardiovascular diseases (ASCVD) are still the leading cause of morbidity and mortality in Bosnia and Herzegovina. Elevated LDL-cholesterol is established as a strong marker of cardiovascular risk. Some researchers believe that measuring triglyceride levels gives a good assessment of the residual risk for ASCVD besides the measurement of LDL-cholesterol. OBJECTIVE: The aim of this study was to evaluate the overall prevalence of major risk factors for ASCVD, lipid profile and 10-year fatal cardiovascular risk using the HeartSCORE scoring system. Further, we want to evaluate the prevalence and relationship between elevated triglyceride levels and high …10-year fatal cardiovascular risk calculated as a HeartSCORE. METHODS: This is a cross-sectional study conducted on 832 volunteers aged between 40 and 65 years without a diagnosis of diabetes and without known preexisting cardiovascular disease, as a part of the preventive program conducted at the Family Medicine office. Data were collected for ASCVD risk factors and lipid panel (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides). 10-year fatal cardiovascular risk was calculated using the HeartSCORE scoring system for countries with high CV risk. RESULTS: Among 832 participants included, 565 (67.9%) were female, and 267 (32.1%) were male. We found high prevalence of hypertension (27.7%), obesity (32.2%), and smoking (36.2%). All lipid parameters, except HDL-C, were not optimal. Only 17.4% of participants had normal estimated HeartSCORE risk, while more than one-third (33.9%) had high or very high estimated HeartSCORE risk. Although we found a higher percentage of participants with elevated triglycerides in groups with higher HeartSCORE, there was a very weak positive correlation between values of triglycerides and the 10-year risk of a fatal cardiovascular event (r = 0.249, p = 0.000). CONCLUSION: The high prevalence of major known risk factors and high estimated HeartSCORE risk indicate a high overall risk for ASCVD in the sample. The proportion of participants with elevated triglycerides was increased in patients with high HeartSCORE risk what implicates importance of triglyceride measurement. Show more

Keywords: Risk factor, triglycerides, cardiology, HeartScore

DOI: 10.3233/THC-220874

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2145-2153, 2023

Authors: Al-Jazaeri, Ayman | Alhammad, Abdulaziz | Almuhaideb, Mana | Alyahya, Ahmed | Al-Jazaeri, Sarah | Alyami, Fahad

Article Type: Research Article

Abstract: BACKGROUND: A multi-pod catheter (MPC) is a large drainage catheter that can house multiple smaller retractable (MPC-R) and deployable catheters (MPC-D) within the body. OBJECTIVE: The drainage capabilities and resistance to clogging of a novel MPC have been assessed. METHODS: The drainage capabilities are evaluated by placing the MPC in a bag of either a non-clogging (H 2 O) or clogging medium. The results are then compared to matched-size single-lumen catheters with either a close (CTC) or open tip (OTC). The means of five test runs were used to measure …drainage rate, maximum drained volume (MaxDV), and time to drain the first 200 mL (TTD200). RESULTS: In the non-clogging medium, MPC-D had a slightly higher MaxDV than MPC-R, and higher flow rate than CTC and MPC-R. Moreover, MPC-D needed less TTD200 than MPC-R. In the clogging medium, MPC-D had a higher MaxDV than CTC and OTC, higher flow rate, and faster TTD200 than CTC. However, comparison with MPC-R showed no significant difference. CONCLUSION: The novel catheter may offer superior drainage compared to the single-lumen catheter in a clogging medium, implying various clinical applications, particularly when clogging is a potential risk. Further testing may be required to simulate various clinical scenarios. Show more

Keywords: Catheter, drainage, peritoneal dialysis, foley, ventriculoperitoneal shunt

DOI: 10.3233/THC-230015

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2155-2164, 2023

Authors: Li, Yang | Han, Qinglin | Chen, Simeng | Cui, Gaozhi | Bai, Ke | Cui, Linqi

Article Type: Research Article

Abstract: BACKGROUND: The emergency rescue ability of firefighters is particularly important in the event of major disasters or accidents. Therefore, an assessment of the firefighter-training effectiveness is necessary. OBJECTIVE: This paper aims to achieve a scientific and effective assessment of the firefighter-training effectiveness in China. An assessment method based on human factor parameters and machine learning was proposed. METHOD: The model is constructed by collecting the corresponding human factor parameters such as electrocardiographic signals, electroencephalographic signals, surface electromyographic signals, and photoplethysmographic signals through wireless sensors and using them as constraint indicators. For the problems …of weak human factor parameters and high noise proportion, an improved flexible analytic wavelet transform algorithm is used to denoise and extract the corresponding feature values. To overcome the limitations of traditional assessment methods, improved machine learning algorithms are used to comprehensively assess the training effectiveness of firefighters and provide targeted training suggestions. RESULTS: The effectiveness of this study’s evaluation method is verified by comparing it with the expert scoring method and considering firefighters from a special fire station in Xhongmen, Daxing District, Beijing, as an example. CONCLUSION: This study can effectively guide the scientific training of firefighters and the method is more objective and accurate than the traditional method. Show more

Keywords: Firefighters, training-effectiveness assessment, human factor parameters, flexible analytic wavelet transform (FAWT), machine learning

DOI: 10.3233/THC-230071

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2165-2192, 2023

Authors: Ge, Yi | Xia, Jiaqi | He, Chao | Liu, Shuang

Article Type: Research Article

Abstract: BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms of malignancy. The pathogenesis of HNSCC is involved in the change of gene expression and the abnormal interaction between genes. OBJECTIVE: The purpose of our research is to find genes that affect the survival time of patients and construct circRNA-lncRNA-miRNA-mRNA network. This paper aims to reveal the development mechanism of HNSCC and provide new ideas for clinical prognosis prediction. METHODS: Transcriptome data were obtained from TCGA and GEO databases. A total of 556 samples were included. We screened the …differentially expressed lncRNAs, circRNAs and mRNAs to predict interactions between lncRNA-miRNA, circRNA-miRNA and miRNA-mRNA. Then, we selected the hub mRNAs to predict the prognosis of patients. RESULTS: We identified 8 hub prognostic mRNAs (FAM111A, IFIT2, CAV1, KLF9, OCIAD2, SLCO3A1, S100A16 and APOL3) by a series of bioinformatics analyses and established the prognostic ceRNA network of 8 mRNAs, 3 miRNAs, 2 circRNAs and 1 lncRNAs according to the targeting relationship by using databases. CONCLUSION: We established the circRNA-lncRNA-miRNA-mRNA gene interaction network in HNSCC. We illuminated the molecular mechanism underlying the gene regulation associated with the pathogenesis of HNSCC and predicted the biomarkers related to prognosis. Show more

Keywords: Head and neck squamous cell carcinoma, ceRNA, bioinformatics, interaction network

DOI: 10.3233/THC-230083

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2193-2212, 2023

Authors: Wang, Mei | Liu, Yali

Article Type: Research Article

Abstract: BACKGROUND: The etiology of early neurological deterioration (END) occurring after intravenous thrombolysis is unclear. OBJECTIVE: To investigate the factors associated with END following intravenous thrombolysis in patients with acute ischemic stroke, and to construct a prediction model. METHODS: We selected a total of 321 patients with acute ischemic stroke, who were divided into two groups: the END group (n = 91) and the non-END group (n = 230). They were compared for their demographics, onset-to-needle time (ONT), door-to-needle time (DNT), related score results, …and other data. The risk factors of the END group were identified using logistic regression analysis, and we constructed a nomogram model using the R software. A calibration curve was used to evaluate the calibration of the nomogram, and we assessed its clinical applicability using decision curve analysis (DCA). RESULTS: In our multivariate logistic regression analysis, we found that four indexes, namely, complication with atrial fibrillation, post-thrombolysis National Institutes of Health Stroke Scale (NIHSS) score, pre-thrombolysis systolic blood pressure (SBP), and serum albumin level, were independent risk factors for END following intravenous thrombolysis in the patients (P < 0.05). We constructed an individualized nomogram prediction model using the above four predictors. The AUC value of the nomogram model was 0.785 (95% CI: 0.727–0.845) after internal validation, and the mean absolute error (MAE) in the calibration curve was 0.011, which indicated that the nomogram model had good prediction value. The decision curve analysis indicated that the nomogram model was clinically relevant. CONCLUSION: The model was found to have excellent value in clinical application and prediction of END. This will be beneficial for healthcare providers to develop individualized prevention measures for END in advance, and thus reduce the incidence of END following intravenous thrombolysis. Show more

Keywords: Early neurological deterioration (END), intravenous thrombolysis, nomogram, prediction model, risk factor

DOI: 10.3233/THC-230140

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2213-2223, 2023

Authors: Wang, Mei | Liu, Yali

Article Type: Research Article

Abstract: BACKGROUND: Patients’ self-efficacy levels are significantly associated with the process of recovery and creating social support in the inpatient recovery setting can help prevent post-stroke depression and anxiety. OBJECTIVE: To explore the current status of factors influencing chronic disease self-efficacy in patients with ischemic stroke, to provide theoretical basis and clinical data for implementing corresponding nursing interventions. METHODS: The study included 277 patients with ischemic stroke who were hospitalized in the neurology department of a tertiary hospital in Fuyang, Anhui Province, China from January to May 2021. Participants for the study were selected …by convenience sampling method. A questionnaire for general information developed by the researcher and the Chronic Disease Self-Efficacy Scale were used for collecting data. RESULTS: The patients’ total self-efficacy score was (36.79 ± 10.89), which was in the middle to the upper level. Results of our multifactorial analysis showed that history of falls in the previous 12 months, presence of physical dysfunction, and cognitive impairment were all independent risk factors for chronic disease self-efficacy in patients with ischemic stroke (P < 0.05). CONCLUSION: Chronic disease self-efficacy in patients with ischemic stroke was at an intermediate to high level. History of falls in the previous year, physical dysfunction, and cognitive impairment were factors influencing patients’ chronic disease self-efficacy. Show more

Keywords: Chronic disease self-efficacy, current situation, influencing factors, stroke

DOI: 10.3233/THC-230145

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2225-2233, 2023

Authors: Li, Jie | Zhang, Yunyun | Gu, Wei | Wang, Tianying | Zhou, Yang

Article Type: Research Article

Abstract: BACKGROUND: The anesthesia machine serves as a vital piece of lifesaving equipment. OBJECTIVE: To analyze incidents of failures in the Primus anesthesia machine and address these malfunctions to reduce recurrence of failure, save maintenance costs, enhance safety, and improve overall efficiency. METHODS: We conducted an analysis on the records pertaining to the maintenance and parts replacement of the Primus anesthesia machines used in the Department of Anaesthesiology at Shanghai Chest Hospital over the past two years to identify the most common causes of failure. This included an assessment of the damaged parts and …degree of damage, as well as a review of factors that caused the fault. RESULTS: The main cause of the faults in the anesthesia machine was found to be air leakage and excessive humidity in the central air supply of the medical crane. The logistics department was instructed to increase inspections to check and ensure the quality of the central gas supply and ensure gas safety. CONCLUSION: Summarizing the methods for dealing with anesthesia machine faults can save hospitals a lot of money, ensure normal hospital and department maintenance, and provide a reference to repair such faults. The use of Internet of Things platform technology can continuously develop the direction of digitalization, automation, and intelligent management in each stage of the “whole life cycle” of anesthesia machine equipment. Show more

Keywords: Internet of things platform, preventive maintenance, Primus anesthesia machine, whole life cycle

DOI: 10.3233/THC-230191

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2235-2242, 2023

Authors: Wang, Fei-Fei | Zhang, Xiao-Nan | Wang, Xiao-Juan

Article Type: Research Article

Abstract: BACKGROUND: Rhabdomyosarcoma (RMS) is a highly malignant tumor that originates from myogenic progenitor cells. OBJECTIVE: To investigate the magnetic resonance imaging (MRI) characteristics of prostate embryonal rhabdomyosarcoma (ERMS). METHODS: We retrospectively analyzed the clinical and MRI imaging data of 9 cases of prostate ERMS that were confirmed pathologically. The patients were aged between 14∼ 49 years with a median age of 27 years, and they all underwent MRI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). RESULTS: The MRI scan of the lesions showed an irregular shape, mixed …signals, uneven equal/long T1 signal and an equal/long T2 signal, cystic necrosis in 9 cases and hemorrhage in 6 cases; DWI and ADC images showed a mixed high/low signal, and the tumor parenchyma showed ADC low signal, with an average ADC value of 0.666 × 10 - 3 mm 2 /s. There were 5 cases of DCE-MRI TIC type II and 4 cases of DCE-MRI TIC type I. The average value of Tpeak was 120 s and the average value of MCER was 172.3%. After the enhancement, the signal of tumor enhancement was uneven, and showed patchy and reticular enhancement, however, the cyst degeneration, necrosis area, and hemorrhage focus were not enhanced. There were 3 cases with multiple pelvic lymph nodes and 1 case with multiple bone metastases. CONCLUSION: The MRI manifestations of prostate ERMS have certain characteristics, and the combination of DWI and DCE-MRI are helpful in the diagnosis. Show more

Keywords: Apparent diffusion coefficient, diffusion weighted imaging, dynamic contrast-enhanced MRI, rhabdomyosarcoma

DOI: 10.3233/THC-230192

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2243-2250, 2023

Authors: Pan, Ling | Liu, Wenya | Zhao, Hao | Chen, Bin | Yue, Xuandi

Article Type: Research Article

Abstract: BACKGROUND: MicroRNAs (miRNAs) exert certain functions in the development of several cancers and can be a potential hallmark for cancer diagnosis and prognosis. MiR-191-5p has been proven to have high expression in breast cancer (BC), while its biological role and potential regulatory mechanisms in BC remain an open issue. OBJECTIVE: Bioinformatics was utilized to assay miR-191-5p level in BC tissues and predict its downstream target gene as well as the enriched signaling pathways of the target gene. METHODS: qRT-PCR was carried out to assay miR-191-5p and KLF6 levels in BC cells as well …as miR-191-5p level in blood-derived exosomes from BC patients. Western blot was to examine the expression of proteins linked with cell adhesion, epithelial-mesenchymal transition (EMT), and exosome markers. A dual luciferase reporter assay was utilized to verify the interaction between miR-191-5p and KLF6. Abilities of cell phenotypes of BC cells were detected by CCK8, Transwell, and cell adhesion assay, separately. RESULTS: Upregulated miR-191-5p expression and downregulated KLF6 expression were observed in BC cells. There was a targeting relationship between miR-191-5p and KLF6. MiR-191-5p negatively regulated KLF6 to promote EMT and malignant progression of BC cells. Additionally, we described a dramatically high level of miR-191-5p in the blood exosomes of BC patients. CONCLUSION: MiR-191-5p advances the EMT of BC by targeting KLF6, indicating that miR-191-5p and KLF6 may be new biomarkers for BC. Show more

Keywords: microRNAs, KLF6 protein, breast neoplasms, cell adhesion, epithelial-mesenchymal transition

DOI: 10.3233/THC-230217

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2251-2265, 2023

Authors: Alkhalaf, Mohammad | Zhang, Zhenyu | Chang, Hui-Chen (Rita) | Wei, Wenxi | Yin, Mengyang | Deng, Chao | Yu, Ping

Article Type: Research Article

Abstract: BACKGROUND: Malnutrition is a serious health risk facing older people living in residential aged care facilities. Aged care staff record observations and concerns about older people in electronic health records (EHR), including free-text progress notes. These insights are yet to be unleashed. OBJECTIVE: This study explored the risk factors for malnutrition in structured and unstructured electronic health data. METHODS: Data of weight loss and malnutrition were extracted from the de-identified EHR records of a large aged care organization in Australia. A literature review was conducted to identify causative factors for malnutrition. Natural language …processing (NLP) techniques were applied to progress notes to extract these causative factors. The NLP performance was evaluated by the parameters of sensitivity, specificity and F1-Score. RESULTS: The NLP methods were highly accurate in extracting the key data, values for 46 causative variables, from the free-text client progress notes. Thirty three percent (1,469 out of 4,405) of the clients were malnourished. The structured, tabulated data only recorded 48% of these malnourished clients, far less than that (82%) identified from the progress notes, suggesting the importance of using NLP technology to uncover the information from nursing notes to fully understand the health status of the vulnerable older people in residential aged care. CONCLUSION: This study identified 33% of older people suffered from malnutrition, lower than those reported in the similar setting in previous studies. Our study demonstrates that NLP technology is important for uncovering the key information about health risks for older people in residential aged care. Future research can apply NLP to predict other health risks for older people in this setting. Show more

Keywords: Natural language processing, malnutrition, electronic health records, residential aged care, nursing home

DOI: 10.3233/THC-230229

Citation: Technology and Health Care, vol. 31, no. 6, pp. 2267-2278, 2023