Technology and Health Care - Volume 32, issue 2

Authors: Lin, Wenqian | Lin, Jun | Yang, Yongyong | Lin, Lianhe | Lin, Qun

Article Type: Review Article

Abstract: BACKGROUND: Dural mater is punctured by using a spinal needle without drugs administrated into intrathecal space directly in dural puncture epidural (DPE) analgesia. OBJECTIVE: This study aimed to summarize the evidence of benefits and risks of DPE analgesia with 25-G spinal needles for labor pain relief. METHODS: DPE analgesia with EP analgesia for labor pain relief were systematically searched. The Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science databases were systematically searched till 6th November 2022 to find out randomized controlled trials (RCTs) comparing DPE (using 25-G spinal …needles) with conventional epidural (EP) analgesia. The risk of bias was assessed with the Cochrane tool. Risk ratio, mean difference, and 95% confidence intervals were calculated. RESULTS: Seven RCTs with 761 parturients were identified. Pool data showed that DPE technique was associated with shorter time to pain score ⩽ 3/10, higher percentage with pain score ⩽ 3/10 at 10 min and 20 min, lower incidence of epidural top-up bolus and no S2 block, higher incidence of bilateral S2 blockade at 10 min and during labor, lower incidence of epidural top-up bolus and incidence of asymmetric block. No statistical difference in side effect and parturient satisfaction between DPE and EP technique. CONCLUSION: DPE technique with 25-G spinal needles was associated with faster analgesia onset and sacral coverage, greater sacral spread, lesser requirement of epidural top-up and lower incidence of asymmetric block. DPE technique with 25-G spinal needles showed a greater benefit to parturients. Show more

Keywords: Labor pain, epidural, analgesia, meta-analysis

DOI: 10.3233/THC-230059

Citation: Technology and Health Care, vol. 32, no. 2, pp. 495-510, 2024

Authors: Wang, Pu | Fu, Yan-Hua | Qi, Hong-Feng | He, Peng | Wang, Hai-Feng | Li, Chao | Liu, Xue-Cong

Article Type: Review Article

Abstract: BACKGROUND: Radical resection of lung cancer and chemotherapy are the main methods for the treatment of early lung cancer, but surgical treatment is still the key and preferred method. OBJECTIVE: To evaluate the efficacy and safety of robotic-assisted thoracic surgery (RATS) and video assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC). METHODS: The clinical cohort studies on the comparison of the effects of RATS and VATS in the treatment of NSCLC published in Web of Science, PubMed, The National Library of Medicine (NLM), China National Knowledge Infrastructure (CNKI) and Wanfang database …from January 1, 2015 to December 31, 2022 were searched. Two researchers independently screened the literature, extracted the data, such as operation time, intraoperative conversion rate, intraoperative blood loss, number of lymph nodes dissected, and evaluated the quality of the included literature based on the Newcastle-Ottawa Scale (NOS). RevMan 5.3 software was used for Meat analysis. RESULTS: A total of 18 articles and 21,802 subjects were included. The results of the meta-analysis showed that the intraoperative blood loss of RATS was significantly less than that of VAS, and the difference was statistically significant [MD = - 38.43 (95% CI: - 57.71, - 19.15, P < 0.001)]. Compared with VATS, the number of lymph nodes dissected in RATS was significantly higher [MD = 2.61 (95% CI: 0.47, 4.76, P = 0.02)]. The rate of conversion to thoracotomy in RATS was lower, and the difference was statistically significant [OR = 0.59 (95% CI: 0.50, 0.70, P < 0.001)]. There was no significant difference between RATS and VATS in operation time [MD = - 9.34 (95% CI: - 28.72, 10.04, P = 0.34)], postoperative thoracic drainage time [MD = - 0.08 (95% CI: - 0.42, 0.26, P = 0.64)], postoperative hospital stay [MD = - 0.05 (95% CI: - 0.19, 0.08, P = 0.42)], postoperative mortality [OR = 0.88 (95% CI: 0.56, 1.36, P = 0.56)] and postoperative complications [OR = 1.03 (95% CI: 0.93, 1.13, P = 0.57)]. CONCLUSION: Compared with VATS, the number of lymph nodes dissected in RATS was significantly more, and the removal of lesions and lymph nodes was more thorough and accurate. More flexible and precise operation avoids the injury of important blood vessels during operation, effectively reduces the amount of blood loss during operation, shortens the indwelling time of thoracic drainage tube, and is conducive to postoperative rehabilitation of patients. Show more

Keywords: Robotic-assisted thoracic surgery, video assisted thoracic surgery, non-small cell lung cancer

DOI: 10.3233/THC-230201

Citation: Technology and Health Care, vol. 32, no. 2, pp. 511-523, 2024

Authors: Nie, Xiaojuan | Wang, Dandan | Pan, Ye | Hua, Ye | Lü, Peng | Yang, Yanhua

Article Type: Review Article

Abstract: BACKGROUND: The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system is an acquired immune system of bacteria and archaea. Continued research has resulted in the identification of other Cas13 proteins. OBJECTIVE: This review briefly describes the discovery, classification, and application of the CRISPR-Cas13 system, including recent technological advances in addition to factors affecting system performance. METHODS: Cas13-based molecular therapy of human, animal, and plant transcriptomes was discussed, including regulation of gene expression to combat pathogenic RNA viruses. In addition, the latest progress, potential shortcomings, and challenges of the CRISPR-Cas system for treatment of …animal and plant diseases are reviewed. RESULTS: The CRISPR-Cas system VI is characterized by two RNA-guided higher eukaryotes and prokaryotes nucleotide-binding domains. CRISPR RNA can cleave specific RNA through the interaction between the stem-loop rich chain of uracil residues and the Cas13a protein. The CRISPR-Cas13 system has been applied for gene editing in animal and plant cells, in addition to biological detection via accurate targeting of single-stranded RNA. CONCLUSION: The CRISPR-Cas13 system offers a high-throughput and convenient technology for detection of viruses and potentially the development of anti-cancer drugs in the near future. Show more

Keywords: CRISPR, Cas13, genome edit, gene detection

DOI: 10.3233/THC-230258

Citation: Technology and Health Care, vol. 32, no. 2, pp. 525-544, 2024

Authors: Jiang, Ye | Ju, Weina | Gai, Ning | Qi, Baochang

Article Type: Other

Abstract: BACKGROUND: Nonunion is a major concern for orthopedic surgeons, particularly nonunion of the clavicle, which can cause severe pain, loss of full range of motion, poor sleep quality, and loss of strength in the affected individuals. Platelet-rich plasma (PRP), an important biological agent, is widely used in orthopedics. OBJECTIVE: We used a combination of three techniques – the PRP technique, autologous bone grafting technique, and internal plate fixation technique – to ensure adequate internal fixation and enable a bone growth-supportive environment at the fracture site. METHODS: The surgical approach was applied to a …patient with clavicle nonunion. RESULTS: Based on postoperative follow-up findings and intraoperative findings at the time of re-removal of the patient’s implant, the prognosis at the fracture site was considered satisfactory. CONCLUSION: We observed that the patient treated with this method had favorable clinical outcomes, and we recommend that this technique be used in patients with long-bone nonunion. Show more

Keywords: PRP, autologous bone grafting, internal plate fixation

DOI: 10.3233/THC-230336

Citation: Technology and Health Care, vol. 32, no. 2, pp. 545-550, 2024

Authors: Kayama, Mizue | Nagai, Takashi | Futagami, Takao | Terasawa, Koji

Article Type: Research Article

Abstract: BACKGROUND: The actual changes in biological and physiological parameters during walking are little understood in multiple aspects. OBJECTIVE: The objective of this paper was to examine and link the disparate measures of motor, vision, and brain activity for elderly and young adults. METHOD: The participants were 15 elderly adults and 10 young adults. Accelerometry, eye tracking, and prefrontal cortex (PFC) activity in the functional near-infrared spectroscopy (fNIRS) were used to evaluate the participants in a 10-m walking test. RESULT: The results for the elderly adults were 1) low variabilities of …velocity and acceleration along the front-back and up-down axes, 2) a wider gaze range on the right-left axis than the young adults, 3) a high mean PFC activity, and 4) a larger number of high-relation pairs than the young adults for the correlation coefficients of both gait vs. gaze and gait vs. PFC activity. The variabilities of velocity and acceleration, gaze and PFC activity changes for the young adults were selective. CONCLUSION: Measuring 10-m walking in a polymetric approach may capture some indicators related to physical and cognitive difficulties such as frailty and dementia. Show more

Keywords: 10-m walking, gait, gaze, PFC activity, polymetric approach, elderly adults

DOI: 10.3233/THC-220447

Citation: Technology and Health Care, vol. 32, no. 2, pp. 551-563, 2024

Authors: Huang, Ting | Duan, Miao

Article Type: Research Article

Abstract: BACKGROUND: Hyperbilirubinemia is a common disorder in neonates, with premature infants at higher risk of developing the disorder. OBJECTIVE: Glucose-6-phosphate dehydrogenase (G6PD) gene detection was used to determine the incidence of G6PD deficiency and analyze the etiologies of G6PD deficiency in neonates with hyperbilirubinemia in the Zunyi region with the aim of providing scientific evidence for the clinical diagnosis and treatment. METHODS: For the gene detection, 64 neonates with hyperbilirubinemia were selected as the observation group and 30 normal neonates were selected as the control group, and the risk factors for hyperbilirubinemia were …investigated by using multivariate logistic regression analysis. RESULTS: Among the neonates in the observation group, 59 cases had the G1388A mutation (92.19%) and 5 cases had the G1376T mutation (7.81%). No mutation was detected in the control group. In the observation group, the proportion of neonates who were born prematurely, with artificial feeding, with the age of starting feeding of more than 24 h, the time of first bowel movement of more than 24 h, premature rupture of membranes, infection, scalp hematoma, and perinatal asphyxia was higher than that in the control group, and the difference was statistically significant (p < 0.05). Multivariate logistic regression analysis showed that prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding of more than 24 h, and the time of first bowel movement over 24 h were risk factors for the development of neonatal hyperbilirubinemia (p < 0.05). CONCLUSION: The G1338A and G1376T mutations were important features of the genetics of neonatal hyperbilirubinemia, and genetic detection together with the prevention of prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding, and the time of first bowel movement would help reduce the incidence of this disease. Show more

Keywords: Neonate, hyperbilirubinemia, gene detection, G6PD, risk factor

DOI: 10.3233/THC-220472

Citation: Technology and Health Care, vol. 32, no. 2, pp. 565-572, 2024

Authors: Han, Xueyan | Dong, Litong | Zhang, Wenxiao | Liang, Chun | Wang, Zuobin

Article Type: Research Article

Abstract: BACKGROUND: Cells adherence provides specific information about physiology and pathology, the adhesion measurement between living cells and nanostructures can be measured by atomic force microscopy, but this detection technique is difficult to operate and costly. The adhesion height and effective contact area between cells and substrates are also the key factors affecting measurement value of the overall impedance. These factors change with structural parameters of the substrates, so the adhesion measurement between living cells and substrate can be indirectly reflected by the impedance value. OBJECTIVE: To establish a mapping relationship between the impedance measurement and the …adhesion measurement of living cells. The possibility of dynamic measurement of adhesion is realized by this method, and the experimental process is simplified. METHODS: Laser interference technology was used to prepare nanoarray structures with different periods on the surface of silicon wafers for cells culture. Under the same experimental conditions, the impedance of living cells on the substrates of different cycle sizes were measured. The adhesion between cells and different substrates were analyzed by measuring impedance after the interaction between cells and substrate. RESULTS: The adhesion of living cells on the substrates of different sizes be analyzed, and the mapping relationship between the impedance and the adhesion measurement was established. The results showed that, the larger the impedance value between cells and substrate, the larger the effective contact area and the smaller the gap between them. CONCLUSION: The difference of adhesion height and effective adhesion area between living cells and substrates were obtained. This paper, a new method to measure the adhesion properties of living cells is presented, which provides theoretical basis for the related research. Show more

Keywords: Living cells, nanostructure, impedance, adhesion, effective adhesion areas

DOI: 10.3233/THC-220584

Citation: Technology and Health Care, vol. 32, no. 2, pp. 573-583, 2024

Authors: Egenolf, Philipp | Wahlers, Christopher | Grevenstein, David | Gathof, Birgit S. | Eysel, Peer | Oppermann, Johannes

Article Type: Research Article

Abstract: BACKGROUND: C-reactive protein (CRP)- and leukocyte levels are common parameters to evaluate the inflammatory response after orthopaedic surgery and rule out infectious complications. Nevertheless, both parameters are vulnerable to disturbing biases and therefore leave room for interpretation. OBJECTIVE: Since blood groups are repeatedly discussed to influence inflammatory response, our aim was to observe their impact on CRP and leukocyte levels after total hip and knee arthroplasty (THA/TKA). METHODS: Short term postoperative CRP and leukocyte levels of 987 patients, who received either primary TKH (n = 479) or THA …(n = 508), were retrospectively correlated with their blood group. ABO, Rhesus and a combination of both blood groups were differentiated. RESULTS: CRP levels after TKA were significantly higher in blood type AB than in type A and O on day 2–4 and also than in type A on day 6–8. Leukocyte levels after THA were significantly higher in blood group type O than in type A on day 6–8 while still remaining in an apathological range. We observed no significant differences between Rhesus types and Rhesus types and CRP or leukocyte levels. CONCLUSION: We observed significantly increased CRP levels after TKA in patients with blood group AB. Since the elevated CRP levels do not account for early periprosthetic infection, surgeons should include this variation in their postoperative evaluation. Show more

Keywords: Arthroplasty, leukocytes, C-reactive protein, ABO blood-group system

DOI: 10.3233/THC-220635

Citation: Technology and Health Care, vol. 32, no. 2, pp. 585-593, 2024

Authors: Li, Wenzhe | Xu, Li | Wang, Yajing | Li, Wenjun | Maimaiti, Meiligu | Kou, Bin | Liu, Chenchen | Zhang, Meng | Xia, Hongjuan | Yuan, Fang

Article Type: Research Article

Abstract: BACKGROUND: Without timely and effective interventions or treatments, radiation-induced liver damage (RILD) can lead to serious consequences for the patients and their families. OBJECTIVE: To investigate the protective effect of intermittent hypobaric hypoxia preconditioning (IHHP) in RILD. METHODS: Male adult SD rats were randomly divided into 8 groups including one control group, one only irradiation group and other experimental groups. Blood routine tests and liver function tests were all assessed with abdominal venous blood. Moreover, hematoxylin eosin (HE) staining and immunohistochemistry assay were used to detect the histopathological changes and expressions of transforming …growth factor-β 1 (TGF-β 1), tumor necrosis factor α (TNF-α ) and hypoxia-inducible factor 1α (HIF-1α ) in radiated liver sections. RESULTS: Blood routing tests showed that RBC, WBC and Hb were all significantly increased while the differences of these results between different groups with same simulated altitude were approximate. However, liver function in the IHHP plus irradiation at 4000 m group was significantly decreased (P < 0.05) compared to only irradiation groups, and the manifestation of HE and lower positive expression of TNF-α showed improved histopathological changes in the liver section. Furthermore, no significant difference of HIF-1α expression between any two groups treated with IHHP was observed. CONCLUSION: IHHP at the altitude of 4000 m group could alleviate the radioactive liver damage by downregulating TNF-α and less strong positive expression of TGF-β 1. Furthermore, patients exposed to radiation might benefit from this treatment to prevent or reduce the RILD. Show more

Keywords: Liver injury, irradiation, radiation induced liver damage (RILD), hypoxia inducible factor-1α (HIF-1α), intermittent hypobaric hypoxia preconditioning (IHHP), oxidative stress

DOI: 10.3233/THC-220718

Citation: Technology and Health Care, vol. 32, no. 2, pp. 595-604, 2024

Authors: Bing, Wanchun | Zhang, Xiaoxiao | Wang, Dawei | Gu, Xiaoyan

Article Type: Research Article

Abstract: BACKGROUND: Recurrent acute pancreatitis is a common acute abdominal disease in surgery. OBJECTIVE: To evaluate the radiographic features of pancreatic computed tomography (CT) imaging in the diagnosis of acute and chronic pancreatitis. METHODS: 48 pancreatitis patients who met the criteria were selected in this retrospective study from 2010 to 2019. Each diagnosis was evaluated as functional abdominal pain, recurrent acute pancreatitis, or chronic pancreatitis. All clinical data were collected from the patient’s medical records. 54 radiological features were extracted from each region of interest in outline the pancreas and divided into five categories: …first order statistics, the gray level co-occurrence matrix (GLCM), the gray level run-length matrix (GLRLM), the neighborhood gray level difference matrix (NGTDM), and morphological features by the MATLAB program. RESULTS: Of the 48 patients, 16 had functional abdominal pain (33.3%), 18 had recurrent acute pancreatitis (37.5%), and 14 had chronic pancreatitis (29.2%). In the univariate analysis, nine radiological features, eight GLCM features and one NGTDM feature were significantly different between groups. Nine radiological characteristics had important reference values with AUC values ranging from 0.73–0.91. CONCLUSION: Nine radiographic features of CT imaging demonstrate good evaluation efficiency in the diagnosis of pancreatitis and can distinguish patients with functional abdominal pain, recurrent acute pancreatitis, and chronic pancreatitis. Show more

Keywords: Computed tomography, radiomics, recurrent acute pancreatitis, chronic pancreatitis

DOI: 10.3233/THC-220732

Citation: Technology and Health Care, vol. 32, no. 2, pp. 605-613, 2024

Authors: Liu, Bin | Sun, Chuan | Zhao, Xinyu | Liu, Lingyu | Liu, Shuang | Ma, Haichuan

Article Type: Research Article

Abstract: BACKGROUND: Surgery is the preferred treatment for rectal cancer, but surgical treatment alone sometimes does not achieve satisfactory results. OBJECTIVE: To explore the value of multimodal Magnetic Resonance (MR) images in evaluating T staging of rectal cancer after neoadjuvant therapy and to compare and analyze with pathological results. METHODS: This study retrospectively analyzed 232 patients with stage T3, T4 rectal cancer between January 1, 2017 and October 31, 2022. MR examination was performed within 3 days before surgery. Different MR sequences were used for mrT staging of rectal cancer after neoadjuvant therapy and …compared with pathological pT staging. The accuracy of different MR sequences in evaluating T staging of rectal cancer was calculated, and the consistency between the two was analyzed by kappa test. The sensitivity, specificity, negative predictive value and positive predictive value of different MR sequences in evaluating rectal cancer invading mesorectal fascia after neoadjuvant therapy were calculated. RESULTS: A total of 232 patients with rectal cancer were included in the study. The accuracy of high-resolution T2 WI in evaluating T staging of rectal cancer after neoadjuvant therapy was 49.57%, and the Kappa value was 0.261. The accuracy of high-resolution T2WI combined with diffusion weighted imaging (DWI) in evaluating T staging of rectal cancer after neoadjuvant therapy was 61.64%, and the Kappa value was 0.411. The accuracy of high-resolution combined with DCE-MR images in evaluating T staging of rectal cancer after neoadjuvant therapy was 80.60%, and the Kappa value was 0.706. The sensitivity and specificity of high-resolution t2-weighted imaging (HR-T2WI) combined with dynamic contrast-enhancement magnetic resonance (DCE-MR) in evaluating the invasion of mesorectal fascia were 83.46% and 95.33%, respectively. CONCLUSION: Compared with HR-T2WI combined with DWI images for mrT staging of rectal cancer after neoadjuvant chemoradiotherapy (N-CRT), HR-T2WI combined with DCE-M has the highest accuracy in evaluating mrT staging of rectal cancer after neoadjuvant therapy (80.60%), and has a high consistency with pathological pT staging. It is the best sequence for T staging of rectal cancer after neoadjuvant therapy. At the same time, the sequence has high sensitivity and specificity in evaluating mesorectal fascia invasion, which can provide accurate perioperative information for the formulation of surgical plan. Show more

Keywords: Rectal cancer, neoadjuvant therapy, efficacy, re-staging, magnetic resonance

DOI: 10.3233/THC-220798

Citation: Technology and Health Care, vol. 32, no. 2, pp. 615-627, 2024

Authors: Yu, Zhan-Biao | Cui, Na | Zhang, Nan | Su, Dan | Wu, Jia-Qian | Xi, Xiu-Ming

Article Type: Research Article

Abstract: BACKGROUND: Finding a simple and reliable method to predict and assess fluid responsiveness has long been of clinical interest. OBJECTIVE: To investigate the predictive value of a ventilator disconnection (DV) test combined with the pulse contour-derived cardiac output (PiCCO) index on fluid responsiveness for patients in shock. METHODS: Thirty-two patients were chosen for the study. Patients who were in shock, received mechanical ventilation, and met the inclusion criteria were selected. Patients were divided into a fluid-responsive group (14 patients) and fluid-unresponsive group (18 patients) based on whether the increase in cardiac index (Δ …CI) was > 10% or not, respectively, following the fluid challenge test. Changes in heart rate, pulse oximeter-measured oxygen saturation, mean arterial pressure (MAP), and CI before and after passive leg raising (PLR), DV, and fluid challenge tests were observed. We used Pearson’s correlation coefficient to analyze an increase in the MAP (Δ MAP) and Δ CI before and after the PLR, DV, and fluid challenge tests; the sensitivity and specificity of the Δ MAP and Δ CI in the PLR and DV tests for predicting fluid response were also analyzed by plotting the receiver operating characteristic (ROC) curves. RESULTS: CI results in the PLR and DV tests, as well as the fluid challenge test, were significantly higher in the fluid-responsive group compared with before the test (P < 0.05). The Δ CI before and after the PLR, DV, and fluid challenge tests were positively correlated among patients in the fluid-responsive group. The area under the ROC curve for the post-PLR test CI and the post-DV CI for predicting fluid responsiveness was 0.869 (95% confidence interval (CI) [0.735–1.000, P = 0.000]) and 0.937 (95% CI [0.829–1.000, P = 0.000]), respectively, in patients in the fluid-responsive group. The sensitivity and specificity of the post-DV CI for predicting fluid responsiveness in all patients was 100.0% and 88.9%, respectively, using a 5% increase as the cut-off value. CONCLUSION: Application of DV, combined with PiCCO, has a high predictive value for fluid responsiveness among patients in shock. Show more

Keywords: Shock, ventilator, mechanical, fluid responsiveness, ventilator disconnection test, pulse contour-derived cardiac index

DOI: 10.3233/THC-220799

Citation: Technology and Health Care, vol. 32, no. 2, pp. 629-638, 2024

Authors: Liu, Wen-Juan

Article Type: Research Article

Abstract: BACKGROUND: Strokes are the most common cause of death and the leading cause of acquired disability in adults worldwide. OBJECTIVE: The present study aimed to investigate the value of transcranial Doppler ultrasound (TCD) in the diagnosis of intracranial vascular stenosis in patients with a history of stroke. METHODS: This is a meta-analysis study of diagnostic tests. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP databases were systematically searched. Diagnostic tests using TCD or transcranial colour Doppler ultrasound (TCCD) for detecting intracranial arterial stenosis in patients with a history of stroke …were included, with reference standards of intracranial angiography, computed tomography angiography (CTA), or magnetic resonance angiography. The risk bias map was drawn by Revman v5.3, the sensitivity and specificity forest plot was drawn by Stata v16.0, the receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated. RESULTS: A total of 812 patients with stroke in 12 studies were included in the meta-analysis. The estimated sensitivity of TCD or TCCD for the detection of intracranial vascular stenosis was 0.77–1.00, and the combined sensitivity was 0.96 (95% confidence interval [CI]: 0.88–0.99); the estimated specificity was 0.32–1.00, and the combined specificity was 0.94 (95% CI: 0.82–0.98); the positive likelihood ratio was 15.8 (95% CI: 5.1–48.6); and the negative likelihood ratio was 0.04 (95% CI: 0.01–0.14). The AUC was 0.99 (95% CI: 0.97–0.99). CONCLUSION: Doppler ultrasound has good consistency with conventional methods for the diagnosis of intracranial artery stenosis in patients with a history of stroke. Different reference standards may affect sensitivity and specificity; when CTA was used as the reference standard, the consistency of the TCD in the diagnosis of intracranial artery stenosis in stroke patients was relatively good. Show more

Keywords: Transcranial Doppler, stroke, intracranial artery stenosis, diagnostic value

DOI: 10.3233/THC-220844

Citation: Technology and Health Care, vol. 32, no. 2, pp. 639-649, 2024

Authors: Ochiai, Ryoichi | Terada, Takashi | Sakamoto, Noriaki

Article Type: Research Article

Abstract: BACKGROUND: Several monitors have been developed that measure stroke volume (SV) in a beat-to-beat manner. Accordingly, Stroke volume variation (SVV) induced by positive pressure ventilation is widely used to predict fluid responsiveness. OBJECTIVE: The purpose of this study was to compare the ability of two different methods to predict fluid responsiveness using SVV, stroke volume variation by esCCO (esSVV) and stroke volume variation by FloTrac/VigileoTM (flSVV). METHODS: esSVV, flSVV, and stroke volume index (SVI) by both monitoring devices of 37 adult patients who underwent laparotomy surgery, were measured. Receiver operating characteristic (ROC) …analysis was performed. RESULTS: The area under the ROC curve (AUC) of esSVV was significantly higher than that of flSVV (p = 0.030). esSVV and flSVV showed cutoff values of 6.1% and 10% respectively, to predict an increase of more than 10% in SVI after fluid challenge. The Youden index for esSVV was higher than flSVV, even with a cutoff value between 6% and 8%. CONCLUSION: Since esSVV and flSVV showed significant differences in AUC and cutoff values, the two systems were not comparable in predicting fluid responsiveness. Furthermore, it seems that SVV needs to be personalized to accurately predict fluid responsiveness for each patient. Show more

Keywords: Estimated continuous cardiac output, stroke volume variation, stroke volume index, pulse wave transit time, pressure wave analysis

DOI: 10.3233/THC-220849

Citation: Technology and Health Care, vol. 32, no. 2, pp. 651-662, 2024

Authors: Gao, Jingfang | Zhu, Yuxin | Zhang, Congcong | Yin, Xinxin

Article Type: Research Article

Abstract: BACKGROUND: Peripherally inserted central catheter (PICC) is widely used in chemotherapy of children with malignant tumors because of its safe operation and long indwelling time. OBJECTIVE: To investigate the effect of intracavitary electroencephalogram (CEEG) localization technique on the success rate and complications of PICC in infants. METHODS: A total of 180 children with PICC catheterization and maintenance at Shijiazhuang People’s Hospital First Hospital from January 2017 to January 2020 were selected and divided into control group (n = 90 cases) and observation group (n = …90 cases). The control group observed the tip position of the fixed catheter through X-ray film and adjusted the catheter until its tip was located in the superior vena cava. The observation group used intracavitary electrocardiogram positioning technology. Comparison of the effects of two groups on the success rate and complications of PICC puncture in infants and young children. RESULTS: The success rate of one puncture in the observation group was significantly higher than that in the control group (P < 0.05). Within one month of catheterization, 13 cases had complications, with an incidence rate of 16.00% lower than the control group’s 34.00% (27/80) (P < 0.05). The screening test results showed that the specificity, sensitivity, Youden index, accuracy, kappa coefficient, positive and negative predictive value were 88.89%, 97.56%, 0.86, 96.00%, 0.86, 0.86, respectively. The measured values were 97.56% and 88.89% respectively, and the cost and time of localization were lower than those of X-ray. CONCLUSION: The technique of intracavitary electrogram can be more accurate for infants to place the tip of central venous catheter through peripheral vein, which can effectively improve the success rate of one puncture with low cost, and has high reliability, accuracy and practicability, which is safe and effective. Show more

Keywords: Intracavitary electrocardiogram, infants, peripherally inserted central venous catheter, puncture, complications

DOI: 10.3233/THC-230014

Citation: Technology and Health Care, vol. 32, no. 2, pp. 663-673, 2024

Authors: Liu, Xinyi | Liu, Hao | Liu, Yuanji

Article Type: Research Article

Abstract: BACKGROUND: During an outbreak such as COVID-19, hospital staff needs to be in close contact with all types of patients visiting the hospital and the risk of cross-infection is extremely high. Payment and medication pickup is a mandatory part of a patient’s hospital visit, with direct contact between healthcare workers and patients, and long waiting times in the hospital area, which can easily lead to the spread of disease infection. OBJECTIVE: This paper designed the prototype of a contactless smart medicine cabinet based on RFID technology and optimized the patient consultation and medication pickup process to …address these problems. METHODS: We conducted a 50-day field observation of patients for consultation and medication pickup at the First Hospital in H city, Jiangsu Province, China, and randomly timed 1600 sets of data from Surgery (ophthalmology) and Internal patients, then we designed the prototype of a contactless smart medicine cabinet based on RFID technology, optimized the patient consultation and medication pickup process, comparing the traditional and intelligent models using AnyLogic. RESULTS: The results show that this contactless medicine cabinet was able to reduce the time taken by patients in consultation and medicine pickup by 18.74 minutes, increasing the overall efficiency of the consultation by 32.20%. The simulation revealed that this contactless intelligent medication pickup model was able to reduce the time taken by patients in consultation and medicine pickup, increasing the overall efficiency of the consultation, effectively reducing the frequency of contact between healthcare workers and patients, and reducing the risk of disease infection. CONCLUSION: The proposed technical model provides a new idea to solve the problems of long queues, low efficiency and high risk of infection for patients to consult and get medicine during epidemics. Especially within hospitals it has important theoretical and practical implications for epidemic prevention and control as well as future hospital management. Show more

Keywords: COVID-19, RFID, contactless, hospital, intelligent medication pickup

DOI: 10.3233/THC-230027

Citation: Technology and Health Care, vol. 32, no. 2, pp. 675-693, 2024

Authors: Ma, Jun | Jin, Nana | Wang, Jingyi | Cao, Xiaoli | Zhang, Mingxia

Article Type: Research Article

Abstract: BACKGROUND: Bone defects and deep periodontal pockets often exist distal to the second molar after mandibular third molar extraction, seriously threatening the periodontal health of the second molar. OBJECTIVE: To evaluate the effect of socket preservation with bone substitute materials on alveolar bone resorption and prevention of the distal periodontal defect of the adjacent tooth after mandibular impacted third molar extraction compared with natural healing. METHODS: Ninety-nine patients with mandibular impacted teeth, treated in our hospital from January 2018 to December 2020, were randomly divided into the control and experimental groups. The experimental …group underwent minimally invasive tooth extraction and socket preservation using the deproteinised bovine bone mineral, Bio-Oss and the bioabsorbable collagen membrane, Bio-Gide. The control group healed naturally after minimally invasive tooth extraction. The alveolar ridge dimension of the extraction sites, the probing depth, tooth mobility and gingival index on the distal aspect of the mandibular second molars were examined and recorded before and six months after the operations. RESULTS: There was a significant difference between the experimental group and the control group in the alveolar bone width (P < 0.05) and height (P < 0.05) before and after surgery. The probing depth of the extraction sites in both groups was reduced. CONCLUSION: Using Bio-Oss and Bio-Gide to preserve extraction sites of impacted teeth can promote recovery more effectively than natural healing on the height of the distal alveolar bone and the width of the alveolar crest of the second molar and thus improve the periodontal status of the adjacent second molar. Show more

Keywords: Impacted mandibular third molar, second molar, alveolar bone, socket preservation

DOI: 10.3233/THC-230043

Citation: Technology and Health Care, vol. 32, no. 2, pp. 695-704, 2024

Authors: Lin, Bi-Hua | Zhong, Gui-Qin | Meng, Xiao-Hong | Han, Hai-E | Hu, Xue-Qin | Lin, Jing-Jing | Zhong, Shi-Chai | Lin, Yan-Juan

Article Type: Research Article

Abstract: BACKGROUND: With improving living standards, the incidence of cervical spondylotic myelopathy (CSM) has become increasingly high. OBJECTIVE: The study aims to explore the effect of diversified health-promoting models on rehabilitation exercises in patients with CSM after an operation. METHOD: This was a randomized controlled trial, wherein 107 patients with CSM treated by neurosurgery were selected as the subjects. Of those, 52 patients in the control group adopted the conventional health-promoting model, while the remaining 55 patients in the intervention group adopted diversified health-promoting models. The effect of rehabilitation exercises in the two groups …was evaluated according to the self-efficacy rehabilitation outcome scale, grip strength measurement of the affected limb, and Barthel index. RESULTS: At Day 3 post-operation and before discharge, the self-efficacy management of rehabilitation exercises in the intervention group was better than that of the control group (P < 0.05). The grip strength measurement of the affected limb, Japanese Orthopedic Association score of the cervical vertebra, and Barthel index of the two groups at Day 3 post-operation were lower than before the intervention and were not statistically significant (P > 0.05). However, these three items before discharge were improved when compared with those of before intervention and were statistically significant (P < 0.05). CONCLUSION: Postoperative rehabilitation exercises guided by the diversified health-promoting models for patients with CSM can improve the patients’ self-efficacy management ability in rehabilitation exercises, help improve grip strength, and promote the recovery of cervical vertebra function, thereby improving the patients’ quality of life. Show more

Keywords: Diversified, health-promoting, publicity and education, cervical spondylotic myelopathy, rehabilitation exercise

DOI: 10.3233/THC-230056

Citation: Technology and Health Care, vol. 32, no. 2, pp. 705-718, 2024

Authors: Wang, Wei-Zhong | Ying, Li-Jun | Liu, Wei-Dong | Zhang, Pan | Li, Shun-Fa

Article Type: Research Article

Abstract: BACKGROUND: Providers should adjust the depth of sedation to promote lung-protective ventilation in patients with severe ARDS. This recommendation was based on the assumption that the depth of sedation could be used to assess respiratory drive. OBJECTIVE: To assess the association between respiratory drive and sedation in patients with severe ARDS by using ventilator-measured P0.1 and RASS score. METHODS: Loss of spontaneous breathing was observed within 48 h of mechanical ventilation in patients with severe ARDS, and spontaneous breathing returned after 48 hours. P0.1 was measured by ventilator every 12 ± …2 hours, and the RASS score was measured synchronously. RESULTS: The RASS score was moderately correlated with P0.1 (R 𝑆𝑝𝑒𝑎𝑟𝑚𝑎𝑛 , 0.570; 95% CI, 0.475 to 0.637; p = 0.00). However, only patients with a RASS score of - 5 were considered to have no excessive respiratory drive, but there was a risk for loss of spontaneous breathing. A P0.1 exceeding 3.5 cm H2 O in patients with other RASS scores indicated an increase in respiratory drive. CONCLUSION: RASS score has little clinical significance in evaluating respiratory drive in severe ARDS. P0.1 should be evaluated by ventilator when adjusting the depth of sedation to promote lung-protective ventilation. Show more

Keywords: Acute respiratory distress syndrome, P0.1, respiratory drive, mechanical ventilation, sedation

DOI: 10.3233/THC-230096

Citation: Technology and Health Care, vol. 32, no. 2, pp. 719-726, 2024

Authors: Qi, Hai-Feng | Sun, Xiao-Qin | Du, Hai-Kun | Li, Jun-Hua | Zhang, Li-Yan | Xi, Yong-Guo

Article Type: Research Article

Abstract: BACKGROUND: With more pregnant women undergoing cesarean section, the number of women with scarring in the uterus undergoing uterine magnetic resonance (MR) examination in the second and third trimesters following a subsequent pregnancy, has increased. OBJECTIVE: To investigate features of MR signals in retroplacental basal decidual space. METHODS: The MR imaging data of patients with clinically and pathologically confirmed placenta implantation and complete placental abruption were retrospectively analyzed. RESULTS: Patients with high-intensity signals in T2-weighted images (T2WI) of the retroplacental basal decidual space did not suffer placenta implantation after delivery, …while high-intensity signals in T2WI of the retroplacental basal decidual space was not observed in patients with different degrees of placenta implantation. CONCLUSION: As the retroplacental basal decidual space is the barrier between the placenta and myometrium, high-intensity signals in T2WI can improve the confidence of MR exclusion diagnostics of placenta implantation, and can be used as exclusion criteria for MR diagnosis of placenta implantation. Show more

Keywords: Decidua basalis, magnetic resonance imaging, placenta implantation

DOI: 10.3233/THC-230098

Citation: Technology and Health Care, vol. 32, no. 2, pp. 727-734, 2024

Authors: Yao, Xiaohui | Liu, Shan | Xia, Huan | Li, Hanhan | Wang, Zhijie | Su, Le | Guo, Wei | Chen, Hanrui

Article Type: Research Article

Abstract: BACKGROUND: Recurrence is the main cause of death in hepatocellular carcinoma (HCC) patients after liver resection. OBJECTIVE: The long non-coding RNAs (lncRNAs) have been reported participated in progression and prognosis of HCC, however, the vital role of lncRNA in postoperative recurrence of HCC has rarely been systematically identified. METHODS: RNA-sequencing (RNA-seq) was performed between orthotopic model of HCC and hepatoma postoperative recurrent model to comprehensively analyze the integrated transcriptome expression profiles of lncRNA and mRNA. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was then conducted to quantify the expression levels of DElncRNAs and their …target mRNAs. RESULTS: In our study, 211 lncRNAs (P -value < 0.05) and 1125 mRNAs (P -adjust < 0.05) were significantly differentially expressed (DE) between two groups. Moreover, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that DElncRNAs and DEmRNAs were mainly enriched in lipid metabolism, including Arachidonic acid metabolism, PPAR signaling pathway, Steroid hormone biosynthesis, Linoleic acid metabolism, Inflammatory mediator regulation of TRP channels, and Fatty acid degradation. Furthermore, we constructed lncRNA-mRNA interaction networks and protein-protein interaction (PPI) network, and verified by qRT-PCR, suggesting that increased DEIncRNAs (XLOC_063499 and XLOC_042016) may prevent HCC recurrence after surgery by upregulating on targeted cytochrome P450 (CYP) family genes in the lipid metabolism pathway, such as cyp3a16, cyp3a44, cyp2c39, cyp2c40 and cyp2c68. CONCLUSION: Overall, Our findings provided new insights for further investigation of biological function in lncRNA related HCC recurrence. Show more

Keywords: LncRNA, RNA-seq, postoperative recurrence of HCC, HCC recurrence, hepatoma postoperative recurrent model, CYP

DOI: 10.3233/THC-230123

Citation: Technology and Health Care, vol. 32, no. 2, pp. 735-747, 2024

Authors: Yuan, Gaoteng | Zhai, Yi | Tang, Jiansong | Zhou, Xiaofeng

Article Type: Research Article

Abstract: BACKGROUND: Hepatitis B Virus (HBV) reactivation is the most common complication for patients with primary liver cancer (PLC) after radiotherapy. How to reduce the reactivation of HBV has been a hot topic in the study of postoperative radiotherapy for liver cancer. OBJECTIVE: To find out the inducement of HBV reactivation, a feature selection algorithm (MIC-CS) using maximum information coefficient (MIC) combined with cosine similarity (CS) was proposed to screen the risk factors that may affect HBV reactivation. METHOD: Firstly, different factors were coded and MIC between patients was calculated to acquire the association …between different factors and HBV reactivation. Secondly, a cosine similarity algorithm was constructed to calculate the similarity relationship between different factors, thus removing redundant information. Finally, combined with the weight of the two, the potential risk factors were sorted and the key factors leading to HBV reactivation were selected. RESULTS: The results indicated that HBV baseline, external boundary, TNM, KPS score, VD, AFP, and Child-Pugh could lead to HBV reactivation after radiotherapy. The classification model was constructed for the above factors, with the highest classification accuracy of 84% and the AUC value of 0.71. CONCLUSION: Comparing multiple feature selection methods, the results showed that the effect of the MIC-CS was significantly better than MIM, CMIM, and mRMR, so it has a very broad application prospect. Show more

Keywords: HBV, MIC, cosine similarity, feature selection, classification

DOI: 10.3233/THC-230161

Citation: Technology and Health Care, vol. 32, no. 2, pp. 749-763, 2024

Authors: Zhang, Xuelan | Peng, Yuan | Li, Gaoyang | Li, Jiehua | Luo, Mingyao | Che, Yue | Zheng, Liancun | Anzai, Hitomi | Ohta, Makoto | Shu, Chang

Article Type: Research Article

Abstract: BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening aortic disease. However, little information is available on predicting and understanding of ATBAD. OBJECTIVE: The study sought to explore the underlying mechanism of ATBAD by analyzing the morphological and hemodynamic characteristics related to aortic length. METHODS: The length and tortuosity of the segment and the whole aorta in the ATBAD group (n = 163) and control group (n = 120) were measured. A fixed anatomic landmark from the distal of left subclavian artery …(LSA) to the superior border of sixth thoracic vertebra was proposed as the proximal descending thoracic aorta (PDTA), and the dimensionless parameter, length ratio, was introduced to eliminate the individual differences. The significant morphological parameters were filtrated and the associations between parameters were investigated using statistical approaches. Furthermore, how aortic morphology influenced ATBAD was explored based on idealized aortic models and hemodynamic-related metrics. RESULTS: The PDTA length was significantly increased in the ATBAD group compared with the control group and had a strong positive correlation with the whole aortic length (r = 0.89). The length ratio (LR2 ) and tortuosity (T2 ) of PDTA in the ATBAD group were significantly increased (0.15 ± 0.02 vs 0.12 ± 0.02 and 1.73 ± 0.48 vs 1.50 ± 0.36; P < 0.001), and LR2 was positive correlation with T2 (r = 0.73). In receiver-operating curve analysis, the area under the curve was 0.835 for LR2 and 0.641 for T2 . Low and oscillatory shear (LOS) was positive correlation with LR2 , and the elevated LOS occurred in the distal of LSA. CONCLUSION: Elongation of PDTA is associated with ATBAD, and the length ratio is a novel predictor. Elongated PDTA induced more aggressive hemodynamic forces, and high LOS regions may correspond to the entry tear location. The synergy of the morphological variation and aggressive hemodynamics creates contributory conditions for ATBAD. Show more

Keywords: Aortic dissection, aortic elongation, length ratio, hemodynamics, low and oscillatory shear

DOI: 10.3233/THC-230194

Citation: Technology and Health Care, vol. 32, no. 2, pp. 765-777, 2024

Authors: Mur, Linda | Annon-Eberharter, Natalee | Gombos, Petra | Wald, Martin

Article Type: Research Article

Abstract: BACKGROUND: Dead space is the part of the airway where no gas exchange takes place. Any increase in dead space volume has a proportional effect on the required tidal volume and thus on the risk of ventilation-induced lung injury. Inserts that increase dead space are therefore not used in small preterm infants. This includes end-tidal CO2 measurement. OBJECTIVE: The aim of this study was to investigate the effect of the end-tidal CO2 measurement adapter on ventilation. METHODS: In an experimental setup, an end-tidal CO2 measurement adapter, three different pneumotachographs (PNT-A, …PNT-B, PNT-Neo), and a closed suction adapter were combined in varying set-ups. The time required for CO2 elimination by a CO2 -flooded preterm infant test lung was measured. RESULTS: PNT-A prolonged CO2 elimination time by 0.9 s (+ 3.3%), Neo-PNT by 3.2 s (+ 11.6%) and PNT-B by 9.0 s (+ 32.7%). The end-tidal CO2 measurement adapter prolonged the elimination time by an additional second without the pneumotachograph (+ 3.6%) and in combination with PNT-A (+ 3.1%) and PNT-Neo (+ 3.1%). In conjunction with PNT-B, the end-tidal CO2 measurement adapter reduced the elimination time by 0.3 seconds (- 1%). The use of a closed suction adaptor increased the CO2 elimination time by a further second with PNT-Neo (+ 3.1%) and by an additional two seconds with no flow sensor (+ 6.9%), with PNT-A (+ 6.4%) and with PNT-B (+ 5.5%). CONCLUSION: The flow sensor had the greatest influence on ventilatory effort, while end-tidal CO2 measurement had only a moderate effect. The increased ventilatory effort levied by the CO2 measurement was dependent on the flow sensor selected. The use of closed suctioning more negatively impacted ventilatory effort than did end-tidal CO2 measurement. Show more

Keywords: Neonatal intensive care units, tidal volume, extremely premature infant, ventilator-induced lung injury, mechanical ventilators

DOI: 10.3233/THC-230195

Citation: Technology and Health Care, vol. 32, no. 2, pp. 779-785, 2024

Authors: Elrashid, Afra Hassan | Alsarh, Sarah Ahmad | Alotaibi, Dalia Saleh | Albaqami, Majed Adi | Algadhi, Saleh Khalid | Alfaraj, Reham Ahmad | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Bleaching is a highly common method used nowadays to treat tooth discolouration because it is a significant cosmetic issue, particularly with anterior teeth, however bleaching itself results in microleakage. OBJECTIVE: This study aims to evaluate the impact of in-office bleaching on class V restoration microleakage with type 1 and type 2 composite restorations. METHODS: Three hundred and twenty healthy, caries-free removed human anterior teeth were used in this in-vitro study. All extracted teeth had their buccal and lingual surfaces uniformly prepped for class V cavities. The 120 removed teeth were divided …into two groups, with Group 1 receiving Tetric N-Ceram nanohybrid composite restorations and Group 2 receiving 3 M Filtek Z350 XT nanohybrid composite restorations. Groups 1 and 2 were further broken into four more subgroups of four each. The restorations were sealed with a G-Coat Plus resin. The p -value was kept at 0.005 for the data analysis using the Chi-square and Fisher exact tests. RESULTS: Allocating microleakage among 320 study models revealed that 141 (44.1%) study samples had no microleakage, whereas 20 (6.3%), 54 (16.9%), and 105 (32.8%) study samples had microleakage up to, between, and greater than two-thirds of cavity depth. With a statistically significant p -value of 0.001, no microleakage was discovered in 85 (53.1%) lingual surfaces with Tetric N-Ceram nanohybrid composite restoration and 56 (35%) buccal surfaces with 3M Filtek Z350 XT nanohybrid composite restoration. 19.1% of samples of N-Ceram that were sealed and not bleached had no microleakage, according to analysis of microleakage across several groups. With a p -value of 0.001, the distribution of microleakage among various clusters was statistically notable. CONCLUSION: According to the findings of the study, hydrogen peroxide bleaching has an enhanced impact on micro escape during dye dispersion. Both with and without bleaching, resin coating can be utilised to minimise marginal microleakage. Show more

Keywords: Microleakage, resins, bleaching, composite restorations

DOI: 10.3233/THC-230213

Citation: Technology and Health Care, vol. 32, no. 2, pp. 787-798, 2024

Authors: Petrović, Nikola | Mandić, Sanja | Borojević, Svetlana | Gazivoda, Nemanja | Sovilj, Platon

Article Type: Research Article

Abstract: BACKGROUND: Cognitive neuroscience experiments require accurate and traceable methods of measuring cognitive phenomena, analyzing and processing data, and validating results, including measurement of impact of such phenomena on brain activity and consciousness. EEG measurement is the most widely used tool for evaluation of the experiment’s progress. To extract more information from the EEG signal, continuous innovation is necessary to provide a broader range of information. OBJECTIVE: This paper presents a new tool for measuring and mapping cognitive phenomena using time window-based multispectral brain mapping of electroencephalography (EEG) signals. METHODS: The tool was developed …using Python programming language and enables users to create brain maps images for six spectra (Delta, Theta, Alpha, Beta, Gamma, and Mu) of EEG signal. The system can accept an arbitrary number of EEG channels with standardized labels based on the 10–20 system, and users can select the channels, frequency bandwidth, type of signal processing, and time window length to perform the mapping. RESULTS: The key advantage of this tool is its ability to perform short-time brain mapping, which allows for the exploration and measurement of cognitive phenomena. The tool’s performance was evaluated through testing on real EEG signals, and results demonstrated its effectiveness in accurately mapping cognitive phenomena. CONCLUSION: The developed tool can be used in various applications, including cognitive neuroscience research and clinical studies. Future work involves optimizing the tool’s performance and expanding its capabilities. Show more

Keywords: Biomedical engineering, cognitive neuroscience, electroencephalography, brain mapping, biomedical measurement and instrumentation

DOI: 10.3233/THC-230241

Citation: Technology and Health Care, vol. 32, no. 2, pp. 799-808, 2024

Authors: Li, Miao-Miao | Pan, Jian-Xia | Wang, Jin-Hang | Hu, Zi-Lei | Zhao, Jing | Wei, Hai-Cheng

Article Type: Research Article

Abstract: BACKGROUND: Diabetes is a chronic disease that can lead to a variety of complications and even cause death. The signal characteristics of the photoplethysmography signals (PPG) and electrocardiogram signals (ECG) can reflect the autonomic and vascular aspects of the effects of diabetes on the body. OBJECTIVE: Based on the complex mechanism of interaction between PPG and ECG, a set of ensemble empirical mode decomposition-independent component analysis (EEMD-ICA) fusion multi-scale percussion entropy index (MSPEI) method was proposed to analyze cardiovascular function in diabetic patients. METHODS: Firstly, the original signal was decomposed into multiple Intrinsic …Mode Function (IMFs) by ensemble empirical mode decomposition EEMD, principal components of IMF were extracted by independent component analysis (ICA), then the extracted principal components were reconstructed to eliminate the complex high and low frequency noise of physiological signals. In addition, the MSPEI was calculated for the ECG R-R interval and PPG amplitude sequence.(RRI and Amp) The results showed that, compared with EEMD method, the SNR of EEMD-ICA method increases from 2.1551 to 11.3642, and the root mean square error (RMSE) decreases from 0.0556 to 0.0067. This algorithm can improve the performance of denoising and retain more feature information. The large and small scale entropy of MSPEI (RRI,Amp) was significantly different between healthy and diabetic patients (p < 0.01). RESULTS: Compared with arteriosclerosis index (AI) and multi-scale cross-approximate entropy (MCAE): MSPEISS (RRI,Amp) indicated that diabetes can affect the activity of human autonomic nervous system, while MSPEILS (RRI,Amp) indicated that diabetes can cause or worsen arteriosclerosis. CONCLUSION: Multi-scale Percussion Entropy algorithm has more advantages in analyzing the influence of diabetes on human cardiovascular and autonomic nervous function. Show more

Keywords: Diabetes, electrocardiogram, photoplethysmography, empirical mode decomposition-independent component analysis, multi-scale percussion entropy

DOI: 10.3233/THC-230243

Citation: Technology and Health Care, vol. 32, no. 2, pp. 809-821, 2024

Authors: Pan, Liang | Shan, Rui-Ying | Gao, Su-Fang | Zhou, Yan | Bao, Yuan-Yuan | Fu, Wenjing

Article Type: Research Article

Abstract: BACKGROUND: In malignant tumours of the female reproductive system, cervical cancer is second only to breast cancer, seriously threatening the health and safety of most women. OBJECTIVE: To evaluate the clinical value of 3.0 T multimodal nuclear magnetic resonance imaging (MRI) in the International Federation of Gynecology and Obstetrics’ (FIGO) staging of cervical cancer. METHODS: The clinical data of 30 patients with pathologically diagnosed cervical cancer admitted to our hospital from January 2018 to August 2022 were analysed retrospectively. Before treatment, all patients were examined with conventional MRI, diffusion-weighted imaging and multi-directional contrast-enhanced …imaging. RESULTS: The accuracy of multimodal MRI in the FIGO staging of cervical cancer (29/30, 96.7%) was significantly higher than the accuracy obtained in a control group (21/30, 70.0%), with a statistically significant difference (p = 0.013). In addition, there was good agreement between two observers applying multimodal imaging (kappa = 0.881) and moderate agreement between two observers in the control group (kappa = 0.538). CONCLUSION: Multimodal MRI can evaluate cervical cancer comprehensively and accurately to enable accurate FIGO staging, providing significant evidence for clinical operation planning and subsequent combined therapy. Show more

Keywords: Multimodal imaging, uterine cervical neoplasms, magnetic resonance imaging

DOI: 10.3233/THC-230252

Citation: Technology and Health Care, vol. 32, no. 2, pp. 823-830, 2024

Authors: Ju, Jieqin | Mao, Liqing | Wang, Yuejing | Xie, Haofen | Zhou, Shengjun

Article Type: Research Article

Abstract: BACKGROUND: Femoral artery puncture is still the most used surgical approach. Because the operation requires local anaesthesia, the patient may not be able to exert full self-control, and their upper and lower limbs and trunk need to be constrained by a protection device. OBJECTIVE: To explore the safe application effect of a new type of anti-movement protection device for upper and lower extremities, shoulders and chest in patients undergoing interventional therapy via the femoral artery approach. METHODS: This is a prospective randomised controlled study. A total of 230 patients were randomly divided into …two groups: the study group (n = 115) and the control group (n = 115). The time needed to implement the restraint operation and the loosening of the restraint device in the two groups was recorded, and the satisfaction of surgeons and nurses was investigated. RESULTS: The time needed to perform restraint operation in the study group was significantly less than that in the control group (4.06 ± 0.61 min vs. 7.01 ± 0.76 min, P < 0.05). The satisfaction of surgeons and nurses with the use of the new protective device was significantly better than that of the conventional restraint band (P < 0.05). CONCLUSION: The new anti-movement protection device for upper and lower limbs, shoulders and chest can conveniently and quickly achieve effective protection and braking of patients, ensure the safety of surgery and improve satisfaction. Show more

Keywords: Nursing safety, protective device, patient care, physical restraints, transfemoral intervention

DOI: 10.3233/THC-230254

Citation: Technology and Health Care, vol. 32, no. 2, pp. 831-840, 2024

Authors: Yue, Lei | Huo, Hai-Yang | Yang, Wei | Zhang, Ying-Huai

Article Type: Research Article

Abstract: BACKGROUND: Dental implant restoration is an effective therapy for missing teeth and is widely used in clinical practice to provide more treatment options for patients. OBJECTIVE: To explore the application of a positioning annular gingival cutter in minimally invasive stage II implant surgery and to evaluate its clinical effects. METHOD: Stage II implant surgery using a positioning annular gingival cutter was performed on 15 selected patients at 15 implant sites with sufficient keratinized gingival width in the posterior region. The patient underwent crown restoration 2 weeks after surgery and returned for follow-up 3 …months later. The surgical effects were recorded for each patient, including the duration of surgery, postoperative pain and swelling, keratinized gingiva width, probing depth (PD) measurements, and the percentage of bleeding on probing (BOP) before surgery, during crown restoration, and 3 months after crown restoration. The data were subjected to a paired sample t-test using Statistical Product and Service Solutions (SPSS) 25.0. RESULTS: The duration of stage II implant surgery using a positioning annular gingival cutter was 9.23 ± 1.63 min, and the duration of postoperative pain and swelling was 0.73 ± 0.35 and 0.81 ± 0.35 d, respectively. The keratinized gingiva width was 2.93 ± 0.41 mm before surgery and 2.91 ± 0.46 mm after crown restoration, demonstrating no significant reduction (P > 0.05). The keratinized gingiva width remained stable 3 months after crown restoration, with an average of 2.85 ± 0.49 mm, without significant reduction (P > 0.05). No obvious inflammation is observed. PD was 2.60 ± 0.52 mm and BOP was 10%. CONCLUSION: The use of a positioning annular gingival cutter in stage II implant surgery achieves a positive and stable clinical effect within a short time. Show more

Keywords: Circumferential supracrestal fiberotomy, keratinized gingiva, stage II implant surgery

DOI: 10.3233/THC-230262

Citation: Technology and Health Care, vol. 32, no. 2, pp. 841-847, 2024

Authors: Hong, Mei | Zhao, Yi-Dong | Zhong, Tao-Li | Lu, Ming | Sun, Wen-Hao | Chen, Tian-Yuan | Hong, Nan | Zhu, Yao | Yu, Da-Hai

Article Type: Research Article

Abstract: BACKGROUND: There are 1.8 million lung cancer deaths worldwide, accounting for 18% of global cancer deaths, including 710,000 in China, accounting for 23.8% of all cancer deaths in China. OBJECTIVE: To explore the out-of-set association rules of lung cancer symptoms and drugs through text mining of traditional Chinese medicine (TCM) treatment of lung cancer, and form medical case analysis to analyze the experience of TCM syndrome differentiation in its treatment. METHODS: The medical records of all patients diagnosed with lung cancer in Nanjing Chest Hospital from January to December 2018 were collected, and …the out-of-set association analysis was performed using the MedCase v5.2 TCM clinical scientific research auxiliary platform based on the frequent pattern growth enhanced association analysis algorithm. RESULTS: In terms of TCM treatment of lung cancer, the clinical symptoms with high correlation included cough, expectoration, chest distress, and white phlegm; and the drugs with high correlation included Pinellia ternata , licorice root, white Atractylodes rhizome , and Radix Ophiopogonis ; with the prescriptions based on Erchen and Maimendong decoctions. CONCLUSION: This analytical study of the medical cases of TCM treatment for lung cancer was performed using data mining techniques, and the out-of-set association rules between clinical symptoms and drugs were analyzed, including the understanding of lung cancer in TCM. Moreover, the essence of experience in drug use was gathered, providing significant scientific guidance for the clinical treatment of lung cancer. Show more

Keywords: Data mining, lung cancer, traditional Chinese medicine, out-of-set association

DOI: 10.3233/THC-230269

Citation: Technology and Health Care, vol. 32, no. 2, pp. 849-859, 2024

Authors: Xu, Wen-Bo | Lu, Zhi-Zeng | Mu, Lan

Article Type: Research Article

Abstract: BACKGROUND: With the ageing population in China and an increasing number of the elderly developing chronic illnesses, health services for the elderly have become a major concern. They have significant needs for health information (HI) such as online medical consultation, disease prevention, and medical insurance. OBJECTIVE: To explore the influencing factors and their relative significance in proxy online health information (OHI) seeking among the elderly with chronic illnesses so as to provide a reference for enriching theoretical research and optimizing care for the elderly with chronic illness. METHODS: Twenty-three elderly people with chronic …illnesses participated in semi-structured in-depth interviews in this study. The interview transcripts were subject to three levels of coding (open, axial, and selective coding) based on grounded theory to determine the factors influencing proxy OHI seeking among the elderly and to understand how the main categories are interconnected. We used the interpretive structural modeling (ISM) process to analyze the hierarchy and associated pathways among the factors influencing proxy OHI seeking. RESULTS: From our analysis, we identified four main categories affecting proxy HI seeking: the health status, emotional needs, electronic HI literacy, and self-efficacy of the elderly. There were six subcategories that could be further subclassified into direct factors, key factors, and root factors, which constituted the hierarchical model of influencing factors. CONCLUSION: We found that proxy HI seeking among the elderly was directly triggered by self-efficacy and emotional needs following changes in their evaluation of health information and emotional needs, which originates from their perceptions of their health, concerns about their health, and information retrieval capability. Show more

Keywords: Elderly, grounded theory, interpretative structural modeling, proxy seeking

DOI: 10.3233/THC-230270

Citation: Technology and Health Care, vol. 32, no. 2, pp. 861-871, 2024

Authors: Radakovic, Radivoje | Dasic, Lazar | Dopsaj, Milivoj | Filipovic, Nenad

Article Type: Research Article

Abstract: BACKGROUND: Being in peak physical condition and having specific motor abilities are necessity for every top-level soccer player in order to achieve success in competition. In order to correctly assess soccer players’ performance, this research uses laboratory and field measurements, as well as results of competitive performance obtained by direct software measurements of players’ movement during the actual soccer game. OBJECTIVE: The main goal of this research is to give insight into the key abilities that soccer players need to have in order to perform in competitive tournaments. Besides training adjustments, this research also gives insight …into what variables need to be tracked in order to accurately assess the efficiency and functionality of the players. METHODS: The collected data need to be analyzed using descriptive statistics. Collected data is also used as input for multiple regression models that can predict certain key measurements: total distance covered, percent of effective movements and high index of effective performance movements. RESULTS: Most of the calculated regression models have high predictability level with statistically significant variables. CONCLUSION: Based on the results of regression analysis it can be deduced that motor abilities are important factor in measuring soccer player’s competitive performance and team’s success in the match. Show more

Keywords: Effective movement, motor abilities, soccer player’s competition performance, total distance covered

DOI: 10.3233/THC-230275

Citation: Technology and Health Care, vol. 32, no. 2, pp. 873-884, 2024

Authors: Vavrickova, Lenka | Kapitan, Martin | Schmidt, Jan

Article Type: Research Article

Abstract: BACKGROUND: Digital impression technique or computer-aided impression (CAI) has been recently concluded as a clinically acceptable alternative to conventional impression method (CIM) in the fabrication of crowns, short fixed partial dentures (FPDs), and implant-supported crowns. OBJECTIVE: The purpose of this study was to investigate the patients’ opinion and subjective perception of two different ways of impression – digital and conventional. METHODS: A total of 45 patients were treated with CAI and CIM for the fabrication of tooth or implant-supported crowns. They fulfilled a questionnaire including 11 questions regarding the treatment time, gag reflex, …discomfort related to manipulation, and other aspects of treatment. RESULTS: CAI was considered the preferential method for future treatment in 53% of patients, whereas 28.9% of the respondents preferred CIM. The preference for the impression method was influenced by the total time spent with the procedure, discomfort during manipulation with the tray or scanning head, size of the tray or scanning head, maximal opening discomfort, and (the tendency towards) gag reflex. CONCLUSION: CAI was considered a more comfortable and preferential method. Discomfort or difficulties during CAI negatively affected the patients’ attitude to CAI, whereas the difficulties associated with CIM did not have any influence on the preferred method. Show more

Keywords: Dentistry, conventional impression, digital impression, implant-supported crown, tooth-supported crown, PROMs

DOI: 10.3233/THC-230277

Citation: Technology and Health Care, vol. 32, no. 2, pp. 885-896, 2024

Authors: Dong, Haonan | He, Zexi | Wang, Haifeng | Ding, Mingxia | Huang, Yinglong | Li, Haihao | Shi, Hongjin | Mao, Lan | Hu, Chongzhi | Wang, Jiansong

Article Type: Research Article

Abstract: BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common pathological type of renal cell carcinoma (RCC), and effective biomarkers will improve diagnosis and treatment. OBJECTIVE: This study investigated NPEPL1 expression in ccRCC through public databases and clinical samples and assessed its correlation with clinicopathological features and patient prognosis. METHOD: Data from The Cancer Genome Atlas and clinical specimens were gathered, NPEPL1 expression levels were analyzed; a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NPEPL1; and clinicopathological data was used to study the correlations between expression …and clinical parameters. NPEPL1’s prognostic value was appraised using a Kaplan–Meier (K–M) survival curve, Cox regression analysis, and a nomogram model; Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of differently expressed genes between tissues with high and low NPEPL1 expression were used to estimate the underlying mechanisms involved. RESULTS: NPEPL1 was significantly higher-expressed in ccRCC tissue. ROC analysis showed that NPEPL1 had noteworthy diagnostic efficacy. NPEPL1 expression was closely related to clinicopathological parameters, such as T and M stage. K–M analysis showed that overall survival was significantly shortened with high NPEPL1 expression. Cox regression analysis showed that NPEPL1 expression was an independent risk factor predicting overall survival. The nomogram showed a significantly high clinical value in predicting the 1-, 3-, and 5-year survival probabilities in ccRCC. GO and KEGG enrichment analysis suggested that NPEPL1 may promote the occurrence and development of ccRCC via the Ras signaling and other pathways. CONCLUSION: NPEPL1 expression in ccRCC was higher than that in normal kidney tissues and was significantly associated with advanced clinical stage and poor prognosis. Therefore, NPEPL1 is a promising prognostic biomarker. Show more

Keywords: Renal clear cell carcinoma, NPEPL1, Clinicopathology, prognosis

DOI: 10.3233/THC-230282

Citation: Technology and Health Care, vol. 32, no. 2, pp. 897-914, 2024

Authors: Tang, Bei | Ouyang, Wenbin | Deng, Jing | Huang, Xin

Article Type: Research Article

Abstract: BACKGROUND: In the wave of the novel coronavirus (COVID-19) epidemic, there is a need to investigate the mental health status of Chinese university students. OBJECTIVE: To examine the effects of witnessing cyberbullying on psychological distress and the mediating role of coping on these effects in Chinese university students, which is yet to be examined. METHODS: 306 Chinese university students were enrolled in this cross-sectional study. Linear regression was conducted to analyze the relationship between depression, anxiety and being a bystander to cyberbullying, whereas the bootstrapping approach tested the mediation effects of coping strategies. …RESULTS: Results indicated that 27.12% of subjects (95% CI: 22.22%, 32.48%) suffered from anxiety and 44.12% (95% CI: 38.47%, 49.88%) were depressed. Meanwhile, 89.87% of subjects were involved in witnessing cyberbullying. Being a bystander to cyberbullying was weakly but significantly associated with anxiety (β = 0.195, 95% CI: 0.068, 0.292) and depression (β = 0.223, 95% CI: 0.113,0.333). Negative coping partially mediated between witnessing cyberbullying and anxiety, with mediation effect values of 0.04 (P < 0.05). While being a bystander to cyberbullying was only directly associated with depression. CONCLUSION: Based on our findings, college students in Hunan, China, are experiencing anxiety, depression and cyberbullying after COVID-19. Being a bystander to cyberbullying is associated with coping strategies, anxiety, and depression. Cyberbullying has a direct impact on anxiety, but it also influences anxiety through mediating effects on coping. Show more

Keywords: Bystander of cyberbullying, anxiety, depression, coping strategies, mediation analysis

DOI: 10.3233/THC-230305

Citation: Technology and Health Care, vol. 32, no. 2, pp. 915-924, 2024

Authors: Lian, Weizhen | Lian, Kaimei | Lin, Teng

Article Type: Research Article

Abstract: BACKGROUND: Early breast cancer diagnosis is of great clinical importance for selecting treatment options, improving prognosis, and enhancing the quality of patients’ survival. OBJECTIVE: We investigated the value of virtual touch tissue imaging average grayscale values (VAGV) helper Breast Imaging Reporting and Data System (BI-RADS) in diagnosing breast malignancy. METHODS: We retrospectively analyzed 141 breast tumors in 134 patients. All breast lesions were diagnosed pathologically by biopsy or surgical excision. All patients first underwent conventional ultrasound (US) followed by virtual touch tissue imaging (VTI). The measurement of the VAGV of the lesion was …performed by Image J software. BI-RADS classification was performed for each lesion according to the US. We performed a two-by-two comparison of the diagnostic values of VAGV, BI-RADS, and BI-RADS+ VAGV. RESULTS: VAGV was lower in malignant tumors than in benign ones (35.82 ± 13.39 versus 73.58 ± 42.69, P < 0.001). The area under the receiver operating characteristic curve (AUC ) value, sensitivity, and specificity of VAGV was 0.834, 84.09%, and 69.07%, respectively. Among BI-RADS, VAGV, and BI-RADS+ VAGV, BI-RADS+ VAGV had the highest AUC (0.926 versus 0.882, P = 0.0066; 0.926 versus 0.834, P = 0.0012). There was perfect agreement between the two radiologists using VAGV (ICC = 0.9796) and substantial agreement using BI-RADS (Kappa = 0.725). CONCLUSION: Our study shows that VAGV can accurately diagnose breast cancer. VAGV effectively improves the diagnostic performance of BI-RADS. Show more

Keywords: Breast lesion, average grayscale value, virtual touch tissue imaging, Breast Imaging Reporting and Data System

DOI: 10.3233/THC-230306

Citation: Technology and Health Care, vol. 32, no. 2, pp. 925-936, 2024

Authors: Narula, Gagan | Boss, Jens | Seric, Marko | Baumann, Daniel | Salles, Joan P. | Fröhlich, Jürg | Baumann, Dirk | Keller, Emanuela | Willms, Jan

Article Type: Research Article

Abstract: BACKGROUND: Intracranial pressure (ICP) is a vital parameter that is continuously monitored in patients with severe brain injury and imminent intracranial hypertension. OBJECTIVE: To estimate intracranial pressure without intracranial probes based on transcutaneous near infrared spectroscopy (NIRS). METHODS: We developed machine learning based approaches for noninvasive intracranial pressure (ICP) estimation using signals from transcutaneous near infrared spectroscopy (NIRS) as well as other cardiovascular and artificial ventilation parameters. RESULTS: In a patient cohort of 25 patients, with 22 used for model development and 3 for model testing, the best performing models …were Fourier transform based Transformer ICP waveform estimation which produced a mean absolute error of 4.68 mm Hg (SD = 5.4) in estimation. CONCLUSION: We did not find a significant improvement in ICP estimation accuracy by including signals measured by transcutaneous NIRS. We expect that with higher quality and greater volume of data, noninvasive estimation of ICP will improve. Show more

Keywords: Brain injuries, intracranial pressure, machine learning, spectrum analysis

DOI: 10.3233/THC-230329

Citation: Technology and Health Care, vol. 32, no. 2, pp. 937-949, 2024

Authors: Salihagic, Iva Kozul | Hrkac, Adelina | Ovcaricek, Slaven | Bokarica, Pero | Gilja, Ivan

Article Type: Research Article

Abstract: BACKGROUND: Orthotopic urinary diversion is the preferred diversion after cystectomy. Neobladder reconstruction with a longer ileum segment (60 cm) is advantageous for obtaining a large capacity and continence at the beginning; however, the long-term risk of residual urine, chronic infection, and the need for intermittent catheterization is more pronounced with the neobladder constructed with a longer ileal segment compared to the neobladder tailored from the shorter ileal segment. OBJECTIVE: To establish the differences in the functional outcome of a shorter (< 45 cm) and longer (⩾ 45 cm) ileal segment …usage in the reconstruction of the Hautmann ileal neobladder following the radical cystectomy. METHODS: Between July 2013 and September 2015, 121 patients with muscle-invasive bladder cancer underwent radical cystectomy and Hautmann ileal neobladder reconstruction. Patients were divided into two groups, depending on the length of the ileum used for the diversion creation: < 45 cm of the ileum was used in the first group and ⩾ 45 cm in the second group. Five-year follow-up was performed at 1, 3, 6, and 9 months and 1 and 5 years. The main measured outcomes were functional outcomes and the quality of life. The evaluation included clinical, laboratory, and QLQ-C30 questionnaires. Statistical analysis was performed using descriptive statistics, Mann-Whitney U test, Kolmogorov-Smirnov test, ANOVA, and chi-squared tests. RESULTS: Patients with a smaller neobladder had a better quality of life, and higher global health status scale score. Thirteen early and 21 late complications developed in 10 and 17 patients, respectively. There were significant differences in the need for clean intermittent self-catheterization (CIC) between the two groups: smaller-volume pouch patients had statistically decreased need for CIC in 5 year follow-up compared to larger-volume pouch patients (χ 2 test = 8.245; df = 1; P = 0.004). Eighteen percent of patients with smaller neobladders had urinary tract infections in 5 years, compared to 35% with larger neobladders (χ 2 test = 4.447; df = 1; P = 0.034). CONCLUSION: Minimizing the length of the ileal segment needed for Hautmann neobladder reconstruction is feasible and provides better long-term results than larger-volume neobladders. Show more

Keywords: Hautmann neobladder, urinary diversion, radical cystectomy, urinary retention, urinary infection, continence

DOI: 10.3233/THC-230339

Citation: Technology and Health Care, vol. 32, no. 2, pp. 951-962, 2024

Authors: Ran, Xu | Niu, Guo-Chen | Shao, Yu-Hong | Fan, Fang-Fang | Yang, Min | Lin, Le-Tao | Chen, Lu-Zeng | Zou, Ying-Hua

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerotic renal artery stenosis (ARAS) is a common disease in the elderly population. OBJECTIVE: The aim was to develop a contrast-enhanced ultrasound (CEUS)-based model for predicting post-angioplasty improvement in hypertension in patients with severe ARAS. METHODS: Thirty-five patients with severe ARAS (⩾ 70%) were included in this study, and 42 renal arteries received percutaneous transluminal renal arterial stenting. An optimal integral formula was developed from pre-interventional color-coded duplex sonography (CCDS) and CEUS parameters using least absolute shrinkage and selection operator (LASSO) regression and receiver operating characteristic (ROC) curve analysis. …A model for predicting short-term hypertension improvement was established using the integral formula and clinical risk factors. Bootstrapping was used for internal validation. RESULTS: Two integral formulas, LASSO.CCDS and LASSO.CEUS, were established. ROC curves of the two integral formulas showed that LASSO.CEUS was the better formula for predicting hypertension improvement (AUC 0.816, specificity 78.6%). Univariate and multivariate regression analyses showed that duration of hypertension (OR 0.841, P = 0.027), diabetes (OR = 0.019, P = 0.010), and LASSO.CEUS (OR 7.641, P = 0.052) were predictors of short-term hypertension improvement after interventional therapy. Using LASSO.CEUS combined with clinical risk factors, the following prediction model was established: logit (short-term improvement in hypertension) = 1.879–0.173 × hypertension duration – 3.961 × diabetes + 2.034 × LASSO.CEUS (AUC 0.939). CONCLUSIONS: The model established using CEUS parameters and clinical risk factors could predict hypertension improvement after interventional therapy, but further research and verification are needed. Show more

Keywords: Atherosclerotic renal artery stenosis, percutaneous transluminal renal arterial stenting, renal blood perfusion, contrast-enhanced ultrasound, hypertension

DOI: 10.3233/THC-230357

Citation: Technology and Health Care, vol. 32, no. 2, pp. 963-976, 2024

Authors: Zhao, Li | Xu, Wen-Kui | Wang, Ying | Lu, Wei-Yan | Wu, Yong | Hu, Rong

Article Type: Research Article

Abstract: BACKGROUND: The evolution of critical care medicine and nursing has aided and enabled the rescue of a large number of patients from numerous life-threatening diseases. However, in many cases, patient health may not be quickly restored, and the long-term prognosis may not be optimistic. OBJECTIVES: In this study, we aimed to develop and validate a prediction model for accurate, precise, and objective identification of the severity of chronic critical illness (CCI) in patients. METHODS: We used a retrospective case-control and prospective cohort study with no interventions. Patients diagnosed with CCI admitted to the …ICU of a large metropolitan public hospital were selected. In the case-control study, 344 patients (case: 172; control:172) were enrolled to develop the prognosis prediction model of chronic critical illness (PPCCI Model); 88 patients (case:44; control: 44) in a prospective cohort study, served as the validation cohort. The discrimination of the model was measured using the area under the curve (AUC) of the receiver operating characteristic curve (ROC). RESULTS: Age, prolonged mechanical ventilation (PMV), sepsis or other severe infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding were the nine predictors included in the model. In both cohorts, the PPCCI model outperformed the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA) in identifying deceased patients with CCI (development cohort: AUC, 0.934; 95%CI, 0.908–0.960; validation cohort: AUC, 0.965; 95% CI, 0.931–0.999). CONCLUSION: The PPCCI model can provide ICU medical staff with a standardized measurement tool for assessing the condition of patients with CCI, enabling them to allocate ward monitoring resources rationally and communicate with family members. Show more

Keywords: Chronic critical illness, critical care, model, prediction, prognosis, score

DOI: 10.3233/THC-230359

Citation: Technology and Health Care, vol. 32, no. 2, pp. 977-987, 2024

Authors: Hao, Jinxiang | Liang, Lirong | Ma, Yongduo | Xu, Meisha | Li, Qiuxiang

Article Type: Research Article

Abstract: BACKGROUND: With rapid progression, severe illness and high fatality rate, sepsis has become an acute and critical condition that seriously threatens human life and health. OBJECTIVE: To detect miR-210 and miR-494 expression in patients with sepsis and their relationship with severity and prognosis. METHODS: A total of 165 sepsis patients participated, including 105 patients with septic non-shock and 60 patients with septic shock. 53 sepsis patients died in 28 days, and 112 patients survived. The clinical information of all sepsis patients was retrospectively searched and reviewed. Based on the status of 28-day survival, …they were categorized into survival group and death group. The expression levels in each group were compared on the first, third and seventh day. The ROC curve was applied to know the expression level of plasma miR-210 and miR-494 to predict the death. RESULTS: The two miRNAs expression of the septic shock group were significantly higher than that in sepsis non-shock group on the first, third and seventh day (all were P < 0.05). The ROC curve found that the AUC combined to predict the death on the third day was the largest, which was 0.925 (95%CI: 0.864–0.983). The sensitivity and specificity were 94.6% and 86.3%, respectively. CONCLUSION: The increased expression levels of plasma miR-210 and miR-494 are closely relevant to the severity and prognosis of sepsis patients. Combining the two items on the third day can predict the death of sepsis patients. Show more

Keywords: Sepsis, miR-210, miR-494, prognosis

DOI: 10.3233/THC-230363

Citation: Technology and Health Care, vol. 32, no. 2, pp. 989-996, 2024

Authors: Chen, Ping-Shun | Lai, Chin-Hui | Chen, Ying-Tzu | Lung, Ting-Yu

Article Type: Research Article

Abstract: BACKGROUND: Scheduling patient appointments in hospitals is complicated due to various types of patient examinations, different departments and physicians accessed, and different body parts affected. OBJECTIVE: This study focuses on the radiology scheduling problem, which involves multiple radiological technologists in multiple examination rooms, and then proposes a prototype system of computer-aided appointment scheduling based on information such as the examining radiological technologists, examination departments, the patient’s body parts being examined, the patient’s gender, and the patient’s age. METHODS: The system incorporated a stepwise multiple regression analysis (SMRA) model to predict the number of …examination images and then used the K-Means clustering with a decision tree classification model to classify the patient’s examination time within an appropriate time interval. RESULTS: The constructed prototype creates a feasible patient appointment schedule by classifying patient examination times into different categories for different patients according to the four types of body parts, eight hospital departments, and 10 radiological technologists. CONCLUSION: The proposed patient appointment scheduling system can schedule appointment times for different types of patients according to the type of visit, thereby addressing the challenges associated with diversity and uncertainty in radiological examination services. It can also improve the quality of medical treatment. Show more

Keywords: Data mining, decision tree, patient appointments, appointment scheduling system, stepwise multiple regression analysis

DOI: 10.3233/THC-230374

Citation: Technology and Health Care, vol. 32, no. 2, pp. 997-1013, 2024

Authors: Wu, Qingqing | Li, Xihong | Li, Li | Yan, Ouyang | He, Qingwen

Article Type: Research Article

Abstract: BACKGROUND: Numerous studies have focused on reducing patient absences and effectively scheduling exams. However, very few studies have analyzed the factors influencing examination time and predicted examination time. OBJECTIVES: To investigate the factors affecting ultrasound examination visit length and provide a reference for interventions to optimize ultrasound appointments. METHODS: This cross-sectional study was conducted at a fertility clinic in China. Ultrasound examination time and clinical characteristics were obtained from the electronic records. Univariate and multivariate analyses used 33,432 patients who attended our clinic center between August 1 and October 30, 2018. A quantile …regression model was constructed to examine associations between ultrasound examination time and statistically significant variables in the univariate analysis. RESULTS: Of the 33,432 patients included in this study, 29,085 (87%) were female and 4,347 (13%) were male. Their mean examination time was 6 ± 3 minutes. The doctor’s title and gender, equipment, and patient’s age, examination site, gender, and origin were all statistically significant. Physical examination and outpatient clinic patients had shorter examination times than inpatients. Female physicians had longer examination times than male physicians. Examination time was positively correlated with thyroid, breast, liver, gallbladder, spleen, pancreas, kidney, heart, vascular, adrenal, gynecological, early pregnancy, nuchal translucency, prostate, scrotum, and mid-to-late pregnancy fetal sites. Moreover, NT and mid-to-late pregnancy fetal sites showed a clear and continuous positive trend with increasing examination time. CONCLUSION: The length of the ultrasound examination was correlated with the examination site, physician title, physician gender, patient age, patient gender, patient origin, and instrumentation. The reliability of inspection time predicted by variables such as the physicians’ title, sex, sites examined, and the number of sites examined was higher when they were longer. Show more

Keywords: Assisted reproduction for pregnancy, ultrasound, examination time

DOI: 10.3233/THC-230406

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1015-1027, 2024

Authors: Li, Haiyan | Zhao, Zhizhen

Article Type: Research Article

Abstract: BACKGROUND: The disease spectrum is constantly changing, meaning patients’ medical characteristics are complex and varied, and hospital operations are facing great challenges. OBJECTIVE: To provide a basis for formulating relevant policies, promoting the continuous improvement of medical quality, improving the efficiency of medical services and proposing corresponding countermeasures. METHODS: Information on the first page of the medical cases of patients discharged from 2020–2021 in the case management system of The Second People’s Hospital of Zhangye City was collected, and statistical analysis was performed in terms of the origin, age, gender, occupation and main …diagnosis of the patients. The database was established using Excel software, and statistical description was performed using SPSS 23.0 software, in which the main indicators were the number of cases and relative numbers (%). RESULTS: The total number of inpatients in the hospital exhibited an overall upward trend, with the number in 2021 increasing by 40.53% compared with the previous year. Among them, 0.75% of the inpatients resided outside the province and 99.25% resided within the province. The proportion of inpatients within the city was 98.86%, including 85.50% in Ganzhou District and 14.5% in the five surrounding counties (districts). In 2021, the number of inpatients in the five surrounding districts increased by 60.67% compared with the previous year. The occupational structure of the inpatients was mainly farmers, accounting for 64.68%, which was higher than all other occupational groups, while public employees accounted for 17.9%. Inpatients aged 60 years and above accounted for 37.75%. In terms of disease spectrum ranking, circulatory, digestive, respiratory, injury and oncological system diseases ranked in the top five of the presented diseases, accounting for 64.47% of the total number of inpatients. CONCLUSION: The patients of the new hospital are mainly elderly patients and local farmers. The hospital development should be based on the disease characteristics of this group, improving the diagnosis and treatment capacity of the departments and strengthening the capacity building of the hospital and the level of the medical services. Show more

Keywords: Newly established hospitals, patient characteristics, development strategies

DOI: 10.3233/THC-230416

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1029-1041, 2024

Authors: Jiang, Ziwei | Yi, Peiling | You, Jinping | Cai, Erwei

Article Type: Research Article

Abstract: BACKGROUND: Colorectal cancer (CRC) is a digestive tract malignancy microRNAs (miRNAs) have attracted much attention as biomarkers in tumor studies. OBJECTIVE: This work focused on the predictive potential and mechanism of miR-4310 in CRC. METHODS: The miRNA expression profile sets were obtained from the Gene Expression Omnibus (GEO) database, and the appropriate miRNA was screened by GEO2R. The CRC tissues and control tissues of 88 patients with CRC were collected, and the expression of miR-4310 was detected by quantitative real-time PCR, and the efficacy of miR-4310 in diagnosing CRC was evaluated by the …receiver operating characteristic curve (ROC). The effects of miR-4310 on the proliferation, migration, and invasion of CRC cells were explored by Cell Counting Kit-8 (CCK-8) and Transwell experiments. Predicting the potential binding sites of miR-4310 and Runt-related transcription factor 1 (RUNX1) by four predictive websites. The relationship between miR-4310 and RUNX1 was confirmed by a double luciferase reporter gene experiment. RESULTS: The bioinformatics analysis found that miR-4310 was differentially expressed in CRC tissues and this finding was certified by the expression of miR-4310 in CRC tissues of collected patients and cultured CRC cell lines. The expression of miR-4310 had a predictive possibility for CRC patients. MiR-4310/RUNX1 pathway had effects on CRC viability, migration, and invasion. CONCLUSION: MiR-4310 had the potential to be a biomarker for early screening of CRC. MiR-4310 and RUNX1 participated in the regulation of CRC cells. Show more

Keywords: miR-4310, RUNX1, colorectal cancer, biomarker, mechanism

DOI: 10.3233/THC-230472

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1043-1053, 2024

Authors: Shukla, Anuj K. | Chaturvedi, Saurabh | Ahmed, Abdul Razzaq | Abouzeid, Hoda Lofty | Suleman, Ghazala | Sharif, Rania A. | Gurumurthy, Vishwanath | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Phonetics with mechanics and aesthetics are considered cardinal factors contributing to the success of complete dentures. OBJECTIVE: The aim of the current study was to evaluate the changes in speech in complete denture patients with and without palatal surface changes. METHODS: The data collected for the study involved completely edentulous Patients (n = 80). Patients were divided into two groups. Group A: Up to 50 years (n = 40); Group B: Above 50 years (n = 40) …(including male and female). Each group was further divided into four subgroups for speech analysis-without dentures (A1/B1); with conventional dentures (A2/B2); dentures with a palatogram (A3/B3) and dentures with palate sandblasted (A4/B4). The speech sounds of all patients were evaluated for pitch and intensity using a spectrophotogram (Praat software) and Likert scale. The data so obtained from the quantitative and qualitative analysis were statistically analysed through one-way ANOVA, unpaired student’s t -test, and Pearson correlation coefficient. Qualitative analysis was done with the Mann-Whitney U test. RESULTS: The maximum mean value of the pitch and intensity in Groups A and B was subgroup A3 (Palatogram) 190.37 ± 21.50 and 77.07 ± 7.58, B3 (Palatogram) 190.87 ± 24.36 and 75.33 ± 8.12. When comparing Groups A [A1, A2, A3, A4] and B [B1, B2, B3, B4] on the basis of pitch and intensity, a statistically insignificant value was found. No changes in speech sounds (pitch and intensity) were observed in terms of age. Both quantitative and qualitative analysis results showed that speech sounds in the patients with palatogram, had the highest pitch and intensity and were most clear to the listener and there were statistically significant differences from other groups. CONCLUSION: Speech was better in palatogram-based dentures in comparison to a sandblasted denture, conventional denture and without denture in terms of qualitative and quantitative analysis. The physiologic nature of the palatogram fabrication technique produces the palatal part of the denture more compatible with the tongue, thus producing better speech. Show more

Keywords: Palatal surface, speech, edentulous, prosthodontics, dentistry

DOI: 10.3233/THC-230477

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1055-1065, 2024

Authors: Kamm, Christian P. | Kueng, Roger | Blättler, Remo

Article Type: Research Article

Abstract: BACKGROUND: Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. OBJECTIVE: To develop a new immersive virtual-reality (VR) headset-based dexterity training to improve impaired manual dexterity in persons with MS (pwMS) while being feasible and usable in a home-based setting. METHODS: The training intervention was tailored to the specific group of pwMS by implementing a simple and intuitive application with regard to hardware and software. To be efficacious, the training intervention covers the main functions of the hands and arm …relevant for use in everyday life. RESULTS: Taking clinical, feasibility, usability as well as technical aspects with regard to hardware and software into account, six different training exercises using hand tracking technology were developed on the Meta quest 2 using Unity. CONCLUSION: We report the developmental process of a new immersive virtual VR headset-based dexterity training for pwMS implementing clinical and technical aspects. Good feasibility, usability, and patient satisfaction was already shown in a feasibility study qualifying this training intervention for further efficacy trials. Show more

Keywords: Development, multiple sclerosis, manual dexterity, hand and arm function, virtual reality, immersive, training intervention

DOI: 10.3233/THC-230541

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1067-1078, 2024

Authors: Li, Feixing | Li, Huixian | Li, Fangjiang | Xiong, Xiaobo | Gao, Yang | Zhang, Ai’ai | Song, Jianying | Han, Wei | Niu, Binyu | Liang, Huiqing

Article Type: Research Article

Abstract: BACKGROUND: Anemia associated with heart failure is frequent and can exacerbate the symptoms of heart failure. Dapagliflozin is the first SGLT-2 inhibitor with significant cardiovascular protection. However, the effect of dapagliflozin on anemia in elderly patients with heart failure is unknown. OBJECTIVE: We aimed to study the effect of dapagliflozin on anemia in elderly patients with heart failure by bioinformatics analysis. METHODS: The target genes were determined, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network and modules were constructed. The dapagliflozin-targets …network in anemia and heart failure was constructed. Molecular docking experiments between dapagliflozin and its key target AKT1 were performed. RESULTS: We found 1 dapagliflozin related target gene and 2 disease related genes. Totally, 134 target genes of dapagliflozin on anemia in elderly patients with heart failure were determined. The pathways may involve lipid and atherosclerosis, AGE-RAGE signaling pathway in diabetic complications, hepatitis B, insulin signaling pathway, fluid shear stress and atherosclerosis, neurotrophin signaling pathway, insulin resistance, toxoplasmosis, colorectal cancer, and EGFR tyrosine kinase inhibitor resistance. The hub genes in network were AKT1, TP53, GAPDH, TNF, CASP3, EGFR, and MAPK3. The structure of dapagliflozin and AKT1 molecular docking was exhibited. CONCLUSIONS: The hub genes in network were AKT1, TP53, GAPDH, TNF, CASP3, EGFR, and MAPK3. The structure of dapagliflozin and AKT1 molecular docking was exhibited. Show more

Keywords: Dapagliflozin, anemia, heart failure, AKT1, bioinformatics analysis

DOI: 10.3233/THC-230563

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1079-1089, 2024

Authors: Wu, Chuntao | Lin, Ke | Fan, Qi | Bai, Jing | Tang, Li

Article Type: Research Article

Abstract: BACKGROUND: The measurement of the health literacy level of patients undergoing outpatient surgery has become a major challenge in perioperative nursing of outpatient surgery. OBJECTIVE: To analyze the effect of health literacy on early postoperative recovery of patients undergoing outpatient surgery by developing a health literacy assessment tool for this population. METHODS: A scale for the assessment of health literacy was established based on Nutbeam’s health literacy model. From April to September 2021, 264 patients were selected in the daytime operating rooms of six Class A tertiary hospitals in Kunming, Yunnan Province to …investigate health literacy and early postoperative rehabilitation quality, and the influencing factors of the two variables were analyzed. RESULTS: An assessment scale of health literacy of patients undergoing outpatient surgery was developed, including 3 dimensions and 24 items. The Cronbach’s α coefficient of the total scale was 0.944, the split-half reliability was 0.902, and the content validity was 0.920. Exploratory factor analysis showed that the cumulative variance contribution rate was 66.37%, and the scale had good structural validity. Multiple linear regression analysis showed that age, functional health literacy, interactive health literacy, and critical health literacy could explain 60.4% of the variation (adjusted R 2 = 0.583) of postoperative recovery quality of patients undergoing outpatient surgery. CONCLUSION: Health literacy of patients undergoing outpatient surgery is an important factor that affects the quality of early postoperative recovery. The health literacy assessment scale can assist medical staff in implementing personalized perioperative nursing and health education. Show more

Keywords: Outpatient surgery, health literacy, scale, reliability, validity, recovery

DOI: 10.3233/THC-230592

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1091-1097, 2024