Technology and Health Care - Volume 32, issue 2

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