Technology and Health Care - Volume 32, issue 3

Authors: Park, Joo-Hee | Jeon, Hye-Seon | Kim, Ji-Hyun | Kim, Ye Jin | Moon, Gyeong Ah

Article Type: Review Article

Abstract: BACKGROUND: Virtual reality (VR)-based physical exercise is an innovative and effective intervention strategy for healthcare in older adults. OBJECTIVE: This meta-analysis aimed to clarify the effects of VR-based balance exercise programs on various balancing abilities of older adults. In addition, the effect size of each variable was computed by total exercise time, sensor type, avatar presence, and feedback type to determine influencing factors that lead to the success of VR-based rehabilitation programs. METHODS: The databases searched were PubMed/Medline, CINAHL, NDSL, and Google Scholar. Inclusion criteria were: (1) independent older adults; (2) non-immersive VR exercise; …(3) randomized controlled design; (4) both balance and gait data; and (5) written in English and Korean. The studies without information to compute effect sizes were excluded. Standardized mean difference was used to analyze the effect size (d). RESULTS: Twenty-five studies were finally included in this study. The main findings of this meta-analysis were as follows: (1) Non-immersive VR-based balance exercises are moderately and largely effective for improving overall balance function, (2) VR balance exercise was more effective for static balance than for gait, (3) VR exercise is more effective when avatars are presented and KP is provided as feedback. CONCLUSION: Total exercise time and mode of feedback are influencing factors that affect the effectiveness of VR-based balance exercises. Show more

Keywords: Balance, exercising, gait, meta-analysis, virtual reality

DOI: 10.3233/THC-230156

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1223-1238, 2024

Authors: AlBuraiki, Meisam Jehad | Ingle, Navin Anand | Baseer, Mohammad Abdul | Al Mugeiren, Osamah M. | Minervini, Giuseppe

Article Type: Review Article

Abstract: BACKGROUND: White spot lesions (WSLs) appear as white, opaque areas on the teeth and are caused by a demineralization of the enamel. OBJECTIVE: The purpose of this systematic review and meta-analysis was to determine whether casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has beneficial effects on WSLs and provides remineralizing benefits that are superior to those of placebo or no treatment. METHODS: Following a thorough analysis of the literature across major online sources, 103 papers – 54 of which underwent in-depth evaluation – were found. We used inclusion and exclusion criteria to choose research articles that …were appropriate for our review. RESULTS: 10 papers met this review’s requirements and were subsequently included. As compared to the controls, CPP-ACP demonstrated increased efficacy in treatment of WSLs in terms of remineralisation and other parameters which included microhardness tests and enamel surface roughness. The forest plots present the results of meta-analyses comparing the effect of CPP-ACP versus control/other agents on white spot lesions (WSLs). In terms of odds ratios (OR), CPP-ACP showed a small increase in the odds of WSLs compared to control/other agents. In-vitro studies showed no significant difference in relative risk (RR) between CPP-ACP and control/other agents. Randomized control trials indicated a small increase in the risk of WSLs with CPP-ACP treatment, but the overall effect was not statistically significant. CONCLUSION: There was evidence to support the use of CPP-ACP over other agents for WSL prevention or treatment, but further research is needed to confirm these findings. Show more

Keywords: CPP-ACP, enamel lesions, microhardness tests, remineralisation, white spot lesions

DOI: 10.3233/THC-230722

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1239-1254, 2024

Authors: Begic, Zijo | Djukic, Milan | Begic, Edin | Aziri, Buena | Mladenovic, Zorica | Iglica, Amer | Sabanovic-Bajramovic, Nirvana | Begic, Nedim | Kovacevic-Preradovic, Tamara | Stanetic, Bojan | Badnjevic, Almir

Article Type: Review Article

Abstract: BACKGROUND: Left atrial (LA) strain analysis has emerged as a noninvasive technique for assessing LA function and early detection of myocardial deformation. Recently, its application has also shown promise in the pediatric population, spanning diverse cardiac conditions that demand accurate and sensitive diagnostic measures. OBJECTIVE: This research article endeavors to explore the role of LA strain parameters and contribute to the growing body of knowledge in pediatric cardiology, paving the way for more effective and tailored approaches to patient care. METHODS: A comprehensive literature review was conducted to gather evidence from studies using …echocardiographic strain imaging techniques across pediatric populations. RESULTS: LA strain parameters exhibited greater sensitivity than conventional atrial function indicators, with early detection of diastolic dysfunction and LA remodeling in pediatric cardiomyopathy, children with multisystem inflammatory syndrome, rheumatic heart disease, as well as childhood renal insufficiency and obesity offering prognostic relevance as potential markers in these pediatric subpopulations. However, there remains a paucity of evidence concerning pediatric mitral valve pathology, justifying further exploration. CONCLUSION: LA strain analysis carries crucial clinical and prognostic implications in pediatric cardiac conditions, with reliable accuracy and sensitivity to early functional changes. Show more

Keywords: Left atrium, echocardiography, cardiac diseases

DOI: 10.3233/THC-231087

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1255-1272, 2024

Authors: Medjedovic, Edin | Stanojevic, Milan | Jonuzovic-Prosic, Sabaheta | Ribic, Emina | Begic, Zijo | Cerovac, Anis | Badnjevic, Almir

Article Type: Review Article

Abstract: BACKGROUND: Following the latest trends in the development of artificial intelligence (AI), the possibility of processing an immense amount of data has created a breakthrough in the medical field. Practitioners can now utilize AI tools to advance diagnostic protocols and improve patient care. OBJECTIVE: The aim of this article is to present the importance and modalities of AI in maternal-fetal medicine and obstetrics and its usefulness in daily clinical work and decision-making process. METHODS: A comprehensive literature review was performed by searching PubMed for articles published from inception up until August 2023, including …the search terms “artificial intelligence in obstetrics”, “maternal-fetal medicine”, and “machine learning” combined through Boolean operators. In addition, references lists of identified articles were further reviewed for inclusion. RESULTS: According to recent research, AI has demonstrated remarkable potential in improving the accuracy and timeliness of diagnoses in maternal-fetal medicine and obstetrics, e.g., advancing perinatal ultrasound technique, monitoring fetal heart rate during labor, or predicting mode of delivery. The combination of AI and obstetric ultrasound can help optimize fetal ultrasound assessment by reducing examination time and improving diagnostic accuracy while reducing physician workload. CONCLUSION: The integration of AI in maternal-fetal medicine and obstetrics has the potential to significantly improve patient outcomes, enhance healthcare efficiency, and individualized care plans. As technology evolves, AI algorithms are likely to become even more sophisticated. However, the successful implementation of AI in maternal-fetal medicine and obstetrics needs to address challenges related to interpretability and reliability. Show more

Keywords: Artificial intelligence, machine learning, obstetrics, perinatology

DOI: 10.3233/THC-231482

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1273-1287, 2024

Authors: Deng, Li-Hua | Yao, Ting-Ting | Jin, Hai-Yan | Li, Yi | Zong, Yi | Chen, Mei-Gui | Chen, Peng

Article Type: Research Article

Abstract: BACKGROUND: The nursing model of establishing a chemotherapy safety management supervisory group has guaranteed the safety and effectiveness of intravenous chemotherapy while reducing the adverse effects of chemotherapy and improving patient satisfaction and quality of life. OBJECTIVE: To explore the impact of establishing a nursing supervision group on improving the safety management of patients receiving chemotherapy in the oncology department. METHODS: We selected a total of 60 patients who underwent chemotherapy at the oncology department between January and June 2021 and assigned them to the control group. They received conventional chemotherapy safety management …nursing care. We selected another 60 patients undergoing chemotherapy in the oncology department between July and December 2021 and assigned them to the observation group. They received a nursing intervention model facilitated by the chemotherapy safety supervision team. We compared the intervention effects in the two groups. RESULTS: Patient satisfaction was significantly higher in the observation group than in the control group (P < 0.05); the incidence of post-chemotherapy nausea and vomiting was significantly lower in the observation group than in the control group (P < 0.05); and the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients in the observation group were reduced (P < 0.05) and significantly lower than in the control group (P < 0.05). We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30 (EORTC-QLQ-C30) and found a statistically significant difference in the quality of life of patients before the nursing intervention and on the day of discharge (P < 0.05). CONCLUSION: The establishment of a chemotherapy safety management supervisory group was effective in reducing the incidence of post-chemotherapy nausea and vomiting as well as the patient’s psychological burden; it could also improve the quality of life of patients and their satisfaction with nursing care. Show more

Keywords: Dedicated safety supervisors, nausea and vomiting, patient satisfaction, patients receiving chemotherapy, quality of life

DOI: 10.3233/THC-220686

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1289-1300, 2024

Authors: Shukla, Prashant Kumar | Maheshwary, Priti | Kundu, Shakti | Mondal, Dipannita | Kumar, Ankit | Joshi, Shubham | Pareek, Piyush Kumar

Article Type: Research Article

Abstract: BACKGROUND: Understanding complex systems is made easier with the tools provided by the theory of nonlinear dynamic systems. It provides novel ideas, algorithms, and techniques for signal processing, analysis, and classification. Presently, these ideas are being applied to the investigation of how physiological signals evolve. OBJECTIVE: The study applies nonlinear dynamics theory to electroencephalogram (EEG) signals to better comprehend the range of alcoholic mental states. One of the main contributions of this paper is an algorithm for automatically distinguishing between sober and drunken EEG signals based on their salient features. METHODS: The study …utilized various entropy-based features, including ApEn, SampEn, Shannon and Renyi entropies, PE, TS, FE, WE, and KSE, to extract information from EEG signals. To identify the most relevant features, the study employed ranking methods like T -test, Wilcoxon, and Bhattacharyya, and trained SVM classifiers with the selected features. The Bhattacharyya ranking method was found to be the most effective in achieving high classification accuracy, sensitivity, and specificity. RESULTS: Classification accuracy of 95.89%, the sensitivity of 94.43%, and specificity of 96.67% are achieved by the SVM classifier with radial basis function (RBF) for polynomial Kernel using the Bhattacharyya ranking method. CONCLUSION: From the result, it is clear that the model serves as a cost-effective and accurate decision-support tool for doctors in diagnosing alcoholism and for rehabilitation centres to monitor the effectiveness of interventions aimed at mitigating or reversing brain damage caused by alcoholism. Show more

Keywords: EEG, ApEn, SampEn, PE, TS, FE, WE, KSE, SVM

DOI: 10.3233/THC-220771

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1301-1312, 2024

Authors: Takahashi, Tsuneari | Hatayama, Kazuhisa | Ae, Ryusuke | Saito, Tomohiro | Handa, Mikiko | Kimura, Yuya | Takeshita, Katsushi

Article Type: Research Article

Abstract: BACKGROUND: Total knee arthroplasty (TKA) alleviates pain and improves daily living activities in individuals with end-stage osteoarthritis of the knee. However, up to 20% of patients have sub-optimal outcomes after TKA. OBJECTIVE: No studies have clarified the intraoperative factors that affect postoperative range of motion (ROM) after cruciate-retaining (CR) TKA. Thus, this study aims to clarify these factors. METHODS: Patients with knee osteoarthritis with varus knee deformity who underwent CR-TKA between May 2019 and December 2020 were included in this study. One year after surgery, patients were stratified into two groups based on …knee flexion: Group F (over 120∘ ) and Group NF (below 120∘ ). Patient backgrounds including age, body mass index, hip knee angle, preoperative range of motion for both extension and flexion, intraoperative center joint-gap measurements of 0∘ , 30∘ , 45∘ , 60∘ , 90∘ , and 120∘ of knee flexion using a tensor, intraoperative anterior-posterior (AP) laxity measurements of 30∘ and 90∘ of knee flexion using an instrumental laximeter were compared between the groups. Univariate analyses between the groups were used to construct the initial model. The receiver operating characteristic curve was also analyzed. The predictive variables included in the final model were selected by stepwise backward elimination. RESULTS: Intraoperative AP laxity with 30∘ of knee flexion smaller than 10.8 mm was a significant positive prognostic factor (OR: 1.39, 95% CI: 1.08–1.79, P = 0.011) of postoperative ROM over 120∘ of knee flexion one year after surgery. The sensitivity, specificity, PPV, and NPV were 70.9%, 82.4%, 92.9%, and 46.7%, respectively. CONCLUSION: Intraoperative AP laxity smaller than 10.8 mm was a significant positive predictive factor for obtaining knee flexion greater than 120∘ one year after surgery when using CR-TKA and its PPV was high up to 92.9%. Show more

Keywords: Knee osteoarthritis, total knee arthroplasty, range of motion, mid-flexion instability, instrumental laximetry

DOI: 10.3233/THC-220841

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1313-1322, 2024

Authors: Li, Yan | Qu, Qizhi | Yue, Yuxue | Guo, Yuxuan | Yi, Xiuna

Article Type: Research Article

Abstract: BACKGROUND: Although cone beam computed tomography (CBCT) plays an important role in the diagnosis and treatment of oral diseases, its image segmentation method needs to be further improved, and there are still objections about the clinical application effect of general anesthesia (GA) on children’s dental fear (CDF). OBJECTIVE: This study aimed to investigate the application value of CBCT based on intelligent computer segmentation model in oral diagnosis and treatment of children in the context of biomedical signals, and to analyze the alleviating effect of GA on CDF. METHODS: Based on the regional level …set (CV) algorithm, the local binary fitting (LBF) model was introduced to optimize it, and the tooth CBCT image segmentation model CV-LBF was established to compare the segmentation accuracy (SA), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), over segmentation rate (OR), and under segmentation rate (UR) between these model and other algorithms. 82 children with CDF were divided into general anesthesia group (GAG) (n = 38) and controls (n = 44) according to the voluntary principle of their families. Children in GAG were treated with GA and controls with protective fixed intervention. Children’s fear survey schedule-dental subscale (CFSS-DS) and Venham scores were counted before intervention in the two groups. CFSS-DS scores were recorded at 2 hours after intervention and after recovery in children in GAG. CFSS-DS and Venham scores were performed in all children 1 week after surgery. RESULTS: The results showed that the S ⁢ A value of CV-LBF algorithm was higher than that of region growing algorithm (P < 0.05). OR, UR, MSSD, and ASSD values of CV-LBF algorithm were evidently lower than those of other algorithms (P < 0.05). CFSS-DS scores were lower in GAG than in controls 2 hours after intervention and at return visits after 1 week of intervention (P < 0.001), and Venham scores were lower in GAG than in controls after intervention (P < 0.001). After intervention, the proportion of children with Venham grade 0, 1, 2, and 3 was obviously higher in GAG than in controls (P < 0.001), while the proportion of children with Venham grade 4 and 5 was clearly higher in controls than in GAG (P < 0.001). CONCLUSION: The results revealed that the computer intelligent segmentation model CV-LBF has potential application value in CBCT image segmentation of children’s teeth, and GA can effectively alleviate anxiety of children with CDF and can be used as biomedical signals. Show more

Keywords: Artificial intelligence, cone beam computed tomography (CBCT), oral cavity in children, general anesthesia, children’s dental fear

DOI: 10.3233/THC-230099

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1323-1340, 2024

Authors: Zhang, Ying | Zhang, Xiulun | He, Diwei | Tang, Danfeng | Chen, Zhiying

Article Type: Research Article

Abstract: BACKGROUND: Implantable medical devices are being valued as one of the developments of wireless biomedical technology. OBJECTIVE: This paper presents a mid-field wireless power transmission (WPT) system, which is designed for implantable applications and operates at the 2.40–2.48 GHz band of Industrial, Scientific, and Medical (ISM). METHODS: A new compact transmitter structure is proposed, and a small 4-C planar ring antenna is designed as the receiving element. A measurement setup is fulfilled on porcine tissues to verify the power transmission system. RESULTS: The experimental results show that the operating bandwidth …is 2.2–2.62 GHz and the transmission coefficient can reach - 26.32 dB at a distance of 50 mm. The effects of tissue differences, placement depth, and different transmission distances were also measured. The displacement and deflection tolerances between the transmitter and the implant receiver also have good performance. In the safety standard of specific absorption rate, for the 1 W output power from the mid-field transmitter, the receiving power of the implantable antenna at the mid-field distance can reach 79.6 mW. CONCLUSION: With measurements of different implantation and transmission distance on pork, the mid-field power transmission efficiency is proven and shows the high performance of the system. Show more

Keywords: Mid-field wireless power transmission, implantable antenna, transmission efficiency

DOI: 10.3233/THC-230219

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1341-1349, 2024

Authors: Lee, Kyoung Jin | Lee, Jung Chan

Article Type: Research Article

Abstract: BACKGROUND: Elastomeric pumps have a curved infusion rate profile over infusion time. Chemically driven pumps can overcome such limitations of elastomeric pumps and infuse constantly. However, studies on the pharmacokinetic benefit of chemically-driven pumps are insufficient. OBJECTIVE: This study aimed to determine effects of constant infusion with a chemically-driven pump on plasma drug concentrations compared to elastomeric pumps. METHODS: Infusion rate profiles of a chemically driven pump and two elastomeric pumps were measured in vitro tests under three height conditions of drug reservoir. Plasma drug concentrations were estimated using a pharmacokinetic model …of 5-fluorouracil (5FU). RESULTS: The chemically-driven pump was more accurate than elastomeric pumps during the total infusion time (Root-mean-square-error (RMSE): 3% vs. 13%) which thus reduced its deviation of plasma 5FU concentration over time to one-fifth of that with an elastomeric pump. The chemically-driven pump had less than 5% of RMSE despite the influence of height difference. CONCLUSION: Although chemically-driven pumps maintained plasma 5FU concentration successfully and elastomeric pumps did not, both pumps were proper for 5FU infusion because the time-dependent changes in infusion rate did not affect the area under the curve. Chemically driven pumps would be more advantageous for drugs that are sensitive to their plasma concentrations. Show more

Keywords: Infusion pumps, disposable equipment, 5-fluorouracil, pharmacokinetics

DOI: 10.3233/THC-230227

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1351-1360, 2024