Technology and Health Care - Volume 32, issue 4

Authors: Huang, Yu | Wu, Mei | Li, Jian-Di | Qin, Zhen | Huang, Ke-Qiang | Cui, Jin-Zhu | Ou, Hai-Ling

Article Type: Research Article

Abstract: BACKGROUND: Vesicle-associated membrane protein 7 (VAMP7) plays oncogenic roles in cancers. However, its clinical significance in breast cancer (BC) tissues remains unknown. OBJECTIVE: To elucidate the clinical implications of VAMP7, as well as its involvement in the tumor microenvironment and molecular pathways of breast cancer. METHODS: BC (n = 100) and non-cancerous breast tissues (n = 100) were collected for an immunohistochemical experiment (1:200). The protein expression level of VAMP7 was determined by using a semi-quantitative scoring method. High-throughput RNA-sequencing data of BC tissues …were analyzed to confirm the mRNA expression trend of VAMP7. Additionally, the largest BC prognosis cohort data were collected to mine the potential impact VAMP7 has on BC progression. The association between VAMP7 and the microenvironment of BC was evaluated by using a CIBERSORT algorithm. Moreover, we explored the co-expressed molecular mechanisms of VAMP7 in BC by calculating Pearson correlation coefficients and overexpressed genes. Finally, the biological mechanism underlying the relationship between VAMP7 and the key pathways was also explored using gene set enrichment analysis (GSEA). Potential therapeutic strategies were predicted targeting VAMP7. RESULTS: VAMP7 protein was significantly over-expressed in BC tissue than that in controls (p < 0.001). Compared with 459 normal breast tissues and 113 non-cancerous breast tissues, the expression level of VAMP7 mRNA was significantly increased in 1111 BC tissues. CD4 +T cells, macrophages, and naïve B cells had a higher infiltration rate in BC tissues with high VAMP7 expression, while regulatory T cells and CD8 +T cells had a lower infiltration rate. Over-expressed VAMP7 was associated with macrophages activation and transition from M1 to M2 polarization. Upregulated VAMP7 could predicted poorer OS, DMFS, PPS, and RFS outcomes. Upregulated VAMP7 co-expressed genes were significantly enriched in the cell cycle checkpoints. GSEA confirmed that over-expressed VAMP7 are markedly associated with functional enrichment in cell cycle related categories, including mitotic spindle, G2M checkpoint, and E2F targets. KU-55933 was predicted as a putative therapeutic drug for BC targeting VAMP7. CONCLUSIONS: VAMP7 was upregulated in BC tissue and correlated with poor prognosis of BC patients. VAMP7 may promote BC progression by targeting the cell cycle pathway. Show more

Keywords: Breast cancer, vesicle-associated membrane protein 7, immunohistochemistry, molecular mechanisms

DOI: 10.3233/THC-230832

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2141-2157, 2024

Authors: Kim, Juhee | Bae, Young-Hyeon | Ho, Seung Hee | Lee, Hyungjoo | Park, Hyukyoung

Article Type: Research Article

Abstract: BACKGROUND: People with disabilities face challenges in daily life during the COVID-19 pandemic, including limited access to care, exposure to lifestyle-related diseases, and difficulties in regular exercise. Therefore, it is important to establish health safety nets using Information and Communication Technology (ICT) in communities. OBJECTIVE: This study aimed to develop an m-Health-based personalized lifestyle intervention algorithm targeting high-risk groups of lifestyle-related diseases (including hypertension, diabetes, and obesity) among people with hemiplegic disabilities, and to verify its feasibility. METHODS: Six people at a high risk of lifestyle-related diseases participated in an 8-week lifestyle intervention …using a wearable device and the S-Health program. The self-health management areas included walking, moderate-intensity exercise, weight, blood pressure, blood sugar, diet, calorie intake, heart rate, sobriety, no smoking. Health, physical, psychological, and social changes were measured before and after the study. RESULTS: The intervention had a positive impact on the participants’ health, with statistically significant differences found in fasting blood glucose, highest systolic blood pressure, grip strength, and motor function assessment. Quality of life, health-related quality of life, and self-efficacy improved post-intervention. CONCLUSION: Our findings can be used as preliminary evidence for establishing m-Health-based health safety net systems for people with disabilities who live in communities. Show more

Keywords: Community, stroke, m-Health, lifestyle interventions, feasibility

DOI: 10.3233/THC-230857

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2159-2170, 2024

Authors: Lai, Xing | Zhang, Songsong | Gong, Jianping | Ma, Rong

Article Type: Research Article

Abstract: BACKGROUND: Primary liver cancer is a major health issue, so finding the most effective treatment is vital. OBJECTIVE: The present meta-analysis compares high-intensity focused ultrasound (HIFU) to radiofrequency (RF) ablation for primary liver cancer treatment. METHODS: PubMed, MEDLINE, CNKI, VIP, and Wanfang were used to search for English and Chinese papers. After carefully confirming data completeness and applying inclusion and exclusion criteria, RevMan 5.3 was used to evaluate the included literature. Data analysis utilized a fixed-effects model for heterogeneity between 0.1 and 0.5. RESULTS: The meta-analysis included 304 patients: 119 …had HIFU and 185 RF ablation. For primary liver cancer, HIFU and RF ablation were equally efficacious (odds ratio 1.02, 95% confidence interval [0.54, 1.92]). Overall survival, disease-free survival, and complications at 1, 2, and 3 years were not significantly different (odds ratio 0.72, 95% confidence range [0.04, 12.79], P = 0.82). CONCLUSION: The meta-analysis shows no significant difference in efficacy, long-term survival rates, or complication rates between HIFU and RF ablation for primary liver cancer, but more large-scale, high-quality randomized clinical trials are needed to prove their equivalence. Both therapy strategies seem promising, but additional information is needed to determine their respective merits. Show more

Keywords: HIFU, radiofrequency ablation, primary liver cancer, meta-analysis

DOI: 10.3233/THC-230868

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2171-2182, 2024

Authors: Yu, Juan | Peng, Yan | Yu, Liqun | Shi, Shutian

Article Type: Research Article

Abstract: BACKGROUND: Ectopic pregnancy is a major contributor to maternal morbidity and mortality across the globe. OBJECTIVE: This study aims to investigate the clinical benefits of laparoscopic surgery in treating ectopic pregnancy, and its impact on tubal patency and reproductive outcomes. METHODS: A clinical study was conducted to compare laparoscopic and medical conservative treatment for ectopic pregnancy. A total of 206 patients were treated for ectopic pregnancy at our hospital from January 2018 to June 2020. Among them, 46 underwent laparoscopic ipsilateral salpingectomy, 54 underwent laparoscopic ipsilateral salpingostomy with lesion removal, and 106 were …treated conservatively with medication. RESULTS: The age range and average age of each group are provided, with no significant differences in these general demographic characteristics (p > 0.05). Both the salpingostomy and medication groups had higher rates of ectopic pregnancy compared to the salpingectomy group, with statistically significant differences (p < 0.05). The comparison of ectopic pregnancy rates between the salpingostomy and medication groups showed no significant difference. Within three years, the salpingostomy group had 10 cases of recurrent ectopic pregnancy, with 2 cases on the same side, while the medication group had 18 cases, with 8 cases on the same side. At 3 months after the normalization of blood β -HCG, the salpingostomy group showed 43 cases of tubal patency (patency rate: 79.63%), while the medication group showed 57 cases (patency rate: 53.77%), with a statistically significant difference between the two groups (p = 0.01). CONCLUSION: Laparoscopic surgery for ectopic pregnancy offers significant clinical benefits over conservative medical treatment, including higher rates of tubal patency and improved reproductive outcomes. These findings support laparoscopic surgery as an effective approach for the management of ectopic pregnancy. Show more

Keywords: Ectopic pregnancy, laparoscopic surgery, medical conservative treatment, clinical advantages, fertility outcomes

DOI: 10.3233/THC-230920

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2183-2192, 2024

Authors: P, Elayaraja | S, Kumarganesh | Sagayam, K. Martin | J, Andrew

Article Type: Research Article

Abstract: BACKGROUND: Cervical malignancy is considered among the most perilous cancers affecting women in numerous East African and South Asian nations, both in terms of its prevalence and fatality rates. OBJECTIVE: This research aims to propose an efficient automated system for the segmentation of cancerous regions in cervical images. METHODS: The proposed techniques encompass preprocessing, feature extraction with an optimized feature set, classification, and segmentation. The original cervical image undergoes smoothing using the Gaussian Filter technique, followed by the extraction of Local Binary Pattern (LBP) and Grey Level Co-occurrence Matrix (GLCM) features from the …enhanced cervical images. LBP features capture pixel relationships within a mask window, while GLCM features quantify energy metrics across all pixels in the images. These features serve to distinguish normal cervical images from abnormal ones. The extracted features are optimized using Genetic Algorithm (GA) as an optimization method, and the optimized sets of features are classified using the Co-Active Adaptive Neuro-Fuzzy Inference System (CANFIS) classification method. Subsequently, a morphological segmentation technique is employed to categorize irregular cervical images, identifying and segmenting malignant regions within them. RESULTS: The proposed approach achieved a sensitivity of 99.09%, specificity of 99.39%, and accuracy of 99.36%. CONCLUSION: The proposed approach demonstrated superior performance compared to state-of-the-art techniques, and the results have been validated by expert radiologists. Show more

Keywords: Cervical cancer, gaussian filter, features, optimization, genetic algorithm, classification

DOI: 10.3233/THC-230926

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2193-2209, 2024

Authors: Khusheim, Lina H.

Article Type: Research Article

Abstract: BACKGROUND: Hospitals employ many social workers, whose tasks are complicated and arduous. Quality of life assessments by healthcare professionals (HCWs) are essential for better healthcare and skillful health service delivery. HCWs have been under tremendous mental and psychological strain and at high risk of virus acquisition since the COVID-19 pandemic outbreak. OBJECTIVE: This study evaluated public hospital efficiency issues and remedies in the Kingdom of Saudi Arabia. METHODS: The study examined leadership styles and job satisfaction among Saudi Arabian healthcare workers (HCWs). Between September 1 and December 31, 2021, a descriptive cross-sectional investigation …was conducted. During the COVID-19 pandemic, a verified web-based survey reached the appropriate sample and data was collected. A web-based self-administered survey collected demographic data, leadership style using Multifactor Leadership Questionnaire Form 6-S (MLQ-6S), and health care employee satisfaction (SEHC) from HCWs. RESULTS: Leadership styles affected HCW job satisfaction, according to this study. Individual concern, idealized influence, contingent compensation, and inspiring motivation were negatively correlated with work satisfaction ratings. CONCLUSION: Creating a special training programme for new leaders should cover leadership styles and approaches, the skills needed to foster a productive workplace with high-quality care, and the creation of motivated work opportunities that can boost worker engagement and satisfaction. Show more

Keywords: Leadership style, transformation leadership, transaction leadership, job satisfaction, healthcare worker, COVID-19

DOI: 10.3233/THC-230945

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2211-2229, 2024

Authors: Huizinga, Maarten R. | de Vries, Astrid J. | Verkerke, G.J. | Brouwer, Reinoud W.

Article Type: Research Article

Abstract: BACKGROUND: Given the increasing numbers of young patients with knee osteoarthritis there is a need for treatments that can postpone a joint prosthesis (total knee replacement). OBJECTIVE: As an alternative to the effective yet invasive knee joint distraction procedure, a knee orthosis was developed aiming to unload the affected knee and improving synovial fluid flow. The aim of this study was to examine the effectiveness of using a load-reducing orthosis for two months on functioning, pain, and disease progression (e.g. amount of damaged cartilage) in patients with symptomatic osteoarthritis of the knee for at least one …year. METHODS: This is an interventional single-center pilot study. Ten patients with symptomatic osteoarthritis of one knee (5 males/5 females; median age 57; age range 42–59) used a custom-made orthosis for 60 days during daily life activities that involved knee loading (e.g. standing, walking, but not during stair climbing). Cycling was not allowed. Clinical outcomes were assessed up to 24 months after intervention at 6 timepoints using patient reported-outcome measures Western Ontario and McMaster Universities Osteoarthritis (WOMAC) range 0–100; Visual Analogue Scale (VAS), range 0–100 for pain. Minimum joint space width (mJSW) was assessed using knee images digital analysis (KIDA) and articular cartilage volume with magnetic resonance imaging (MRI) using custom software at baseline and at 12 and 24 months follow-up. RESULTS: Clinically beneficial effects were found for functioning (WOMAC improvement compared to baseline ranged between 18 points at 3 months follow-up and 31 points at 12 months follow-up, with only the 24-months follow-up (improvement of 27 points) not reaching statistical significance (p < 0.05)) and for pain (VAS improvement compared to baseline at follow-up time points ranged between 41–56 points; all p < 0.05). No improvements in mJSW- or MRI-derived parameters were found. CONCLUSION: This study demonstrates that use of a custom-made knee-unloading orthosis for 60 days can result in improved functional ability and decrease in pain in relatively young patients with knee osteoarthritis. No effect on disease progression could be evidenced. Show more

Keywords: Knee osteoarthritis, orthosis, patient reported outcome measures, cartilage, joint space width, MRI

DOI: 10.3233/THC-230953

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2231-2241, 2024

Authors: Wu, Mei-Mei | Li, Yao | Jiang, He-Qun | Ma, Ye

Article Type: Research Article

Abstract: BACKGROUND: During the COVID-19 pandemic, the mobile field hospital, a rapidly deployable healthcare facility for emergency care, was effective in ensuring rapid diagnosis and treatment of patients with mild or asymptomatic SARS-CoV2 infections, effectively preventing the spread of COVID-19. OBJECTIVE: We conducted a survey to gain a thorough understanding of the epidemiological traits among the elderly who contracted the Omicron variant of the SARS-CoV-2 virus at a mobile field hospital set up at the National Exhibition and Convention Center (Shanghai). METHODS: A cross-sectional study approach was employed to examine various factors such as …demographic characteristics, clinical features, vaccination status, and nucleic acid testing. We utilized the DezhenTech Integrated Electronic Medical Record Platform (Municipal Isolation Hospital) to collect data and focused on elderly individuals infected with COVID-19 in the fifth isolation zone of the mobile field hospital set up at the National Exhibition and Convention Center (Shanghai). The patients were categorized into different age groups for analysis. RESULTS: Among the 3,183 elderly patients, 54.7% were males and 45.3% were females, with an average age of 65.32 ± 4.41 years. Among them, 47.8% (1523/3183) were 60–64 years old, 34.0% (1082/3183) were 65–69 years old, 14.0% (444/3183) were 70–74 years old, 3.2% (103/3183) were 75–79 years old, and 1.0% (31/3183) were ⩾ 80 years old. The majority (95.7%) of the elderly patients with chronic conditions had hypertension, diabetes, and coronary heart disease. The first viral nucleic acid screening showed a higher positive rate in the community and hospital fever clinics. The cumulative positive rate of the nucleic acid test in the mobile field hospital was 38.7%. The average CT value of the COVID-19 ORF1ab gene was 34.56 ± 5.98, while the average CT value of the N gene was 33.10 ± 6.50. The patients took an average of 3.40 ± 0.45 days to test negative, with a positive rate of 15.4% and an average hospital stay of 7.45 ± 0.53 days. The overall rate of COVID-19 vaccine coverage was 68.0%, with an enhanced coverage rate of 40% and a non-coverage rate of 29.3%. CONCLUSIONS: The overall prognosis for elderly patients who experienced a mild or asymptomatic SARS-CoV-2 Omicron infection at the mobile field hospital was favorable, although the vaccination rate in general was not high. By effectively managing underlying health conditions, the duration of their hospital stay in the mobile field hospital was reduced. Show more

Keywords: Elderly patients, epidemiology, mobile field hospital, SARS-CoV-2

DOI: 10.3233/THC-230973

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2243-2250, 2024

Authors: Xu, Chun-Guang | Yang, Li-Xia | Zhu, Rui | Zhang, Jie | Li, Yan | Chao, Chun-Fang

Article Type: Research Article

Abstract: BACKGROUND: Psychrophilic bacteria can survive in a unique living environment. OBJECTIVE: To explore the mechanism of low temperature adaptation and the physiological function of thermophilic metabolic genes. METHOD: Serratia marcescens strain F13 stored in microbial laboratory was cultured at 5∘ C, 10∘ C and 25∘ C respectively, and the obtained strains were sequenced by high-throughput transcriptome. Serratia marcescens strain CAV1761 was used as the reference strain. The data produced by transcriptome sequencing were statistically analyzed by biostatistics software such as soapnuke, soap and edger. …The differentially expressed genes were found based on the gene expression, and analyzed by Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. RESULTS: The results showed that there were 718 differential genes in F13-10 vs F13-5 comparison group, 1614 differential genes in F13-25 vs F13-5 comparison group and 1636 differential genes in F13-25 vs F13-10 comparison group. GO function enrichment analysis showed that the GO term mainly enriched by different genes in the three comparison groups was mostly related to the migration and transport of cellular or subcellular components, cell localization and transmembrane transporter activity, as well as cilia or flagella dependent cell movement. In the enrichment analysis of KEGG pathway, the three comparison groups all enriched the largest number of differential genes in the branch pathway of KEGG metabolism, followed by the branch pathway of environmental information processing. CONCLUSION: In F13-10 vs F13-5, the differential genes were mainly concentrated in 20 pathways such as ATP-binding cassette transport (ABC) transporters, thiamine metabolism and flagella assembly; In F13-25 vs F13-5, the differential genes are mainly concentrated in 20 pathways, such as (ABC) transporters, arginine and proline metabolism, two-component system and so on; In F13-25 vs F13-10, the differential genes are mainly concentrated in 20 pathways such as various types of glycan synthesis, two-component system and arginine metabolism. Show more

Keywords: Low temperature bacteria, transcriptome analysis, psychrophilic mechanism

DOI: 10.3233/THC-231022

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2251-2264, 2024

Authors: Wang, Zhi | Xu, Lei | Sun, Lin | Jiang, Xin | Wang, Juan

Article Type: Research Article

Abstract: BACKGROUND: Coronary atherosclerotic heart disease (CAHD) is the leading cause of death in developed countries. OBJECTIVE: This study aimed to explore the correlation between the properties of coronary atherosclerotic plaque and blood lipids using computed tomography angiography (CTA). METHODS: A total of 83 patients with coronary heart disease were included in this study (males: 50; females: 33; average age: [59 ± 8] years old). They were classified into the stable angina group and unstable angina group. Atherosclerotic plaques were classified as fatty plaques (soft plaques), fibrous plaques, and calcified plaques …based on the computed tomography (CT) values. SPSS 17.0 statistical software was used to analyze the correlation between the properties of angina and the CT values of atherosclerotic plaques, blood lipids, and plaque properties, and then compared between the stable and unstable angina groups. RESULTS: There were statistically significant differences in plaque properties between the stable and unstable angina groups (P < 0.001). During CTA examination, we found statistically significant differences in the CT density values of atherosclerotic plaques between the stable and unstable angina groups (P < 0.001). There were statistically significant differences between the properties of angina and the level of blood lipids (P < 0.05). CONCLUSION: Anginal properties negatively correlated with calcified plaques and positively correlated with non-calcified plaques. Calcified plaques negatively correlated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), and positively correlated with high-density lipoprotein cholesterol (HDL-C). Non-calcified plaques negatively correlated with HDL-C and positively correlated with TC, LDL-C, and TG. Show more

Keywords: Angina, atherosclerotic plaques, blood lipids, coronary artery, multi-slice spiral CT

DOI: 10.3233/THC-231036

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2265-2275, 2024