Technology and Health Care - Volume 32, issue 4

Authors: Luo, Linjie | Li, Ying | Zhang, Lin | Yang, Lijie

Article Type: Research Article

Abstract: BACKGROUND: Lung adenocarcinoma (LUAD), a prevalent form of lung cancer, is characterized by its high global mortality rate. Previous studies have demonstrated the significance of Nucleoside diphosphate kinase (NME) in various cancers; however, the specific role of NME6 in LUAD remains inadequately understood. OBJECTIVE: This research aims to enhance our understanding of LUAD by investigating the expression level, epigenetic mechanism, signaling activities, and immune infiltrating characteristic immune cells of NME6 in patients. METHODS: The NME6 expression was explored between LUAD and normal tissue samples using GEPIA, UALCAN and HPA databases. The survival analysis …was performed by Kaplan-Meier plotter. The Shiny Methylation Analysis Resource Tool was employed to examine the methylation characteristics of NME6. The Tumor Immune Single-cell Hub (TISCH) and CIBERSORT algorithm were utilized to analyze immune infiltrating characteristic immune cells between NME6 high- and low-expression group in LUAD. RESULTS: According to GEPIA, UALCAN, and HPA databases, NME6 is highly expressed in LUAD compared to normal tissues. At the same time, elevated levels of NME6 were found to be significantly correlated with inferior overall survival outcomes in LUAD patients. Subsequently, the top 10 genes interacted with NME6 were mainly involved in seven pathways, such as p53 signaling pathway, glutathione metabolism, thiamine metabolism, metabolic pathways, and drug metabolism. Notably, NME6 methylation in LUAD samples was lower than in normal samples. The methylation of cg04625862 has a significant impact on the regulation of NME6 expression in LUAD. Furthermore, high NME6 expression in LUAD was associated with tumor stages and relative abundance of tumor infiltrating immune cells, such as Macrophage M2, activated mast cell, and neutrophil. Moreover, NME6 regulated the expression of m6A modification of genes related to LUAD, including METTL3, WTAP, RBM15B, METTL14, RBMX, VIRMA, YTHDC1, RBM15, ZC3H13, YTHDF1, YTHDC2, IGF2BP2, YTHDF3, HNRNPA2B1, YTHDF2, HNRNPC, FTO, and ALKBH5. CONCLUSION: The analysis showed that NME6 is a crucial prognostic factor for LUAD patients. NME6 regulates genes related to m6A modification and immune cells infiltration. Furthermore, NME6 could sever as a potential therapeutic target for LUAD. Show more

Keywords: Nucleoside diphosphate kinase 6, lung adenocarcinoma, DNA methylation, survival analysis, immune infiltration, m6A modification

DOI: 10.3233/THC-231058

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2277-2291, 2024

Authors: Li, Sujiao | Cai, Wenqian | Zhu, Pei | He, Wanying | Zheng, Jinyu | Fang, Fanfu | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: Rehabilitation assessment is a critical component of rehabilitation treatment. OBJECTIVE: This study focuses on a comprehensive analysis of patients’ movement performance using the upper limb rehabilitation robot. It quantitatively assessed patients’ motor control ability and constructed an intelligent grading model of functional impairments. These findings contribute to a deeper understanding of patients’ motor ability and provide valuable insights for personalized rehabilitation interventions. METHODS: Patients at different Brunnstrom stages underwent rehabilitation training using the upper limb rehabilitation robot, and data on the distal movement positions of the patients’ upper limbs were collected. A …total of 22 assessment metrics related to movement efficiency, smoothness, and accuracy were extracted. The performance of these assessment metrics was measured using the Mann-Whitney U test and Pearson correlation analysis. Due to the issue of imbalanced sample categories, data augmentation was performed using the Synthetic Minority Over-sampling Technique (SMOTE) algorithm based on weighted sampling, and an intelligent grading model of functional impairment based on the Extreme Gradient Boosting Tree (XGBoost) algorithm was constructed. RESULTS: Sixteen assessment metrics were screened. These metrics were effectively normalized to their maximum values, enabling the derivation of quantitative assessment scores for motor control ability across the three dimensions through a weighted fusion approach. Notably, when applied to the data-enhanced dataset, the intelligent grading model exhibited remarkable improvement, achieving an accuracy rate exceeding 0.98. Moreover, significant enhancements were observed in terms of precision, recall, and f1-score. CONCLUSION: The research findings demonstrate that this study enables the quantitative assessment of patients’ motor control ability and intelligent grading of functional impairments, thereby contributing to the efficiency enhancement of clinical rehabilitation assessment. Moreover, this method resolves the issues associated with the subjectivity and prolonged periods of traditional rehabilitation assessment methods. Show more

Keywords: Stroke, robotic rehabilitation, kinematic parameters, intelligent assessment, Brunnstrom stages

DOI: 10.3233/THC-231076

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2293-2306, 2024

Authors: Liu, Yining | Xu, Liming | Fang, Qiongyan | Rong, Hui | Zheng, Huaiyu

Article Type: Research Article

Abstract: BACKGROUND: Danshen Chuanxiong Injection (DCI) has demonstrated significant clinical efficacy in the treatment of acute pancreatitis (AP); however, the precise molecular mechanisms underlying its therapeutic effects remain incompletely understood. OBJECTIVE: In this study, we employed network pharmacology analysis to comprehensively investigate the active components, potential targets, and signaling pathways involved in DCI-mediated treatment of AP. METHODS: We utilized the mouse pancreatic acinar cell line 266-6 to establish an cholecystokinin (CCK)-induced AP cell injury model and evaluated cell viability using the Cell counting kit-8 assay. Western blotting and quantitative PCR were employed to determine …the expression levels of key target proteins and genes. RESULTS: Network pharmacology analysis identified a total of 144 active components and 430 potential targets within DCI. By integrating data from public databases, we identified 762 AP-related genes. Among these, we identified 93 potential targets that may be involved in the therapeutic effects of DCI for AP. These targets were significantly enriched in biological processes such as oxidative stress, regulation of cytokine production, leukocyte migration, and the TNF signaling pathway. Molecular docking studies revealed a high binding affinity between the active components and the key targets AKT1 and NFKBA, indicative of potential interaction. Additionally, CCK-induced acinar cell injury led to upregulation of AKT1, NFKBA, and P53 proteins, as well as TNF, IL6, and MMP9 genes. Conversely, treatment with DCI dose-dependently attenuated CCK-induced acinar cell injury and restored the expression levels of the aforementioned proteins and genes. CONCLUSION: Overall, this study provides a comprehensive understanding of the molecular mechanisms underlying the therapeutic effects of DCI in the treatment of AP. Our findings confirm the protective effect of DCI against CCK-induced acinar cell injury and its regulation of key targets. Show more

Keywords: Danshen Chuanxiongqin injection, acute pancreatitis, network pharmacology, acinar cells, molecular docking

DOI: 10.3233/THC-231086

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2307-2320, 2024

Authors: Fajkić, Almir | Jahić, Rijad | Begić, Edin | Dervišević, Amela | Kurtović, Avdo | Lepara, Orhan

Article Type: Research Article

Abstract: BACKGROUND: Metabolic syndrome (MetS) is a group of comorbidities related to regulating hyperglycemia and acute cardiovascular incidents and complications. With the increasing prevalence in individuals with type 2 diabetes mellitus (T2DM), MetS represents an increasing public health problem and clinical challenge, and early diagnosis is necessary to avoid the accelerated development of diabetic complications. OBJECTIVE: To investigate the role of Complete Blood Count-derived Inflammation Indexes (CBCIIs) in predicting MetS in T2DM individuals. METHODS: The study was designed as a two-year prospective study and included 80 T2DM individuals divided into MetS and non-MetS groups …based on MetS development over two years. The sera samples were analyzed for complete blood count parameters and C-reactive protein (CRP). Based on the laboratory test results, 13 CBCIIs were calculated and analyzed. The receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine prognostic accuracy. RESULTS: There were significant differences between T2DM participants with Mets and those without MetS concerning Neutrophil to Platelet Ratio (NPR) values (p < 0.001), Neutrophil to Lymphocyte and Platelet Ratio (NLPR) (p < 0.001), Platelet to Lymphocyte Ratio (PLR) (p < 0.001), Lymphocyte to C-reactive protein Ratio (LCR) (p < 0.001), C-reactive protein to Lymphocyte Ratio (CRP/Ly) (p < 0.001), Systemic immune inflammation index (SII) (< 0.001), and Aggregate Index of Systemic Inflammation (AISI) (p = 0.005). The results of ROC curve analysis have shown that the LCR (AUC of 0.907), CRP/Ly (AUC of 0.907) can serve as excellent predictors, but NPR (AUC of 0.734), NLRP (AUC of 0.755), PLR (AUC of 0.823), SII (AUC of 0.745), and AISI (AUC of 0.688) as good predictors of MetS in T2 DM individuals. CONCLUSION: This study confirms the reliability of the CBCIIs as novel, simple, low cost and valuable predictors of MetS developing in T2DM. Show more

Keywords: Diabetes mellitus, metabolic syndrome, complete blood count-derived inflammation indexes

DOI: 10.3233/THC-231101

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2321-2330, 2024

Authors: Yuan, Zheng | Zhao, Wei | You, Yali | Wu, Wenbo | Duan, Guochen

Article Type: Research Article

Abstract: BACKGROUND: Lung cancer is one of the most common malignant tumours that threaten human health globally. Radical resection under thoracoscopic guidance has been accepted as the major therapeutic option for treating lung cancer clinically. However, the procedure still has some adverse impacts on the comfort of patients following thoracoscopic surgery. OBJECTIVE: To analyse the reliability and validity of the postoperative comfort scale for patients with lung cancer undergoing endoscopic surgery and to evaluate patient comfort. METHODS: With 210 patients with lung cancer undergoing endoscopic surgery as the participants, this study was performed to …assess the reliability and validity of the postoperative comfort scale for patients with lung cancer undergoing endoscopic surgery, with the assessment performed by eight experts. RESULTS: The postoperative comfort scale included 28 items and consisted of four dimensions (physiological, psychological, socio-cultural and environmental). The total Cronbach’s alpha coefficient of the scale was 0.851, and the split-half reliability coefficient was 0.875. Meanwhile, the content validity index (CVI) was 0.875∼ 1, and the scale-level average CVI was 0.99. The Chi-square/degree-of-freedom ratio of construct validity was 2.844, suggesting a good model-fitting. Furthermore, the overall average score of patient comfort was 3.72 ± 0.57, with scores ranging between 3.59 ± 0.71 and 3.83 ± 1.06 across all four dimensions, with the lowest score in the physiological dimension. CONCLUSION: The postoperative comfort scale has good reliability and validity and can be applied for the postoperative comfort assessment of patients undergoing endoscopic surgery for lung cancer. Overall, the degree of patient comfort in this assessment was moderate, meaning targeted measures may be required to further improve patient comfort, especially in the physiological dimension. Show more

Keywords: Lung cancer, patients after endoscopic surgery, comfort assessment scale, reliability, validity, comfort evaluation

DOI: 10.3233/THC-231102

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2331-2343, 2024

Authors: Yu, Cai-Cha | Jiao, Yan | Wang, Jia-Jia | Zhao, Xiao-Si | Chen, Lei

Article Type: Research Article

Abstract: BACKGROUND: Endometrial receptivity is crucial for the establishment of a healthy pregnancy outcome. Previous research on endometrial receptivity primarily examined endometrial thickness, endometrial echo types, and endometrial blood supply. OBJECTIVE: To explore the differences in the elastic modulus of the endometrium in women with various pregnancy outcomes by real-time shear wave elastography (SWE) and to investigate its application value in evaluation of endometrial receptivity. METHODS: A total of 205 pregnant women who were admitted at Wenzhou People’s Hospital between January 2021 and December 2022 were selected. Three-dimensional transvaginal sonography and real-time shear wave …elastography were performed in the proliferative phase and receptive phase of the endometrium, and the average elastic modulus of the endometrium in the two phases was obtained and compared. According to whether the pregnancy was successful or not, the participants were divided into the pregnancy group (n = 72) and non-pregnancy group (n = 133), and the differences in intimal thickness, 3D blood flow parameters, and average elastic modulus of intima were compared between the two groups. RESULTS: The average elastic modulus of the endometrium in the proliferative phase and receptive phase was (23.92 ± 2.31) kPa and (11.82 ± 2.24) kPa, respectively, and the difference was statistically significant P < 0.05. The average elastic modulus of the endometrium in the pregnancy group and non-pregnancy group was (9.97 ± 1.08) kPa and (12.82 ± 2.06) kPa, respectively, and the difference was statistically significant P < 0.05. The area under the curve of predicting pregnancy by the average elastic modulus of the endometrium in the receptive phase was 0.888 (0.841∼ 0.934), with corresponding P value < 0.05. The critical value was 11.15, with a corresponding sensitivity of 81.7% and specificity of 78.2%. CONCLUSION: Real-time shear wave elastography can quantitatively evaluate endometrial elasticity, indirectly reflect the endometrial phase, and provide a new diagnostic concept for evaluating endometrial receptivity and predicting pregnancy outcome in infertile patients. Show more

Keywords: Elastic modulus value, endometrial receptivity, real-time shear wave elastography

DOI: 10.3233/THC-231106

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2345-2352, 2024

Authors: Miao, Zhuang | Yu, Xinyue | Zhang, Lizhen | Zhu, Liqiao | Sheng, Huagang

Article Type: Research Article

Abstract: BACKGROUND: As a traditional digestive medicine, stir-fried Raphani Semen (SRS) has been used to treat food retention for thousands of years in China. Modern research has shown that SRS has a good therapeutic effect on functional dyspepsia (FD). However, the active components and mechanism of SRS in the treatment of FD are still unclear. OBJECTIVE: The purpose of this study is to elucidate the material basis and mechanism of SRS for treating FD based on UPLC-Q-Exactive Orbitrap MS/MS combined with network pharmacology and molecular docking. METHODS: The compounds of SRS water decoction were …identified by UPLC-Q-Exactive Orbitrap MS/MS and the potential targets of these compounds were predicted by Swiss Target Prediction. FD-associated targets were collected from disease databases. The overlapped targets of SRS and FD were imported into STRING to construct Protein-Protein Interaction (PPI) network. Then, the Metascape was used to analyze Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway after introducing overlapped targets. Finally, the active components and core targets were obtained by analyzing the “component-target-pathway” network, and the affinity between them was verified by molecular docking. RESULTS: 53 components were identified, and 405 targets and 1487 FD-related targets were collected. GO and KEGG analysis of 174 overlapped targets showed that SRS had important effects on hormone levels, serotonin synapses, calcium signaling pathway and cAMP signaling pathway. 7 active components and 15 core targets were screened after analyzing the composite network. Molecular docking results showed that multiple active components had high affinity with most core targets. CONCLUSION: SRS can treat FD through a variety of pathways, which provides a direction for the modern application of SRS in FD treatment. Show more

Keywords: Network pharmacology, stir-fried Raphani Semen, functional dyspepsia, UPLC-Q-Exactive Orbitrap MS/MS, mechanism, molecular docking

DOI: 10.3233/THC-231122

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2353-2379, 2024

Authors: Wang, Qiuyang | An, Peng | Song, Lina | Liu, Junjie | Liu, Jisheng

Article Type: Research Article

Abstract: BACKGROUND: Nasopharyngeal carcinoma (NC) is one of the prevalent malignancies of the head and neck region with poor prognosis. OBJECTIVE: The aim of this study is to establish a predictive model for assessing NC prognosis based on clinical and MR radiomics data, subsequently to develop a nomogram for practical application. METHODS: Retrospective analysis was conducted on clinical and imaging data collected between May 2010 and August 2018, involving 211 patients diagnosed with histologically confirmed NC who received concurrent chemoradiotherapy or radical surgery in Xiangyang No. 1 People’s Hospital. According to 5–10 years of …follow-up results, the patients were divided into two groups: the study group (n = 76), which experienced recurrence, metastasis, or death, and the control group (n = 135), characterized by normal survival. Training and testing subsets were established at a 7:3 ratio, with a predefined time cutoff. In the training set, three prediction models were established: a clinical data model, an imaging model, and a combined model using the integrated variation in clinical characteristics along with MR radiomics parameters (Delta-Radscore) observed before and after concurrent chemoradiotherapy. Model performance was compared using Delong’s test, and net clinical benefit was assessed via decision curve analysis (DCA). Then, external validation was conducted on the test set, and finally a nomogram predicting NC prognosis was created. RESULTS: Univariate analysis identified that the risk factors impacting the prognosis of NC included gender, pathological type, neutrophil to lymphocyte ratio (NLR), degree of tumor differentiation, MR enhancement pattern, and Delta-Radscore (P < 0.05). The combined model established based on the abovementioned factors exhibited significantly higher predictive performance [AUC: 0.874, 95% CI (0.810–0.923)] than that of the clinical data model [AUC: 0.650, 95% CI (0.568–0.727)] and imaging model [AUC: 0.824, 95% CI (0.753–0.882)]. DCA also demonstrated superior clinical net benefit in the combined model, a finding further verified by results from the test set. The developed nomogram, based on the combined model, exhibited promising performance in clinical applications. CONCLUSION: The Delta-Radscore derived from MR radiomics data before and after concurrent chemoradiotherapy helps enhance the performance of the NC prognostic model. The combined model and resultant nomogram provide valuable support for clinical decision-making in NC treatment, ultimately contributing to an improved survival rate. Show more

Keywords: Delta radiomics, nasopharyngeal cancer, predictive models, nomogram, decision curves, magnetic resonance imaging (MR)

DOI: 10.3233/THC-231173

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2381-2394, 2024

Authors: Al Ahmari, Nasser M. | Alshehri, Abdulkarim H. | Gadah, Thrya S. | Alqahtani, Jaber A. | Almushafi, Mohammed A. | Al Moaleem, Mohammed M. | Al Hatlan, Ebtisam N. | Alqhatani, Aliya S. | Alabydi, Shahad M.

Article Type: Research Article

Abstract: BACKGROUND: Endocrowns (ECs) are alternatives for rebuilding severely damaged teeth and show superior efficacy in molars over premolars. OBJECTIVE: The objective of this in vitro study is to evaluate the effects of different preparation designs with short pulp chambers on the mean color change (Δ ⁢ E ), fracture resistance, and failure types of mandibular molar ECs. METHOD: A total of 40 extracted mandibular molars were treated endodontically and divided into four groups. Samples in groups 1, 2, 3, and 4 had occlusal preparation depths of 5 mm, 3 …mm, 3 mm with ferrule, and 3 mm with boxes, respectively. The samples were immersed in coffee and their Δ ⁢ E values were measured by using the Commission Internationale de l’Eclairage color system. They were also subjected to a fracture test. Next, all specimens were examined visually under a stereomicroscope to evaluate their failure modes and identify their fracture origins. Data were entered and analyzed by using Statistical Package for Social Sciences. RESULTS: Among all groups, group 4 (3 mm + boxes) presented the highest Δ ⁢ E (4.15) after immersion in coffee. Moreover, ANOVA revealed that the Δ ⁢ E of group 4 (occlusal preparation depth of 3 mm with boxes) was significantly different (p < 0.05) from that of group 2 (3 mm + ferrule, 3.07). The EC with a 3 mm chamfer and ferrule showed the highest maximum load of 2847.68 ± 693.27 N, whereas that with a 5 mm chamfer finish line had a marginally reduced load at fracture of 2831.52 ± 881.83 N. The EC with a 3 mm chamber and boxes had a slightly increased maximum load of 2700.75 ± 436.40 N, whereas that with the 3 mm chamber had the lowest maximum load at fracture of 2385.97 ± 465.61 N. One-way ANOVA showed that different EC preparation designs had no effect on maximum fracture load (F [3,16] = 0.550, p = 0.6). CONCLUSION: The recorded Δ ⁢ E values of ECs in all groups were equal or marginally higher than the acceptable values. The EC with a 3 mm chamfer and ferrule displayed the highest mean maximum load. The EC with a 5 mm chamfer finish line had a marginally lower maximum load at fracture than other ECs. Failures, such as ceramic fracture, split fracture, and ceramic and tooth splitting above the cemento–enamel junction (CEJ) or vertically were predominant in samples with occlusal preparation depths of 3 mm with ferrule and 5 mm. Show more

Keywords: Endocrown, color measurement, fracture strength, failure type, endocrown design

DOI: 10.3233/THC-231175

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2395-2408, 2024

Authors: Alhussaini, Khalid | Aleid, Adham | Alsadon, Omar | Aldohbeyb, Ahmed A. | Aljelaifie, Rakan | Javed, Ravish

Article Type: Research Article

Abstract: BACKGROUND: Adequate equipment maintenance is necessary to ensure efficient dental care facilities and satisfactory medical equipment performance. OBJECTIVE: This study aimed to assess maintenance practices and manpower adequacy in private dental centres (DCs) across Riyadh, Saudi Arabia. METHODS: A questionnaire was designed to evaluate equipment maintenance and manpower strength based on international and national standards. Thirty-three private DCs were visited in-person with the designed questionnaire to conduct the study. The Chi-square test and t -test were performed. RESULTS: Only 21 dental centres had a scheduled maintenance plan for …medical equipment, whereas the rest had no plan. Furthermore, only 22 DCs maintained equipment maintenance records, while 11 DCs did not have any records. Additionally, the study found a lack of trained personnel to handle medical equipment and overall inadequate maintenance practices. Significant differences were observed between the responses for many questions (p < 0.05). CONCLUSION: These findings increase health risks to both the patient and the user. To address these issues, DC administrators should implement stricter measures to adhere to local DCs standards and hire qualified personnel who can periodically maintain and repair medical equipment. Show more

Keywords: Medical devices, equipment readiness, patient safety, healthcare, manpower requirement, private dental center

DOI: 10.3233/THC-231177

Citation: Technology and Health Care, vol. 32, no. 4, pp. 2409-2419, 2024