Technology and Health Care - Volume 32, issue 5

Authors: Badnjević, Almir | Zebić, Emina Zejnilović

Article Type: Editorial

DOI: 10.3233/THC-248050

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2853-2858, 2024

Authors: Xu, Bi-Qing | Si, Qin | Feng, Yin-Ping | Guo, Jing | Jiang, Li-Ping

Article Type: Research Article

Abstract: BACKGROUND: Patients who have been treated with mechanical ventilation for more than 72 hours are susceptible to symptoms such as hypoxia and respiratory muscle fatigue after weaning, which may result in weaning difficulty and delay, as well as an increased incidence of negative emotions such as anxiety and depression. Correct pulmonary rehabilitation exercise technique and timing can improve the weaning success rate, reduce the disability rate, and reduce the incidence of pulmonary infection, as well as reduce medical expenses. OBJECTIVE: This article provides a review of pulmonary rehabilitation interventions for mechanically ventilated patients, searching relevant literature …through databases such as CNKI and PubMed, aiming to provide guidance for the successful weaning of mechanically ventilated patients. METHODS: We selected articles related to pulmonary rehabilitation interventions for mechanically ventilated patients from CNKI (China National Knowledge Infrastructure) and PubMed over the years. RESULTS: This article provides a comprehensive review of the research on lung rehabilitation for patients who are mechanically ventilated during the weaning process in an effort to serve as a guide for a successful transition from mechanical ventilation. CONCLUSION: Early pulmonary rehabilitation training can effectively increase the pulmonary function level and ventilation function of patients and reduce the duration of mechanical ventilation and hospitalization, and is an effective, safe, and feasible treatment method. Show more

Keywords: Mechanical ventilation, pulmonary rehabilitation, research progress, weaning

DOI: 10.3233/THC-231562

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2859-2864, 2024

Authors: Lv, Guodong | Wang, Yuntao

Article Type: Review Article

Abstract: BACKGROUND: The widespread use of antibiotics has led to a gradual adaptation of bacteria to these drugs, diminishing the effectiveness of treatments. OBJECTIVE: To comprehensively assess the research progress of antibiotic resistance prediction models based on machine learning (ML) algorithms, providing the latest quantitative analysis and methodological evaluation. METHODS: Relevant literature was systematically retrieved from databases, including PubMed, Embase and the Cochrane Library, from inception up to December 2023. Studies meeting predefined criteria were selected for inclusion. The prediction model risk of bias assessment tool was employed for methodological quality assessment, and a …random-effects model was utilised for meta-analysis. RESULTS: The systematic review included a total of 22 studies with a combined sample size of 43,628; 10 studies were ultimately included in the meta-analysis. Commonly used ML algorithms included random forest, decision trees and neural networks. Frequently utilised predictive variables encompassed demographics, drug use history and underlying diseases. The overall sensitivity was 0.57 (95% CI: 0.42–0.70; p < 0.001; I 2 = 99.7%), the specificity was 0.95 (95% CI: 0.79–0.99; p < 0.001; I2 = 99.9%), the positive likelihood ratio was 10.7 (95% CI: 2.9–39.5), the negative likelihood ratio was 0.46 (95% CI: 0.34–0.61), the diagnostic odds ratio was 23 (95% CI: 7–81) and the area under the receiver operating characteristic curve was 0.78 (95% CI: 0.74–0.81; p < 0.001), indicating a good discriminative ability of ML models for antibiotic resistance. However, methodological assessment and funnel plots suggested a high risk of bias and publication bias in the included studies. CONCLUSION: This meta-analysis provides a current and comprehensive evaluation of ML models for predicting antibiotic resistance, emphasising their potential application in clinical practice. Nevertheless, stringent research design and reporting are warranted to enhance the quality and credibility of future studies. Future research should focus on methodological innovation and incorporate more high-quality studies to further advance this field. Show more

Keywords: Antibiotics, machine learning, meta-analysis, prediction

DOI: 10.3233/THC-240119

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2865-2882, 2024

Authors: Yue, Yiting | Guo, Jinli | Huang, Yongbo | Li, Wenbin | Xue, Ruifang | Li, Hongmei | Xue, Jingjing | Yang, Yujing

Article Type: Research Article

Abstract: BACKGROUND: Developmental dislocation of the hip (DDH) is a common congenital deformity of the skeletal system in children. OBJECTIVE: To investigate the efficacy of post-surgery cluster nursing in children with DDH. METHODS: A total of 60 children with DDH who underwent hip joint orthopedic surgery in our hospital from September 2021 to September 2022 were enrolled as the research participants in this prospective study, and divided into the control group and the observation group according to the numerical table method, with 30 patients in each group. The control group was given routine pain …care, and the observation group was given cluster pain care. The hip joint function scores, pain scores, self-rating anxiety score (SAS) were compared between the two groups and between before intervention and after intervention in the two groups. RESULTS: The pain score of the children and the SAS of the primary caregivers after the intervention in the observation group were lower than those in the control group (P < 0.05), and the hip joint function score and family satisfaction degree were higher than those in the control group (P < 0.05). CONCLUSION: Family-based cluster pain care can reduce pain in children with DDH after surgery, promote hip joint functional recovery, reduce the negative emotions of caregivers, and improve family satisfaction, and has clinical popularization value. Show more

Keywords: Cluster nursing, hip dislocation, family-based, pain measurement, hip joint function, self-rating anxiety score

DOI: 10.3233/THC-230879

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2883-2891, 2024

Authors: Paramasivam, Gokila Brindha | Ramasamy Rajammal, Rajalaxmi

Article Type: Research Article

Abstract: BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a medical condition that causes hormonal disorders in women in their childbearing years. The hormonal imbalance leads to a delayed or even absent menstrual cycle. Women with PCOS mainly suffer from extreme weight gain, facial hair growth, acne, hair loss, skin darkening, and irregular periods, leading to infertility in rare cases. Doctors usually examine ultrasound images and conclude the affected ovary but are incapable of deciding whether it is a normal cyst, PCOS, or cancer cyst manually. OBJECTIVE: To have access to the high-risk crucial PCOS and to detect the …condition and the treatment aimed at mitigating health hazards such as endometrial hyperplasia/cancer, infertility, pregnancy complications, and the long-term burden of chronic diseases such as cardiometabolic disorders linked with PCOS. METHODS: The proposed Self-Defined Convolution Neural Network method (SD_CNN) is used to extract the features and machine learning models such as SVM, Random Forest, and Logistic Regression are used to classify PCOS images. The parameter tuning is done with lesser parameters in order to overcome over-fitting issues. The self-defined model predicts the occurrence of the cyst based on the analyzed features and classifies the class labels effectively. RESULTS: The Random Forest Classifier was found to be the most reliable and accurate among Support Vector Machine (SVM) and Logistic Regression (LR), with accuracy being 96.43%. CONCLUSION: The proposed model establishes better trade-off compared to various other approaches and works effectually for PCOS prediction. Show more

Keywords: SD_CNN, follicles, grid search, recognition rate, dropout, multinomial, exponential growth, and perimeter

DOI: 10.3233/THC-230935

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2893-2909, 2024

Authors: Dayama, Nikhil Vitthal | Ali, Mariyam | Gaur, Abhishek | Pandey, Kaushik Kumar | Alqahtani, Nasser M. | Alfarsi, Mohammed A. | Zarbah, Mohammad A. | Chaturvedi, Saurabh | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Bonding between metal and ceramic is one of the most important aspects of a successful prosthesis. Various methods have been recommended for preparing the metal surface to enhance the bond between metal and ceramic including the use of a metal bonding agent. OBJECTIVE: This study aims to evaluate and compare the shear bond strength of the metal-ceramic (M-C) interface after combinations of various surface treatments including the application of a metal bonding agent. METHOD: 40 Ni-Cr alloy specimens were made and divided into 4 groups of 10 each based on the combination …of surface treatments. Sandblasting, surface grinding, and Oxidation heat treatment (OHT) were performed on specimens from Group 1 (Control). In addition, Group 2 specimens received ultrasonic cleaning, Group 3 steam cleaning, and Group 4 metal bonding agent application. Following surface treatments on all specimens, porcelain build-up was performed, and shear bond strength was tested in a Digital Universal testing machine. The statistical tests used were independent t -test and ANOVA. RESULTS: Results revealed that Group 4 specimens had the highest mean value of shear bond strength of 39.087 MPa while Group 3 specimens showed the least mean shear bond strength of 18.154 MPa with highly statistically significant results (p < 0.001). CONCLUSION: The surface treatments and application of bonding agent to metal prior to porcelain application resulted in increased shear bond strength of the metal-ceramic interface. Show more

Keywords: Metal bonding agent, shear bond strength, surface treatments, alloys, composition, metal-ceramic

DOI: 10.3233/THC-231003

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2911-2923, 2024

Authors: Zhu, Yu-Ling | Wang, Sheng | Gu, Yan | Mao, Mao | Yan, Li-Hua

Article Type: Research Article

Abstract: BACKGROUND: Aortic dissection is usually managed with interventional therapy, conservative therapy, and surgery to inhibit disease progression and improve prognoses. Nevertheless, the absence of meticulous and effective nursing during the treatment greatly increases the complication rates, which is detrimental to the recovery of patients. OBJECTIVE: This study aimed to explore the efficacy of predictive pain intervention in the nursing process of patients with aortic dissection. METHODS: Sixty patients with aortic dissection who were admitted to our hospital from December 2018 to December 2020 were observed in this study. Specifically, these patients were randomly …and equally classified into Group A (patients who were given conventional nursing intervention) and Group B (patients who were given predictive pain intervention). Subsequently, the pain score, complication rates, and nursing satisfaction in the two groups were compared and analyzed. RESULTS: Compared with patients in Group A, patients in Group B had significantly lower pain scores (P < 0.05); complication rates were significantly lower in Group B than in Group A (6.67% vs. 23.33%, P < 0.05); patient satisfaction with care was significantly better in Group B compared to Group A (96.67% vs. 73.33%, P < 0.05). CONCLUSION: Predictive pain intervention is widely recognized as useful in the treatment of patients with aortic dissection. It has significant clinical application value as it can largely alleviate pain and is relatively safe for patients. Show more

Keywords: Aortic dissection, efficacy, predictive pain intervention

DOI: 10.3233/THC-231066

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2925-2930, 2024

Authors: Zhang, Xinliang | Wang, Lin | Li, Mei | Dong, Shimin

Article Type: Research Article

Abstract: BACKGROUND: Investigating the secondary sepsis of pneumonia is of great significance for rapid diagnosis and early treatment of sepsis. OBJECTIVE: This study aimed to investigate the predictive value of micro ribonucleic acids (miRNA) 7110-5p and miR-223-3p in sepsis secondary to pneumonia. A miRNA microarray was used to analyze the differences in miRNA expression between patients with pneumonia and those with sepsis secondary to pneumonia. METHODS: The study included a total of 50 patients with pneumonia and 42 patients with sepsis secondary to pneumonia. Quantitative polymerase chain reaction analysis was conducted to measure the …circulating miRNA expression levels in patients and assess their correlations with clinical characteristics and prognosis. In this study, nine miRNAs – hsa-miR-4689-5p, hsa-miR-4621-5p, hsa-miR-6740-5p, hsa-miR-7110-5p, hsa-miR-765, hsa-miR-940, hsa-miR-213-5p, hsa-miR-223-3p, and hsa-miR-122 – met the screening criteria of having a fold change ⩾ 2 or < 0.5; p < 0.01 indicated significant differences in the results. RESULTS: The expression levels of miR-7110-5p and miR-223-3p differed between the two patient groups, being up-regulated in the plasma of patients with sepsis secondary to pneumonia. miR-7110-5p and miR-223-3p showed higher expression levels in both patients with pneumonia and sepsis compared to healthy controls. Moreover, the receiver operating characteristic curve revealed that the areas under the curve for predicting pneumonia using miR-7110-5p were 0.781 while those for predicting sepsis secondary to pneumonia were 0.862. For miR-223-3p, the corresponding values for predicting pneumonia and sepsis secondary to pneumonia were 0.879 and 0.924, respectively. However, there were no significant differences in the levels of miR-7110-5p and miR-223-3p between the plasma of survived and deceased patients with sepsis. CONCLUSIONS: MiR-7110-5p and miR-223-3p have the potential to serve as biological indicators for predicting sepsis secondary to pneumonia. Show more

Keywords: miR-7110-5p, miR-223-3p, pneumonia, sepsis secondary to pneumonia

DOI: 10.3233/THC-231137

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2931-2939, 2024

Authors: He, Hui | Yan, Shuai | Chen, Dan-Dan | Guo, Cong | Xi, Zeng-Hui

Article Type: Research Article

Abstract: BACKGROUND: Secondary hyperparathyroidism (SHPT) is one of the common complications of end-stage renal disease-uremia, and is mainly manifested as parathyroid hyperplasia and abnormal secretion of parathyroid hormone (PTH). OBJECTIVE: To investigate the value and advantages of contrast-enhanced ultrasound (CEUS) in evaluating the survival of autografts after parathyroidectomy + parathyroid autotransplantation. METHODS: In this study, 125 patients with renal failure due to polycystic kidney disease, chronic nephritis, diabetic nephropathy, lupus nephritis, and atherosclerotic nephropathy were enrolled as the participants and each of them had 4 secondary hyperactive parathyroid glands and underwent …parathyroid autotransplantation. One parathyroid gland was taken from each patient and equally divided into 4 parts and placed in the subcutaneous fat of one forearm for transplantation. CEUS was performed 14 days after the transplantation to observe the micro blood supply of the graft and assess the survival and secretory function of the transplanted parathyroid. The grafts were divided into the partial survival group and the total survival group based on the enhancement characteristics. The survival of the grafts was determined by comparing the parathyroid hormone level in bilateral elbow cephalic veins 1 month after surgery. RESULTS: Among the 125 patients, 112 had linear or punctate enhancement of 2–4 parathyroid glands 14 days after surgery, and 13 patients had linear or punctate enhancement of 0–1 parathyroid gland. There were statistically significant differences in the perfusion pattern, enhancement uniformity, and parathyroid hormone levels in the cephalic veins at the elbow on both the graft and non-graft sides among all groups (P < 0.05). CONCLUSION: Compared to the detection of the difference in the parathyroid hormone level in the cephalic vein of bilateral elbows 1 month after surgery, CEUS can reflect the parathyroid survival after transplantation more quickly and accurately 2 weeks later, and provide a more rapid and agile non-invasive clinical diagnosis method. Show more

Keywords: Contrast-enhanced ultrasound (CEUS), parathyroid autotransplantation, secondary hyperparathyroidism, survival

DOI: 10.3233/THC-231191

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2941-2949, 2024

Authors: Wang, Juan | Zhang, Fan | Ma, Yulin | Ju, Hongjuan | Zhang, Yuena | Wang, Yueheng

Article Type: Research Article

Abstract: BACKGROUND: Chronic kidney disease (CKD) is a major public health problem, so it is particularly important to quantitatively assess and intervene in the degree of early renal damage in CKD. OBJECTIVE: The objective of the research is to establish reference values for kidney elasticity by using real-time shear wave elastography (RT-SWE) technology to quantify Young’s modulus values in the renal cortex of normal adults. The intention is to provide a foundation for evaluating renal function and structural changes in patients with CKD. Furthermore, this research investigates the role of RT-SWE in the early detection of renal …fibrosis in CKD, providing insights into its diagnostic value for detecting pathological changes at an early stage. METHODS: Between August 2019 and December 2021, we collected a sample of 100 healthy people (55 men with an average age of 43.5 ± 15.2 years and 45 women with an average age of 41.6 ± 19.8 years) for medical evaluations at our hospital’s Department of Ultrasound Medicine. In addition, 97 individuals with CKD1-3 stage were considered. Following the removal of contraindications and relevant confounding variables, we included a final cohort of 80 individuals in the research (45 men and 35 females, with an average age of 39.1 ± 19.2 years). The RENAL mode was selected and a convex array probe S6-1 operating at a frequency of 3.5–5.5 MHz was used in the research, which made use of the French Supersonic AixPlorer ultrasonic diagnostic instrument. Renal RT-SWE elastography was performed after conventional two-dimensional and color Doppler ultrasonography. The study used RT-SWE technology to assess the mean Young’s modulus of the cortex in healthy individuals (Emean), with data analysis and comparisons based on age and gender. Furthermore, the Emean values of CKD stage 1–3 patients were determined, and analyses were performed about 24-hour urine protein quantitative (24hUTP), serum creatinine concentration (SCr), and renal biopsy pathology, specifically the degree of interstitial fibrosis. RESULTS: Healthy group: a) The average kPa values of the left kidney (4.2 ± 2.3), right kidney (4.3 + 2.5) kPa, both kidneys’ average kPa values (4.3 ± 2.4) kPa, and the average kPa values of the left and right kidneys do not differ statistically (p = 0.986). b) There was no difference in the kPa values of healthy male and female kidneys (4.4 + 2.1 and 4.2 + 2.6, respectively. c) There was no difference in the renal kPa values of healthy adults aged 50 (4.4 ± 2.8) kPa and renal kPa of the 50-year-old population (4.2 + 2.1) kPa (p = 0.041). Case group: a) the group of patients with CKD1-3 stage and the group did not vary in their Emean values (both p < 0.05); b) There is a difference between CKD stages 1, 2, and 3 (p < 0.05), however, there is still no difference in the pyEmean value corrected for patient age between patients in stages 1 and 2 (p > 0.05). CONCLUSION: The study reveals no significant differences in the Emean value of bilateral kidneys in normal people and no differences in the elasticity value of kidneys and gender. However, age-based differences were statistically significant. pyEmean may be useful for comparing CKD stage 1, 2, and 3 patients, and RT-SWE can assess early renal damage. Show more

Keywords: Shear wave elastography, chronic kidney disease, renal fibrosis, early renal injury

DOI: 10.3233/THC-231270

Citation: Technology and Health Care, vol. 32, no. 5, pp. 2951-2964, 2024