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Price: EUR 150.00Authors: Lu, Ting | Ma, Hongxia | Shang, Lijing
Article Type: Research Article
Abstract: BACKGROUND: It is recommended to use non-invasive positive pressure ventilation in elderly patients with heart failure combined with obstructive sleep apnea syndrome (OSAS). OBJECTIVE: To study the therapeutic effect of non-invasive positive pressure ventilation on elderly patients with heart failure complicated with OSAS. METHODS: Using the random number table method, 119 elderly patients with heart failure complicated with OSAS who were admitted to our hospital from April 2020 to April 2021 were divided into the observation (60 cases) and control (59 cases) groups. On the basis of conventional drug treatment, patients in the …observation group were treated with non-invasive positive pressure ventilation, and patients in the control group were treated with low-flow oxygen inhalation. The sleep quality, hemoglobin, red blood cells, erythropoietin, pro-brain natriureticpeptide (pro-BNP) levels and blood pressure were compared. RESULTS: After treatment, levels of hemoglobin, erythrocytes, erythropoietin, pro-BNP, blood pressure and sleep apnea-hypopnea index in the observation group were lower before treatment and in the control group in the same period. The oxygen saturation was higher before treatment and the control group in the same period (P < 0.05). The overall satisfaction with sleep quality in the observation group was higher (P < 0.05). CONCLUSION: Non-invasive positive pressure ventilation can improve blood oxygen saturation and sleep quality in elderly patients with heart failure complicated with OSAS, and reduce pro-BNP level. Show more
Keywords: Non-invasive positive pressure ventilation, elderly, heart failure, obstructive sleep apnea syndrome, sleep quality
DOI: 10.3233/THC-230554
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Cui, Ling | Gao, Lina | Geng, Huanhuan | Zhang, Huiru | Wei, Hongyan
Article Type: Research Article
Abstract: BACKGROUND: Mild cognitive impairment (MCI) is a mild memory or cognitive impairment. OBJECTIVE: To explore the relationship between serum klotho (K1) protein and insulin-like growth factor-1 and mild cognitive impairment in the elderly in order to provide accurate and appropriate indicators for clinical diagnosis and treatment of MCI. METHODS: This randomized stratified study adopted a multistage cluster sampling method. 161 elderly patients with mild cognitive impairment were included as the MCI group, and 161 healthy people matched with the MCI group in gender, age and education were selected as the control group. …RESULTS: The levels of serum K1 protein and insulin-like growth factor-1 in the MCI group were lower than those in the control group (P < 0.05). Both IGF-1 and K1 had predictive value for MCI (P < 0.05). The area under the curve (AUC) of IGF-1 for predicting MCI was 0.859 (95% CI: 0.790∼ 0.929), and the AUC of K1 for predicting MCI was 0.793 (95% CI: 0.694∼ 0.892). The value of joint prediction of the two indicators was the highest, with an AUC of 0.939 (95% CI: 0.896–0.993). CONCLUSION: High serum K1 and insulin-like growth factor-1 are the protective factors of cognitive impairment in MCI patients. Both IGF-1 and serum K1 proteins have predictive value for MCI, and the combination of the two indicators has the highest predictive value. Show more
Keywords: Mild cognitive impairment, klotho protein, serum insulin-like growth factor-1
DOI: 10.3233/THC-230462
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Martins, Hélder Domiciano Dantas | de Lucena, Cassiane Pereira | da Silva, Quemuel Pereira | Dantas, Maria Vitória Oliveira | Costa, Maria do Desterro Andrêzza Souza | de Lucena, Edson Hilan Gomes | Bonan, Paulo Rogério Ferreti
Article Type: Research Article
Abstract: BACKGROUND: Teledentistry is considered a good tool in the diagnostic process. In oral medicine, there is a low number of trained professionals and dentists have difficulty in diagnosing and treating oral lesions. OBJECTIVE: We aimed to perform a cross-sectional evaluation based on the mobile application for oral diagnosis using a mobile application in a Brazilian State. METHODS: This is a retrospective, cross-sectional, observational study of the data of the “Telehealth in Stomatology in Paraíba” carried out between May 2021 and November 2022. RESULTS: The app has a team of …16 consultants (Ph.D. professors, postgraduate students, residents, and dentists). In addition, there are 289 registered professionals, with a mean age of 33.7 years, predominantly female (70.2%), working in primary care (79.2%), and general practitioners (42.6%). Regarding the cases, the app has 194 cases, and reactive lesions are the most suggested hypotheses reported by dentists (24.5%) and consultants (22.3%). We had an overall concordance rate of 64.1%. CONCLUSION: The application is easily accessible and has an assistance network that helps with early diagnosis. In addition, it has good coverage with users in more than 50% of the cities in the state. Thus, applications that provide specialized care to distant areas are important for better public health. Show more
Keywords: Telemedicine, diagnosis, oral, biomedical technology
DOI: 10.3233/THC-230584
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
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. Pre-press, no. Pre-press, pp. 1-15, 2023
Authors: Sayed, Mohammed E. | Jain, Saurabh | Jokhadar, Hossam F. | Alshahrani, Ahid Amer | AlResayes, Saad Saleh | Alqahtani, Saeed M. | Alqarni, Hatem | Anab, Najwa Ali | Alsubeaie, Nouf H. | Alsubaie, Shaa H. | Khalid, Asaad | Franco, Rocco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Provisional fixed dental prosthesis (FDP) plays an important role during fixed prosthodontic therapy till the definitive. Discoloration of materials used for provisional FDPs can cause patient dissatisfaction and may create doubt about the color stability of the definitive FDP. Surface roughness is the other major property to be taken into consideration for provisional FDP materials. Smokeless tobacco is reported to affect the color stability and surface roughness of different prosthetic materials. OBJECTIVE: The aim of the current study was to evaluate the effect of two types of smokeless tobacco (black and white) on color stability …and surface roughness of 3D printed, CAD/CAM milled, and conventional provisional FDP resin materials. METHODS: A total of 144 disc-shaped specimens were fabricated using four techniques CAD/CAM subtractive technique (milling), CAD/CAM additive technique (3D Printing), and conventional technique using autopolymerized PMMA, and autopolymerized Bis-acrylic resins. Each group was subdivided into three subgroups of twelve specimens each, and were submerged into three solutions (artificial salivary substitute, black smokeless tobacco, white smokeless tobacco). The change in color and surface roughness was evaluated and the data collected were statistically analyzed. RESULTS: It was observed that black smokeless tobacco caused the maximum color change and the effect was highest in autopolymerized PMMA resin specimens (Δ E = 9.343 ± 0.489), followed by 3D printed (Δ E = 7.187 ± 0.391), autopolymerized Bis-acryl (Δ E = 6.464 ± 0.453) and milled (Δ E = 4.978 ± 0.227). White smokeless tobacco was found to cause a maximum change in surface roughness and the effect was highest in autopolymerized Bis-acryl specimens (Δ Ra = 0.321 ± 0.015 μ m), followed by autopolymerized PMMA (Δ Ra = 0.297± 0.015 μ m), 3D printed (Δ Ra = 0.191 ± 0.019 μ m), and milled (Δ Ra = 0.168 ± 0.014 μ m). Statistically significant (p -value < 0.05) differences were observed among all techniques and solutions. CONCLUSIONS: The change in color and surface roughness were maximum in the case of FDPs prepared using autopolymerizing resins, followed by 3D printed, and CAD/CAM milled reins. Show more
Keywords: Smokeless Tobacco, PMMA; 3D printing, CAD/CAM Milling, color stability, surface roughness, Provisional fixed dental prosthesis
DOI: 10.3233/THC-230723
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2023
Authors: Su, Shunqing | Xiong, Disheng | Zeng, Zhijian | Ding, Xiumei | Kuang, Jinan | Lin, Yuechun | Wu, Yongwei
Article Type: Research Article
Abstract: BACKGROUND: Pressure ulcers remain a worldwide problem. OBJECTIVE: To introduce an intermittent and feasible wound treatment method for the treatment of pressure ulcers in elderly patients. METHODS: This surgical procedure was performed on eight elderly patients suffering from pressure ulcers. Microskin measuring 0.1 × 0.1 centimeters was cut from a small amount of thin skin and then grafted onto the wound surface in conjunction with closed negative pressure therapy. RESULTS: Seven patients had their wounds closed after a single surgery, while one patient required two surgeries to …close the wound. CONCLUSION: Autologous microskin implantation for the treatment of pressure ulcers in the elderly is an effective method to close the wound, which can prevent the elderly from living with wounds in their later years and is a viable treatment option. Show more
Keywords: Elderly patients, pressure ulcers, skin grafts, vacuum sealing drainage, wound repair
DOI: 10.3233/THC-230707
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: An, Peng | Liu, Junjie | Yu, Mengxing | Wang, Jinsong | Wang, Zhongqiu
Article Type: Research Article
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic airway diseases in the world. OBJECTIVE: To predict the degree of mixed venous oxygen saturation (SvO 2 ) impairment in patients with COPD by modeling using clinical-CT radiomics data and to provide reference for clinical decision-making. METHODS: A total of 236 patients with COPD diagnosed by CT and clinical data at Xiangyang No. 1 People’s Hospital (n = 157) and Xiangyang Central Hospital (n = 79) from …June 2018 to September 2021 were retrospectively analyzed. The patients were divided into group A (SvO⩾ 2 62%, N = 107) and group B (SvO< 2 62%, N = 129). We set up training set and test set at a ratio of 7/3 and time cutoff spot; In training set, Logistic regression was conducted to analyze the differences in general data (e.g. height, weight, systolic blood pressure), laboratory indicators (e.g. arterial oxygen saturation and pulmonary artery systolic pressure), and CT radiomics (radscore generated using chest CT texture parameters from 3D slicer software and LASSO regression) between these two groups. Further the risk factors screened by the above method were used to establish models for predicting the degree of hypoxia in COPD, conduct verification in test set and create a nomogram. RESULTS: Univariate analysis demonstrated that age, smoking history, drinking history, systemic systolic pressure, digestive symptoms, right ventricular diameter (RV), mean systolic pulmonary artery pressure (sPAP), cardiac index (CI), pulmonary vascular resistance (PVR), 6-min walking distance (6MWD), WHO functional classification of pulmonary hypertension (WHOPHFC), the ratio of forced expiratory volume in the first second to the forced vital capacity (FEV1%), and radscore in group B were all significantly different from those in group A (P < 0.05). Multivariate regression demonstrated that age, smoking history, digestive symptoms, 6MWD, and radscore were independent risk factors for SvO 2 impairment. The combined model established based on the abovementioned indicators exhibited a good prediction effect [AUC: 0.903; 95%CI (0.858–0.937)], higher than the general clinical model [AUC: 0.760; 95%CI (0.701–0.813), P < 0.05] and laboratory examination-radiomics model [AUC: 0.868; 95%CI (0.818–0.908), P = 0.012]. The newly created nomogram may be helpful for clinical decision-making and benefit COPD patients. CONCLUSION: SvO 2 is an important indicator of hypoxia in COPD, and it is highly related to age, 6MWD, and radscore. The combined model is helpful for early identification of SvO 2 impairment and adjustment of COPD treatment strategies. Show more
Keywords: Cardiac function, cardiac index, chronic obstructive pulmonary disease (COPD), digestive symptoms, hemodynamics, mixed venous oxygen saturation (SvO2), pulmonary systolic pressure, WHO functional classification of pulmonary hypertension
DOI: 10.3233/THC-230619
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Yang, Li | Song, Ling-Xia | Zhang, Yong-Mei | Liu, Han-Mei
Article Type: Research Article
Abstract: BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in …Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P < 0.05). NEWS values correlated positively with illness severity (r = 0.605, P < 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden’s index, with statistically significant differences (P < 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration. Show more
Keywords: Gastrointestinal illness, geriatric, illness severity assessment, National Early Warning Score
DOI: 10.3233/THC-230369
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Yu, Yong Ming | Hu, Yang
Article Type: Research Article
Abstract: BACKGROUND: As a critical m6A RNA methylation regulator, HNRNPC has been revealed to serve as potential biomarkers in various human cancers. The specific expression and significance of HNRNPC in colorectal cancer remain unknown. OBJECTIVE: This study aimed to confirm HNRNPC expression level and evaluate its function in colorectal cancer progression. METHODS: 101 paired tissue samples were collected from colorectal cancer patients. HNRNPC levels in colorectal cancer were detected using PCR. CCK8 and transwell assays were conducted to estimate the effect of HNRNPC on cell growth and metastasis with the regulation of HNRNPC by …cell transfection. RESULTS: Upregulated HNRNPC was observed in colorectal cancer compared with normal tissues and cells. The higher HNRNPC levels in tumor tissues were associated with the advanced TNM stage and positive lymph node metastasis. Meanwhile, HNRNPC upregulation could indicate adverse outcomes of colorectal cancer patients. In vitro , the knockdown of HNRNPC significantly suppressed the proliferation, migration, and invasion of colorectal cancer cells. CONCLUSIONS: Upregulated HNRNPC served as a biomarker for the prognosis and development of colorectal cancer, which provides a novel therapeutic target for colorectal cancer. Show more
Keywords: N6-methyladenosine (m6A), HNRNPC, colorectal cancer, prognosis, progression
DOI: 10.3233/THC-230429
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Wang, Yanxia | Li, Yaqing | Wang, Xiaoqing | Niu, Zhancong | Zhou, Lixia
Article Type: Research Article
Abstract: BACKGROUND: Stroke is the second reason for global deaths and a major reason for disabilities. OBJECTIVE: To unravel the clinical value of the coagulation index and serum inflammatory cytokines in hemorrhagic stroke patients with pulmonary infection in the sequelae stage. METHODS: Altogether, 130 hemorrhagic stroke patients who received treatment in Hebei General Hospital from April 2019 to December 2020 were selected. Patients were classified into the infection group (n = 65) and non-infection group (n = 65) according to whether they had a …pulmonary infection in the sequelae stage of hemorrhagic stroke. Levels of coagulation index and serum inflammatory cytokines of patients in two groups were compared. Multiple linear regression analysis was used to analyze pulmonary infection-related factors of hemorrhagic stroke patients. The diagnostic value of the coagulation index and serum inflammatory cytokines in pulmonary infection was analyzed by the receiver operating characteristic (ROC) curve. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT) related to coagulation function levels and interleukin 1β (IL-1β ), interleukin 17 (IL-17) related to serum inflammatory cytokines levels of patients in the infection group were higher than those in non-infection groups (p < 0.05). Multiple linear regression analysis uncovered that FIB, D-D, PLT, and IL-17 were influencing factors of pulmonary infection in the sequelae of patients with hemorrhagic stroke (p < 0.05). Area under the curve (AUC) values of pulmonary infection in the sequelae stage of patients with hemorrhagic stroke diagnosed by FIB, D-D, PLT, and IL-17 were 0.823, 0.758, 0.660, and 0.755, respectively. CONCLUSION: FIB, D-D, PLT, and IL-17 levels could be used for pulmonary infection diagnosis in the sequelae stage of hemorrhagic stroke patients. Show more
Keywords: Coagulation index, inflammatory factor, hemorrhagic stroke, sequelae stage, pulmonary infection, diagnosis
DOI: 10.3233/THC-230345
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Zou, Li | Dong, Wei | Ai, Ying | Li, Yantao | Cheng, Yun | Feng, Yun
Article Type: Research Article
Abstract: BACKGROUND: Recurrent spontaneous abortion affects approximately 1–2% of reproductive-age women, with roughly half of RSA cases classified as unexplained recurrent spontaneous abortion (URSA). Genetic polymorphisms in eNOS gene have been shown to have significant implications across various disease processes. Nevertheless, the potential impact of eNOS gene polymorphisms on the susceptibility to URSA in Yunnan population has yet to be explored or documented. OBJECTIVE: This study aims to investigate the potential association between specific variations in the eNOS gene (VNTR 4b/a, - 786T > C, and + 894G > …T) and the risk of URSA in Yunnan population. METHODS: A total of 243 URSA patients and 241 healthy females are involved in this study. We conducted amplification of the eNOS gene fragment and performed sanger sequencing to detect the specific eNOS gene polymorphisms, including VNTR 4b/a, - 786T > C, and + 894G > T. Using a multivariate logistic regression model, we evaluate the potential association between eNOS gene polymorphisms (VNTR 4b/a, - 786T > C, and + 894G > T) and the risk of URSA. Furthermore, serum NO levels were measured in URSA patients. RESULTS: The presence of VNTR 4a, - 786C, and + 894T alleles was found to be associated with an increased risk of URSA. Additionally, our study revealed a significant association between the G-C-4b haplotype of the investigated eNOS gene polymorphisms and a predisposition to URSA. Notably, these eNOS polymorphisms were shown to reduce serum NO levels in URSA patients. CONCLUSION: This study provides evidence supporting the association between eNOS gene polymorphisms, VNTR 4b/a, - 786T > C, and + 894G > T, and the occurrence of URSA in Yunnan Province, China. Show more
Keywords: eNOS, URSA, VNTR 4b/a, -786T > C, +894G > T
DOI: 10.3233/THC-230934
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
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 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. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Badnjević, Almir | Pokvić, Lejla Gurbeta | Smajlhodžić-Deljo, Merima | Spahić, Lemana | Bego, Tamer | Meseldžić, Neven | Prnjavorac, Lejla | Prnjavorac, Besim | Bedak, Omer
Article Type: Research Article
Abstract: BACKGROUND: With the end of the coronavirus disease 2019 (COVID-19) pandemic, it becomes intriguing to observe the impact of innovative digital technologies on the diagnosis and management of diseases, in order to improve clinical outcomes for patients. OBJECTIVE: The research aims to enhance diagnostics, prediction, and personalized treatment for patients across three classes of clinical severity (mild, moderate, and severe). What sets this study apart is its innovative approach, wherein classification extends beyond mere disease presence, encompassing the classification of disease severity. This novel perspective lays the foundation for a crucial decision support system during patient …triage. METHODS: An artificial neural network, as a deep learning technique, enabled the development of a complex model based on the analysis of data collected during the process of diagnosing and treating 1000 patients at the Tešanj General Hospital, Bosnia and Herzegovina. RESULTS: The final model achieved a classification accuracy of 82.4% on the validation data set, which testifies to the successful application of the artificial neural network in the classification of clinical outcomes and therapy in patients infected with viral infections. CONCLUSION: The results obtained show that expert systems are valuable tools for decision support in healthcare in communities with limited resources and increased demands. The research has the potential to improve patient care for future epidemics and pandemics. Show more
Keywords: COVID-19, artificial intelligence, medical techniques, classification, digitization, prediction
DOI: 10.3233/THC-230917
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Hamid, Suraya | Roslan, Muhammad Hamirul Hamizan | Norman, Azah Anir | Ghani, Norjihan Abdul
Article Type: Research Article
Abstract: BACKGROUND: Several studies focus on the use of emerging technologies to support and monitor health but are centred around the elderly group of people. Meanwhile, the average elderly popularly known as the middle-aged have not been put into consideration regarding the subject matter. OBJECTIVE: This article focuses on the use behaviour and acceptance of emerging technologies that can assist in providing a middle-aged population with a healthy lifestyle. METHODS: This study collected the primary data through an online questionnaire survey to empirically evaluate final 169 respondents. The analysis for this study was done …utilising SmartPLS software via partial least squares structural equation modelling. RESULTS: The results indicate that 9 out of 11 were tested as supported hypotheses. All supported hypotheses showed the strong relationship between acceptance and user behaviour with emerging technology. CONCLUSION: The experience of acceptance and behaviour of using emerging technology in a healthy lifestyle was found as an important determinant of outcome in preparing the middle-aged for their elderly age by adapting emerging technology as early as possible. Show more
Keywords: Emerging technology, healthy lifestyle, middle aged, health, acceptance
DOI: 10.3233/THC-230604
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2023
Authors: Wang, Ping | Shen, Yue | Chen, Jinghan | Li, Qianwen | Tong, Lin | Li, Xitao
Article Type: Research Article
Abstract: BACKGROUND: Beamforming is vital for medical ultrasound imaging systems. The generalized sidelobe canceller (GSC) beamforming can improve the image quality of lateral resolution, but its performance improvement in contrast and robustness is limited. OBJECTIVE: This paper proposes an improved generalized sidelobe canceller algorithm based on multi-apodization with cross-correlation (MAXB-IGSC), which aims to improve the contrast and robustness of ultrasound imaging while maintaining the high image resolution and background speckle quality of GSC. METHODS: The proposed MAXB-IGSC uses multiple pairs of complementary received apodization functions to process the echo data individually to obtain multiple …pairs of data sets. The average of their normalized cross-correlation coefficients is then calculated and utilized to determine the adaptive subarray length of the GSC covariance matrix and weights the output of the improved GSC. RESULTS: The MAXB-IGSC improves the contrast ratio (CR) by 171.18% in anechoic cyst simulation and by 91.23%/130.97%/171.76% in geabr_0 (a dataset from the University of Michigan) experiment compared with GSC, respectively. Furthermore, MAXB-IGSC exhibits significant noise immunity, which greatly improves the robustness of the imaging. The technology also maintains the brightness and uniformity of the background speckle. CONCLUSION: The proposed MAXB-IGSC has potential for obtaining high-quality ultrasound images in clinical applications. Show more
Keywords: Ultrasound imaging, cross-correlation coefficient, adaptive subarray length, robustness
DOI: 10.3233/THC-230724
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2023
Authors: Lee, Hung Fu | Liao, Pei-Hung
Article Type: Research Article
Abstract: BACKGROUND: Improved access to media and medical knowledge has elicited stronger public health awareness. OBJECTIVE: This study developed a smart drug interaction reminder system for patients to increase knowledge and reduce nurse workload. METHODS: This study used a single-group pre-test/post-test design and applied mining techniques to analyze the weight and probability of interaction among various medicines. Data were collected from 258 participants at a teaching hospital in northern Taiwan using convenience sampling. An app was used to give patients real-time feedback to obtain access to information and remind them of their health issues. …In addition to guiding the patients on medications, this app measured the nurses’ work satisfaction and patients’ knowledge of drug interaction. RESULTS: The results indicate that using information technology products to assist the app’s real-time feedback system promoted nurses’ work satisfaction, improved their health education skills, and helped patients to better understand drug interactions. CONCLUSION: Using information technology to provide patients with real-time inquiring functions has a significant effect on nurses’ load reduction. Thus, smart drug interaction reminder system apps can be considered suitable nursing health education tools and the SDINRS app can be integrated into quantitative structure-activity relationship intelligence in the future. Show more
Keywords: Drug interaction, data mining, reminder systems, nurses, application
DOI: 10.3233/THC-230650
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Qiu, Bin | Chen, Hang | Zhang, Enke | Ma, Fuchun | An, Gaili | Zong, Yuan | Shang, Liang | Zhang, Yulian | Zhu, Huolan
Article Type: Research Article
Abstract: BACKGROUND: The incidence of type 2 diabetes is rapidly increasing worldwide. Studies have shown that it is also associated with cancer-related morbidities. Early detection of cancer in patients with type 2 diabetes is crucial. OBJECTIVE: This study aimed to construct a model to predict cancer risk in patients with type 2 diabetes. METHODS: This study collected clinical data from a total of 5198 patients. A cancer risk prediction model was established by analyzing 261 items from routine laboratory tests. We screened 107 risk factors from 261 clinical tests based on the importance of …the characteristic variables, significance of differences between groups (P < 0.05), and minimum description length algorithm. RESULTS: Compared with 16 machine learning classifiers, five classifiers based on the decision tree algorithm (CatBoost, light gradient boosting, random forest, XGBoost, and gradient boosting) had an area under the receiver operating characteristic curve (AUC) of > 0.80. The AUC for CatBoost was 0.852 (sensitivity: 79.6%; specificity: 83.2%). CONCLUSION: The constructed model can predict the risk of cancer in patients with type 2 diabetes based on tumor biomarkers and routine tests using machine learning algorithms. This is helpful for early cancer risk screening and prevention to improve patient outcomes. Show more
Keywords: Type 2 diabetes, cancer risk, machine learning, prediction model
DOI: 10.3233/THC-230385
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
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. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Seget, Sebastian | Chobot, Agata | Rusak, Ewa | Ochab, Agnieszka | Bielawska, Anna | Polanska, Joanna | Jarosz-Chobot, Przemysława
Article Type: Research Article
Abstract: BACKGROUND: Given the steadily rising incidence of type 1 diabetes (T1D), particularly among the youngest preschool children, coupled with well-documented challenges of achieving and maintaining optimal metabolic control in this age group, there is a growing need for advanced technological devices. OBJECTIVE: To evaluate glycaemic control in children below the age of seven with type 1 diabetes (T1D) and assess the safety of the advanced hybrid closed loop (AHCL) system in comparison to the previous treatment method, a sensor-augmented pump with predictive low-glucose suspend (SAP-PLGS). METHOD: Data from 10 children (aged 2.60–6.98 years) …with T1D who transitioned to the AHCL system from SAP-PLGS were analysed. SAP-PLGS records from two weeks prior to the initiation of AHCL were compared with records from the initial four weeks post-switch (excluding the training period). These data were examined at two 2-week intervals and compared with records from two weeks post six-month usage of the AHCL. RESULTS: A significant decrease in the average nighttime glucose concentration was observed compared to pre-AHCL values (p = 0.001, concordance W = 0.53). The Glucose Management Indicator (GMI) value significantly decreased from 6.88 ± 0.37% to 6.52 ± 0.32% (p = 0.018, rbc = 0.93) immediately following the device switch and stabilized at 6.50 ± 0.28% (p = 0.001, W = 0.53) and 6.55 ± 0.41% (p = 0.001, W = 0.53) at subsequent stages of the study. An improvement was also observed in mean glucose values for time spent < 54 mg/dl, while the proportion of time within this range was maintained, both during the day (p < 0.001, W = 0.58) and at night (p = 0.002, W = 0.83). CONCLUSION: The AHCL MiniMed 780G TM system improved glycaemic control in the studied group of children under seven years of age with T1D compared to previous SAP-PLGS therapy. It proved to be safe for delivering insulin in this age group. Show more
Keywords: Type 1 diabetes, advanced hybrid closed-loop system, young children, hybrid closed-loop
DOI: 10.3233/THC-230490
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
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. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Kim, Sun Kyung | Lee, Youngho | Wang, Hye Ri H. | Park, Su Yeon
Article Type: Research Article
Abstract: BACKGROUND: The in-depth understanding of human anatomy is the foundation for safety in nursing practice. Augmented reality is an emerging technology that can be used for integrative learning in nursing education. OBJECTIVE: The study aimed to develop a human anatomy-based skill training system and pilot test its usability and feasibility. METHODS: Twenty-seven nursing students participated in 3D anatomy-based skill training for intramuscular injection and Levin tube feeding using HoloLens 2. Various user interfaces including pictures, videos, animation graphics, and annotation boxes assisted users with a comprehensive understanding of the step-by-step procedures for these …techniques. A one-group pre-post test was conducted to observe changes in skill performance competency, usability, and learning satisfaction. RESULTS: After study participation, a statistically significant improvement in skill performance competency (p < 0.05) was observed. The usability results showed that students were satisfied with the usefulness of the program (9.55 ± 0.49) and scored highly for the intention to participate in other educational programs (9.62 ± 0.59). A high level of learning satisfaction was achieved (9.55 ± 0.49), with positive responses in fostering students’ engagement and excitement in the application of cutting-edge technology. CONCLUSION: The 3D anatomy-based nursing skill training demonstrated good potential to improve learning outcomes and facilitate engagement in self-directed practice. This can be integrated into undergraduate nursing education as an assistant teaching tool, contributing to the combination of knowledge and practice. Show more
Keywords: HoloLens 2, augmented reality, nursing, 3D, human anatomy, practice
DOI: 10.3233/THC-230586
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
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. Pre-press, no. Pre-press, pp. 1-10, 2023
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. Pre-press, no. Pre-press, pp. 1-13, 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. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ozcelik, Neslihan | Kıvrak, Mehmet | Kotan, Abdurrahman | Selimoğlu, İnci
Article Type: Research Article
Abstract: BACKGROUND: Lung cancer is the most common type of cancer, accounting for 12.8% of cancer cases worldwide. As initially non-specific symptoms occur, it is difficult to diagnose in the early stages. OBJECTIVE: Image processing techniques developed using machine learning methods have played a crucial role in the development of decision support systems. This study aimed to classify benign and malignant lung lesions with a deep learning approach and convolutional neural networks (CNNs). METHODS: The image dataset includes 4459 Computed tomography (CT) scans (benign, 2242; malignant, 2217). The research type was retrospective; the case-control …analysis. A method based on GoogLeNet architecture, which is one of the deep learning approaches, was used to make maximum inference on images and minimize manual control. RESULTS: The dataset used to develop the CNNs model is included in the training (3567) and testing (892) datasets. The model’s highest accuracy rate in the training phase was estimated as 0.98. According to accuracy, sensitivity, specificity, positive predictive value, and negative predictive values of testing data, the highest classification performance ratio was positive predictive value with 0.984. CONCLUSION: The deep learning methods are beneficial in the diagnosis and classification of lung cancer through computed tomography images. Show more
Keywords: Lung cancer, deep learning, convolutional neural network, GoogLeNet
DOI: 10.3233/THC-230810
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
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. Pre-press, no. Pre-press, pp. 1-12, 2023
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. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Zhou, Xuan | Li, Zhen-Fei | Guo, Xuan-Zhu | Wei, Qiao | Niu, Ya-Nan | Li, Meng | Xia, Jia-Ning | Chen, Li-Ping
Article Type: Research Article
Abstract: BACKGROUND: The first-line treatment for cervical dystonia (CD) consists of repeated intramuscular injections of botulinum toxin (BoNT). However, the efficacy in some patients may be unsatisfactory and they may discontinue treatment. OBJECTIVE: To examine the factors associated with the maximum rate of remission in patients with CD after initial botulinum neurotoxin type A (or botulinum toxin type A abbreviated as BTX-A or BoNT-A) treatment. METHODS: Patients with CD who received BoNT-A injections were evaluated using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Tsui scale, with follow-up endpoints lasting until the …start of the second injection. Patients who did not receive a second injection of BoNT-A were followed up for at least 5 months. The maximum remission rates were determined using the lowest Tsui and TWSTRS total scores during the follow-up period. We obtained basic information about these patients such as age, gender, duration of disease, presence of additional disease, types of torticollis, presence of anxiety, depression, tremors, single-photon emission computed tomography (SPECT) findings, injected dose, and so on from their medical records. RESULTS: A total of 70 patients with CD participated in this study, with males comprising 35.7% (25 individuals) with an average age of 45 ± 14 years old. The duration of disease was an independent risk factor for determining whether a complete remission has been attained using the Tsui scale (odds ratio [OR] = 0.978, 95% confidence interval [CI]: 0.959–0.997, P = 0.026). The optimal cut-off point for predicting patients who were unable to achieve complete remission based on duration of disease was 7.5 months (AUG = 0.711). Patients with CD with additional disease had greater difficulty achieving complete remission than those with CD alone based on TWSTRS assessments (P = 0.049). During the study, approximately 17% of all participants reported experiencing adverse reactions that lasted between 1 to 3 weeks before disappearing. CONCLUSION: BoNT is an effective and safe method for treating CD. The maximum remission rates of patients after their first injections are influenced by the duration of their disease. Thus, treatment using BoNT injections must be administered as soon as possible. Show more
Keywords: Botulinum neurotoxin (BoNT), cervical dystonia, efficacy, maximum remission rate, spasmodic torticollis
DOI: 10.3233/THC-231182
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Ding, Ling | Tao, Xinyan | Zhou, Jingjing
Article Type: Research Article
Abstract: BACKGROUND: Comprehensive geriatric assessment (CGA) has been used in inpatient, outpatient, and emergency patients in Western countries and is an important evaluation tool in medicine. In China, the application of CGA to multiple single diseases has achieved satisfactory intervention effects. OBJECTIVE: To explore the effect of CGA on postoperative quality of life (QoL), psychological state, neurological recovery, and self-efficacy in patients with cerebral hemorrhage. METHODS: In this randomized controlled trial, a total of 133 postoperative patients with cerebral hemorrhage who were treated and nursed in our hospital between March 2019 and March 2021 …were randomly assigned to a control group (68 patients) and an observation group (65 patients). The control group was given a general comprehensive care intervention. The observation group was evaluated using an electronic medical record-based CGA system that assessed patient prognosis and was given individualized interventions based on the CGA findings. The postoperative QoL, psychological state, neurological recovery, and self-efficacy of the two groups were compared. RESULTS: After the intervention, self-decompression, self-decision-making, and positive attitudes of the observation group were higher than those of the control group. However, the National Institute of Health Stroke Scale score of the observation group was lower than that of the control group, the Self-rating anxiety scale and self-rating depression scale scores of the observation group were lower than those of the control group, and the social support score was significantly higher in the observation group than in the control group. After the intervention, the mental vitality, social interaction, emotional restriction, and mental status scores of the observation group were significantly higher than those of the control group. CONCLUSION: Comprehensive evaluation of patients with cerebral hemorrhage based on a CGA, targeting the individual factors that affect the prognosis of patients, and formulating and implementing individualized nursing intervention programs based on the CGA results can effectively relieve the symptoms of cerebral hemorrhage, reduce anxiety and depression, and improve the QoL of patients with cerebral hemorrhage. Show more
Keywords: Intracerebral hemorrhage, comprehensive geriatric assessment, quality of life, neurological function, self-efficacy
DOI: 10.3233/THC-230611
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Hu, Huijun | Ma, Yanfang | Cheng, Aiai | Zhang, Zengqiang
Article Type: Research Article
Abstract: BACKGROUND: There have been studies on the use of cognitive behavioral nursing intervention (CBNI) but the main subjects were patients with secondary glaucoma and there are fewer studies on the care of congenital glaucoma. OBJECTIVE: To explore the clinical value of cognitive behavioral nursing model in patients with congenital glaucoma. METHODS: One hundred and fifty-three postoperative patients with congenital glaucoma treated in our hospital between January 2021 and December 2022 were prospectively selected for the study and randomly divided into a control group (n = 77) and an …observation group (n = 76). The control group was given routine nursing, and the observation group was given cognitive behavioral nursing mode on the basis of the control group. Anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), Connor-Davidson toughness scale, and treatment adherence evaluation scale were used to evaluate the psychological state, mental toughness, treatment adherence, treatment effect and nursing care satisfaction in the two groups before and after 2 weeks of intervention. The efficacy of the treatment was also assessed by determining the visual acuity (VA), intraocular pressure (IOP), and mean defective (MD) value of the visual field of the two groups of patients. RESULTS: After nursing, the SDS score (46.33 ± 6.16 versus 53.21 ± 5.94) and SAS score (44.41 ± 5.6 versus 52.82 ± 6.31) in the observation group were lower than those in the control group (P < 0.05). The scores of optimism (11.55 ± 1.90 versus 8.20 ± 1.95), self-improvement (22.05 ± 3.60 versus 17.60 ± 4.30), tenacity (37.45 ± 3.10 versus 28.90 ± 4.55) and total score (71.35 ± 8.00 versus 56.85 ± 8.50) in the observation group were higher than those in the control group (P < 0.05). After care, the VA of the observation group (0.95 ± 0.22) was greater than that of the control group (0.84 ± 0.16), and the IOP (14.25 ± 0.58 versus 15.89 ± 0.67) and the MD (5.42 ± 0.46 versus 6.68 ± 0.49) of the observation group were less than that of the control group. The difference between the two groups was statistically significant (P < 0.05). The compliance (96.05% versus 85.71%) and nursing satisfaction (96.10% versus 85.71%) of the observation group were higher than those of the control group (P < 0.05). CONCLUSION: Cognitive-behavioural nursing care for glaucoma patients can improve patients’ mental toughness, improve visual acuity, reduce intraocular pressure and mean visual field defect values, and have a positive effect on enhancing patients’ treatment adherence and nursing satisfaction. Show more
Keywords: Cognitive behavioral nursing, congenital glaucoma, compliance, self-management
DOI: 10.3233/THC-230772
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Orsi, Alexander D. | Mathew, Manu | Plaskos, Christopher | Wakelin, Edgar A. | Slotkin, Eric M. | Coffey, Simon | Ponder, Corey E. | Keggi, John K. | McMahon, Stephen J.
Article Type: Research Article
Abstract: BACKGROUND: Passive smartphone-based apps are becoming more common for measuring patient progress after total hip arthroplasty (THA). Optimum activity levels during early THA recovery have not been well documented. OBJECTIVES: Correlations between step-count and patient reported outcome measures (PROMs) during early recovery were explored. This study also investigated how demographics impact step-count during early post-operative recovery. METHODS: Smartphone captured step-count data from 666 THA patients was retrospectively reviewed. Mean age was 64 ± 11 years. 55% were female. Mean BMI was 29 ± 8kg/m 2 …. Mean daily step-count was calculated for each patient over four time-windows: 60 days prior to surgery (preop), 42–49 days postop (6 weeks), 91–98 days postop (3 months), and 183–197 days postop (6 months). Spearman correlation coefficients and linear regression were used to assess the association between PROMs (HOOS-12, HOOS-Jr, and UCLA) were performed. Patients were separated into three step-count levels: low (< 2500 steps/day), medium (2500–5500 steps/day), and high (> 5500 steps/day). Age > 65 years, BMI > 35 kg/m 2 , and sex were used for demographic comparisons. Post hoc analyses were performed using Welch’s unequal variances t -tests, or Wilcoxon rank-sum tests, both with Bonferroni corrections, where appropriate when comparing between groups. Chi-squared analyses were also used when comparing categorical variables. RESULTS: UCLA correlated with step-count at all time-windows (p < 0.001). HOOS12-Function correlated with step-count preoperatively, at 6 weeks, and at 3 months (p < 0.001). High step-count individuals had improved UCLA scores compared to low step-count individuals preoperatively (Δ 1.5, p < 0.001), at 6 weeks (Δ 0.9, p < 0.001), at 3 months (Δ 1.4, p < 0.001), and at 6 months (Δ 1.4, p < 0.001). High step-count individuals had improved HOOS12-Function scores compared to low step-count individuals preoperatively (Δ 9.6, p < 0.001), at 6 weeks (Δ 5.3, p < 0.001), and at 3 months (Δ 6.1, p < 0.001). Males had greater step-count at all time points (p < 0.001). Younger patients and low BMI patients had greater step-count across all time points (p < 0.001). CONCLUSION: High step-count improved PROMs scores compared to low step-count. Early post-operative step-count was significantly impacted by age, sex, and BMI. Generic recovery profiles may not be appropriate across diverse populations. Show more
Keywords: Total hip arthroplasty, smartphone, step-count, PROMs, remote patient monitoring
DOI: 10.3233/THC-231203
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: DeClaire, Jeffrey H. | Wakelin, Edgar A. | Chattinger, Kayla | Plaskos, Christopher
Article Type: Research Article
Abstract: BACKGROUND: Early complications in total knee arthroplasty (TKA) associated with modern robotics platforms integrated with digital balancing technology have not been investigated. OBJECTIVE: The objective was to compare 90-day complication rates between a manual technique and a modern robotic-assisted ligament balancing TKA platform. METHODS: 895 primary TKA procedures from a single surgeon were retrospectively reviewed (614 manual TKA, 281 using a modern robotics platform with an integrated digitally controlled ligament balancing device). Post-operative complications within the 90-day episode of care were recorded by the Michigan Arthroplasty Registry Collaborative Quality Initiative. Differences in complication …rates between techniques were further divided into inpatient hospital, outpatient hospital, and ambulatory surgery center (ASC) cohorts. RESULTS: In the pooled hospital cohort and inpatient hospital cohort, ‘Return to OR’ was significantly lower for the robotic assisted group (1.3% vs 5.2% and 0% vs 4.9%, respectively, p < 0.0370). Specifically, the need for manipulation under anesthesia (MUA) was reduced for the robotics group (0.0% vs 2.5%, p = 0.0352). No differences in overall complication rate or cause of complication was found between manual and robotics cases for the hospital outpatient and ASC cohorts (p ⩾ 0.68). CONCLUSION: Within the hospital setting, robotic assisted ligament balancing technology was associated with reduced 90-day postoperative complications for ‘Return to OR’ and MUA. Show more
Keywords: Total knee arthroplasty, robotics, soft tissue, complications, hospital, ambulatory surgical center, ASC
DOI: 10.3233/THC-231198
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Guo, Julong | Ning, Yachan | Pan, Dikang | Wu, Sensen | Gao, Xixiang | Wang, Cong | Guo, Lianrui | Gu, Yongquan
Article Type: Research Article
Abstract: BACKGROUND: Endothelial dysfunction, the earliest stage of atherosclerosis, can be caused by smoking, but its molecular mechanism requires further investigation. OBJECTIVE: This study aimed to use bioinformatics analysis to identify potential mechanisms involved in smoking-related atherosclerotic endothelial dysfunction. METHODS: The transcriptome data used for this bioinformatics analysis were obtained from the Gene Expression Omnibus (GEO) database. The GSE137578 and GSE141136 datasets were used to identify common differentially expressed genes (co-DEGs) in endothelial cells treated with oxidized low-density lipoprotein (ox-LDL) and tobacco. The co-DEGs were annotated using Gene Ontology (GO) and Kyoto Encyclopedia of …Genes and Genomics (KEGG) databases. Additionally, a protein-protein interaction (PPI) network was constructed to visualize their interactions and screen for hub genes. GSE120521 dataset was used to verify the expression of hub genes in unstable plaques. The miRNA expression profile GSE137580 and online databases (starBase 2.0, TargetScan 8.0 and DGIdb v4.2.0) were used to predict the related non-coding RNAs and drugs. RESULTS: A total of 232 co-DEGs were identified, including 113 up-regulated genes and 119 down-regulated genes. These DEGs were primarily enriched in detrimental autophagy, cell death, transcription factors, and cytokines, and were implicated in ferroptosis, abnormal lipid metabolism, inflammation, and oxidative stress pathways. Ten hub genes were screened from the constructed PPI network, including up-regulated genes such as FOS, HMOX1, SQSTM1, PTGS2, ATF3, DDIT3, and down-regulated genes MCM4, KIF15, UHRF1, and CCL2. Importantly, HMOX1 was further up-regulated in unstable plaques (p = 0.034). Finally, a regulatory network involving lncRNA/circRNA-miRNA-hub genes and drug-hub genes was established. CONCLUSION: Atherosclerotic endothelial dysfunction is associated with smoking-induced injury. Through bioinformatics analysis, we identified potential mechanisms and provided potential therapeutic targets. Show more
Keywords: Atherosclerosis, smoke, tobacco, endothelial cells, genes
DOI: 10.3233/THC-230796
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Hoveidaei, Amir Human | Esmaeili, Sina | Ghaseminejad-Raeini, Amirhossein | Pirahesh, Seyed Kasra | Hoveidaei, Armin | Sandiford, Nemandra A. | Lahner, Nina | Citak, Mustafa
Article Type: Review Article
Abstract: BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a viable alternative to total knee arthroplasty (TKA) for osteoarthritis patients with single-compartment involvement, with advantages including accelerated recovery, reduced pain, and improved function. Robotic-assisted UKA (rUKA) is a promising development that ensures precise implant positioning and limb alignment. However, concerns about complications remain. OBJECTIVE: This study looks at patient satisfaction as a key metric for determining the efficacy of rUKA versus manual UKA (mUKA). METHODS: The search strategy for this study followed PRISMA. Using precise keywords, PubMed, Scopus, Web of Science, and the Cochrane library were …searched. English articles were searched until August 2, 2023. Selection criteria included mUKA and rUKA patient satisfaction studies. The NOS scale evaluated study quality. Meta-analysis was done with R and heterogeneity analysis. RESULTS: This systematic review examined 5 studies with 1060 UKAs (532 robotic-assisted and 528 manual). Variable satisfaction assessment methods were used. Three studies found no difference in patient satisfaction after robotic-assisted UKA, but two found a higher satisfaction. Meta-analysis showed robotic-assisted UKA improved patient satisfaction (OR = 1.72 [1.25–2.37]). Overall, most studies showed low risk of bias, except one with higher bias. CONCLUSION: This review suggests that robotic assistance may enhance patient satisfaction in UKA procedures. Show more
Keywords: Arthroplasty, replacement, knee, medical device, patient satisfaction, robotic surgical procedures
DOI: 10.3233/THC-231216
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Liu, Dong-Xu | Wu, Ke-Han | Zang, Xi-Yan | Lu, Jia-Yi | Liu, Ming-Yue | Li, Chun-Ming | Gao, Li
Article Type: Research Article
Abstract: BACKGROUND: Oral squamous cell carcinoma (OSCC) is an infiltrative malignancy characterized by a significantly elevated recurrence rate. Dickkopf-related protein 1 (DKK1), which plays an oncogene role in many cancers, acts as an inhibitor of the Wingless protein (Wnt) signaling pathway. Currently, there is a lack of consensus regarding the role of DKK1 in OSCC or its clinical significance. OBJECTIVE: To examine the role and effect of DKK1 in OSCC. METHODS: The identification of differentially expressed genes (DEGs) in OSCC was conducted by utilizing databases such as The Cancer Genome Atlas (TCGA) and Gene …Expression Omnibus (GEO). A comprehensive analysis of gene expression profile interactions (GEPIA) and Kaplan-Meier curve were conducted to investigate the associations among DEGs, patient survival and prognosis in individuals with OSCC. The biological function of DKK1 in OSCC was investigated by using molecular biology approaches. RESULTS: The expression of DKK1 was found to be upregulated in OSCC tissues at various stages. High levels of DKK1 expression exhibited a positive correlation with the overall survival (OS) and progression-free survival (PFS) rates among OSCC patients. DKK1 knockdown suppressed the proliferation and induced apoptotic response in OSCC cells. Moreover, DKK1 exerted a positive regulatory effect on HMGA2 expression, thereby modulating cell growth and apoptosis in OSCC. The expression of DKK1 was found to be positively correlated with the infiltration of immune cells in patients with OSCC. Additionally, higher levels of CD4 + T cells were associated with improved 5-year survival rates. CONCLUSION: DKK1 is a prognostic biomarker for patients with OSCC. Show more
Keywords: Dickkopf-related protein 1, HMGA2, immune status, Oral squamous cell carcinoma
DOI: 10.3233/THC-230527
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Akçaalan, Serhat | Akbulut, Batuhan | Çağlar, Ceyhun | Innocenti, Matteo | Uğurlu, Mahmut | Dogan, Metin | Akkaya, Mustafa
Article Type: Research Article
Abstract: BACKROUND: Periprosthetic joint infection (PJI) is a very important complication that occurs after total joint replacement. Diagnosing PJI is at least as difficult as this disease. There is no biomarker that alone can diagnose PJI. OBJECTIVE: This study aimed to evaluate the effectiveness of large unstained cell percentage (%LUC) in diagnosing PJI and deciding on re-implantation in two stage septic exchange arthroplasty. METHODS: Patients who underwent revision arthroplasty between 2019 and 2023 were screened retrospectively. These patients were grouped as those who underwent two-stage septic exchange and those who underwent aseptic exchange. Prosthesis …removal from the patients who underwent two-stage septic exchange, before spacer application, and on the 3rd post-operative day after spacer application, Blood parameters were collected at the 1st month and before the second stage after the spacer application, and before the revision surgery from the patients who underwent aseptic exchange. White blood cell, neutrophil percentage, %LUC, albumin, sedim and CRP values were checked and recorded one by one from all patients. RESULTS: The data of a total of 233 patients, including 133 patients in the two stage septic exchange group and 100 patients in the aseptic exchange group, were included in the study. When the predictive value of %LUC in PJI was accepted as cut-off 1.75, the sensitivity was 69.2% and the specificity was 73%. The change in %LUC over time in patients who underwent two-stage septic exchange was statistically significant (p = 0.0001). A positive correlation was found between the value of .%LUC after spacer application and the value of CRP before prosthesis protrusion/spacer application surgery, and the Spearman correlation coefficient was found to be 0.005. CONCLUSION: %LUC value can be a promising biomarker for the diagnosis of PJI by considering both sensitivity and specificity rates. Apart from this, it is an easily accessible and effective biomarker for re-implantation decision making and evaluation of response to treatment, especially in two-stage septic exchange surgeries. Show more
Keywords: Periprosthetic joint infection, %LUC, biomarker, two stage, septic exchange
DOI: 10.3233/THC-230903
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Lin, Wan-Rong | Liu, Wei-Qing | Meng, Xuan-Yu | Liu, Xiao-Ting | Kou, Zhi-Yong | Li, Wen-Liang | Yang, Jun
Article Type: Research Article
Abstract: BACKGROUND: Despite the advancement of new screening strategies and the advances in pharmacological therapies, the cancerization rates of familial adenomatous polyposis (FAP) are stable and even increased in the last years. Therefore, it necessitates additional research to characterize and understand the underlying mechanisms of FAP. OBJECTIVE: To determine the genes that drive the pathogenesis of familial adenomatous polyposis (FAP). METHODS: We performed on a cohort (GSE111156) gene profile, which consist of four group of gene expressions (the gene expressions of cancer, adenoma and normal tissue of duodenal cancer from patients with FAP were …defined as Case N, Case A and Case C respectively, while that of adenoma tissue from patients with FAP who did not have duodenal cancer was Ctrl A). Tracking Tumor Immunophenotype (TIP) website was applied to reveal immune infiltration profile and signature genes of FAP. We merged the genes of key module (pink and midnight module) with signature genes to obtained the biomarkers related with FAP pathogenesis. The expression of these five biomarkers in FAP intratumoral region (IT) and tumor rim (TR) was detected with Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). RESULTS: In total, 220, 23 and 63 DEGs were determined in Cases C, A and N, in comparison to Ctrl A. In total, 196 and 10 DEGs were determined in Cases C and A, separately, as compared to Case N. A total of four biomarkers including CCL5, CD3G, CD2 and TLR3 were finally identified associated with pink module, while only one biomarker (KLF2) associated with midnight module was identified. All biomarkers were evidently raised in FAP IT tissues utilizing qRT-PCR. CONCLUSION: We identified five potential biomarkers for pathogenesis of FAP to understand the fundamental mechanisms of FAP progression and revealed some probable targets for the diagnosis or treatment of FAP. Show more
Keywords: Familial adenomatous polyposis, bioinformatics, driver gene, WGCNA, DEGs
DOI: 10.3233/THC-230719
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2023
Authors: Jadhav, Shreya | Jhaveri, Aditi | Pawar, Ajinkya M. | Bhardwaj, Anuj | Vinay, Vineet | di Blasio, Marco | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Forensic odontology is a subfield of forensics that can assist in determining age, gender, and other demographic factors. OBJECTIVE: The focus of this research is to ascertain age by tooth volume ratio of permanent maxillary canines using a CBCT scan. METHODS: In this retrospective investigation, 1000 CBCT images were gathered and focused on only fully developed maxillary canines. For each of the maxillary canines, the researchers measured and calculated the volume of the pulp chamber, root canal, and entire tooth using the ITK Snap programme. The pulp volume to tooth volume ratio …was computed. The equation AGE = 59.208 - (583.652 x pulp volume/tooth volume) was then used to compute age. The samples were divided into 5 age groups; 13–20, 21–30, 31–40, 41–50, and 51–60. The age was calculated for samples in each group and it was compared to the actual age. RESULTS: Between individuals’ actual age and computed age, the study discovered a statistically significant positive association. While groups 3, 4, and 5 demonstrated positive but weaker correlations (r = 0.854, r = 0.658, and r = 0.612, respectively), groups 1 and 2 displayed statistically significant strong positive correlations (r = 0.987 and r = 0.923, respectively). The average total discrepancy between the age that was computed and the actual age was 2.45 1.344. CONCLUSION: The study found a statistically significant positive correlation between computed age and actual age, with the younger age groups 1 (13–20) and 2 (21–30) showing the strongest relationships. This underlines its potential success in court, particularly when dealing with young criminals. Show more
Keywords: Age estimation, canines, cone-beam computed tomography, forensic odontology, pulp tooth volume
DOI: 10.3233/THC-230555
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Wang, Yu | Li, Jun | Shi, Yulin | Jiang, Tao | Tu, Liping | Xu, Jiatuo
Article Type: Research Article
Abstract: BACKGROUND: The sublingual vein (SV) is a specialized diagnostic method used in Traditional Chinese Medicine (TCM). Despite its ability to objectively reflect blood flow, SV is often overlooked in clinical practice. OBJECTIVE: This study aims to analyze the core characteristics of SV and investigate the in-depth relationship between its digital characteristics and hypertension. The goal is to find a link between SV and hypertension and break out of the current situation. METHODS: Modern digital analysis techniques were applied to the traditional SV diagnostic theory. In a controlled study with 204 participants, the digital …characteristics of SV were documented using TFDA-1, and its color value was analyzed using TDAS. Morphological characteristics of SV, such as trunklength, width, and tortuosity, were examined by combining computer vision with expert interpretation. This involved the application of automatic ranging methods and a rectangular approximation algorithm, which are novel approaches in the field of TCM. The t -test and Mann-Whitney U test were used to analyze the digital characteristics of SV in hypertension. Binary logistic regression and neural network models were established using machine learning to explore the deep relationship between SV characteristics and hypertension. RESULTS: There was a significant difference of the tortuosity of SV between the two groups (Z = - 2.629, p = 0.009). The results revealed thick width of SV (OR = 2.64, 95% CI: 1.02–6.79) was the risk factor for hypertension. Addition of SV characteristics improved overall percent correct for hypertension prediction to 80%. CONCLUSION: TCM method of diagnosis of SV has been greatly expanded in terms of technical means, and the close relationship between SV and hypertension has been found in clinical data. Show more
Keywords: Sublingual veins, digital characteristics, hypertension
DOI: 10.3233/THC-230695
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Butter, Christian | Klein, Gunnar | Grönefeld, Gerian | Böcker, Dirk | Suling, Anna | Buchholz, Anika | Felk, Angelika | Hauser, Tino | Wegscheider, Karl | Bänsch, Dietmar
Article Type: Research Article
Abstract: BACKGROUND: Both highly specialized heart centres and less specialized hospitals care for patients with implantable ICDs/CRT-Ds with remote monitoring. OBJECTIVE: To investigate potential differences in patient treatment according to centre’s ICD implantation volume. METHODS: Based on their 2012 ICD/CRT-D implantation volume, centres enrolled in the NORDIC ICD trial in Germany were assigned to one of three groups: high- (HV, n = 345), medium- (MV, n = 340) or low-volume (LV, n = 189). RESULTS: The …HV-centres had a significant higher CRT-D proportion (41.7%; LV: 36.5%; MV: 23.2%; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001), significant shorter median procedure duration (49 min; MV: 58 min; LV: 60 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) but significant longer median hospital stay (4 days; MV and LV: 3 days; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) compared to MV- and LV-centres. The X-ray exposure was shorter in MV/HV-centres (MV: 3.4 min; HV: 3.6 min; LV: 5.5 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001). Only 3.5% (LV: 2.6%; HV: 3.5%; MV: 4.1%) patients received at least one delivered inappropriate shock and 2.5% (HV: 2.0%; LV: 2.6%; MV: 2.9%) patients had withheld inappropriate ICD shocks without subsequent inappropriate shock delivery within 24.5 months of median follow-up. CONCLUSION: Implantation volume-dependent differences were observed in the device selection, procedure duration and x-ray exposure duration. Remote monitoring in combination with adequate response pattern prevented imminent inappropriate shocks in all three groups. Show more
Keywords: Defibrillators, implantable, cardiac resynchronization therapy, hospitals, high-volume, hospitals, low-volume, home monitoring
DOI: 10.3233/THC-230641
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Zeng, Ling-Zhi | Cui, Ji | Jiang, Tao | Tu, Li-Ping | Liu, Hai-Dan | Gong, Ya-Bin | Xu, Ling | Xu, Jia-Tuo
Article Type: Research Article
Abstract: BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T …-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue’s image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process. Show more
Keywords: Non-small cell lung cancer, tongue image, image features, pathological staging, traditional Chinese medicine
DOI: 10.3233/THC-230372
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Zhou, Quan | Chen, Xurui
Article Type: Research Article
Abstract: BACKGROUND: The need for personalised care in the long-term management of patient health is paramount due to the variability in individual features and responses to specific medication. With the availability of large quantities of electronic patient records, big data analysis presents a valuable opportunity to gain insights into disease presentation and patient impact. OBJECTIVE: This study aims to utilise data science in the medical field to extract unknown information from databases, validate previously obtained data, and enhance personalised patient care. METHODS: An analytics suite is developed for monitoring patient health and treating cholesterol, …thyroid, and diabetes disorders. This suite employs exploratory, predictive, and visual analytics to categorise patient data into multiple tiers and forecast related complication risk and treatment response. RESULTS: The study found that the analytics suite could successfully identify correlations between various biological indicators of patients and disorders. The suite also showcased potential in predicting health risks and responses to treatments. CONCLUSION: The analytics employed in this study suggest advanced methods of data analysis, which could serve as potential decision-making tools for healthcare providers. These methods might lead to improved treatment outcomes, contributing significantly to personalised patient care. Show more
Keywords: Data analytics, neural networks, decision support system, patient monitoring, survival probability and visualization
DOI: 10.3233/THC-230980
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Pan, Yanyan | Wu, Xiujuan | Zhu, Miao | Zhang, Tingting | Gao, Lanlan | Zhu, Yamei | Mao, Huijuan | Lv, Xiaolin | Sun, Guozhen
Article Type: Research Article
Abstract: BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the …Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P < 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P < 0.05), and negatively correlated with self-care compliance (r = - 0.35, P < 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P < 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P < 0.05). High RAAQ was associated with high VAS (b = 0.11, 95% CI: 0.05, 0.18), DTI (b = 0.28, 95% CI: 0.17, 0.38), SXI (b = 0.24, 95% CI: 0.14, 0.34) and TDS (b = 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception. Show more
Keywords: End-stage renal disease, maintenance hemodialysis, thirst, RAAQ, RABQ
DOI: 10.3233/THC-230749
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Gu, Bao-Di | Wang, Yun | Ding, Rong
Article Type: Research Article
Abstract: BACKGROUND: Malnutrition is a widespread problem in critically ill patients with neurological disorders. OBJECTIVE: The purpose of this study is to investigate the effect of a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support on the outcome metrics in patients with neurological disorders who are critically ill. METHODS: We enrolled 84 participants who were hospitalized in the intensive care unit (ICU) of Yancheng No. 1 People’s Hospital for neurological disorders between June 2018 and December 2021. The participants were randomly assigned to the control group and the test …group. The control group received traditional nutritional support, while the test group was treated with a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support. We collected the general information, feeding tolerance (FT), nutritional risk score, and laboratory indicators before intervention, after intervention for one week, and after intervention for 2 weeks, and other data of the participants. RESULTS: After the intervention, the test group scored significantly lower than the control group in the incidence of gastroparesis and diarrhea, as well as the NUTRIC score, with statistically significant differences (P < 0.001). The prealbumin levels in the test group increased progressively prior to intervention, after intervention for one week, and after intervention for two weeks. Compared to the control group, the test group had higher prealbumin levels prior to intervention, after intervention for one week, and after intervention for two weeks, with statistically significant differences (P < 0.001). CONCLUSION: We developed a multidisciplinary collaborative nutritional treatment model based on a standard unit for nutritional support. This model can improve neural function, FT, and pertinent outcome indicators and is generally applicable. Show more
Keywords: Nervous system diseases, nutrition therapy, patient care team
DOI: 10.3233/THC-230791
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Chen, Jiaqi | Zhang, Xiaohong | Wu, Wenjing | Yuan, Youyuan | Xue, Wupemg | Cao, Wendong | Du, Rongxin
Article Type: Research Article
Abstract: BACKGROUND: Endoluminal interventions have become one of the main options for the treatment of arteriosclerosis obliterans (ASO). OBJECTIVE: To explore the effect of hydration therapy and nursing intervention on the prevention of contrast-induced nephropathy (CIN) after interventional treatment of lower extremity ASO. METHODS: A convenience sampling method was used to select 94 patients who received ASO treatment in our hospital from March 2019 to May 2021 as the study subjects. All patients underwent endovascular interventional therapy and were randomly divided into two groups by the random number table method, with odd numbers entering …the observation group (n = 47) and even numbers entering the control group (n = 47). The control group received routine nursing intervention, while the observation group underwent hydration therapy and had a corresponding nursing intervention scheme. The clinical efficacy of the two groups and the incidence of contrast-induced nephropathy after interventional therapy were compared, and an evaluation of satisfaction within the two groups was performed via a questionnaire. RESULTS: The total effective rate of patients in the observation group was higher after hydration treatment (97.87% vs 87.23%, p < 0.05). The blood urea nitrogen, creatinine, and β 2 microglobulin levels in the observation group were significantly lower than those in the control group after the intervention (p < 0.05). Patients in the observation group had higher nursing satisfaction after using preventive measures of hydration therapy combined with nursing interventions (100% vs 89.36%, p < 0.05). CONCLUSION: Hydration therapy and nursing intervention can effectively prevent CIN after interventional treatment of lower extremity ASO. After interventional therapy, patients had better clinical outcomes, lower biochemical indexes and improved satisfaction evaluations. The therapy is worthy of clinical promotion and application. Show more
Keywords: Lower extremity arteriosclerosis obliterans, interventional therapy, contrast nephropathy, nursing, hydration therapy
DOI: 10.3233/THC-230256
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
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. Pre-press, no. Pre-press, pp. 1-15, 2023
Authors: Loganathan, Prakash Kannan | Dorkins, Charles | Marlow, George | Zahra, James | Tulsianey, Mudit A. | Rowles, Toby J. | Chadwick, Paula
Article Type: Research Article
Abstract: BACKGROUND: Newborn hypothermia at birth remains as global challenge across all settings. The prevention of delivery room hypothermia at birth could potentially reduce neonatal morbidity and mortality. OBJECTIVE: To compare the heat conservation efficacy of Neohelp and Neowrap and evaluate the heat production efficacy of trans-warmer infant mattress (TWM) in a laboratory setting. METHODS: A beaker of water was heated at 60 ∘ C was covered by Neohelp or two layers of Neowrap and left to cool in an open room for 90 minutes and calculated the decay constant. Using …infra-red camera, we measured the maximum temperature and time taken to reach the temperature in the TWM. RESULTS: Neowrap took 863 seconds for the temperature to drop from 37 ∘ C to 35 ∘ C, compared with 941 seconds with Neohelp. When activated TWM reached a maximum temperature of 39.3 ± 0.1 ∘ C. It took 30 seconds when the activator was placed in the centre, compared with 88 seconds when it was at the corner. CONCLUSION: Compared to Neowrap, Neohelp had better heat conservation properties. Activating the metal disk from the TWM center would deliver quicker heat. Show more
Keywords: Hypothermia, neohelp, neowrap, trans-warmer mattress
DOI: 10.3233/THC-231001
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2023
Authors: Cao, Xu | Pei, Xiaomei
Article Type: Research Article
Abstract: BACKGROUND: Diabetic kidney disease (DKD) is an important microvascular complication of diabetes mellitus (DM). OBJECTIVE: This study aimed to develop predictive nomograms to estimate the risk of DKD in patients with type 2 diabetes mellitus (T2DM). METHODS: The medical records of patients with T2DM in our hospital from March 2022 to March 2023 were retrospectively reviewed. The enrolled patients were randomly selected for training and validation sets in a 7:3 ratio. The models for predicting risk of DKD were virtualized by the nomograms using logistic regression analysis. RESULTS: Among the …enrolled 597 patients, 418 were assigned to the training set, while 179 were assigned to the validation set. Using the predictors included glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), presence of diabetic retinopathy (DR) and duration of diabetes (DD), we constructed a full model (model 1) for predicting DKD. And using the laboratory indexes of HbA1c, HDL-C, and cystatin C (Cys-C), we developed a laboratory-based model (model 2). The C-indexes were 0.897 for model 1 and 0.867 for model 2, respectively. The calibration curves demonstrated a good agreement between prediction and observation in the two models. The decision curve analysis (DCA) curves showed that the two models achieved a net benefit across all threshold probabilities. CONCLUSION: We successfully constructed two prediction models to evaluate the risk of DKD in patients with T2DM. The two models exhibited good predictive performance and could be recommended for DKD screening and early detection. Show more
Keywords: Diabetic kidney disease, type 2 diabetes mellitus, nomogram, risk factor, glycated hemoglobin A1c
DOI: 10.3233/THC-230811
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
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. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Ong, Christian B. | Buchan, Graham B.J. | Hecht II, Christian J. | Kendoff, Daniel O. | Homma, Yasuhiro | Kamath, Atul F.
Article Type: Research Article
Abstract: BACKGROUND: Patient obesity is a risk factor for poor acetabular cup positioning in total hip arthroplasty (THA). OBJECTIVE: To assess the impact of using a novel, fluoroscopy-based robotic THA system on acetabular cup placement in obese versus non-obese patients. METHODS: A review of 105 consecutive manual unassisted (mTHA) (47 Obese/58 Non-obese) and 102 robotic-assisted (RA-THA) (50 Obese/52 Non-obese) primary, direct anterior approach THA procedures was conducted. All cases were performed by a single surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Obesity was defined as a Body Mass Index …(BMI) ⩾ 30 kg/m 2 . Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone. RESULTS: Obese patients in the mTHA cohort had larger cup inclination angles on average compared to non-obese patients (44.82 ∘ ± 6.51 vs. 41.39 ∘ ± 6.75; p = 0.009). Obese mTHA patients were less likely to have cup placement within the Lewinnek zone compared to non-obese mTHA patients (0.48 vs. 0.67; p = 0.027). Obesity had no effect on the accuracy of RA-THA. CONCLUSION: Obesity affects the placement of the acetabular component in manual THA. The novel, fluoroscopy-based robotic THA system in this study demonstrated accurate cup placement regardless of obesity status. Show more
Keywords: Arthroplasty, hip, acetabulum, robotic-assisted surgery, obesity
DOI: 10.3233/THC-231127
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Jia, Limin | Zhang, Chenguang | Fu, Xin | Chen, Caihua | Zheng, Hongkui | Yang, Caifang
Article Type: Research Article
Abstract: BACKGROUND: The use of indwelling closed thoracic drainage tubes in the wedge resection of the lungs is of great significance to postoperative recovery. However, there are potential risks. OBJECTIVE: To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. METHODS: A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer …system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t -test to compare the differences between the two groups. RESULTS: There were no statistically significant differences in terms of age, gender and sweating between the two groups. Compared with the control group, the unplanned extubation rate of the experimental group was lower (χ 2 = 8.513; P = 0.004), the indwelling time of the drainage tube was shorter (t = 2.108; P = 0.037), the cumulative material cost was lower (t = 3.778; P < 0.001), the time cost was also lower (Z = 2.717; P = 0.008), the degree of comfort was higher (Z = 2.752; P = 0.006), and the degree of pain was lower (Z = 4.019; P < 0.001). The incidence of subcutaneous emphysema was significantly lower in the experimental group than in the control group (χ 2 = 8.513; P = 0.004). CONCLUSION: The use of the triple-buffer system to fix small-diameter (18 F) thoracic closed drainage tubes can reduce the unplanned extubation rate, indwelling time of the drainage tube and the incidence of adverse reactions. Show more
Keywords: Lung wedge resection, small-diameter closed thoracic drainage tube, fixed method
DOI: 10.3233/THC-230558
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Gao, Jing | Zhang, Chao | Xin, Hong
Article Type: Research Article
Abstract: BACKGROUND: Using a COOK ® Cervical Ripening Balloon (CCRB) for cervical maturity has become a common clinical practice for the induction of labour (IOL). OBJECTIVE: To develop and validate a predictive instrument that could estimate the risk of a caesarean after IOL in term pregnancies with CCRB treatment. METHODS: The medical records of 415 pregnant women requiring IOL from January 2018 to October 2022 were retrospectively reviewed and randomly selected for training (290) and validation (125) sets in a 7:3 ratio. A model for predicting the risk of a …caesarean was virtualised by a nomogram using logistic regression analysis. RESULTS: After completing the multivariate analysis, parity (odds ratio [OR] = 0.226; p = 0.017), modified Bishop score at induction (OR = 0.688; p = 0.005) and the artificial rupture of membranes (OR = 0.436; p = 0.010) were identified as the predictors for implementing a caesarean delivery after IOL. The decision curve analysis showed that the model achieved a net benefit across all threshold probabilities. CONCLUSION: We successfully constructed a nomogram for caesarean delivery after IOL in pregnancies with CCRB treatment using factors including parity, modified Bishop score at induction and the artificial rupture of membrane. Show more
Keywords: Induction of labour, caesarean delivery, nomogram, Bishop score, cervical ripening balloon
DOI: 10.3233/THC-230761
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Wang, Xiangyun | Chen, Yuanjing | Ai, Hongjun | Li, Panpan | Zhu, Chengjie | Yuan, Jiaying
Article Type: Research Article
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory complication among the elderly, and its severity can escalate to respiratory failure as the disease progresses. OBJECTIVE: To evaluate the application value of non-invasive ventilation in the clinical treatment of patients with COPD and lung cancer. This study assesses its therapeutic effects and its impact on patients’ quality of life (QoL) as measured by the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. METHODS: A retrospective analysis was conducted on clinical data from 102 patients with COPD and lung cancer. Patients were divided into …two groups: the control group (n = 48), who received conventional treatment, and the observation group (n = 54), who received non-invasive positive pressure ventilation (NIPPV) in addition to conventional treatment. Relevant indicators of curative effect, including blood gas indices, incidence of dyspnoea, improvements in mental health and appetite, and FACT-L QoL scores, were analysed at 2 weeks, 1 month, and 6 months post-treatment. RESULTS: At 2 weeks post-treatment, the observation group who had used NIPPV showed significant improvements in blood gas indices, dyspnoea, mental state and self-care ability compared with the control group (p < 0.05). At 1 month, these benefits persisted and included improved maintenance of body weight (p < 0.05). By 6 months, the observation group had a lower incidence of pulmonary encephalopathy (p < 0.05), and QoL, as measured by the FACT-L scale, improved significantly in the observation group but declined in the control group (p < 0.05). CONCLUSION: NIPPV demonstrates significant efficacy in treating COPD patients with lung cancer, particularly in enhancing curative effects and improving patients’ QoL. Show more
Keywords: Non-invasive ventilation, lung cancer, respiratory failure, quality of life
DOI: 10.3233/THC-231063
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Chang, Jihui | Zhang, Shuang | Qiu, XuZhong | Huang, HaiJun | Zhang, Yun | Li, Kai
Article Type: Research Article
Abstract: BACKGROUND: Humeral fracture is a common long bone fracture in orthopedic clinical diagnosis and treatment. OBJECTIVE: To investigate the local temperature increase owing to changes in the specific absorption ratio (SAR) of the human body caused by humeral bone nails during magnetic resonance imaging (MRI). METHODS: A refined geometric model of the upper body was constructed via data segmentation and post-processing using the digital human image dataset. Finally, the geometric model was imported into COMSOL, a 3-T magnetic resonance coil was built, and the operating frequency (128 MHz) was set to analyze the …SAR of the bone-nail pair and temperature changes. RESULTS: The analysis of the changes after bone-nail implantation under different tissue conditions revealed that the SAR and temperature after implantation and fixation were three times higher than those before, and the areas with abrupt changes in SAR and temperature were primarily concentrated in the bone-nail area. CONCLUSION: In MRI, metal implants can cause local elevation of the SAR near the implant in the human body, resulting in a temperature increase around the implant. Consequently, long-term scanning can damage the human body. Show more
Keywords: Bone nails, magnetic resonance imaging, temperature rise effect, specific absorption ratio, digital human
DOI: 10.3233/THC-230995
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Fink, Bernd | Hoyka, Marius | Blersch, Benedikt | Baum, Hannsjörg | Sax, Florian Hubert
Article Type: Research Article
Abstract: BACKGROUND: Graphic type differentiation of cell count data of synovial aspirates is a new method for the diagnosis of early and late periprosthetic joint infection. OBJECTIVE: The aim of the study was to analyse if the same 6 LMNE-types can be differentiated in the new Yumizen H500 cell counter as it was the case for the old cell counter ABX Pentra XL 80 of previous publications, to verify if the erythrocyte and thrombocyte curves of the new device give additional information and to calculate the difference of cell count in LMNE-type I and III (with abrasion) …in the cell counter and in the manual counting chamber (Neubauer improved). METHODS: 450 aspirates of 152 total hip arthroplasties and 298 knee arthroplasties obtained for the diagnosis of periprosthetic joint infection were analysed with the Yumizen H500. RESULTS: All LMNE-matrices of the 450 aspirates could assigned to one of the six LMNE-types. There were 76 LMNE-type I, 72 LMNE-type II, 14 LMNE-type III, 241 LMNE-type IV, 36 LMNE-type V and 12 LMNE-type VI. The erythrocyte and thrombocyte distribution curves were very helpful for differentiation of hematoma and infection. The cell count in the manual counting procedure was lower than in the cell counter: for the LMNE-type I (abrasion type) the median of the difference was 925/μ L (median) and for the LMNE-type III (combined type of infection and abrasion) 3570/μ L (median). CONCLUSION: The described graphic type differentiation is a new and helpful method for differentiation of hematoma and early PJI as well as abrasion and late PJI. Show more
Keywords: Leucocyte count, synovia, periprosthetic joint infection, cell counter
DOI: 10.3233/THC-231006
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Ong, Christian B. | Buchan, Graham B.J. | Hecht II, Christian J. | Homma, Yasuhiro | Harmon, Daniel J. | Kendoff, Daniel O. | Petterwood, Joshua | Kamath, Atul F.
Article Type: Research Article
Abstract: BACKGROUND: Robotic assistance in total hip arthroplasty (RA-THA) has been shown to minimize laterality-based differences in acetabular cup positioning. OBJECTIVE: To determine if the use of a novel, fluoroscopy-based RA-THA system mitigates differences in acetabular cup placement between left (L) and right (R) side hip procedures, when compared to manual, fluoroscopic-assisted technique. METHODS: We conducted a retrospective review of 106 consecutive mTHA (40 L/66 R) and 102 RA-THA (48 L/54 R) primary direct anterior approach procedures. All cases were performed by a single right-hand-dominant surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, …or rheumatoid arthritis. Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone. RESULTS: The average inclination of mTHA L cases was smaller than that of mTHA R cases (41.10 ∘ ± 7.38 vs. 43.97 ∘ ± 6.27; p = 0.04). For RA-THA, L and R cup angles were similar. There were fewer overall mTHA hips within the Lewinnek safe-zone compared to RA-THA (0.59 vs. 0.78; p = 0.003), as well as fewer mTHA R cases than RA-THA R cases (0.59 vs. 0.80; p = 0.03) within safe zone. CONCLUSION: Use of a novel, fluoroscopy-based robotic system mitigates laterality-based differences in acetabular cup placement that were observed in a manual, fluoroscopic-assisted cohort. Show more
Keywords: Arthroplasty, hip, acetabulum, robotic-assisted surgery, functional laterality
DOI: 10.3233/THC-231126
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
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. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Liu, Xiuping | Li, Ping | Yang, Yuemin | Tian, Cheng
Article Type: Research Article
Abstract: BACKGROUND: Currently, there are a variety of methods for ultrasound to localize the conus medullaris. A concern is that measured values can be influenced by variations in spinal flexion and extension. OBJECTIVE: To overcome this limitation, the present study measures the horizontal distance (HD) between the end of the conus medullaris and the caudal edge of last vertebral body ossification in normal fetus at different gestational weeks, and analyzes the relationship between the measured value and fetal growth, as well as the utility of these measurements in assessing the position of the conus medullaris. …METHODS: A total of 655 fetuses at gestational weeks 18–40, who underwent routine prenatal ultrasound, were selected in the study. We measured the distance between the end of the cone of the fetal spinal cord and the caudal end of the final vertebral ossification center (Distance1, D1), the distance between the end of the spinal cord cone and the intersection of the extension of D1 with the caudal skin (Distance2, D2), and HD. We analyzed the correlation between the measurements and gestational weeks, established normal reference values, the ratio of D1, D2 and HD to the commonly used growth parameters was calculated. The ratios of D1, D2, HD and the application value of each ratio phase were analyzed, and the reliability analysis of repeated measurement results among physicians was performed. RESULTS: D1, D2 and HD exhibited strong linear correlations with gestational weeks. Among the ratios of D1, D2 and HD to common growth parameters, D2/FL stabilized after 20 weeks of gestation and consistently exceeded 1. Repeatability tests between D1, D2 and HD showed good reliability (P > 0.05). CONCLUSION: D1, D2 and HD are significantly correlated with gestational age. Horizontal distance measurement can effectively determine the position of fetal conus medullaris, enabling rapid prenatal evaluation of low position of conus medullaris and excluding the possibility of tethered cord. Show more
Keywords: Fetus, ultrasonic examination, conus medullaris, tethered spinal cord
DOI: 10.3233/THC-230332
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
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. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Bao, Zhi-Guo | Zhou, Qing | Zhao, Sen | Ren, Wen-Yan | Du, Sen | Li, Yan | Wang, Hang-Yu
Article Type: Research Article
Abstract: BACKGROUND: Acute pancreatitis (AP) is a severe condition with complications that can impact multiple organ systems throughout the body. Specifically, the diffusion of peripancreatic effusion to the pleural cavity is a significant phenomenon in AP. However, its pathways and implications for disease severity are not fully understood. OBJECTIVE: This study aims to investigate the anatomical routes of peripancreatic effusion diffusion into the pleural cavity in patients with AP and to analyze the correlation between the severity of pleural effusion (PE) and the computed tomography severity index (CTSI) and acute physiology and chronic health evaluation II (APACHE …II) scoring system. METHODS: 119 patients with AP admitted to our institution were enrolled in this study (mean age 50 years, 74 male and 45 female). Abdominal CT was performed, and the CTSI and APACHE II index were used to evaluate the severity of the AP, Meanwhile, the prevalence and semiquantitative of PE were also mentioned. The anatomical pathways of peripancreatic effusion draining to pleural were analyzed. Finally, the correlation relationship between the severity of AP and the PE was analyzed. RESULTS: In 119 patients with AP, 74.8% of patients had PE on CT. The anatomic pathways of peripancreatic effusion draining to pleural included esophageal hiatus in 33.7% of patients, aortic hiatus in 6.7% of patients and inferior vena cava hiatus in 3.37% of patients. The rating of PE on CT was correlated with CTSI scores (r = 0.449, P = 0.000) and was slightly correlated with the APACHE II scores (r = 0.197, P = 0.016). CONCLUSION: PE is a common complication of AP, which can be caused by anatomic pathways such as diaphragmatic hiatus. Due to its correlation with the CTSI score, the PE may be a supplementary indicator in determining the severity of AP. Show more
Keywords: Acute pancreatitis, pleural effusion, anatomical pathways, CT
DOI: 10.3233/THC-230702
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Huang, Nannan | Fu, Min | Gao, Fumei | Wang, Yanbing | Lu, Man | Li, Xin | Wang, Dandan | Wang, Jing
Article Type: Research Article
Abstract: BACKGROUND: The success of assisted pregnancy relies heavily on the effectiveness of the embryo transfer process. Currently, embryo transfer is typically conducted with the assistance of abdominal ultrasound. OBJECTIVE: The primary aim of this study was to evaluate the influence of targeted nursing interventions on the embryo transfer procedure, its impact on pregnancy outcomes, and the level of patient comfort concerning bladder management throughout the procedure. METHODS: A total of 247 patients who underwent embryo transfer at the Reproductive Center of Peking University People’s Hospital from December 2019 to August 2020 were included …in this study. These patients were categorized into two groups: the control group (n = 124) and the experimental group (n = 123). Within the control group, patients received conventional preoperative education, whereas those within the experimental group were subjected to targeted nursing interventions. Furthermore, patients in the experimental group were furnished with explicit instructions pertaining to the volume and timing of water intake. Multiple factors were assessed in this study, encompassing bladder filling, the quality of uterine imaging, the utilization of assistive devices during the surgical procedure, and pregnancy outcomes. Additionally, a post-operative questionnaire was administered to both groups to gauge their comfort levels regarding urinary retention. RESULTS: Following the targeted nursing intervention, ultrasound scans indicated an increase in bladder depth (5.91 ± 1.76 vs. 5.40 ± 1.61, P = 0.02), resulting in clearer endometrial imaging (96.74% vs. 88.71%, P = 0.02). Additionally, the experimental group reported significantly higher levels of comfort with urine retention (P = 0.01) compared to the control group, and these differences held statistical significance. Furthermore, the pregnancy rate in the experimental group was greater than that in the control group (52.85% vs. 50.8%, P > 0.05). CONCLUSION: Based on the premise that pregnancy rates remain unaffected, the implementation of targeted nursing care has the potential to augment bladder filling, enhance the quality of endometrial imaging, reduce the requirement for instrument-assisted embryo transfers, and notably enhance the comfort of patients in relation to urine retention. Show more
Keywords: Bladder filling, comfort with urine retention, embryo transfer, IVF, targeted nursing
DOI: 10.3233/THC-230380
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Bai, Yuan | He, Fang | Yu, Ying | Li, Jia
Article Type: Research Article
Abstract: BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) have been shown to die mainly due to disease-induced acute respiratory distress syndrome (ARDS). Prone position ventilation (PPV) is an important ventilation strategy in the management of patients with ARDS. OBJECTIVE: To investigate the application of PPV in ventilation strategies for patients with COVID-19. METHODS: Three hundred patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Shanxi Bethune Hospital from January 2020 to June 2021 were retrospectively collected. Based on body position and conscious state, all patients were divided into three groups: intubation prone …position group (n = 110), awake prone position group (n = 90) and supine position group (n = 100); The acute physiology and chronic health evaluation II (APACHE-II) scores, blood gas indicators, complications and other relevant clinical indicators were compared among the three groups. One-way ANOVA was used to compare means between multiple groups for quantitative information that conformed to a normal distribution. Repeated measures ANOVA was used for repeated measures data. Component comparisons were made using the Kruskal-Wallis H rank sum test for non-normally distributed quantitative data. RESULTS: One-way repeated-measures ANOVA main effect analysis showed different effects of different treatments on PaO2 in patients with COVID-19 (F treatment = 256.231, P < 0.05), with the order of awake prone position group > intubation prone position group > supine position group. The effects of the three different treatments on P/F in patients with COVID-19 (F treatment = 311.661, P < 0.05), with the order of awake prone position group > supine position group > intubation prone position group; Moreover, the three treatments had different effects on APACHE II scores in patients with COVID-19 (F treatment = 201.342, P < 0.05), with the order of intubation prone position group > supine position group > awake prone position group. CONCLUSION: Intubation prone position and awake prone position can improve lung function to some extent in patients with COVID-19, and should be applied as early as possible in patients with COVID-19-induced ARDS. Show more
Keywords: Prone position ventilation, supine position, coronavirus disease 2019, lung function, efficacy
DOI: 10.3233/THC-230874
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Zhang, Hua | Wang, Ning | Zhang, Xiao-Yan | Liu, Cong | Zhang, Jing
Article Type: Research Article
Abstract: BACKGROUND: The use of telemonitoring electrocardiogram (ECG) improves the detection rate of various arrhythmias as it offers an extended recording time and does not impose activity restrictions. However, many community hospitals lack the resources to conduct this test due to a lack of cardiac function specialists and antiquated screening equipment. OBJECTIVE: To establish a digital ECG telemonitoring system and remote consultation service between tertiary hospitals and community medical service stations to improve diagnosis and treatment effectiveness. METHODS: We used the PI ECG telemonitoring data acquisition system, with a personal digital assistant (PDA) or …computer serving as the platform for ECG acquisition, storage, display, printing, and transmission. We introduced this system to standardize the storage and transmission of ECG telemonitoring data, and ensure accurate transmission, reproducibility, and preservation of data. RESULTS: The implementation of the PI ECG telemonitoring data acquisition system enabled the sharing of remote ambulatory electrocardiography data between Beijing Shijitan Hospital and its affiliated community hospitals. This has resulted in reduced waiting times for patients to receive reports (from 0.3 to 1 hour, to 0.1 or less), shortened consultation times (from 2 hours to 0.1 hour), and improved patient satisfaction with consultations (> 20% of the patients reported they were highly satisfied). The system successfully combined the goals of intelligence, real-time synchronization, and efficiency, revolutionizing ECG telemonitoring diagnosis in the network era. CONCLUSION: Sharing digital telematics information between tertiary and community hospitals enables a tiered approach to diagnosis and treatment and allows for more efficient, accurate, and convenient remote diagnostics. Show more
Keywords: Community-based medical and health services, digital telemonitoring electrocardiography for diagnosis and treatment, information sharing, tiered diagnosis and treatment
DOI: 10.3233/THC-230914
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Incesoy, Mustafa Alper | Yildiz, Fatih | Pulatkan, Mehmet Anil | Yesiller, Omer Faruk | Toluk, Ozlem | Erdem, Ahmet Can | Tuncay, Ibrahim
Article Type: Research Article
Abstract: BACKGROUND: With the restoration of the natural hip biomechanics, a successful total hip arthroplasty (THA) and long-term survival is pursued. Although robotic THA (rTHA) has been developed to increase accuracy of implant positioning, leg lengths and offsets, discussions about its radiological and clinical advantages over conventional THA (cTHA) continues. OBJECTIVE: The aim of this study was to compare clinical and radiological outcomes of robotic and conventional THA. METHODS: This retrospective study compares functional and radiological outcomes of 82 rTHA with a matched group of 82 cTHA in terms of age, sex, body mass …index and preoperative functional scores. The minimum follow up was 12 months for all patients. Functional outcomes were Harris Hip Score (HHS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) evaluated pre- and postoperatively. Radiological evaluations included position of cup placement according to Lewinnek and Callanan safe zones, Canal Fill Ratio (CFR), Leg Length Discrepancy (LLD), Lateral offset (LO) and Femoral Component Alignment (FCA). Complications were also evaluated. RESULTS: In the rTHA group, 91.5% (75 out of 82) of the acetabular cups were positioned within the safe zone whereas it was 63.4% (52 out of 82) for the cTHA group (p < 0.001). According to Callanan, they were 84.1% and 50%, respectively (p < 0.001). Between the groups, no statistically significant difference was found in CFR, LLD, HO, FCA, AI, AA, WOMAC, HHS and major complication rates. CONCLUSION: rTHA is superior to cTHA in terms of accuracy and reproducibility of the cup placement, however no apparent clinical benefit was found in short term follow. Show more
Keywords: Total hip arthroplasty, robot-assisted surgery, component positioning, robotic total hip replacement
DOI: 10.3233/THC-231111
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Lv, Chen | Guo, Qian | Peng, Shuang-Shuang | Chen, Xiao-Feng | Liu, Su-Fang | Wang, Xiu-Hua
Article Type: Research Article
Abstract: BACKGROUND: The implementation of the rotation system in the Chinese medical industry has achieved significant results. OBJECTIVES: The present study aims to 1) explore the strengths, weaknesses, opportunities and challenges of rotational nursing department implementation and 2) provide references for developing nursing staff’s competencies in leadership, performance evaluation, quality of care, communication in relationships and human resources. METHODS: A total of 16 rotational nursing department staff members from a tertiary tuberculosis specialist hospital in Beijing were interviewed, and the interview data were analysed using a strengths, weaknesses, opportunities and threats analysis and class …analysis. RESULTS: The advantages of the rotational nursing department included: (1) stimulating the nursing staff’s enthusiasm and creativity; (2) strengthening the communication and collaboration between departments; (3) improving the detailed management of nursing quality; and (4) enhancing the nursing staff’s comprehensive abilities. The disadvantages included: (1) the design of the rotation programme focusing on practice; (2) a lack of personalisation; and (3) imperfect performance assessment of the rotating staff. Opportunities included: (1) deepening the connotation of nursing job management and (2) developing the construction of nursing discipline and the need for personal career development and value realisation. Threats included the lack of a sound rotation management model to draw on. CONCLUSION: A rotational nursing department is conducive to enhancing the competence of nursing staff in management positions and providing new ideas for hospitals to select and train nursing management talents. By taking full advantage of the benefits of vertical nursing management, designing personalised rotation training programmes, building a diversified learning and training platform and developing a positive performance incentive mechanism is recommended to fully engage the role of rotation in nursing management talent training. Show more
Keywords: Job rotation training, post competency, SWOT analysis, nursing management
DOI: 10.3233/THC-231282
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Rossi, Stefano Marco Paolo | Sangaletti, Rudy | Andriollo, Luca | Matascioli, Luca | Benazzo, Francesco
Article Type: Research Article
Abstract: BACKGROUND: Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants. OBJECTIVE: The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant. METHODS: Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled. Patients included in the …study showed a minimum 15 degrees varus or 10 degrees valgus deviation. RESULTS: 20 cases were varus knees and 10 cases were valgus knees. Postoperative neutral alignment was defined as 0 ∘ ± 2.5 ∘ . A CCK implant was used in 20 cases while a Constrained Posterior Stabilized implant was used in 10 cases. A neutral alignment was achieved in all patients. At a minimum 6 months follow up (f-u 6–30 months) clinical outcomes including ROM, KSS, HSS, OKS and WOMAC showed significant improvement and no major complications were registered. CONCLUSIONS: The robotic system showed the achievement of a mechanical alignment with reliable radiographic outcomes and clinical results in the treatment of major deformities of the lower limb with the use of higher constrained implants at short term follow up. Further follow up and studies are necessary to confirm and verify these promising outcomes. Show more
Keywords: Robotics, knee, major deformities, varus, valgus, constaint, computer-aided surgical planning, orthopedic surgery
DOI: 10.3233/THC-231261
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Siegel, Danielle N. | Ogle, Melissa M. | Wilson, Christopher | Scholes, Olivia | Prow, Abby | Mannen, Erin M.
Article Type: Research Article
Abstract: BACKGROUND: Rolling is an important developmental milestone for infants where identifying the coordinated movement patterns could facilitate the early identification of motor development delays. Current methods for identifying coordinated movements of rolling are limited to a laboratory setting and not feasible for clinicians. OBJECTIVE: To develop video-based methods in which six coordinated movements, previously defined through motion capture, can be identified through video alone. METHODS: Forty-five videos of sixteen healthy infants achieving a roll were used to develop the video-based methodology and twenty-four videos had corresponding motion capture data used for validation. Four raters …comprised of researchers and a clinician identified rolling coordination using the new video-based methods. A Fleiss’ Kappa statistical test determined the inter- and intra-rater reliability of agreement for the new methodology and compared it to motion capture. RESULTS: The comparison of the motion capture and video-based methods resulted in substantial agreement. The video-based methods inter- and intra-rater reliability were substantial and almost perfect, respectively. CONCLUSIONS: We developed reliable methodology to accurately identify the coordinated movements of infant rolling using only 2D video. This methodology will allow researchers to reliably define coordinated movements of infants through video alone and may assist clinicians in identifying possible motor development delays and disorders. Show more
Keywords: Motor development, kinematics, milestones, biomechanics, experimental design
DOI: 10.3233/THC-231281
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 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. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Mu, Shangdong | Tian, Qiusi | Shen, Liangyu
Article Type: Research Article
Abstract: BACKGROUND: Nucleolar protein 16 (NOP16) is present in the protein complex of the nucleolus. The NOP16 promoter contains a c-Myc binding site, and the transcriptional regulation by c-Myc directly regulates NOP16 expression levels. OBJECTIVE: Dysregulation of NOP 16 is currently reported in only a small number of cancers. In this study, the expression profile of NOP 16 in hepatocellular carcinoma (LIHC) and its clinical significance were analyzed. METHODS: NOP16 expression in hepatocellular carcinoma (LIHC) and its relationship with the clinical characters of LIHC were examined using the Cancer Genome Atlas (TCGA), the Gene …Expression comprehensive database (GEO), Kaplan-Meier survival analysis, univariate Cox analysis, multivariate Cox analysis, ROC curve analysis of KEGG enrichment, GSEA enrichment, in vitro experiments (e.g., siRNA interference of NOP16 expression in hepatoma cells, Keap1-Nrf2 pathway, cell cycle, cell apoptosis and Transwell assays), and LIHC single-cell sequencing (scRNA). RESULTS: Pan-cancer analysis revealed that NOP16 was highly expressed in 20 cancer types, including LIHC, and high NOP16 expression was an independent adverse prognostic factor in LIHC patients. The expression levels of NOP16 mRNA and protein were significantly increased in tumour tissues of LIHC patients compared to normal tissues. The functions of co-expressed genes were primarily enriched in the cell cycle and reactive oxygen species metabolism. The experimental results showed that knockdown of NOP16 activated the Keap/Nrf2 signalling pathway and inhibited the invasion, migration, and EMT progression of LIHC cells. LIHC scRNA-seq data showed that NOP16 was primarily expressed in T lymphocytes. CONCLUSIONS: NOP16 promoted cancer development in LIHC and caused an imbalance in Keap/Nrf2 signalling, which subsequently caused the aberrant expression of genes typical for EMT, cell cycle progression and apoptosis. NOP16 is a potential prognostic marker and therapeutic target for hepatocellular carcinoma progression. Show more
Keywords: NOP16, Keap1-Nrf2 pathway, hepatic cell liver cancer, bioinformatics
DOI: 10.3233/THC-231256
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 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. Pre-press, no. Pre-press, pp. 1-10, 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. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Darshan, B.S. Dhruva | Sampathila, Niranjana | Bairy, Muralidhar G. | Belurkar, Sushma | Prabhu, Srikanth | Chadaga, Krishnaraj
Article Type: Research Article
Abstract: BACKGROUND: Anaemia is a commonly known blood illness worldwide. Red blood cell (RBC) count or oxygen carrying capability being insufficient are two ways to describe anaemia. This disorder has an impact on the quality of life. If anaemia is detected in the initial stage, appropriate care can be taken to prevent further harm. OBJECTIVE: This study proposes a machine learning approach to identify anaemia from clinical markers, which will help further in clinical practice. METHODS: The models are designed with a dataset of 364 samples and 12 blood test attributes. The developed algorithm …is expected to provide decision support to the clinicians based on blood markers. Each model is trained and validated on several performance metrics. RESULTS: The accuracy obtained by the random forest, K nearest neighbour, support vector machine, Naive Bayes, xgboost, and catboost are 97%, 98%, 95%, 95%, 98% and 97% respectively. Four explainers such as Shapley Additive Values (SHAP), QLattice, Eli5 and local interpretable model-agnostic explanations (LIME) are explored for interpreting the model predictions. CONCLUSION: The study provides insights into the potential of machine learning algorithms for classification and may help in the development of automated and accurate diagnostic tools for anaemia. Show more
Keywords: Clinical markers, decision support, explainable artificial intelligence, machine learning
DOI: 10.3233/THC-231207
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Alshehhi, Talib | Ayesh, Aladdin | Yang, Yingjie | Chen, Feng
Article Type: Research Article
Abstract: BACKGROUND: The term ‘dementia’ covers a range of progressive brain diseases from which many elderly people suffer. Traditional cognitive and pathological tests are currently used to detect dementia, however, applications using Artificial Intelligence (AI) methods have recently shown improved results from improved detection accuracy and efficiency. OBJECTIVE: This research paper investigates the efficacy of one type of data analytics called supervised learning to detect Alzheimer’s disease (AD) – a common dementia condition. METHODS: The aim is to evaluate cognitive tests and common biological markers (biomarkers) such as cerebrospinal fluid (CSF) to develop predictive …classification systems for dementia detection. RESULTS: A data analytics process has been proposed, implemented, and tested against real data obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) repository. CONCLUSION: The models showed good power in predicting AD levels, notably from specified cognitive tests’ scores and tauopathy related features. Show more
Keywords: Alzheimer’s disease, biomarkers, data analytics, dementia, medical screening
DOI: 10.3233/THC-220598
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 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. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zeeshan, Tayyaba | Qamar, Zeeshan | Abdul, Nishath Sayed | Soman, Cristalle | Bamousa, Badr | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals. OBJECTIVE: The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS). METHODS: Noordini’s Artifical Mouth model was used for developing the …single species biofilm with early microbial colonizers of oral biofilm (A. viscosus , Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count. RESULTS: From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis , S.sanguinis and A.viscosus . There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p ⩽ 0.05). CONCLUSION: It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora. Show more
Keywords: Bacterial retention, essential oils, chlorhexidine gluconate, curcumin photosensitizer
DOI: 10.3233/THC-231814
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Muniasamy, Anandhavalli | Begum, Arshiya | Sabahath, Asfia | yaqub, Humara | Karunakaran, Gauthaman
Article Type: Research Article
Abstract: BACKGROUND: Coronary heart disease (CHD) is one of the deadliest diseases and a risk prediction model for cardiovascular conditions is needed. Due to the huge number of features that lead to heart problems, it is often difficult for an expert to evaluate these huge features into account. So, there is a need of appropriate feature selection for the given CHD dataset. For early CHD detection, deep learning modes (DL) show promising results in the existing studies. OBJECTIVE: This study aimed to develop a deep convolution neural network (CNN) model for classification with a selected number of …efficient features using the LASSO (least absolute shrinkage and selection operator) technique. Also, aims to compare the model with similar studies and analyze the performance of the proposed model using accuracy measures. METHODS: The CHD dataset of NHANES (National Health and Nutritional Examination Survey) was examined with 49 features using LASSO technique. This research work is an attempt to apply an improved CNN model for the classification of the CHD dataset with huge features CNN model with feature extractor consists of a fully connected layer with two convolution 1D layers, and classifier part consists of two fully connected layers with SoftMax function was trained on this dataset. Metrics like accuracy recall, specificity, and ROC were used for the evaluation of the proposed model. RESULTS: The feature selection was performed by applying the LASSO model. The proposed CNN model achieved 99.36% accuracy, while previous studies model achieved over 80 to 92% accuracy. CONCLUSION: The application of the proposed CNN with the LASSO model for the classification of CHD can speed up the diagnosis of CHD and appears to be effective in predicting cardiovascular disease based on risk features. Show more
Keywords: Coronary heart disease, deep learning, machine learning, LASSO, convolutional neural network
DOI: 10.3233/THC-231807
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Bečić, Ervina | Salihović, Mirsada | Tüzün, Burak | Omeragić, Elma | Imamović, Belma | Dedić, Mirza | Roca, Sunčica | Špirtović-Halilović, Selma
Article Type: Research Article
Abstract: BACKGROUND: Computational research plays an important role in predicting the chemical and physical properties of biologically active compounds important in future structural modifications to improve or modify biological activity. OBJECTIVE: This research focuses on quantum chemical and spectroscopic investigations properties of synthesized 4-hydroxycoumarin derivatives. METHODS: Quantum chemical calculations were obtained using B3LYP, HF, and M06-2x level methods with the 6-31++G (d,p) basis set. Afterward, IR, 1 H, 13 C, UV-Visible experimentally parameters were compared with the results obtained using the B3LYP/6-31+G*(d) basis set of the …molecules to be able to characterize the structures. RESULTS: Based on the quantum chemical calculations compound with acetamido group on the phenyl ring is the most reactive, and compound with nitro substituent is the least reactive and the the strongest electrophile among tested compounds. With the exception of compounds with dimethylamino group, all other compounds have a pronounced tautomer between between OH and C = O group. The calculated and experimental values are in agreement with each other. CONCLUSION: The molecular structure in the ground state of six 3-cinnamoyl 4-hydroxycoumarin derivatives was optimized using density functional theory. The observed and computed values were compared and it can be concluded that the theoretical results were in good linear agreement with the experimental data. Show more
Keywords: Density functional theory (DFT), coumarin derivatives, quantum chemical calculations
DOI: 10.3233/THC-231798
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Feng, Ruigang | Huang, Wenwen | Liu, Bowen | Li, Dan | Zhao, Jinlai | Yu, Yue | Cao, Xuchen | Wang, Xin
Article Type: Research Article
Abstract: BACKGROUND: The effective treatment of breast cancer in elderly patients remains a major challenge. OBJECTIVE: To construct a nomogram affecting the overall survival of triple-negative breast cancer (TNBC) and establish a survival risk prediction model. METHODS: A total of 5317 TPBC patients with negative expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) who were diagnosed and received systematic treatment from 2010 to 2015 were collected from the American Cancer Surveillance, Epidemiology and End Results (SEER) database. They were randomly divided into training set (n = …3721) and validation set (n = 1596). Univariate and multivariate Cox regression analysis were used to identify prognostic features, and a nomogram was established to predict the probability of 1-year, 3-year and 5-year OS and BCSS. We used consistency index (C-index), calibration curve, area under the curve (AUC) and decision curve analysis (DCA) to evaluate the predictive performance and clinical utility of the nomogram. RESULTS: The C-indices of the nomograms for OS and BCSS in the training cohort were 0.797 and 0.825, respectively, whereas those in the validation cohort were 0.795 and 0.818, respectively. The receiver operating characteristic (ROC) curves had higher sensitivity at all specificity values as compared with the Tumor Node Metastasis (TNM) system. The calibration plot revealed a satisfactory relationship between survival rates and predicted outcomes in both the training and validation cohorts. DCA demonstrated that the nomogram had clinical utility when compared with the TNM staging system. CONCLUSION: This study provides information on population-based clinical characteristics and prognostic factors for patients with triple-negative breast cancer, and constructs a reliable and accurate prognostic nomogram. Show more
Keywords: Triple negative breast cancer, nomogram, overall survival, breast cancer-specific survival, SEER database
DOI: 10.3233/THC-231240
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Luschi, Alessio
Article Type: Letter
DOI: 10.3233/THC-231784
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-3, 2024
Authors: Tekeli, Seçkin Özgür | Köse, Özkan | Yapar, Dilek | Tekeli, Feyza Yağmur | Asoğlu, Mehmet Melih | Kartal, Emre Mücahit
Article Type: Research Article
Abstract: BACKGROUND: The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. OBJECTIVE: This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. METHODS: This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. RESULTS: Of the participants, 49.2% (n = 1,683) were diagnosed …with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p < 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5–2.0; p < 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. CONCLUSIONS: The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65. Show more
Keywords: Vitamin D, knee, osteoarthritis, female sex, biomedical imaging, elderly healthcare, orthopedic surgery
DOI: 10.3233/THC-230802
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Wu, Mingzhen | Luan, Jixin | Zhang, Di | Fan, Hua | Qiao, Lishan | Zhang, Chuanchen
Article Type: Research Article
Abstract: BACKGROUND: Histopathological evaluation is currently the gold standard for grading gliomas; however, this technique is invasive. OBJECTIVE: This study aimed to develop and validate a diagnostic prediction model for glioma by employing multiple machine learning algorithms to identify risk factors associated with high-grade glioma, facilitating the prediction of glioma grading. METHODS: Data from 1114 eligible glioma patients were obtained from The Cancer Genome Atlas (TCGA) database, which was divided into a training set (n = 781) and a test set (n = 333). …Fifty machine learning algorithms were employed, and the optimal algorithm was selected to construct a prediction model. The performance of the machine learning prediction model was compared to the clinical prediction model in terms of discrimination, calibration, and clinical validity to assess the performance of the prediction model. RESULTS: The area under the curve (AUC) values of the machine learning prediction models (training set: 0.870 vs. 0.740, test set: 0.863 vs. 0.718) were significantly improved from the clinical prediction models. Furthermore, significant improvement in discrimination was observed for the Integrated Discrimination Improvement (IDI) (training set: 0.230, test set: 0.270) and Net Reclassification Index (NRI) (training set: 0.170, test set: 0.170) from the clinical prognostic model. Both models showed a high goodness of fit and an increased net benefit. CONCLUSION: A strong prediction accuracy model can be developed using machine learning algorithms to screen for high-grade glioma risk predictors, which can serve as a non-invasive prediction tool for preoperative diagnostic grading of glioma. Show more
Keywords: Glioma, machine learning, prediction model, grading, risk predictors
DOI: 10.3233/THC-231645
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Dedić, Mirza | Omeragić, Elma | Imamović, Belma | Bilajac, Esma | Mahmutović, Lejla | Glamočlija, Una | Bečić, Ervina
Article Type: Research Article
Abstract: BACKGROUND: Preclinical drug testing requires in vitro and in vivo assessments that are vital for studying drug pharmacokinetics and toxicity. Distinct factors that play an important role in drug screening, such as hydrophobicity, solubility of the substance and serum protein binding can be challenging by inducing result inconsistencies. Hence, establishing accurate methods to quantify drug concentrations in cell cultures becomes pivotal for reliable and reproducible results important for in vivo dosing predictions. OBJECTIVE: This research focuses on developing an optimized analytical approach via high-pressure liquid chromatography (HPLC) to determine thymoquinone (TQ) levels in …monolayer cell cultures. METHODS: The method’s validation adheres to the International Council for Harmonisation (ICH) guideline M10, ensuring its acceptance and applicability. Using an HPLC system with a Diode Array Detector (DAD), the study fine-tuned various parameters to achieve an efficient separation of TQ. Validation covered specificity, sensitivity, matrix effects, linearity, precision, and accuracy, alongside assessing TQ stability in RPMI-1640 medium. RESULTS: The HPLC method exhibited remarkable TQ specificity, free from interfering peaks at the analyte retention. Sensitivity analysis at the lower limit of quantification (LLOQ) revealed 5.68% %CV and 98.37% % mean accuracy. Matrix effect evaluation showcased accuracy within 85–115%. Linearity spanned in the concentration range of 2–10 μ M with a correlation coefficient (r 2 ) of 0.9993. Precision and accuracy were aligned with acceptance criteria. The proposed method was found to be greener in terms of usage of persistent, bioaccumulative, and toxic chemicals and solvents, corrosive samples, and waste production. CONCLUSION: The developed HPLC-DAD method emerges as specific, accurate, sensitive, and reliable for TQ determination in cell cultures. It ensures robust TQ quantification, enhancing precise in vitro assessments and dependable dosing predictions for in vivo studies. Further research is advocated to investigate TQ’s stability across diverse environmental conditions. Show more
Keywords: Method validation, RPMI-1640, thymoquinone concentration determination
DOI: 10.3233/THC-231432
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Wang, Wenhong | Zhang, Zhenbo | Xia, Fenbo
Article Type: Review Article
Abstract: BACKGROUND: Mechanical ventilation (MV) is a crucial intervention for the support of patients with acute and severe respiratory failure in modern intensive care medicine. However, the mechanical forces resulting from the interplay between the ventilator and the respiratory system may cause pulmonary injury. OBJECTIVE: To compare the effects of high-flow nasal cannula (HFNC) therapy and other oxygen therapy modalities on the risk of endotracheal reintubation in mechanically ventilated patients after extubation in the intensive care unit (ICU). METHODS: An electronic search was carried out across various databases including PubMed, Embase, Ovid, Medline, Cochrane …Library, Embase, VIP, and Wanfang. The objective of this search was to locate prospective randomized controlled trials that examined the effects of multiple oxygen therapy approaches on the incidence of reintubation in patients in the ICU after undergoing mechanical ventilation. The meta package in R language was used to analyze parameters adopted by the included studies such as reintubation rate, mortality rate, and length of hospital stay. RESULTS: This study enrolled 22 articles, involving 4,160 participants, with 2,061 in the study group and 2,099 in the control group. Among these, 20 articles presented data on the reintubation rate of the patients included with an odds ratio (OR) of 0.90 (95% CI: 0.74, 1.09) for HFNC and an OR of 1.77 (95% CI: 0.93, 3.38) for HFNC in the chronic obstructive pulmonary disease (COPD) subgroup. Moreover, 10 articles assessed the incidence of respiratory failure after extubation, revealing an OR for HFNC was 0.68 (95% CI: 0.55, 0.84) using a fixed-effects model. Nine articles addressed ICU mortality, while 13 pieces of literature examined hospital mortality. HFNC showed no significant impact on either ICU mortality or hospital mortality. CONCLUSION: HFNC therapy markedly reduces the incidence of respiratory failure in mechanically ventilated patients following extubation in the ICU. Furthermore, it specifically reduces the risk of reintubation in patients diagnosed with COPD. Show more
Keywords: Mechanical ventilation, intensive care unit, high-flow nasal cannula, respiratory failure, mortality rate
DOI: 10.3233/THC-231024
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Li, Jiahao
Article Type: Research Article
Abstract: BACKGROUND: The main goal of sports science is to monitor sports injuries. Nevertheless, the existing sports injury monitoring projects have many expensive instruments and excessively extended monitoring periods, which makes it difficult to expand sports injury monitoring on a large scale. OBJECTIVE: The advancement of machine learning algorithms opens up new avenues for the tracking of sports injuries. METHODS: A training set of sports injuries was created using the Discrete Wavelet Transform (DWT) and Random Forest algorithms. Next, a basic analytic framework was created based on the lower-body movement of runners, and an …athlete’s injury likelihood monitoring system was established. First off, the wearable gyroscope device can efficiently plot the motion displacement curve and monitor the three-dimensional mechanics of the athlete’s hips, thighs, and calves. Secondly, the system has a higher computational efficiency and an advantage over other classifier-based systems in terms of testing and training times RESULTS: The suggested system framework identifies athletes’ injury propensity, providing preventive recommendations based on displacement curves, and offering a low total cost and high testing accuracy, making it easy to implement and cost-effective. CONCLUSION: All things considered, the sports injury monitoring device is very accurate and reasonably priced, making it appropriate for widespread use. Show more
Keywords: Discrete wavelet transform, random forest algorithm, three-dimensional mechanics, gyroscope, computational efficiency
DOI: 10.3233/THC-231789
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 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. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Pan, Wan | Zhou, Yan | Ji, Yueping | Zhou, Lianfang | Wang, Li
Article Type: Research Article
Abstract: OBJECTIVE: In order to improve nursing quality management and protect patient medical safety, it is necessary to change the default mode and completely integrate information technology and nursing quality control utilising lean management. METHODS: A database was created, the nurse quality control scoring standard was entered into the computer and after the inspection, and various inspection reports were entered into the computer to precisely and promptly preserve data. The computer was then utilised to precisely assess the intensity and quality of nursing work, compute, count, and analyse the stored data, output the quality of nursing work …in each department as a report, and adopt lean management for the gathered issues. RESULTS: To reach the objective of raising nursing quality, data analysis makes it simple to identify flaws and consistently strengthen the weak points. In order to create an information-based nursing quality control system with a simple and effective method as well as results that are scientific and objective, lean management is brought into the construction process. Show more
Keywords: Lean management, information based nursing quality control system, experience
DOI: 10.3233/THC-230730
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhu, Li-Jun | Lin, Hui | Wu, Xiao-Tong | Shi, Shao-Hua | Qiao, Xi
Article Type: Research Article
Abstract: BACKGROUND: Diarrhea is a prevalent complication after renal transplantation. OBJECTIVE: To examine the risk factors for diarrhea after renal transplantation, evaluate their combined predictive values, and analyze the prognosis. METHODS: Clinical data of patients who underwent allogeneic renal transplantation in the Second People’s Hospital of Shanxi Province from January 2019 to March 2020 were retrospectively analyzed, cases were screened and grouped, independent risk factors for diarrhea after renal transplantation were analyzed by univariate analysis and multivariate analysis, and their predictive value was evaluated by receiver operating characteristic (ROC) curve. The survival time of …recipient grafts in diarrhea and non-diarrhea groups were evaluated by Kaplan-Meier and log-rank test. RESULTS: We included 166 recipients in the study and the incidence of diarrhea was 25.9%; univariate and logistic regression multivariate analyses revealed that independent risk factors for diarrhea in recipients were that the type of renal transplant donor was DCD (donation after circulatory death), immunity induction was onducted with basiliximab + antithymocyte globulin (ATG), and ATG alone, the type of mycophenolic acid (MPA) used was mycophenolate mofetil capsules, and delayed graft function (DGF) occurred after transplantation. The ROC curve indicated that the combination of the four factors had good accuracy in predicting the occurrence of diarrhea in recipients. The graft survival rate two years after the operation in the diarrhea group was significantly lower than that in the non-diarrhea group. CONCLUSION: Diarrhea affected the two-year survival rate of the graft. The type of donor, immunity induction scheme, and the type of MPA and DGF were independent risk factors for diarrhea in recipients, and the combination of the four factors had good prognostic prediction value. Show more
Keywords: Delayed graft function, diarrhea, mycophenolic acid, renal transplantation, type of donor
DOI: 10.3233/THC-230579
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Maheshkumar, Hima | Meenakshi, Srinivasa Iyer | Rao, Shyla Dureja, Raghunath Nagasundara | Shivakumar, Ganiga Channaiah | Marrapodi, Maria Maddalena | Cervino, Gabriele | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Polymethyl methacrylate (PMMA) is a commonly used denture base material, but susceptibility to fracture under functional loading remains a challenge. OBJECTIVE: This preliminary screening study aims to investigate the potential of sericin and fibroin as reinforcing agents in the PMMA denture base material. METHODS: The flexural and impact strengths of PMMA incorporated with 0.01% sericin, and 0.01% each of sericin and fibroin, were evaluated. The control group consisted of PMMA without any additives. The maximum load and energy required to break the samples were measured. Statistical analysis was performed using one-way ANOVA …test and Scheffe Post Hoc tests to compare mean values between subgroups. RESULTS: The results indicated significant improvement in the flexural and impact strengths of PMMA with the addition of sericin and fibroin. The subgroups with 0.01% sericin, and 0.01% each of sericin and fibroin, demonstrated higher mean values in load and energy measurements compared to the control group. The statistical analysis confirmed the significance of these findings. CONCLUSION: The addition of 0.01% sericin and 0.01% each of sericin and fibroin to PMMA denture-based resin material significantly increases its flexural and impact strengths. These preliminary findings suggest the potential of sericin and fibroin as effective reinforcing agents in PMMA denture base materials, thereby enhancing their biomechanical properties. Show more
Keywords: PMMA, denture base material, sericin, fibroin, flexural strength, impact strength, reinforcing agents
DOI: 10.3233/THC-231772
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Netto, Ann Nita | Abraham, Lizy | Philip, Saji
Article Type: Research Article
Abstract: BACKGROUND: Cardiac diseases are highly detrimental illnesses, responsible for approximately 32% of global mortality [1]. Early diagnosis and prompt treatment can reduce deaths caused by cardiac diseases. In paediatric patients, it is challenging for paediatricians to identify functional murmurs and pathological murmurs from heart sounds. OBJECTIVE: The study intends to develop a novel blended ensemble model using hybrid deep learning models and softmax regression to classify adult, and paediatric heart sounds into five distinct classes, distinguishing itself as a groundbreaking work in this domain. Furthermore, the research aims to create a comprehensive 5-class paediatric phonocardiogram (PCG) …dataset. The dataset includes two critical pathological classes, namely atrial septal defects and ventricular septal defects, along with functional murmurs, pathological and normal heart sounds. METHODS: The work proposes a blended ensemble model (HbNet-Heartbeat Network) comprising two hybrid models, CNN-BiLSTM and CNN-LSTM, as base models and Softmax regression as meta-learner. HbNet leverages the strengths of base models and improves the overall PCG classification accuracy. Mel Frequency Cepstral Coefficients (MFCC) capture the crucial audio signal characteristics relevant to the classification. The amalgamation of these two deep learning structures enhances the precision and reliability of PCG classification, leading to improved diagnostic results. RESULTS: The HbNet model exhibited excellent results with an average accuracy of 99.72% and sensitivity of 99.3% on an adult dataset, surpassing all the existing state-of-the-art works. The researchers have validated the reliability of the HbNet model by testing it on a real-time paediatric dataset. The paediatric model’s accuracy is 86.5%. HbNet detected functional murmur with 100% precision. CONCLUSION: The results indicate that the HbNet model exhibits a high level of efficacy in the early detection of cardiac disorders. Results also imply that HbNet has the potential to serve as a valuable tool for the development of decision-support systems that aid medical practitioners in confirming their diagnoses. This method makes it easier for medical professionals to diagnose and initiate prompt treatment while performing preliminary auscultation and reduces unnecessary echocardiograms. Show more
Keywords: Blended ensemble, mel frequency cepstral coefficient, meta-learner, phonocardiogram, softmax regression
DOI: 10.3233/THC-231290
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Sun, Yi | Ren, Tao | Ji, Xueli
Article Type: Research Article
Abstract: BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). …Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization. Show more
Keywords: Hyperbaric oxygen therapy-specialized care, hyperbaric oxygen, cerebral infarction, motor function, mental state
DOI: 10.3233/THC-231643
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Maheshwaran, Bipin | Chokkatt, Jerry Joe | Shenoy, Amrutha | Ganapathy, Dhanraj | Yadalam, Pradeep Kumar | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Titanium nanoparticles (NPs) offer promising applications in the treatment and prevention of inflammatory disorders due to their unique physicochemical characteristics. However, additional research is necessary to attain a thorough comprehension and validate the efficacy of this approach in dental practice. OBJECTIVE: This study scrutinizes the anti-inflammatory properties of a dental varnish infused with ginger and rosemary extracts mediated by titanium dioxide (TiO2) nanoparticles. METHODS: A herbal dental varnish was formulated by integrating ginger and rosemary extracts with titanium dioxide nanoparticles at concentrations of 10, 20, 30, 40, and 50 μ L. …Anti-inflammatory properties were assessed through Bovine Serum Albumin denaturation and membrane stabilization assays, comparing results with a control group. RESULTS: The results reveal concentration-dependent antioxidant and anti-inflammatory properties in the test group when compared to the control group. The BSA assay corroborates increased percent inhibition with rising titanium dioxide nanoparticle concentrations. In line with existing literature, titanium dioxide nanoparticles enhance dental material properties. CONCLUSION: The bioactive compounds in ginger and rosemary, such as phenolic compounds and terpenes, contribute to anti-inflammatory and antioxidant effects of the varnish. Additionally, the therapeutic potential of titanium dioxide nanoparticles in addressing inflammatory diseases underscores their significance in this formulation. Show more
Keywords: Preventive dentistry, nanoparticles, titanium dioxide, green synthesis, antioxidant
DOI: 10.3233/THC-231994
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
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. CD 4 +T cells, macrophages, and naïve B cells had a higher infiltration rate in BC tissues with high VAMP7 expression, while regulatory T cells and CD 8 +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. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Rogers, Nathan | Rullán, Pedro J. | Pasqualini, Ignacio | Khan, Shujaa T. | Klika, Alison K. | Surace, Peter A. | Molloy, Robert M. | Piuzzi, Nicolas S. | Bloomfield, Michael
Article Type: Research Article
Abstract: BACKGROUND: The value of robotic-assisted total hip arthroplasty (rTHA) has yet to be determined compared to conventional manual THA (mTHA). OBJECTIVE: Evaluate 90-day inpatient readmission rates, rates of reoperation, and clinically significant improvement of patient-reported outcome measures (PROMs) at 1-year in a cohort of patients who underwent mTHA or rTHA through a direct anterior (DA) approach. METHODS: A single-surgeon, prospective institutional cohort of 362 patients who underwent primary THA for osteoarthritis via the DA approach between February 2019 and November 2020 were included. Patient demographics, surgical time, discharge disposition, length of stay, acetabular …cup size, 90-day inpatient readmission, 1-year reoperation, and 1-year PROMs were collected for 148 manual and 214 robotic THAs, respectively. RESULTS: Patients undergoing rTHA had lower 90-day readmission (3.74% vs 9.46%, p = 0.04) and lower 1-year reoperation (0.93% vs 4.73% mTHA, p = 0.04). rTHA acetabular cup sizes were smaller (rTHA median 52, interquartile range [IQR] 50; 54, mTHA median 54, IQR 52; 58, p < 0.001). Surgical time was longer for rTHA (114 minutes vs 101 minutes, p < 0.001). At 1-year post-operatively, there was no difference in any of the PROMs evaluated. CONCLUSION: Robotic THA demonstrated lower 90-day readmissions and 1-year reoperation rates than manual THA via the DA approach. PROMs were not significantly different between the two groups at one year. Show more
Keywords: THA, direct anterior approach, HOOS, satisfaction, value of robotics
DOI: 10.3233/THC-231646
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Kasiviswanathan, Sivachandar | Vijayan, Thulasi Bai
Article Type: Research Article
Abstract: BACKGROUND: Artificial Intelligence (AI) plays a pivotal role in the diagnosis of health conditions ranging from general well-being to critical health issues. In the realm of health diagnostics, an often overlooked but critical aspect is the consideration of cost-sensitive learning, a facet that this study prioritizes over the non-invasive nature of the diagnostic process whereas the other standard metrics such as accuracy and sensitivity reflect weakness in error profile. OBJECTIVE: This research aims to investigate the total cost of misclassification (Total Cost) by decision rule Machine Learning (ML) algorithms implemented in Java platforms such as DecisionTable, …JRip, OneR, and PART. An augmented dataset with conjunctiva images along candidates’ demographic and anthropometric features under supervised learning is considered with a specific emphasis on cost-sensitive classification. METHODS: The opted decision rule classifiers use the text features, additionally the image feature ‘a* value of CIELAB color space’ extracted from the conjunctiva digital images as input attributes. The pre-processing consists of amalgamating text and image features on a uniform scale, normalizing. Then the 10-fold cross-validation enables the classification of samples into two categories: the presence or absence of the anemia. This study utilizes the Cost Ratio (ρ ) extracted from the cost matrix to meticulously monitor the Total Cost in four different cost ratio methodologies namely Uniform (U), Uniform Inverted (UI), Non-Uniform (NU), and Non-Uniform Inverted (NUI). RESULTS: It has been established that the PART classifier stands out as the top performer in this binary classification task, yielding the lowest mean total cost of 629.9 compared to other selected classifiers. Moreover, it demonstrates a comparatively lower standard deviation 335.9, and lower total cost across all four different cost ratio methodologies. The ranking of algorithm performance goes as follows: PART, JRIP, DecisionTable, and OneR. CONCLUSION: The significance of adopting a cost-sensitive learning approach is emphasized showing the PART classifier’s consistent performance within the proposed framework for learning the anemia dataset. This emphasis on cost-sensitive learning not only enhances the recommendations in diagnosis but also holds the potential for substantial cost savings and makes it a noteworthy focal point in the advancement of AI-driven health care. Show more
Keywords: Cost matrix, cost ratio, cost sensitive classifier, decision rule classifier, DecisionTable, JRip, OneR, PART
DOI: 10.3233/THC-231946
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Wang, Luo | Li, Xin | Dong, Xue-Juan | Yu, Xiao-Ling | Zhang, Jing | Cheng, Zhi-Gang | Han, Zhi-Yu | Liu, Fang-Yi | Yu, Jie | Liang, Ping
Article Type: Research Article
Abstract: BACKGROUND: Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC). OBJECTIVE: This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC. METHODS: This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio …of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy. RESULTS: The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: p = 0.036; recurrent HCC: p = 0.026). For patients with primary HCC, the recurrence frequency was reduced (p = 0.002), and recurrence interval (19 months vs. 9 months, p < 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients ⩽ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3+ (p = 0.049), CD8/CD28+ (p = 0.045) were elevated. CONCLUSION: Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients ⩽ 60 years old or with moderately-differentiated HCC or co-infected with HBV. Show more
Keywords: Hepatocellular carcinoma, immunotherapy, ablation, dendritic cell, cytokine killer
DOI: 10.3233/THC-230871
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 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. Pre-press, no. Pre-press, pp. 1-11, 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. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Tomasevic, Smiljana | Anic, Milos | Arsic, Branko | Gakovic, Branko | Filipovic, Nenad | Djukic, Tijana
Article Type: Research Article
Abstract: BACKGROUND: Ultrasound is one of the non-invasive techniques that are used in clinical diagnostics of carotid artery disease. OBJECTIVE: This paper presents software methodology that can be used in combination with this imaging technique to provide additional information about the state of patient-specific artery. METHODS: Overall three modules are combined within the proposed methodology. A clinical dataset is used within the deep learning module to extract the contours of the carotid artery. This data is then used within the second module to perform the three-dimensional reconstruction of the geometry of the carotid bifurcation …and ultimately this geometry is used within the third module, where the hemodynamic analysis is performed. The obtained distributions of hemodynamic quantities enable a more detailed analysis of the blood flow and state of the arterial wall and could be useful to predict further progress of present abnormalities in the carotid bifurcation. RESULTS: The performance of the deep learning module was demonstrated through the high values of relevant common classification metric parameters. Also, the accuracy of the proposed methodology was shown through the validation of results for the reconstructed parameters against the clinically measured values. CONCLUSION: The presented methodology could be used in combination with standard clinical ultrasound examination to quickly provide additional quantitative and qualitative information about the state of the patient’s carotid bifurcation and thus ensure a treatment that is more adapted to the specific patient. Show more
Keywords: Convolutional neural networks, 3D reconstruction, blood flow, patient-specific geometry, validation against clinical data
DOI: 10.3233/THC-231306
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
Authors: Liu, Lili
Article Type: Research Article
Abstract: BACKGROUND: Osteoporosis is a medical disorder that causes bone tissue to deteriorate and lose density, increasing the risk of fractures. Applying Neural Networks (NN) to analyze medical imaging data and detect the presence or severity of osteoporosis in patients is known as osteoporosis classification using Deep Learning (DL) algorithms. DL algorithms can extract relevant information from bone images and discover intricate patterns that could indicate osteoporosis. OBJECTIVE: DCNN biases must be initialized carefully, much like their weights. Biases that are initialized incorrectly might affect the network’s learning dynamics and hinder the model’s ability to converge to …an ideal solution. In this research, Deep Convolutional Neural Networks (DCNNs) are used, which have several benefits over conventional ML techniques for image processing. METHOD: One of the key benefits of DCNNs is the ability to automatically Feature Extraction (FE) from raw data. Feature learning is a time-consuming procedure in conventional ML algorithms. During the training phase of DCNNs, the network learns to recognize relevant characteristics straight from the data. The Squirrel Search Algorithm (SSA) makes use of a combination of Local Search (LS) and Random Search (RS) techniques that are inspired by the foraging habits of squirrels. RESULTS: The method made it possible to efficiently explore the search space to find prospective values while using promising areas to refine and improve the solutions. Effectively recognizing optimum or nearly optimal solutions depends on balancing exploration and exploitation. The weight in the DCNN is optimized with the help of SSA, which enhances the performance of the classification. CONCLUSION: The comparative analysis with state-of-the-art techniques shows that the proposed SSA-based DCNN is highly accurate, with 96.57% accuracy. Show more
Keywords: Osteoporosis, classification, accuracy, optimization, bias, neural network, and squirrel search
DOI: 10.3233/THC-231517
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 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. Pre-press, no. Pre-press, pp. 1-14, 2024
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