Technology and Health Care - Volume Pre-press, issue Pre-press

Authors: Jiang, Ziwei | Yi, Peiling | You, Jinping | Cai, Erwei

Article Type: Research Article

Abstract: BACKGROUND: Colorectal cancer (CRC) is a digestive tract malignancy microRNAs (miRNAs) have attracted much attention as biomarkers in tumor studies. OBJECTIVE: This work focused on the predictive potential and mechanism of miR-4310 in CRC. METHODS: The miRNA expression profile sets were obtained from the Gene Expression Omnibus (GEO) database, and the appropriate miRNA was screened by GEO2R. The CRC tissues and control tissues of 88 patients with CRC were collected, and the expression of miR-4310 was detected by quantitative real-time PCR, and the efficacy of miR-4310 in diagnosing CRC was evaluated by the …receiver operating characteristic curve (ROC). The effects of miR-4310 on the proliferation, migration, and invasion of CRC cells were explored by Cell Counting Kit-8 (CCK-8) and Transwell experiments. Predicting the potential binding sites of miR-4310 and Runt-related transcription factor 1 (RUNX1) by four predictive websites. The relationship between miR-4310 and RUNX1 was confirmed by a double luciferase reporter gene experiment. RESULTS: The bioinformatics analysis found that miR-4310 was differentially expressed in CRC tissues and this finding was certified by the expression of miR-4310 in CRC tissues of collected patients and cultured CRC cell lines. The expression of miR-4310 had a predictive possibility for CRC patients. MiR-4310/RUNX1 pathway had effects on CRC viability, migration, and invasion. CONCLUSION: MiR-4310 had the potential to be a biomarker for early screening of CRC. MiR-4310 and RUNX1 participated in the regulation of CRC cells. Show more

Keywords: miR-4310, RUNX1, colorectal cancer, biomarker, mechanism

DOI: 10.3233/THC-230472

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Yao, Xiaohui | Liu, Shan | Xia, Huan | Li, Hanhan | Wang, Zhijie | Su, Le | Guo, Wei | Chen, Hanrui

Article Type: Research Article

Abstract: BACKGROUND: Recurrence is the main cause of death in hepatocellular carcinoma (HCC) patients after liver resection. OBJECTIVE: The long non-coding RNAs (lncRNAs) have been reported participated in progression and prognosis of HCC, however, the vital role of lncRNA in postoperative recurrence of HCC has rarely been systematically identified. METHODS: RNA-sequencing (RNA-seq) was performed between orthotopic model of HCC and hepatoma postoperative recurrent model to comprehensively analyze the integrated transcriptome expression profiles of lncRNA and mRNA. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was then conducted to quantify the expression levels of DElncRNAs and their …target mRNAs. RESULTS: In our study, 211 lncRNAs (P -value < 0.05) and 1125 mRNAs (P -adjust < 0.05) were significantly differentially expressed (DE) between two groups. Moreover, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that DElncRNAs and DEmRNAs were mainly enriched in lipid metabolism, including Arachidonic acid metabolism, PPAR signaling pathway, Steroid hormone biosynthesis, Linoleic acid metabolism, Inflammatory mediator regulation of TRP channels, and Fatty acid degradation. Furthermore, we constructed lncRNA-mRNA interaction networks and protein-protein interaction (PPI) network, and verified by qRT-PCR, suggesting that increased DEIncRNAs (XLOC_063499 and XLOC_042016) may prevent HCC recurrence after surgery by upregulating on targeted cytochrome P450 (CYP) family genes in the lipid metabolism pathway, such as cyp3a16, cyp3a44, cyp2c39, cyp2c40 and cyp2c68. CONCLUSION: Overall, Our findings provided new insights for further investigation of biological function in lncRNA related HCC recurrence. Show more

Keywords: LncRNA, RNA-seq, postoperative recurrence of HCC, HCC recurrence, hepatoma postoperative recurrent model, CYP

DOI: 10.3233/THC-230123

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Xu, Fan | Zheng, Qihang | Shi, Jia | Yan, Keyu

Article Type: Research Article

Abstract: BACKGROUND: Alzheimer’s disease (AD) endangers the physical and mental health of the elderly, constituting one of the most crucial social challenges. Due to lack of effective AD intervention drugs, it is very important to diagnose AD in the early stage, especially in the Mild Cognitive Impairment (MCI) phase. OBJECTIVE: At present, an automatic classification technology is urgently needed to assist doctors in analyzing the status of the candidate patient. The artificial intelligence enhanced Alzheimer’s disease detection can reduce costs to detect Alzheimer’s disease. METHODS: In this paper, a novel pre-trained ensemble-based AD detection …(PEADD) framework with three base learners (i.e., ResNet, VGG, and EfficientNet) for both the audio-based and PET (Positron Emission Tomography)-based AD detection is proposed under a unified image modality. Specifically, the effectiveness of context-enriched image modalities instead of the traditional speech modality (i.e., context-free audio matrix) for the audio-based AD detection, along with simple and efficient image denoising strategy has been inspected comprehensively. Meanwhile, the PET-based AD detection based on the denoised PET image has been described. Furthermore, different voting methods for applying an ensemble strategy (i.e., hard voting and soft voting) has been investigated in detail. RESULTS: The results showed that the classification accuracy was 92% and 99% on the audio-based and PET-based AD datasets, respectively. Our extensive experimental results demonstrate that our PEADD outperforms the state-of-the-art methods on both audio-based and PET-based AD datasets simultaneously. CONCLUSIONS: The network model can provide an objective basis for doctors to detect Alzheimer’s Disease. Show more

Keywords: Alzhemier’s disease, early detection, pre-training, ensembling, modality

DOI: 10.3233/THC-230571

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2023

Authors: Tang, Bei | Ouyang, Wenbin | Deng, Jing | Huang, Xin

Article Type: Research Article

Abstract: BACKGROUND: In the wave of the novel coronavirus (COVID-19) epidemic, there is a need to investigate the mental health status of Chinese university students. OBJECTIVE: To examine the effects of witnessing cyberbullying on psychological distress and the mediating role of coping on these effects in Chinese university students, which is yet to be examined. METHODS: 306 Chinese university students were enrolled in this cross-sectional study. Linear regression was conducted to analyze the relationship between depression, anxiety and being a bystander to cyberbullying, whereas the bootstrapping approach tested the mediation effects of coping strategies. …RESULTS: Results indicated that 27.12% of subjects (95% CI: 22.22%, 32.48%) suffered from anxiety and 44.12% (95% CI: 38.47%, 49.88%) were depressed. Meanwhile, 89.87% of subjects were involved in witnessing cyberbullying. Being a bystander to cyberbullying was weakly but significantly associated with anxiety (β = 0.195, 95% CI: 0.068, 0.292) and depression (β = 0.223, 95% CI: 0.113,0.333). Negative coping partially mediated between witnessing cyberbullying and anxiety, with mediation effect values of 0.04 (P < 0.05). While being a bystander to cyberbullying was only directly associated with depression. CONCLUSION: Based on our findings, college students in Hunan, China, are experiencing anxiety, depression and cyberbullying after COVID-19. Being a bystander to cyberbullying is associated with coping styles, anxiety, and depression. Cyberbullying has a direct impact on anxiety, but it also influences anxiety through mediating effects on coping. Show more

Keywords: Bystander of cyberbullying, anxiety, depression, coping strategies, mediation analysis

DOI: 10.3233/THC-230305

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Chen, Ping-Shun | Lai, Chin-Hui | Chen, Ying-Tzu | Lung, Ting-Yu

Article Type: Research Article

Abstract: BACKGROUND: Scheduling patient appointments in hospitals is complicated due to various types of patient examinations, different departments and physicians accessed, and different body parts affected. OBJECTIVE: This study focuses on the radiology scheduling problem, which involves multiple radiological technologists in multiple examination rooms, and then proposes a prototype system of computer-aided appointment scheduling based on information such as the examining radiological technologists, examination departments, the patient’s body parts being examined, the patient’s gender, and the patient’s age. METHODS: The system incorporated a stepwise multiple regression analysis (SMRA) model to predict the number of …examination images and then used the K-Means clustering with a decision tree classification model to classify the patient’s examination time within an appropriate time interval. RESULTS: The constructed prototype creates a feasible patient appointment schedule by classifying patient examination times into different categories for different patients according to the four types of body parts, eight hospital departments, and 10 radiological technologists. CONCLUSION: The proposed patient appointment scheduling system can schedule appointment times for different types of patients according to the type of visit, thereby addressing the challenges associated with diversity and uncertainty in radiological examination services. It can also improve the quality of medical treatment. Show more

Keywords: Data mining, decision tree, patient appointments, appointment scheduling system, stepwise multiple regression analysis

DOI: 10.3233/THC-230374

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2023

Authors: Hong, Mei | Zhao, Yi-Dong | Zhong, Too-Li | Lu, Ming | Sun, Wen-Hao | Chen, Tian-Yuan | Hong, Nan | Zhu, Yao | Yu, Da-Hai

Article Type: Research Article

Abstract: BACKGROUND: There are 1.8 million lung cancer deaths worldwide, accounting for 18% of global cancer deaths, including 710,000 in China, accounting for 23.8% of all cancer deaths in China. OBJECTIVE: To explore the out-of-set association rules of lung cancer symptoms and drugs through text mining of traditional Chinese medicine (TCM) treatment of lung cancer, and form medical case analysis to analyze the experience of TCM syndrome differentiation in its treatment. METHODS: The medical records of all patients diagnosed with lung cancer in Nanjing Chest Hospital from January to December 2018 were collected, and …the out-of-set association analysis was performed using the MedCase v5.2 TCM clinical scientific research auxiliary platform based on the frequent pattern growth enhanced association analysis algorithm. RESULTS: In terms of TCM treatment of lung cancer, the clinical symptoms with high correlation included cough, expectoration, chest distress, and white phlegm; and the drugs with high correlation included Pinellia ternata , licorice root, white Atractylodes rhizome , and Radix Ophiopogonis ; with the prescriptions based on Erchen and Maimendong decoctions. CONCLUSION: This analytical study of the medical cases of TCM treatment for lung cancer was performed using data mining techniques, and the out-of-set association rules between clinical symptoms and drugs were analyzed, including the understanding of lung cancer in TCM. Moreover, the essence of experience in drug use was gathered, providing significant scientific guidance for the clinical treatment of lung cancer. Show more

Keywords: Data mining, lung cancer, traditional Chinese medicine, out-of-set association

DOI: 10.3233/THC-230269

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Liu, Xinyi | Liu, Hao | Liu, Yuanji

Article Type: Research Article

Abstract: BACKGROUND: During an outbreak such as COVID-19, hospital staff needs to be in close contact with all types of patients visiting the hospital and the risk of cross-infection is extremely high. Payment and medication pickup is a mandatory part of a patient’s hospital visit, with direct contact between healthcare workers and patients, and long waiting times in the hospital area, which can easily lead to the spread of disease infection. OBJECTIVE: This paper designed the prototype of a contactless smart medicine cabinet based on RFID technology and optimized the patient consultation and medication pickup process to …address these problems. METHODS: We conducted a 50-day field observation of patients for consultation and medication pickup at the First Hospital in H city, Jiangsu Province, China, and randomly timed 1600 sets of data from Surgery (ophthalmology) and Internal patients, then we designed the prototype of a contactless smart medicine cabinet based on RFID technology, optimized the patient consultation and medication pickup process, comparing the traditional and intelligent models using AnyLogic. RESULTS: The results show that this contactless medicine cabinet was able to reduce the time taken by patients in consultation and medicine pickup by 19.24 minutes, increasing the overall efficiency of the consultation by 32.20%. The simulation revealed that this contactless intelligent medication pickup model was able to reduce the time taken by patients in consultation and medicine pickup, increasing the overall efficiency of the consultation, effectively reducing the frequency of contact between healthcare workers and patients, and reducing the risk of disease infection. CONCLUSION: The proposed technical model provides a new idea to solve the problems of long queues, low efficiency and high risk of infection for patients to consult and get medicine during epidemics. Especially within hospitals it has important theoretical and practical implications for epidemic prevention and control as well as future hospital management. Show more

Keywords: COVID-19, RFID, contactless, hospital, intelligent medication pickup

DOI: 10.3233/THC-230027

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2023

Authors: Kamm, Christian P. | Kueng, Roger | Blättler, Remo

Article Type: Research Article

Abstract: BACKGROUND: Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. OBJECTIVE: To develop a new immersive virtual-reality (VR) headset-based dexterity training to improve impaired manual dexterity in persons with MS (pwMS) while being feasible and usable in a home-based setting. METHODS: The training intervention was tailored to the specific group of pwMS by implementing a simple and intuitive application with regard to hardware and software. To be efficacious, the training intervention covers the main functions of the hands and arm …relevant for use in everyday life. RESULTS: Taking clinical, feasibility, usability as well as technical aspects with regard to hardware and software into account, six different training exercises using hand tracking technology were developed on the Meta quest 2 using Unity. CONCLUSION: We report the developmental process of a new immersive virtual VR headset-based dexterity training for pwMS implementing clinical and technical aspects. Good feasibility, usability, and patient satisfaction was already shown in a feasibility study qualifying this training intervention for further efficacy trials. Show more

Keywords: Development, multiple sclerosis, manual dexterity, hand and arm function, virtual reality, immersive, training intervention

DOI: 10.3233/THC-230541

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Lian, Weizhen | Lian, Kaimei | Lin, Teng

Article Type: Research Article

Abstract: BACKGROUND: Early breast cancer diagnosis is of great clinical importance for selecting treatment options, improving prognosis, and enhancing the quality of patients’ survival. OBJECTIVE: We investigated the value of virtual touch tissue imaging average grayscale values (VAGV) helper Breast Imaging Reporting and Data System (BI-RADS) in diagnosing breast malignancy. METHODS: We retrospectively analyzed 141 breast tumors in 134 patients. All breast lesions were diagnosed pathologically by biopsy or surgical excision. All patients first underwent conventional ultrasound (US) followed by virtual touch tissue imaging (VTI). The measurement of the VAGV of the lesion was …performed by Image J software. BI-RADS classification was performed for each lesion according to the US. We performed a two-by-two comparison of the diagnostic values of VAGV, BI-RADS, and BI-RADS+ VAGV. RESULTS: VAGV was lower in malignant tumors than in benign ones (35.82 ± 13.39 versus 73.58 ± 42.69, P < 0.001). The area under the receiver operating characteristic curve (AUC ) value, sensitivity, and specificity of VAGV was 0.834, 84.09%, and 69.07%, respectively. Among BI-RADS, VAGV, and BI-RADS+ VAGV, BI-RADS+ VAGV had the highest AUC (0.926 versus 0.882, P = 0.0066; 0.926 versus 0.834, P = 0.0012). There was perfect agreement between the two radiologists using VAGV (ICC = 0.9796) and substantial agreement using BI-RADS (Kappa = 0.725). CONCLUSION: Our study shows that VAGV can accurately diagnose breast cancer. VAGV effectively improves the diagnostic performance of BI-RADS. Show more

Keywords: Breast lesion, average grayscale value, virtual touch tissue imaging, Breast Imaging Reporting and Data System

DOI: 10.3233/THC-230306

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Yue, Lei | Huo, Hai-Yang | Yang, Wei | Zhang, Ying-Huai

Article Type: Research Article

Abstract: BACKGROUND: Dental implant restoration is an effective therapy for missing teeth and is widely used in clinical practice to provide more treatment options for patients. OBJECTIVE: To explore the application of a positioning annular gingival cutter in minimally invasive stage II implant surgery and to evaluate its clinical effects. METHOD: Stage II implant surgery using a positioning annular gingival cutter was performed on 15 selected patients at 15 implant sites with sufficient keratinized gingival width in the posterior region. The patient underwent crown restoration 2 weeks after surgery and returned for follow-up 3 …months later. The surgical effects were recorded for each patient, including the duration of surgery, postoperative pain and swelling, keratinized gingiva width, probing depth (PD) measurements, and the percentage of bleeding on probing (BOP) before surgery, during crown restoration, and 3 months after crown restoration. The data were subjected to a paired sample t-test using Statistical Product and Service Solutions (SPSS) 25.0. RESULTS: The duration of stage II implant surgery using a positioning annular gingival cutter was 9.23 ± 1.63 min, and the duration of postoperative pain and swelling was 0.73 ± 0.35 and 0.81 ± 0.35 d, respectively. The keratinized gingiva width was 2.93 ± 0.41 mm before surgery and 2.91 ± 0.46 mm after crown restoration, demonstrating no significant reduction (P > 0.05). The keratinized gingiva width remained stable 3 months after crown restoration, with an average of 2.85 ± 0.49 mm, without significant reduction (P > 0.05). No obvious inflammation is observed. PD was 2.60 ± 0.52 mm and BOP was 10%. CONCLUSION: The use of a positioning annular gingival cutter in stage II implant surgery achieves a positive and stable clinical effect within a short time. Show more

Keywords: Circumferential supracrestal fiberotomy, keratinized gingiva, stage II implant surgery

DOI: 10.3233/THC-230262

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2023

Authors: Nie, Xiaojuan | Wang, Dandan | Pan, Ye | Lü, Peng | Yang, Yanhua

Article Type: Review Article

Abstract: BACKGROUND: The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system is an acquired immune system of bacteria and archaea. Continued research has resulted in the identification of other Cas13 proteins. OBJECTIVE: This review briefly describes the discovery, classification, and application of the CRISPR-Cas13 system, including recent technological advances in addition to factors affecting system performance. METHODS: Cas13-based molecular therapy of human, animal, and plant transcriptomes was discussed, including regulation of gene expression to combat pathogenic RNA viruses. In addition, the latest progress, potential shortcomings, and challenges of the CRISPR-Cas system for treatment of …animal and plant diseases are reviewed. RESULTS: The CRISPR-Cas system VI is characterized by two RNA-guided higher eukaryotes and prokaryotes nucleotide-binding domains. CRISPR RNA can cleave specific RNA through the interaction between the stem-loop rich chain of uracil residues and the Cas13a protein. The CRISPR-Cas13 system has been applied for gene editing in animal and plant cells, in addition to biological detection via accurate targeting of single-stranded RNA. CONCLUSION: The CRISPR-Cas13 system offers a high-throughput and convenient technology for detection of viruses and potentially the development of anti-cancer drugs in the near future. Show more

Keywords: ???

DOI: 10.3233/THC-230258

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2023

Authors: Zhao, Li | Xu, Wen-Kui | Wang, Ying | Lu, Wei-Yan | Wu, Yong | Hu, Rong

Article Type: Research Article

Abstract: BACKGROUND: The evolution of critical care medicine and nursing has aided and enabled the rescue of a large number of patients from numerous life-threatening diseases. However, in many cases, patient health may not be quickly restored, and the long-term prognosis may not be optimistic. OBJECTIVES: In this study, we aimed to develop and validate a prediction model for accurate, precise, and objective identification of the severity of chronic critical illness (CCI) in patients. METHODS: We used a retrospective case-control and prospective cohort study with no interventions. Patients diagnosed with CCI admitted to the …ICU of a large metropolitan public hospital were selected. In the case-control study, 344 patients (case: 172; control:172) were enrolled to develop the prognosis prediction model of chronic critical illness (PPCCI Model); 88 patients (case:44; control: 44) in a prospective cohort study, served as the validation cohort. The discrimination of the model was measured using the area under the curve (AUC) of the receiver operating characteristic curve (ROC). RESULTS: Age, prolonged mechanical ventilation (PMV), sepsis or other severe infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding were the nine predictors included in the model. In both cohorts, the PPCCI model outperformed the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA) in identifying deceased patients with CCI (development cohort: AUC, 0.934; 95%CI, 0.908–0.960; validation cohort: AUC, 0.965; 95% CI, 0.931–0.999). CONCLUSION: The PPCCI model can provide ICU medical staff with a standardized measurement tool for assessing the condition of patients with CCI, enabling them to allocate ward monitoring resources rationally and communicate with family members. Show more

Keywords: Chronic critical illness, critical care, model, prediction, prognosis, score

DOI: 10.3233/THC-230359

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Kayama, Mizue | Takashi, Takai | Futagami, Takao | Terasawa, Koji

Article Type: Research Article

Abstract: BACKGROUND: The actual changes in biological and physiological parameters during walking are little understood in multiple aspects. OBJECTIVE: The objective of this paper was to examine and link the disparate measures of motor, vision, and brain activity for elderly and young adults. METHOD: The participants were 15 elderly adults and 10 young adults. Accelerometry, eye tracking, and prefrontal cortex (PFC) activity in the functional near-infrared spectroscopy (fNIRS) were used to evaluate the participants in a 10-m walking test. RESULT: The results for the elderly adults were 1) low variabilities of …velocity and acceleration along the front-back and up-down axes, 2) a wider gaze range on the right-left axis than the young adults, 3) a high mean PFC activity, and 4) a larger number of high-relation pairs than the young adults for the correlation coefficients of both gait vs. gaze and gait vs. PFC activity. The variabilities of velocity and acceleration, gaze and PFC activity changes for the young adults were selective. CONCLUSION: Measuring 10-m walking in a polymetric approach may capture some indicators related to physical and cognitive difficulties such as frailty and dementia. Show more

Keywords: 10-m walking, gait, gaze, PFC activity, polymetric approach, elderly adults

DOI: 10.3233/THC-220447

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Zhang, Xuelan | Peng, Yuan | Li, Gaoyang | Li, Jiehua | Luo, Mingyao | Che, Yue | Zheng, Liancun | Anzai, Hitomi | Ohta, Makoto | Shu, Chang

Article Type: Research Article

Abstract: BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening aortic disease. However, little information is available on predicting and understanding of ATBAD. OBJECTIVE: The study sought to explore the underlying mechanism of ATBAD by analyzing the morphological and hemodynamic characteristics related to aortic length. METHODS: The length and tortuosity of the segment and the whole aorta in the ATBAD group (n = 163) and control group (n = 120) were measured. A fixed anatomic landmark from the distal of left subclavian artery …(LSA) to the superior border of sixth thoracic vertebra was proposed as the proximal descending thoracic aorta (PDTA), and the dimensionless parameter, length ratio, was introduced to eliminate the individual differences. The significant morphological parameters were filtrated and the associations between parameters were investigated using statistical approaches. Furthermore, how aortic morphology influenced ATBAD was explored based on idealized aortic models and hemodynamic-related metrics. RESULTS: The PDTA length was significantly increased in the ATBAD group compared with the control group and had a strong positive correlation with the whole aortic length (r = 0.89). The length ratio (LR 2 ) and tortuosity (T 2 ) of PDTA in the ATBAD group were significantly increased (0.15 ± 0.02 vs 0.12 ± 0.02 and 1.73 ± 0.48 vs 1.50 ± 0.36; P < 0.001), and LR 2 was positive correlation with T 2 (r = 0.73). In receiver-operating curve analysis, the area under the curve was 0.835 for LR 2 and 0.641 for T 2 . Low and oscillatory shear (LOS) was positive correlation with LR 2 , and the elevated LOS occurred in the distal of LSA. CONCLUSION: Elongation of PDTA is associated with ATBAD, and the length ratio is a novel predictor. Elongated PDTA induced more aggressive hemodynamic forces, and high LOS regions may correspond to the entry tear location. The synergy of the morphological variation and aggressive hemodynamics creates contributory conditions for ATBAD. Show more

Keywords: Aortic dissection, aortic elongation, length ratio, hemodynamics, low and oscillatory shear

DOI: 10.3233/THC-230194

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Wu, Qingqing | Li, Xihong | Li, Li | Yan, Ouyang | He, Qingwen

Article Type: Research Article

Abstract: BACKGROUND: Numerous studies have focused on reducing patient absences and effectively scheduling exams. However, very few studies have analyzed the factors influencing examination time and predicted examination time. OBJECTIVES: To investigate the factors affecting ultrasound examination visit length and provide a reference for interventions to optimize ultrasound appointments. METHODS: This cross-sectional study was conducted at a fertility clinic in China. Ultrasound examination time and clinical characteristics were obtained from the electronic records. Univariate and multivariate analyses used 33,432 patients who attended our clinic center between August 1 and October 30, 2018. A quantile …regression model was constructed to examine associations between ultrasound examination time and statistically significant variables in the univariate analysis. RESULTS: Of the 33,432 patients included in this study, 29,085 (87%) were female and 4,347 (13%) were male. Their mean examination time was 6 ± 3 minutes. The doctor’s title and gender, equipment, and patient’s age, examination site, gender, and origin were all statistically significant. Physical examination and outpatient clinic patients had shorter examination times than inpatients. Female physicians had longer examination times than male physicians. Examination time was positively correlated with thyroid, breast, liver, gallbladder, spleen, pancreas, kidney, heart, vascular, adrenal, gynecological, early pregnancy, nuchal translucency, prostate, scrotum, and mid-to-late pregnancy fetal sites. Moreover, NT and mid-to-late pregnancy fetal sites showed a clear and continuous positive trend with increasing examination time. CONCLUSION: The length of the ultrasound examination was correlated with the examination site, physician title, physician gender, patient age, patient gender, patient origin, and instrumentation. The reliability of inspection time predicted by variables such as the physicians’ title, sex, sites examined, and the number of sites examined was higher when they were longer. Show more

Keywords: Assisted reproduction for pregnancy, ultrasound, examination time

DOI: 10.3233/THC-230406

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023

Authors: Ochiai, Ryoichi | Terada, Takashi | Sakamoto, Noriaki

Article Type: Research Article

Abstract: BACKGROUND: Several monitors have been developed that measure stroke volume (SV) in a beat-to-beat manner. Accordingly, Stroke volume variation (SVV) induced by positive pressure ventilation is widely used to predict fluid responsiveness. OBJECTIVE: The purpose of this study was to compare the ability of two different methods to predict fluid responsiveness using SVV, stroke volume variation by esCCO (esSVV) and stroke volume variation by FloTrac/Vigileo TM (flSVV). METHODS: esSVV, flSVV, and stroke volume index (SVI) by both monitoring devices of 37 adult patients who underwent laparotomy surgery, were measured. …Receiver operating characteristic (ROC) analysis was performed. RESULTS: The area under the ROC curve (AUC) of esSVV was significantly higher than that of flSVV (p = 0.030). esSVV and flSVV showed cutoff values of 6.1% and 10% respectively, to predict an increase of more than 10% in SVI after fluid challenge. The Youden index for esSVV was higher than flSVV, even with a cutoff value between 6% and 8%. CONCLUSION: Since esSVV and flSVV showed significant differences in AUC and cutoff values, the two systems were not comparable in predicting fluid responsiveness. Furthermore, it seems that SVV needs to be personalized to accurately predict fluid responsiveness for each patient. Show more

Keywords: Estimated continuous cardiac output, stroke volume variation, stroke volume index, pulse wave transit time, pressure wave analysis

DOI: 10.3233/THC-220849

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Li, Wenzhe | Xu, Li | Wang, Yajing | Li, Wenjun | Maimaiti, Meiligu | Kou, Bin | Liu, Chenchen | Zhang, Meng | Xia, Hongjuan | Yuan, Fang

Article Type: Research Article

Abstract: BACKGROUND: Without timely and effective interventions or treatments, radiation-induced liver damage (RILD) can lead to serious consequences for the patients and their families. OBJECTIVE: To investigate the protective effect of intermittent hypobaric hypoxia preconditioning (IHHP) in RILD. METHODS: Male adult SD rats were randomly divided into 8 groups including one control group, one only irradiation group and other experimental groups. Blood routine tests and liver function tests were all assessed with abdominal venous blood. Moreover, hematoxylin eosin (HE) staining and immunohistochemistry assay were used to detect the histopathological changes and expressions of transforming …growth factor-β 1 (TGF-β 1), tumor necrosis factor α (TNF-α ) and hypoxia-inducible factor 1α (HIF-1α ) in radiated liver sections. RESULTS: Blood routing tests showed that RBC, WBC and Hb were all significantly increased while the differences of these results between different groups with same simulated altitude were approximate. However, liver function in the IHHP plus irradiation at 4000 m group was significantly decreased (P < 0.05) compared to only irradiation groups, and the manifestation of HE and lower positive expression of TNF-α showed improved histopathological changes in the liver section. Furthermore, no significant difference of HIF-1α expression between any two groups treated with IHHP was observed. CONCLUSION: IHHP at the altitude of 4000 m group could alleviate the radioactive liver damage by downregulating TNF-α and less strong positive expression of TGF-β 1. Furthermore, patients exposed to radiation might benefit from this treatment to prevent or reduce the RILD. Show more

Keywords: Liver injury, irradiation, radiation induced liver damage (RILD), hypoxia inducible factor-1α (HIF-1α), intermittent hypobaric hypoxia preconditioning (IHHP), oxidative stress

DOI: 10.3233/THC-220718

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Lan, Fang-Fang | Zhao, Wu-Xiao | Gan, Lu

Article Type: Research Article

Abstract: BACKGROUND: Amblyopia is a neurological deficit in binocular vision that affects 3% of the population and is the result of disruptions in early visual development. OBJECTIVE: In this study, we used a visual perceptual learning system for the short-term treatment of children with ametropic amblyopia and evaluated the clinical efficacy of this system in terms of visual plasticity. METHODS: We conducted a retrospective analysis of the clinical data of 114 children (228 eyes) with refractive amblyopia, who were aged 6.51 ± 1.51 years. Prior to the treatment, we evaluated all …children with amblyopia using the visual information processing test. We determined the type of amblyopic defect according to the type of amblyopia, corrected visual acuity, and advanced visual function test results. Based on the type of defect, each child with amblyopia was given short-term visual perception training for 10 days. Finally, we compared the results of visual acuity and visual information processing tests before and after the treatment. RESULTS: The best-corrected visual acuity of patients was better after 10 days of visual training than that before training (P < 0.05). The perceptual eye position after training improved with statistically significant differences in horizontal and vertical perceptual eye position (both P < 0.05) compared to that before training. The number of amblyopic children without suppression in both eyes was 81 cases (71.1%) after training which was higher than that (65 cases, or 57.0%) before training, with a statistically significant difference (P < 0.05). Binocular fine stereopsis and dynamic stereopsis improved after training with a statistically significant difference (both P < 0.05). CONCLUSION: In this study, it was found that patients with amblyopia showed visual plasticity. Moreover, continuous visual perceptual learning improved the best-corrected visual acuity and recovered stereopsis in children with refractive amblyopia. Show more

Keywords: Refractive amblyopia, stereopsis, visual perceptual learning, visual plasticity

DOI: 10.3233/THC-230183

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2023

Authors: Narula, Gagan | Boss, Jens | Seric, Marko | Baumann, Daniel | Salles, Joan P. | Fröhlich, Jürg | Baumann, Dirk | Keller, Emanuela | Willms, Jan

Article Type: Research Article

Abstract: BACKGROUND: Intracranial pressure (ICP) is a vital parameter that is continuously monitored in patients with severe brain injury and imminent intracranial hypertension. OBJECTIVE: To estimate intracranial pressure without intracranial probes based on transcutaneous near infrared spectroscopy (NIRS). METHODS: We developed machine learning based approaches for noninvasive intracranial pressure (ICP) estimation using signals from transcutaneous near infrared spectroscopy (NIRS) as well as other cardiovascular and artificial ventilation parameters. RESULTS: In a patient cohort of 25 patients, with 22 used for model development and 3 for model testing, the best performing models …were Fourier transform based Transformer ICP waveform estimation which produced a mean absolute error of 4.68 mm Hg (SD = 5.4) in estimation. CONCLUSION: We did not find a significant improvement in ICP estimation accuracy by including signals measured by transcutaneous NIRS. We expect that with higher quality and greater volume of data, noninvasive estimation of ICP will improve. Show more

Keywords: Brain injuries, intracranial pressure, machine learning, spectrum analysis

DOI: 10.3233/THC-230329

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Shukla, Anuj K. | Chaturvedi, Saurabh | Ahmed, Abdul Razzaq | Abouzeid, Hoda Lofty | Suleman, Gazala | Sharif, Rania A. | Gurumurthy, Vishwanath | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Phonetics with mechanics and aesthetics are considered cardinal factors contributing to the success of complete dentures. OBJECTIVE: The aim of the current study was to evaluate the changes in speech in complete denture patients with and without palatal surface changes. METHODS: The data collected for the study involved completely edentulous Patients (n = 80). Patients were divided into two groups. Group A: Up to 50 years (n = 40); Group B: Above 50 years (n = 40) …(including male and female). Each group was further divided into four subgroups for speech analysis-without dentures (A1/B1); with conventional dentures (A2/B2); dentures with a palatogram (A3/B3) and dentures with palate sandblasted (A4/B4). The speech sounds of all patients were evaluated for pitch and intensity using a spectrophotogram (Praat software) and Likert scale. The data so obtained from the quantitative and qualitative analysis were statistically analysed through one-way ANOVA, unpaired student’s t -test, and Pearson correlation coefficient. Qualitative analysis was done with the Mann-Whitney U test. RESULTS: The maximum mean value of the pitch and intensity in Groups A and B was subgroup A3 (Palatogram) 190.37 ± 21.50 and 77.07 ± 7.58, B3 (Palatogram) 190.87 ± 24.36 and 75.33 ± 8.12. When comparing Groups A [A1, A2, A3, A4] and B [B1, B2, B3, B4] on the basis of pitch and intensity, a statistically insignificant value was found. No changes in speech sounds (pitch and intensity) were observed in terms of age. Both quantitative and qualitative analysis results showed that speech sounds in the patients with palatogram, had the highest pitch and intensity and were most clear to the listener and there were statistically significant differences from other groups. CONCLUSION: Speech was better in palatogram-based dentures in comparison to a sandblasted denture, conventional denture and without denture in terms of qualitative and quantitative analysis. The physiologic nature of the palatogram fabrication technique produces the palatal part of the denture more compatible with the tongue, thus producing better speech. Show more

Keywords: Palatal surface, speech, edentulous, prosthodontics, dentistry

DOI: 10.3233/THC-230477

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Dong, Haonan | He, Zexi | Wang, Haifeng | Ding, Mingxia | Huang, Yinglong | Li, Haihao | Shi, Hongjin | Mao, Lan | Hu, Chongzhi | Wang, Jiansong

Article Type: Research Article

Abstract: BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common pathological type of renal cell carcinoma (RCC), and effective biomarkers will improve diagnosis and treatment. OBJECTIVE: This study investigated NPEPL1 expression in ccRCC through public databases and clinical samples and assessed its correlation with clinicopathological features and patient prognosis. METHOD: Data from The Cancer Genome Atlas and clinical specimens were gathered, NPEPL1 expression levels were analyzed; a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NPEPL1; and clinicopathological data was used to study the correlations between expression …and clinical parameters. NPEPL1’s prognostic value was appraised using a Kaplan–Meier (K–M) survival curve, Cox regression analysis, and a nomogram model; Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of differently expressed genes between tissues with high and low NPEPL1 expression were used to estimate the underlying mechanisms involved. RESULTS: NPEPL1 was significantly higher-expressed in ccRCC tissue. ROC analysis showed that NPEPL1 had noteworthy diagnostic efficacy. NPEPL1 expression was closely related to clinicopathological parameters, such as T and M stage. K–M analysis showed that overall survival was significantly shortened with high NPEPL1 expression. Cox regression analysis showed that NPEPL1 expression was an independent risk factor predicting overall survival. The nomogram showed a significantly high clinical value in predicting the 1-, 3-, and 5-year survival probabilities in ccRCC. GO and KEGG enrichment analysis suggested that NPEPL1 may promote the occurrence and development of ccRCC via the Ras signaling and other pathways. CONCLUSION: NPEPL1 expression in ccRCC was higher than that in normal kidney tissues and was significantly associated with advanced clinical stage and poor prognosis. Therefore, NPEPL1 is a promising prognostic biomarker. Show more

Keywords: Renal clear cell carcinoma, NPEPL1, Clinicopathology, prognosis

DOI: 10.3233/THC-230282

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2023

Authors: Mur, Linda | Annon-Eberharter, Natalee | Gombos, Petra | Wald, Martin

Article Type: Research Article

Abstract: BACKGROUND: Dead space is the part of the airway where no gas exchange takes place. Any increase in dead space volume has a proportional effect on the required tidal volume and thus on the risk of ventilation-induced lung injury. Inserts that increase dead space are therefore not used in small preterm infants. This includes end-tidal CO 2 measurement. OBJECTIVE: The aim of this study was to investigate the effect of the end-tidal CO 2 measurement adapter on ventilation. METHODS: In an experimental setup, an end-tidal …CO 2 measurement adapter, three different pneumotachographs (PNT-A, PNT-B, PNT-Neo), and a closed suction adapter were combined in varying set-ups. The time required for CO 2 elimination by a CO 2 -flooded preterm infant test lung was measured. RESULTS: PNT-A prolonged CO 2 elimination time by 0.9 s (+ 3.3%), Neo-PNT by 3.2 s (+ 11.6%) and PNT-B by 9.0 s (+ 32.7%). The end-tidal CO 2 measurement adapter prolonged the elimination time by an additional second without the pneumotachograph (+ 3.6%) and in combination with PNT-A (+ 3.1%) and PNT-Neo (+ 3.1%). In conjunction with PNT-B, the end-tidal CO 2 measurement adapter reduced the elimination time by 0.3 seconds (- 1%). The use of a closed suction adaptor increased the CO 2 elimination time by a further second with PNT-Neo (+ 3.1%) and by an additional two seconds with no flow sensor (+ 6.9%), with PNT-A (+ 6.4%) and with PNT-B (+ 5.5%). CONCLUSION: The flow sensor had the greatest influence on ventilatory effort, while end-tidal CO 2 measurement had only a moderate effect. The increased ventilatory effort levied by the CO 2 measurement was dependent on the flow sensor selected. The use of closed suctioning more negatively impacted ventilatory effort than did end-tidal CO 2 measurement. Show more

Keywords: Neonatal intensive care units, tidal volume, extremely premature infant, ventilator-induced lung injury, mechanical ventilators

DOI: 10.3233/THC-230195

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2023

Authors: Elrashid, Afra Hassan | Alsarh, Sarah Ahmad | Alotaibi, Dalia Saleh | Albaqami, Majed Adi | Algadhi, Saleh Khalid | Alfaraj, Reham Ahmad | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Bleaching is a highly common method used nowadays to treat tooth discolouration because it is a significant cosmetic issue, particularly with anterior teeth, however bleaching itself results in microleakage. OBJECTIVE: This study aims to evaluate the impact of in-office bleaching on class V restoration microleakage with type 1 and type 2 composite restorations. METHODS: Three hundred and twenty healthy, caries-free removed human anterior teeth were used in this in-vitro study. All extracted teeth had their buccal and lingual surfaces uniformly prepped for class V cavities. The 120 removed teeth were divided …into two groups, with Group 1 receiving Tetric N-Ceram nanohybrid composite restorations and Group 2 receiving 3 M Filtek Z350 XT nanohybrid composite restorations. Groups 1 and 2 were further broken into four more subgroups of four each. The restorations were sealed with a G-Coat Plus resin. The p -value was kept at 0.005 for the data analysis using the Chi-square and Fisher exact tests. RESULTS: Allocating microleakage among 320 study models revealed that 141 (44.1%) study samples had no microleakage, whereas 20 (6.3%), 54 (16.9%), and 105 (32.8%) study samples had microleakage up to, between, and greater than two-thirds of cavity depth. With a statistically significant p -value of 0.001, no microleakage was discovered in 85 (53.1%) lingual surfaces with Tetric N-Ceram nanohybrid composite restoration and 56 (35%) buccal surfaces with 3M Filtek Z350 XT nanohybrid composite restoration. 19.1% of samples of N-Ceram that were sealed and not bleached had no microleakage, according to analysis of microleakage across several groups. With a p -value of 0.001, the distribution of microleakage among various clusters was statistically notable. CONCLUSION: According to the findings of the study, hydrogen peroxide bleaching has an enhanced impact on micro escape during dye dispersion. Both with and without bleaching, resin coating can be utilised to minimise marginal microleakage. Show more

Keywords: Microleakage, resins, bleaching, composite restorations

DOI: 10.3233/THC-230213

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Hu, Xiaomin | Lu, Jiachun | Wang, Yunyun | Pang, Rizhao | Liu, Jiancheng | Gou, Xiang | Bai, Xingang | Zhang, Anren | Cheng, Hong | Wang, Qian | Chang, Youjun | Yin, Jie | Chang, Cong | Xiao, Hua | Wang, Wenchun

Article Type: Research Article

Abstract: BACKGROUND: In recent years, lower limb walking exoskeletons have been widely used in the study of spinal cord injury (SCI). OBJECTIVE: To explore the effect of a lower limb walking exoskeleton on quality of life and functional independence in patients with motor complete SCI. METHODS: This was a multi-center, single blind, randomized controlled trial. A total of 16 SCI patients were randomly assigned to either the exoskeleton-assisted walking (EAW) group (n = 8) or the conventional group (n = 8). Both groups received conventional rehabilitation training, …including aerobic exercise and strength training. The EAW group additionally conducted the exoskeleton-assisted walking training using an AIDER powered robotic exoskeleton for 40–50 minutes, 5 times/week for 8 weeks. World Health Organization quality of life-BREF (WHOQOL-BREF) and the Spinal Cord Independence Measure III (SCIM-III) were used for assessment before and after training. RESULTS: There was an increasing tendency of scores in the psychological health, physical health, and social relationships domain of WHOQOL-BREF in the EAW group after the intervention compared with the pre-intervention period, but there was no significant difference (P > 0.05). SCIM-III scores increased in both groups compared to pre-training, with only the conventional group showing a significant difference after 8 weeks of training (P < 0.05). CONCLUSION: A lower limb walking exoskeleton may have potential benefits for quality of life and activities of daily living in patients with motor complete SCI. Show more

Keywords: Exoskeleton, spinal cord injury, quality of life, activities of daily living

DOI: 10.3233/THC-220871

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Ju, Jieqin | Mao, Liqing | Wang, Yuejing | Xie, Haofen | Zhou, Shengjun

Article Type: Research Article

Abstract: BACKGROUND: Femoral artery puncture is still the most used surgical approach. Because the operation requires local anaesthesia, the patient may not be able to exert full self-control, and their upper and lower limbs and trunk need to be constrained by a protection device. OBJECTIVE: To explore the safe application effect of a new type of anti-movement protection device for upper and lower extremities, shoulders and chest in patients undergoing interventional therapy via the femoral artery approach. METHODS: This is a prospective randomised controlled study. A total of 230 patients were randomly divided into …two groups: the study group (n = 115) and the control group (n = 115). The time needed to implement the restraint operation and the loosening of the restraint device in the two groups was recorded, and the satisfaction of surgeons and nurses was investigated. RESULTS: The time needed to perform restraint operation in the study group was significantly less than that in the control group (4.06 ± 0.61 min vs. 7.01 ± 0.76 min, P < 0.05). The satisfaction of surgeons and nurses with the use of the new protective device was significantly better than that of the conventional restraint band (P < 0.05). CONCLUSION: The new anti-movement protection device for upper and lower limbs, shoulders and chest can conveniently and quickly achieve effective protection and braking of patients, ensure the safety of surgery and improve satisfaction. Show more

Keywords: Nursing safety, protective device, patient care, physical restraints, transfemoral intervention

DOI: 10.3233/THC-230254

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Li, Miao-Miao | Pan, Jian-Xia | Wang, Jin-Hang | Hu, Zi-Lei | Zhao, Jing | Wei, Hai-Cheng

Article Type: Research Article

Abstract: BACKGROUND: Diabetes is a chronic disease that can lead to a variety of complications and even cause death. The signal characteristics of the photoplethysmography signals (PPG) and electrocardiogram signals (ECG) can reflect the autonomic and vascular aspects of the effects of diabetes on the body. OBJECTIVE: Based on the complex mechanism of interaction between PPG and ECG, a set of ensemble empirical mode decomposition-independent component analysis (EEMD-ICA) fusion multi-scale percussion entropy index (MSPEI) method was proposed to analyze cardiovascular function in diabetic patients. METHODS: Firstly, the original signal was decomposed into multiple Intrinsic …Mode Function (IMFs) by ensemble empirical mode decomposition EEMD, principal components of IMF were extracted by independent component analysis (ICA), then the extracted principal components were reconstructed to eliminate the complex high and low frequency noise of physiological signals. In addition, the MSPEI was calculated for the ECG R-R interval and PPG amplitude sequence.(RRI and Amp) The results showed that, compared with EEMD method, the SNR of EEMD-ICA method increases from 2.1551 to 11.3642, and the root mean square error (RMSE) decreases from 0.0556 to 0.0067. This algorithm can improve the performance of denoising and retain more feature information. The large and small scale entropy of MSPEI (RRI,Amp) was significantly different between healthy and diabetic patients (p < 0.01). RESULTS: Compared with arteriosclerosis index (AI) and multi-scale cross-approximate entropy (MCAE): MSPEI 𝑆𝑆 (RRI,Amp) indicated that diabetes can affect the activity of human autonomic nervous system, while MSPEI 𝐿𝑆 (RRI,Amp) indicated that diabetes can cause or worsen arteriosclerosis. CONCLUSION: Multi-scale Percussion Entropy algorithm has more advantages in analyzing the influence of diabetes on human cardiovascular and autonomic nervous function. Show more

Keywords: Diabetes, electrocardiogram, photoplethysmography, empirical mode decomposition-independent component analysis, multi-scale percussion entropy

DOI: 10.3233/THC-230243

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Yabusaki, Yumie | Asai, Kenji | Hisakado, Hiroshi | Takano, Noriyuki

Article Type: Research Article

Abstract: BACKGROUND: Short stems are advantageous for revision as they preserve autogenous bone. At present, the method of short-stem installation is determined based on the surgeon’s experience. OBJECTIVE: To provide the guideline for installing a short stem, we aimed to investigate the alignment effect on the initial fixation of the stem, stress transfer, and the risk of failure numerically. METHODS: Models in which the caput-collum-diaphyseal (CCD) angle and flexion angle were hypothetically changed based on the two clinical cases of hip osteoarthritis were analyzed using the non-linear finite element method. RESULTS: …The medial settlement of the stem increased in the varus model and decreased in the valgus model. With varus alignment, the stresses acting on the femur were high in the distal to the femoral neck. In contrast, the stresses in the proximal to the femoral neck tend to be higher with valgus alignment, although the difference in the femur stress between varus and valgus alignment was slight. CONCLUSION: Both initial fixation and stress transmission are lower when the device was placed in the valgus model than in the actual surgical case. In order to obtain initial fixation and suppress stress shielding, it is essential to extend the contact area between the medial portion of the stem and the femur along the bone axis, and to ensure adequate contact between the lateral portion of the stem tip and the femur. Show more

Keywords: Hip joint, arthroplasty, finite element analysis, hip prosthesis, initial fixation, stress shielding

DOI: 10.3233/THC-220591

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023

Authors: Bai, He | Wang, Rui | Dai, Yu | Xue, Yuan

Article Type: Research Article

Abstract: BACKGROUND: Milling operations of laminae in spinal surgery generate high temperatures, which can lead to thermal injury and osteonecrosis and affect the biomechanical effects of implants, ultimately leading to surgical failure. OBJECTIVE: In this paper, a backpropagation artificial neural network (Bp-ANN) temperature prediction model was developed based on full factorial experimental data of laminae milling to optimize the milling motion parameters and to improve the safety of robot-assisted spine surgery. METHODS: A full factorial experiment design were used to analyze the parameters affecting the milling temperature of laminae. The experimental matrixes were established …by collecting the corresponding cutter temperature T c and bone surface temperature T b for the milling depth, feed speed and different bone densities. The Bp-ANN lamina milling temperature prediction model was constructed from experiment data. RESULTS: Increasing milling depth increases bone surface and cutter temperature. Increasing feed speed had little effect on cutter temperature, but decreased bone surface temperature. Increasing bone density of laminae increased cutter temperature. The Bp-ANN temperature prediction model had best training results in the 10th epoch, and there is no overfitting (training set R = 0.99661, validation set R = 0.85003, testing set R = 0.90421, all temperature data set R = 0.93807). The goodness of fit R of Bp-ANN was close to 1, indicating that the predicted temperature was in good agreement with the experiment measurements. CONCLUSION: This study can help spinal surgery-assisted robot to select appropriate motion parameters at different density bones to improve lamina milling safety. Show more

Keywords: Lamina milling parameter, thermal damage, full factorial experiment, artificial neural network

DOI: 10.3233/THC-220812

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023

Authors: Bao, Lingyun | Du, Kun | Gao, Jin | Jiang, Rongrong | Li, Bin | Liu, Tingting

Article Type: Research Article

Abstract: BACKGROUND: Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year. OBJECTIVE: The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies. METHODS: A total of 202 preterm infants with a gestational age of 26 weeks …to 36 + 6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed. RESULTS: There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy. CONCLUSION: A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants. Show more

Keywords: Preterm infant, fungal infection, high-risk factors

DOI: 10.3233/THC-230218

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Yang, Ying | Qian, Qiu-Yang | Yang, Xiao-Yan | Li, De-Sheng | Chen, De-Sheng | Mei, Shen

Article Type: Research Article

Abstract: BACKGROUND: Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE: In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS: We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n = 10) and healthy control group …(n = 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS: We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P < 0.001; control group: P < 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P < 0.01, using independent t -test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P < 0.01, using independent t -test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P < 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION: SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function. Show more

Keywords: Cycling training, exercise, ischemic stroke inpatients, non-invasive cardiac output, poststroke cardiac dysfunction

DOI: 10.3233/THC-220823

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Evron, Ilanit | Schwartz, Oren | Sajina, Anna | Grosman-Rimon, Liza | Dudkiewicz, Israel

Article Type: Research Article

Abstract: BACKGROUND: The Selfit system was developed to improve the mobility and gait-related functions of stroke patients by providing digital exercises and augmented reality training system. OBJECTIVE: To evaluate the effects of a digital exercise and augmented reality training system on mobility, gait-related functions and self-efficacy outcomes in stroke patients. METHODS: A randomized control trial was conducted on 25 men and women diagnosed with an early sub-acute stroke. Patients were randomly assigned to either the intervention (N = 11) or the control groups (N = …14). Patients in the intervention group received a digital exercise and augmented reality training using the Selfit system in addition to the standard physical therapy treatment. Patients in the control group were treated with a conventional physical therapy program. Timed Up and Go (TUG) test, 10-meter walk test, the Dynamic Gait Index (DGI), and the Activity-specific Balance Confidence (ABC) scale were completed before and after the intervention. Feasibility and satisfaction among patients and therapists were also assessed after the completion of the study. RESULTS: The intervention group practiced proportionally more time per session than the control group with a mean change of 19.7% following 6 sessions (p = 0.002). The intervention group showed better improvement in post-TUG score compared to the control group (p = 0.04). ABC, DGI, and the 10-meter walk test scores were not significantly different between the groups. Both therapists and participants demonstrated high satisfaction with the Selfit system. CONCLUSION: The findings suggest that Selfit holds promise as an effective intervention for improving mobility and gait-related functions among patients with an early sub-acute stroke as compared to conventional physical therapy treatments. Show more

Keywords: Stroke, gait, mobility, digital exercise, augmented reality

DOI: 10.3233/THC-220521

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Han, Xueyan | Dong, Litong | Zhang, Wenxiao | Liang, Chun | Wang, Zuobin

Article Type: Research Article

Abstract: BACKGROUND: Cells adherence provides specific information about physiology and pathology, the adhesion measurement between living cells and nanostructures can be measured by atomic force microscopy, but this detection technique is difficult to operate and costly. The adhesion height and effective contact area between cells and substrates are also the key factors affecting measurement value of the overall impedance. These factors change with structural parameters of the substrates, so the adhesion measurement between living cells and substrate can be indirectly reflected by the impedance value. OBJECTIVE: To establish a mapping relationship between the impedance measurement and the …adhesion measurement of living cells. The possibility of dynamic measurement of adhesion is realized by this method, and the experimental process is simplified. METHODS: Laser interference technology was used to prepare nanoarray structures with different periods on the surface of silicon wafers for cells culture. Under the same experimental conditions, the impedance of living cells on the substrates of different cycle sizes were measured. The adhesion between cells and different substrates were analyzed by measuring impedance after the interaction between cells and substrate. RESULTS: The adhesion of living cells on the substrates of different sizes be analyzed, and the mapping relationship between the impedance and the adhesion measurement was established. The results showed that, the larger the impedance value between cells and substrate, the larger the effective contact area and the smaller the gap between them. CONCLUSION: The difference of adhesion height and effective adhesion area between living cells and substrates were obtained. This paper, a new method to measure the adhesion properties of living cells is presented, which provides theoretical basis for the related research. Show more

Keywords: Living cells, nanostructure, impedance, adhesion, effective adhesion areas

DOI: 10.3233/THC-220584

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Yuan, Gaoteng | Zhai, Yi | Tang, Jiansong | Zhou, Xiaofeng

Article Type: Research Article

Abstract: BACKGROUND: Hepatitis B Virus (HBV) reactivation is the most common complication for patients with primary liver cancer (PLC) after radiotherapy. How to reduce the reactivation of HBV has been a hot topic in the study of postoperative radiotherapy for liver cancer. OBJECTIVE: To find out the inducement of HBV reactivation, a feature selection algorithm (MIC-CS) using maximum information coefficient (MIC) combined with cosine similarity (CS) was proposed to screen the risk factors that may affect HBV reactivation. METHOD: Firstly, different factors were coded and MIC between patients was calculated to acquire the association …between different factors and HBV reactivation. Secondly, a cosine similarity algorithm was constructed to calculate the similarity relationship between different factors, thus removing redundant information. Finally, combined with the weight of the two, the potential risk factors were sorted and the key factors leading to HBV reactivation were selected. RESULTS: The results indicated that HBV baseline, external boundary, TNM, KPS score, VD, AFP, and Child-Pugh could lead to HBV reactivation after radiotherapy. The classification model was constructed for the above factors, with the highest classification accuracy of 84% and the AUC value of 0.71. CONCLUSION: Comparing multiple feature selection methods, the results showed that the effect of the MIC-CS was significantly better than MIM, CMIM, and mRMR, so it has a very broad application prospect. Show more

Keywords: HBV, MIC, cosine similarity, feature selection, classification

DOI: 10.3233/THC-230161

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2023

Authors: Petrović, Nikola | Mandić, Sanja | Borojević, Svetlana | Gazivoda, Nemanja | Sovilj, Platon

Article Type: Research Article

Abstract: BACKGROUND: Cognitive neuroscience experiments require accurate and traceable methods of measuring cognitive phenomena, analyzing and processing data, and validating results, including measurement of impact of such phenomena on brain activity and consciousness. EEG measurement is the most widely used tool for evaluation of the experiment’s progress. To extract more information from the EEG signal, continuous innovation is necessary to provide a broader range of information. OBJECTIVE: This paper presents a new tool for measuring and mapping cognitive phenomena using time window-based multispectral brain mapping of electroencephalography (EEG) signals. METHODS: The tool was developed …using Python programming language and enables users to create brain maps images for six spectra (Delta, Theta, Alpha, Beta, Gamma, and Mu) of EEG signal. The system can accept an arbitrary number of EEG channels with standardized labels based on the 10–20 system, and users can select the channels, frequency bandwidth, type of signal processing, and time window length to perform the mapping. RESULTS: The key advantage of this tool is its ability to perform short-time brain mapping, which allows for the exploration and measurement of cognitive phenomena. The tool’s performance was evaluated through testing on real EEG signals, and results demonstrated its effectiveness in accurately mapping cognitive phenomena. CONCLUSION: The developed tool can be used in various applications, including cognitive neuroscience research and clinical studies. Future work involves optimizing the tool’s performance and expanding its capabilities. Show more

Keywords: Biomedical engineering, cognitive neuroscience, electroencephalography, brain mapping, biomedical measurement and instrumentation

DOI: 10.3233/THC-230241

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Chen, Huilian | Dong, Peifang | Zhong, Peng

Article Type: Research Article

Abstract: BACKGROUND: The existing patient clothing is not suitable for patients that have to maintain a prone position for a long time after vitrectomy. OBJECTIVE: To investigate the effect of a new design of patient gowns for prone position patients after vitrectomy. METHOD: This study designed a kind of patient’s gown for prone position patients. A non-randomized, concurrent, controlled study was conducted on 212 patients who met the inclusion criteria for the prone position after vitrectomy in Grade III at a Class A hospital department of ophthalmology in Zhejiang Province from April to August …2020. The experimental group (106 patients in prone position) and the control group (106 patients in common position) were managed by the same group of nurses. The study recorded and compared the comfort degree of patients’ clothing used in the course of operation rehabilitation between the two groups and the satisfaction degree of doctors with nurses to patients’ clothing used in the prone position. RESULTS: The satisfaction degree and comfort degree of patients and the health care providers in the experiment group were significantly higher than those in the control group (p < 0.001). CONCLUSION: The process of making patient gowns for prone position patients is simple, which can improve the safety and comfort of patients when they were in the prone position. The new design also facilitated the treatment and nursing procedures of the medical staff and improved satisfaction among patients and medical staff. Show more

Keywords: Prone position patient, vitrectomy, gown, satisfaction, comfort

DOI: 10.3233/THC-220455

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Song, Yu-Jie | Xu, Jiang-Qin | Chen, Xi | Hu, Yi-Wei | Xiong, Hao-Deng-Jie | Ou, Su-Jiao | Zhou, Hui-Lin | Sun, Xing-Lan

Article Type: Research Article

Abstract: BACKGROUND: Chronic heart failure (CHF) is the terminal stage of cardiovascular disease. OBJECTIVE: In this study, the “hospital-to-home + online-to-offline” (H2H + O2O) care scheme was implemented for patients with CHF during vulnerable periods, and its effect was evaluated. METHODS: Patients with CHF in the cardiovascular department of a Class III/Grade A hospital in Jiangxi Province from January to December 2020 were selected using a convenience sampling method and randomly divided into a control and intervention group (n = 100 each). The …patients in the control group received routine in-hospital treatment and out-of-hospital follow-up, while in the intervention group, a multi-disciplinary cooperation team with CHF specialist nurses evaluated and stratified the patients before discharge and formulated individualized prescriptions and care plans. Based on the “Health & Happiness” chronic disease follow-up application designed for this study, the specialist nurses provided patients with one-to-one guidance. After three months, the cardiac function, heart failure knowledge, self-care behavior, and re-hospitalization rate of the patients were compared between the two groups. Cardiac function was evaluated by the serum B-type natriuretic peptide (BNP), the left ventricular ejection fraction (LVEF), and a six-minute walking test (6MWT). Heart failure knowledge and self-care behavior was assessed using specific questionaries. RESULTS: The level of cardiac function in the intervention group was significantly higher than that in the control group, and the difference was statistically significant (P < 0.001). The mastery of heart failure knowledge and self-care behavior in the intervention group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05). The re-hospitalization rate due to CHF in the intervention group was 21.0%, which was lower than that in the control group (35.0%), and the difference was statistically significant (P < 0.05). CONCLUSION: The H2H + O2O care scheme can be used for the transition of vulnerable patients with CHF from the hospital to family care to improve the patients’ level of cardiac function, elevate their knowledge level and self-care abilities, and improve their overall health outcomes. Show more

Keywords: Chronic heart failure, vulnerable period, hospital-family, online and offline

DOI: 10.3233/THC-220693

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Wang, Yanan | Zhai, Shifen | Liu, Lili | Qu, Bin | Wang, Ziqian

Article Type: Research Article

Abstract: BACKGROUND: Situation, Background, Assessment, and Recommendation (SBAR) is a structured method for communicating critical information that requires immediate attention and action. OBJECTIVE: To study the effects of empathy nursing combined with the SBAR communication system on the negative emotions and nursing quality of children undergoing tracheotomy. METHODS: This is a clinical observational study. A total of 100 tracheotomy patients who were cared for in the pediatric intensive care unit of our hospital from September 2021 to June 2022 were recruited and assigned at a ratio of 1:1 either into a control group (empathic …care) or an observation group (empathic care combined with SBAR) using a randomized method. Further, the postoperative anxiety self-rating scale scores, negative emotions, hope index, and nursing quality were compared between the two groups. RESULTS: After nursing, the psychological resilience scale score of the observation group was higher than that of the control group, whereas the anxiety self-rating scale score was significantly lower than that of the control group (all P < 0.05). Basic and special nursing, knowledge awareness, and safety management of the two groups of patients improved significantly, with higher results in the observation group than in the control group (P < 0.05). CONCLUSION: Empathy nursing combined with the SBAR communication system considerably improves postoperative negative emotions and enhances the quality of nursing care for patients undergoing tracheotomy. Show more

Keywords: Tracheotomy, empathy nursing, SBAR communication system, nursing effect, children

DOI: 10.3233/THC-230231

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Liu, Bin | Sun, Chuan | Zhao, Xinyu | Liu, Lingyu | Liu, Shuang | Ma, Haichuan

Article Type: Research Article

Abstract: BACKGROUND: Surgery is the preferred treatment for rectal cancer, but surgical treatment alone sometimes does not achieve satisfactory results. OBJECTIVE: To explore the value of multimodal Magnetic Resonance (MR) images in evaluating T staging of rectal cancer after neoadjuvant therapy and to compare and analyze with pathological results. METHODS: This study retrospectively analyzed 232 patients with stage T3, T4 rectal cancer between January 1, 2017 and October 31, 2022. MR examination was performed within 3 days before surgery. Different MR sequences were used for mrT staging of rectal cancer after neoadjuvant therapy and …compared with pathological pT staging. The accuracy of different MR sequences in evaluating T staging of rectal cancer was calculated, and the consistency between the two was analyzed by kappa test. The sensitivity, specificity, negative predictive value and positive predictive value of different MR sequences in evaluating rectal cancer invading mesorectal fascia after neoadjuvant therapy were calculated. RESULTS: A total of 232 patients with rectal cancer were included in the study. The accuracy of high-resolution T2 WI in evaluating T staging of rectal cancer after neoadjuvant therapy was 49.57%, and the Kappa value was 0.261. The accuracy of high-resolution T2WI combined with diffusion weighted imaging (DWI) in evaluating T staging of rectal cancer after neoadjuvant therapy was 61.64%, and the Kappa value was 0.411. The accuracy of high-resolution combined with DCE-MR images in evaluating T staging of rectal cancer after neoadjuvant therapy was 80.60%, and the Kappa value was 0.706. The sensitivity and specificity of high-resolution t2-weighted imaging (HR-T2WI) combined with dynamic contrast-enhancement magnetic resonance (DCE-MR) in evaluating the invasion of mesorectal fascia were 83.46% and 95.33%, respectively. CONCLUSION: Compared with HR-T2WI combined with DWI images for mrT staging of rectal cancer after neoadjuvant chemoradiotherapy (N-CRT), HR-T2WI combined with DCE-M has the highest accuracy in evaluating mrT staging of rectal cancer after neoadjuvant therapy (80.60%), and has a high consistency with pathological pT staging. It is the best sequence for T staging of rectal cancer after neoadjuvant therapy. At the same time, the sequence has high sensitivity and specificity in evaluating mesorectal fascia invasion, which can provide accurate perioperative information for the formulation of surgical plan. Show more

Keywords: Rectal cancer, neoadjuvant therapy, efficacy, re-staging, magnetic resonance

DOI: 10.3233/THC-220798

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Peng, Yongyi | Wu, Zhongping | Lin, Kuiqing | Huang, Ruibo | Huang, Jinhai | Lin, Junfeng | Chen, Shubing | Zheng, Jinping | Gao, Yi

Article Type: Research Article

Abstract: BACKGROUND: At present, robust quality criteria and methods for the assessment of Peak inspiratory flow meter performance are lacking. OBJECTIVE: A standard flow-volume simulator for quality control analyses of an inhalation assessment device was utilized with different simulated resistance levels in order to propose a quality testing method and associated standard for this device type. METHODS: A standard flow-volume simulator was utilized to assess the performance of an In-Check DIAL ® (Device I) and an intelligent inhalation assessment device (Device P) at a fixed volume and flow rate. Indices …used to evaluate these two instruments included repeatability, accuracy, linearity, and impedance. RESULTS: Both devices exhibited good repeatability ( < ± 3 L/min). The difference between test results and standard simulator values for Device P was less than ± 5 L/min at resistance level R1 but higher than ± 5 L/min at resistance levels R2–5, while Device I were greater than 5 L/min at all resistance levels. The relative error for Device P was < ± 10% at resistance levels R1, R2, and R4, but > 10% at resistance levels R3 and R5. The relative error values for Device I at all five resistance levels were > 10%. Device P passed the linearity test at the R2 resistance level, while Device I partially passed the linearity test at all five resistance levels. CONCLUSION: Standard monitoring methods and standards provide a valuable approach to the more reliable clinical assessment and application of these instruments. Show more

Keywords: Peak inspiratory flow, PIF, quality criteria, inhaler, assessment devices

DOI: 10.3233/THC-220905

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Mao, Wenjuan | Jiang, Mingzhu | Chen, Wenduo | Du, Juan | Xiao, Qian

Article Type: Research Article

Abstract: BACKGROUND: Stress urinary incontinence is prevalent among women and the incidence increases with age. OBJECTIVE: To explore the effect of intelligent pelvic floor muscle rehabilitation on elderly female patients with incontinence. METHODS: A total of 209 patients with urinary incontinence who were treated with pelvic floor muscle rehabilitation at Peking University International Hospital from September 2020 to June 2021 were selected by convenient sampling. All subjects were divided into the 50–60 year old patient group (n = 51) and over 60 years old patient group according to age …(n = 158). The subjects of different age group were divided into an experimental group and a control group. The patients in the control group received routine nursing and health education, and the patients in the observation group received a combination of mobile application use and smart dumbbells. Based on this, we constructed an intervention model for intelligent, continuous pelvic floor rehabilitation. After 7 and 12 weeks, pelvic floor muscle function knowledge and exercise compliance in the two groups were evaluated. The improvement of urinary incontinence symptoms, pelvic floor muscle strength grades and quality-of-life scales were evaluated. RESULTS: The results showed that pelvic floor knowledge and exercise compliance in the experimental group were better than in the control group at 7 and 12 weeks after intervention (P < 0.05). There was no significant difference in pelvic floor muscle strength and quality of life between the two groups at 7 weeks after intervention (P > 0.05). However, there was a significant difference in pelvic floor muscle strength and quality of life between the two groups at 12 weeks after intervention (P < 0.05). There was no significant difference between different age groups. CONCLUSION: The intelligent pelvic floor rehabilitation model that combines a mobile application with smart dumbbells can maintain and strengthen the clinical treatment effect for elderly patients with urinary incontinence. Show more

Keywords: Intelligent app, pelvic floor muscle training exercise, older female, urinary incontinence

DOI: 10.3233/THC-220845

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Radivoje, Radakovic | Lazar, Dasic | Milivoj, Dopsaj | Nenad, Filipovic

Article Type: Research Article

Abstract: BACKGROUND: Being in peak physical condition and having specific motor abilities are necessity for every top-level soccer player in order to achieve success in competition. In order to correctly assess soccer players’ performance, this research uses laboratory and field measurements, as well as results of competitive performance obtained by direct software measurements of players’ movement during the actual soccer game. OBJECTIVE: The main goal of this research is to give insight into the key abilities that soccer players need to have in order to perform in competitive tournaments. Besides training adjustments, this research also gives insight …into what variables need to be tracked in order to accurately assess the efficiency and functionality of the players. METHODS: The collected data need to be analyzed using descriptive statistics. Collected data is also used as input for multiple regression models that can predict certain key measurements: total distance covered, percent of effective movements and high index of effective performance movements. RESULTS: Most of the calculated regression models have high predictability level with statistically significant variables. CONCLUSION: Based on the results of regression analysis it can be deduced that motor abilities are important factor in measuring soccer player’s competitive performance and team’s success in the match. Show more

Keywords: Effective movement, motor abilities, soccer player’s competition performance, total distance covered

DOI: 10.3233/THC-230275

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Zhao, Jie | Liu, Haiming | Qi, Tao | Zhao, Hui | Ye, Tingting | Ning, Peng

Article Type: Research Article

Abstract: BACKGROUND: Lung cancer is prone to metastasize to the brain, which is difficult for surgery and leads to poor prognosis due to poor chemotherapy efficacy. OBJECTIVE: Our aim is to evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for brain multi-metastases. METHODS: In the retrospective study, a total of 51 non-small cell lung cancer (NSCLC) patients with brain multi-metastases (3–5 metastases) receiving SBRT in the local hospital between 2016 and 2019 were enrolled for analyzing the efficacy and safety of SBRT. The primary endpoints included 1-year local control rate, radiotherapy toxicity, …overall survival and progression-free survival. RESULTS: The median follow-up for the enrolled patients was 21 months, and the 1-year and 2-year OS rates were 82.4% and 45.1%, respectively. Demographic analysis showed no significant differences between SBRT alone and combination with whole brain radiotherapy in clinical characteristics including age, gender and Eastern Cooperative Oncology Group performance status. The 1-year local control rate was 77.3% (17/22) for SBRT alone, which was comparable to 79.3% (23/29) of combined radiotherapy. Cox proportional hazard regression demonstrated that the prognostic benefit of combining WBRT was not significantly superior to SBRT alone (HR = 0.851, P = 0.263). Their radiotherapy toxicity rate was lower in SBRT alone group (13.6%, vs. 44.8% for combination; P = 0.017). CONCLUSION: The current research suggested that SBRT alone could effectively relieve tumor burden and improve the prognosis and quality of life for NSCLC patients with brain multi-metastases, which should be validated in further prospective clinical trials. Show more

Keywords: Stereotactic body radiotherapy, NSCLC, whole brain radiotherapy, brain metastases, safety, efficacy

DOI: 10.3233/THC-230104

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023

Authors: Huang, Ting | Duan, Miao

Article Type: Research Article

Abstract: BACKGROUND: Hyperbilirubinemia is a common disorder in neonates, with premature infants at higher risk of developing the disorder. OBJECTIVE: Glucose-6-phosphate dehydrogenase (G6PD) gene detection was used to determine the incidence of G6PD deficiency and analyze the etiologies of G6PD deficiency in neonates with hyperbilirubinemia in the Zunyi region with the aim of providing scientific evidence for the clinical diagnosis and treatment. METHODS: For the gene detection, 64 neonates with hyperbilirubinemia were selected as the observation group and 30 normal neonates were selected as the control group, and the risk factors for hyperbilirubinemia were …investigated by using multivariate logistic regression analysis. RESULTS: Among the neonates in the observation group, 59 cases had the G1388A mutation (92.19%) and 5 cases had the G1376T mutation (7.81%). No mutation was detected in the control group. In the observation group, the proportion of neonates who were born prematurely, with artificial feeding, with the age of starting feeding of more than 24 h, the time of first bowel movement of more than 24 h, premature rupture of membranes, infection, scalp hematoma, and perinatal asphyxia was higher than that in the control group, and the difference was statistically significant (p < 0.05). Multivariate logistic regression analysis showed that prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding of more than 24 h, and the time of first bowel movement over 24 h were risk factors for the development of neonatal hyperbilirubinemia (p < 0.05). CONCLUSION: The G1338A and G1376T mutations were important features of the genetics of neonatal hyperbilirubinemia, and genetic detection together with the prevention of prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding, and the time of first bowel movement would help reduce the incidence of this disease. Show more

Keywords: Neonate, hyperbilirubinemia, gene detection, G6PD, risk factor

DOI: 10.3233/THC-220472

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Wu, Jiaqi | Wang, Xiujing | Jiang, Jiuhui | Bai, Yunyang

Article Type: Research Article

Abstract: BACKGROUND: Polyetheretherketone (PEEK) is a polyaromatic semi-crystalline thermoplastic polymer with mechanical and lubrication properties favorable for biomedical applications. Despite of its aesthetic appearance, ceramic brackets are unsatisfactory in brittleness and thickness, while PEEK is a potential material for aesthetic orthodontic brackets. OBJECTIVE: To fabricate a novel aesthetic orthodontic bracket and evaluate friction properties of PEEK and stainless steel wires. METHODS: All polyether ether ketone (PEEK) and ceramic samples disks were made into disks (diameter, 5 mm; thickness, 2 mm). The tested surfaces of PEEK were ground with #600, #800 and #1200 SiC papers, followed …by polishing with Sof-Lex kit (3M ESPE, USA). The surface roughness was tested using a laser profilometer device (VK-X200, Keyence, Japan). The COFs of the specimens and stainless steel (SS) archwires were tested using a Universal Micro-Tribotester (UMT-3, Bruker, USA). The wear scratches on the materials’ surfaces were examined by using a scanning electron microscope (SEM) (Hitachi SU8010). The elastic modulus and hardness of samples were examined with a nano-indenter (XP, Keysight Technologies, USA). RESULTS: The mean surface roughness of PEEK and Ceramic are 0.320 ± 0.028 μ m and 0.343 ± 0.044 μ m, respectively. PEEK has a lower Friction coefficient than Ceramic and the difference between the two groups was statistically significant (P < 0.05). The abrasive wear of Ceramic was the main wear style and was characterized by the observation of chipping fractures. While PEEK surface still looks smooth without obvious scale-like desquamations and granular debris, indicating adhesive wear. CONCLUSION: Within the limitations of the present study, PEEK shows lower coefficient of friction than ceramic. PEEK has excellent properties such as low friction coefficient, smooth surface and good mechanical properties, and thus meets the requirements for orthodontic brackets. It is considered as a potential bracket material with both low friction and aesthetic performance. Show more

Keywords: Polyetheretherketone, orthodontic brackets, esthetics, orthodontic friction, coefficient of friction

DOI: 10.3233/THC-230001

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Wang, Wei-Zhong | Ying, Li-Jun | Liu, Wei-Dong | Zhang, Pan | Li, Shun-Fa

Article Type: Research Article

Abstract: BACKGROUND: Providers should adjust the depth of sedation to promote lung-protective ventilation in patients with severe ARDS. This recommendation was based on the assumption that the depth of sedation could be used to assess respiratory drive. OBJECTIVE: To assess the association between respiratory drive and sedation in patients with severe ARDS by using ventilator-measured P0.1 and RASS score. METHODS: Loss of spontaneous breathing was observed within 48 h of mechanical ventilation in patients with severe ARDS, and spontaneous breathing returned after 48 hours. P0.1 was measured by ventilator every 12 ± …2 hours, and the RASS score was measured synchronously. RESULTS: The RASS score was moderately correlated with P0.1 (R 𝑆𝑝𝑒𝑎𝑟𝑚𝑎𝑛 , 0.570; 95% CI, 0.475 to 0.637; p = 0.00). However, only patients with a RASS score of - 5 were considered to have no excessive respiratory drive, but there was a risk for loss of spontaneous breathing. A P0.1 exceeding 3.5 cm H 2 O in patients with other RASS scores indicated an increase in respiratory drive. CONCLUSION: RASS score has little clinical significance in evaluating respiratory drive in severe ARDS. P0.1 should be evaluated by ventilator when adjusting the depth of sedation to promote lung-protective ventilation. Show more

Keywords: Acute respiratory distress syndrome, P0.1, respiratory drive, mechanical ventilation, sedation

DOI: 10.3233/THC-230096

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Pan, Liang | Shan, Rui-Ying | Gao, Su-Fang | Zhou, Yan | Bao, Yuan-Yuan | Fu, Wenjing

Article Type: Research Article

Abstract: BACKGROUND: In malignant tumours of the female reproductive system, cervical cancer is second only to breast cancer, seriously threatening the health and safety of most women. OBJECTIVE: To evaluate the clinical value of 3.0 T multimodal nuclear magnetic resonance imaging (MRI) in the International Federation of Gynecology and Obstetrics’ (FIGO) staging of cervical cancer. METHODS: The clinical data of 30 patients with pathologically diagnosed cervical cancer admitted to our hospital from January 2018 to August 2022 were analysed retrospectively. Before treatment, all patients were examined with conventional MRI, diffusion-weighted imaging and multi-directional contrast-enhanced …imaging. RESULTS: The accuracy of multimodal MRI in the FIGO staging of cervical cancer (29/30, 96.7%) was significantly higher than the accuracy obtained in a control group (21/30, 70.0%), with a statistically significant difference (p = 0.013). In addition, there was good agreement between two observers applying multimodal imaging (kappa = 0.881) and moderate agreement between two observers in the control group (kappa = 0.538). CONCLUSION: Multimodal MRI can evaluate cervical cancer comprehensively and accurately to enable accurate FIGO staging, providing significant evidence for clinical operation planning and subsequent combined therapy. Show more

Keywords: Multimodal imaging, uterine cervical neoplasms, magnetic resonance imaging

DOI: 10.3233/THC-230252

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Shin, Sun-Shil | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND: According to previous studies, the relationship between lumbar lordosis and thoracic kyphosis or that between pelvic parameters and thoracic kyphosis have been inconsistent. OBJECTIVE: The purpose of this study was to investigate spinal sagittal alignment and its relationship to global and regional lumbar and thoracic angles, pelvic and sway angles, and C7–S1 distance measurements, followed by a detailed subgroup analysis using an inertial measurement unit system. METHODS: A total of 51 asymptomatic volunteers stood in a comfortable posture with inertial measurement units attached to the T1, T7, T12, L3, and S2 vertebrae. …T1, T7, T12, L3, and S2 sagittal angles were acquired during standing posture using the Eulerian angle coordinate system. All angles are reported as the mean of three 5-s measurements. Following the measurement of lumbar lordosis angles (T12 relative S2), participants were divided into the flat lumbar and normal lordosis groups. RESULTS: There were different correlation patterns between groups because of spinal sagittal imbalance, which was greater in the flat lumbar group than in the normal lordosis group. In addition, sacral inclination proved the ideal parameter to evaluate reciprocal balance in lumbar lordosis, showing a stronger correlation with lower than with upper lumbar lordosis. T1 was the key element in assessing thoracic kyphosis, which showed a stronger correlation with upper than with lower thoracic kyphosis. CONCLUSION: We suggest that when assessing posture, it is necessary to identify the global and regional angles and it is useful to classify spinal sagittal alignment into subgroups according to lumbar lordosis and evaluate the groups separately. Show more

Keywords: Global angle, lumbar lordosis, regional angle, sagittal balance, thoracic kyphosis

DOI: 10.3233/THC-220098

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Yuan, Youyuan | Chen, Jiaqi | Wang, Xueqi | Song, Jialu

Article Type: Research Article

Abstract: BACKGROUND: Lower extremity arteriosclerosis obliterans (ASO) is the most common occlusive disease of the peripheral blood vessels. OBJECTIVE: To explore the application effect of symptom management-based rehabilitation strategy in postoperative functional exercises in patients with lower extremity ASO. METHODS: The researchers selected 136 patients that underwent lower extremity ASO surgery for the first time in their department from January to September 2020. Patients were divided into a control group (n = 68) and an experimental group (n = 68). The control group implemented …routine discharge rehabilitation education and continuous nursing. On this basis, the experimental group applied the symptom management theory to the rehabilitation management strategy to compare the degree of pain, the ankle-brachial index, self-care ability and quality of life between the two groups before and after the intervention. RESULTS: Three months (P = 0.045) and six months (P = 0.013) after discharge, the experimental group’s degree of pain was significantly lower than that of the control group. At one month (P = 0.019), three months (P = 0.003) and six months (P = 0.000) after discharge, the experimental group recovered significantly better than the control group. At six months after discharge, the self-care ability, mood status and physical pain of the experimental group were significantly higher than in the control group (P < 0.05). CONCLUSION: The rehabilitation management strategy, which is based on symptom management theory, can effectively improve the symptoms, quality of life and self-efficacy of ASO patients in continuous care. This nursing strategy is worthy of clinical promotion. Show more

Keywords: Symptom management, rehabilitation, lower extremity arteriosclerosis obliterans, functional exercise

DOI: 10.3233/THC-220478

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Zhang, Mengmeng | Du, Hongxia | Ma, Xiaoxia | Zhao, Wenxing

Article Type: Research Article

Abstract: BACKGROUND: Pressure injury (PI) is a local injury of the skin and/or soft tissue located at the bone caused by medical or other equipment and is common in long-term bedridden patients. OBJECTIVE: To investigate the clinical effect of Urgotul foam dressing in the treatment of stage 3 ∼ 4 PI and deep tissue PI. METHODS: A total of 38 patients with stage 3 ∼ 4 PI and deep tissue PI admitted to Jinan Central Hospital from January 2016 to December 2018 were selected and randomly divided into …a control group (dressing change plus silver ion cream dressing) and an observation group (dressing change plus Urgotul Absorb non-border foam dressing), with 19 cases in each group. After 4 weeks of treatment, the pain intensity during dressing change and the treatment efficacy for PI wounds were compared between the two groups. RESULTS: There were no differences in gender (P = 0.740), age (P = 0.130), single wound area (P = 0.673), consultation department (P = 0.972), stage (P = 0.740), presence of undermining (P = 0.721), deep tissue PI (P = 0.721), and systemic antibiotic therapy (P = 1.000) between the two groups, which were comparable. The treatment effect of the observation group was better than that of the control group (P = 0.003), and the pain score of the observation group was lower than that of the control group (P < 0.001). CONCLUSION: Urgotul Absorb non-border foam dressing has a good effect in the treatment of stage 3 ∼ 4 PI and deep tissue PI and can relieve patients’ pain, and is thus worth promoting. Show more

Keywords: Pressure injury, pain intensity, Urgotul Absorb non-border foam dressing, efficacy of wound dressings, clinical effect

DOI: 10.3233/THC-220604

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2023

Authors: Chiu, Chien-Hung | Ke, Shih-Wen | Tsai, Chih-Fong | Lin, Wei-Chao | Huang, Min-Wei | Ko, Yi-Hsiu

Article Type: Research Article

Abstract: BACKGROUND: In practice, the collected datasets for data analysis are usually incomplete as some data contain missing attribute values. Many related works focus on constructing specific models to produce estimations to replace the missing values, to make the original incomplete datasets become complete. Another type of solution is to directly handle the incomplete datasets without missing value imputation, with decision trees being the major technique for this purpose. OBJECTIVE: To introduce a novel approach, namely Deep Learning-based Decision Tree Ensembles (DLDTE), which borrows the bounding box and sliding window strategies used in deep learning techniques to …divide an incomplete dataset into a number of subsets and learning from each subset by a decision tree, resulting in decision tree ensembles. METHOD: Two medical domain problem datasets contain several hundred feature dimensions with the missing rates of 10% to 50% are used for performance comparison. RESULTS: The proposed DLDTE provides the highest rate of classification accuracy when compared with the baseline decision tree method, as well as two missing value imputation methods (mean and k-nearest neighbor), and the case deletion method. CONCLUSION: The results demonstrate the effectiveness of DLDTE for handling incomplete medical datasets with different missing rates. Show more

Keywords: Data science, deep learning, decision trees, classifier ensembles, missing value imputation

DOI: 10.3233/THC-220514

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023