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Price: EUR 150.00Authors: Sun, Yi | Ren, Tao | Ji, Xueli
Article Type: Research Article
Abstract: BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). …Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization. Show more
Keywords: Hyperbaric oxygen therapy-specialized care, hyperbaric oxygen, cerebral infarction, motor function, mental state
DOI: 10.3233/THC-231643
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Maheshwaran, Bipin | Chokkatt, Jerry Joe | Shenoy, Amrutha | Ganapathy, Dhanraj | Yadalam, Pradeep Kumar | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Titanium nanoparticles (NPs) offer promising applications in the treatment and prevention of inflammatory disorders due to their unique physicochemical characteristics. However, additional research is necessary to attain a thorough comprehension and validate the efficacy of this approach in dental practice. OBJECTIVE: This study scrutinizes the anti-inflammatory properties of a dental varnish infused with ginger and rosemary extracts mediated by titanium dioxide (TiO2) nanoparticles. METHODS: A herbal dental varnish was formulated by integrating ginger and rosemary extracts with titanium dioxide nanoparticles at concentrations of 10, 20, 30, 40, and 50 μ L. …Anti-inflammatory properties were assessed through Bovine Serum Albumin denaturation and membrane stabilization assays, comparing results with a control group. RESULTS: The results reveal concentration-dependent antioxidant and anti-inflammatory properties in the test group when compared to the control group. The BSA assay corroborates increased percent inhibition with rising titanium dioxide nanoparticle concentrations. In line with existing literature, titanium dioxide nanoparticles enhance dental material properties. CONCLUSION: The bioactive compounds in ginger and rosemary, such as phenolic compounds and terpenes, contribute to anti-inflammatory and antioxidant effects of the varnish. Additionally, the therapeutic potential of titanium dioxide nanoparticles in addressing inflammatory diseases underscores their significance in this formulation. Show more
Keywords: Preventive dentistry, nanoparticles, titanium dioxide, green synthesis, antioxidant
DOI: 10.3233/THC-231994
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Huang, Yu | Wu, Mei | Li, Jian-Di | Qin, Zhen | Huang, Ke-Qiang | Cui, Jin-Zhu | Ou, Hai-Ling
Article Type: Research Article
Abstract: BACKGROUND: Vesicle-associated membrane protein 7 (VAMP7) plays oncogenic roles in cancers. However, its clinical significance in breast cancer (BC) tissues remains unknown. OBJECTIVE: To elucidate the clinical implications of VAMP7, as well as its involvement in the tumor microenvironment and molecular pathways of breast cancer. METHODS: BC (n = 100) and non-cancerous breast tissues (n = 100) were collected for an immunohistochemical experiment (1:200). The protein expression level of VAMP7 was determined by using a semi-quantitative scoring method. High-throughput RNA-sequencing data of BC tissues …were analyzed to confirm the mRNA expression trend of VAMP7. Additionally, the largest BC prognosis cohort data were collected to mine the potential impact VAMP7 has on BC progression. The association between VAMP7 and the microenvironment of BC was evaluated by using a CIBERSORT algorithm. Moreover, we explored the co-expressed molecular mechanisms of VAMP7 in BC by calculating Pearson correlation coefficients and overexpressed genes. Finally, the biological mechanism underlying the relationship between VAMP7 and the key pathways was also explored using gene set enrichment analysis (GSEA). Potential therapeutic strategies were predicted targeting VAMP7. RESULTS: VAMP7 protein was significantly over-expressed in BC tissue than that in controls (p < 0.001). Compared with 459 normal breast tissues and 113 non-cancerous breast tissues, the expression level of VAMP7 mRNA was significantly increased in 1111 BC tissues. CD 4 +T cells, macrophages, and naïve B cells had a higher infiltration rate in BC tissues with high VAMP7 expression, while regulatory T cells and CD 8 +T cells had a lower infiltration rate. Over-expressed VAMP7 was associated with macrophages activation and transition from M1 to M2 polarization. Upregulated VAMP7 could predicted poorer OS, DMFS, PPS, and RFS outcomes. Upregulated VAMP7 co-expressed genes were significantly enriched in the cell cycle checkpoints. GSEA confirmed that over-expressed VAMP7 are markedly associated with functional enrichment in cell cycle related categories, including mitotic spindle, G2M checkpoint, and E2F targets. KU-55933 was predicted as a putative therapeutic drug for BC targeting VAMP7. CONCLUSIONS: VAMP7 was upregulated in BC tissue and correlated with poor prognosis of BC patients. VAMP7 may promote BC progression by targeting the cell cycle pathway. Show more
Keywords: Breast cancer, vesicle-associated membrane protein 7, immunohistochemistry, molecular mechanisms
DOI: 10.3233/THC-230832
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Rogers, Nathan | Rullán, Pedro J. | Pasqualini, Ignacio | Khan, Shujaa T. | Klika, Alison K. | Surace, Peter A. | Molloy, Robert M. | Piuzzi, Nicolas S. | Bloomfield, Michael
Article Type: Research Article
Abstract: BACKGROUND: The value of robotic-assisted total hip arthroplasty (rTHA) has yet to be determined compared to conventional manual THA (mTHA). OBJECTIVE: Evaluate 90-day inpatient readmission rates, rates of reoperation, and clinically significant improvement of patient-reported outcome measures (PROMs) at 1-year in a cohort of patients who underwent mTHA or rTHA through a direct anterior (DA) approach. METHODS: A single-surgeon, prospective institutional cohort of 362 patients who underwent primary THA for osteoarthritis via the DA approach between February 2019 and November 2020 were included. Patient demographics, surgical time, discharge disposition, length of stay, acetabular …cup size, 90-day inpatient readmission, 1-year reoperation, and 1-year PROMs were collected for 148 manual and 214 robotic THAs, respectively. RESULTS: Patients undergoing rTHA had lower 90-day readmission (3.74% vs 9.46%, p = 0.04) and lower 1-year reoperation (0.93% vs 4.73% mTHA, p = 0.04). rTHA acetabular cup sizes were smaller (rTHA median 52, interquartile range [IQR] 50; 54, mTHA median 54, IQR 52; 58, p < 0.001). Surgical time was longer for rTHA (114 minutes vs 101 minutes, p < 0.001). At 1-year post-operatively, there was no difference in any of the PROMs evaluated. CONCLUSION: Robotic THA demonstrated lower 90-day readmissions and 1-year reoperation rates than manual THA via the DA approach. PROMs were not significantly different between the two groups at one year. Show more
Keywords: THA, direct anterior approach, HOOS, satisfaction, value of robotics
DOI: 10.3233/THC-231646
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Kasiviswanathan, Sivachandar | Vijayan, Thulasi Bai
Article Type: Research Article
Abstract: BACKGROUND: Artificial Intelligence (AI) plays a pivotal role in the diagnosis of health conditions ranging from general well-being to critical health issues. In the realm of health diagnostics, an often overlooked but critical aspect is the consideration of cost-sensitive learning, a facet that this study prioritizes over the non-invasive nature of the diagnostic process whereas the other standard metrics such as accuracy and sensitivity reflect weakness in error profile. OBJECTIVE: This research aims to investigate the total cost of misclassification (Total Cost) by decision rule Machine Learning (ML) algorithms implemented in Java platforms such as DecisionTable, …JRip, OneR, and PART. An augmented dataset with conjunctiva images along candidates’ demographic and anthropometric features under supervised learning is considered with a specific emphasis on cost-sensitive classification. METHODS: The opted decision rule classifiers use the text features, additionally the image feature ‘a* value of CIELAB color space’ extracted from the conjunctiva digital images as input attributes. The pre-processing consists of amalgamating text and image features on a uniform scale, normalizing. Then the 10-fold cross-validation enables the classification of samples into two categories: the presence or absence of the anemia. This study utilizes the Cost Ratio (ρ ) extracted from the cost matrix to meticulously monitor the Total Cost in four different cost ratio methodologies namely Uniform (U), Uniform Inverted (UI), Non-Uniform (NU), and Non-Uniform Inverted (NUI). RESULTS: It has been established that the PART classifier stands out as the top performer in this binary classification task, yielding the lowest mean total cost of 629.9 compared to other selected classifiers. Moreover, it demonstrates a comparatively lower standard deviation 335.9, and lower total cost across all four different cost ratio methodologies. The ranking of algorithm performance goes as follows: PART, JRIP, DecisionTable, and OneR. CONCLUSION: The significance of adopting a cost-sensitive learning approach is emphasized showing the PART classifier’s consistent performance within the proposed framework for learning the anemia dataset. This emphasis on cost-sensitive learning not only enhances the recommendations in diagnosis but also holds the potential for substantial cost savings and makes it a noteworthy focal point in the advancement of AI-driven health care. Show more
Keywords: Cost matrix, cost ratio, cost sensitive classifier, decision rule classifier, DecisionTable, JRip, OneR, PART
DOI: 10.3233/THC-231946
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Wang, Luo | Li, Xin | Dong, Xue-Juan | Yu, Xiao-Ling | Zhang, Jing | Cheng, Zhi-Gang | Han, Zhi-Yu | Liu, Fang-Yi | Yu, Jie | Liang, Ping
Article Type: Research Article
Abstract: BACKGROUND: Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC). OBJECTIVE: This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC. METHODS: This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio …of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy. RESULTS: The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: p = 0.036; recurrent HCC: p = 0.026). For patients with primary HCC, the recurrence frequency was reduced (p = 0.002), and recurrence interval (19 months vs. 9 months, p < 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients ⩽ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3+ (p = 0.049), CD8/CD28+ (p = 0.045) were elevated. CONCLUSION: Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients ⩽ 60 years old or with moderately-differentiated HCC or co-infected with HBV. Show more
Keywords: Hepatocellular carcinoma, immunotherapy, ablation, dendritic cell, cytokine killer
DOI: 10.3233/THC-230871
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Alhussaini, Khalid | Aleid, Adham | Alsadon, Omar | Aldohbeyb, Ahmed A. | Aljelaifie, Rakan | Javed, Ravish
Article Type: Research Article
Abstract: BACKGROUND: Adequate equipment maintenance is necessary to ensure efficient dental care facilities and satisfactory medical equipment performance. OBJECTIVE: This study aimed to assess maintenance practices and manpower adequacy in private dental centres (DCs) across Riyadh, Saudi Arabia. METHODS: A questionnaire was designed to evaluate equipment maintenance and manpower strength based on international and national standards. Thirty-three private DCs were visited in-person with the designed questionnaire to conduct the study. The Chi-square test and t -test were performed. RESULTS: Only 21 dental centres had a scheduled maintenance plan for …medical equipment, whereas the rest had no plan. Furthermore, only 22 DCs maintained equipment maintenance records, while 11 DCs did not have any records. Additionally, the study found a lack of trained personnel to handle medical equipment and overall inadequate maintenance practices. Significant differences were observed between the responses for many questions (p < 0.05). CONCLUSION: These findings increase health risks to both the patient and the user. To address these issues, DC administrators should implement stricter measures to adhere to local DCs standards and hire qualified personnel who can periodically maintain and repair medical equipment. Show more
Keywords: Medical devices, equipment readiness, patient safety, healthcare, manpower requirement, private dental center
DOI: 10.3233/THC-231177
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Wang, Zhi | Xu, Lei | Sun, Lin | Jiang, Xin | Wang, Juan
Article Type: Research Article
Abstract: BACKGROUND: Coronary atherosclerotic heart disease (CAHD) is the leading cause of death in developed countries. OBJECTIVE: This study aimed to explore the correlation between the properties of coronary atherosclerotic plaque and blood lipids using computed tomography angiography (CTA). METHODS: A total of 83 patients with coronary heart disease were included in this study (males: 50; females: 33; average age: [59 ± 8] years old). They were classified into the stable angina group and unstable angina group. Atherosclerotic plaques were classified as fatty plaques (soft plaques), fibrous plaques, and calcified plaques …based on the computed tomography (CT) values. SPSS 17.0 statistical software was used to analyze the correlation between the properties of angina and the CT values of atherosclerotic plaques, blood lipids, and plaque properties, and then compared between the stable and unstable angina groups. RESULTS: There were statistically significant differences in plaque properties between the stable and unstable angina groups (P < 0.001). During CTA examination, we found statistically significant differences in the CT density values of atherosclerotic plaques between the stable and unstable angina groups (P < 0.001). There were statistically significant differences between the properties of angina and the level of blood lipids (P < 0.05). CONCLUSION: Anginal properties negatively correlated with calcified plaques and positively correlated with non-calcified plaques. Calcified plaques negatively correlated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), and positively correlated with high-density lipoprotein cholesterol (HDL-C). Non-calcified plaques negatively correlated with HDL-C and positively correlated with TC, LDL-C, and TG. Show more
Keywords: Angina, atherosclerotic plaques, blood lipids, coronary artery, multi-slice spiral CT
DOI: 10.3233/THC-231036
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Tomasevic, Smiljana | Anic, Milos | Arsic, Branko | Gakovic, Branko | Filipovic, Nenad | Djukic, Tijana
Article Type: Research Article
Abstract: BACKGROUND: Ultrasound is one of the non-invasive techniques that are used in clinical diagnostics of carotid artery disease. OBJECTIVE: This paper presents software methodology that can be used in combination with this imaging technique to provide additional information about the state of patient-specific artery. METHODS: Overall three modules are combined within the proposed methodology. A clinical dataset is used within the deep learning module to extract the contours of the carotid artery. This data is then used within the second module to perform the three-dimensional reconstruction of the geometry of the carotid bifurcation …and ultimately this geometry is used within the third module, where the hemodynamic analysis is performed. The obtained distributions of hemodynamic quantities enable a more detailed analysis of the blood flow and state of the arterial wall and could be useful to predict further progress of present abnormalities in the carotid bifurcation. RESULTS: The performance of the deep learning module was demonstrated through the high values of relevant common classification metric parameters. Also, the accuracy of the proposed methodology was shown through the validation of results for the reconstructed parameters against the clinically measured values. CONCLUSION: The presented methodology could be used in combination with standard clinical ultrasound examination to quickly provide additional quantitative and qualitative information about the state of the patient’s carotid bifurcation and thus ensure a treatment that is more adapted to the specific patient. Show more
Keywords: Convolutional neural networks, 3D reconstruction, blood flow, patient-specific geometry, validation against clinical data
DOI: 10.3233/THC-231306
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
Authors: Liu, Lili
Article Type: Research Article
Abstract: BACKGROUND: Osteoporosis is a medical disorder that causes bone tissue to deteriorate and lose density, increasing the risk of fractures. Applying Neural Networks (NN) to analyze medical imaging data and detect the presence or severity of osteoporosis in patients is known as osteoporosis classification using Deep Learning (DL) algorithms. DL algorithms can extract relevant information from bone images and discover intricate patterns that could indicate osteoporosis. OBJECTIVE: DCNN biases must be initialized carefully, much like their weights. Biases that are initialized incorrectly might affect the network’s learning dynamics and hinder the model’s ability to converge to …an ideal solution. In this research, Deep Convolutional Neural Networks (DCNNs) are used, which have several benefits over conventional ML techniques for image processing. METHOD: One of the key benefits of DCNNs is the ability to automatically Feature Extraction (FE) from raw data. Feature learning is a time-consuming procedure in conventional ML algorithms. During the training phase of DCNNs, the network learns to recognize relevant characteristics straight from the data. The Squirrel Search Algorithm (SSA) makes use of a combination of Local Search (LS) and Random Search (RS) techniques that are inspired by the foraging habits of squirrels. RESULTS: The method made it possible to efficiently explore the search space to find prospective values while using promising areas to refine and improve the solutions. Effectively recognizing optimum or nearly optimal solutions depends on balancing exploration and exploitation. The weight in the DCNN is optimized with the help of SSA, which enhances the performance of the classification. CONCLUSION: The comparative analysis with state-of-the-art techniques shows that the proposed SSA-based DCNN is highly accurate, with 96.57% accuracy. Show more
Keywords: Osteoporosis, classification, accuracy, optimization, bias, neural network, and squirrel search
DOI: 10.3233/THC-231517
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2024
Authors: Liu, Yining | Xu, Liming | Fang, Qiongyan | Rong, Hui | Zheng, Huaiyu
Article Type: Research Article
Abstract: BACKGROUND: Danshen Chuanxiong Injection (DCI) has demonstrated significant clinical efficacy in the treatment of acute pancreatitis (AP); however, the precise molecular mechanisms underlying its therapeutic effects remain incompletely understood. OBJECTIVE: In this study, we employed network pharmacology analysis to comprehensively investigate the active components, potential targets, and signaling pathways involved in DCI-mediated treatment of AP. METHODS: We utilized the mouse pancreatic acinar cell line 266-6 to establish an cholecystokinin (CCK)-induced AP cell injury model and evaluated cell viability using the Cell counting kit-8 assay. Western blotting and quantitative PCR were employed to determine …the expression levels of key target proteins and genes. RESULTS: Network pharmacology analysis identified a total of 144 active components and 430 potential targets within DCI. By integrating data from public databases, we identified 762 AP-related genes. Among these, we identified 93 potential targets that may be involved in the therapeutic effects of DCI for AP. These targets were significantly enriched in biological processes such as oxidative stress, regulation of cytokine production, leukocyte migration, and the TNF signaling pathway. Molecular docking studies revealed a high binding affinity between the active components and the key targets AKT1 and NFKBA, indicative of potential interaction. Additionally, CCK-induced acinar cell injury led to upregulation of AKT1, NFKBA, and P53 proteins, as well as TNF, IL6, and MMP9 genes. Conversely, treatment with DCI dose-dependently attenuated CCK-induced acinar cell injury and restored the expression levels of the aforementioned proteins and genes. CONCLUSION: Overall, this study provides a comprehensive understanding of the molecular mechanisms underlying the therapeutic effects of DCI in the treatment of AP. Our findings confirm the protective effect of DCI against CCK-induced acinar cell injury and its regulation of key targets. Show more
Keywords: Danshen Chuanxiongqin injection, acute pancreatitis, network pharmacology, acinar cells, molecular docking
DOI: 10.3233/THC-231086
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Yang, Wen | Chen, Yue
Article Type: Research Article
Abstract: BACKGROUND: Electronic coloscopy is an invasive procedure and achieving an ideal result can be challenging, leading to low intestinal cleanliness scores and a poor intestinal polyp positive rate. OBJECTIVE: (1) To demonstrate the impact of intensified nursing intervention on electronic colonoscopy. (2) To improve patients’ satisfaction with medical services related to intestinal cleanliness during preparation, the accuracy of the intestinal polyp-positive rate, and nursing. METHODS: Our study included 120 patients who underwent electronic coloscopy. These patients were randomly assigned to either the observation group or the control group, with 60 cases in each …group. Patients in the control group received conventional nursing intervention, which included face-to-face oral and written instructions. In addition to the conventional intervention, patients in the observation group received intensified guidance interventions, which included instructions via phone, as well as WeChat messages and pictures. RESULTS: The patients in the observation group who received intensified guidance interventions demonstrated better intestinal cleanliness during preparation compared to the control group (P < 0.05). Besides, the accuracy of the intestinal polyp positive rate was higher in the observation group than in the control group (P < 0.05). Finally, regarding patient satisfaction with the nursing service provided by the endoscopy center, the observation group had a higher level of satisfaction than the control group (P < 0.05). CONCLUSION: The intensified guidance interventions provided to patients undergoing electronic colonoscopy resulted in a significant improvement in intestinal cleanliness during preparation, as well as an increase in the accuracy of the intestinal polyp-positive rate and patient satisfaction with our nursing service. Therefore, we believe that these interventions are highly beneficial and should be promoted and applied in clinical settings. Show more
Keywords: Colonoscopy, nursing intervention, intestinal cleanliness, intestinal polyp positive rate, satisfaction with nursing service
DOI: 10.3233/THC-230774
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Yang, Xin-Lei | Ni, Dong-He | Yu, Yang | Zhao, Jin-Cui | Lin, Rui | Xiu, Chao | Chang, Zhe-Xing
Article Type: Research Article
Abstract: BACKGROUND: Breast cancer has the second highest mortality rate of all cancers and occurs mainly in women. OBJECTIVE: To investigate the relationship between magnetic resonance imaging (MRI) radiomics features and histological grade of invasive ductal carcinoma (IDC) of the breast and to evaluate its diagnostic efficacy. METHODS: The two conventional MRI quantitative indicators, i.e. the apparent diffusion coefficient (ADC) and the initial enhancement rate, were collected from 112 patients with breast cancer. The breast cancer lesions were manually segmented in dynamic contrast-enhanced MRI (DCE-MRI) and ADC images, the differences in radiomics features between …Grades I, II and III IDCs were compared and the diagnostic efficacy was evaluated. RESULTS: The ADC values (0.77 ± 0.22 vs 0.91 ± 0.22 vs 0.92 ± 0.20, F = 4.204, p < 0.01), as well as the B_sum_variance (188.51 ± 67.803 vs 265.37 ± 77.86 vs 263.74 ± 82.58, F = 6.040, p < 0.01), L_energy (0.03 ± 0.02 vs 0.13 ± 0.11 vs 0.12 ± 0.14, F = 7.118, p < 0.01) and L_sum_average (0.78 ± 0.32 vs 16.34 ± 4.23 vs 015.45 ± 3.74, F = 21.860, p < 0.001) values of patients with Grade III IDC were significantly lower than those of patients with Grades I and II IDC. The B_uniform (0.15 ± 0.12 vs 0.11 ± 0.04 vs 0.12 ± 0.03, F = 3.797, p < 0.01) and L_SRE (0.85 ± 0.07 vs 0.78 ± 0.03 vs 0.79 ± 0.32, F = 3.024, p < 0.01) values of patients with Grade III IDC were significantly higher than those of patients with Grades I and II IDC. All differences were statistically significant (p < 0.05). The ADC radiomics signature model had a higher area-under-the-curve value in identifying different grades of IDC than the ADC value model and the DCE radiomics signature model (0.869 vs 0.711 vs 0.682). The accuracy (0.812 vs 0.647 vs 0.710), specificity (0.731 vs 0.435 vs 0.342), positive predictive value (0.815 vs 0.663 vs 0.669) and negative predictive value (0.753 vs 0.570 vs 0.718) of the ADC radiomics signature model were all significantly better than the ADC value model and the DCE radiomics signature model. CONCLUSION: ADC values and breast MRI radiomics signatures are significant in identifying the histological grades of IDC, with the ADC radiomics signatures having greater value. Show more
Keywords: Invasive ductal carcinoma, magnetic resonance imaging, radiomics, histological grading
DOI: 10.3233/THC-230671
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Al Ahmari, Nasser M. | Alshehri, Abdulkarim H. | Gadah, Thrya S. | Alqahtani, Jaber A. | Almushafi, Mohammed A. | Al Moaleem, Mohammed M. | Al Hatlan, Ebtisam N. | Alqhatani, Aliya S. | Alabydi, Shahad M.
Article Type: Research Article
Abstract: BACKGROUND: Endocrowns (ECs) are alternatives for rebuilding severely damaged teeth and show superior efficacy in molars over premolars. OBJECTIVE: The objective of this in vitro study is to evaluate the effects of different preparation designs with short pulp chambers on the mean color change (Δ E ), fracture resistance, and failure types of mandibular molar ECs. METHOD: A total of 40 extracted mandibular molars were treated endodontically and divided into four groups. Samples in groups 1, 2, 3, and 4 had occlusal preparation depths of 5 mm, 3 …mm, 3 mm with ferrule, and 3 mm with boxes, respectively. The samples were immersed in coffee and their Δ E values were measured by using the Commission Internationale de l’Eclairage color system. They were also subjected to a fracture test. Next, all specimens were examined visually under a stereomicroscope to evaluate their failure modes and identify their fracture origins. Data were entered and analyzed by using Statistical Package for Social Sciences. RESULTS: Among all groups, group 4 (3 mm + boxes) presented the highest Δ E (4.15) after immersion in coffee. Moreover, ANOVA revealed that the Δ E of group 4 (occlusal preparation depth of 3 mm with boxes) was significantly different (p < 0.05) from that of group 2 (3 mm + ferrule, 3.07). The EC with a 3 mm chamfer and ferrule showed the highest maximum load of 2847.68 ± 693.27 N, whereas that with a 5 mm chamfer finish line had a marginally reduced load at fracture of 2831.52 ± 881.83 N. The EC with a 3 mm chamber and boxes had a slightly increased maximum load of 2700.75 ± 436.40 N, whereas that with the 3 mm chamber had the lowest maximum load at fracture of 2385.97 ± 465.61 N. One-way ANOVA showed that different EC preparation designs had no effect on maximum fracture load (F [3,16] = 0.550, p = 0.6). CONCLUSION: The recorded Δ E values of ECs in all groups were equal or marginally higher than the acceptable values. The EC with a 3 mm chamfer and ferrule displayed the highest mean maximum load. The EC with a 5 mm chamfer finish line had a marginally lower maximum load at fracture than other ECs. Failures, such as ceramic fracture, split fracture, and ceramic and tooth splitting above the cemento–enamel junction (CEJ) or vertically were predominant in samples with occlusal preparation depths of 3 mm with ferrule and 5 mm. Show more
Keywords: Endocrown, color measurement, fracture strength, failure type, endocrown design
DOI: 10.3233/THC-231175
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Wang, Gang | Zhang, Hao-Cheng | Zhang, Si-Jin | Yao, Yan-Yi | Zhao, Yan | Wang, Zeng | Zhang, Ting
Article Type: Research Article
Abstract: BACKGROUND: Coronary artery disease can be quantified by measuring the fat attenuation index (FAI). OBJECTIVE: To explore the correlations between FAI, high-risk plaque and the degree of coronary artery stenosis. METHODS: The clinical data of patients with coronary atherosclerosis who underwent a coronary computed tomography (CT) angiography examination between July 2020 and June 2023 were selected for retrospective analysis. These patients were classified into a high-risk plaque group and non-high-risk plaque group according to the presence of CT high-risk plaque. The diagnostic value of FAI and FAI combined with the degree of stenosis …was evaluated for CT high-risk plaque. RESULTS: Differences in age, body mass index, smoking history, FAI and the degree of stenosis between the two groups were statistically significant (all P < 0.05). The results of a binary logistic regression analysis revealed that FAI (odds ratio (OR): 1.131, 95% confidence interval (CI): 1.101–1.173, P < 0.001) and the degree of stenosis (OR: 1.021, 95% CI: 1.012–1.107, P < 0.001) were risk factors for high-risk plaque. CONCLUSION: The FAI can be used to monitor the inflammation level of the coronary artery; the higher the FAI is, the higher the risk of plaque and degree of stenosis. Show more
Keywords: Coronary computed tomography angiography, peripheral coronary adipose tissue, fat attenuation index, plaque
DOI: 10.3233/THC-230676
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Lu, Cancan | Shi, Jimin | Tan, Yamin | Hu, Huixian
Article Type: Research Article
Abstract: BACKGROUND: There is no specificity in the clinical presentation of hemophagocytic lymphohistiocytosis (HLH). OBJECTIVE: To study some clinical, etiological, and prognostic features of HLH to improve the clinical understanding of the disease. METHODS: Retrospective analysis of the clinical data of 125 patients with HLH admitted to our hospital from June 2015 to August 2021, including clinical characteristics, laboratory indicators, and survival period. Statistical analysis was performed from the overall group of study indicators, which included population, children, and adults. RESULTS: In the whole population, sex, age, blood myoglobin, and NK …cell ratio of M-HLH and non-M-HLH patients (P < 0.05), serum albumin, and direct bilirubin were independent correlates of M-HLH. In the pediatric group, age and the proportion of NK cells were significantly different between M-HLH and non-M-HLH patients (P < 0.05). Multivariate Logistic regression analysis showed that all factors were not significantly associated with M-HLH. The associated regression analysis showed that all factors were not significantly associated with M-HLH. ROC curve analysis showed that the best predictive value of NK cell percentage for M-HLH diagnosis in the overall population was 4.96% in the pediatric group and 4.96% in the adult group. The best predictive value for M-HLH diagnosis was 2.08%. The univariate analysis showed that platelet count, alanine aminotransferase, aspartate aminotransferase, serum albumin, direct bilirubin and indirect bilirubin affected prognosis; COX regression showed that none of these factors had a significant relationship. The overall median survival time was 20.7 months in the adult group, 44.3 months in non-M-HLH patients, and 7.73 months in M-HLH patients (p = 0.011); univariate analysis showed that platelet count and serum albumin level affected prognosis; COX regression results in serum albumin level was an independent risk factor for prognosis. CONCLUSION: The survival rate of non-M-HLH was significantly better than that of M-HLH; the proportion of NK cells had predictive value for the diagnosis of M-HLH; in the general population, non-M-HLH was more likely to have abnormal liver function than M-HLH: lower platelet count and serum albumin level were associated with poor prognosis, and the lower the platelet count and serum albumin level, the worse the prognosis: in addition, adults with lower serum albumin levels are also associated with poor prognosis. Show more
Keywords: HLH, EB virus infection, inclusion criteria, diagnostic criteria, demographics
DOI: 10.3233/THC-231275
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Álvarez Valdivielso, Ainhoa | Akkaya, Mustafa | Mau, Hans | Luo, T. David | Gehrke, Thorsten | Citak, Mustafa
Article Type: Research Article
Abstract: BACKGROUND: Surgeons still face difficulties when performing aseptic acetabular revision on patients with extensive defects. Advances in three-dimensional printing technology (3DP) have afforded to the surgeons to create a patient-specific implant matching the morphology and topography of the defect. OBJECTIVE: The aim of the current research was to determine the survivorship in the treatment of acetabular bone defects with pelvic discontinuity (PD). METHODS: In order to reconstruct Paprosky type III defects with PD, twenty-three patients underwent revision total hip arthroplasty (THA) utilizing 3D-printed implants (Mobelife). The primary outcomes were the implant-associated failure rate …correlated with survivorship. As secondary variables, complications and the effect of age, sex, comorbidities, history of infections and the presence of other lower limb arthroplasties on a new revision were analyzed. RESULTS: Patients were followed out to a mean of 67.22 ± 39.44 months (range, 0.9–127 months). Mobelife implant mean survival was 102.57 ± 9.90 months (95% CI 83.17–121.96). The cohort’s implant one-year survival rate was 87%; at ten years, it dropped to 78.3%. There were four revisions: three due to periprosthetic joint infection (PJI) and one case due to aseptic loosening. Cox regression analysis did not identify any variable as predictor of failure. CONCLUSION: The use of 3DP patient-specific acetabular components has shown encouraging results and it is a viable treatment option for addressing acetabular defects with combined PD in aseptic THA revision. Show more
Keywords: Acetabular bone loss, Paprosky type III bone defect, pelvic discontinuity, patient-specific implants, 3D printing
DOI: 10.3233/THC-231647
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Incesoy, Mustafa Alper | Yildiz, Fatih | Pulatkan, Mehmet Anil | Yesiller, Omer Faruk | Toluk, Ozlem | Erdem, Ahmet Can | Tuncay, Ibrahim
Article Type: Research Article
Abstract: BACKGROUND: With the restoration of the natural hip biomechanics, a successful total hip arthroplasty (THA) and long-term survival is pursued. Although robotic THA (rTHA) has been developed to increase accuracy of implant positioning, leg lengths and offsets, discussions about its radiological and clinical advantages over conventional THA (cTHA) continues. OBJECTIVE: The aim of this study was to compare clinical and radiological outcomes of robotic and conventional THA. METHODS: This retrospective study compares functional and radiological outcomes of 82 rTHA with a matched group of 82 cTHA in terms of age, sex, body mass …index and preoperative functional scores. The minimum follow up was 12 months for all patients. Functional outcomes were Harris Hip Score (HHS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) evaluated pre- and postoperatively. Radiological evaluations included position of cup placement according to Lewinnek and Callanan safe zones, Canal Fill Ratio (CFR), Leg Length Discrepancy (LLD), Lateral offset (LO) and Femoral Component Alignment (FCA). Complications were also evaluated. RESULTS: In the rTHA group, 91.5% (75 out of 82) of the acetabular cups were positioned within the safe zone whereas it was 63.4% (52 out of 82) for the cTHA group (p < 0.001). According to Callanan, they were 84.1% and 50%, respectively (p < 0.001). Between the groups, no statistically significant difference was found in CFR, LLD, HO, FCA, AI, AA, WOMAC, HHS and major complication rates. CONCLUSION: rTHA is superior to cTHA in terms of accuracy and reproducibility of the cup placement, however no apparent clinical benefit was found in short term follow. Show more
Keywords: Total hip arthroplasty, robot-assisted surgery, component positioning, robotic total hip replacement
DOI: 10.3233/THC-231111
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Huizinga, Maarten R. | de Vries, Astrid J. | Verkerke, G.J. | Brouwer, Reinoud W.
Article Type: Research Article
Abstract: BACKGROUND: Given the increasing numbers of young patients with knee osteoarthritis there is a need for treatments that can postpone a joint prosthesis (total knee replacement). OBJECTIVE: As an alternative to the effective yet invasive knee joint distraction procedure, a knee orthosis was developed aiming to unload the affected knee and improving synovial fluid flow. The aim of this study was to examine the effectiveness of using a load-reducing orthosis for two months on functioning, pain, and disease progression (e.g. amount of damaged cartilage) in patients with symptomatic osteoarthritis of the knee for at least one …year. METHODS: This is an interventional single-center pilot study. Ten patients with symptomatic osteoarthritis of one knee (5 males/5 females; median age 57; age range 42–59) used a custom-made orthosis for 60 days during daily life activities that involved knee loading (e.g. standing, walking, but not during stair climbing). Cycling was not allowed. Clinical outcomes were assessed up to 24 months after intervention at 6 timepoints using patient reported-outcome measures Western Ontario and McMaster Universities Osteoarthritis (WOMAC) range 0–100; Visual Analogue Scale (VAS), range 0–100 for pain. Minimum joint space width (mJSW) was assessed using knee images digital analysis (KIDA) and articular cartilage volume with magnetic resonance imaging (MRI) using custom software at baseline and at 12 and 24 months follow-up. RESULTS: Clinically beneficial effects were found for functioning (WOMAC improvement compared to baseline ranged between 18 points at 3 months follow-up and 31 points at 12 months follow-up, with only the 24-months follow-up (improvement of 27 points) not reaching statistical significance (p < 0.05)) and for pain (VAS improvement compared to baseline at follow-up time points ranged between 41–56 points; all p < 0.05). No improvements in mJSW- or MRI-derived parameters were found. CONCLUSION: This study demonstrates that use of a custom-made knee-unloading orthosis for 60 days can result in improved functional ability and decrease in pain in relatively young patients with knee osteoarthritis. No effect on disease progression could be evidenced. Show more
Keywords: Knee osteoarthritis, orthosis, patient reported outcome measures, cartilage, joint space width, MRI
DOI: 10.3233/THC-230953
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Lv, Chen | Guo, Qian | Peng, Shuang-Shuang | Chen, Xiao-Feng | Liu, Su-Fang | Wang, Xiu-Hua
Article Type: Research Article
Abstract: BACKGROUND: The implementation of the rotation system in the Chinese medical industry has achieved significant results. OBJECTIVES: The present study aims to 1) explore the strengths, weaknesses, opportunities and challenges of rotational nursing department implementation and 2) provide references for developing nursing staff’s competencies in leadership, performance evaluation, quality of care, communication in relationships and human resources. METHODS: A total of 16 rotational nursing department staff members from a tertiary tuberculosis specialist hospital in Beijing were interviewed, and the interview data were analysed using a strengths, weaknesses, opportunities and threats analysis and class …analysis. RESULTS: The advantages of the rotational nursing department included: (1) stimulating the nursing staff’s enthusiasm and creativity; (2) strengthening the communication and collaboration between departments; (3) improving the detailed management of nursing quality; and (4) enhancing the nursing staff’s comprehensive abilities. The disadvantages included: (1) the design of the rotation programme focusing on practice; (2) a lack of personalisation; and (3) imperfect performance assessment of the rotating staff. Opportunities included: (1) deepening the connotation of nursing job management and (2) developing the construction of nursing discipline and the need for personal career development and value realisation. Threats included the lack of a sound rotation management model to draw on. CONCLUSION: A rotational nursing department is conducive to enhancing the competence of nursing staff in management positions and providing new ideas for hospitals to select and train nursing management talents. By taking full advantage of the benefits of vertical nursing management, designing personalised rotation training programmes, building a diversified learning and training platform and developing a positive performance incentive mechanism is recommended to fully engage the role of rotation in nursing management talent training. Show more
Keywords: Job rotation training, post competency, SWOT analysis, nursing management
DOI: 10.3233/THC-231282
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Rossi, Stefano Marco Paolo | Sangaletti, Rudy | Andriollo, Luca | Matascioli, Luca | Benazzo, Francesco
Article Type: Research Article
Abstract: BACKGROUND: Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants. OBJECTIVE: The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant. METHODS: Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled. Patients included in the …study showed a minimum 15 degrees varus or 10 degrees valgus deviation. RESULTS: 20 cases were varus knees and 10 cases were valgus knees. Postoperative neutral alignment was defined as 0 ∘ ± 2.5 ∘ . A CCK implant was used in 20 cases while a Constrained Posterior Stabilized implant was used in 10 cases. A neutral alignment was achieved in all patients. At a minimum 6 months follow up (f-u 6–30 months) clinical outcomes including ROM, KSS, HSS, OKS and WOMAC showed significant improvement and no major complications were registered. CONCLUSIONS: The robotic system showed the achievement of a mechanical alignment with reliable radiographic outcomes and clinical results in the treatment of major deformities of the lower limb with the use of higher constrained implants at short term follow up. Further follow up and studies are necessary to confirm and verify these promising outcomes. Show more
Keywords: Robotics, knee, major deformities, varus, valgus, constaint, computer-aided surgical planning, orthopedic surgery
DOI: 10.3233/THC-231261
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Siegel, Danielle N. | Ogle, Melissa M. | Wilson, Christopher | Scholes, Olivia | Prow, Abby | Mannen, Erin M.
Article Type: Research Article
Abstract: BACKGROUND: Rolling is an important developmental milestone for infants where identifying the coordinated movement patterns could facilitate the early identification of motor development delays. Current methods for identifying coordinated movements of rolling are limited to a laboratory setting and not feasible for clinicians. OBJECTIVE: To develop video-based methods in which six coordinated movements, previously defined through motion capture, can be identified through video alone. METHODS: Forty-five videos of sixteen healthy infants achieving a roll were used to develop the video-based methodology and twenty-four videos had corresponding motion capture data used for validation. Four raters …comprised of researchers and a clinician identified rolling coordination using the new video-based methods. A Fleiss’ Kappa statistical test determined the inter- and intra-rater reliability of agreement for the new methodology and compared it to motion capture. RESULTS: The comparison of the motion capture and video-based methods resulted in substantial agreement. The video-based methods inter- and intra-rater reliability were substantial and almost perfect, respectively. CONCLUSIONS: We developed reliable methodology to accurately identify the coordinated movements of infant rolling using only 2D video. This methodology will allow researchers to reliably define coordinated movements of infants through video alone and may assist clinicians in identifying possible motor development delays and disorders. Show more
Keywords: Motor development, kinematics, milestones, biomechanics, experimental design
DOI: 10.3233/THC-231281
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Wu, Mei-Mei | Li, Yao | Jiang, He-Qun | Ma, Ye
Article Type: Research Article
Abstract: BACKGROUND: During the COVID-19 pandemic, the mobile field hospital, a rapidly deployable healthcare facility for emergency care, was effective in ensuring rapid diagnosis and treatment of patients with mild or asymptomatic SARS-CoV2 infections, effectively preventing the spread of COVID-19. OBJECTIVE: We conducted a survey to gain a thorough understanding of the epidemiological traits among the elderly who contracted the Omicron variant of the SARS-CoV-2 virus at a mobile field hospital set up at the National Exhibition and Convention Center (Shanghai). METHODS: A cross-sectional study approach was employed to examine various factors such as …demographic characteristics, clinical features, vaccination status, and nucleic acid testing. We utilized the DezhenTech Integrated Electronic Medical Record Platform (Municipal Isolation Hospital) to collect data and focused on elderly individuals infected with COVID-19 in the fifth isolation zone of the mobile field hospital set up at the National Exhibition and Convention Center (Shanghai). The patients were categorized into different age groups for analysis. RESULTS: Among the 3,183 elderly patients, 54.7% were males and 45.3% were females, with an average age of 65.32 ± 4.41 years. Among them, 47.8% (1523/3183) were 60–64 years old, 34.0% (1082/3183) were 65–69 years old, 14.0% (444/3183) were 70–74 years old, 3.2% (103/3183) were 75–79 years old, and 1.0% (31/3183) were ⩾ 80 years old. The majority (95.7%) of the elderly patients with chronic conditions had hypertension, diabetes, and coronary heart disease. The first viral nucleic acid screening showed a higher positive rate in the community and hospital fever clinics. The cumulative positive rate of the nucleic acid test in the mobile field hospital was 38.7%. The average CT value of the COVID-19 ORF1ab gene was 34.56 ± 5.98, while the average CT value of the N gene was 33.10 ± 6.50. The patients took an average of 3.40 ± 0.45 days to test negative, with a positive rate of 15.4% and an average hospital stay of 7.45 ± 0.53 days. The overall rate of COVID-19 vaccine coverage was 68.0%, with an enhanced coverage rate of 40% and a non-coverage rate of 29.3%. CONCLUSIONS: The overall prognosis for elderly patients who experienced a mild or asymptomatic SARS-CoV-2 Omicron infection at the mobile field hospital was favorable, although the vaccination rate in general was not high. By effectively managing underlying health conditions, the duration of their hospital stay in the mobile field hospital was reduced. Show more
Keywords: Elderly patients, epidemiology, mobile field hospital, SARS-CoV-2
DOI: 10.3233/THC-230973
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Mu, Shangdong | Tian, Qiusi | Shen, Liangyu
Article Type: Research Article
Abstract: BACKGROUND: Nucleolar protein 16 (NOP16) is present in the protein complex of the nucleolus. The NOP16 promoter contains a c-Myc binding site, and the transcriptional regulation by c-Myc directly regulates NOP16 expression levels. OBJECTIVE: Dysregulation of NOP 16 is currently reported in only a small number of cancers. In this study, the expression profile of NOP 16 in hepatocellular carcinoma (LIHC) and its clinical significance were analyzed. METHODS: NOP16 expression in hepatocellular carcinoma (LIHC) and its relationship with the clinical characters of LIHC were examined using the Cancer Genome Atlas (TCGA), the Gene …Expression comprehensive database (GEO), Kaplan-Meier survival analysis, univariate Cox analysis, multivariate Cox analysis, ROC curve analysis of KEGG enrichment, GSEA enrichment, in vitro experiments (e.g., siRNA interference of NOP16 expression in hepatoma cells, Keap1-Nrf2 pathway, cell cycle, cell apoptosis and Transwell assays), and LIHC single-cell sequencing (scRNA). RESULTS: Pan-cancer analysis revealed that NOP16 was highly expressed in 20 cancer types, including LIHC, and high NOP16 expression was an independent adverse prognostic factor in LIHC patients. The expression levels of NOP16 mRNA and protein were significantly increased in tumour tissues of LIHC patients compared to normal tissues. The functions of co-expressed genes were primarily enriched in the cell cycle and reactive oxygen species metabolism. The experimental results showed that knockdown of NOP16 activated the Keap/Nrf2 signalling pathway and inhibited the invasion, migration, and EMT progression of LIHC cells. LIHC scRNA-seq data showed that NOP16 was primarily expressed in T lymphocytes. CONCLUSIONS: NOP16 promoted cancer development in LIHC and caused an imbalance in Keap/Nrf2 signalling, which subsequently caused the aberrant expression of genes typical for EMT, cell cycle progression and apoptosis. NOP16 is a potential prognostic marker and therapeutic target for hepatocellular carcinoma progression. Show more
Keywords: NOP16, Keap1-Nrf2 pathway, hepatic cell liver cancer, bioinformatics
DOI: 10.3233/THC-231256
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Fajkić, Almir | Jahić, Rijad | Begić, Edin | Dervišević, Amela | Kurtović, Avdo | Lepara, Orhan
Article Type: Research Article
Abstract: BACKGROUND: Metabolic syndrome (MetS) is a group of comorbidities related to regulating hyperglycemia and acute cardiovascular incidents and complications. With the increasing prevalence in individuals with type 2 diabetes mellitus (T2DM), MetS represents an increasing public health problem and clinical challenge, and early diagnosis is necessary to avoid the accelerated development of diabetic complications. OBJECTIVE: To investigate the role of Complete Blood Count-derived Inflammation Indexes (CBCIIs) in predicting MetS in T2DM individuals. METHODS: The study was designed as a two-year prospective study and included 80 T2DM individuals divided into MetS and non-MetS groups …based on MetS development over two years. The sera samples were analyzed for complete blood count parameters and C-reactive protein (CRP). Based on the laboratory test results, 13 CBCIIs were calculated and analyzed. The receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine prognostic accuracy. RESULTS: There were significant differences between T2DM participants with Mets and those without MetS concerning Neutrophil to Platelet Ratio (NPR) values (p < 0.001), Neutrophil to Lymphocyte and Platelet Ratio (NLPR) (p < 0.001), Platelet to Lymphocyte Ratio (PLR) (p < 0.001), Lymphocyte to C-reactive protein Ratio (LCR) (p < 0.001), C-reactive protein to Lymphocyte Ratio (CRP/Ly) (p < 0.001), Systemic immune inflammation index (SII) (< 0.001), and Aggregate Index of Systemic Inflammation (AISI) (p = 0.005). The results of ROC curve analysis have shown that the LCR (AUC of 0.907), CRP/Ly (AUC of 0.907) can serve as excellent predictors, but NPR (AUC of 0.734), NLRP (AUC of 0.755), PLR (AUC of 0.823), SII (AUC of 0.745), and AISI (AUC of 0.688) as good predictors of MetS in T2 DM individuals. CONCLUSION: This study confirms the reliability of the CBCIIs as novel, simple, low cost and valuable predictors of MetS developing in T2DM. Show more
Keywords: Diabetes mellitus, metabolic syndrome, complete blood count-derived inflammation indexes
DOI: 10.3233/THC-231101
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: P, Elayaraja | S, Kumarganesh | Sagayam, K. Martin | J, Andrew
Article Type: Research Article
Abstract: BACKGROUND: Cervical malignancy is considered among the most perilous cancers affecting women in numerous East African and South Asian nations, both in terms of its prevalence and fatality rates. OBJECTIVE: This research aims to propose an efficient automated system for the segmentation of cancerous regions in cervical images. METHODS: The proposed techniques encompass preprocessing, feature extraction with an optimized feature set, classification, and segmentation. The original cervical image undergoes smoothing using the Gaussian Filter technique, followed by the extraction of Local Binary Pattern (LBP) and Grey Level Co-occurrence Matrix (GLCM) features from the …enhanced cervical images. LBP features capture pixel relationships within a mask window, while GLCM features quantify energy metrics across all pixels in the images. These features serve to distinguish normal cervical images from abnormal ones. The extracted features are optimized using Genetic Algorithm (GA) as an optimization method, and the optimized sets of features are classified using the Co-Active Adaptive Neuro-Fuzzy Inference System (CANFIS) classification method. Subsequently, a morphological segmentation technique is employed to categorize irregular cervical images, identifying and segmenting malignant regions within them. RESULTS: The proposed approach achieved a sensitivity of 99.09%, specificity of 99.39%, and accuracy of 99.36%. CONCLUSION: The proposed approach demonstrated superior performance compared to state-of-the-art techniques, and the results have been validated by expert radiologists. Show more
Keywords: Cervical cancer, gaussian filter, features, optimization, genetic algorithm, classification
DOI: 10.3233/THC-230926
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Bečić, Ervina | Salihović, Mirsada | Tüzün, Burak | Omeragić, Elma | Imamović, Belma | Dedić, Mirza | Roca, Sunčica | Špirtović-Halilović, Selma
Article Type: Research Article
Abstract: BACKGROUND: Computational research plays an important role in predicting the chemical and physical properties of biologically active compounds important in future structural modifications to improve or modify biological activity. OBJECTIVE: This research focuses on quantum chemical and spectroscopic investigations properties of synthesized 4-hydroxycoumarin derivatives. METHODS: Quantum chemical calculations were obtained using B3LYP, HF, and M06-2x level methods with the 6-31++G (d,p) basis set. Afterward, IR, 1 H, 13 C, UV-Visible experimentally parameters were compared with the results obtained using the B3LYP/6-31+G*(d) basis set of the …molecules to be able to characterize the structures. RESULTS: Based on the quantum chemical calculations compound with acetamido group on the phenyl ring is the most reactive, and compound with nitro substituent is the least reactive and the the strongest electrophile among tested compounds. With the exception of compounds with dimethylamino group, all other compounds have a pronounced tautomer between between OH and C = O group. The calculated and experimental values are in agreement with each other. CONCLUSION: The molecular structure in the ground state of six 3-cinnamoyl 4-hydroxycoumarin derivatives was optimized using density functional theory. The observed and computed values were compared and it can be concluded that the theoretical results were in good linear agreement with the experimental data. Show more
Keywords: Density functional theory (DFT), coumarin derivatives, quantum chemical calculations
DOI: 10.3233/THC-231798
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Feng, Ruigang | Huang, Wenwen | Liu, Bowen | Li, Dan | Zhao, Jinlai | Yu, Yue | Cao, Xuchen | Wang, Xin
Article Type: Research Article
Abstract: BACKGROUND: The effective treatment of breast cancer in elderly patients remains a major challenge. OBJECTIVE: To construct a nomogram affecting the overall survival of triple-negative breast cancer (TNBC) and establish a survival risk prediction model. METHODS: A total of 5317 TPBC patients with negative expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) who were diagnosed and received systematic treatment from 2010 to 2015 were collected from the American Cancer Surveillance, Epidemiology and End Results (SEER) database. They were randomly divided into training set (n = …3721) and validation set (n = 1596). Univariate and multivariate Cox regression analysis were used to identify prognostic features, and a nomogram was established to predict the probability of 1-year, 3-year and 5-year OS and BCSS. We used consistency index (C-index), calibration curve, area under the curve (AUC) and decision curve analysis (DCA) to evaluate the predictive performance and clinical utility of the nomogram. RESULTS: The C-indices of the nomograms for OS and BCSS in the training cohort were 0.797 and 0.825, respectively, whereas those in the validation cohort were 0.795 and 0.818, respectively. The receiver operating characteristic (ROC) curves had higher sensitivity at all specificity values as compared with the Tumor Node Metastasis (TNM) system. The calibration plot revealed a satisfactory relationship between survival rates and predicted outcomes in both the training and validation cohorts. DCA demonstrated that the nomogram had clinical utility when compared with the TNM staging system. CONCLUSION: This study provides information on population-based clinical characteristics and prognostic factors for patients with triple-negative breast cancer, and constructs a reliable and accurate prognostic nomogram. Show more
Keywords: Triple negative breast cancer, nomogram, overall survival, breast cancer-specific survival, SEER database
DOI: 10.3233/THC-231240
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Luschi, Alessio
Article Type: Letter
DOI: 10.3233/THC-231784
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-3, 2024
Authors: Tekeli, Seçkin Özgür | Köse, Özkan | Yapar, Dilek | Tekeli, Feyza Yağmur | Asoğlu, Mehmet Melih | Kartal, Emre Mücahit
Article Type: Research Article
Abstract: BACKGROUND: The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. OBJECTIVE: This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. METHODS: This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. RESULTS: Of the participants, 49.2% (n = 1,683) were diagnosed …with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p < 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5–2.0; p < 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. CONCLUSIONS: The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65. Show more
Keywords: Vitamin D, knee, osteoarthritis, female sex, biomedical imaging, elderly healthcare, orthopedic surgery
DOI: 10.3233/THC-230802
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Wu, Mingzhen | Luan, Jixin | Zhang, Di | Fan, Hua | Qiao, Lishan | Zhang, Chuanchen
Article Type: Research Article
Abstract: BACKGROUND: Histopathological evaluation is currently the gold standard for grading gliomas; however, this technique is invasive. OBJECTIVE: This study aimed to develop and validate a diagnostic prediction model for glioma by employing multiple machine learning algorithms to identify risk factors associated with high-grade glioma, facilitating the prediction of glioma grading. METHODS: Data from 1114 eligible glioma patients were obtained from The Cancer Genome Atlas (TCGA) database, which was divided into a training set (n = 781) and a test set (n = 333). …Fifty machine learning algorithms were employed, and the optimal algorithm was selected to construct a prediction model. The performance of the machine learning prediction model was compared to the clinical prediction model in terms of discrimination, calibration, and clinical validity to assess the performance of the prediction model. RESULTS: The area under the curve (AUC) values of the machine learning prediction models (training set: 0.870 vs. 0.740, test set: 0.863 vs. 0.718) were significantly improved from the clinical prediction models. Furthermore, significant improvement in discrimination was observed for the Integrated Discrimination Improvement (IDI) (training set: 0.230, test set: 0.270) and Net Reclassification Index (NRI) (training set: 0.170, test set: 0.170) from the clinical prognostic model. Both models showed a high goodness of fit and an increased net benefit. CONCLUSION: A strong prediction accuracy model can be developed using machine learning algorithms to screen for high-grade glioma risk predictors, which can serve as a non-invasive prediction tool for preoperative diagnostic grading of glioma. Show more
Keywords: Glioma, machine learning, prediction model, grading, risk predictors
DOI: 10.3233/THC-231645
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Dedić, Mirza | Omeragić, Elma | Imamović, Belma | Bilajac, Esma | Mahmutović, Lejla | Glamočlija, Una | Bečić, Ervina
Article Type: Research Article
Abstract: BACKGROUND: Preclinical drug testing requires in vitro and in vivo assessments that are vital for studying drug pharmacokinetics and toxicity. Distinct factors that play an important role in drug screening, such as hydrophobicity, solubility of the substance and serum protein binding can be challenging by inducing result inconsistencies. Hence, establishing accurate methods to quantify drug concentrations in cell cultures becomes pivotal for reliable and reproducible results important for in vivo dosing predictions. OBJECTIVE: This research focuses on developing an optimized analytical approach via high-pressure liquid chromatography (HPLC) to determine thymoquinone (TQ) levels in …monolayer cell cultures. METHODS: The method’s validation adheres to the International Council for Harmonisation (ICH) guideline M10, ensuring its acceptance and applicability. Using an HPLC system with a Diode Array Detector (DAD), the study fine-tuned various parameters to achieve an efficient separation of TQ. Validation covered specificity, sensitivity, matrix effects, linearity, precision, and accuracy, alongside assessing TQ stability in RPMI-1640 medium. RESULTS: The HPLC method exhibited remarkable TQ specificity, free from interfering peaks at the analyte retention. Sensitivity analysis at the lower limit of quantification (LLOQ) revealed 5.68% %CV and 98.37% % mean accuracy. Matrix effect evaluation showcased accuracy within 85–115%. Linearity spanned in the concentration range of 2–10 μ M with a correlation coefficient (r 2 ) of 0.9993. Precision and accuracy were aligned with acceptance criteria. The proposed method was found to be greener in terms of usage of persistent, bioaccumulative, and toxic chemicals and solvents, corrosive samples, and waste production. CONCLUSION: The developed HPLC-DAD method emerges as specific, accurate, sensitive, and reliable for TQ determination in cell cultures. It ensures robust TQ quantification, enhancing precise in vitro assessments and dependable dosing predictions for in vivo studies. Further research is advocated to investigate TQ’s stability across diverse environmental conditions. Show more
Keywords: Method validation, RPMI-1640, thymoquinone concentration determination
DOI: 10.3233/THC-231432
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Wang, Wenhong | Zhang, Zhenbo | Xia, Fenbo
Article Type: Review Article
Abstract: BACKGROUND: Mechanical ventilation (MV) is a crucial intervention for the support of patients with acute and severe respiratory failure in modern intensive care medicine. However, the mechanical forces resulting from the interplay between the ventilator and the respiratory system may cause pulmonary injury. OBJECTIVE: To compare the effects of high-flow nasal cannula (HFNC) therapy and other oxygen therapy modalities on the risk of endotracheal reintubation in mechanically ventilated patients after extubation in the intensive care unit (ICU). METHODS: An electronic search was carried out across various databases including PubMed, Embase, Ovid, Medline, Cochrane …Library, Embase, VIP, and Wanfang. The objective of this search was to locate prospective randomized controlled trials that examined the effects of multiple oxygen therapy approaches on the incidence of reintubation in patients in the ICU after undergoing mechanical ventilation. The meta package in R language was used to analyze parameters adopted by the included studies such as reintubation rate, mortality rate, and length of hospital stay. RESULTS: This study enrolled 22 articles, involving 4,160 participants, with 2,061 in the study group and 2,099 in the control group. Among these, 20 articles presented data on the reintubation rate of the patients included with an odds ratio (OR) of 0.90 (95% CI: 0.74, 1.09) for HFNC and an OR of 1.77 (95% CI: 0.93, 3.38) for HFNC in the chronic obstructive pulmonary disease (COPD) subgroup. Moreover, 10 articles assessed the incidence of respiratory failure after extubation, revealing an OR for HFNC was 0.68 (95% CI: 0.55, 0.84) using a fixed-effects model. Nine articles addressed ICU mortality, while 13 pieces of literature examined hospital mortality. HFNC showed no significant impact on either ICU mortality or hospital mortality. CONCLUSION: HFNC therapy markedly reduces the incidence of respiratory failure in mechanically ventilated patients following extubation in the ICU. Furthermore, it specifically reduces the risk of reintubation in patients diagnosed with COPD. Show more
Keywords: Mechanical ventilation, intensive care unit, high-flow nasal cannula, respiratory failure, mortality rate
DOI: 10.3233/THC-231024
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Li, Jiahao
Article Type: Research Article
Abstract: BACKGROUND: The main goal of sports science is to monitor sports injuries. Nevertheless, the existing sports injury monitoring projects have many expensive instruments and excessively extended monitoring periods, which makes it difficult to expand sports injury monitoring on a large scale. OBJECTIVE: The advancement of machine learning algorithms opens up new avenues for the tracking of sports injuries. METHODS: A training set of sports injuries was created using the Discrete Wavelet Transform (DWT) and Random Forest algorithms. Next, a basic analytic framework was created based on the lower-body movement of runners, and an …athlete’s injury likelihood monitoring system was established. First off, the wearable gyroscope device can efficiently plot the motion displacement curve and monitor the three-dimensional mechanics of the athlete’s hips, thighs, and calves. Secondly, the system has a higher computational efficiency and an advantage over other classifier-based systems in terms of testing and training times RESULTS: The suggested system framework identifies athletes’ injury propensity, providing preventive recommendations based on displacement curves, and offering a low total cost and high testing accuracy, making it easy to implement and cost-effective. CONCLUSION: All things considered, the sports injury monitoring device is very accurate and reasonably priced, making it appropriate for widespread use. Show more
Keywords: Discrete wavelet transform, random forest algorithm, three-dimensional mechanics, gyroscope, computational efficiency
DOI: 10.3233/THC-231789
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Darshan, B.S. Dhruva | Sampathila, Niranjana | Bairy, Muralidhar G. | Belurkar, Sushma | Prabhu, Srikanth | Chadaga, Krishnaraj
Article Type: Research Article
Abstract: BACKGROUND: Anaemia is a commonly known blood illness worldwide. Red blood cell (RBC) count or oxygen carrying capability being insufficient are two ways to describe anaemia. This disorder has an impact on the quality of life. If anaemia is detected in the initial stage, appropriate care can be taken to prevent further harm. OBJECTIVE: This study proposes a machine learning approach to identify anaemia from clinical markers, which will help further in clinical practice. METHODS: The models are designed with a dataset of 364 samples and 12 blood test attributes. The developed algorithm …is expected to provide decision support to the clinicians based on blood markers. Each model is trained and validated on several performance metrics. RESULTS: The accuracy obtained by the random forest, K nearest neighbour, support vector machine, Naive Bayes, xgboost, and catboost are 97%, 98%, 95%, 95%, 98% and 97% respectively. Four explainers such as Shapley Additive Values (SHAP), QLattice, Eli5 and local interpretable model-agnostic explanations (LIME) are explored for interpreting the model predictions. CONCLUSION: The study provides insights into the potential of machine learning algorithms for classification and may help in the development of automated and accurate diagnostic tools for anaemia. Show more
Keywords: Clinical markers, decision support, explainable artificial intelligence, machine learning
DOI: 10.3233/THC-231207
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Alshehhi, Talib | Ayesh, Aladdin | Yang, Yingjie | Chen, Feng
Article Type: Research Article
Abstract: BACKGROUND: The term ‘dementia’ covers a range of progressive brain diseases from which many elderly people suffer. Traditional cognitive and pathological tests are currently used to detect dementia, however, applications using Artificial Intelligence (AI) methods have recently shown improved results from improved detection accuracy and efficiency. OBJECTIVE: This research paper investigates the efficacy of one type of data analytics called supervised learning to detect Alzheimer’s disease (AD) – a common dementia condition. METHODS: The aim is to evaluate cognitive tests and common biological markers (biomarkers) such as cerebrospinal fluid (CSF) to develop predictive …classification systems for dementia detection. RESULTS: A data analytics process has been proposed, implemented, and tested against real data obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) repository. CONCLUSION: The models showed good power in predicting AD levels, notably from specified cognitive tests’ scores and tauopathy related features. Show more
Keywords: Alzheimer’s disease, biomarkers, data analytics, dementia, medical screening
DOI: 10.3233/THC-220598
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Yu, Cai-Cha | Jiao, Yan | Wang, Jia-Jia | Zhao, Xiao-Si | Chen, Lei
Article Type: Research Article
Abstract: BACKGROUND: Endometrial receptivity is crucial for the establishment of a healthy pregnancy outcome. Previous research on endometrial receptivity primarily examined endometrial thickness, endometrial echo types, and endometrial blood supply. OBJECTIVE: To explore the differences in the elastic modulus of the endometrium in women with various pregnancy outcomes by real-time shear wave elastography (SWE) and to investigate its application value in evaluation of endometrial receptivity. METHODS: A total of 205 pregnant women who were admitted at Wenzhou People’s Hospital between January 2021 and December 2022 were selected. Three-dimensional transvaginal sonography and real-time shear wave …elastography were performed in the proliferative phase and receptive phase of the endometrium, and the average elastic modulus of the endometrium in the two phases was obtained and compared. According to whether the pregnancy was successful or not, the participants were divided into the pregnancy group (n = 72) and non-pregnancy group (n = 133), and the differences in intimal thickness, 3D blood flow parameters, and average elastic modulus of intima were compared between the two groups. RESULTS: The average elastic modulus of the endometrium in the proliferative phase and receptive phase was (23.92 ± 2.31) kPa and (11.82 ± 2.24) kPa, respectively, and the difference was statistically significant P < 0.05. The average elastic modulus of the endometrium in the pregnancy group and non-pregnancy group was (9.97 ± 1.08) kPa and (12.82 ± 2.06) kPa, respectively, and the difference was statistically significant P < 0.05. The area under the curve of predicting pregnancy by the average elastic modulus of the endometrium in the receptive phase was 0.888 (0.841∼ 0.934), with corresponding P value < 0.05. The critical value was 11.15, with a corresponding sensitivity of 81.7% and specificity of 78.2%. CONCLUSION: Real-time shear wave elastography can quantitatively evaluate endometrial elasticity, indirectly reflect the endometrial phase, and provide a new diagnostic concept for evaluating endometrial receptivity and predicting pregnancy outcome in infertile patients. Show more
Keywords: Elastic modulus value, endometrial receptivity, real-time shear wave elastography
DOI: 10.3233/THC-231106
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zeeshan, Tayyaba | Qamar, Zeeshan | Abdul, Nishath Sayed | Soman, Cristalle | Bamousa, Badr | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals. OBJECTIVE: The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS). METHODS: Noordini’s Artifical Mouth model was used for developing the …single species biofilm with early microbial colonizers of oral biofilm (A. viscosus , Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count. RESULTS: From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis , S.sanguinis and A.viscosus . There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p ⩽ 0.05). CONCLUSION: It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora. Show more
Keywords: Bacterial retention, essential oils, chlorhexidine gluconate, curcumin photosensitizer
DOI: 10.3233/THC-231814
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Muniasamy, Anandhavalli | Begum, Arshiya | Sabahath, Asfia | yaqub, Humara | Karunakaran, Gauthaman
Article Type: Research Article
Abstract: BACKGROUND: Coronary heart disease (CHD) is one of the deadliest diseases and a risk prediction model for cardiovascular conditions is needed. Due to the huge number of features that lead to heart problems, it is often difficult for an expert to evaluate these huge features into account. So, there is a need of appropriate feature selection for the given CHD dataset. For early CHD detection, deep learning modes (DL) show promising results in the existing studies. OBJECTIVE: This study aimed to develop a deep convolution neural network (CNN) model for classification with a selected number of …efficient features using the LASSO (least absolute shrinkage and selection operator) technique. Also, aims to compare the model with similar studies and analyze the performance of the proposed model using accuracy measures. METHODS: The CHD dataset of NHANES (National Health and Nutritional Examination Survey) was examined with 49 features using LASSO technique. This research work is an attempt to apply an improved CNN model for the classification of the CHD dataset with huge features CNN model with feature extractor consists of a fully connected layer with two convolution 1D layers, and classifier part consists of two fully connected layers with SoftMax function was trained on this dataset. Metrics like accuracy recall, specificity, and ROC were used for the evaluation of the proposed model. RESULTS: The feature selection was performed by applying the LASSO model. The proposed CNN model achieved 99.36% accuracy, while previous studies model achieved over 80 to 92% accuracy. CONCLUSION: The application of the proposed CNN with the LASSO model for the classification of CHD can speed up the diagnosis of CHD and appears to be effective in predicting cardiovascular disease based on risk features. Show more
Keywords: Coronary heart disease, deep learning, machine learning, LASSO, convolutional neural network
DOI: 10.3233/THC-231807
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Zeng, Ling-Zhi | Cui, Ji | Jiang, Tao | Tu, Li-Ping | Liu, Hai-Dan | Gong, Ya-Bin | Xu, Ling | Xu, Jia-Tuo
Article Type: Research Article
Abstract: BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T …-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue’s image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process. Show more
Keywords: Non-small cell lung cancer, tongue image, image features, pathological staging, traditional Chinese medicine
DOI: 10.3233/THC-230372
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Zhou, Quan | Chen, Xurui
Article Type: Research Article
Abstract: BACKGROUND: The need for personalised care in the long-term management of patient health is paramount due to the variability in individual features and responses to specific medication. With the availability of large quantities of electronic patient records, big data analysis presents a valuable opportunity to gain insights into disease presentation and patient impact. OBJECTIVE: This study aims to utilise data science in the medical field to extract unknown information from databases, validate previously obtained data, and enhance personalised patient care. METHODS: An analytics suite is developed for monitoring patient health and treating cholesterol, …thyroid, and diabetes disorders. This suite employs exploratory, predictive, and visual analytics to categorise patient data into multiple tiers and forecast related complication risk and treatment response. RESULTS: The study found that the analytics suite could successfully identify correlations between various biological indicators of patients and disorders. The suite also showcased potential in predicting health risks and responses to treatments. CONCLUSION: The analytics employed in this study suggest advanced methods of data analysis, which could serve as potential decision-making tools for healthcare providers. These methods might lead to improved treatment outcomes, contributing significantly to personalised patient care. Show more
Keywords: Data analytics, neural networks, decision support system, patient monitoring, survival probability and visualization
DOI: 10.3233/THC-230980
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Pan, Yanyan | Wu, Xiujuan | Zhu, Miao | Zhang, Tingting | Gao, Lanlan | Zhu, Yamei | Mao, Huijuan | Lv, Xiaolin | Sun, Guozhen
Article Type: Research Article
Abstract: BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the …Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P < 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P < 0.05), and negatively correlated with self-care compliance (r = - 0.35, P < 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P < 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P < 0.05). High RAAQ was associated with high VAS (b = 0.11, 95% CI: 0.05, 0.18), DTI (b = 0.28, 95% CI: 0.17, 0.38), SXI (b = 0.24, 95% CI: 0.14, 0.34) and TDS (b = 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception. Show more
Keywords: End-stage renal disease, maintenance hemodialysis, thirst, RAAQ, RABQ
DOI: 10.3233/THC-230749
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Gu, Bao-Di | Wang, Yun | Ding, Rong
Article Type: Research Article
Abstract: BACKGROUND: Malnutrition is a widespread problem in critically ill patients with neurological disorders. OBJECTIVE: The purpose of this study is to investigate the effect of a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support on the outcome metrics in patients with neurological disorders who are critically ill. METHODS: We enrolled 84 participants who were hospitalized in the intensive care unit (ICU) of Yancheng No. 1 People’s Hospital for neurological disorders between June 2018 and December 2021. The participants were randomly assigned to the control group and the test …group. The control group received traditional nutritional support, while the test group was treated with a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support. We collected the general information, feeding tolerance (FT), nutritional risk score, and laboratory indicators before intervention, after intervention for one week, and after intervention for 2 weeks, and other data of the participants. RESULTS: After the intervention, the test group scored significantly lower than the control group in the incidence of gastroparesis and diarrhea, as well as the NUTRIC score, with statistically significant differences (P < 0.001). The prealbumin levels in the test group increased progressively prior to intervention, after intervention for one week, and after intervention for two weeks. Compared to the control group, the test group had higher prealbumin levels prior to intervention, after intervention for one week, and after intervention for two weeks, with statistically significant differences (P < 0.001). CONCLUSION: We developed a multidisciplinary collaborative nutritional treatment model based on a standard unit for nutritional support. This model can improve neural function, FT, and pertinent outcome indicators and is generally applicable. Show more
Keywords: Nervous system diseases, nutrition therapy, patient care team
DOI: 10.3233/THC-230791
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Chen, Jiaqi | Zhang, Xiaohong | Wu, Wenjing | Yuan, Youyuan | Xue, Wupemg | Cao, Wendong | Du, Rongxin
Article Type: Research Article
Abstract: BACKGROUND: Endoluminal interventions have become one of the main options for the treatment of arteriosclerosis obliterans (ASO). OBJECTIVE: To explore the effect of hydration therapy and nursing intervention on the prevention of contrast-induced nephropathy (CIN) after interventional treatment of lower extremity ASO. METHODS: A convenience sampling method was used to select 94 patients who received ASO treatment in our hospital from March 2019 to May 2021 as the study subjects. All patients underwent endovascular interventional therapy and were randomly divided into two groups by the random number table method, with odd numbers entering …the observation group (n = 47) and even numbers entering the control group (n = 47). The control group received routine nursing intervention, while the observation group underwent hydration therapy and had a corresponding nursing intervention scheme. The clinical efficacy of the two groups and the incidence of contrast-induced nephropathy after interventional therapy were compared, and an evaluation of satisfaction within the two groups was performed via a questionnaire. RESULTS: The total effective rate of patients in the observation group was higher after hydration treatment (97.87% vs 87.23%, p < 0.05). The blood urea nitrogen, creatinine, and β 2 microglobulin levels in the observation group were significantly lower than those in the control group after the intervention (p < 0.05). Patients in the observation group had higher nursing satisfaction after using preventive measures of hydration therapy combined with nursing interventions (100% vs 89.36%, p < 0.05). CONCLUSION: Hydration therapy and nursing intervention can effectively prevent CIN after interventional treatment of lower extremity ASO. After interventional therapy, patients had better clinical outcomes, lower biochemical indexes and improved satisfaction evaluations. The therapy is worthy of clinical promotion and application. Show more
Keywords: Lower extremity arteriosclerosis obliterans, interventional therapy, contrast nephropathy, nursing, hydration therapy
DOI: 10.3233/THC-230256
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Medjedovic, Edin | Stanojevic, Milan | Jonuzovic-Prosic, Sabaheta | Ribic, Emina | Begic, Zijo | Cerovac, Anis | Badnjevic, Almir
Article Type: Review Article
Abstract: BACKGROUND: Following the latest trends in the development of artificial intelligence (AI), the possibility of processing an immense amount of data has created a breakthrough in the medical field. Practitioners can now utilize AI tools to advance diagnostic protocols and improve patient care. OBJECTIVE: The aim of this article is to present the importance and modalities of AI in maternal-fetal medicine and obstetrics and its usefulness in daily clinical work and decision-making process. METHODS: A comprehensive literature review was performed by searching PubMed for articles published from inception up until August 2023, including …the search terms “artificial intelligence in obstetrics”, “maternal-fetal medicine”, and “machine learning” combined through Boolean operators. In addition, references lists of identified articles were further reviewed for inclusion. RESULTS: According to recent research, AI has demonstrated remarkable potential in improving the accuracy and timeliness of diagnoses in maternal-fetal medicine and obstetrics, e.g., advancing perinatal ultrasound technique, monitoring fetal heart rate during labor, or predicting mode of delivery. The combination of AI and obstetric ultrasound can help optimize fetal ultrasound assessment by reducing examination time and improving diagnostic accuracy while reducing physician workload. CONCLUSION: The integration of AI in maternal-fetal medicine and obstetrics has the potential to significantly improve patient outcomes, enhance healthcare efficiency, and individualized care plans. As technology evolves, AI algorithms are likely to become even more sophisticated. However, the successful implementation of AI in maternal-fetal medicine and obstetrics needs to address challenges related to interpretability and reliability. Show more
Keywords: Artificial intelligence, machine learning, obstetrics, perinatology
DOI: 10.3233/THC-231482
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2023
Authors: Loganathan, Prakash Kannan | Dorkins, Charles | Marlow, George | Zahra, James | Tulsianey, Mudit A. | Rowles, Toby J. | Chadwick, Paula
Article Type: Research Article
Abstract: BACKGROUND: Newborn hypothermia at birth remains as global challenge across all settings. The prevention of delivery room hypothermia at birth could potentially reduce neonatal morbidity and mortality. OBJECTIVE: To compare the heat conservation efficacy of Neohelp and Neowrap and evaluate the heat production efficacy of trans-warmer infant mattress (TWM) in a laboratory setting. METHODS: A beaker of water was heated at 60 ∘ C was covered by Neohelp or two layers of Neowrap and left to cool in an open room for 90 minutes and calculated the decay constant. Using …infra-red camera, we measured the maximum temperature and time taken to reach the temperature in the TWM. RESULTS: Neowrap took 863 seconds for the temperature to drop from 37 ∘ C to 35 ∘ C, compared with 941 seconds with Neohelp. When activated TWM reached a maximum temperature of 39.3 ± 0.1 ∘ C. It took 30 seconds when the activator was placed in the centre, compared with 88 seconds when it was at the corner. CONCLUSION: Compared to Neowrap, Neohelp had better heat conservation properties. Activating the metal disk from the TWM center would deliver quicker heat. Show more
Keywords: Hypothermia, neohelp, neowrap, trans-warmer mattress
DOI: 10.3233/THC-231001
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2023
Authors: Cao, Xu | Pei, Xiaomei
Article Type: Research Article
Abstract: BACKGROUND: Diabetic kidney disease (DKD) is an important microvascular complication of diabetes mellitus (DM). OBJECTIVE: This study aimed to develop predictive nomograms to estimate the risk of DKD in patients with type 2 diabetes mellitus (T2DM). METHODS: The medical records of patients with T2DM in our hospital from March 2022 to March 2023 were retrospectively reviewed. The enrolled patients were randomly selected for training and validation sets in a 7:3 ratio. The models for predicting risk of DKD were virtualized by the nomograms using logistic regression analysis. RESULTS: Among the …enrolled 597 patients, 418 were assigned to the training set, while 179 were assigned to the validation set. Using the predictors included glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), presence of diabetic retinopathy (DR) and duration of diabetes (DD), we constructed a full model (model 1) for predicting DKD. And using the laboratory indexes of HbA1c, HDL-C, and cystatin C (Cys-C), we developed a laboratory-based model (model 2). The C-indexes were 0.897 for model 1 and 0.867 for model 2, respectively. The calibration curves demonstrated a good agreement between prediction and observation in the two models. The decision curve analysis (DCA) curves showed that the two models achieved a net benefit across all threshold probabilities. CONCLUSION: We successfully constructed two prediction models to evaluate the risk of DKD in patients with T2DM. The two models exhibited good predictive performance and could be recommended for DKD screening and early detection. Show more
Keywords: Diabetic kidney disease, type 2 diabetes mellitus, nomogram, risk factor, glycated hemoglobin A1c
DOI: 10.3233/THC-230811
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Dayama, Nikhil Vitthal | Ali, Mariyam | Gaur, Abhishek | Pandey, Kaushik Kumar | Alqahtani, Nasser M. | Alfarsi, Mohammed A. | Zarbah, Mohammad A. | Chaturvedi, Saurabh | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Bonding between metal and ceramic is one of the most important aspects of a successful prosthesis. Various methods have been recommended for preparing the metal surface to enhance the bond between metal and ceramic including the use of a metal bonding agent. OBJECTIVE: This study aims to evaluate and compare the shear bond strength of the metal-ceramic (M-C) interface after combinations of various surface treatments including the application of a metal bonding agent. METHOD: 40 Ni-Cr alloy specimens were made and divided into 4 groups of 10 each based on the combination …of surface treatments. Sandblasting, surface grinding, and Oxidation heat treatment (OHT) were performed on specimens from Group 1 (Control). In addition, Group 2 specimens received ultrasonic cleaning, Group 3 steam cleaning, and Group 4 metal bonding agent application. Following surface treatments on all specimens, porcelain build-up was performed, and shear bond strength was tested in a Digital Universal testing machine. The statistical tests used were independent t -test and ANOVA. RESULTS: Results revealed that Group 4 specimens had the highest mean value of shear bond strength of 39.087 MPa while Group 3 specimens showed the least mean shear bond strength of 18.154 MPa with highly statistically significant results (p < 0.001). CONCLUSION: The surface treatments and application of bonding agent to metal prior to porcelain application resulted in increased shear bond strength of the metal-ceramic interface. Show more
Keywords: Metal bonding agent, shear bond strength, surface treatments, alloys, composition, metal-ceramic
DOI: 10.3233/THC-231003
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Ong, Christian B. | Buchan, Graham B.J. | Hecht II, Christian J. | Kendoff, Daniel O. | Homma, Yasuhiro | Kamath, Atul F.
Article Type: Research Article
Abstract: BACKGROUND: Patient obesity is a risk factor for poor acetabular cup positioning in total hip arthroplasty (THA). OBJECTIVE: To assess the impact of using a novel, fluoroscopy-based robotic THA system on acetabular cup placement in obese versus non-obese patients. METHODS: A review of 105 consecutive manual unassisted (mTHA) (47 Obese/58 Non-obese) and 102 robotic-assisted (RA-THA) (50 Obese/52 Non-obese) primary, direct anterior approach THA procedures was conducted. All cases were performed by a single surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Obesity was defined as a Body Mass Index …(BMI) ⩾ 30 kg/m 2 . Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone. RESULTS: Obese patients in the mTHA cohort had larger cup inclination angles on average compared to non-obese patients (44.82 ∘ ± 6.51 vs. 41.39 ∘ ± 6.75; p = 0.009). Obese mTHA patients were less likely to have cup placement within the Lewinnek zone compared to non-obese mTHA patients (0.48 vs. 0.67; p = 0.027). Obesity had no effect on the accuracy of RA-THA. CONCLUSION: Obesity affects the placement of the acetabular component in manual THA. The novel, fluoroscopy-based robotic THA system in this study demonstrated accurate cup placement regardless of obesity status. Show more
Keywords: Arthroplasty, hip, acetabulum, robotic-assisted surgery, obesity
DOI: 10.3233/THC-231127
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Jia, Limin | Zhang, Chenguang | Fu, Xin | Chen, Caihua | Zheng, Hongkui | Yang, Caifang
Article Type: Research Article
Abstract: BACKGROUND: The use of indwelling closed thoracic drainage tubes in the wedge resection of the lungs is of great significance to postoperative recovery. However, there are potential risks. OBJECTIVE: To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. METHODS: A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer …system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t -test to compare the differences between the two groups. RESULTS: There were no statistically significant differences in terms of age, gender and sweating between the two groups. Compared with the control group, the unplanned extubation rate of the experimental group was lower (χ 2 = 8.513; P = 0.004), the indwelling time of the drainage tube was shorter (t = 2.108; P = 0.037), the cumulative material cost was lower (t = 3.778; P < 0.001), the time cost was also lower (Z = 2.717; P = 0.008), the degree of comfort was higher (Z = 2.752; P = 0.006), and the degree of pain was lower (Z = 4.019; P < 0.001). The incidence of subcutaneous emphysema was significantly lower in the experimental group than in the control group (χ 2 = 8.513; P = 0.004). CONCLUSION: The use of the triple-buffer system to fix small-diameter (18 F) thoracic closed drainage tubes can reduce the unplanned extubation rate, indwelling time of the drainage tube and the incidence of adverse reactions. Show more
Keywords: Lung wedge resection, small-diameter closed thoracic drainage tube, fixed method
DOI: 10.3233/THC-230558
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
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