Technology and Health Care - Volume 31, issue 2

Authors: Xiao, Wanyi | Zhao, Xinyu | Li, Chunqiang | Huang, Qianpeng | He, Anqi | Liu, Gang

Article Type: Research Article

Abstract: BACKGROUND: To date, a few studies indicated that probiotics are beneficial to pouchitis, but no meta-analyses summarized the outcomes of probiotics in pouchitis in detail. OBJECTIVE: This meta-analysis discusses probiotics in the prevention of pouchitis for patients after ileal pouch-anal anastomosis (IPAA) and the relationship between probiotics preventive effect and the duration of therapy and history. METHODS: PubMed, EMBASE and Cochrane Library databases were searched from inception until February 2022. Risk ratio (RR), mean difference (MD) and their 95% confidence interval (CI) were analyzed by Review Manager 5.3. The subgroup analysis was also …performed to explore the agent for influencing outcomes. RESULTS: A total of 8 studies were included in this meta-analysis. The incidence of pouchitis in probiotics was significantly lower than that in the control (RR = 0.19, 95%CI [0.12, 0.32], P ⁢ ï ⁢ ¼ ⁢ œ 0.00001), and the PDAI (pouchitis disease activity index) in probiotics was also significantly lower (MD = - 5.65, 95%CI [- 9.48, - 1.83]). After the subgroup analysis, we found that probiotics work better in the short-term (RR = 0.12, 95%CI [0.04, 0.40], P = 0.0004), but may not achieve the desired effect in the long-term (RR = 1.20, 95%CI [0.40, 3.60], P = 0.75). CONCLUSIONS: Probiotics are beneficial in the prevention of pouchitis after IPAA, especially in the short-term. Show more

Keywords: Pouchitis, probiotics, proctocolectomy, restorative, IPAA

DOI: 10.3233/THC-220402

Citation: Technology and Health Care, vol. 31, no. 2, pp. 401-415, 2023

Authors: Hsieh, Jui-Chien | Shih, Hsing | Xin, Ling-Lin | Yang, Chung-Chi | Han, Chih-Lu

Article Type: Research Article

Abstract: BACKGROUND: Because clinically used 12-lead electrocardiography (ECG) devices have high falsepositive errors in automatic interpretations of atrial fibrillation (AF), they require substantial improvements before use. OBJECTIVE: A clinical 12-lead ECG pre-processing method with a parallel convolutional neural network (CNN) model for 12-lead ECG automatic AF recognition is introduced. METHODS: Raw AF diagnosis data from a 12-lead ECG device were collected and analyzed by two cardiologists to differentiate between true- and false-positives. Using a stationary wavelet transform (SWT) and independent component analysis (ICA) noise reduction was conducted and baseline wandering was corrected for the …raw signals. AF patterns were learned and predicted using a parallel CNN deep learning (DL) model. (1) The proposed method alleviates the decreased ECG QRS amplitude enhances the signal-to-noise ratio and clearly shows atrial and ventricular activities. (2) After training, the CNNbased AF detector significantly reduced false-positive errors. The precision of AF diagnosis increased from 77.3% to 94.0 ± 1.5% as compared to ECG device interpretation. For AF screening, the model showed an average sensitivity of 96.8 ± 2.2%, specificity of 79.0 ± 5.8%, precision of 94.0 ± 1.5%, F1-measure of 95.2 ± 1.0%, and overall accuracy of 92.7 ± 1.5%. CONCLUSIONS: The method can bridge the gap between the research and clinical practice The ECG signal pre-processing and DL-based AF interpretation can be rapidly implemented clinically. Show more

Keywords: 12-lead ECG, atrial fibrillation, stationary wavelet transform, independent component analysis, convolutional neural network, deep learning

DOI: 10.3233/THC-212925

Citation: Technology and Health Care, vol. 31, no. 2, pp. 417-433, 2023

Authors: He, Fan | Wang, Xinyu | Hua, Lu | Guo, Tingting

Article Type: Research Article

Abstract: BACKGROUND: In recent years, arterial stenosis has become one of the serious diseases threatening people’s life and health. OBJECTIVE: The main purpose of the present study is to examine the changes of hemodynamic parameters in different stenosis locations of arteries. METHODS: An arterial stenosis model with fluid-structure interaction and microcirculation as the outlet boundary of seepage is adopted in this paper. Considering the interaction between blood and arterial wall, a numerical simulation is carried out using the finite element method. RESULTS: The results show that hemodynamic parameters are sensitive to …the change of stenosis location. The closer to the microcirculation zone the stenosis location, the lower the blood flow velocity, pressure and the wall shear stress. In addition, the velocity trend is transformed from the gradual increase to decrease with the increasing distance away from the inlet when the stenosis location moves to the microcirculation zone. CONCLUSION: This work proves that the stenosis location has a great influence on hemodynamics based on microcirculation function. Microcirculation is an important factor that cannot be ignored in the numerical simulation of arterial hemodynamics. The numerical results could provide the potential of clinical preconditions for disease diagnosis and treatment. Show more

Keywords: Stenosis, microcirculation, hemodynamics, fluid-structure interaction

DOI: 10.3233/THC-213165

Citation: Technology and Health Care, vol. 31, no. 2, pp. 435-445, 2023

Authors: Sharma, Swati | Makkar, Monika | Luthra, Reena | Arora, Suraj | Pathania, Poonam | Das, Gotam | Chaturvedi, Saurabh

Article Type: Research Article

Abstract: BACKGROUND: Endodontically treated teeth are structurally more susceptible to root fractures. Proper tooth restorations with digitally fabricated or fibre post following endodontic therapy is essential to restore function and esthetics. OBJECTIVE: The aim of this in vitro study is to evaluate the fracture load of digitally fabricated and prefabricated fibre posts in endodontically treated teeth. METHODS: Sixty extracted human single rooted teeth were selected. The crowns were sectioned at the cement-enamel junction to standardize the remaining root length at 15 mm from the apices. Cleaning, shaping and obturation was done using conventional …step back technique to an ISO K-file size 40. The roots were divided into two groups of 30 samples each: Group S: teeth reinforced with digitally fabricated posts; Group F: teeth reinforced with fibre posts. Each group was further divided into three subgroups (S7, S9, S12, F7, F9, F12) based on lengths 7, 9 and 12 mm at which the posts were cemented. Composite resin core was fabricated and prepared to receive a complete metal crown. Universal testing machine was used to measure the compressive load required to fracture the teeth. RESULTS: The highest fracture resistance of 1532N was observed with fibre posts at 12 mm of post space length followed by digitally fabricated post 1398N at 12 mm, but the difference was not statistically significant. CONCLUSION: The highest fracture resistance was observed in the teeth restored with fibre posts with 12 mm length and the lowest with digitally fabricated post with 7 mm length. As the length of post increases irrespective of type of post fracture resistance increased. Show more

Keywords: Post and core, glass fibre post, digitally fabricated post, endodontically treated teeth, fracture resistance

DOI: 10.3233/THC-213690

Citation: Technology and Health Care, vol. 31, no. 2, pp. 447-458, 2023

Authors: He, Chen | Xiao, Yixuan | Li, Xinwei | Deng, Zhipeng | Qian, Yu | Zhao, Jing | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: The limited number of hip prostheses users makes it less feasible to conduct amputee tests for prosthesis development in the clinic, which restricts the development efficiency of the intelligent prostheses. OBJECTIVE: This study proposes a hip disarticulation prostheses test system (HDPTS) to supplement the amputee tests for hip disarticulation prosthesis (HDP) evaluation, which would potentially facilitate the prosthesis evaluation safety and development efficiency. METHODS: The hip trajectory of an individual with normal gait was acquired and reproduced by calculating the corresponding movement joint angle of a manipulator. Then, an HDP was fit …on an amputee and on the HDPTS respectively to obtain the hip and knee joint angles of the HDP during walking. Comparing the root mean square error (RMSE) of the expected and planned trajectory, the joint angles between the amputee test and HDPTS test, to verify the feasibility and accuracy of the HDPTS for prosthesis evaluation. RESULTS: The RMSE between the expected and planned trajectory value was less than 1.20 mm (< 0.19%). The RMSE of the joint angles between the amputee test and HDPTS test were 2.18 ∘ (1.8%) and 3.13 ∘ (5.92%) for hip and knee joint respectively. CONCLUSION: The HDPTS was found accurate in hip trajectory reproduction and feasible in gait simulation for the prosthesis evaluation, which could potentially supplement the amputee test for prosthesis design thus improving prosthesis test safety and development efficiency. Show more

Keywords: Hip disarticulation, gait simulation, prosthesis evaluation, prosthesis test system, trajectory planning

DOI: 10.3233/THC-220091

Citation: Technology and Health Care, vol. 31, no. 2, pp. 459-469, 2023

Authors: Kim, Kyoung-Il | Im, Sang-Cheol | Kim, Kyoung

Article Type: Research Article

Abstract: BACKGROUND: Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE: To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS: In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group …underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS: Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P < 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P < 0.025). CONCLUSION: Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke. Show more

Keywords: Stroke, visual feedback, stabilization exercise, balance, gait

DOI: 10.3233/THC-220100

Citation: Technology and Health Care, vol. 31, no. 2, pp. 471-483, 2023

Authors: Zhang, Wenxin | Qu, Shoufang | Chen, Qiong | Yang, Xuexi | Yu, Jing | Zeng, Shuang | Chu, Yuxing | Zou, Hao | Zhang, Zhihong | Wang, Xiaowen | Jing, Ruilin | Wu, Yingsong | Liu, Zhipeng | Xu, Ren | Wu, Chunyan | Huang, Chuanfeng | Huang, Jie

Article Type: Research Article

Abstract: BACKGROUND: Along with the dramatic development of molecular diagnostic testing for the detection of oncogene variations, reference materials (RMs) have become increasingly important in performance evaluation of genetic testing. OBJECTIVE: In this study, we built a set of RMs for genetic testing based on next-generation sequencing (NGS). METHOD: Solid tumor tissues were selected as the samples of RMs for preparation. NGS was used to determine and validate the variants and the mutation frequency in DNA samples. Digital PCR was used to determine the copy numbers of RNA samples. The performance of the RMs …was validated by six laboratories. RESULTS: Thirty common genetic alterations were designed based on these RMs. RMs consisted of a positive reference, a limit of detection reference, and a negative reference. The validation results confirmed the performance of the RMs. CONCLUSION: These RMs may be an attractive tool for the development, validation, and quality monitoring of molecular genetic testing. Show more

Keywords: Reference materials, genetic testing, quality control, oncogene variants

DOI: 10.3233/THC-220102

Citation: Technology and Health Care, vol. 31, no. 2, pp. 485-495, 2023

Authors: Yang, Hai-Ping | Chen, Yue-Ling | Liu, Zong-Jian | Hao, Yi | Chen, Lin | Zhang, Zhen-Hua | He, Ning | Wang, Jing

Article Type: Research Article

Abstract: BACKGROUND: Circular RNAs (circRNAs) are a new class of noncoding RNAs, which interfere with gene transcription by absorbing microRNAs (miRNAs). OBJECTIVE: The expression profile and roles of circRNAs in unstable angina (UA) patients remains unclear. METHODS: An initial screening of circRNA expression by microarray analysis was performed using blood samples from three pairs of UA patients and matched healthy individuals. The differential expression of the chosen six circRNAs from the results of the microarray analysis was validated by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: The microarray results demonstrated that …some circRNAs were markedly different in UA patients, when compared with matched healthy individuals. In these UA patients, 22 circRNAs were upregulated and six circRNAs were downregulated when a P -value of < 0.05 was considered as a cut-off level and the fold change was > 1.5. Among the six circRNAs chosen for further analysis, qRT-PCR identified that five of these were upregulated, and the remaining circRNA was downregulated. By comparing the outcome of the six candidate circRNAs between the circRNAs microarray assay and RT-PCR validation, it was found that four circRNAs (hsa_circ_0002229, hsa_circ_0005580, hsa_circ_0046667, and hsa_circ_0001451) had the same variation trend. CONCLUSION: The present study provided the expression profile of circRNAs in UA patients. Moreover, some circRNAs have the potential to be biomarkers for the detection of UA patients. Further studies with a larger population will focus on hsa_circ_0002229, hsa_circ_0005580, hsa_circ_0046667 and hsa_circ_0001451. Show more

Keywords: Unstable angina, circular RNAs, expression profile, biomarkers

DOI: 10.3233/THC-220131

Citation: Technology and Health Care, vol. 31, no. 2, pp. 497-505, 2023

Authors: Anderson, Philip Mark | Rudert, Maximilian | Holzapfel, Boris Michael | Meyer, Julian Stefan | Weißenberger, Manuel | Bölch, Sebastian Philipp

Article Type: Research Article

Abstract: BACKGROUND: The incidence of conversion total hip arthroplasty (cTHA) following reduction and fixation for proximal femur fractures will increase in parallel to the aging population worldwide. OBJECTIVE: The goal of this study is to report the frequency of bacterial detection and the outcome of cTHA at the authors’ institution and to analyze preoperative factors that correlate with higher rates of bacterial growth and septic revision. METHODS: 48 patients who had been converted to THA after osteosynthesis of a proximal femur fracture either by a one- or two-stage procedure were included. Septic failure rate …and the frequency of bacterial detection at the time of fixation device removal were calculated. The influence of different preoperative factors was examined by the odds ratio. A receiver operating characteristic curve of c-reactive protein (CRP) for detection of bacterial growth at the time of fixation device removal was calculated. RESULTS: 18.8% patients showed positive bacterial cultures, with Staph. epidermidis being the most frequent pathogen (33.3%). Septic failure after cTHA occurred in 4.2%. Fixation with cephalomedullary nails and complications with the internal fixation showed higher odds for bacterial growth at time of cTHA. CRP for predicting bacterial growth had an area under the curve of 0.661. Implant survival was worse when temporary spacers were used. CONCLUSION: Bacterial detection rate at the time of cTHA is high, whereas septic failure rates are low. Isolated evaluation of inflammatory blood markers without other diagnostic modalities for infection is not decisive and does not justify a two-stage approach with implantation of a temporary spacer. Show more

Keywords: Conversion, total hip arthroplasty, hip, periprosthetic joint infection

DOI: 10.3233/THC-220136

Citation: Technology and Health Care, vol. 31, no. 2, pp. 507-516, 2023

Authors: Takeo, Atsumi | Okazaki, Hideto | Takeda, Kotaro | Nakagawa, Yuki | Sonoda, Shigeru

Article Type: Research Article

Abstract: BACKGROUND: The number of wheelchair users is increasing as the population ages. However, there is still lack of tools to objectively assess posture during wheelchair propulsion. OBJECTIVE: The purpose of this study was to develop a system to measure trunk and pelvis ROM (range of motion) while driving a wheelchair and to assess the reproducibility of the measured posture changes and cyclic fluctuations during propulsion. METHODS: Motion recorders were attached to the sternum and pelvis of fifteen healthy adults, and a pressure sensor was attached to the right heel. Subjects drove a standard …wheelchair using their right leg and trunk and pelvis ROM was measured in two separate sessions. To detect the trend of postural changes during propulsion, a trend curve was computed from the measured ROM using a low-pass filter and then subtracted from the measured ROM waveforms. The resulting curves were normalized and averaged, and the maximum, minimum, and amplitude of the cyclic variation during propulsion were assessed for reproducibility. RESULTS: Intraclass correlation coefficients of the maximum, minimum, and amplitude ranged from 0.65 to 0.84. CONCLUSIONS: The proposed method can estimate the posture change and the periodic fluctuation during wheelchair propulsion with high reproducibility. Show more

Keywords: Wheelchair propulsion, motion recorder, motion analysis, reproducibility, posture

DOI: 10.3233/THC-220139

Citation: Technology and Health Care, vol. 31, no. 2, pp. 517-525, 2023