Technology and Health Care - Volume 30, issue 5

Authors: Zor, Zeynep Fatma | Kılınç, Yeliz | Erkmen, Erkan | Kurt, Ahmet

Article Type: Research Article

Abstract: BACKGROUND: The effect of different thread designs and diameters on the all-on-four concept is unclear. OBJECTIVE: The aim of the study was to clarify the differences in stress distribution of dental implants with various thread designs and diameters based on the all-on-four concept with three dimensional (3D) finite element analysis (FEA). METHODS: A 3D model of a totally edentulous mandible was used to perform the FEA. Four different models (M1, M2, M3, and M4) including 3.5 and 4.3 mm diameter dental implants with active and passive threaded designs were generated. The dental implants …were positioned according to the all-on-four concept. The Von Mises stresses on dental implants and maximum and minimum principal stresses (Pmax and Pmin) on bony structures were calculated under vertical, oblique and horizontal loads. RESULTS: For Von Mises stresses, the highest stress values were detected on the distal implants for all models. Distal implants had also the highest stress values for vertical loading. The Von Mises stresses were found to be concentrated around the implant’s neck. In all models the highest Pmax and Pmin stresses occurred in the bone surrounding the distal implant. It was noted that the active threaded implants showed the highest Pmax and Pmin stress values. CONCLUSION: The implant thread design and diameter might have a strong influence on the stress values in the all-on-four concept. Show more

Keywords: All-on-four, dental implant, diameter, finite element analysis, thread design

DOI: 10.3233/THC-213072

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1031-1042, 2022

Authors: Zhou, Qian | Xu, Ping | Ding, Hong | Wang, Yong | Fu, Lina | Wang, Bo | Liu, Danru

Article Type: Research Article

Abstract: BACKGROUND: The global prevalence of thyroid cancer has increased significantly in recent years. Ultrasonography is the preferred method for differentiating benign and malignant thyroid nodules preoperatively and is recommended by guidelines. OBJECTIVE: To assess the application value of gray-scale ultrasound and shear wave elastography in distinguishing small thyroid nodules. METHODS: A retrospective analysis of 228 thyroid nodules, all of which were confirmed by pathology after surgery or FNA from January 2019 to January 2020, was carried out. All nodules were divided into a ⩽ 5 mm group and a > …5 mm group according to their maximum size. We compared the differences in the gray scale and elastography of the nodules between the two groups and the accuracy of different diagnostic methods. RESULTS: The accuracies of gray-scale ultrasound and shear wave elastography in the ⩽ 5 mm group were found to be lower than those in the > 5 mm group, and the gray-scale accuracy was slightly higher than that of shear wave elastography in both groups (p < 0.05). The largest AUC (area under the curve) of elastic parameters in the ⩽ 5 mm and > 5 mm groups was found for Emax and Esd, respectively. Based on a combination of these two parameters, the accuracies of the two groups were significantly higher than those of the parameters or gray scale alone (p < 0.05) and were 84.62% and 85.48%, respectively. CONCLUSION: Shear wave elastography is valuable in the diagnosis of benign and malignant thyroid nodules using ultrasonography. When combining gray-scale ultrasound and shear wave elastography, the diagnostic accuracy is obviously improved, especially for ⩽ 5 mm small thyroid nodules. Show more

Keywords: Thyroid nodules, diagnostic imaging, ultrasonography, elasticity imaging techniques

DOI: 10.3233/THC-213137

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1043-1054, 2022

Authors: Chen, Gary Yu-Hsin | Chen, Ping-Shun | Tsai, Tzu-Tao

Article Type: Research Article

Abstract: BACKGROUND: Medical staff scheduling problems are complex and involve numerous constraints. OBJECTIVE: This research uses the task-technology fit (TTF) model to measure the technology characteristics of information technology (IT) systems as a reference for constructing a prototype for a medical staff scheduling system to identify function requirements and design human interfaces. METHOD: After the evaluation of the proposed scheduling system, this research excludes compatibility from the 13 technology characteristics and adds two technology characteristics for consideration: customization and scalability. RESULTS: Based on the revised technology characteristics of the TTF model, …this research develops flexible scheduling functions to satisfy daily manpower requirements and allow predetermined schedules and day-off reservations for a hospital’s radiological technologists. Characterized by flexibility, customization, and scalability, the system can accommodate several algorithms to generate a better schedule that satisfies hard and soft constraints. Furthermore, the scheduler can choose the required hard and soft constraints from all constraints. The prototype of the scheduling system will be easily extended to add or modify constraints in the case of requirement or regulation changes. CONCLUSION: The results of this study provide a prototype for system developers to design a customized staff scheduling system for each medical unit. Show more

Keywords: Medical staff scheduling system, task-technology fit (TTF) model, staff scheduling, customization, hard and soft constraints, technology characteristic

DOI: 10.3233/THC-213260

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1055-1075, 2022

Authors: Shi, Jian | Chen, Luzeng | Wang, Bin | Zhang, Hong | Xu, Ling | Ye, Jingming | Liu, Yinhua | Shao, Yuhong | Sun, Xiuming | Zou, Yinghua

Article Type: Research Article

Abstract: BACKGROUND: Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%) in the global cancer statistics 2020. OBJECTIVE: To evaluate the diagnostic value of ultrasound elastography combined with multi-parameters in differentiating category 4 benign and malignant lesions in the breast imaging reporting and data system (BI-RADS). METHODS: This study retrospectively analyzed 206 patients (213 breast lesions) who visited the Department of Breast Surgery and underwent a breast core needle biopsy in the Department of Ultrasound in Peking University First hospital from April …to December 2019. The shear wave velocity (SWV) values were collected at the following locations by virtual touch tissue imaging quantification (VTIQ): breast lesion interior, breast lesion margin, surrounding glands, and surrounding fat. Simultaneously, the strain ratio (SR) of breast lesions to glands and the area ratio (AR) of breast lesions were collected under strain elastography and a two-dimensional ultrasound mode. RESULTS: Univariate analysis found that the SWV value, measured by ultrasound elastography parameters, and the AR between the elasticity and the two-dimensional ultrasound breast lesions showed statistical differences when differentiating benign and malignant lesions (p < 0.05). Binary logistic regression analysis found that the SWV values of the lesion interior and the surrounding glands were statistically significant. The joint predictors were calculated and analyzed by Receiver Operating Characteristic (ROC), and it was found that the joint predictors and the SWV values of the lesion interior have great diagnostic value. The cut-off value, sensitivity and specificity of the joint predictor and the SWV value of the lesion interior were > 3.65, 88.35% and 76.36% and > 5.55 m/s, 79.61% and 82.73%, respectively. CONCLUSIONS: Ultrasound elastography combined with multi-parameters has good diagnostic value in differentiating BI-RADS 4 breast lesions. Show more

Keywords: Ultrasound elastography, strain elastography, ARFI, VTIQ, SWV, breast lesion

DOI: 10.3233/THC-213272

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1077-1089, 2022

Authors: Guleken, Zozan | Kanber, Eyüp Murat | Sarıbal, Devrim | Depciuch, Joanna

Article Type: Research Article

Abstract: BACKGROUND: The venous disease of the legs is a common disease among adults that may lead to a deterioration in the structure and concentration of biomolecules. N-Butyl Cyanoacrylate Ablation Surgery (NBCA) or cyanoacrylate embolization (CAE) technique to adhesive the saphenous vein is an alternative method for the treatment of venous disease. OBJECTIVE: We aimed to show what kind of changes occurs after CAE surgery using FTIR spectroscopy combined chemometrics. We compared before and after surgery blood sera of patients to find whether a correlation between spectral data and laboratory indexes. We studied the blood sera of …those who suffered from varicose veins and treated them by CAE technique. METHODS: In order to examine the molecular profiles in blood sera who underwent the CAE technique of the great saphenous vein for the treatment we used Fourier Transform InfraRed spectroscopy (FTIR) spectroscopy of blood samples of patients before and after surgery as a fast diagnostic technique. To obtain information about the spectra variation among the types of samples Principal component analysis (PCA) was performed for fingerprint, amide II with amide I regions. To find normality among variations Partial Least Square P-P plot of residual was performed. RESULTS: Absorbance values were statistically significant only in amide II, amide I, and OH vibrations. In the blood collected before surgery, higher peaks area of α -helix and β -harmonica were noticed. However, in both groups of samples, a higher amount of β -harmonica was visible. Pearson correlation analysis showed that the value of white blood cells (WBC) correlate with absorbance at 2858 cm - 1 wavenumber. Moreover, a correlation between neutrophil (NEU) and OH vibrations, and between hematocrit (HCT) and 1082 cm - 1 , were found. Furthermore, a high correlation Platelets (PLT) and FTIR peak at 1165 cm - 1 , was noticed. CONCLUSIONS: This methodology suggests with PCA analysis CAE caused structural and quantitative chemical changes in blood samples of patients. Show more

Keywords: Varicose veins, Cyanoacrylate Ablation Surgery, blood parameters, Fourier Transform InfraRed spectroscopy, Principal component analysis

DOI: 10.3233/THC-213642

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1091-1106, 2022

Authors: Meng, Yinghui | Dong, Minghao | Dai, Xumin | Tang, Haipeng | Zhao, Chen | Jiang, Jingfeng | Xu, Shun | Zhou, Ying | Zhu, Fubao | Xu, Zhihui | Zhou, Weihua

Article Type: Research Article

Abstract: BACKGROUND: Automatic identification of proper image frames at the end-diastolic (ED) and end-systolic (ES) frames during the review of invasive coronary angiograms (ICA) is important to assess blood flow during a cardiac cycle, reconstruct the 3D arterial anatomy from bi-planar views, and generate the complementary fusion map with myocardial images. The current identification method primarily relies on visual interpretation, making it not only time-consuming but also less reproducible. OBJECITVE: In this paper, we propose a new method to automatically identify angiographic image frames associated with the ED and ES cardiac phases. METHOD: A …detection algorithm is first used to detect the key points (i.e. landmarks) of coronary arteries, and then an optical flow method is employed to track the trajectories of the selected key points. The ED and ES frames are identified based on all these trajectories. Our method was tested with 62 ICA videos from two separate medical centers. RESULTS: Comparing consensus interpretations by two human expert readers, excellent agreement was achieved by the proposed algorithm: the agreement rates within a one-frame range were 92.99% and 92.73% for the automatic identification of the ED and ES image frames, respectively. CONCLUSION: The proposed automated method showed great potential for being an integral part of automated ICA image analysis. Show more

Keywords: Coronary artery disease, invasive coronary angiography, cardiac cycle, optical flow

DOI: 10.3233/THC-213693

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1107-1116, 2022

Authors: Al Ahmari, Nasser M.

Article Type: Research Article

Abstract: BACKGROUND: The success of dental implants depend on implant design, surgical technique, bone density, implant morphology and postoperative care. Initial stability is utmost importance and is of concern in low density bone. The osseo-densification strategy enhance primary stability by raising density of the osteotomy site walls by non-subtractive drilling, unlike conventional technique. OBJECTIVE: The aim of this in vivo study was to assess and compare the osseo-densification implant drilling technique with conventional implant drilling in terms of primary implant stability along with other factors, plaque index, bleeding on probe, pocket depth and radiographic assessment of …bone density, marginal bone loss using CBCT. METHOD: A total of 20 patients aged between 40 and 59 years were included in this research. A split-mouth configuration of 40 implants was used. In the osseo-densification group, specialized (Densah) bur kit was used to insert 20 implants on one side. In the conventional group, standard bur kit was used to insert 20 implants on the opposite side of the jaw. For each patient, clinical and radiographic assessment was performed at regular intervals at the beginning (immediately after surgery), seven months, and a year following surgery. RESULTS: With the exception of bone density, which was statistically significant in favour of the osseo-densification group immediately after surgery, primary and secondary stability, plaque index, bleeding on probe, pocket depth and even marginal bone loss were not significantly different between the two groups in this investigation. CONCLUSION: Osseo-densification technique provided a better primary stability in the low density bone cases thus, can be consider as a trustworthy treatment for speeding up the healing process while also maintaining marginal bone integrity following loading. Use of specialized bur while drilling procedure improves the density around the implants. Show more

Keywords: Osseo-densification, low density bone, primary stability, implant success

DOI: 10.3233/THC-220048

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1117-1124, 2022

Authors: Soliman, Osama | Pflugmacher, Robert | Koch, Ernst MW | Mohamed, Hesham | van der Beck, Susanne | Abdallah, Hany | Bornemann, Rahel

Article Type: Research Article

Abstract: BACKGROUND: While pain in the severe sacroiliac joint (SIJ) is a common cause of lower back pain, SIJ disease is often overlooked as a diagnosis. OBJECTIVE: This study examines the extent of sufficient long-term pain relief and functional improvement in patients with SIJ syndrome that are treated with thermocoagulation. Some patients treated with thermocoagulation noted initial improvement, but the functionality and pain relief had limited duration and efficacy. Patients with insufficient improvement were recommended to undergo fusion surgery as an option for better and longer lasting results. METHOD: Patients with a long history …of back or pelvic problems were selected for the study. Endoscopic thermal coagulation of the SIJ was carried out. The follow-up examinations took place after 1, 3, 6, 12 months. In patients with insufficient pain relief and functionality after thermocoagulation, a fusion surgery was performed. The results of the fusion surgery were documented over a 12-month follow-up period. To carry out the statistical evaluation visual analog scale (VAS), Oswestry-Disability-Index (ODI) and the consumption of opioids were recorded. RESULTS: Forty-eight patients were included. The mean VAS values 12 months after thermocoagulation were 68.9. The ODI after 12 months was very near or somewhat higher than their baseline prior to the thermocoagulation. Thus, a fusion surgery was recommended. Thirty-three patients agreed to the fusion operation. The VAS values 12 months after fusion surgery decreased to 53.1. Analogous to the VAS values, the Oswestry index (ODI) showed a significant improvement after the fusion operation. CONCLUSION: The success of surgical intervention in 88% of the SIJ syndrome patients with inadequate results 12 months after thermocoagulation proves the superiority of SIJ fusion surgery. This study showed long-lasting pain relief by an average of 65% and a median improvement in functional impairments of 60%. In view of these results, fusion surgery should be considered for patients without sufficient success of thermocoagulation. Show more

Keywords: SIJ, thermal coagulation, fusion surgery, sacroiliac joints syndrome, implant systems, iFuse

DOI: 10.3233/THC-213183

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1125-1138, 2022

Authors: Kasapovic, Adnan | Schwetje, Desirée | Ali, Thaer | Jaenisch, Max | Gathen, Martin | Bornemann, Rahel | Abdallah, Hany | Vieweg, Uwe

Article Type: Research Article

Abstract: BACKGROUND: Sacroiliac joint (SIJ) painful dysfunction is a common source of low back pain (LBP). Several surgical treatment options for SIJ fusion were described. A promising treatment option with demonstrated clinical improvement is the minimally-invasive SIJ fusion. OBJECTIVE: The aim of this case study was to document the effectiveness and safety of the new SIJ system (Torpedo ® ) over a period of 6 months after the minimally invasive implantation. METHODS: Patients with failed conservative treatment of painful SIJ dysfunction were enrolled successively in two centers. The Diagnosis was made …by positive response to SIJ-injection with local anesthetic and at least by two positive SIJ provocation tests. The Torpedo ® Implant system was used for the implantation. This workpiece made of titanium alloy is characterized by a helical profile geometry (CST: chronical spinal turn) with a hydrophilic surface. The evaluated endpoints LBP and grade of disability were assessed using a 0–10 numerical rating scale (NRS), and Oswestry Disability Index (ODI) preoperatively and at one, three and six months postoperatively. RESULTS: 15 patients (10 female, 5 male; mean age 59 ± 13 years) were operated on one after the other. The pain intensity decreased in all 15 patients. After 6 months, a decrease in the median values of 70% (quartiles 1–3: 65–79%) was calculated. The median values of the Oswestry Disability Index after 6 months were 62% (quartiles 1–3: 53–67) lower than before the operation. Before surgery, 13 patients (87%) were taking opioids for pain management. Six months after the operation, opioids were only needed by 3 patients (20%). Implant malpositioning was not detected on plain radiograph. No surgical site infections or perioperative complications occurred. CONCLUSIONS: The clinical improvement in early follow up and the absence of surgery related complications demonstrate a high grade of device-related safety and effectiveness of the treatment with a novel minimally-invasive SIJ fusion system. Show more

Keywords: SIJ-syndrome, SIJ-pain, chronic pain, low back pain, SIJ-fusion

DOI: 10.3233/THC-213348

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1139-1145, 2022

Authors: Takahashi, Tsuneari | Sugimoto, Kazutaka | Ae, Ryusuke | Saito, Tomohiro | Kimura, Yuya | Kubo, Tatsuya | Handa, Mikiko | Takeshita, Katsushi

Article Type: Research Article

Abstract: BACKGROUND: Total knee arthroplasty (TKA) is a widely performed procedure to alleviate pain and restore function of patients with end-stage knee osteoarthritis. OBJECTIVE: The study aim was to determine if tibia-first (TF) total knee arthroplasty (TKA) using a novel computer-assisted surgery (CAS) system can yield better anterior and posterior (AP) knee stability. METHODS: Patients with knee osteoarthritis with obvious varus knee who met the indication for and underwent TKA from May 2019 to November 2020 were included. Forty-one measured resection (MR)-TKAs and 32 TF-TKAs were compared. The varus-valgus ligament balance and joint tension …at a joint center-gap setting equal to the tibial-baseplate thickness were measured, and appropriate polyethylene inserts with 0 ∘ , 30 ∘ , 45 ∘ , 60 ∘ , 90 ∘ , and 120 ∘ of knee flexion were placed. A Kneelax 3 arthrometer was used to measure knee AP laxity in the postoperative anesthetized patients with 30 ∘ and 90 ∘ of knee flexion. RESULTS: The horizontal gap balance was significantly closer in the TF-TKA group than the MR-TKA group for 0 ∘ , 30 ∘ , 45 ∘ , and 60 ∘ of knee flexion. In contrast, no significant differences were observed for 90 ∘ and 120 ∘ of knee flexion. No significant differences in joint-gap tensions among all knee-flexion angles were observed. Translation was significantly smaller in the TF-TKA group than the MR-TKA group for AP laxity with 30 ∘ of knee flexion (8.8 ± 2.9 mm vs. 10.7 ± 3.1 mm, P = 0.0079). In contrast, no significant AP laxity was observed with 90 ∘ of knee flexion (7.2 ± 2.8 mm vs. 7.2 ± 3.5 mm). CONCLUSION: TF-TKA using a novel CAS system provided better AP knee stability with close to horizontal gap balances. Show more

Keywords: Total knee arthroplasty, computer-assisted surgery, tibia-first technique, anterior and posterior knee stability, gap balance

DOI: 10.3233/THC-213535

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1147-1154, 2022

Authors: Yin, Meng | Huang, Binhua | Yi, Zhengkun | Cai, Shibo

Article Type: Research Article

Abstract: BACKGROUND: The complex in-hand manipulation puts forward higher requirements for the dexterity and joint control accuracy of the prosthetic hand. The tendon-sheath drive has important application potential in the fields of prosthetic hand to obtain higher dexterity. However, the existing control methods of tendon-sheath driven joint are mainly open-loop compensation based on friction model, which makes it difficult to achieve high-precision joint control. OBJECTIVE: The purpose of this work is to improve the position control accuracy of the tendon-sheath driven joint for the prosthetic hand. METHODS: The structure of the prosthetic hand is …introduced, and the encoder and potentiometer are mounted on the driving motor and joint respectively. Then, the transfer function of the joint is established based on the dynamic model. The adaptive sliding mode control strategy based on RBF network is applied to realize the closed-loop feedback position control of the prosthetic hand joint. The stability of the system is demonstrated by Lyapunov theorem. RESULTS: Under the condition of constant and variable sheath curvature, the effectiveness of the controller is demonstrated by simulation and joint motion experiments, respectively. The results show that the closed-loop control has better position tracking ability than the open-loop control, and the designed controller can reduce the tracking error more obviously than the traditional algorithm. The high-precision position control can be realized by designing the controller based on the joint angle feedback. CONCLUSIONS: The research content has certain theoretical and practical significance for the development of joint high-precision control of tendon-sheath driven prosthetic hand. This is beneficial to the implementation of complex in-hand manipulation for prosthetic hand. Show more

Keywords: Prosthetic hand, tendon-sheath driven joint, RBF network, adaptive sliding mode

DOI: 10.3233/THC-213242

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1155-1165, 2022

Authors: Meng, Qiaoling | Fei, Cuizhi | Jiao, Zongqi | Xie, Qiaolian | Dai, Yue | Fan, Yuanjie | Shen, Zhijia | Yu, Hongliu

Article Type: Research Article

Abstract: BACKGROUND: Upper-limb rehabilitation robots have become an important piece of equipment in stroke rehabilitation. The design of exoskeleton mechanisms plays a key role to improve human-robot interface in the upper-limb movements under passive and active rehabilitation training. OBJECTIVE: This paper proposes a novel of the 7-DOF (RR-RR-PRR) under-actuated exoskeleton mechanism based on the characteristics of the upper-limb movements in both of active and passive training. This aim of the proposed work is to improve human-robot interface in rehabilitation training with robots. METHODS: Firstly, the characteristics of active and passive movement training are analyzed …depending on the human upper-limb model. Then, a novel 7-DOF (RR-RR-PRR) exoskeleton mechanism is proposed based on the analyzed characteristics. After that, kinematical performances of the proposed exoskeleton are analyzed on the workspace, manipulability and manipulability ellipsoid by compared with the common exoskeleton configuration of the 7 DOFs (RRR-R-PRR) mechanism. In the end, the prototype is manufactured and tested by undergoing the experiments of single-joint passive movement training and multi-joint active movement training. The human-robot interface of the proposed exoskeleton is demonstrated by root mean square error, Pearson correlation coefficient, and the time-delay difference. RESULTS: The results of the kinematical performance show that the effective workspace and the flexibility of the exoskeleton with the proposed configuration are increased by 10.44% and 1.7%. In the single-joint passive movement training experiment, the root mean square errors are 6.986, 7.568, 5.846, and Pearson correlation coefficients are 0.989, 0.984, 0.988 at the shoulder joint and the elbow joint, respectively. The time-delay differences are not beyond 3.1%. In the multi-joint active movement training experiment, the root mean square errors are 9.312 and 7.677, and Pearson correlation coefficients are 0.906 and 0.968 at the shoulder joint and the elbow joint, respectively. The time-delay differences are not beyond 3.28%. CONCLUSIONS: The proposed 7 DOFs exoskeleton mechanism shows uniformity with that of the common exoskeleton on the same rehabilitation trajectory which is effective to improve human-robot interface under passive and active rehabilitation training. Show more

Keywords: Upper-limb rehabilitation exoskeleton, active and passive movement training, kinematical performance, workspace, manipulability

DOI: 10.3233/THC-213573

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1167-1182, 2022

Authors: Chrif, Farouk | van Hedel, Hubertus J.A. | Vivian, Mauro | Nef, Tobias | Hunt, Kenneth J.

Article Type: Research Article

Abstract: BACKGROUND: The use of robotic technology for neurorehabilitative applications has become increasingly important for adults and children with different motor impairments. OBJECTIVE: The aim of this study was to evaluate the technical feasibility and usability of a new interactive leg-press training robot that was developed to train leg muscle strength and control, suitable for children with neuromuscular impairments. METHODS: An interactive robotic training system was designed and constructed with various control strategies, actuators and force/position sensors to enable the performance of different training modes (passive, active resistance, and exergames). Five paediatric patients, aged …between 7 and 16 years (one girl, age 13.0 ± 3.7 years, [mean ± SD]), with different neuromuscular impairments were recruited to participate in this study. Patients evaluated the device based on a user satisfaction questionnaire and Visual Analog Scale (VAS) scores, and therapists evaluated the device with the modified System Usability Scale (SUS). RESULTS: One patient could not perform the training session because of his small knee range of motion. Visual Analog Scale scores were given by the 4 patients who performed the training sessions. All the patients adjudged the training with the interactive device as satisfactory. The average SUS score given by the therapists was 61.2 ± 18.4. CONCLUSION: This study proposed an interactive lower limb training device for children with different neuromuscular impairments. The device is deemed feasible for paediatric rehabilitation applications, both in terms of technical feasibility and usability acceptance. Both patients and therapists provided positive feedback regarding the training with the device. Show more

Keywords: Neurorehabilitation, leg press, paediatric rehabilitation

DOI: 10.3233/THC-213629

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1183-1197, 2022

Authors: Guduk, Omer Faruk | Sivrikaya, Efe Can | Yilmaz, Nagehan | Baygin, Ozgul | Tuzuner, Tamer

Article Type: Research Article

Abstract: BACKGROUND: Stainless steel crowns (SSCs), which have been used frequently in the treatment of first permanent molars in children until now, has become less applicable due to its poor aesthetic appearance. Zirconia crowns (ZCs) have become more popular due to their aesthetic advantage. However, stress transmission of ZCs to dental tissues under occlusal forces in endodontically treated teeth has not been described. OBJECTIVE: The aim of this study was to compare the stress distribution of different crown materials (ZCS, SSCs) and adhesive materials on dentin in endodontically treated permanent teeth and to specify the crown-adhesive model …with lower stress. METHODS: Finite element analysis (FEA) was used to apply a force of 300 N from the inner part of the buccal tubercles (vertical loading) and a lingo-buccal at an angle of 30 degrees (oblique loading) of the first permanent molars (FPM) with different crown (ZCS, SSCs) and adhesive (Glass ionomer cement, Resin modified glass ionomer cement, Resin cement) materials in twelve separate models. The von Mises values obtained from the models were compared and the optimal stress values were determined by FEA. RESULTS: The lowest stress values of dentin were found in zirconia crown model with glass ionomer cement (GIC) adhesive under vertical loading (26,793 Mpa). In the zircon crown and GIC adhesive model, less von Mises stress occurred on the dentin under all conditions. CONCLUSIONS: ZCs and GIC adhesive may be recommended for teeth with a high probability of dentin fracture. Show more

Keywords: Endodontically treated teeth, FEA, stainless steel crown, zirconium crown

DOI: 10.3233/THC-213505

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1199-1207, 2022

Authors: Ji, Juanjuan | Li, Xudong | Zhu, Yaling | Wang, Rui | Yang, Shuang | Peng, Bei | Zhou, Zhi

Article Type: Research Article

Abstract: BACKGROUND: Periodontitis is a common oral immune inflammatory disease and early detection plays an important role in its prevention and progression. However, there are no accurate biomarkers for early diagnosis. OBJECTIVE: This study screened periodontitis-related diagnostic biomarkers based on weighted gene correlation network analysis and machine algorithms. METHODS: Transcriptome data and sample information of periodontitis and normal samples were obtained from the Gene Expression Omnibus (GEO) database, and key genes of disease-related modules were obtained by bioinformatics. The key genes were subjected to Gene Ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and …Genomes (KEGG) enrichment analysis and 5 machine algorithms: Logistic Regression (LR), Random Forest (RF), Gradient Boosting Decisio Tree (GBDT), Extreme Gradient Boosting (XGBoost), and Support Vector Machine (SVM). Expression and correlation analysis were performed after screening the optimal model and diagnostic biomarkers. RESULTS: A total of 47 candidate genes were obtained, and the LR model had the best diagnostic efficiency. The COL15A1, ICAM2, SLC15A2, and PIP5K1B were diagnostic biomarkers for periodontitis, and all of which were upregulated in periodontitis samples. In addition, the high expression of periodontitis biomarkers promotes positive function with immune cells. CONCLUSION: COL15A1, ICAM2, SLC15A2 and PIP5K1B are potential diagnostic biomarkers of periodontitis. Show more

Keywords: Periodontitis, WGCNA, machine algorithms, diagnostic biomarkers

DOI: 10.3233/THC-THC213662

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1209-1221, 2022

Authors: Ou, Tzu-Ming | Hu, Wei-Wen | Chang, Chia-Hung | Hsu, Chia-Chin | Wang, Chih-Hsuan

Article Type: Research Article

Abstract: BACKGROUD: Recently, monitoring the vital-sign with the noncontact method is a popular technology. OBJECTIVE: In this work, we present a fully pulse radar system including front-end sensing and back-end data processing. A series of ultra-wide band sensing pulses is generated and radiated to detect the subject’s chest vibration which in turn obtains the required vital-sign signals. METHODS: An artificial plywood with 3 centimeter thickness is placed between a transmitting/receiving antenna of the radar and subject to demonstrate the characteristic of noncontact sensing. The firmware and digital signal processing are also presented in this paper to …optimize physiological data quality. RESULTS: The experimental results show that the continuous heart rate and breathing rate can be monitored by this customized system radar module. CONCLUSION: A fully customized ultra-wide band radar for vital-sign application is presented. The radar system plan with wall parameter is also incorporated into the design consideration to meet the FCC requirement and SNR. Show more

Keywords: Radar, UWB, noncontact, real time, vital signs

DOI: 10.3233/THC-THC220022

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1223-1231, 2022

Authors: Luo, Guiyuan | Liao, Dan | Lin, Wenjin | Chen, Liuyun | Chen, Xiaojun | Yao, Dianye

Article Type: Research Article

Abstract: BACKGROUND: Da Vinci surgery is used extensively, but the high costs of the surgical instrument are a serious clinical and management problem. OBJECTIVE: To reduce the cost of the Da Vinci robotic surgical instrument supply chain. METHODS: Patients were selected from the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Control group patients underwent Da Vinci robot-assisted surgery between January 2019 and June 2019 (control group). Patients who were operated with the same robot from July 2019 to December 2019 were selected as the experimental group (SCM group). The cost analysis and …comparison were carried out to integrate instrument sets, working hours, workforce expenditure, and direct and indirect expenses. RESULTS: Compared with the control group, the number of instrument packages was lower (4.5 ± 1.4 vs. 11.5 ± 1.6, P < 0.001) and the personnel’s awareness of the instruments was higher (92.3 ± 4.2 vs. 83.4 ± 3.7, P < 0.001) in the SCM group. The SCM group showed lower processing time per device (8.1 ± 1.6 vs. 44.2 ± 5.6 min, P < 0.001) and lower costs per surgical instrument (RMB 11.5 ± 2.3 vs. 60.3 ± 10.2, P < 0.001). CONCLUSION: The application of the supply chain management can reduce the costs of robotic surgery, improve work efficiency and decrease the failure rate of instruments. Show more

Keywords: Supply chain management, Da Vinci’s surgical instruments, robotic surgery, management, cost analysis

DOI: 10.3233/THC-213563

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1233-1241, 2022

Authors: Dong, Qi | Cao, Miao | Gu, Feng | Gong, Weifang | Cai, Qingwu

Article Type: Research Article

Abstract: BACKGROUND: Thermal ablation of liver tumors is a conventional mode for treating liver tumors. In order to reduce the damage to normal tissue endangered by thermal ablation, the physician needs to plan the puncture path before surgery. OBJECTIVE: In this paper, a puncture trajectory planning method for thermal ablation of liver tumor based on NSGA-III is proposed. This method takes the clinical hard constraints and soft constraints into account. METHOD: The feasible puncture region is solved by the hard constraints, and after that the pareto front points are obtained under the soft constraints. …When accessing the feasible puncture region, an adaptive morphological closing operation method based on K-means algorithm is adopted to process the spherical angle binary image of obstacles that might be encountered in the puncture process. RANSAC is performed to fit the tangent plane of liver surface when calculating the angle between the puncture trajectory and liver surface. In order to evaluate the puncture path obtained by this method, 6 tumors are selected as experimental subjects, and Hausdorff distance and Overlap Rate of Pareto front points with manually recommend points are calculated respectively. RESULTS: The average value of Hausdorff distance is 24.91 mm, and the mean value of the overlap rate is 86.43%. CONCLUSION: The proposed method can provide high safety and clinical practice of the puncture route. Show more

Keywords: Liver tumor puncture ablation planning, multi-objective optimization, K-means, Random Sampling Consistent algorithm, NSGA-III

DOI: 10.3233/THC-213592

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1243-1256, 2022

Authors: Wang, Yonggang | Zhou, Min | Ding, Yong | Li, Xu | Zhou, Zhenyu | Xie, Tianchen | Shi, Zhenyu | Fu, Weiguo

Article Type: Research Article

Abstract: BACKGROUND: Endovascular aortic aneurysm repair (EVAR) is currently established as the first-line treatment for anatomically suitable abdominal aortic aneurysm (AAA). OBJECTIVE: To establish a deep convolutional neural networks (DCNN) model for fully automatic segmentation intraluminal thrombosis (ILT) of abdominal aortic aneurysm (AAA) in pre-operative computed tomography angiography (CTA) images. METHODS: We retrospectively reviewed 340 patients of AAA with ILT at our single center. The software ITKSNAP was used to draw AAA and ILT region of interests (ROIs), respectively. Image preprocessing and DCNN model build using MATLAB. Randomly divided, 80% of patients was classified …as training set, 20% of patients was classified as test set. Accuracy, intersection over union (IOU), Boundary F1 (BF) Score were used to evaluate the predictive effect of the model. RESULTS: By training in 34760–35652 CTA images (n = 204) and validation in 6968–7860 CTA images (n = 68), the DCNN model achieved encouraging predictive performance in test set (n = 68, 6898 slices): Global accuracy 0.9988 ± 5.7735E-05, mean accuracy 0.9546 ± 0.0054, ILT IOU 0.8650 ± 0.0033, aortic lumen IOU 0.8595 ± 0.0085, ILT weighted IOU 0.9976 ± 0.0001, mean IOU 0.9078 ± 0.0029, mean BF Score 0.9829 ± 0.0011. Our DCNN model achieved a mean IOU of more than 90.78% for segmentation of ILT and aortic lumen. It provides a mean relative volume difference between automatic segmentation and ground truth (P > 0.05). CONCLUSION: An end-to-end DCNN model could be used as an efficient and adjunctive tool for fully automatic segmentation of abdominal aortic thrombus in pre-operative CTA image. Show more

Keywords: Abdominal aortic aneurysm, intraluminal thrombosis, computed tomography angiography, convolutional neural networks, deep learning

DOI: 10.3233/THC-THC213630

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1257-1266, 2022

Authors: Yi, Shuai | Li, Wenzhao | Ding, Muliang | Ni, Jiangdong | Wang, Junjie

Article Type: Case Report

Abstract: BACKGROUND: Congenital pseudarthrosis of the clavicle (CPC) is a rare congenital entity with unresolved aetiology and pathogenesis. Nearly 250 cases have been reported to date. CPC is characterized by a definite defect in the mid-clavicle at birth and is usually diagnosed when the deformity becomes evident in late childhood or adolescence. Surgical management is controversial, especially in asymptomatic children, with various techniques reported in the literature. CASE REPORT: We report a case of a 6-year-old boy who was diagnosed with CPC during a medical examination for primary school enrollment. Operative treatment included debridement of pseudoarthrosis, internal …fixation with third tube plate, and barrel-shaped mono-cortical iliac crest autograft. RESULTS: A complete bone union was obtained 9 months after the operation, and satisfactory function and cosmetic appearance were observed 4 years and 3 months postoperatively. CONCLUSION: In our opinion, reconstruction with barrel-shaped mono-cortical iliac crest autograft was an effective and reproducible surgical technique to treat CPC. Show more

Keywords: Congenital pseudarthrosis of the clavicle, operative treatment, iliac crest autograft, osteosynthesis

DOI: 10.3233/THC-213658

Citation: Technology and Health Care, vol. 30, no. 5, pp. 1267-1272, 2022