Technology and Health Care - Volume 31, issue 3

Authors: Hu, Yang | Wu, Yanqing | Tu, Jianglong | Su, Hai | Zeng, Luchuan | Lei, Jie | Xia, Linglin

Article Type: Research Article

Abstract: BACKGROUND: At present, the clinical diagnosis of white matter change (WMC) patients depends on cranial magnetic resonance imaging (MRI) technology. This diagnostic method is costly and does not allow for large-scale screening, leading to delays in the patient’s condition due to inability to receive timely diagnosis. OBJECTIVE: To evaluate whether the burden of WMC is associated with the degree of invisible hand tremor in humans. METHODS: Previous studies have shown that tremor is associated with WMC, however, tremor does not always have imaging of WMC. Therefore, to confirm that the appearance of WMC …causes tremor, which are sometimes invisible to the naked eye, we achieved an optical-based computer-aided diagnostic device by detecting the invisible hand tremor, and we proposed a calculation method of WMC volume by using the characteristics of MRI images. RESULTS: Statistical analysis results further clarified the relationship between WMC and tremor, and our devices are validated for the detection of tremors with WMC. CONCLUSIONS: The burden of WMC volume is positive factor for degree of invisible hand tremor in the participants without visible hand tremor. Detection technology provides a more convenient and low-cost evaluating method before MRI for tremor diseases. Show more

Keywords: WMC, tremor, segmentation, multiple linear regression, hands

DOI: 10.3233/THC-220361

Citation: Technology and Health Care, vol. 31, no. 3, pp. 921-931, 2023

Authors: Lee, Yeji | Lee, Hyun Ju | Tae, Ki Sik

Article Type: Research Article

Abstract: BACKGROUND: Non-invasive Brain-Computer Interface (BCI) uses an electroencephalogram (EEG) to obtain information on brain neural activity. Because EEG can be contaminated by various artifacts during the collection process, it has primarily evolved into motor imagery (MI) with a low risk of contamination. However, MI has a disadvantage in that accurate data is difficult to obtain. OBJECTIVE: The goal of this study was to determine which motor imagery and movement execution (ME) of the knee has the best classification performance. METHODS: Ten subjects were selected to provide MI and ME data for four different …types of knee exercise. The experiment was conducted to keep the left, right, and both knees extend or bend for five seconds, and there was a five seconds break between each movement. Each motion was performed 20 times and the MI was carried out in the same protocol. Motions were classified through a modified model of the Lenet-5 of CNN (Convolution Neural Network). RESULTS: The deep learning data was classified, and a study discovered that ME (98.91%) could be classified significantly more accurately than MI (98.37%) (p < 0.001). CONCLUSION: If future studies on other body movements are conducted, we anticipate that BCI can be further developed to be more accurate. And such advancements in BCI can be used to facilitate the patient’s communication by analyzing the user’s movement intention. These results can also be used for various controls such as robots using a combination of MI and ME. Show more

Keywords: Brain-Computer Interface (BCI), electroencephalogram (EEG), motor imagery (MI), movement execution (ME), deep learning

DOI: 10.3233/THC-220363

Citation: Technology and Health Care, vol. 31, no. 3, pp. 933-942, 2023

Authors: Kim, Sung Shin | Park, Jun Sik | Choi, Dongil | Shin, Yumi | Jo, Kyeyeob | Kim, Youngkyung | Kim, Sun Ok | Kweon, Hyosun | Lee, Anna | Bae, Young-Hyeon

Article Type: Research Article

Abstract: BACKGROUND: An electric bed can easily change posture from a lying position and was effective in preventing pressure ulcer. OBJECTIVE: This study aimed to identify the optimal posture for the prevention of pressure ulcers by analyzing pressure changes applied to the pelvic region. METHODS: Pressure changes resulting from lateral rotations of the body using an electronic adjustable bed and changes in the posture and angles of the trunk and knees were assessed. Twelve conditions with varying angles of the trunk and knees (15–35 ∘ in 5 ∘ …increments) and varying lateral angles (20–35 ∘ in 5 ∘ increments) were tested. The pressure (maximum and average) and contact area in the pelvic region of 20 individuals without disabilities were calculated. RESULTS: The conditions in which the average and maximum pressures did not increase according to the increase in angle were 25 ∘ for the upper body and knee angles and 35 ∘ for the side. CONCLUSIONS: The body pressure changed according to the posture rather than according to physical characteristics. Lateral rotation combined with changes in the angles of the trunk and knees effectively prevented pressure ulcers. Changes in the posture at various angles prevented an increased pressure on the body. Show more

Keywords: Pressure ulcer, body posture, positioning bed, body pressure, pressure area

DOI: 10.3233/THC-220376

Citation: Technology and Health Care, vol. 31, no. 3, pp. 943-954, 2023

Authors: von Schudnat, Christian | Lahmann, Benjamin | Schoeneberg, Klaus-Peter | Albors-Garrigos, Jose | De-Miguel-Molina, María

Article Type: Research Article

Abstract: BACKGROUND: The continuous decrease of healthcare resources requires hospitals to improve efficiency while striving to improve quality standards that deliver better patient outcomes. OBJECTIVE: The objective of this study was to analyze whether the implementation of digital support systems during orthopedic surgery positively affected clinical processes and quality ratios. METHODS: A retrospective case-control study of 297 knee joint replacement procedures was conducted between 2015 and 2020. Thirty-five patients were allocated to the treatment and control groups after they were identified with exact matching and estimation of the propensity score. Both groups were balanced regarding …the selected covariates. The effect of the surgical procedure manager (SPM) on the incidence of acute haemorrhagic anaemia between the two groups was evaluated with a t -test, and the odds ratio was calculated. RESULTS: SPM-supported surgery has no significant influence on the incidence of acute haemorrhagic anaemia but leads to significantly shorter hospital stay (1.93 days), changeover (4.14 minutes) and recovery room time (20.20 minutes). In addition, it reduces the standard deviation of operation room times. CONCLUSIONS: The study concludes that SPM enhances surgical efficiency and maintains quality outcomes. To overcome their increasing financial pressure hospital management should commercially evaluate the implementation of digital support systems. Show more

Keywords: Quality improvement, efficiency, operating rooms, the standard of care, digital technology, surgical procedure manager

DOI: 10.3233/THC-220395

Citation: Technology and Health Care, vol. 31, no. 3, pp. 955-968, 2023

Authors: Jiménez-Gayosso, Sandra Isabel | Morales-Luckie, Raúl Alberto | Robles-Bermeo, Norma Leticia | Hernández-Martínez, César Tadeo | Villalobos-Rodelo, Juan José | Islas-Zarazúa, Rosalina | Navarrete-Hernández, José de Jesús | Patiño-Marín, Nuria | Medina-Solís, Carlo Eduardo | Maupomé, Gerardo

Article Type: Research Article

Abstract: BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment. OBJECTIVE: To evaluate the pH variations before and after placement of PMCs. METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one …month after placement. ANOVA and Pearson correlation were performed in SPSS. RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p < 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p = 0.001) and one month (p = 0.002). CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact. Show more

Keywords: Oral health, pediatric dentistry, prefabricated metal crowns, pH

DOI: 10.3233/THC-220433

Citation: Technology and Health Care, vol. 31, no. 3, pp. 969-976, 2023

Authors: Milovanovic, Aleksandar | Saveljic, Igor | Filipovic, Nenad

Article Type: Research Article

Abstract: BACKGROUND: The fractional flow reserve (FFR) index has been widely accepted as a standard diagnostic method for identifying functional relevance of coronary stenosis. Since the invasive techniques used for its determination are associated with a certain risk of vascular injury, as well as with an increased cost, several non-invasive procedures have been developed. OBJECTIVE: The aim of this study was to compare FFR values for the coronary artery obtained by computational fluid dynamics (CFD) and coronary computed tomography angiography (CCTA). METHODS: Computation of FFR has been performed using both numerical and the analytical …method. The numerical method employs CFD to solve the governing equations which relate to mass and momentum conservation (the continuity equation and the Navier-Stokes equations) as well as CCTA to generate the three-dimensional computational domain. After imposing the appropriate boundary conditions, the values of the pressure change are calculated and the FFR index is determined. Based on Bernoulli’s law, the analytical method calculates the overall pressure drop across the stenosis in the coronary artery, enabling FFR determination. RESULTS: The clinical data for twenty patients who underwent invasive coronary angiography are used to validate the results obtained by using CFD (together with CCTA) simulation and analytical solution. The medically measured FFR compared to the analytical one differs by about 4%, while, the difference is about 2.6% when compared to the numerical FFR. For FFR values below 0.8 (which are considered to be associated with myocardial ischemia) the standard error has a value of 0.01201, while the standard deviation is 0.02081. For FFR values above 0.80, these values are slightly higher. Bland-Altman analysis showed that medical measurement and numerical FFR were in good agreement (SD = 0.0292, p < 0.0001). CONCLUSIONS: The analytically calculated FFR has a slightly lower coefficient of determination than the numerically computed FFR when compared with experimental one. However, it can still give a reliable answer to the question of whether patients need a stent, bypass surgery or only drug treatment and it requires a significantly lower computation time. Show more

Keywords: Coronary artery stenosis, fractional flow reserve, CFD, Bernoulli’s law

DOI: 10.3233/THC-220435

Citation: Technology and Health Care, vol. 31, no. 3, pp. 977-990, 2023

Authors: Shu, Yan | Li, Ling | Shu, Fanglian | Wei, Yanhong | Zhang, Li | Zhou, You

Article Type: Research Article

Abstract: BACKGROUND: Foot drop is one of the most common complications after stroke. OBJECTIVE: This study investigates the role of an adjustable medical foot support pillow in preventing foot drop and improving the lower limb function of patients after stroke. METHODS: A total of 88 patients with strokes admitted to our hospital from September 2019 to September 2020 were selected and categorised into the control (n = 44) and intervention groups (n = 44) using a random number table. The control group received routine rehabilitation …nursing, while the intervention group adopted a self-made adjustable medical foot support pillow based on routine rehabilitation nursing. After four weeks, the simplified Fugl Meyer Assessment (FMA) and the modified activities of daily living (ADL) scales were used to measure the ankle range of motion of the lower limbs. The lower limb motor function, ADL, and ankle mobility before and after treatment, as well as the incidence of foot ptosis, were compared between the two groups. RESULTS: After the procedure, the intervention group was superior to the control group in the FMA score of the lower extremities, ADL score, and ankle joint mobility in the lower limbs, indicating statistically significant differences (P < 0.05). The incidence rate of foot drop was lower in the intervention group than in the control group, and the difference was statistically significant (P < 0.05). CONCLUSION: The adjustable medical foot support pillow can prevent foot drop in patients after stroke, improve lower limb function, provide a favourable basis for walking training, and improve the ADL of patients. Show more

Keywords: Stroke, foot drop, rehabilitation, mobility limitation, rehabilitation

DOI: 10.3233/THC-220462

Citation: Technology and Health Care, vol. 31, no. 3, pp. 991-1001, 2023

Authors: Chen, Hongbing | Su, Tong | Wang, Qi | Zheng, Zhe | Li, Hongwei | Li, Jianbo

Article Type: Research Article

Abstract: BACKGROUND: Aneurysms are associated with a mortality rate of 81% or more in cases of rupture. Intraluminal thrombus (ILT) is a common complication of aneurysms, it can greatly increase the risk of rupture. Especially for some of the more complex aneurysms, physicians need to consider the risk of thrombosis or progression and precisely formulate a treatment plan. Therefore, it is particularly important to assess the level of thrombosis risk through haemodynamics. OBJECTIVE: To analyse the haemodynamic indices and compare the thrombosis risk in a double false lumen abdominal aortic dissection aneurysm using computational fluid dynamics (CFD). …METHODS: Computer tomography angiography (CTA) imaging data were collected from a patient with a double false lumen abdominal aortic dissection aneurysm, and three different lesion morphology aneurysm models were established, double false lumen abdominal aortic dissection aneurysm, single false lumen abdominal aortic dissection aneurysm and saccular abdominal aortic aneurysm, in order to analyse the flow velocity, time-averaged shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT) of blood flow, and endothelial cell activation potential (ECAP). RESULTS: All three aneurysms were in a low-flow state within the body, and the low-flow velocity flow in the proximal vessel wall extended to the right common iliac artery; the vortex intensity was more intense in the abdominal aortic dissection aneurysm than in the saccular abdominal aortic aneurysm. The risk area for thrombosis was concentrated in the expansion part of the aneurysm and the false lumen. The RRT and ECAP maxima of the double false lumen abdominal aortic dissection aneurysm were much greater than those of the single false lumen dissection aneurysm and saccular aortic aneurysm. CONCLUSION: Low-velocity blood flow, high OSI, low TAWSS, high RRT, and high ECAP regions correlate with the risk of thrombosis. The double false lumen type of abdominal aortic dissection aneurysm had some specificity in this case. The risk of thrombosis in the patient was extremely high, and the largest risk zone was within the smaller false lumen, which could be because the smaller false lumen was connected to the true lumen by only one breach. The results of the study provide some guidance in the early screening and development of treatment plans. Show more

Keywords: Abdominal aortic dissection aneurysm, CTA, computational fluid dynamics (CFD), thrombosis risk, patient-specific simulation

DOI: 10.3233/THC-220481

Citation: Technology and Health Care, vol. 31, no. 3, pp. 1003-1015, 2023

Authors: Yang, Cun | Yang, Lei | Gao, Guo-Dong | Zong, Hui-Qian | Gao, Duo

Article Type: Research Article

Abstract: BACKGROUND: Artificial intelligence (AI) technology is a promising diagnostic adjunct in fracture detection. However, few studies describe the improvement of clinicians’ diagnostic accuracy for nasal bone fractures with the aid of AI technology. OBJECTIVE: This study aims to determine the value of the AI model in improving the diagnostic accuracy for nasal bone fractures compared with manual reading. METHODS: A total of 252 consecutive patients who had undergone facial computed tomography (CT) between January 2020 and January 2021 were enrolled in this study. The presence or absence of a nasal bone fracture was …determined by two experienced radiologists. An AI algorithm based on the deep-learning algorithm was engineered, trained and validated to detect fractures on CT images. Twenty readers with various experience were invited to read CT images with or without AI. The accuracy, sensitivity and specificity with the aid of the AI model were calculated by the readers. RESULTS: The deep-learning AI model had 84.78% sensitivity, 86.67% specificity, 0.857 area under the curve (AUC) and a 0.714 Youden index in identifying nasal bone fractures. For all readers, regardless of experience, AI-aided reading had higher sensitivity ([94.00 ± 3.17]% vs [83.52 ± 10.16]%, P < 0.001), specificity ([89.75 ± 6.15]% vs [77.55 ± 11.38]%, P < 0.001) and AUC (0.92 ± 0.04 vs 0.81 ± 0.10, P < 0.001) compared with reading without AI. With the aid of AI, the sensitivity, specificity and AUC were significantly improved in readers with 1–5 years or 6–10 years of experience (all P < 0.05, Table 4 ). For readers with 11–15 years of experience, no evidence suggested that AI could improve sensitivity and AUC (P = 0.124 and 0.152, respectively). CONCLUSION: The AI model might aid less experienced physicians and radiologists in improving their diagnostic performance for the localisation of nasal bone fractures on CT images. Show more

Keywords: Nasal bone fracture, artificial intelligence, sensitivity, specificity, deep learning

DOI: 10.3233/THC-220501

Citation: Technology and Health Care, vol. 31, no. 3, pp. 1017-1025, 2023

Authors: Zhang, Weiyi | Liang, Hongping

Article Type: Research Article

Abstract: BACKGROUND: Preeclampsia (PE) has adverse effects on pregnant women, fetuses, and newborns [1], and accounts for 3%–10% of pregnancy-related diseases globally. OBJECTIVE: This study aimed to screen a series of prenatal markers (pregnancy-associated plasma protein [PAPP-A], β -human chorionic gonadotropin [β -hCG], alpha fetoprotein [AFP], and estriol [uE3]) to establish a risk model and evaluate the diagnostic values of the markers for predicting PE. METHODS: Sixty-five pregnant women were enrolled in this study. They were divided into two groups containing healthy pregnant women (n = …51, the non-PE group) and pregnant women with PE (n = 14, the PE group). According to the stage of pregnancy, the pregnant women in each group were divided into early, middle, and late pregnancy groups for statistical analysis. The levels of PAPPA-A β -hCG, AFP, and uE3 were compared among these groups. Then, a risk model was established, and PE was diagnosed using receiver operating characteristic (ROC) curve results. RESULTS: In the early pregnancy group, the differences in the levels of PAPP-A, AFP, and uE3 between the PE and non-PE groups were statistically significant (P < 0.001, P = 0.029, and P = 0.033, respectively), while the difference in the single remaining marker was not statistically significant. A ROC curve analysis revealed that in early pregnancy, the sensitivity and specificity of PAPP-A were 76.5% and 71.4%, respectively, and the sensitivity and specificity of β -hCG were 82.4% and 57.1%, respectively. The sensitivity and specificity of the combination of the two markers for diagnosing PE were 86.3% and 57.1%, respectively. CONCLUSION: This study demonstrated that the combination of PAPP-A and β -hCG has diagnostic value for PE in pregnant women. Accordingly, we should formulate innovative PE screening strategies to target the prevention of PE and create important conditions for predictive and preventive personalized medical treatments. Show more

Keywords: Pregnancy-associated plasma protein-A, β-human chorionic gonadotropin, alpha fetoprotein, estriol, preeclampsia

DOI: 10.3233/THC-220523

Citation: Technology and Health Care, vol. 31, no. 3, pp. 1027-1037, 2023