Technology and Health Care - Volume 31, issue 4

Authors: Zhou, Shuguang | Jin, Qinqin | Jiang, Xiya | Wang, Rui | Wang, Bingbing | Li, Jin | Yao, Hui | Yang, Yinting | Gao, Wei | Zhang, Weiyu | Cao, Wujun

Article Type: Research Article

Abstract: BACKGROUND: Internet-related technologies have rapidly developed and started to impact the traditional medical practices, which combined wireless communication technology as well as “cloud service” technology with electronic fetal heart monitoring have become a mainstream tendency. OBJECTIVE: To investigate the clinical application value of remote fetal heart rate monitoring mode (RFHRM) on late pregnancy during the coronavirus disease (COVID-19) pandemic. METHODS: From March 2021 to February 2022, we recruited 800 cases of pregnant women received prenatal examination at the Anhui Province Maternity and Child Healthcare Hospital. These pregnant women were randomly divided into two …groups: the control group (n = 400), which was given traditional management, and the observation group (n = 400), which received remote monitoring technology on this basis. The two groups were compared with neonatal asphyxia, pregnancy outcomes, Edinburgh postnatal depression scale scores (EPDS), prenatal examination expenses and total time consumption. RESULTS: There were no statistically significant differences between the groups in pregnancy outcome and neonatal outcome (P > 0.05). However, total EPDS score of 12.5% pregnant women in the observation group were higher than 12. The TPE group had significantly higher mean EPDS scores compared with the RFHRM group (7.79 ± 3.58 vs 5.10 ± 3.07; P < 0.05). The results showed a significant difference in maternity expenses (2949.83 ± 456.07 vs 2455.37 ± 506.67; P < 0.05) and total time consumption (42.81 ± 7.60 vs 20.43 ± 4.16; P < 0.05) between the groups. CONCLUSION: Remote fetal heart rate monitoring via internet served as an innovative, acceptable, safe and effective reduced-frequency prenatal examination model without affecting the outcome of perinatology of pregnant women with different risk factors. Show more

Keywords: COVID-19, prenatal examination, late trimester of pregnancy, fetal monitoring, remote monitoring technology, perinatal outcome

DOI: 10.3233/THC-220700

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1105-1117, 2023

Authors: Jiang, Sheng Li | Jiang, Xiu Min | Zheng, Qing Xiang | Liu, Xiu Wu

Article Type: Research Article

Abstract: BACKGROUND: Acupoint buried beans on the auricle is a feasible method to prevent and treat postpartum urinary retention. OBJECTIVE: This study investigated the effect of auricular acupoint buried beans on postpartum urination and maternal and fetal outcomes following epidural analgesia for labor. METHODS: Two hundred forty primiparas underwent vaginal trial labor analgesia from May 2020 to January 2021 and were randomly placed into the intervention and control groups. Both groups received epidural labor analgesia. Maternal urination during labor, 2 h postpartum, and the time for first postpartum urination were recorded as primary outcomes, …with maternal and infant outcomes documented as secondary results. Statistical analysis was performed using the independent sample t -test, non-parametric rank-sum, or chi-square test using the SPSS Statistics 25.0 software. RESULTS: Two hundred eight study participants were subsequently included in the results, i.e., 105 patients in the intervention group and 103 in the control group. The intervention group comprised a significantly lower number of patients with excessive residual urine volume at cervical dilatation of 5–6 cm (P < 0.05). The total postpartum score of the intervention group was lower than in the control group (P < 0.01), and the time to first urination was shorter compared with the control group (P < 0.05). In the intervention group, the time of labor analgesia, the duration of the first stage of labor, and the total labor time were shorter compared with the control group (P < 0.01). CONCLUSION: Auricular acupoint embedded beans can improve the urination status at cervical dilatation of 5–6 cm and 2 h postpartum, as well as significantly shorten the duration of labor. Show more

Keywords: Ear-point buried beans, maternal outcome, epidural labor analgesia, urinary retention, labor

DOI: 10.3233/THC-220660

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1119-1127, 2023

Authors: Ghaffar, Asim | Dehghani-Sanij, Abbas A. | Xie, Sheng Quan

Article Type: Research Article

Abstract: BACKGROUND: The aim of a robotic exoskeleton is to match the torque and angular profile of a healthy human subject in performing activities of daily living. Power and mass are the main requirements considered in the robotic exoskeletons that need to be reduced so that portable designs to perform independent activities by the elderly users could be adopted. OBJECTIVE: This paper evaluates a systematic approach for the design optimization strategies of elastic elements and implements an actuator design solution for an ideal combination of components of an elastic actuation system while providing the same level of …support to the elderly. METHODS: A multi-factor optimization technique was used to determine the optimum stiffness and engagement angle of the spring within its elastic limits at the hip, knee and ankle joints. An actuator design framework was developed for the elderly users to match the torque-angle characteristics of the healthy human with the best motor and transmission system combined with series or parallel elasticity in an elastic actuator. RESULTS: With the optimized spring stiffness, a parallel elastic element significantly reduced the torque and power requirements up to 90% for some manoeuvres for the users to perform ADL. When compared with the rigid actuation system, the optimized robotic exoskeleton actuation system reduced the power consumption of up to 52% using elastic elements. CONCLUSION: A lightweight, smaller design of an elastic actuation system consuming less power as compared to a rigid system was realized using this approach. This will help to reduce the battery size and hence the portability of the system could be better adopted to support elderly users in performing daily living activities. It was established that parallel elastic actuators (PEA) can reduce the torque and power better than series elastic actuators (SEA) in performing everyday tasks for the elderly. Show more

Keywords: Wearable electronic devices, exoskeleton device, robotics, actuators

DOI: 10.3233/THC-220145

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1129-1151, 2023

Authors: Temporiti, Federico | Adamo, Paola | Mandelli, Andrea | Buccolini, Fabio | Viola, Erika | Aguzzi, Damiano | Gatti, Roberto | Barajon, Isabella

Article Type: Research Article

Abstract: BACKGROUND: The BHOHB system (Bhohb S.r.l., Italy) is a portable non-invasive photographic marker-based device for postural examination. OBJECTIVE: To assess the test-retest reliability of the BHOHB system and compare its reliability with an optoelectronic system (SMART-DX 700, BTS, Italy). METHODS: Thirty volunteers were instructed to stand upright with five markers on the spinous processes of C7, T6, T12, L3 and S1 vertebrae to define the dorsal kyphosis and lumbar lordosis (sagittal plane) angles. Three markers were placed on the great trochanter, apex of iliac crest and lateral condyle of the femur to detect …pelvic tilt. Finally, to define angles between the acromion and the spinous processes (frontal plane), two markers were placed on the right and left acromion. Postural angles were recoded simultaneously with BHOHB and optoelectronic systems during two consecutive recording sessions. RESULTS: The BHOHB system revealed excellent reliability for all the angles (ICCs: 0.92–0.99, SEM: 0.78 ∘ –3.33 ∘ ) as well as a shorter processing time compared to the optoelectronic system. Excellent reliability was also found for all the angles detected through the optoelectronic system (ICCs: 0.91–0.99, SEM: 0.84 ∘ –2.80 ∘ ). CONCLUSION: The BHOHB system resulted as a reliable non-invasive and user-friendly device to monitor spinal posture, especially in subjects requiring repeat examinations. Show more

Keywords: Posture, postural assessment, photographic system, optoelectronic system

DOI: 10.3233/THC-220155

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1153-1160, 2023

Authors: Nan, Chong | Li, Yanjun | Liu, Yuxiu | Ma, Liang | Ma, Zhanbei

Article Type: Research Article

Abstract: BACKGROUND: The femoral neck system (FNS) has been considered as a novel strategy for femoral neck fracture. The diversity of internal fixation creates difficulties in choosing an effective option for Pauwels III type femoral neck fractures. Therefore, it is significant to investigate the biomechanical effects of FNS versus conventional approaches on bones. OBJECTIVE: To evaluate the biomechanical characteristics of FNS versus cannulated screws coupled with medial plate (CSS+ MP) for the treatment of Pauwels III type femoral neck fractures. METHODS: Through three-dimensional computer software (Minics, Geomagic – Warp), the proximal femur …model was rebuilt. Based on the present clinical characteristics, models of internal fixation were reconstructed in SolidWorks, including cannulated screws (CSS), medial plate (MP) and FNS. After parameter setting and meshing, boundary conditions and loads were set up for the final mechanical calculation in Ansys Software. Under identical experimental conditions, such as the same Pauwels angle and force loading, the peak values of displacement, shear stress and equivalent (von Mises) stress were recorded. RESULTS: This study showed that the displacement of the models was CSS, CSS+ MP, and FNS in descending order of magnitude. The shear stress and equivalent stress of the models was CSS+ MP, FNS, and CSS in descending order. The principal shear stress of CSS+ MP was concentrated on the medial plate. The equivalent stress of FNS was more dispersed and distributed from the proximal main nail to the distal locking screw. CONCLUSION: CSS+ MP and FNS exhibited better initial stability compared to CSS. However, the MP was subjected to more shear stress, which could increase the risk of internal fixation failure. Due to its unique design, FNS may be a good choice for the treatment of Pauwels III type femoral neck fractures. Show more

Keywords: Femoral neck system, femoral neck fractures, finite element analysis, biomechanics

DOI: 10.3233/THC-220267

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1161-1170, 2023

Authors: Liu, Shuai | Chen, Ruili | Gu, Yun | Yu, Qiong | Su, Guoxiong | Ren, Yanjiao | Huang, Lan | Zhou, Fengfeng

Article Type: Research Article

Abstract: BACKGROUND: Acne is a skin lesion type widely existing in adolescents, and poses computational challenges for automatic diagnosis. Computer vision algorithms are utilized to detect and determine different subtypes of acne. Most of the existing acne detection algorithms are based on the facial natural images, which carry noisy factors like illuminations. OBJECTIVE: In order to tackle this issue, this study collected a dataset ACNEDer of dermoscopic acne images with annotations. Deep learning methods have demonstrated powerful capabilities in automatic acne diagnosis, and they usually release the training epoch with the best performance as the delivered model. …METHODS: This study proposes a novel self-ensemble and stacking-based framework AcneTyper for diagnosing the acne subtypes. Instead of delivering the best epoch, AcneTyper consolidates the prediction results of all training epochs as the latent features and stacks the best subset of these latent features for distinguishing different acne subtypes. RESULTS: The proposed AcneTyper framework achieves a promising detection performance of acne subtypes and even outperforms a clinical dermatologist with two-year experiences by 6.8% in accuracy. CONCLUSION: The method we proposed is used to determine different subtypes of acne and outperforms inexperienced dermatologists and contributes to reducing the probability of misdiagnosis. Show more

Keywords: Acne subtype, deep learning, self-ensemble, stacking, classification

DOI: 10.3233/THC-220295

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1171-1187, 2023

Authors: Heo, Min | Kang, Seung-Rok | Yu, Mi | Kwon, Tae-Kyu

Article Type: Research Article

Abstract: BACKGROUND: The weakening of the ability of the elderly to perform gait is becoming a major cause of the increase in the frequency of falls. OBJECTIVE: In this study, we designed and manufactured a treadmill capable of restraining walking by providing a sudden repulsive force on the left and right legs of a pedestrian when walking for the fall prevention training of the elderly. Through this, it is possible for the elderly person to strengthen the lower extremity muscles to prevent and prepare for falling through the fall prevention training similar to the fall environment that …may occur in daily life. METHOD: The development system includes a motor for generating a driving force in the form of a left and a right driving system and a belt separated from each other, an electromagnetic clutch for rapidly stopping the running belt of the motor transmitted to the running belt to stop the running belt, and a controller for controlling the driver. RESULTS: In order to evaluate the development system, the motor driving ability test and the power transmission, connection and shut-off performance of the electromagnetic clutch were carried out. The subject’s muscle activity of the lower extremity muscles was evaluated when the running belt stopped at the beginning of the right folding. CONCLUSION: It is expected that the developed dual function system would be helpful for the fall prevention exercise as well as the rehabilitation exercise for patients who have recovered from surgery or hemiplegic patients. Show more

Keywords: People with gait disability, fall prevention training, power train and control, split-treadmill, smart medical device

DOI: 10.3233/THC-220392

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1189-1201, 2023

Authors: Jin, Qianheng | Yu, Chenghao | Xu, Lei | Zhang, Guangliang | Ju, Jihui | Hou, Ruixing

Article Type: Research Article

Abstract: BACKGROUND: Bionic grafts can replace autologous tissue through tissue engineering in cases of cardiovascular disease. However, small-diameter vessel grafts remain challenging to precellularize. OBJECTIVE: Bionic small-diameter vessels with endothelial and smooth muscle cells (SMCs) manufactured with a novel approach. METHODS: A 1-mm-diameter bionic blood vessel was constructed by combining light-cured hydrogel gelatin-methacryloyl (GelMA) with sacrificial hydrogel Pluronic F127. Mechanical properties of GelMA (Young’s modulus and tensile stress) were tested. Cell viability and proliferation were detected using Live/dead staining and CCK-8 assays, respectively. The histology and function of the vessels were observed using hematoxylin …and eosin and immunofluorescence staining. RESULTS: GelMA and Pluronic were printed together using extrusion. The temporary Pluronic support was removed by cooling during GelMA crosslinking, yielding a hollow tubular construct. A bionic bilayer vascular structure was fabricated by loading SMCs into the GelMA bioink, followed by perfusion with endothelial cells. In the structure, both cell types maintained good cell viability. The vessel showed good histological morphology and function. CONCLUSION: Using light-cured and sacrificial hydrogels, we formed a small ca bionic vessel with a small caliber containing SMCs and endothelial cells, demonstrating an innovative approach for construction of bionic vascular tissues. Show more

Keywords: 3D bioprinting, tissue-engineered vascular, cardiovascular disease, endothelium, smooth muscle

DOI: 10.3233/THC-220393

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1203-1213, 2023

Authors: Abgeena, Abgeena | Garg, Shruti

Article Type: Research Article

Abstract: BACKGROUND: Recognising emotions in humans is a great challenge in the present era and has several applications under affective computing. Deep learning (DL) is found as a successful tool for prediction of human emotions in different modalities. OBJECTIVE: To predict 3D emotions with high accuracy in multichannel physiological signals, i.e. electroencephalogram (EEG). METHODS: A hybrid DL model consisting of convolutional neural network (CNN) and gated recurrent units (GRU) is proposed in this work for emotion recognition in EEG data. CNN has the capability of learning abstract representation, whereas GRU can explore temporal correlation. …A bi-directional variation of GRU is used here to learn features in both directions. Discrete and dimensional emotion indices are recognised in two publicly available datasets SEED and DREAMER, respectively. A fused feature of energy and Shannon entropy ( 𝐸𝑛𝑆𝐸 → ) and energy and differential entropy ( 𝐸𝑛𝐷𝐸 → ) are fed in the proposed classifier to improve the efficiency of the model. RESULTS: The performance of the presented model is measured in terms of average accuracy, which is obtained as 86.9% and 93.9% for SEED and DREAMER datasets, respectively. CONCLUSION: The proposed convolution bi-directional gated recurrent unit neural network (CNN-BiGRU) model outperforms most of the state-of-the-art and competitive hybrid DL models, which indicates the effectiveness of emotion recognition using EEG signals and provides a scientific base for the implementation in human-computer interaction (HCI). Show more

Keywords: EEG, hybrid deep learning, CNN, BiGRU, emotion recognition

DOI: 10.3233/THC-220458

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1215-1234, 2023

Authors: Jiang, Runxue | Li, Zhi | Wang, Xia | Cai, Haifeng | Wu, Shouling | Chen, Shuohua | Hu, Hailong

Article Type: Research Article

Abstract: BACKGROUND: Metabolic syndrome increases the risk of developing several types of cancer in humans; however, its effect on the development of kidney cancer is not uniform. OBJECTIVE: To investigate the association between metabolic syndrome (MetS) and its components and the risk of developing kidney cancer. METHODS: We conducted a cohort-based case-control study. The case group included 217 patients with new kidney cancer in the Kailuan cohort. A total of 868 subjects who were matched for age and sex with those in the case group age (± 1 year) at 1:4 …as the control group were selected from baseline survey participants without malignant tumours at the same time as the case group. Biennial baseline survey data of the cases and controls were collected, and the baseline data nearest to the onset time of cases were used for statistical analyses. Logistic proportional risk regression models were used to analyse the association between MetS and its components and the risk of developing kidney cancer. RESULTS: The proportion of MetS patients in the case group was significantly higher than that in the control group (P < 0.01). The risk of developing kidney cancer was significantly higher in the MetS group than in the non-MetS group [odds ratio (OR) (95% confidence interval, CI) = 1.63 (1.20–2.21)], and the risk of kidney cancer increased as the number of MetS components increased compared with subjects without any MetS components (p 𝑡𝑟𝑒𝑛𝑑 < 0.01). Elevated blood pressure and low high-density lipoprotein cholesterol levels were associated with the risk of kidney cancer [OR (95% CI) = 1.49 (1.02–2.17) and 1.55 (1.13–2.13), respectively]. CONCLUSION: Our findings suggest that the risk of developing kidney cancer is correlated with MetS. Show more

Keywords: Kidney cancer, metabolic syndrome, case-control study, Kailuan Study

DOI: 10.3233/THC-220482

Citation: Technology and Health Care, vol. 31, no. 4, pp. 1235-1244, 2023