Technology and Health Care - Volume 31, issue 5

Authors: Wieber, Juliane | Brandt, Jasmin | Pieper, Maike | Hirschhäuser, Eva | Catalá-Lehnen, Philip | Rein, Robert | Braunstein, Bjoern

Article Type: Research Article

Abstract: BACKGROUND: Joint position sense test assess patient mobility and proprioceptive ability. Yet, application used under different conditions may biases reproduction error resulting in different therapeutic consequences. OBJECTIVE: To investigate knee angle reproduction test under different test conditions. METHODS: 25 healthy subjects (mean ± SD, age = 25 ± 2 years, activity level: 9 ± 2 training hours/week) performed knee angle reproduction test in the sitting and prone position, while changing the knee angle starting (i) from flexion and (ii) extension, (iii) …inducing vibration on the semitendinosus tendon. RESULTS: Absolute mean knee angle reproduction error showed significant difference for body position and vibration (Position: 95% CI 0.71 to 2.32; p < 0.001. No Vibration & Vibration: 95% CI - 1.71 to - 0.12; p = 0.027). Relative knee angle reproduction error was significant different in all conditions (No Vibration & Vibration: 95% CI - 3.30 to - 0.45; p = 0.010. Body orientation: 95% CI 1.08 to 3.93; p < 0.001. Direction of movement: 95% CI 0.56 to 3.41; p = 0.007). CONCLUSION: Body orientation and movement direction influence the resulting knee angle reproduction error in healthy subjects. Practitioners are advised to use standardised test procedures when comparing different within- and between-patient results. Trial registration: DOI 10.17605/OSF.IO/AFWRP. Show more

Keywords: Anterior cruciate ligament, proprioception, knee joint, return to sport, physiotherapy

DOI: 10.3233/THC-220747

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1567-1578, 2023

Authors: Rafeeq, Reem A. | Saleem, Alan E. | Nahidh, Mohammed | Kadhum, Ammar S. | Al-Huwaizi, Akram F. | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: SARS-CoV-2 (COVID-19) is considered a highly infectious and life threatening disease. OBJECTIVE: The present paper aims to evaluate various aspects of preventive measures and clinical management of the scheduled visits for orthodontic patients to the dental clinics during the outbreak of COVID-19, and to assess how orthodontists dealt with this challenge. METHODS: Orthodontists in private and public clinics were invited to fill a questionnaire that addressed infection control protocols and concerns about clinical management of patients in the clinics during the pandemic. Frequncies and percentages of the responses were obtained and compared …using Chi-square tests. RESULTS: About 77% of those working in private clinics, and 63% of those working in private and governmental clinics performed room disinfection following each patient. In case of patients needing urgent management and have active infection, 56% of the participants provided care under high infection control measures; on the contrary, 64% provided symptomatic intervention including orthodontic wax, analgesics and sometimes mouthwash. CONCLUSION: The COVID-19 pandemic has had a negative impact on the orthodontic treatments. All pre-cautionary measures have to be made available in the clinic in order to minimize the spread of viral infection with continuous dental health care training. Show more

Keywords: COVID-19, infection control, orthodontics

DOI: 10.3233/THC-220909

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1579-1592, 2023

Authors: Elmanowski, Jule | Kleynen, Melanie | Geers, Richard P.J. | Rovelo-Ruiz, Gustavo | Geurts, Eva | Coninx, Karin | Verbunt, Jeanine A. | Seelen, Henk A.M.

Article Type: Research Article

Abstract: BACKGROUND: Improving arm-hand skill performance is a major therapeutic target in stroke rehabilitation. Arm-hand rehabilitation may be enriched in content and variation by using technology-assisted training. Especially for people with a severely affected arm, technology-assisted training offers more challenging training possibilities. OBJECTIVE: The aim of this study was to explore the feasibility of ReHab-TOAT, a “Remote Handling Based Task-Oriented Arm Training” approach featuring enriched haptic feedback aimed at improving daily activities and participation. METHODS: Five subacute or chronic stroke patients suffering moderate to severe arm-hand impairments and five rehabilitation therapists participated. All participants …received 2 ReHab-TOAT sessions. Outcome measure was a bespoke feasibility questionnaire on user experiences and satisfaction regarding ‘motivation ’, ‘individualization of training ’, ‘potential training effects ’, and ‘implementation in rehabilitation ’ of patients and therapists. RESULTS: Both patients and therapists experienced ReHab-TOAT as being feasible. They found ReHab-TOAT very motivating and challenging. All patients perceived an added value of ReHab-TOAT and would continue the training. Small improvements regarding exercise variability were suggested. CONCLUSION: ReHab-TOAT seems to be a feasible and very promising training approach for arm-hand rehabilitation of stroke patients with a moderately or severely affected arm. Further research is necessary to investigate potential training effects of ReHab-TOAT. Show more

Keywords: ReHab-TOAT, technology-assisted, arm-hand skill performance, rehabilitation, stroke

DOI: 10.3233/THC-220465

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1593-1605, 2023

Authors: Riemer, Lena | Dargel, Jens | Schäferhoff, Peter | Eysel, Peer | Steimel, Thomas | Reineck, Sönke | Grevenstein, David

Article Type: Research Article

Abstract: BACKGROUND: Rupture of the anterior cruciate ligament (ACL) is one of the most common knee injuries and has substantial impact on knee function. Beside primary ruptures, an increasing number of re-(re-)ruptures occur, representing a therapeutical challenge for the treating surgeon. Several risk factors for re-ruptures have been previously identified, including an increased tibial slope. OBJECTIVE: In this study, we investigated the effect of femoral condyle configuration on ACL-ruptures and re-ruptures. METHODS: In-vivo magnetic resonance imaging scans of three different groups of patients were compared. Group 1 included patients with an intact ACL on …both sides, group 2 included patients with primary, unilateral ACL-rupture, while group 3 included patients with an ACL-re-rupture or re-(re-)rupture. Fourteen different variables were obtained and analyzed regarding their impact on ACL-re-(re-)rupture. RESULTS: Overall, 334 knees were investigated. Our data allowed us to define parameters to identify anatomical configurations of bones associated with an increased risk of ACL-re-rupture. Our results show, that patients with ACL-re-rupture show increased radii of the extension facet of the lateral femoral condyle (p < 0.001) as well as of the extension facet of the medial femoral condyle (p < 0.001). CONCLUSION: We conclude that a spherical femoral condyle form does influence the clinical outcome after ACL-reconstruction. Show more

Keywords: Anterior cruciate ligament, ACL, ACL-tear, knee, femoral condyle, knee anatomy

DOI: 10.3233/THC-220640

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1607-1617, 2023

Authors: Ma, Zhuo | Zhang, Yan-Nan | Ma, Xun | Chen, Chen | Feng, Hao-Yu

Article Type: Research Article

Abstract: BACKGROUND: Few studies have compared the clinical efficacy of unilateral and bilateral pedicle screw fixation and fusion in treating atlantoaxial fracture-dislocation. OBJECTIVE: To compare the efficacy of unilateral and bilateral fixation and fusion for atlantoaxial fracture-dislocation and to explore the feasibility of the unilateral surgical procedure. METHODS: Twenty-eight consecutive patients with atlantoaxial fracture-dislocation were included in the study from June 2013 to May 2018. They were divided into a unilateral fixation group and a bilateral fixation group (14 patients in each group with an average age of 43.6 ± 16.3 …years and 51.8 ± 15.4 years, respectively). The unilateral group had a unilateral anatomical variation of the pedicle or vertebral artery, or traumatic pedicle destruction. All patients underwent atlantoaxial unilateral or bilateral pedicle screw fixation and fusion. Intraoperative blood loss and operation time were recorded. The visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scoring systems were used to evaluate pre- and postoperative occipital-neck pain and neurological function. X-ray and computerized tomography (CT) were used to assess atlantoaxial stability, the implants’ position, and bone graft fusion. RESULTS: All patients were followed up for 39–71 months postoperatively. Intraoperatively, no spinal cord or vertebral artery injury was observed. At the last follow-up, occipital-neck pain and neurological function in the two groups were significantly improved (P < 0.05). The X-ray films and CT showed satisfactory atlantoaxial stability, implant position, and osseous fusion in all the patients at 6 months postoperatively. CONCLUSION: Unilateral and bilateral pedicle screw fixation and fusion can restore atlantoaxial stability and improve occipital-neck pain and neurological function in patients with atlantoaxial fracture-dislocation. The unilateral surgical procedure can be a supplementary option for patients with unilateral abnormal atlantoaxial lesions. Show more

Keywords: Atlantoaxial, fracture-dislocation, unilateral, pedicle screw, fusion

DOI: 10.3233/THC-220721

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1619-1629, 2023

Authors: Yang, Yu-Lan | Su, Rong-Rong | Chen, Li | Xu, Yuan

Article Type: Research Article

Abstract: BACKGROUND: In recent years, the incidence of viral keratitis has been on the rise. OBJECTIVE: This study explored the application effect of continuous care for patients with viral keratitis. METHODS: A total of 148 patients with viral keratitis admitted to the ophthalmology department of the authors’ hospital from January 2019 to December 2020 were selected and divided into the observation group and the control group via the random number table method, with 74 cases in each group. Continuous care was conducted following routine discharge guidance for patients in the observation group, while routine …discharge guidance only was provided for the control group. The patients in both groups were continuously observed for one year. The medication compliance, return visit rate, recurrence rate, nursing satisfaction, and quality of life between the two groups were compared and analyzed after one year. RESULTS: The medication compliance was higher in the observation than in the control group and the difference was statistically significant (P < 0.05). The rate of return visits at 1 week, 1 month, 3 months, 6 months, and 1 year in the observation group were higher than those in the control group and the differences were statistically significant (P < 0.05). The difference in the recurrence rate between the two groups at 1 week was not statistically significant (P > 0.05), while the recurrence rate at 1, 3, and 6 months, and 1 year in the observation group were higher than those in the control group, and the difference was statistically significant (P < 0.05). The total score of the quality of life in the observation group was higher than in the control group and the difference was statistically significant (P < 0.05). CONCLUSION: Continuous care had a good application effect on patients with viral keratitis, which could potentially effectively improve medication compliance and the rate of return visits, reduce recurrence rate, and improve patient satisfaction and their quality of life. Accordingly, the results of this study present high clinical value. Show more

Keywords: Continuous care, viral keratitis, application effects

DOI: 10.3233/THC-220767

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1631-1645, 2023

Authors: Zhang, Weiliang | Cao, Xiaoqin | Yang, Lu | Duan, Yajian | Zhang, Wei

Article Type: Research Article

Abstract: BACKGROUND: Orbital blowout fracture is common in ocular trauma. Accurate measurement of orbital volume after fracture is key in improving intraocular correction. OBJECTIVE: This study aims to explore the impact of 3D reconstruction technology in restoring normal exophthalmos in patients with old orbital wall fractures. METHODS: A total of 31 patients were randomly divided into an experimental group (n = 15) and a control group (n = 16). For orbital wall repair and reconstruction, the conventional group used the conventional surgical scheme, and …the 3D group used 3D printing technology. RESULTS: There was no statistical difference between the preoperative mean extraocular muscle volume of the healthy eye and the affected eye. However, the mean orbital volume (24.76 vs 27.11, P = 0.005) and mean retrobulbar fat volume (17.53 vs 16.42, P = 0.006) were significantly different between the healthy eye and the affected eye. After an average follow-up of 16 weeks, the differences in pre- and post-surgery exophthalmos in the two groups were 0.42 ± 0.08 mm and 1.63 ± 0.51 mm, respectively. The difference between the two groups was statistically significant (t = 4.42, P = 0.003). The complications were not statistically different. CONCLUSION: Using 3D reconstruction technology preoperatively can significantly improve exophthalmos in patients with old orbital wall fractures. Show more

Keywords: Orbital wall fracture, old, exophthalmos, 3D reconstruction

DOI: 10.3233/THC-220245

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1647-1657, 2023

Authors: Liu, Xin | Guo, Xinwei | Zhang, Zhimin | Wu, Huang | Zhang, Yu | Zhao, Hongyan

Article Type: Research Article

Abstract: BACKGROUND: Dentists must be able to identify subtle color changes as shade-matching is crucial in aesthetic dentistry. OBJECTIVE: To determine whether color discrimination ability is related to shade-matching accuracy among dentists. METHODS: The sensitivity of the normal-color vision population to different colors was investigated using Farnsworth Munsell 100 Hue (FM-100) test results. The FM-100 test was administered to 37 dentists at the Hospital of Stomatology, Jilin University. Sensitivity of dentists with normal-color vision to different colors was investigated using the FM-100 test. Participants were instructed to arrange color caps of various colors according …to the gradual change in colors and the results were scored. Visual shade matching test using Vita 3D-MASTER shade guide was performed to determine shade-matching accuracy. The relationship between color discrimination ability and shade-matching accuracy was analyzed. The number of misplaced color caps in the FM-100 test was also calculated. RESULTS: The FM-100 test revealed that 16 and 21 participants had excellent and average color discrimination ability, respectively, and their shade-matching accuracies were 68.75% and 66.67%, respectively. No significant difference was observed in the shade-matching accuracy between the two groups. No significant correlation was observed between the color discrimination ability and shade-matching accuracy. In addition, the number of wrong color caps on the 43–63 color tray with the transition from blue-green to blue-purple was the highest according to Friedman’s test. CONCLUSION: Color discrimination ability of dentists does not affect their visual shade-matching accuracy. Additionally, people with normal color vision are not sensitive to the transition from blue-green to blue-purple. Show more

Keywords: Color vision, cosmetic dentistry, tooth preparation, color perception tests

DOI: 10.3233/THC-220344

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1659-1669, 2023

Authors: Xing, Xiu-Rong | Luo, Li-Ping | Li, Ya-Lin | Guo, Ya-Wei | Wang, Jing | Qin, Jian

Article Type: Research Article

Abstract: BACKGROUND: Despite advances in the treatment of sepsis over time, this condition remains both a serious threat and a cause of death among critical patients. OBJECTIVE: This study aimed to explore the role of the nuclear factor kappa B (NF-κ B) signaling pathway in the development of septic cardiomyopathy in rats with sepsis. METHOD: A total of 32 Sprague Dawley rats were randomized into a sham operation group and three groups with sepsis, which were tested at one of the following time-points: 3, 6, or 12 h. Each group included eight …rats. Sepsis models were created via cecal ligation and puncture procedures. All the study rats had the following cardiac parameters and serum levels measured at either 3, 6, or 12 h after the operation (according to their assigned group): heart rate, left ventricular systolic pressure (LVSP), maximum rate of left ventricular pressure rise (+ dP/dt max ) and fall (- dP/dt max ), tumor necrosis factor alpha (TNF-α ), interleukin 1 beta (IL-1β ), interleukin 6 (IL-6), and cardiac troponin I (cTnI). The myocardium of the left ventricle was collected and subjected to hematoxylin and eosin staining to observe the changes in pathological morphology. The expression of toll-like receptor 4 (TLR4) and NF-κ B in the myocardium were detected by western blot analysis. RESULTS: Compared with the sham operation group, the rats in the sepsis subgroups exhibited significantly lower values for all the cardiac parameters measured, including the heart rate (sham operation group = 386.63 ± 18.62 beats per minute [bpm], sepsis 3-h group = 368.38 ± 12.55 bpm, sepsis 6-h group = 341.75 ± 17.05 bpm, sepsis 12-h group = 302.13 ± 21.15 bpm), LVSP (sham operation group = 125.50 ± 11.45 mmHg, sepsis 3-h group = 110.88 ± 7.51 mmHg, sepsis 6-h group = 100.00 ± 15.06 mmHg, sepsis 12-h group = 91.38 ± 14.73 mmHg), + dp/dtmax (sham operation group = 7137.50 ± 276.44 mm Hg/sec, sepsis 3-h group = 5745.00 ± 346.16 mm Hg/sec, sepsis 6-h group = 4360.00 ± 312.04 mm Hg/sec, sepsis 12-h group = 2871.25 ± 443.99 mm Hg/sec), and - dp/dtmax (sham operation group = 6363.75 ± 123.86 mm Hg/sec, sepsis 3-h group = 6018.75 ± 173.49 mm Hg/sec, sepsis 6-h group = 5350.00 ± 337.89 mm Hg/sec, sepsis 12-h group = 4085.00 ± 326.76 mm Hg/sec). They also displayed significantly higher levels of serum cytokines, including TNF-α (sham operation group = 14.72 ± 2.90 pg/mL, sepsis 3-h group = 34.90 ± 4.79 pg/mL, sepsis 6-h group = 24.91 ± 2.57 pg/mL, sepsis 12-h group 22.06 ± 3.11 pg/mL), IL-1β (sham operation group = 42.25 ± 16.91, 3-h group = 112.25 ± 13.77, sepsis 6-h group = 207.90 ± 22.64, sepsis 12-h group = 157.18 ± 23.06), IL-6 (sham operation group = 39.89 ± 5.74, sepsis 3-h group = 78.27 ± 9.31, sepsis 6-h group = 123.75 ± 13.11, sepsis 12-h group = 93.21 ± 8.96), and cTnI (sham operation group = 0.07 ± 0.03 ng/mL, sepsis 3-h group = 0.18 ± 0.06 ng/mL, sepsis 6-h group = 0.67 ± 0.19 ng/mL, sepsis = 12-h group 1.28 ± 0.10 ng/mL). The rats in the sepsis groups exhibited pathological changes in the myocardium, which deteriorated gradually over time. The animals in all the sepsis groups exhibited significantly higher levels of TLR4 and NF-κ B protein expression compared with the sham group. The TLR4 protein expressions were 0.376 in the sham operation group, 0.534 in the sepsis 3-h group, 0.551 in the sepsis 6-h group, and 0.719 in the sepsis 12-h group. The NF-κ B protein expressions were 0.299 in the sham operation group, 0.488 in the sepsis 3-h group, 0.516 in the sepsis 6-h group, and 0.636 in the sepsis 12-h group. CONCLUSION: Sepsis can lead to myocardial injury and cardiac dysfunction. This may be related to the activation of the NF-κ B intracellular signal transduction pathway and the release of inflammatory factors as a result of lipopolysaccharides acting on TLR4 during the onset of sepsis. Show more

Keywords: Septic cardiomyopathy, TLR4, NF-κB signaling pathway, tumor necrosis factor-α, interleukin-1β, interleukin-6

DOI: 10.3233/THC-220471

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1671-1681, 2023

Authors: Zhong, Baoying | Shi, Chunjuan | Xu, Dan

Article Type: Research Article

Abstract: BACKGROUND: The incidence of anxiety in patients with breast cancer is high, which seriously affects the physical and mental health of patients. OBJECTIVE: This study aimed to investigate the effect of acupoint stimulation on the anxiety of patients with breast cancer during operations and in the waiting period for intraoperative frozen section analysis. METHODS: Sixty patients with breast cancer experiencing anxiety who met the inclusion and exclusion criteria were randomly divided into the experimental group and the control group. The patients in the control group received routine nursing, and the patients in the …experimental group were given acupoint stimulation on the basis of routine nursing. The HAMD scores, blood pressure readings, and heart rates were recorded before admission at one hour before the operation and in the waiting period for intraoperative frozen section analysis. RESULTS: The HAMD scores, blood pressure readings, and heart rates of the two groups showed an upward trend at all time points, and the differences were statistically significant. Compared with the control group, there were significant differences in indices detected at one hour before the operation and in the waiting period for intraoperative frozen section analysis. CONCLUSION: Acupoint stimulation therapy can effectively alleviate anxiety in patients with breast cancer. Show more

Keywords: Acupoint stimulation, patients with breast cancer, anxiety

DOI: 10.3233/THC-220488

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1683-1689, 2023

Authors: Lin, Rui | Li, Guo-Sheng | Gan, Xiang-Yu | Peng, Jun-Xi | Feng, Yue | Wang, Li-Ting | Zhang, Chu-Yue | Huang, Kun-Ying | Huang, Shi-Hai | Yang, Lin | Kong, Jin-Liang | Zhou, Hua-Fu | Chen, Gang | Huang, Wan-Ying

Article Type: Research Article

Abstract: BACKGROUND: At present, studies on MircoRNA-22-3p (miR-22-3p) in lung adenocarcinoma use a single method, lack multi-center validation and multi-method validation, and there is no big data concept to predict and validate target genes. OBJECTIVE: To investigate the expression, potential targets and clinicopathological significance of miR-22-3p in lung adenocarcinoma (LUAD) tissues. METHODS: LUAD formalin-fixed paraffin-embedded (FFPE) tumors and adjacent normal lung tissues were collected for real-time quantitative polymerase chain reaction (RT-qPCR). Collect miR-22-3p in LUAD and non-cancer lung tissue from high-throughput datasets, standardized mean difference (SMD) and area under the curve (AUC) of the …comprehensive receiver operating curve (summary receiver operating characteristic cure, sROC curve) were calculated. Cell function experiments on A549 cells transfected with LV-hsa-miR-22-3p. Target genes were predicted by the miRwalk2.0 website and the resulting target genes were subjected to Gene Ontology (GO) pathway enrichment analysis and constructed to protein-protein interaction network. Finally, the protein expression level of the key gene TP53 was validated by searching The Human Protein Atlas (THPA) database to incorporate TP53 immunohistochemical results in LUAD. RESULTS: RT-qPCR result from 41 pairs of LUAD and adjacent lung tissues showed that miR-22-3p was downregulated in LUAD (AUC = 0.6597, p = 0.0128). Globally, a total of 838 LUADs and 494 non-cancerous lung tissues were included, and were finally combined into 14 platforms. Compared with noncancerous tissue, miR-22-3p expression level was significantly reduced in LUAD tissue (SMD = - 0.32, AUC = 0.72l); cell function experiments showed that miR-22-3p has inhibitory effects on cell proliferation, migration and invasion, and has promotion effect on apoptosis. Moreover, target genes prediction, GO pathway enrichment analysis and PPI network exhibited TP53 as a key gene of target gene of miR-22-3p; at last, a total of 114 high-throughput datasets were included, including 3897 LUADs and 2993 non-cancerous lung tissues, and were finally combined into 37 platforms. Compared with noncancerous tissue, TP53 expression level was significantly increased in LUAD (SMD = 0.39, p < 0.01) and it was verified by the protein expression data from THPA. CONCLUSION: Overexpression of miR-22-3p may inhibit LUAD cell proliferation, migration and invasion through TP53, and promote cell apoptosis. Show more

Keywords: miR-22-3p, lung adenocarcinoma, target gene, TP53

DOI: 10.3233/THC-220494

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1691-1707, 2023

Authors: You, Xiao-Lan | Huang, Chang-Yun | Liu, Ru-Meng

Article Type: Research Article

Abstract: BACKGROUND: Local inflammatory reaction is the basis of wound healing. Inappropriate inflammatory reaction will delay wound healing. OBJECTIVE: This study aimed to investigate the effect of silver-containing dressings combined with hydrogel on healing of immunosuppression-induced skin ulcerations (IISU). METHODS: A retrospective analysis was conducted on 48 cases of patients with IISU admitted to The First People’s Hospital of Jiande from March 2018 to March 2019. According to the different treatment methods, the patients were divided into the observation group and the control group, with 24 cases in each group. Patients in the observation …group were treated with silver-containing dressings combined with hydrogel, while patients in the control group were treated with silver-containing dressings alone. Initially, patients in the observation group and control group were treated with the same method of debridement and cleaning. Afterwards, for patients in the observation group, the wounded surface was coated with a layer of hydrogel. Both groups had the wound covered with a silver-containing dressing as the inner dressing, and gauze was used as the outer dressing to wrap and fix the wound. The dressing change frequency was the same for both groups. The effective rate, basic healing rate, and complete healing rate of the two groups were compared after one week and two weeks of treatment. RESULTS: The effective rate of dressing application and wound healing rate in the observation group were significantly better than those in the control group, and the differences were statistically significant (P < 0.05). CONCLUSION: A silver-containing dressing combined with hydrogel as the inner dressing can provide a better environment for wound healing, significantly shorten the course of treatment of patients with IISU, promote the early recovery of patients, and improve the quality of life of patients. Therefore, it can be applied in clinical practice. Show more

Keywords: Skin ulceration, silver dressing, hydrogel

DOI: 10.3233/THC-220540

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1709-1714, 2023

Authors: Wang, Hua-Xin | Gao, Wen-Yu | Yang, Yang | Li, Yun-Feng | Zhang, Yan | Zhang, Xin-Yi | Li, Yu-Xia

Article Type: Research Article

Abstract: BACKGROUND: It is estimated that 1.95% and 5.55% of adults in China suffer from subclinical thyroid diseases, which is difficult to diagnose and treat. OBJECTIVE: This study aimed to explore the development and prognosis of subclinical thyroid diseases to provide a reference from our single center experience. METHODS: A total of 240 cases from April 2019 to August 2021 in the laboratory information system database of Huanghua Development Boai Hospital were retrospectively analyzed. Binary logistic regression was conducted to analyze odds ratio (OR) of subclinical thyroid disease types returning to a normal state. …RESULTS: Among the patients hypothyroidism Ia and hyperthyroidism Ia were the most common type with conversion to the normal state (P < 0.001). TSH level of patients with conversion to a normal state was significantly lower than that of those who developed to abnormal disease (P = 0.015). The OR values of hyperthyroidism Ia and hypothyroidism Ia that returned to a normal state compared with hyperthyroidism Ib were 2.659 (1.159 ∼ 6.096, P = 0.021) and 3.138 (1.1.278 ∼ 7.709, P = 0.013), respectively. The OR value of hypothyroidism Ib that returned to normal compared with hyperthyroidism Ib was 0.629 (0.131 ∼ 3.010, P = 0.561). Thyroid hormone levels, age, and gender at first diagnosis were not impact factor for prognosis of subclincal thyroid disease (P > 0.05). CONCLUSION: Cases with grade hypothyroidism Ia and hyperthyroidism Ia are more likely to revert to normal state than other subclinical thyroid diseases. TSH reference range should be explored for diagnosis and treatment. Show more

Keywords: Subclinical hyperthyroidism, subclinical hypothyroidism, diagnostic grading, prognosis, odds ratio

DOI: 10.3233/THC-220562

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1715-1722, 2023

Authors: Senirkentli, G. Burcu | İnce Bingöl, Sinem | Ünal, Metehan | Bostancı, Erkan | Güzel, Mehmet Serdar | Açıcı, Koray

Article Type: Research Article

Abstract: BACKGROUND: Pedodontists and general practitioners may need support in planning the early orthodontic treatment of patients with mixed dentition, especially in borderline cases. The use of machine learning algorithms is required to be able to consistently make treatment decisions for such cases. OBJECTIVE: This study aimed to use machine learning algorithms to facilitate the process of deciding whether to choose serial extraction or expansion of maxillary and mandibular dental arches for early treatment of borderline patients suffering from moderate to severe crowding. METHODS: The dataset of 116 patients who were previously treated by …senior orthodontists and divided into two groups according to their treatment modalities were examined. Machine Learning algorithms including Multilayer Perceptron, Linear Logistic Regression, k-nearest Neighbors, Naïve Bayes, and Random Forest were trained on this dataset. Several metrics were used for the evaluation of accuracy, precision, recall, and kappa statistic. RESULTS: The most important 12 features were determined with the feature selection algorithm. While all algorithms achieved over 90% accuracy, Random Forest yielded 95% accuracy, with high reliability values (kappa = 0.90). CONCLUSION: The employment of machine learning methods for the treatment decision with or without extraction in the early treatment of patients in the mixed dentition can be particularly useful for pedodontists and general practitioners. Show more

Keywords: Serial extraction, maxillary expansion, machine learning, orthodontic treatment planning

DOI: 10.3233/THC-220563

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1723-1735, 2023

Authors: Baser, Baris | Gulnar, Burak | Tuhan Kutlu, Esra

Article Type: Research Article

Abstract: BACKGROUND: With the development of modern technology, the use of software-based applications in the field of health has become increasingly widespread. For this reason, computer-assisted personal registration forms have been developed using software programs. OBJECTIVE: The aim of this study was to compare surface contamination during the filling of orthodontic anamnesis-consent forms, traditionally on paper and digitally on a tablet equipped with a software application, measured in confined spaces using the 3M Clean-Trace Luminometer device. METHODS: In order for the participants to complete the orthodontic anamnesis-consent forms, two separate identical cabins with standard …flat surfaces were prepared. In the first cabin, the participants conventionally completed these forms on paper (conventional group), while in the second cabin, the other group used a tablet equipped with a software program for this purpose (digital group). After the form completion process, surface pollution of the predetermined areas was measured in both cabins using a 3M Clean-Trace Luminometer device. RESULTS: Surface contamination was found to be statistically significantly higher in all measurement areas in the conventional group than in the digital group. Despite a statistically significant difference between the two groups in relation to the measurements performed using the pens (conventional or electronic), this was not as strong as those found for the remaining surfaces. CONCLUSION: The completion of orthodontic anamnesis-consent forms over tablets significantly reduced surface contamination in the close environment. This study reflects the importance of digitization – which has become beneficial in many fields – in reducing the spread of infections. Show more

Keywords: Patient consent-anamnesis form, conventional-digital applications, software, surface contamination

DOI: 10.3233/THC-220600

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1737-1746, 2023

Authors: Aryani, Toetik | Budiatin, Aniek Setiya | Samirah, | Maulidina, Aulia | Firdaus, Aulia Intan | Gani, Maria Apriliani | Nisak, Khoirotin | Khotib, Junaidi | Syukriya, Alvi Jauharotus

Article Type: Research Article

Abstract: BACKGROUND: Bone fracture is the main consequence of osteoporosis, which may become a neglected disease. OBJECTIVE: This study aims to fabricate bovine hydroxyapatite-gelatine (BHA-GEL) based bone-implant with alendronate (ALE) in vivo. METHODS: Wistar rats were used for an osteoporotic animal model induced by ovariectomy. There were three groups: negative control, BHA-GEL implant, and BHA-GEL-ALE implant. Each group performed a defect by drilling the femur (diameter of 2.2 mm and depth of 2 mm). Observations on the closure of bone defects were performed by X-ray radiography at the second and sixth week after surgery. The …mechanism of bone healing was observed by using hematoxylin-eosin (HE) staining and immunohistochemical technique with anti-vascular endothelial growth factor (VEGF) and anti-alkaline phosphatase (ALP) antibodies. RESULTS: The radiograph examination showed the implanted group had accelerated bone growth. In addition, the osteoblast, osteoclast and osteocyte had accelerated migration to the defect area. Moreover, the immunoreactive score (IRS) of VEGF at the sixth week in the BHA-GEL-ALE group was lower than the other groups. Meanwhile, the IRS of ALP in BHA-GEL-ALE was higher compared to other groups. CONCLUSION: The BHA-GEL-ALE implant accelerates the healing of bone defect in the osteoporotic rat by increasing the ALP expression and the total number of cells. Show more

Keywords: Osteoporosis, bovine hydroxyapatite, implant, alendronate, neglected disease

DOI: 10.3233/THC-220612

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1747-1757, 2023

Authors: Hong, Mei | Sun, Wen-Hao | Lu, Ming | Zhong, Tao-Li | Chen, Tian-Yuan | Zhao, Yi-Dong | Hong, Nan | Zhu, Yao | Ding, Yi-Yan

Article Type: Research Article

Abstract: BACKGROUND: In recent years, malignant tumors have gradually become one of the main causes of death for Chinese residents, of which lung cancer ranks first in both the incidence and mortality in China. OBJECTIVE: To mine the text of traditional Chinese medicine (TCM) clinical medical cases after data cleaning, analyze it, and study the experience of TCM doctors in treating non-small cell lung cancer (NSCLC). METHODS: The applied approach was based on the data mining methods of decentralized and hierarchical system clustering of data from a drug and prescription database. This study involved …215 patients, 287 cases, and 147 types of clinical drugs. RESULTS: The data analysis of the clinical treatment of NSCLC in TCM showed that Erchen Decoction was the main method for the treatment of non-small cell lung cancer in clinical treatment of non-small cell lung cancer. Junjian recipes were close to each other, with Banzhilian, Lobelia, Shanci Mushroom, Hedyotis diffusa to anticancer and detoxify. CONCLUSION: This study analyzed the core TCM prescription for NSCLC by collecting the empirical essence and characteristics of specific medications. It has some guiding scientific significance for the clinical treatment of lung cancer. Show more

Keywords: Traditional Chinese medicine medical records, cluster analysis, non-small cell lung cancer, clinical experience, data mining, clinical research

DOI: 10.3233/THC-220644

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1759-1770, 2023

Authors: Wang, Miao | Yue, Meng | Zhao, Xiaopeng | He, Xu | Zhang, Haoran | Jin, Jing | Wang, Hongyan

Article Type: Research Article

Abstract: BACKGROUND: According to the eighth edition of the tumor node metastasis (TNM) staging system for esophageal cancer, it is recommended that extracapsular lymph node involvement (EC-LNI) is included as a registered independent variable for the disease. However, its role in the prognosis has not been clearly explained. OBJECTIVE: To study the value of EC-LNI in the prognosis of esophageal cancer and attempt to explore its molecular mechanism via an enrichment analysis. METHODS: A retrospective analysis was performed on 544 patients with esophageal squamous cell carcinoma (ESCC) who underwent radical surgery in the department …of thoracic surgery of our hospital, focusing on the relationship between EC-LNI and clinicopathological characteristics and its effect on prognosis. Additionally, the mechanism of EC-LNI in esophageal cancer was explored. RESULTS: Among the 271 patients with lymph node metastasis, 125 were EC-LNI (+ ). The degrees of tumor differentiation, location, TNM stage, vascular tumor thrombus, and nerve invasion were related to the occurrence of EC-LNI. The stage of TNM was considered an independent risk factor for the development of EC-LNI. A significant difference was found in terms of overall survival (OS) and disease-free survival (DFS) between the EC-LNI (+ ) and EC-LNI (- ) groups. A univariate analysis showed that the degrees of tumor differentiation, T stage, N stage, TNM stage, EC-LNI, EC-LNI number, and EC-LNI distance were significantly correlated with prognosis. A multivariate survival analysis showed that tumor differentiation, TNM stage, and EC-LNI were independent prognostic factors for OS, while TNM stage and EC-LNI were independent prognostic factors for DFS. The enrichment analysis identified the molecular targets and signaling pathways that can regulate cell proliferation, differentiation, and apoptosis. CONCLUSION: Extracapsular LNI has a high prognostic value in patients with esophageal cancer and is closely related to the stage of tumors. Our preliminary molecular mechanism research indicated that the molecular targets of EC-LNI are expected to become a new direction for the treatment of esophageal cancer. Show more

Keywords: ESCC, EC-LNI, prognosis, risk factor

DOI: 10.3233/THC-220645

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1771-1786, 2023

Authors: Luo, Zhi-Juan | Lin, Yun-Hong | Yin, Yi | Zhou, Ting | Li, Xing-Xing

Article Type: Research Article

Abstract: BACKGROUND: Removable partial dentures (RPDs) are widely used as a dental prosthesis and have a wide application scope. OBJECTIVE: To explore the effect of using design software in the preclinical teaching of removable partial dentures (RPDs). METHODS: Unreal Engine software was used to build the RPD framework design teaching and training software. All 131 undergraduate students majoring in stomatology in the class of 2018, Kunming Medical University, were randomly divided into three groups and received either traditional experiment teaching, flipped classroom teaching, or software teaching for RPD design. The application effect of the …software in the preclinical teaching of RPD design was evaluated by analyzing the examination results and through the use of a questionnaire survey. RESULTS: The differences in the theoretical examination scores among the traditional teaching group, the flipped classroom group, and the software teaching group were not statistically significant (P > 0.05), while the average design scores of upper Kennedy Class I and lower Kennedy Class II subclass II in the software teaching group were significantly higher than those in the traditional teaching group (P < 0.05). Overall, 75% of the students in the software teaching group reported that this teaching method could improve their learning initiative, a higher percentage than in the traditional teaching group (55.8%, P < 0.05). Meanwhile, 90.9% of the students in the software teaching group reported that the software could make RPD-related theoretical knowledge more visual and intuitive, and 93.2% of these students felt it was helpful for understanding the RPD three-dimensional (3D) spatial structure. These percentages were higher than those in the traditional teaching and flipped classroom groups (P < 0.05). CONCLUSION: In the preclinical teaching of RPD design, software training helped the students better understand the 3D structure of RPDs and establish clear design ideas, and it may also be valuable for in-depth research and promotion purposes. Show more

Keywords: Removable partial denture framework design, teaching software, dental education

DOI: 10.3233/THC-220654

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1787-1798, 2023

Authors: He, Yongsheng | Qi, Xuan | Luo, Xiao | Wang, Wuling | Yang, Hongkai | Xu, Min | Wu, Xuanyuan | Fan, Wenjie

Article Type: Research Article

Abstract: BACKGROUND: Gastric cancer (GC) is the fifth most common cancer worldwide and the third leading cause of cancer death. Due to the low rate of early diagnosis, most patients are already in the advanced stage and lose the chance of radical surgery. OBJECTIVE: To investigate the clinical value of computed tomography (CT) dual-energy imaging in preoperative evaluation of pathological types of gastric cancer patients. METHODS: 121 patients with gastric cancer were selected. Dual-energy CT imaging was performed on the patients. The CT values of virtual noncontrast (VNC) images and iodine concentration of the …lesion were measured, and the standardized iodine concentration ratio was calculated. The iodine concentration, iodine concentration ratio and CT values of VNC images of different pathological types were analyzed and compared. RESULTS: The iodine concentration and iodine concentration ratio of gastric mucinous carcinoma patients in venous phase and parenchymal phase were lower than those of gastric non-mucinous carcinoma patients, and the differences were statistically significant (P < 0.05). The iodine concentration and iodine concentration ratio of patients with mucinous adenocarcinoma in venous phase and parenchymal phase were lower than those of patients with choriocarcinoma, and the differences were statistically significant (P < 0.05). The iodine concentration and iodine concentration ratio of middle and high differentiated adenocarcinoma patients in venous phase and parenchymal phase were lower than those of low differentiated adenocarcinoma patients, and the differences were statistically significant (P < 0.05). However, there was no significant difference in CT values of VNC images among venous, arterial, and parenchymal phases in all pathological types of gastric cancer patients (P > 0.05). CONCLUSION: Dual-energy CT imaging plays an important role in the preoperative evaluation of patients with gastric cancer. The pathological types of gastric cancer are different, and the iodine concentration will change accordingly. Dual-energy CT imaging can effectively evaluate the pathological types of gastric cancer and has high clinical application value. Show more

Keywords: Dual-energy CT imaging, gastric cancer, pathological type, preoperative evaluation

DOI: 10.3233/THC-220664

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1799-1808, 2023

Authors: Zhao, Yi | Wu, Yong-Meng | Hu, Die | Xiang, Ze-Rui | Zhi, Jin-Yi | Xu, Bo-Chu

Article Type: Research Article

Abstract: BACKGROUND: High-speed health trains are important tools and guarantees in major accidents, epidemic pandemics, disasters, and warfare health care, and the health trains currently developed for common train platforms have more functional defects. OBJECTIVE: The purpose of this study is to analyze the relationship between the medical transfer system and the medical system, and to obtain a better medical transfer train formation through the established model. METHODS: Based on the case study of medical transport tools, this paper analyzes the components and interrelationships of the medical transport system and the medical system, and …then analyzes the medical transport task process of the health train by using the hierarchical task analysis (HTA) method. Combined with the Chinese standard EMU, a medical transport task model of the high-speed health train is established. Through this model, the functional compartment unit of the high-speed health train and the marshaling scheme of the high-speed health train are obtained. RESULTS: The expert system is used to evaluate the scheme. The results show that the train formation scheme formulated by the model in this paper is superior to other train formation schemes in three indicators, meeting the requirements of large medical transfer tasks. CONCLUSION: The results of this study can improve the ability of on-site treatment of patients, and can provide a basis for the research and development of a high-speed health train, which has a certain practical application value. Show more

Keywords: High-speed health train, HTA, medical transport

DOI: 10.3233/THC-220675

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1809-1823, 2023

Authors: Ye, Bao-Ying | He, Ping | Liu, Yuan

Article Type: Research Article

Abstract: BACKGROUND: Pregnancy luteoma is a rare hormone-dependent ovarian tumor-like lesion caused by increased androgenic activity during pregnancy. OBJECTIVE: To explore the clinical history, ultrasound manifestations, and differential diagnosis of pregnancy luteoma. METHOD: A retrospective analysis was conducted on 26 cases of pregnancy luteoma diagnosed by postoperative pathology, from 2009 to 2022. All cases were from two hospitals: Shanghai First Maternity and Infant Hospital and International Peace Maternity and Child Health Hospital. The clinical history data and ultrasound characteristics were analyzed and the relevant literature was reviewed. RESULTS: Among the 26 …cases, five of them had preoperative ultrasound images. Among these five cases, three patients showed hyperechoic masses with less internal uniformity, while two demonstrated loculated anechoic zones, with clear boundary and regular morphology. Color Doppler showed no obvious internal blood flow signals, or that blood flow signals were visible within the cyst wall and hyperechoic mass. Among the cases, 16 had multiple gestations, while two visited the clinic due to sudden abdominal pain and a huge ovarian mass was found by ultrasonography. The ovarian lump was detected during routine obstetric ultrasound in three cases. The remaining were ovarian cysts found incidentally during caesarean section. Four patients presented with hairy manifestations and one patient had a deepened voice. CONCLUSION: There is no characteristic ultrasound of pregnancy luteoma, and its diagnosis is mainly based on clinical history data and laboratory tests. Show more

Keywords: Clinical history, differential diagnosis, ovarian tumor-like lesions, pregnancy luteoma, retrospective analysis, ultrasound

DOI: 10.3233/THC-220685

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1825-1833, 2023

Authors: Nascimben, Mauro | Lippi, Lorenzo | Fusco, Nicola | de Sire, Alessandro | Invernizzi, Marco | Rimondini, Lia

Article Type: Research Article

Abstract: BACKGROUND: Establishing baseline measurements on normative data is essential to evaluate standards of care and the impact of clinical or surgical treatments. Hand volume determination is relevant in pathological conditions where the anatomical structures might undergo modifications like post-treatment chronic edema. For example, one of the consequences of breast cancer treatment is the possibility of developing uni-lateral lymphedema on the upper limbs. OBJECTIVE: Arm and forearm volumetrics are well-studied techniques, whereas hand volumetry computation poses several challenges both from the clinical and digital perspectives. The current work has explored routine clinical and customized digital methodologies for …hand volume appraisal on healthy subjects. METHODS: Clinical hand volumes computed by water displacement or circumferential measurements were compared to digital volumetry calculated from 3D laser scans. Digital volume quantification algorithms exploited the gift wrapping concept or cubic tessellation of acquired 3D shapes. This latter digital technique is parametric, and a calibration methodology to define the resolution of the tessellation has been validated. RESULTS: Results on a group of normal subjects demonstrated that the volumes computed from digital hand representations extracted by tessellation return values similar to the clinical water displacement volume assessment at low tolerances. CONCLUSIONS: The current investigation suggested that the tessellation algorithm could be considered a digital equivalent of water displacement for hand volumetrics. Future studies are needed to confirm these results in people with lymphedema. Show more

Keywords: Volume assessment, lymphedema, rehabilitation, hand, 3D laser scanner

DOI: 10.3233/THC-220694

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1835-1854, 2023

Authors: Wu, Zhi-Ping | Yin, Jian-Lin | Liu, Shan-Kai | Ji, Song | Liu, Jian-Yu | Wang, Hai-Lan | Zhang, Yi-Sheng | Zhang, Da-Zhong

Article Type: Research Article

Abstract: BACKGROUND: The microsurgical treatment of paraclinoid aneurysms can be challenging due to the anatomical structures that surround them. OBJECTIVE: This study compared the clinical and angiographic outcomes of unruptured paraclinoid aneurysms treated with enterprise (EP) stents and low-profile visualized intraluminal support (LVIS) stents. METHODS: A retrospective analysis of the clinical and radiological data from 133 patients with 139 unruptured paraclinoid aneurysms, who received an EP or an LVIS stent between January 2017 and June 2021 at Taizhou People’s Hospital, was performed. Immediate postoperative and follow-up angiographic results were analyzed retrospectively using the Raymond-Roy …occlusion classification (RROC). Any complications following the procedure and the patients’ clinical outcomes were noted. RESULTS: Enterprise stents were used for stent-assisted coiling in 64 patients with 68 aneurysms and LVIS stents were used in 69 patients with 71 aneurysms. Both groups exhibited an increase in the proportion of aneurysms meeting the criteria for RROC class I, but the LVIS group demonstrated a higher rate of aneurysms meeting the class I criteria compared with the EP group, both on immediate postoperative angiography (45.1% vs. 11.8%, p < 0.001) and on follow-up angiography (94.9% vs. 80.6%, p = 0.025). Procedure-related complications were experienced by 9.4% of patients in the EP group (one coil prolapse, two parent artery occlusions, and three thromboembolic events), and 8.7% of patients in the LVIS group (three stent-related thrombosis and three thromboembolic events). There were no statistically significant differences between the two groups in relation to perioperative complications (p = 0.746) or favorable clinical outcomes (p = 0.492). CONCLUSION: A greater proportion of aneurysms in the LVIS group met the criteria for RROC class I compared with the EP group. There is no significant difference in procedural complications or clinical outcomes between EP and LVIS stents. Although no aneurysm recurrence was observed during the short follow-up period, continued monitoring is required. Show more

Keywords: Paraclinoid aneurysm, enterprise stent, LVIS stent, stent-assisted coiling

DOI: 10.3233/THC-220697

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1855-1865, 2023

Authors: Melcher, Carolin | Gottschalk, Oliver | Mazoochian, Farhad | Pieper, Korbinian | Wegener, Veronika | Pellengahr, Christoph Schulze | Teske, Wolfram | Wegener, Bernd

Article Type: Research Article

Abstract: BACKGROUND: Over the last 50 years arthroplasty became the gold-standard treatment for disabling conditions of the coxofemoral joint. Variations of anterior, lateral, and dorsal incision have been applied, but as each approach requires the incision and reflection of various muscles to gain adequate exposure of the joint results are still controversial. OBJECTIVE: The purpose of this study was to develop a minimal-invasive, tissue-sparing approach in sheep with reduced risks in animal testing. METHODS: 12 mature sheep underwent hip surgery as part of a study to evaluate a hip resurfacing system. In line with …the preliminary cadaveric tests a modified, minimal-invasive, musclepreserving surgical approach was sought after. RESULTS: We developed a surgical approach to the coxofemoral joint in sheep using only blunt tissue dissection after skin incision without any limitations in joint exposure or increased blood loss/duration of surgery. CONCLUSION: Even though limitations occur and femoral orientation in sheep differs from man, joint forces have similar relative directions to the bone with similar bony and vascular anatomy. Therefore, this minimal-invasive muscle preserving approach might be a safe and comparable alternative in still inevitable animal testing. Show more

Keywords: Hip replacement, blunt dissection, muscle-sparing approach, sheep

DOI: 10.3233/THC-220805

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1867-1874, 2023

Authors: Wang, Ning | Guo, Zi-Hao | Wu, Yan-Hong | Zhang, Chuan

Article Type: Research Article

Abstract: BACKGROUND: At present, there are few studies related to mean nocturnal baseline impedance (MNBI), esophageal dynamic reflux monitoring, high-resolution esophageal manometry (HRM) parameter indexes, and its diagnostic value in gastroesophageal reflux disease (GERD). OBJECTIVE: To analyze the factors influencing MNBI and examine the diagnostic value of MNBI in GERD. METHODS: A retrospective analysis on 434 patients with typical reflux symptoms who underwent gastroscopy, 24-hour multichannel intraluminal impedance and pH monitoring (MII/pH) and HRM. They were divided into the conclusive evidence group (103 cases), borderline evidence group (229 …cases), and exclusion evidence group (102 cases) according to the level of diagnostic evidence of GERD based on the Lyon Consensus. We analyzed the differences in MNBI, esophagitis grade, MII/pH and HRM index among the groups; the correlation between MNBI and the above indexes and its influence on MNBI; and to evaluate the diagnostic value of MNBI in GERD. RESULTS: There were significant differences in MNBI, Acid Exposure Time (AET) 4%, DeMeester score, and total reflux episodes among the three groups (P < 0.001). EGJ contractile integral (EGJ-CI) of the conclusive evidence group and the borderline evidence group was significantly lower than that in the exclusion evidence group (P < 0.001). MNBI was significantly and negatively correlated with age, BMI, AET 4%, DeMeester score, total reflux episodes, EGJ classification, esophageal motility abnormalities, and esophagitis grade (all P < 0.05), and significantly and positively correlated with EGJ-CI (P < 0.001). Age, BMI, AET 4%, EGJ classification, EGJ-CI, and esophagitis grade had significant effects on MNBI (P < 0.05); MNBI was used to diagnose GERD with a diagnostic cutoff of 2061 Ω , and AUC was 0.792 (sensitivity 74.9%, specificity 67.4%); MNBI was used to diagnose exclusion evidence group with a diagnostic cutoff of 2432 Ω , AUC was 0.774 (sensitivity 67.6%, specificity 72%). CONCLUSION: AET, EGJ-CI, and esophagitis grade are the most important influence factors of MNBI. MNBI has good diagnostic value in identifying conclusive GERD. Show more

Keywords: Diagnosis, gastroesophageal reflux disease, high resolution manometry of esophagus, mean nocturnal baseline impedance, 24-hour multichannel intraluminal impedance and pH monitoring

DOI: 10.3233/THC-220814

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1875-1886, 2023

Authors: Meng, Li-Na | Li, Gang | Yuan, Hong-Xun | Feng, Xi-Cui | Liu, Fang | Zhang, Shuang-Long

Article Type: Research Article

Abstract: BACKGROUND: Metagenomic next-generation sequencing (mNGS) is a new method that combines high-throughput sequencing and bioinformatics analysis. However, it has not become as popular due to the limited testing equipment and high costs and lack of family awareness with not much relevant intensive care unit (ICU) research data. OBJECTIVE: To explore the clinical use and value of metagenomics next-generation sequencing (mNGS) in patients with sepsis in the ICU. METHODS: We conducted a retrospective analysis of 102 patients with sepsis admitted to the ICU of Peking University International Hospital from January 2018 to January 2022. …Based on whether mNGS was performed, the identified patients were divided into the observation group (n = 51) and the control group (n = 51), respectively. Routine laboratory tests, including routine blood test, C-reactive protein, procalcitonin, and culture of suspicious lesion specimens were performed in both groups within 2 hours after admission to the ICU, while mNGS tests were performed in the observation group. Patients in both groups were routinely given initial anti-infective, anti-shock, and organ support treatment. Antibiotic regimens were optimized in a timely manner according to the etiological results. Relevant clinical data were collected. RESULTS: The testing cycle of mNGS was shorter than that of the conventional culture (30.79 ± 4.01 h vs. 85.38 ± 9.94 h, P < 0.001), while the positive rate of mNGS was higher than that of the conventional culture (82.35% vs. 45.1%, P < 0.05), with obvious superiority in the detection of viruses and fungus. There were significant differences in the optimal time of antibiotics (48 h vs.100 h) and length of ICU stay (11 d vs. 16 d) between the observation group and control group (P < 0.01) respectively, with no difference in 28-day mortality (33.3% vs. 41.2%, P > 0.05). CONCLUSION: mNGS is useful in the detection of sepsis-causing pathogens in the ICU with the advantages of short testing time and high positive rate. There was no difference in the 28-day outcome between the two groups, which may be related to other confounding factors such as small sample size. Additional studies with extended sample size are needed. Show more

Keywords: Intensive care unit, microorganism culture, mNGS, sepsis, health management

DOI: 10.3233/THC-220856

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1887-1899, 2023

Authors: Gu, Jun-Hua | Li, Wen-Qi | Chen, Chuan-Jun

Article Type: Research Article

Abstract: BACKGROUND: Whole-process management is a novel approach widely applied in industry and commerce; however, it is not widely used in the management of medical records in hospitals. OBJECTIVE: The purpose of this study is to investigate the application of whole-process control in the administration of a hospital’s medical records department to achieve refined management of medical records. METHODS: Whole-process control is a management measure that begins with process conception and implementation and includes control over all processes. The control group included medical records that were created prior to the implementation of whole-process control, …i.e., those created between June 1 and December 31, 2020. The observation group included medical records that were created after the implementation of whole-process control. The behavior of the medical records staff (in terms of medical record collection, sorting, entry, inquiry, and supply) and the final quality of the medical records (the number of grade-A medical records and their front-page quality) were compared between the two groups, and subjective judgments related to staff satisfaction were reviewed. RESULTS: The implementation of whole-process control improved the behavior of the medical records staff. The final quality of the medical records was also improved, as was the job satisfaction of the medical records staff. CONCLUSION: Implementing whole-process control improved the management of medical records and quality of medical records. Show more

Keywords: Medical records, refined management, whole-process control

DOI: 10.3233/THC-220863

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1901-1910, 2023

Authors: Zheng, Shan-Shan | Zhang, Hui | Zhang, Man-Hua | Li, Xue | Chang, Kuo | Yang, Feng-Chi

Article Type: Research Article

Abstract: BACKGROUND: Studies have shown that community-based group rehabilitation activities can have a positive impact on patients. OBJECTIVE: This study attempted to improve schizophrenia patients’ social and self-cognition through short-term group-based cognitive behavioral therapy (G-CBT), break negative coping styles, and improve the patients’ quality of life. METHODS: The patients with schizophrenia who participated in long-term community-based group rehabilitation were treated with G-CBT. Training on coping styles was conducted to improve their self-cognition and social cognition, and the rehabilitation effects of G-CBT on these patients were evaluated. RESULTS: Compared with the control …group, patient scores for self-esteem, self-efficacy, and positive coping in the G-CBT group increased, while patient scores for negative coping decreased. Compared with the control group, the differences in the total scores for mental health and the five dimensions of physical functioning, general health, vitality, social functioning, and emotional role function in the short-form (SF-12) survey were statistically significant. Compared with the baseline data, the differences in self-esteem, self-efficacy, positive coping, negative coping, and quality of life scores were statistically significant. CONCLUSION: Short-term G-CBT had a good effect on patients with chronic schizophrenia who participated in community-based group rehabilitation for the long-term. Show more

Keywords: Schizophrenia, group-based cognitive behavioral therapy, community-based mental rehabilitation

DOI: 10.3233/THC-220904

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1911-1922, 2023

Authors: Qazi, Noreen | Pawar, Madhura | Padhly, Preeti P. | Pawar, Vivek | D’Amico, Cesare | Nicita, Fabiana | Fiorillo, Luca | Alushi, Adela | Minervini, Giuseppe | Meto, Aida

Article Type: Research Article

Abstract: BACKGROUND: Instagram statistic has attracted roughly one billion, monthly active users. In 2021, Instagram belonged to the most popular social networks worldwide. It has been considered an effective tool that contributes to the contemporary sharing of information for raising public awareness while providing educational information. The growing presence of Instagram and frequent user engagement has made it a potentially effective platform for patient communication, seeking educational information, product information for consumers, and advertisements in the form of images and videos. OBJECTIVE: To assess and compare the contents of Instagram posts by healthcare professionals (HP) and non-professional …healthcare workers (NPHW) on bruxism and to assess public engagement with this content. METHODS: Twelve “hashtag” terms linked to bruxism were searched. HP and NPHW analyzed the content of relevant posts for the presence of domains. Discourse analysis assessed the post quality for themes. We conducted the descriptive and univariate statistical analysis, whereas inter-rater reliability was tested using Cohen’s kappa. RESULTS: A total of 1184 posts were retrieved, with the majority uploaded by NPHW (622 posts). The posts by HPs were in text and image(s) format (53%) with the range of 25–1100 Instagram post “Likes.” “Mouthguard” (90) % was the most frequently included domain posted by HP, followed by “treatment plan/pain management”, and complaints of clicking or locking of TMJ” (84%). Greater number of domains (p = 0.03) were seen in the posts by NPHWs, compared to HP’s having more bruxism-related content. The inter-rater reliability method (0.89) was used for the presence of domains. CONCLUSION: NPHW uses Instagram more frequently to post bruxism-related information than HP. HPs must ascertain that the content posted by NPHW is relevant and the concerns addressed in posts are to the purpose. Show more

Keywords: Instagram, teledentistry, bruxism, hashtag, temporomandibular disorders

DOI: 10.3233/THC-220910

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1923-1934, 2023

Authors: Li, Zishuo | Long, Yanli | Yang, Qing | Liu, Jing | Wang, Yahong

Article Type: Research Article

Abstract: BACKGROUND: A variety of reviews have indicated the effectiveness of smartphone-based interventions in preventing secondary cardiovascular disease (CVD). However, few studies have focused on clinical outcomes. OBJECTIVE: This meta-analysis aimed to evaluate the potential benefits of application interventions and short message service (SMS) interventions on CVD outcomes. METHODS: Electronic databases were searched to identify randomized controlled trials (RCT) investigating an application or SMS intervention for secondary CVD prevention. Primary outcomes included major adverse cardiovascular events (MACE), cardiovascular death, and cardiac hospitalization. Secondary outcomes were cardiovascular risk factors (BMI, blood pressure, and cholesterol). …RESULTS: A total of 26 RCTs were included, with 16 investigating applications and 10 assessing SMS. Overall, there was no significant difference in MACE, cardiovascular death, and cardiac hospitalization when comparing application interventions with usual care, as well as comparing SMS with usual care. Subgroup analysis revealed that patients who received applications without a medical interface had a significantly lower incidence of MACE (OR = 0.56; 95% CI: 0.33, 0.98). Participants who received applications with a medical interface showed a tendency towards higher rates of cardiac hospitalization (OR = 2.03; 95% CI: 0.85, 4.87). Significant reduction in waist circumference (SMD = - 0.80; 95% CI: - 1.58, - 0.03) was found in application interventions compared to usual care; while significant reductions in SBP (SMD = - 0.08; 95% CI: - 0.15, - 0.01) and TC (SMD = - 0.31; 95% CI: - 0.57, - 0.08) were found in SMS interventions compared to usual care. CONCLUSION: Smartphone-based interventions, including applications and SMS, have the potential to benefit the secondary prevention of CVD. Applications may reduce the incidence of cardiovascular-related adverse events, while SMS interventions may improve cardiovascular risk factors. Show more

Keywords: mHealth, mobile applications, text messaging, cardiovascular disease, mobile phone

DOI: 10.3233/THC-230022

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1935-1948, 2023

Authors: Kovacevic, Pedja | Djajic, Vlado | Skrbic, Ranko | Milivojevic, Natasa | Jereb, Matjaz | Gradisek, Primoz | Gorjup, Vojka

Article Type: Review Article

Abstract: BACKGROUND: Critical care medicine is a young branch of medicine, of which the development was much faster in High Income Countries (HICs) than in Low Resources Settings (LRS). Slovenia, as one of the successor states of former Yugoslavia, passed the process of transition and joined the European Union successfully. On the contrary, Bosnia and Herzegovina (B&H) went through the extremely difficult process of transition (four years of civil war), which left a deep scar to the healthcare system, including critical care medicine. OBJECTIVE: To examine the impact of HICs on the development of critical care in …LRS. METHOD: This review examined the process of growing up the first modern Medical Intensive Care Unit (MICU) in the Republic of Srpska. RESULTS: The five-year process of transferring critical care knowledge from Slovenia to the health care system of Republic of Srpska has contributed to the existence of modern and state of the art MICU with tremendous social effects. CONCLUSION: The model of using the impact of HICs for improving critical care in LRS can be extrapolated to other similar settings. Show more

Keywords: Critical care, low resources settings, high-income countries, translation

DOI: 10.3233/THC-230117

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1949-1955, 2023

Authors: Alobaid, Mohammed A. | Chaturvedi, Saurabh | Alshahrani, Ebtihal Mobarak S. | Alshehri, Ebtsam M. | Shaiban, Amal S. | Addas, Mohamed Khaled | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Cone-beam computed tomography (CBCT) could be more beneficial in clinical situations that involve the determination of root canal morphology. AIM: The aim of the study was to ascertain the prevalence of radix molaris (paramolaris-RP and entomolaris-RE) in a subpopulation of Saudi Arabia using CBCT. METHOD: A total of 700 CBCT scans of mandibular permanent first molars were included in this study. All CBCT scans were interpreted by two trained dentists and an endodontist. Mandibular permanent first molars with fully developed roots and closed apices were only included. Computed Tomography scans were obtained …from the dental college record. The anatomic characteristics which were checked included: the prevalence of radix molaris in both RE and RP and the prevalence of radix molaris according to the patient’s gender and age. All CBCT images were processed and reconstructed using OnDemand3D TM imaging software. RESULTS: Of the 700 patients included, 651 (93.0%) did not have radix molaris, 46 (6.6%) had radix entomolaris and 3 (0.4%) had radix paramolaris in the study group. There was no statistically significant difference between the genders and age in the incidence of RE and RP (P -value < 0.05). CONCLUSION: The study showed that RE prevalence is more compared to RP in the first lower molars in the population studied. It is important to identify extra roots and associated canals to perform successful root canal treatment and avoid failure. Show more

Keywords: Cone-beam computed tomography, mandibular first molars, radix molaris, radix entomolaris, radix paramolaris, root canal morphology

DOI: 10.3233/THC-230300

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1957-1968, 2023

Authors: Chen, Wei-Ling | Lin, Chia-Hung | Yang, Tsung-Lung | Lin, Che-Wei | Kan, Chung-Dann

Article Type: Research Article

Abstract: BACKGROUND: The increasing prevalence of end-stage renal disease (ESRD) imposes a substantial economic burden on public health-care systems. Hemodialysis (HD) is a pivotal treatment modality for patients with ESRD. However, prolonged use of HD vessels may result in stenosis, thrombosis, and occlusion due to repeated daily punctures. Thus, early detection and prevention of the dysfunction of dialysis routes are crucial. OBJECTIVE: In this study, we designed a wearable device for the early and accurate detection of arteriovenous access (AVA) stenosis in HD patients. METHODS: A personalized three-dimensional (3D) printed wearable device was designed …by combining the phonoangiography (PAG) and photoplethysmography (PPG) techniques. The capability of this device to monitor AVA dysfunction before and after percutaneous transluminal angioplasty (PTA) was evaluated. RESULTS: After PTA, the amplitudes of both PAG and PPG signals increased in patients with arteriovenous fistulas and those with arteriovenous grafts; this might be due to increased blood flow. CONCLUSION: Our designed multi-sensor wearable medical device using PAG, PPG, and 3D printing appears suitable for early and accurate detection of AVA stenosis in HD patients. Show more

Keywords: Hemodialysis, personalized 3D printed device, phonoangiography

DOI: 10.3233/THC-235000

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1969-1979, 2023

Authors: Han, Seungju | Kim, Changhee | Kim, Kangil | Lee, Sangmin

Article Type: Research Article

Abstract: BACKGROUND: In retinal prosthetic systems on multi-channel microelectrodes to effectively stimulate retinal neurons, the electrode-electrolyte interface impedance of a microelectrode should be minimized to drive sufficiently large current at a given supply voltage. OBJECTIVE: This paper presents the fabrication of the nanostructured microelectrode array with simplified fabrication and its characteristic evaluation using biphasic current stimulator. METHODS: The nanostructured microelectrodes with the base diameter of 25 μ m, 50 μ m, 75 μ m are fabricated, and the maximum allowable current injection limits are measured to verify the …estimated injection limit. Also, a biphasic stimulator has been fabricated using the 2-stage amplifier and 4 switches based on a stimulator cell. The adjustable load resistance is adopted to control between 5 kΩ to 20 kΩ , and the biphasic stimulator can drive the stimulation current between 50 uA and 200 uA. RESULTS: The proposed electrode-electrolyte interface impedance of the fabricated nanostructured microelectrode is 3178 Ω , 1218 Ω and 798.8 Ω for electrodes with diameter of 25 μ m, 50 μ m, 75 μ m, respectively. CONCLUSION: This paper shows the advantages of the nanostructured microelectrode arrays for high resolution retinal prostheses, which could be a basic experiment for artificial retina research. Show more

Keywords: Retinal prosthetic system, nanostructured microelectrode, microelectrode array

DOI: 10.3233/THC-235001

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1981-1995, 2023

Authors: Sa-nguannarm, Phataratah | Elbasani, Ermal | Kim, Jeong-Dong

Article Type: Research Article

Abstract: BACKGROUND: Stress is one of the critical health factors that could be detected by Human Activity Recognition (HAR) which consists of physical and mental health. HAR can raise awareness of self-care and prevent critical situations. Recently, HAR used non-invasive wearable physiological sensors. Moreover, deep learning techniques are becoming a significant tool for analyzing health data. OBJECTIVE: In this paper, we propose a human lifelog monitoring model for stress behavior recognition based on deep learning, which analyses stress levels during activity. The proposed approach considers activity and physiological data for recognizing physical activity and stress levels. …METHODS: To tackle these issues, we proposed a model that utilizes hand-crafted feature generation techniques compatible with a Bidirectional Long Short-Term Memory (Bi-LSTM) based method for physical activity and stress level recognition. We have used a dataset called WESAD, collected using wearable sensors for model evaluation. This dataset presented four levels of stress emotion, including baseline, amusement, stress, and meditation. RESULTS: The following results are from the hand-crafted feature approaches compatible with the bidirectional LSTM model. The proposed model achieves an accuracy of 95.6% and an F1-score of 96.6%. CONCLUSION: The proposed HAR model efficiently recognizes stress levels and contributes to maintaining physical and mental well-being. Show more

Keywords: Human activity recognition, stress behavior recognition, bidirectional long short-term memory, recurrent neural network, deep learning

DOI: 10.3233/THC-235002

Citation: Technology and Health Care, vol. 31, no. 5, pp. 1997-2007, 2023