Technology and Health Care - Volume 31, issue 5

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