Technology and Health Care - Volume 32, issue 1

Authors: Bao, Lingyun | Du, Kun | Gao, Jin | Jiang, Rongrong | Li, Bin | Liu, Tingting

Article Type: Research Article

Abstract: BACKGROUND: Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year. OBJECTIVE: The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies. METHODS: A total of 202 preterm infants with a gestational age of 26 weeks …to 36 + 6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed. RESULTS: There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy. CONCLUSION: A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants. Show more

Keywords: Preterm infant, fungal infection, high-risk factors

DOI: 10.3233/THC-230218

Citation: Technology and Health Care, vol. 32, no. 1, pp. 361-367, 2024

Authors: Wang, Yanan | Zhai, Shifen | Liu, Lili | Qu, Bin | Wang, Ziqian

Article Type: Research Article

Abstract: BACKGROUND: Situation, Background, Assessment, and Recommendation (SBAR) is a structured method for communicating critical information that requires immediate attention and action. OBJECTIVE: To study the effects of empathy nursing combined with the SBAR communication system on the negative emotions and nursing quality of children undergoing tracheotomy. METHODS: This is a clinical observational study. A total of 100 tracheotomy patients who were cared for in the pediatric intensive care unit (subsequent treatment in the tracheotomy clinic or otolaryngology ward) of our hospital from September 2021 to June 2022 were recruited and assigned at a …ratio of 1:1 either into a control group (empathic care) or an observation group (empathic care combined with SBAR) using a randomized method. Further, the postoperative anxiety self-rating scale scores, negative emotions, hope index, and nursing quality were compared between the two groups. RESULTS: After nursing, the psychological resilience scale score of the observation group was higher than that of the control group, whereas the anxiety self-rating scale score was significantly lower than that of the control group (all P < 0.05). Basic and special nursing, knowledge awareness, and safety management of the two groups of patients improved significantly, with higher results in the observation group than in the control group (P < 0.05). CONCLUSION: Empathy nursing combined with the SBAR communication system considerably improves postoperative negative emotions and enhances the quality of nursing care for patients undergoing tracheotomy. Show more

Keywords: Tracheotomy, empathy nursing, SBAR communication system, nursing effect, children

DOI: 10.3233/THC-230231

Citation: Technology and Health Care, vol. 32, no. 1, pp. 369-378, 2024

Authors: Xu, Fan | Zheng, Qihang | Shi, Jia | Yan, Keyu | Wang, Mingwen

Article Type: Research Article

Abstract: BACKGROUND: Alzheimer’s disease (AD) endangers the physical and mental health of the elderly, constituting one of the most crucial social challenges. Due to lack of effective AD intervention drugs, it is very important to diagnose AD in the early stage, especially in the Mild Cognitive Impairment (MCI) phase. OBJECTIVE: At present, an automatic classification technology is urgently needed to assist doctors in analyzing the status of the candidate patient. The artificial intelligence enhanced Alzheimer’s disease detection can reduce costs to detect Alzheimer’s disease. METHODS: In this paper, a novel pre-trained ensemble-based AD detection …(PEADD) framework with three base learners (i.e., ResNet, VGG, and EfficientNet) for both the audio-based and PET (Positron Emission Tomography)-based AD detection is proposed under a unified image modality. Specifically, the effectiveness of context-enriched image modalities instead of the traditional speech modality (i.e., context-free audio matrix) for the audio-based AD detection, along with simple and efficient image denoising strategy has been inspected comprehensively. Meanwhile, the PET-based AD detection based on the denoised PET image has been described. Furthermore, different voting methods for applying an ensemble strategy (i.e., hard voting and soft voting) has been investigated in detail. RESULTS: The results showed that the classification accuracy was 92% and 99% on the audio-based and PET-based AD datasets, respectively. Our extensive experimental results demonstrate that our PEADD outperforms the state-of-the-art methods on both audio-based and PET-based AD datasets simultaneously. CONCLUSIONS: The network model can provide an objective basis for doctors to detect Alzheimer’s Disease. Show more

Keywords: Alzhemier’s disease, early detection, pre-training, ensembling, modality

DOI: 10.3233/THC-230571

Citation: Technology and Health Care, vol. 32, no. 1, pp. 379-395, 2024

Authors: Li, Xingping | Chen, Fuyan | Wang, Wenqing | Liu, Yang | Han, Jiang-Qin | Ke, Zi | Zhu, Hong-Hang

Article Type: Research Article

Abstract: BACKGROUND: Hypertension has become one of the most pathogenic diseases in the world. OBJECTIVE: This paper summarizes and analyzes the acupuncture point combinations and treatment principles of acupuncture for hypertension in a systematic way by means of big data mining. METHODS: The literature for this paper was obtained from CNKI, Wanfang, VIP, SinoMed and PubMed, Embase, Cochrane Library, Web of Science, and Ovid databases. Thedata were collected to obtain combinations of acupoints with strong associations through association rule analysis, complex networks for screening to obtain core acupoint nuclei, and cluster analysis to derive …treatment principles. RESULTS: A total of 127 acupuncture prescriptions involving 66 acupoints were included in this study. Tai-chong (LR3), Qu-chi (LI11), Zu-san-li (ST36), Feng-chi (GB20), and He-gu (LI4) were the most commonly used acupoints. The large intestine meridian was the preferred meridian, and most of the extremity acupoints, especially the lower extremities, were selected clinically. The association rule reveals that Qu-chi (LI11) and Zu-san-li (ST36) are the dominant combination acupoints. 3 core association points obtained after complex network analysis, the 1st association, Bai-hui (DU20), Tai-xi (KI3), Gan-shu (BL18), Shen-shu (BL23); The 2nd association, Qu-chi (LI11), He-gu (LI4), San-yin-jiao (SP6), Zu-san-li (ST36), Feng-chi (GB20), Tai-chong (LR3); The 3rd association, Qi-hai (RN6), Guan-yuan (RN4), Zhong-wan (RN12), Zhao-hai (KI6), Tai-yang (EX-HN5), Lie-que (LU7), Yang-ling-quan (GB34), Xing-jian (LR2), Yin-ling-quan (SP9). Cluster analysis yielded the treatment principles of nourishing Yin and submerging Yang, pacifying the liver and submerging Yang, tonifying Qi and Blood, and calming the mind and restoring the pulse, improving clinical outcomes. CONCLUSION: By means of big data mining, we can provide reference for acupuncture point grouping and selection for clinical acupuncture treatment of hypertension. Show more

Keywords: Acupuncture, acupoints, hypertension, data mining technology, mechanism

DOI: 10.3233/THC-230581

Citation: Technology and Health Care, vol. 32, no. 1, pp. 397-410, 2024

Authors: Wei, Wei | Lu, Lin-Xiang | Hao, Ying | Kang, Sheng | Liu, Yonghua | Yu, Jing | Chen, Wenli | Fan, Cheng-Hui

Article Type: Research Article

Abstract: BACKGROUND: Chinese chest pain centers (CPCs) have been expanding and maturing for the past decade, but patient wait times for pre-hospital care remain long. OBJECTIVE: To demonstrate that the remote electrocardiogram (ECG) monitoring system can ensure more efficient treatment for patients with ST-elevation myocardial infarction (STEMI) in CPCs, we compared patients with high-risk chest pain who used remote ECG monitoring systems to those who used conventional ECGs in retrospective cohort study. METHODS: Based on the inclusion and exclusion criteria, 290 patients who visited our CPC between June 2019 and March 2022 with acute …chest pain and a diagnosis of STEMI as well as patients who had undergone an emergency primary percutaneous coronary intervention were selected. Among them, 73 patients with STEMI had employed remote real-time dynamic 12-lead ECG monitoring devices, while 217 patients with STEMI (i.e., the controls) had used conventional ECG monitoring. The effectiveness of treatment procedures for the two groups was investigated. As statistical measures, the symptom onset-to-wire times, first medical contact (FMC)-to-wire times, door-to-wire times, major adverse cardiac events in hospital, and the troponin T levels were analyzed. RESULTS: Compared with the control group, the patients with remote real-time dynamic 12-lead ECG monitoring devices showed shorter times for both symptom onset-to-wire (234.8 ± 95.8 min vs. 317.6 ± 129.6 min, P = 0.0321) and from symptom onset-to-FMC (170.5 ± 86.3 min vs. 245.3 ± 115.6 min, P = 0.0287); this group also had a lower 30-day mortality rate (2.73% vs. 4.14%, P = 0.003). The differences between the two groups were statistically significant (P < 0.05). CONCLUSION: With remote real-time dynamic 12-lead ECG monitoring equipment, myocardial ischemia can be treated more quickly, leading to fewer possible cardiac events and a better prognosis. Show more

Keywords: Remote electrocardiogram monitoring, high-risk chest pain, acute myocardial infarction, wearable devices

DOI: 10.3233/THC-230582

Citation: Technology and Health Care, vol. 32, no. 1, pp. 411-421, 2024

Authors: Allabun, Sarah M.

Article Type: Research Article

Abstract: BACKGROUND: The monitoring of fetal heart rate (FHR) before intrapartum has been crucial in modern obstetrics. FHR has been used for about 300 years to determine fetal status, leading to the development of monitoring devices to prevent fetal death during gestation. While medical devices like fetal electrocardiograms exist for disease detection, their size and cost limit individual use. OBJECTIVE: To address cardiovascular issues during pregnancy, a mobile system is developed to display heart rates and blood pressure on mobile devices. The system is generated from a medical device with Bluetooth communication, supplementing traditional monitoring. …METHOD: The study focuses on creating a mobile system that connects to mobile operating systems, enhancing treatment, diagnosis, and patient monitoring. The mobile system displays cardiovascular data obtained from the medical device. RESULTS: The results are expected to have an immediate impact on cases where abnormal measurement parameters of the monitoring system occur during pregnancy. The use of mobile systems or applications on smartphones is seen as beneficial in distributing processing and census of embedded health systems. CONCLUSION: The study highlights the potential benefits of mobile systems in distributing processing for health systems, particularly in addressing cardiovascular problems during pregnancy. The creation of a mobile system for displaying cardiovascular data could significantly improve monitoring and early detection. Show more

Keywords: Mobile health, wireless communication interfaces, fetal heart rate, parameters measurement

DOI: 10.3233/THC-230587

Citation: Technology and Health Care, vol. 32, no. 1, pp. 423-439, 2024

Authors: Duan, Mengyao | Zhang, Yiming | Liu, Yixing | Mao, Boyan | Li, Gaoyang | Han, Dongran | Zhang, Xiaoqing

Article Type: Research Article

Abstract: BACKGROUND: Coronary heart disease (CHD) is the first cause of death globally. Hypertension is considered to be the most important independent risk factor for CHD. Early and accurate diagnosis of CHD in patients with hypertension can plays a significant role in reducing the risk and harm of hypertension combined with CHD. OBJECTIVE: To propose a non-invasive method for early diagnosis of coronary heart disease according to tongue image features with the help of machine learning techniques. METHODS: We collected standard tongue images and extract features by Diagnosis Analysis System (TDAS) and ResNet-50. On …the basis of these tongue features, a common machine learning method is used to customize the non-invasive CHD diagnosis algorithm based on tongue image. RESULTS: Based on feature fusion, our algorithm has good performance. The results showed that the XGBoost model with fused features had the best performance with accuracy of 0.869, the AUC of 0.957, the AUPR of 0.961, the precision of 0.926, the recall of 0.806, and the F1-score of 0.862. CONCLUSION: We provide a feasible, convenient, and non-invasive method for the diagnosis and large-scale screening of CHD. Tongue image information is a possible effective marker for the diagnosis of CHD. Show more

Keywords: Coronary heart disease, machine learning, hypertension, early diagnosis, feature fusion

DOI: 10.3233/THC-230590

Citation: Technology and Health Care, vol. 32, no. 1, pp. 441-457, 2024

Authors: Hoffeld, Kai | Lenz, Maximilian | Meiss, Inken | Eysel, Peer | Oppermann, Johannes

Article Type: Research Article

Abstract: BACKGROUND: The cup inclination in total hip arthroplasty is key to minimising complications. Stereometric effects (parallax) in two-dimensional projections can alter angle measurements. Even for different approaches, fluoroscopy causes different results in the measurement of inclination. A previous study has introduced a corrective factor for intraoperative radiographic cup inclination measurements compared to the postoperative standing radiographs. OBJECTIVE: The aim of this study was to find out whether, first, the correction factor is reproducible and second, whether the correction factor is independent of the surgical approach and C-arm model used. METHODS: A series of …377 cases of primary total hip arthroplasty was reviewed. We compared the cup inclination angle in the intraoperative and postoperative radiographic images. Based on this, it was possible to specify a standard of correction factor in defined ranges. RESULTS: The mean cup inclination in intraoperative images was 37.47 ∘ and the mean angle in postoperative images was 41.42, resulting in a mean difference of 3.95 ∘ with a strong correlation (r = 0.706). CONCLUSION: An added correction factor of 4 ∘ should be respected in intraoperative inclination measurements to adapt for parallax. An increased correction factor of 6 ∘ in particularly low-positioned cups (< 31 ∘ ) and a decreased correction factor of 2 ∘ in particularly steeply positioned cups (> 43 ∘ ) is recommended. Show more

Keywords: Total hip arthroplasty, THA, Cup positioning, Inclination, Intraoperative fluoroscopy Level of evidence: 4

DOI: 10.3233/THC-230651

Citation: Technology and Health Care, vol. 32, no. 1, pp. 459-466, 2024

Authors: Yin, Liang | Zhao, Xin-Xiu | Gao, Shun-Li | Yuan, Wen-Ling | Wu, Ke | Qian, Wei-Dong | Li, Qian-Qian

Article Type: Research Article

Abstract: BACKGROUND: Vascular tortuosity is a prevalent morphological change that frequently occurs in arteries across different parts of the body. OBJECTIVE: To analyze the relationship between the tortuosities of the extracranial internal carotid artery (EICA) and extracranial vertebral artery (EVA) with mild cognitive impairment. METHODS: The tortuosity index (TI), vascular deviation degree, tortuosity degree, and angle number of the EICA and EVA were retrospectively analyzed and calculated in 160 patients who underwent computed tomography angiography (CTA) in this study’s department, and the Montreal cognitive assessment was adopted to evaluate the cognitive function of the …patients. RESULTS: The differences in age, gender, arterial hypertension (AH), and diabetes mellitus (DM) between the normal group and the mild cognitive impairment group were statistically significant (p < 0.01). The TI was negatively correlated with the score of cognitive function. The tortuosities of the EICA and EVA were correlated with mild cognitive impairment (p < 0.05). The reduction in visual-spatial ability was correlated with the right EICA tortuosity, and the reduction in memory was correlated with the EVA tortuosity. Age, gender, HP, DM, and coronary heart disease (CHD) were potential risk factors for carotid tortuosity (p < 0.05). CONCLUSION: There was a significant correlation observed between the TIs of both the EICA and EVA and the presence of mild cognitive impairment. Advanced age, female, HP, DM, and CHD were independent risk factors for EICA and EVA tortuosities. Show more

Keywords: Arterial tortuosity, mild cognitive impairment, pearson correlation analysis, risk factors

DOI: 10.3233/THC-230677

Citation: Technology and Health Care, vol. 32, no. 1, pp. 467-479, 2024

Authors: Syed, Wajid | Al-Rawi, Mahmood Basil A.

Article Type: Research Article

Abstract: BACKGROUND: Several revolutions are currently taking place in the healthcare industry to provide accurate, reliable, and valid healthcare to patients. Among these is artificial intelligence (AI). OBJECTIVE : This study aimed to assess the CP’s awareness, perceptions, and opinions of AI in health care among community pharmacists. METHODS: This cross-sectional survey-based study was conducted over 3 months in 2023 using structured prevalidated 34 items questionnaires. RESULTS: In this study, 94.5% (n = 258) of the CPs were aware of AI, yet 25.6% (n = …70) believed that AI would eventually replace healthcare professionals. However, 63.4% (n = 173) of the CPs concurred that AI is a technology that supports healthcare workers. 12.8% of the CPs believed that there is a risk of losing their jobs if AI is widely used in Saudi Arabia, but 68.9% (n = 188) of them considered that healthcare professionals will benefit from the extensive use of AI. Eighty-four percent of CPs (n = 232) agreed or strongly agreed that AI decreases drug mistakes in clinical practice. Similarly, 86% of the CPs (n = 235) concurred that AI makes it easier for patients to access the service. In contrast, almost 58% of the CPs (n = 232) agreed that AI makes it easier for healthcare professionals to acquire information, and 87.9% of the CPs (n = 240) said that AI helps them make better decisions. CONCLUSION: This study concluded that most of the CPs were aware of AI and agreed that AI is a tool that helps healthcare professionals. In addition, the majority of the CPs thought that AI adoption in healthcare practice will benefit healthcare practitioners. Show more

Keywords: Artificial intelligence, awareness, perceptions, community pharmacists, Saudi Arabia

DOI: 10.3233/THC-230784

Citation: Technology and Health Care, vol. 32, no. 1, pp. 481-493, 2024