Technology and Health Care - Volume 32, issue 2

Authors: Yao, Xiaohui | Liu, Shan | Xia, Huan | Li, Hanhan | Wang, Zhijie | Su, Le | Guo, Wei | Chen, Hanrui

Article Type: Research Article

Abstract: BACKGROUND: Recurrence is the main cause of death in hepatocellular carcinoma (HCC) patients after liver resection. OBJECTIVE: The long non-coding RNAs (lncRNAs) have been reported participated in progression and prognosis of HCC, however, the vital role of lncRNA in postoperative recurrence of HCC has rarely been systematically identified. METHODS: RNA-sequencing (RNA-seq) was performed between orthotopic model of HCC and hepatoma postoperative recurrent model to comprehensively analyze the integrated transcriptome expression profiles of lncRNA and mRNA. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was then conducted to quantify the expression levels of DElncRNAs and their …target mRNAs. RESULTS: In our study, 211 lncRNAs (P -value < 0.05) and 1125 mRNAs (P -adjust < 0.05) were significantly differentially expressed (DE) between two groups. Moreover, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that DElncRNAs and DEmRNAs were mainly enriched in lipid metabolism, including Arachidonic acid metabolism, PPAR signaling pathway, Steroid hormone biosynthesis, Linoleic acid metabolism, Inflammatory mediator regulation of TRP channels, and Fatty acid degradation. Furthermore, we constructed lncRNA-mRNA interaction networks and protein-protein interaction (PPI) network, and verified by qRT-PCR, suggesting that increased DEIncRNAs (XLOC_063499 and XLOC_042016) may prevent HCC recurrence after surgery by upregulating on targeted cytochrome P450 (CYP) family genes in the lipid metabolism pathway, such as cyp3a16, cyp3a44, cyp2c39, cyp2c40 and cyp2c68. CONCLUSION: Overall, Our findings provided new insights for further investigation of biological function in lncRNA related HCC recurrence. Show more

Keywords: LncRNA, RNA-seq, postoperative recurrence of HCC, HCC recurrence, hepatoma postoperative recurrent model, CYP

DOI: 10.3233/THC-230123

Citation: Technology and Health Care, vol. 32, no. 2, pp. 735-747, 2024

Authors: Yuan, Gaoteng | Zhai, Yi | Tang, Jiansong | Zhou, Xiaofeng

Article Type: Research Article

Abstract: BACKGROUND: Hepatitis B Virus (HBV) reactivation is the most common complication for patients with primary liver cancer (PLC) after radiotherapy. How to reduce the reactivation of HBV has been a hot topic in the study of postoperative radiotherapy for liver cancer. OBJECTIVE: To find out the inducement of HBV reactivation, a feature selection algorithm (MIC-CS) using maximum information coefficient (MIC) combined with cosine similarity (CS) was proposed to screen the risk factors that may affect HBV reactivation. METHOD: Firstly, different factors were coded and MIC between patients was calculated to acquire the association …between different factors and HBV reactivation. Secondly, a cosine similarity algorithm was constructed to calculate the similarity relationship between different factors, thus removing redundant information. Finally, combined with the weight of the two, the potential risk factors were sorted and the key factors leading to HBV reactivation were selected. RESULTS: The results indicated that HBV baseline, external boundary, TNM, KPS score, VD, AFP, and Child-Pugh could lead to HBV reactivation after radiotherapy. The classification model was constructed for the above factors, with the highest classification accuracy of 84% and the AUC value of 0.71. CONCLUSION: Comparing multiple feature selection methods, the results showed that the effect of the MIC-CS was significantly better than MIM, CMIM, and mRMR, so it has a very broad application prospect. Show more

Keywords: HBV, MIC, cosine similarity, feature selection, classification

DOI: 10.3233/THC-230161

Citation: Technology and Health Care, vol. 32, no. 2, pp. 749-763, 2024

Authors: Zhang, Xuelan | Peng, Yuan | Li, Gaoyang | Li, Jiehua | Luo, Mingyao | Che, Yue | Zheng, Liancun | Anzai, Hitomi | Ohta, Makoto | Shu, Chang

Article Type: Research Article

Abstract: BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening aortic disease. However, little information is available on predicting and understanding of ATBAD. OBJECTIVE: The study sought to explore the underlying mechanism of ATBAD by analyzing the morphological and hemodynamic characteristics related to aortic length. METHODS: The length and tortuosity of the segment and the whole aorta in the ATBAD group (n = 163) and control group (n = 120) were measured. A fixed anatomic landmark from the distal of left subclavian artery …(LSA) to the superior border of sixth thoracic vertebra was proposed as the proximal descending thoracic aorta (PDTA), and the dimensionless parameter, length ratio, was introduced to eliminate the individual differences. The significant morphological parameters were filtrated and the associations between parameters were investigated using statistical approaches. Furthermore, how aortic morphology influenced ATBAD was explored based on idealized aortic models and hemodynamic-related metrics. RESULTS: The PDTA length was significantly increased in the ATBAD group compared with the control group and had a strong positive correlation with the whole aortic length (r = 0.89). The length ratio (LR2 ) and tortuosity (T2 ) of PDTA in the ATBAD group were significantly increased (0.15 ± 0.02 vs 0.12 ± 0.02 and 1.73 ± 0.48 vs 1.50 ± 0.36; P < 0.001), and LR2 was positive correlation with T2 (r = 0.73). In receiver-operating curve analysis, the area under the curve was 0.835 for LR2 and 0.641 for T2 . Low and oscillatory shear (LOS) was positive correlation with LR2 , and the elevated LOS occurred in the distal of LSA. CONCLUSION: Elongation of PDTA is associated with ATBAD, and the length ratio is a novel predictor. Elongated PDTA induced more aggressive hemodynamic forces, and high LOS regions may correspond to the entry tear location. The synergy of the morphological variation and aggressive hemodynamics creates contributory conditions for ATBAD. Show more

Keywords: Aortic dissection, aortic elongation, length ratio, hemodynamics, low and oscillatory shear

DOI: 10.3233/THC-230194

Citation: Technology and Health Care, vol. 32, no. 2, pp. 765-777, 2024

Authors: Mur, Linda | Annon-Eberharter, Natalee | Gombos, Petra | Wald, Martin

Article Type: Research Article

Abstract: BACKGROUND: Dead space is the part of the airway where no gas exchange takes place. Any increase in dead space volume has a proportional effect on the required tidal volume and thus on the risk of ventilation-induced lung injury. Inserts that increase dead space are therefore not used in small preterm infants. This includes end-tidal CO2 measurement. OBJECTIVE: The aim of this study was to investigate the effect of the end-tidal CO2 measurement adapter on ventilation. METHODS: In an experimental setup, an end-tidal CO2 measurement adapter, three different pneumotachographs (PNT-A, …PNT-B, PNT-Neo), and a closed suction adapter were combined in varying set-ups. The time required for CO2 elimination by a CO2 -flooded preterm infant test lung was measured. RESULTS: PNT-A prolonged CO2 elimination time by 0.9 s (+ 3.3%), Neo-PNT by 3.2 s (+ 11.6%) and PNT-B by 9.0 s (+ 32.7%). The end-tidal CO2 measurement adapter prolonged the elimination time by an additional second without the pneumotachograph (+ 3.6%) and in combination with PNT-A (+ 3.1%) and PNT-Neo (+ 3.1%). In conjunction with PNT-B, the end-tidal CO2 measurement adapter reduced the elimination time by 0.3 seconds (- 1%). The use of a closed suction adaptor increased the CO2 elimination time by a further second with PNT-Neo (+ 3.1%) and by an additional two seconds with no flow sensor (+ 6.9%), with PNT-A (+ 6.4%) and with PNT-B (+ 5.5%). CONCLUSION: The flow sensor had the greatest influence on ventilatory effort, while end-tidal CO2 measurement had only a moderate effect. The increased ventilatory effort levied by the CO2 measurement was dependent on the flow sensor selected. The use of closed suctioning more negatively impacted ventilatory effort than did end-tidal CO2 measurement. Show more

Keywords: Neonatal intensive care units, tidal volume, extremely premature infant, ventilator-induced lung injury, mechanical ventilators

DOI: 10.3233/THC-230195

Citation: Technology and Health Care, vol. 32, no. 2, pp. 779-785, 2024

Authors: Elrashid, Afra Hassan | Alsarh, Sarah Ahmad | Alotaibi, Dalia Saleh | Albaqami, Majed Adi | Algadhi, Saleh Khalid | Alfaraj, Reham Ahmad | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Bleaching is a highly common method used nowadays to treat tooth discolouration because it is a significant cosmetic issue, particularly with anterior teeth, however bleaching itself results in microleakage. OBJECTIVE: This study aims to evaluate the impact of in-office bleaching on class V restoration microleakage with type 1 and type 2 composite restorations. METHODS: Three hundred and twenty healthy, caries-free removed human anterior teeth were used in this in-vitro study. All extracted teeth had their buccal and lingual surfaces uniformly prepped for class V cavities. The 120 removed teeth were divided …into two groups, with Group 1 receiving Tetric N-Ceram nanohybrid composite restorations and Group 2 receiving 3 M Filtek Z350 XT nanohybrid composite restorations. Groups 1 and 2 were further broken into four more subgroups of four each. The restorations were sealed with a G-Coat Plus resin. The p -value was kept at 0.005 for the data analysis using the Chi-square and Fisher exact tests. RESULTS: Allocating microleakage among 320 study models revealed that 141 (44.1%) study samples had no microleakage, whereas 20 (6.3%), 54 (16.9%), and 105 (32.8%) study samples had microleakage up to, between, and greater than two-thirds of cavity depth. With a statistically significant p -value of 0.001, no microleakage was discovered in 85 (53.1%) lingual surfaces with Tetric N-Ceram nanohybrid composite restoration and 56 (35%) buccal surfaces with 3M Filtek Z350 XT nanohybrid composite restoration. 19.1% of samples of N-Ceram that were sealed and not bleached had no microleakage, according to analysis of microleakage across several groups. With a p -value of 0.001, the distribution of microleakage among various clusters was statistically notable. CONCLUSION: According to the findings of the study, hydrogen peroxide bleaching has an enhanced impact on micro escape during dye dispersion. Both with and without bleaching, resin coating can be utilised to minimise marginal microleakage. Show more

Keywords: Microleakage, resins, bleaching, composite restorations

DOI: 10.3233/THC-230213

Citation: Technology and Health Care, vol. 32, no. 2, pp. 787-798, 2024

Authors: Petrović, Nikola | Mandić, Sanja | Borojević, Svetlana | Gazivoda, Nemanja | Sovilj, Platon

Article Type: Research Article

Abstract: BACKGROUND: Cognitive neuroscience experiments require accurate and traceable methods of measuring cognitive phenomena, analyzing and processing data, and validating results, including measurement of impact of such phenomena on brain activity and consciousness. EEG measurement is the most widely used tool for evaluation of the experiment’s progress. To extract more information from the EEG signal, continuous innovation is necessary to provide a broader range of information. OBJECTIVE: This paper presents a new tool for measuring and mapping cognitive phenomena using time window-based multispectral brain mapping of electroencephalography (EEG) signals. METHODS: The tool was developed …using Python programming language and enables users to create brain maps images for six spectra (Delta, Theta, Alpha, Beta, Gamma, and Mu) of EEG signal. The system can accept an arbitrary number of EEG channels with standardized labels based on the 10–20 system, and users can select the channels, frequency bandwidth, type of signal processing, and time window length to perform the mapping. RESULTS: The key advantage of this tool is its ability to perform short-time brain mapping, which allows for the exploration and measurement of cognitive phenomena. The tool’s performance was evaluated through testing on real EEG signals, and results demonstrated its effectiveness in accurately mapping cognitive phenomena. CONCLUSION: The developed tool can be used in various applications, including cognitive neuroscience research and clinical studies. Future work involves optimizing the tool’s performance and expanding its capabilities. Show more

Keywords: Biomedical engineering, cognitive neuroscience, electroencephalography, brain mapping, biomedical measurement and instrumentation

DOI: 10.3233/THC-230241

Citation: Technology and Health Care, vol. 32, no. 2, pp. 799-808, 2024

Authors: Li, Miao-Miao | Pan, Jian-Xia | Wang, Jin-Hang | Hu, Zi-Lei | Zhao, Jing | Wei, Hai-Cheng

Article Type: Research Article

Abstract: BACKGROUND: Diabetes is a chronic disease that can lead to a variety of complications and even cause death. The signal characteristics of the photoplethysmography signals (PPG) and electrocardiogram signals (ECG) can reflect the autonomic and vascular aspects of the effects of diabetes on the body. OBJECTIVE: Based on the complex mechanism of interaction between PPG and ECG, a set of ensemble empirical mode decomposition-independent component analysis (EEMD-ICA) fusion multi-scale percussion entropy index (MSPEI) method was proposed to analyze cardiovascular function in diabetic patients. METHODS: Firstly, the original signal was decomposed into multiple Intrinsic …Mode Function (IMFs) by ensemble empirical mode decomposition EEMD, principal components of IMF were extracted by independent component analysis (ICA), then the extracted principal components were reconstructed to eliminate the complex high and low frequency noise of physiological signals. In addition, the MSPEI was calculated for the ECG R-R interval and PPG amplitude sequence.(RRI and Amp) The results showed that, compared with EEMD method, the SNR of EEMD-ICA method increases from 2.1551 to 11.3642, and the root mean square error (RMSE) decreases from 0.0556 to 0.0067. This algorithm can improve the performance of denoising and retain more feature information. The large and small scale entropy of MSPEI (RRI,Amp) was significantly different between healthy and diabetic patients (p < 0.01). RESULTS: Compared with arteriosclerosis index (AI) and multi-scale cross-approximate entropy (MCAE): MSPEISS (RRI,Amp) indicated that diabetes can affect the activity of human autonomic nervous system, while MSPEILS (RRI,Amp) indicated that diabetes can cause or worsen arteriosclerosis. CONCLUSION: Multi-scale Percussion Entropy algorithm has more advantages in analyzing the influence of diabetes on human cardiovascular and autonomic nervous function. Show more

Keywords: Diabetes, electrocardiogram, photoplethysmography, empirical mode decomposition-independent component analysis, multi-scale percussion entropy

DOI: 10.3233/THC-230243

Citation: Technology and Health Care, vol. 32, no. 2, pp. 809-821, 2024

Authors: Pan, Liang | Shan, Rui-Ying | Gao, Su-Fang | Zhou, Yan | Bao, Yuan-Yuan | Fu, Wenjing

Article Type: Research Article

Abstract: BACKGROUND: In malignant tumours of the female reproductive system, cervical cancer is second only to breast cancer, seriously threatening the health and safety of most women. OBJECTIVE: To evaluate the clinical value of 3.0 T multimodal nuclear magnetic resonance imaging (MRI) in the International Federation of Gynecology and Obstetrics’ (FIGO) staging of cervical cancer. METHODS: The clinical data of 30 patients with pathologically diagnosed cervical cancer admitted to our hospital from January 2018 to August 2022 were analysed retrospectively. Before treatment, all patients were examined with conventional MRI, diffusion-weighted imaging and multi-directional contrast-enhanced …imaging. RESULTS: The accuracy of multimodal MRI in the FIGO staging of cervical cancer (29/30, 96.7%) was significantly higher than the accuracy obtained in a control group (21/30, 70.0%), with a statistically significant difference (p = 0.013). In addition, there was good agreement between two observers applying multimodal imaging (kappa = 0.881) and moderate agreement between two observers in the control group (kappa = 0.538). CONCLUSION: Multimodal MRI can evaluate cervical cancer comprehensively and accurately to enable accurate FIGO staging, providing significant evidence for clinical operation planning and subsequent combined therapy. Show more

Keywords: Multimodal imaging, uterine cervical neoplasms, magnetic resonance imaging

DOI: 10.3233/THC-230252

Citation: Technology and Health Care, vol. 32, no. 2, pp. 823-830, 2024

Authors: Ju, Jieqin | Mao, Liqing | Wang, Yuejing | Xie, Haofen | Zhou, Shengjun

Article Type: Research Article

Abstract: BACKGROUND: Femoral artery puncture is still the most used surgical approach. Because the operation requires local anaesthesia, the patient may not be able to exert full self-control, and their upper and lower limbs and trunk need to be constrained by a protection device. OBJECTIVE: To explore the safe application effect of a new type of anti-movement protection device for upper and lower extremities, shoulders and chest in patients undergoing interventional therapy via the femoral artery approach. METHODS: This is a prospective randomised controlled study. A total of 230 patients were randomly divided into …two groups: the study group (n = 115) and the control group (n = 115). The time needed to implement the restraint operation and the loosening of the restraint device in the two groups was recorded, and the satisfaction of surgeons and nurses was investigated. RESULTS: The time needed to perform restraint operation in the study group was significantly less than that in the control group (4.06 ± 0.61 min vs. 7.01 ± 0.76 min, P < 0.05). The satisfaction of surgeons and nurses with the use of the new protective device was significantly better than that of the conventional restraint band (P < 0.05). CONCLUSION: The new anti-movement protection device for upper and lower limbs, shoulders and chest can conveniently and quickly achieve effective protection and braking of patients, ensure the safety of surgery and improve satisfaction. Show more

Keywords: Nursing safety, protective device, patient care, physical restraints, transfemoral intervention

DOI: 10.3233/THC-230254

Citation: Technology and Health Care, vol. 32, no. 2, pp. 831-840, 2024

Authors: Yue, Lei | Huo, Hai-Yang | Yang, Wei | Zhang, Ying-Huai

Article Type: Research Article

Abstract: BACKGROUND: Dental implant restoration is an effective therapy for missing teeth and is widely used in clinical practice to provide more treatment options for patients. OBJECTIVE: To explore the application of a positioning annular gingival cutter in minimally invasive stage II implant surgery and to evaluate its clinical effects. METHOD: Stage II implant surgery using a positioning annular gingival cutter was performed on 15 selected patients at 15 implant sites with sufficient keratinized gingival width in the posterior region. The patient underwent crown restoration 2 weeks after surgery and returned for follow-up 3 …months later. The surgical effects were recorded for each patient, including the duration of surgery, postoperative pain and swelling, keratinized gingiva width, probing depth (PD) measurements, and the percentage of bleeding on probing (BOP) before surgery, during crown restoration, and 3 months after crown restoration. The data were subjected to a paired sample t-test using Statistical Product and Service Solutions (SPSS) 25.0. RESULTS: The duration of stage II implant surgery using a positioning annular gingival cutter was 9.23 ± 1.63 min, and the duration of postoperative pain and swelling was 0.73 ± 0.35 and 0.81 ± 0.35 d, respectively. The keratinized gingiva width was 2.93 ± 0.41 mm before surgery and 2.91 ± 0.46 mm after crown restoration, demonstrating no significant reduction (P > 0.05). The keratinized gingiva width remained stable 3 months after crown restoration, with an average of 2.85 ± 0.49 mm, without significant reduction (P > 0.05). No obvious inflammation is observed. PD was 2.60 ± 0.52 mm and BOP was 10%. CONCLUSION: The use of a positioning annular gingival cutter in stage II implant surgery achieves a positive and stable clinical effect within a short time. Show more

Keywords: Circumferential supracrestal fiberotomy, keratinized gingiva, stage II implant surgery

DOI: 10.3233/THC-230262

Citation: Technology and Health Care, vol. 32, no. 2, pp. 841-847, 2024

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

Article Type: Research Article

Abstract: BACKGROUND: There are 1.8 million lung cancer deaths worldwide, accounting for 18% of global cancer deaths, including 710,000 in China, accounting for 23.8% of all cancer deaths in China. OBJECTIVE: To explore the out-of-set association rules of lung cancer symptoms and drugs through text mining of traditional Chinese medicine (TCM) treatment of lung cancer, and form medical case analysis to analyze the experience of TCM syndrome differentiation in its treatment. METHODS: The medical records of all patients diagnosed with lung cancer in Nanjing Chest Hospital from January to December 2018 were collected, and …the out-of-set association analysis was performed using the MedCase v5.2 TCM clinical scientific research auxiliary platform based on the frequent pattern growth enhanced association analysis algorithm. RESULTS: In terms of TCM treatment of lung cancer, the clinical symptoms with high correlation included cough, expectoration, chest distress, and white phlegm; and the drugs with high correlation included Pinellia ternata , licorice root, white Atractylodes rhizome , and Radix Ophiopogonis ; with the prescriptions based on Erchen and Maimendong decoctions. CONCLUSION: This analytical study of the medical cases of TCM treatment for lung cancer was performed using data mining techniques, and the out-of-set association rules between clinical symptoms and drugs were analyzed, including the understanding of lung cancer in TCM. Moreover, the essence of experience in drug use was gathered, providing significant scientific guidance for the clinical treatment of lung cancer. Show more

Keywords: Data mining, lung cancer, traditional Chinese medicine, out-of-set association

DOI: 10.3233/THC-230269

Citation: Technology and Health Care, vol. 32, no. 2, pp. 849-859, 2024

Authors: Xu, Wen-Bo | Lu, Zhi-Zeng | Mu, Lan

Article Type: Research Article

Abstract: BACKGROUND: With the ageing population in China and an increasing number of the elderly developing chronic illnesses, health services for the elderly have become a major concern. They have significant needs for health information (HI) such as online medical consultation, disease prevention, and medical insurance. OBJECTIVE: To explore the influencing factors and their relative significance in proxy online health information (OHI) seeking among the elderly with chronic illnesses so as to provide a reference for enriching theoretical research and optimizing care for the elderly with chronic illness. METHODS: Twenty-three elderly people with chronic …illnesses participated in semi-structured in-depth interviews in this study. The interview transcripts were subject to three levels of coding (open, axial, and selective coding) based on grounded theory to determine the factors influencing proxy OHI seeking among the elderly and to understand how the main categories are interconnected. We used the interpretive structural modeling (ISM) process to analyze the hierarchy and associated pathways among the factors influencing proxy OHI seeking. RESULTS: From our analysis, we identified four main categories affecting proxy HI seeking: the health status, emotional needs, electronic HI literacy, and self-efficacy of the elderly. There were six subcategories that could be further subclassified into direct factors, key factors, and root factors, which constituted the hierarchical model of influencing factors. CONCLUSION: We found that proxy HI seeking among the elderly was directly triggered by self-efficacy and emotional needs following changes in their evaluation of health information and emotional needs, which originates from their perceptions of their health, concerns about their health, and information retrieval capability. Show more

Keywords: Elderly, grounded theory, interpretative structural modeling, proxy seeking

DOI: 10.3233/THC-230270

Citation: Technology and Health Care, vol. 32, no. 2, pp. 861-871, 2024

Authors: Radakovic, Radivoje | Dasic, Lazar | Dopsaj, Milivoj | Filipovic, Nenad

Article Type: Research Article

Abstract: BACKGROUND: Being in peak physical condition and having specific motor abilities are necessity for every top-level soccer player in order to achieve success in competition. In order to correctly assess soccer players’ performance, this research uses laboratory and field measurements, as well as results of competitive performance obtained by direct software measurements of players’ movement during the actual soccer game. OBJECTIVE: The main goal of this research is to give insight into the key abilities that soccer players need to have in order to perform in competitive tournaments. Besides training adjustments, this research also gives insight …into what variables need to be tracked in order to accurately assess the efficiency and functionality of the players. METHODS: The collected data need to be analyzed using descriptive statistics. Collected data is also used as input for multiple regression models that can predict certain key measurements: total distance covered, percent of effective movements and high index of effective performance movements. RESULTS: Most of the calculated regression models have high predictability level with statistically significant variables. CONCLUSION: Based on the results of regression analysis it can be deduced that motor abilities are important factor in measuring soccer player’s competitive performance and team’s success in the match. Show more

Keywords: Effective movement, motor abilities, soccer player’s competition performance, total distance covered

DOI: 10.3233/THC-230275

Citation: Technology and Health Care, vol. 32, no. 2, pp. 873-884, 2024

Authors: Vavrickova, Lenka | Kapitan, Martin | Schmidt, Jan

Article Type: Research Article

Abstract: BACKGROUND: Digital impression technique or computer-aided impression (CAI) has been recently concluded as a clinically acceptable alternative to conventional impression method (CIM) in the fabrication of crowns, short fixed partial dentures (FPDs), and implant-supported crowns. OBJECTIVE: The purpose of this study was to investigate the patients’ opinion and subjective perception of two different ways of impression – digital and conventional. METHODS: A total of 45 patients were treated with CAI and CIM for the fabrication of tooth or implant-supported crowns. They fulfilled a questionnaire including 11 questions regarding the treatment time, gag reflex, …discomfort related to manipulation, and other aspects of treatment. RESULTS: CAI was considered the preferential method for future treatment in 53% of patients, whereas 28.9% of the respondents preferred CIM. The preference for the impression method was influenced by the total time spent with the procedure, discomfort during manipulation with the tray or scanning head, size of the tray or scanning head, maximal opening discomfort, and (the tendency towards) gag reflex. CONCLUSION: CAI was considered a more comfortable and preferential method. Discomfort or difficulties during CAI negatively affected the patients’ attitude to CAI, whereas the difficulties associated with CIM did not have any influence on the preferred method. Show more

Keywords: Dentistry, conventional impression, digital impression, implant-supported crown, tooth-supported crown, PROMs

DOI: 10.3233/THC-230277

Citation: Technology and Health Care, vol. 32, no. 2, pp. 885-896, 2024

Authors: Dong, Haonan | He, Zexi | Wang, Haifeng | Ding, Mingxia | Huang, Yinglong | Li, Haihao | Shi, Hongjin | Mao, Lan | Hu, Chongzhi | Wang, Jiansong

Article Type: Research Article

Abstract: BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common pathological type of renal cell carcinoma (RCC), and effective biomarkers will improve diagnosis and treatment. OBJECTIVE: This study investigated NPEPL1 expression in ccRCC through public databases and clinical samples and assessed its correlation with clinicopathological features and patient prognosis. METHOD: Data from The Cancer Genome Atlas and clinical specimens were gathered, NPEPL1 expression levels were analyzed; a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NPEPL1; and clinicopathological data was used to study the correlations between expression …and clinical parameters. NPEPL1’s prognostic value was appraised using a Kaplan–Meier (K–M) survival curve, Cox regression analysis, and a nomogram model; Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of differently expressed genes between tissues with high and low NPEPL1 expression were used to estimate the underlying mechanisms involved. RESULTS: NPEPL1 was significantly higher-expressed in ccRCC tissue. ROC analysis showed that NPEPL1 had noteworthy diagnostic efficacy. NPEPL1 expression was closely related to clinicopathological parameters, such as T and M stage. K–M analysis showed that overall survival was significantly shortened with high NPEPL1 expression. Cox regression analysis showed that NPEPL1 expression was an independent risk factor predicting overall survival. The nomogram showed a significantly high clinical value in predicting the 1-, 3-, and 5-year survival probabilities in ccRCC. GO and KEGG enrichment analysis suggested that NPEPL1 may promote the occurrence and development of ccRCC via the Ras signaling and other pathways. CONCLUSION: NPEPL1 expression in ccRCC was higher than that in normal kidney tissues and was significantly associated with advanced clinical stage and poor prognosis. Therefore, NPEPL1 is a promising prognostic biomarker. Show more

Keywords: Renal clear cell carcinoma, NPEPL1, Clinicopathology, prognosis

DOI: 10.3233/THC-230282

Citation: Technology and Health Care, vol. 32, no. 2, pp. 897-914, 2024

Authors: Tang, Bei | Ouyang, Wenbin | Deng, Jing | Huang, Xin

Article Type: Research Article

Abstract: BACKGROUND: In the wave of the novel coronavirus (COVID-19) epidemic, there is a need to investigate the mental health status of Chinese university students. OBJECTIVE: To examine the effects of witnessing cyberbullying on psychological distress and the mediating role of coping on these effects in Chinese university students, which is yet to be examined. METHODS: 306 Chinese university students were enrolled in this cross-sectional study. Linear regression was conducted to analyze the relationship between depression, anxiety and being a bystander to cyberbullying, whereas the bootstrapping approach tested the mediation effects of coping strategies. …RESULTS: Results indicated that 27.12% of subjects (95% CI: 22.22%, 32.48%) suffered from anxiety and 44.12% (95% CI: 38.47%, 49.88%) were depressed. Meanwhile, 89.87% of subjects were involved in witnessing cyberbullying. Being a bystander to cyberbullying was weakly but significantly associated with anxiety (β = 0.195, 95% CI: 0.068, 0.292) and depression (β = 0.223, 95% CI: 0.113,0.333). Negative coping partially mediated between witnessing cyberbullying and anxiety, with mediation effect values of 0.04 (P < 0.05). While being a bystander to cyberbullying was only directly associated with depression. CONCLUSION: Based on our findings, college students in Hunan, China, are experiencing anxiety, depression and cyberbullying after COVID-19. Being a bystander to cyberbullying is associated with coping strategies, anxiety, and depression. Cyberbullying has a direct impact on anxiety, but it also influences anxiety through mediating effects on coping. Show more

Keywords: Bystander of cyberbullying, anxiety, depression, coping strategies, mediation analysis

DOI: 10.3233/THC-230305

Citation: Technology and Health Care, vol. 32, no. 2, pp. 915-924, 2024

Authors: Lian, Weizhen | Lian, Kaimei | Lin, Teng

Article Type: Research Article

Abstract: BACKGROUND: Early breast cancer diagnosis is of great clinical importance for selecting treatment options, improving prognosis, and enhancing the quality of patients’ survival. OBJECTIVE: We investigated the value of virtual touch tissue imaging average grayscale values (VAGV) helper Breast Imaging Reporting and Data System (BI-RADS) in diagnosing breast malignancy. METHODS: We retrospectively analyzed 141 breast tumors in 134 patients. All breast lesions were diagnosed pathologically by biopsy or surgical excision. All patients first underwent conventional ultrasound (US) followed by virtual touch tissue imaging (VTI). The measurement of the VAGV of the lesion was …performed by Image J software. BI-RADS classification was performed for each lesion according to the US. We performed a two-by-two comparison of the diagnostic values of VAGV, BI-RADS, and BI-RADS+ VAGV. RESULTS: VAGV was lower in malignant tumors than in benign ones (35.82 ± 13.39 versus 73.58 ± 42.69, P < 0.001). The area under the receiver operating characteristic curve (AUC ) value, sensitivity, and specificity of VAGV was 0.834, 84.09%, and 69.07%, respectively. Among BI-RADS, VAGV, and BI-RADS+ VAGV, BI-RADS+ VAGV had the highest AUC (0.926 versus 0.882, P = 0.0066; 0.926 versus 0.834, P = 0.0012). There was perfect agreement between the two radiologists using VAGV (ICC = 0.9796) and substantial agreement using BI-RADS (Kappa = 0.725). CONCLUSION: Our study shows that VAGV can accurately diagnose breast cancer. VAGV effectively improves the diagnostic performance of BI-RADS. Show more

Keywords: Breast lesion, average grayscale value, virtual touch tissue imaging, Breast Imaging Reporting and Data System

DOI: 10.3233/THC-230306

Citation: Technology and Health Care, vol. 32, no. 2, pp. 925-936, 2024

Authors: Narula, Gagan | Boss, Jens | Seric, Marko | Baumann, Daniel | Salles, Joan P. | Fröhlich, Jürg | Baumann, Dirk | Keller, Emanuela | Willms, Jan

Article Type: Research Article

Abstract: BACKGROUND: Intracranial pressure (ICP) is a vital parameter that is continuously monitored in patients with severe brain injury and imminent intracranial hypertension. OBJECTIVE: To estimate intracranial pressure without intracranial probes based on transcutaneous near infrared spectroscopy (NIRS). METHODS: We developed machine learning based approaches for noninvasive intracranial pressure (ICP) estimation using signals from transcutaneous near infrared spectroscopy (NIRS) as well as other cardiovascular and artificial ventilation parameters. RESULTS: In a patient cohort of 25 patients, with 22 used for model development and 3 for model testing, the best performing models …were Fourier transform based Transformer ICP waveform estimation which produced a mean absolute error of 4.68 mm Hg (SD = 5.4) in estimation. CONCLUSION: We did not find a significant improvement in ICP estimation accuracy by including signals measured by transcutaneous NIRS. We expect that with higher quality and greater volume of data, noninvasive estimation of ICP will improve. Show more

Keywords: Brain injuries, intracranial pressure, machine learning, spectrum analysis

DOI: 10.3233/THC-230329

Citation: Technology and Health Care, vol. 32, no. 2, pp. 937-949, 2024

Authors: Salihagic, Iva Kozul | Hrkac, Adelina | Ovcaricek, Slaven | Bokarica, Pero | Gilja, Ivan

Article Type: Research Article

Abstract: BACKGROUND: Orthotopic urinary diversion is the preferred diversion after cystectomy. Neobladder reconstruction with a longer ileum segment (60 cm) is advantageous for obtaining a large capacity and continence at the beginning; however, the long-term risk of residual urine, chronic infection, and the need for intermittent catheterization is more pronounced with the neobladder constructed with a longer ileal segment compared to the neobladder tailored from the shorter ileal segment. OBJECTIVE: To establish the differences in the functional outcome of a shorter (< 45 cm) and longer (⩾ 45 cm) ileal segment …usage in the reconstruction of the Hautmann ileal neobladder following the radical cystectomy. METHODS: Between July 2013 and September 2015, 121 patients with muscle-invasive bladder cancer underwent radical cystectomy and Hautmann ileal neobladder reconstruction. Patients were divided into two groups, depending on the length of the ileum used for the diversion creation: < 45 cm of the ileum was used in the first group and ⩾ 45 cm in the second group. Five-year follow-up was performed at 1, 3, 6, and 9 months and 1 and 5 years. The main measured outcomes were functional outcomes and the quality of life. The evaluation included clinical, laboratory, and QLQ-C30 questionnaires. Statistical analysis was performed using descriptive statistics, Mann-Whitney U test, Kolmogorov-Smirnov test, ANOVA, and chi-squared tests. RESULTS: Patients with a smaller neobladder had a better quality of life, and higher global health status scale score. Thirteen early and 21 late complications developed in 10 and 17 patients, respectively. There were significant differences in the need for clean intermittent self-catheterization (CIC) between the two groups: smaller-volume pouch patients had statistically decreased need for CIC in 5 year follow-up compared to larger-volume pouch patients (χ 2 test = 8.245; df = 1; P = 0.004). Eighteen percent of patients with smaller neobladders had urinary tract infections in 5 years, compared to 35% with larger neobladders (χ 2 test = 4.447; df = 1; P = 0.034). CONCLUSION: Minimizing the length of the ileal segment needed for Hautmann neobladder reconstruction is feasible and provides better long-term results than larger-volume neobladders. Show more

Keywords: Hautmann neobladder, urinary diversion, radical cystectomy, urinary retention, urinary infection, continence

DOI: 10.3233/THC-230339

Citation: Technology and Health Care, vol. 32, no. 2, pp. 951-962, 2024

Authors: Ran, Xu | Niu, Guo-Chen | Shao, Yu-Hong | Fan, Fang-Fang | Yang, Min | Lin, Le-Tao | Chen, Lu-Zeng | Zou, Ying-Hua

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerotic renal artery stenosis (ARAS) is a common disease in the elderly population. OBJECTIVE: The aim was to develop a contrast-enhanced ultrasound (CEUS)-based model for predicting post-angioplasty improvement in hypertension in patients with severe ARAS. METHODS: Thirty-five patients with severe ARAS (⩾ 70%) were included in this study, and 42 renal arteries received percutaneous transluminal renal arterial stenting. An optimal integral formula was developed from pre-interventional color-coded duplex sonography (CCDS) and CEUS parameters using least absolute shrinkage and selection operator (LASSO) regression and receiver operating characteristic (ROC) curve analysis. …A model for predicting short-term hypertension improvement was established using the integral formula and clinical risk factors. Bootstrapping was used for internal validation. RESULTS: Two integral formulas, LASSO.CCDS and LASSO.CEUS, were established. ROC curves of the two integral formulas showed that LASSO.CEUS was the better formula for predicting hypertension improvement (AUC 0.816, specificity 78.6%). Univariate and multivariate regression analyses showed that duration of hypertension (OR 0.841, P = 0.027), diabetes (OR = 0.019, P = 0.010), and LASSO.CEUS (OR 7.641, P = 0.052) were predictors of short-term hypertension improvement after interventional therapy. Using LASSO.CEUS combined with clinical risk factors, the following prediction model was established: logit (short-term improvement in hypertension) = 1.879–0.173 × hypertension duration – 3.961 × diabetes + 2.034 × LASSO.CEUS (AUC 0.939). CONCLUSIONS: The model established using CEUS parameters and clinical risk factors could predict hypertension improvement after interventional therapy, but further research and verification are needed. Show more

Keywords: Atherosclerotic renal artery stenosis, percutaneous transluminal renal arterial stenting, renal blood perfusion, contrast-enhanced ultrasound, hypertension

DOI: 10.3233/THC-230357

Citation: Technology and Health Care, vol. 32, no. 2, pp. 963-976, 2024

Authors: Zhao, Li | Xu, Wen-Kui | Wang, Ying | Lu, Wei-Yan | Wu, Yong | Hu, Rong

Article Type: Research Article

Abstract: BACKGROUND: The evolution of critical care medicine and nursing has aided and enabled the rescue of a large number of patients from numerous life-threatening diseases. However, in many cases, patient health may not be quickly restored, and the long-term prognosis may not be optimistic. OBJECTIVES: In this study, we aimed to develop and validate a prediction model for accurate, precise, and objective identification of the severity of chronic critical illness (CCI) in patients. METHODS: We used a retrospective case-control and prospective cohort study with no interventions. Patients diagnosed with CCI admitted to the …ICU of a large metropolitan public hospital were selected. In the case-control study, 344 patients (case: 172; control:172) were enrolled to develop the prognosis prediction model of chronic critical illness (PPCCI Model); 88 patients (case:44; control: 44) in a prospective cohort study, served as the validation cohort. The discrimination of the model was measured using the area under the curve (AUC) of the receiver operating characteristic curve (ROC). RESULTS: Age, prolonged mechanical ventilation (PMV), sepsis or other severe infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding were the nine predictors included in the model. In both cohorts, the PPCCI model outperformed the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA) in identifying deceased patients with CCI (development cohort: AUC, 0.934; 95%CI, 0.908–0.960; validation cohort: AUC, 0.965; 95% CI, 0.931–0.999). CONCLUSION: The PPCCI model can provide ICU medical staff with a standardized measurement tool for assessing the condition of patients with CCI, enabling them to allocate ward monitoring resources rationally and communicate with family members. Show more

Keywords: Chronic critical illness, critical care, model, prediction, prognosis, score

DOI: 10.3233/THC-230359

Citation: Technology and Health Care, vol. 32, no. 2, pp. 977-987, 2024

Authors: Hao, Jinxiang | Liang, Lirong | Ma, Yongduo | Xu, Meisha | Li, Qiuxiang

Article Type: Research Article

Abstract: BACKGROUND: With rapid progression, severe illness and high fatality rate, sepsis has become an acute and critical condition that seriously threatens human life and health. OBJECTIVE: To detect miR-210 and miR-494 expression in patients with sepsis and their relationship with severity and prognosis. METHODS: A total of 165 sepsis patients participated, including 105 patients with septic non-shock and 60 patients with septic shock. 53 sepsis patients died in 28 days, and 112 patients survived. The clinical information of all sepsis patients was retrospectively searched and reviewed. Based on the status of 28-day survival, …they were categorized into survival group and death group. The expression levels in each group were compared on the first, third and seventh day. The ROC curve was applied to know the expression level of plasma miR-210 and miR-494 to predict the death. RESULTS: The two miRNAs expression of the septic shock group were significantly higher than that in sepsis non-shock group on the first, third and seventh day (all were P < 0.05). The ROC curve found that the AUC combined to predict the death on the third day was the largest, which was 0.925 (95%CI: 0.864–0.983). The sensitivity and specificity were 94.6% and 86.3%, respectively. CONCLUSION: The increased expression levels of plasma miR-210 and miR-494 are closely relevant to the severity and prognosis of sepsis patients. Combining the two items on the third day can predict the death of sepsis patients. Show more

Keywords: Sepsis, miR-210, miR-494, prognosis

DOI: 10.3233/THC-230363

Citation: Technology and Health Care, vol. 32, no. 2, pp. 989-996, 2024

Authors: Chen, Ping-Shun | Lai, Chin-Hui | Chen, Ying-Tzu | Lung, Ting-Yu

Article Type: Research Article

Abstract: BACKGROUND: Scheduling patient appointments in hospitals is complicated due to various types of patient examinations, different departments and physicians accessed, and different body parts affected. OBJECTIVE: This study focuses on the radiology scheduling problem, which involves multiple radiological technologists in multiple examination rooms, and then proposes a prototype system of computer-aided appointment scheduling based on information such as the examining radiological technologists, examination departments, the patient’s body parts being examined, the patient’s gender, and the patient’s age. METHODS: The system incorporated a stepwise multiple regression analysis (SMRA) model to predict the number of …examination images and then used the K-Means clustering with a decision tree classification model to classify the patient’s examination time within an appropriate time interval. RESULTS: The constructed prototype creates a feasible patient appointment schedule by classifying patient examination times into different categories for different patients according to the four types of body parts, eight hospital departments, and 10 radiological technologists. CONCLUSION: The proposed patient appointment scheduling system can schedule appointment times for different types of patients according to the type of visit, thereby addressing the challenges associated with diversity and uncertainty in radiological examination services. It can also improve the quality of medical treatment. Show more

Keywords: Data mining, decision tree, patient appointments, appointment scheduling system, stepwise multiple regression analysis

DOI: 10.3233/THC-230374

Citation: Technology and Health Care, vol. 32, no. 2, pp. 997-1013, 2024

Authors: Wu, Qingqing | Li, Xihong | Li, Li | Yan, Ouyang | He, Qingwen

Article Type: Research Article

Abstract: BACKGROUND: Numerous studies have focused on reducing patient absences and effectively scheduling exams. However, very few studies have analyzed the factors influencing examination time and predicted examination time. OBJECTIVES: To investigate the factors affecting ultrasound examination visit length and provide a reference for interventions to optimize ultrasound appointments. METHODS: This cross-sectional study was conducted at a fertility clinic in China. Ultrasound examination time and clinical characteristics were obtained from the electronic records. Univariate and multivariate analyses used 33,432 patients who attended our clinic center between August 1 and October 30, 2018. A quantile …regression model was constructed to examine associations between ultrasound examination time and statistically significant variables in the univariate analysis. RESULTS: Of the 33,432 patients included in this study, 29,085 (87%) were female and 4,347 (13%) were male. Their mean examination time was 6 ± 3 minutes. The doctor’s title and gender, equipment, and patient’s age, examination site, gender, and origin were all statistically significant. Physical examination and outpatient clinic patients had shorter examination times than inpatients. Female physicians had longer examination times than male physicians. Examination time was positively correlated with thyroid, breast, liver, gallbladder, spleen, pancreas, kidney, heart, vascular, adrenal, gynecological, early pregnancy, nuchal translucency, prostate, scrotum, and mid-to-late pregnancy fetal sites. Moreover, NT and mid-to-late pregnancy fetal sites showed a clear and continuous positive trend with increasing examination time. CONCLUSION: The length of the ultrasound examination was correlated with the examination site, physician title, physician gender, patient age, patient gender, patient origin, and instrumentation. The reliability of inspection time predicted by variables such as the physicians’ title, sex, sites examined, and the number of sites examined was higher when they were longer. Show more

Keywords: Assisted reproduction for pregnancy, ultrasound, examination time

DOI: 10.3233/THC-230406

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1015-1027, 2024

Authors: Li, Haiyan | Zhao, Zhizhen

Article Type: Research Article

Abstract: BACKGROUND: The disease spectrum is constantly changing, meaning patients’ medical characteristics are complex and varied, and hospital operations are facing great challenges. OBJECTIVE: To provide a basis for formulating relevant policies, promoting the continuous improvement of medical quality, improving the efficiency of medical services and proposing corresponding countermeasures. METHODS: Information on the first page of the medical cases of patients discharged from 2020–2021 in the case management system of The Second People’s Hospital of Zhangye City was collected, and statistical analysis was performed in terms of the origin, age, gender, occupation and main …diagnosis of the patients. The database was established using Excel software, and statistical description was performed using SPSS 23.0 software, in which the main indicators were the number of cases and relative numbers (%). RESULTS: The total number of inpatients in the hospital exhibited an overall upward trend, with the number in 2021 increasing by 40.53% compared with the previous year. Among them, 0.75% of the inpatients resided outside the province and 99.25% resided within the province. The proportion of inpatients within the city was 98.86%, including 85.50% in Ganzhou District and 14.5% in the five surrounding counties (districts). In 2021, the number of inpatients in the five surrounding districts increased by 60.67% compared with the previous year. The occupational structure of the inpatients was mainly farmers, accounting for 64.68%, which was higher than all other occupational groups, while public employees accounted for 17.9%. Inpatients aged 60 years and above accounted for 37.75%. In terms of disease spectrum ranking, circulatory, digestive, respiratory, injury and oncological system diseases ranked in the top five of the presented diseases, accounting for 64.47% of the total number of inpatients. CONCLUSION: The patients of the new hospital are mainly elderly patients and local farmers. The hospital development should be based on the disease characteristics of this group, improving the diagnosis and treatment capacity of the departments and strengthening the capacity building of the hospital and the level of the medical services. Show more

Keywords: Newly established hospitals, patient characteristics, development strategies

DOI: 10.3233/THC-230416

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1029-1041, 2024

Authors: Jiang, Ziwei | Yi, Peiling | You, Jinping | Cai, Erwei

Article Type: Research Article

Abstract: BACKGROUND: Colorectal cancer (CRC) is a digestive tract malignancy microRNAs (miRNAs) have attracted much attention as biomarkers in tumor studies. OBJECTIVE: This work focused on the predictive potential and mechanism of miR-4310 in CRC. METHODS: The miRNA expression profile sets were obtained from the Gene Expression Omnibus (GEO) database, and the appropriate miRNA was screened by GEO2R. The CRC tissues and control tissues of 88 patients with CRC were collected, and the expression of miR-4310 was detected by quantitative real-time PCR, and the efficacy of miR-4310 in diagnosing CRC was evaluated by the …receiver operating characteristic curve (ROC). The effects of miR-4310 on the proliferation, migration, and invasion of CRC cells were explored by Cell Counting Kit-8 (CCK-8) and Transwell experiments. Predicting the potential binding sites of miR-4310 and Runt-related transcription factor 1 (RUNX1) by four predictive websites. The relationship between miR-4310 and RUNX1 was confirmed by a double luciferase reporter gene experiment. RESULTS: The bioinformatics analysis found that miR-4310 was differentially expressed in CRC tissues and this finding was certified by the expression of miR-4310 in CRC tissues of collected patients and cultured CRC cell lines. The expression of miR-4310 had a predictive possibility for CRC patients. MiR-4310/RUNX1 pathway had effects on CRC viability, migration, and invasion. CONCLUSION: MiR-4310 had the potential to be a biomarker for early screening of CRC. MiR-4310 and RUNX1 participated in the regulation of CRC cells. Show more

Keywords: miR-4310, RUNX1, colorectal cancer, biomarker, mechanism

DOI: 10.3233/THC-230472

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1043-1053, 2024

Authors: Shukla, Anuj K. | Chaturvedi, Saurabh | Ahmed, Abdul Razzaq | Abouzeid, Hoda Lofty | Suleman, Ghazala | Sharif, Rania A. | Gurumurthy, Vishwanath | Cicciù, Marco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Phonetics with mechanics and aesthetics are considered cardinal factors contributing to the success of complete dentures. OBJECTIVE: The aim of the current study was to evaluate the changes in speech in complete denture patients with and without palatal surface changes. METHODS: The data collected for the study involved completely edentulous Patients (n = 80). Patients were divided into two groups. Group A: Up to 50 years (n = 40); Group B: Above 50 years (n = 40) …(including male and female). Each group was further divided into four subgroups for speech analysis-without dentures (A1/B1); with conventional dentures (A2/B2); dentures with a palatogram (A3/B3) and dentures with palate sandblasted (A4/B4). The speech sounds of all patients were evaluated for pitch and intensity using a spectrophotogram (Praat software) and Likert scale. The data so obtained from the quantitative and qualitative analysis were statistically analysed through one-way ANOVA, unpaired student’s t -test, and Pearson correlation coefficient. Qualitative analysis was done with the Mann-Whitney U test. RESULTS: The maximum mean value of the pitch and intensity in Groups A and B was subgroup A3 (Palatogram) 190.37 ± 21.50 and 77.07 ± 7.58, B3 (Palatogram) 190.87 ± 24.36 and 75.33 ± 8.12. When comparing Groups A [A1, A2, A3, A4] and B [B1, B2, B3, B4] on the basis of pitch and intensity, a statistically insignificant value was found. No changes in speech sounds (pitch and intensity) were observed in terms of age. Both quantitative and qualitative analysis results showed that speech sounds in the patients with palatogram, had the highest pitch and intensity and were most clear to the listener and there were statistically significant differences from other groups. CONCLUSION: Speech was better in palatogram-based dentures in comparison to a sandblasted denture, conventional denture and without denture in terms of qualitative and quantitative analysis. The physiologic nature of the palatogram fabrication technique produces the palatal part of the denture more compatible with the tongue, thus producing better speech. Show more

Keywords: Palatal surface, speech, edentulous, prosthodontics, dentistry

DOI: 10.3233/THC-230477

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1055-1065, 2024

Authors: Kamm, Christian P. | Kueng, Roger | Blättler, Remo

Article Type: Research Article

Abstract: BACKGROUND: Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. OBJECTIVE: To develop a new immersive virtual-reality (VR) headset-based dexterity training to improve impaired manual dexterity in persons with MS (pwMS) while being feasible and usable in a home-based setting. METHODS: The training intervention was tailored to the specific group of pwMS by implementing a simple and intuitive application with regard to hardware and software. To be efficacious, the training intervention covers the main functions of the hands and arm …relevant for use in everyday life. RESULTS: Taking clinical, feasibility, usability as well as technical aspects with regard to hardware and software into account, six different training exercises using hand tracking technology were developed on the Meta quest 2 using Unity. CONCLUSION: We report the developmental process of a new immersive virtual VR headset-based dexterity training for pwMS implementing clinical and technical aspects. Good feasibility, usability, and patient satisfaction was already shown in a feasibility study qualifying this training intervention for further efficacy trials. Show more

Keywords: Development, multiple sclerosis, manual dexterity, hand and arm function, virtual reality, immersive, training intervention

DOI: 10.3233/THC-230541

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1067-1078, 2024

Authors: Li, Feixing | Li, Huixian | Li, Fangjiang | Xiong, Xiaobo | Gao, Yang | Zhang, Ai’ai | Song, Jianying | Han, Wei | Niu, Binyu | Liang, Huiqing

Article Type: Research Article

Abstract: BACKGROUND: Anemia associated with heart failure is frequent and can exacerbate the symptoms of heart failure. Dapagliflozin is the first SGLT-2 inhibitor with significant cardiovascular protection. However, the effect of dapagliflozin on anemia in elderly patients with heart failure is unknown. OBJECTIVE: We aimed to study the effect of dapagliflozin on anemia in elderly patients with heart failure by bioinformatics analysis. METHODS: The target genes were determined, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network and modules were constructed. The dapagliflozin-targets …network in anemia and heart failure was constructed. Molecular docking experiments between dapagliflozin and its key target AKT1 were performed. RESULTS: We found 1 dapagliflozin related target gene and 2 disease related genes. Totally, 134 target genes of dapagliflozin on anemia in elderly patients with heart failure were determined. The pathways may involve lipid and atherosclerosis, AGE-RAGE signaling pathway in diabetic complications, hepatitis B, insulin signaling pathway, fluid shear stress and atherosclerosis, neurotrophin signaling pathway, insulin resistance, toxoplasmosis, colorectal cancer, and EGFR tyrosine kinase inhibitor resistance. The hub genes in network were AKT1, TP53, GAPDH, TNF, CASP3, EGFR, and MAPK3. The structure of dapagliflozin and AKT1 molecular docking was exhibited. CONCLUSIONS: The hub genes in network were AKT1, TP53, GAPDH, TNF, CASP3, EGFR, and MAPK3. The structure of dapagliflozin and AKT1 molecular docking was exhibited. Show more

Keywords: Dapagliflozin, anemia, heart failure, AKT1, bioinformatics analysis

DOI: 10.3233/THC-230563

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1079-1089, 2024

Authors: Wu, Chuntao | Lin, Ke | Fan, Qi | Bai, Jing | Tang, Li

Article Type: Research Article

Abstract: BACKGROUND: The measurement of the health literacy level of patients undergoing outpatient surgery has become a major challenge in perioperative nursing of outpatient surgery. OBJECTIVE: To analyze the effect of health literacy on early postoperative recovery of patients undergoing outpatient surgery by developing a health literacy assessment tool for this population. METHODS: A scale for the assessment of health literacy was established based on Nutbeam’s health literacy model. From April to September 2021, 264 patients were selected in the daytime operating rooms of six Class A tertiary hospitals in Kunming, Yunnan Province to …investigate health literacy and early postoperative rehabilitation quality, and the influencing factors of the two variables were analyzed. RESULTS: An assessment scale of health literacy of patients undergoing outpatient surgery was developed, including 3 dimensions and 24 items. The Cronbach’s α coefficient of the total scale was 0.944, the split-half reliability was 0.902, and the content validity was 0.920. Exploratory factor analysis showed that the cumulative variance contribution rate was 66.37%, and the scale had good structural validity. Multiple linear regression analysis showed that age, functional health literacy, interactive health literacy, and critical health literacy could explain 60.4% of the variation (adjusted R 2 = 0.583) of postoperative recovery quality of patients undergoing outpatient surgery. CONCLUSION: Health literacy of patients undergoing outpatient surgery is an important factor that affects the quality of early postoperative recovery. The health literacy assessment scale can assist medical staff in implementing personalized perioperative nursing and health education. Show more

Keywords: Outpatient surgery, health literacy, scale, reliability, validity, recovery

DOI: 10.3233/THC-230592

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1091-1097, 2024

Authors: Zhao, Wei-Feng | He, Wei | Han, Quan-Hong | Qi, Shi-Xin

Article Type: Research Article

Abstract: BACKGROUND: The correlation between the change in foveal thickness measured using optical coherence tomography (OCT) following surgery for infectious endophthalmitis and preoperative and postoperative visual acuity is uncertain, and there are few pertinent studies on this topic. OBJECTIVE: We explored the variations in macular thickness using OCT after emergency vitrectomy for post-cataract infectious endophthalmitis and the relationship between macular thickness with changes in visual function. METHODS: We included 10 cases of post-cataract infectious endophthalmitis. Each patient underwent 25-G vitrectomy. RESULTS: The infection in all 10 patients was under control and …visual function improved. Postoperative vitreous humor culture was positive in 8 patients, including 7 cases of coagulase-negative Staphylococcus epidermidis and 1 case of Lactobacillus acidophilus . The average age of these 10 patients was 71.60 ± 8.71 years (P < 0.05, two-tailed). There was no significant correlation between time 2 (the time of onset after cataract surgery) and visual prognosis. The average time 1 (the time of the vitrification surgery caused by the onset of the disease) was 1.45 ± 0.76 days (P < 0.05, two-tailed). The postoperative 3dVA ranged from 0.20 to 3.00, with an average visual acuity of 1.87 ± 1.12, which was superior to the preoperative value (P < 0.01, two-tailed). The correlation between the post3dVA and post 1mVA was significant. The post 1mVA ranged from 0.05 to 2.20, with an average visual acuity of 0.94 ± 0.74 (P < 0.05, two-tailed). The correlation between post 1mVA and post3mVA was significant. Also, paired t -tests comparing preoperative and postoperative visual acuity revealed a significant correlation (P < 0.05, two-tailed). The post3mVA was 0–1.00 with an average visual acuity of 0.44 ± 0.41. The postoperative foveal thickness ranged from 176.00 to 514.00 μ m, with an average thickness of 281.10 ± 113.12 μ m. CONCLUSION: Emergency 25-G minimally invasive vitrectomy can improve visual acuity and decrease the reoperation rate for patients who have acquired post-cataract infectious endophthalmitis. There were significant correlations between age, disease onset to operation time, preoperative and postoperative visual acuity, and postoperative macular thickness. Show more

Keywords: Coagulase-negative Staphylococcus epidermidis, infectious endophthalmitis, optical coherence tomography, preoperative logarithm of the minimum angle of resolution, visual acuity, 25-G minimally invasive vitrectomy

DOI: 10.3233/THC-230607

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1099-1110, 2024

Authors: Leinum, Lisbeth R. | Baandrup, Anders O. | Gögenur, Ismail | Krogsgaard, Marianne | Azawi, Nessn

Article Type: Research Article

Abstract: BACKGROUND: Precise fluid balance monitoring is essential for patient treatment, as incorrect fluid balance can lead to disorders. OBJECTIVE: This study aimed to assess the accuracy of the digital technology LICENSE (LIquid balanCE moNitoring SystEm) for fluid balance charting and compare it to the standard method (SM) to determine its usability in clinical practice. METHODS: This prospective study included 20 patients. The results from LICENSE were compared to those from SM and a reference measurement (manual weight of fluids, RM). Three LICENSE devices were used for urine output, intravenous fluids, and oral fluid …intake. The accuracy of methods was evaluated using Bland Altman plots. RESULTS: The mean difference between LICENSE and RM was less than 2 millilitres (p = 0.031 and p = 0.047), whereas the mean difference between SM and RM was 6.6 ml and 10.8 ml (p < 0.0001). The range between the upper and lower limits of agreement was between 16.4 and 27.8 ml for LICENSE measurements and 25.2 and 52 ml for SM. CONCLUSION: LICENSE is comparable to or more accurate than the standard method for fluid balance monitoring. The use of LICENSE may improve the accuracy of fluid balance measurements. Further research is needed to evaluate its feasibility in daily clinical practice. Show more

Keywords: Digital technology, automation, equipment design, monitoring, physiologic, water-electrolyte balance

DOI: 10.3233/THC-230664

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1111-1122, 2024

Authors: Vulović, Aleksandra | Warchomicka, Fernando Gustavo | Pixner, Florian | Filipović, Nenad

Article Type: Research Article

Abstract: BACKGROUND: In order to ensure the proper function of the cementless hip implant, the connection between the femoral bone and the implant has to be as strong as possible. According to experimental studies, implants with a rough surface reduce micro-movements between femoral bone and implant, which helps form a stronger connection between them. OBJECTIVE: The goal of this study was to analyze how half-cylinder surface topographies of different diameter values affect shear stress values and their distribution on the surface of the hip implant and trabecular femoral bone. METHODS: Nine models with different …half-cylinder diameter values (200 μ m, 400 μ m, and 500 μ m) and distances between half-cylinders were created for the analysis using the finite element method. Each model consisted of three layers: implant, trabecular, and cortical femoral bone. RESULTS: For all three diameter values, the highest shear stress value, for the implant layer, was located after the first half-cylinder on the side where force was defined. For the trabecular bone, the first half-cylinder was under lower amounts of shear stress. CONCLUSION: If we only consider shear stress values, we can say that models with 400 μ m and 500 μ m diameter values are a better choice than models with 100 μ m diameter values. Show more

Keywords: Finite element analysis, hip implant, shear stress, surface topography

DOI: 10.3233/THC-230692

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1123-1133, 2024

Authors: Mao, Wenjuan | Chen, Wenduo | Wang, Yanbo

Article Type: Research Article

Abstract: BACKGROUND: Although the prognosis of ovarian cancer can be significantly improved through standardized surgery and chemotherapy, 70% of epithelial ovarian cancer (EOC) patients would suffer from drug resistance and recurrence during the long chemotherapy cycle. OBJECTIVE: To explore the impact of a training mode based on the integration of virtual reality technology and mindfulness on anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy. METHOD: Through virtual reality technology, a mindfulness training software was designed and developed, and a mindfulness training mode based on virtual reality technology was constructed. Using a …self-controlled design, 48 ovarian cancer patients undergoing chemotherapy who were hospitalized in a tertiary hospital in Beijing from August 2022 to May 2023 were conveniently selected as the research subjects. The patients were subjected to four weeks of mindfulness training based on virtual reality technology, and the acceptance of the mindfulness training mode using virtual reality technology was evaluated. The Hospital Anxiety and Depression Scale (HADS) and Cancer Related Fatigue Scale (CRF) were used to evaluate the anxiety, depression, and fatigue of patients before and after intervention. RESULTS: The virtual reality based mindfulness training mode includes four functional modules: personalized curriculum, intelligent monitoring, emotion tracking, and Funny Games. 48 patients had a high acceptance score (139.21 ± 10.47), and after using mindfulness training mode based on virtual reality technology, anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy were significantly reduced, with a statistically significant difference (p < 0.001). CONCLUSION: Ovarian cancer patients during chemotherapy have a high acceptance of virtual reality based mindfulness training mode. The application of this mode can reduce the psychological problems of anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy, and is worth promoting and using. Show more

Keywords: Virtual reality technology, mindfulness training, anxiety and depression, chemotherapy period, oophoroma

DOI: 10.3233/THC-230735

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1135-1148, 2024

Authors: Heo, Jin-Su | Lee, Hyung-Joo | Ko, Byung-Woo | Yoon, Hyun-Soo | Bae, Young-Hyeon

Article Type: Research Article

Abstract: BACKGROUND: To improve gait disability in patients with chronic stroke, ankle muscle strengthening and calf muscle stretching exercises are required. However, currently available ankle training equipment limit ankle exercises based on the position. Recently developed ankle training equipment enables spring resistance-based plantar press exercises to be performed in the standing position with weight support. OBJECTIVE: To conduct a usability test of the ankle training equipment in the standing position by stroke patients with hemiplegic gait and verify its effects on ankle movements. METHODS: The ankle training equipment was applied to five patients with …chronic stroke and hemiplegic gait. In the standing position, the patients performed forefoot and rearfoot press exercises in the affected side with a day’s interval at 20 repetitions maximum (RM). During the exercises, surface electromyography (sEMG) was used to measure the maximum voluntary isometric contraction (%MVIC) of the leg muscles. The System Usability Scale (SUS) was used to assess the ankle training equipment. Wilcoxon signed-rank test was used to evaluate the differences in muscle activity between the two exercises. RESULTS: Forefoot and rearfoot press exercises increased the %MVIC in the biceps femoris. Additionally, the tibialis anterior and medial gastrocnemius activity was significantly different between the two exercises. The SUS was 78.75% (SD 12.7). CONCLUSION: The usability test of the passive-control foot press trainer (PFPT) that with improvements in the structure and functions for convenience, it could be commercialized. PFPT could be an alternative to the ankle rehabilitation robot that necessitates a sitting position. Show more

Keywords: Chronic stroke, standing position, ankle training equipment, usability test, muscle activity

DOI: 10.3233/THC-230747

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1149-1158, 2024

Authors: Alqahtani, Reem A. | AlSaadi, Ziad S. | Al-Qahtani, Zainah A. | Al-Garni, Abdulaziz M. | Shati, Ayed A. | Malik, Amna A. | Al Jabbar, Imtinan S. | Mahmood, Syed E.

Article Type: Research Article

Abstract: BACKGROUND: Concerns about the harmful effects of smartphone use on teenage development have been raised as the use of cell phones among adolescents has risen. OBJECTIVE: This study aimed to examine the associations of smartphone usage patterns with Body Image Distortion (BID) and weight loss behaviors among adolescent smartphone users in Saudi Arabia. METHODS: This population-based, cross-sectional study was conducted from July to October 2022. We assessed the mean daily length of smartphone use and classified it into quartiles using data from a self-reported survey and data on weekday and weekend use. Self-reported …body weight and height were collected via an online survey. Out of the 11384 adolescents, the majority was females (65.7%) and was secondary school students (68.9%). RESULTS: The prolonged smartphone use (301 min/d) was found in 36.4% of adolescents, 181–300 min/d in 27.6% of respondents, 121–180 min/d in 22.4% of respondents, while the modest smartphone use (1–120 min/d) was found only in 13.6% of participants. The duration of smartphone use was significantly associated with BID (P = 0.000); students with middle perceived stress levels (51.4%) and no depressive symptoms (68.9%) used smartphones 121–180 min/d sparingly. However, prolonged smartphone use was significantly associated with the presence of depressive symptoms (42.6%) and high perceived stress levels (21.5%). Weight loss behaviors were significantly associated with smartphone use duration. Modest smartphone use was significantly found in students with normal weight (P = 0.00, 71.9%); however, aerobic physical activity weight loss strategy (P = 0.00, 30.9%) was correlated with prolonged smartphone use. CONCLUSION: Adequate parental advice is required to assist teenagers in developing healthy smartphone usage practices. Digital platform companies may increase their social responsibility for the information generated and delivered on their networks, boosting its beneficial effect. Show more

Keywords: Smartphone usage patterns, body image distortion (BID), weight loss behaviors, adolescents

DOI: 10.3233/THC-230756

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1159-1176, 2024

Authors: Zhang, Li-Hua | Ying, Ya-Fen | Yin, Jing | Li, Na | Cheng, Yan | Yu, Rong-Yan

Article Type: Research Article

Abstract: BACKGROUND: Day surgery is a new surgical model in which patients complete the admission, surgery, and discharge on the same day. OBJECTIVE: The present study aimed to explore the effect of pre-admission “quasi-collective” health education for patients with ophthalmic day surgery. METHODS: For this study, a total of 200 patients undergoing ophthalmic day surgery from February 2019 to December 2019 were enrolled as the research subjects. The patients were divided randomly into the observation group and the control group, with 100 cases in each group. For the control group, conventional health education was …conducted after admission. On the day of admission, the admission education and peri-operative health education were performed. For the observation group, pre-admission health education was provided to the patients, and detailed education on the admission instructions, pre-operative precautions, and simulation of the intra-operative process were given by the medical staff. On the day of admission, the understanding of the education was evaluated, and any weaknesses in the health education were addressed. The anxiety status, method of handwashing, method of administering the drug to the eye, preoperative preparations, intra-operative training, preoperative medication, diet guidance, and postoperative care were compared between the two groups of patients. RESULTS: Before discharge, there were significant differences in the anxiety scores, impact, and satisfaction of health education between the two groups of patients, all of which were statistically significant (P < 0.05). CONCLUSION: The pre-admission “quasi-collective” health education for patients undergoing day surgery in ophthalmology was better than conventional health education. Show more

Keywords: Ophthalmic day surgery, pre-admission, quasi-collective education, health education, impact

DOI: 10.3233/THC-230877

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1177-1184, 2024

Authors: Nair, Srilakshmi | Madhav, V.N.V. | Saini, Ravinder S. | Alshadidi, Abdulkhaliq Ali F. | Aldosari, Lujain Ibrahim N. | Heboyan, Artak

Article Type: Research Article

Abstract: BACKGROUND: The issue of an increase in pulpal temperature affects direct and indirect techniques, where the fabricating material will come in direct contact with the prepared teeth. OBJECTIVE: The aim of this study was to assess the pulpal thermal variations during provisional fabrication using direct and indirect-direct techniques, with three commonly commercially available provisional fabricating materials. METHOD: In this vitro analytical study, 120 extracted human teeth were placed in a dentulous mould and dental stone was poured, to create a working model with an embedded natural right maxillary central incisor. Recording of thermal …changes in the pulp chamber during provisionalization with direct (technique 1) and indirect-direct (technique 2) using three common types of provisional crown materials. 120 provisional crowns were fabricated using polymethyl methacrylate (DPI) (Group 1), Bis-acryl composite (Protemp 4) (Group 2) and Visible-light polymerizing (VLP) Urethane Dimethacrylate (Revotek LC) (Group 3) by two techniques and recording of peak temperature changes were done. Temperature rise in the pulp chamber was recorded using a thermocouple. RESULTS: The mean initial and final temperature of the pulp chamber recorded for Groups 1, 2 and 3 was 31.52, 32.56; 31.01, 32.34; 32.29, 34.47 for technique 1 and 29.13, 30.5; 29.29, 31.11; 30.31, 32.65 for technique 2. The mean change in temperature was higher in Group 3 compared to the other groups. CONCLUSION: The temperature rise detected according to this study was within the safer pulpal health limits with all the investigated materials and techniques. The resin material recommended for clinical use when the direct technique is employed for the fabrication of provisional crowns is bis-acryl composite resin (Protemp-4) as it caused minimal temperature rise in the pulpal chamber. Show more

Keywords: Provisional crown, Temporization, fixed partial denture, temperature rise

DOI: 10.3233/THC-230933

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1185-1197, 2024

Authors: Muniasamy, Anandhavalli | Alquhtani, Salma Abdulaziz Saeed | Bilfaqih, Syeda Meraj | Balaji, Prasanalakshmi | Karunakaran, Gauthaman

Article Type: Research Article

Abstract: BACKGROUND: Lung cancer (LC) is a harmful malignant tumor and potentially lethal illness. Therefore, early detection of LC is an urgent need, and dependent on the type of histology and the type of disease. The use of deep learning algorithms (DL) is required to analyse the histopathology images of LC and make treatment decisions accordingly. OBJECTIVE: This study aimed to apply pretrained EfficientNetB7 model to facilitate the process of classifying LC histopathology images as primary malignancy categories (adenocarcinoma, squamous cell carcinoma and large cell carcinoma) for early treatment of LC patients. Also, aims to analyse the …performance of the proposed model using the accuracy measure. METHODS: The dataset of 15000 histopathology images of lung cancer were examined. EfficientNetB7, a special type of convolution neural network (CNN), pretrained with ImageNet for transfer learning were trained on this dataset. Accuracy metric was used for the evaluation of the proposed model. RESULTS: The feature extraction was performed by applying transfer learning using EfficientNetB7 as pretrained model. The proposed model achieved 99.77% accuracy, while previous studies model achieved over 90 to 99% accuracy. CONCLUSION: The employment of CNN based EfficientNetB7 model for the classification of LC based on histopathology images can speed up the diagnosis of LC and reduce the burden on pathologists for the early treatment of patients. Show more

Keywords: Lung cancer, histopathology images, convolutional neural network, EfficientNet7, ImageNet

DOI: 10.3233/THC-231029

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1199-1210, 2024

Authors: Çoban Büyükbayraktar, Zeynep | Eninanç, İlknur

Article Type: Research Article

Abstract: BACKGROUND: Changes in bone trabeculae occur during skeletal maturation. Fractal analysis is a technique for assessing changes in the internal structure of the bone. OBJECTIVE: The aim of this study was to investigate correlation of bone trabeculation measured on panoramic and lateral cephalometric radiographs with cervical vertebral maturation stages (CVMS). METHODS: CVMS was evaluated on lateral cephalometric radiographs of 120 individuals aged 6 to 18 years. The subjects were divided into 6 groups (n = 20 each) according to CVMS. On panoramic and lateral cephalometric radiographs, fractal dimension …(FD) analyses were performed in mandibular corpus, gonial and condylar regions and cervical vertebral bodies (C2, C3, C4). RESULTS: FD measurements from the mandibular corpus region bilaterally and C2–C4 vertebral bodies showed significant positive correlations with CVMS (r = 0.418, r = 0.412, r = 0.324, r = 0.304, r = 0.263, respectively). Significant differences were found in the FD values of the right/left mandibular corpus and C2 and C3 vertebrae compared to CVMS (P < 0.001, P < 0.001, P = 0.005, P = 0.019, respectively). CONCLUSION: Significant positive moderate correlations between the FD values of the right and left mandibular corpus and CVMS suggest that fractal analysis may be useful in determining skeletal maturity stage. The significant FD values obtained from the right/left mandibular corpus, and C2 and C3 vertebra indicate that the complexity of the internal trabecular structure increases with maturation. Show more

Keywords: Skeletal maturation, fractal analysis, trabecular bone, cervical vertebrae, radiographs

DOI: 10.3233/THC-231100

Citation: Technology and Health Care, vol. 32, no. 2, pp. 1211-1221, 2024