Technology and Health Care - Volume 32, issue 2

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