Technology and Health Care - Volume 32, issue 3

Authors: Chen, Jiaqi | Zhang, Xiaohong | Wu, Wenjing | Yuan, Youyuan | Xue, Wupemg | Cao, Wendong | Du, Rongxin

Article Type: Research Article

Abstract: BACKGROUND: Endoluminal interventions have become one of the main options for the treatment of arteriosclerosis obliterans (ASO). OBJECTIVE: To explore the effect of hydration therapy and nursing intervention on the prevention of contrast-induced nephropathy (CIN) after interventional treatment of lower extremity ASO. METHODS: A convenience sampling method was used to select 94 patients who received ASO treatment in our hospital from March 2019 to May 2021 as the study subjects. All patients underwent endovascular interventional therapy and were randomly divided into two groups by the random number table method, with odd numbers entering …the observation group (n = 47) and even numbers entering the control group (n = 47). The control group received routine nursing intervention, while the observation group underwent hydration therapy and had a corresponding nursing intervention scheme. The clinical efficacy of the two groups and the incidence of contrast-induced nephropathy after interventional therapy were compared, and an evaluation of satisfaction within the two groups was performed via a questionnaire. RESULTS: The total effective rate of patients in the observation group was higher after hydration treatment (97.87% vs 87.23%, p < 0.05). The blood urea nitrogen, creatinine, and β 2 microglobulin levels in the observation group were significantly lower than those in the control group after the intervention (p < 0.05). Patients in the observation group had higher nursing satisfaction after using preventive measures of hydration therapy combined with nursing interventions (100% vs 89.36%, p < 0.05). CONCLUSION: Hydration therapy and nursing intervention can effectively prevent CIN after interventional treatment of lower extremity ASO. After interventional therapy, patients had better clinical outcomes, lower biochemical indexes and improved satisfaction evaluations. The therapy is worthy of clinical promotion and application. Show more

Keywords: Lower extremity arteriosclerosis obliterans, interventional therapy, contrast nephropathy, nursing, hydration therapy

DOI: 10.3233/THC-230256

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1361-1369, 2024

Authors: Liu, Xiuping | Li, Ping | Yang, Yuemin | Tian, Cheng

Article Type: Research Article

Abstract: BACKGROUND: Currently, there are a variety of methods for ultrasound to localize the conus medullaris. A concern is that measured values can be influenced by variations in spinal flexion and extension. OBJECTIVE: To overcome this limitation, the present study measures the horizontal distance (HD) between the end of the conus medullaris and the caudal edge of last vertebral body ossification in normal fetus at different gestational weeks, and analyzes the relationship between the measured value and fetal growth, as well as the utility of these measurements in assessing the position of the conus medullaris. …METHODS: A total of 655 fetuses at gestational weeks 18–40, who underwent routine prenatal ultrasound, were selected in the study. We measured the distance between the end of the cone of the fetal spinal cord and the caudal end of the final vertebral ossification center (Distance1, D1), the distance between the end of the spinal cord cone and the intersection of the extension of D1 with the caudal skin (Distance2, D2), and HD. We analyzed the correlation between the measurements and gestational weeks, established normal reference values, the ratio of D1, D2 and HD to the commonly used growth parameters was calculated. The ratios of D1, D2, HD and the application value of each ratio phase were analyzed, and the reliability analysis of repeated measurement results among physicians was performed. RESULTS: D1, D2 and HD exhibited strong linear correlations with gestational weeks. Among the ratios of D1, D2 and HD to common growth parameters, D2/FL stabilized after 20 weeks of gestation and consistently exceeded 1. Repeatability tests between D1, D2 and HD showed good reliability (P > 0.05). CONCLUSION: D1, D2 and HD are significantly correlated with gestational age. Horizontal distance measurement can effectively determine the position of fetal conus medullaris, enabling rapid prenatal evaluation of low position of conus medullaris and excluding the possibility of tethered cord. Show more

Keywords: Fetus, ultrasonic examination, conus medullaris, tethered spinal cord

DOI: 10.3233/THC-230332

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1371-1382, 2024

Authors: Wang, Yanxia | Li, Yaqing | Wang, Xiaoqing | Niu, Zhancong | Zhou, Lixia

Article Type: Research Article

Abstract: BACKGROUND: Stroke is the second reason for global deaths and a major reason for disabilities. OBJECTIVE: To unravel the clinical value of the coagulation index and serum inflammatory cytokines in hemorrhagic stroke patients with pulmonary infection in the sequelae stage. METHODS: Altogether, 130 hemorrhagic stroke patients who received treatment in Hebei General Hospital from April 2019 to December 2020 were selected. Patients were classified into the infection group (n = 65) and non-infection group (n = 65) according to whether they had a …pulmonary infection in the sequelae stage of hemorrhagic stroke. Levels of coagulation index and serum inflammatory cytokines of patients in two groups were compared. Multiple linear regression analysis was used to analyze pulmonary infection-related factors of hemorrhagic stroke patients. The diagnostic value of the coagulation index and serum inflammatory cytokines in pulmonary infection was analyzed by the receiver operating characteristic (ROC) curve. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT) related to coagulation function levels and interleukin 1β (IL-1β ), interleukin 17 (IL-17) related to serum inflammatory cytokines levels of patients in the infection group were higher than those in non-infection groups (p < 0.05). Multiple linear regression analysis uncovered that FIB, D-D, PLT, and IL-17 were influencing factors of pulmonary infection in the sequelae of patients with hemorrhagic stroke (p < 0.05). Area under the curve (AUC) values of pulmonary infection in the sequelae stage of patients with hemorrhagic stroke diagnosed by FIB, D-D, PLT, and IL-17 were 0.823, 0.758, 0.660, and 0.755, respectively. CONCLUSION: FIB, D-D, PLT, and IL-17 levels could be used for pulmonary infection diagnosis in the sequelae stage of hemorrhagic stroke patients. Show more

Keywords: Coagulation index, inflammatory factor, hemorrhagic stroke, sequelae stage, pulmonary infection, diagnosis

DOI: 10.3233/THC-230345

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1383-1391, 2024

Authors: Yang, Li | Song, Ling-Xia | Zhang, Yong-Mei | Liu, Han-Mei

Article Type: Research Article

Abstract: BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in …Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P < 0.05). NEWS values correlated positively with illness severity (r = 0.605, P < 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden’s index, with statistically significant differences (P < 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration. Show more

Keywords: Gastrointestinal illness, geriatric, illness severity assessment, National Early Warning Score

DOI: 10.3233/THC-230369

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1393-1402, 2024

Authors: Zeng, Ling-Zhi | Cui, Ji | Jiang, Tao | Tu, Li-Ping | Liu, Hai-Dan | Gong, Ya-Bin | Xu, Ling | Xu, Jia-Tuo

Article Type: Research Article

Abstract: BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T …-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue’s image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process. Show more

Keywords: Non-small cell lung cancer, tongue image, image features, pathological staging, traditional Chinese medicine

DOI: 10.3233/THC-230372

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1403-1420, 2024

Authors: Huang, Nannan | Fu, Min | Gao, Fumei | Wang, Yanbing | Lu, Man | Li, Xin | Wang, Dandan | Wang, Jing

Article Type: Research Article

Abstract: BACKGROUND: The success of assisted pregnancy relies heavily on the effectiveness of the embryo transfer process. Currently, embryo transfer is typically conducted with the assistance of abdominal ultrasound. OBJECTIVE: The primary aim of this study was to evaluate the influence of targeted nursing interventions on the embryo transfer procedure, its impact on pregnancy outcomes, and the level of patient comfort concerning bladder management throughout the procedure. METHODS: A total of 247 patients who underwent embryo transfer at the Reproductive Center of Peking University People’s Hospital from December 2019 to August 2020 were included …in this study. These patients were categorized into two groups: the control group (n = 124) and the experimental group (n = 123). Within the control group, patients received conventional preoperative education, whereas those within the experimental group were subjected to targeted nursing interventions. Furthermore, patients in the experimental group were furnished with explicit instructions pertaining to the volume and timing of water intake. Multiple factors were assessed in this study, encompassing bladder filling, the quality of uterine imaging, the utilization of assistive devices during the surgical procedure, and pregnancy outcomes. Additionally, a post-operative questionnaire was administered to both groups to gauge their comfort levels regarding urinary retention. RESULTS: Following the targeted nursing intervention, ultrasound scans indicated an increase in bladder depth (5.91 ± 1.76 vs. 5.40 ± 1.61, P = 0.02), resulting in clearer endometrial imaging (96.74% vs. 88.71%, P = 0.02). Additionally, the experimental group reported significantly higher levels of comfort with urine retention (P = 0.01) compared to the control group, and these differences held statistical significance. Furthermore, the pregnancy rate in the experimental group was greater than that in the control group (52.85% vs. 50.8%, P > 0.05). CONCLUSION: Based on the premise that pregnancy rates remain unaffected, the implementation of targeted nursing care has the potential to augment bladder filling, enhance the quality of endometrial imaging, reduce the requirement for instrument-assisted embryo transfers, and notably enhance the comfort of patients in relation to urine retention. Show more

Keywords: Bladder filling, comfort with urine retention, embryo transfer, IVF, targeted nursing

DOI: 10.3233/THC-230380

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1421-1429, 2024

Authors: Qiu, Bin | Chen, Hang | Zhang, Enke | Ma, Fuchun | An, Gaili | Zong, Yuan | Shang, Liang | Zhang, Yulian | Zhu, Huolan

Article Type: Research Article

Abstract: BACKGROUND: The incidence of type 2 diabetes is rapidly increasing worldwide. Studies have shown that it is also associated with cancer-related morbidities. Early detection of cancer in patients with type 2 diabetes is crucial. OBJECTIVE: This study aimed to construct a model to predict cancer risk in patients with type 2 diabetes. METHODS: This study collected clinical data from a total of 5198 patients. A cancer risk prediction model was established by analyzing 261 items from routine laboratory tests. We screened 107 risk factors from 261 clinical tests based on the importance of …the characteristic variables, significance of differences between groups (P < 0.05), and minimum description length algorithm. RESULTS: Compared with 16 machine learning classifiers, five classifiers based on the decision tree algorithm (CatBoost, light gradient boosting, random forest, XGBoost, and gradient boosting) had an area under the receiver operating characteristic curve (AUC) of > 0.80. The AUC for CatBoost was 0.852 (sensitivity: 79.6%; specificity: 83.2%). CONCLUSION: The constructed model can predict the risk of cancer in patients with type 2 diabetes based on tumor biomarkers and routine tests using machine learning algorithms. This is helpful for early cancer risk screening and prevention to improve patient outcomes. Show more

Keywords: Type 2 diabetes, cancer risk, machine learning, prediction model

DOI: 10.3233/THC-230385

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1431-1443, 2024

Authors: Yu, Yong Ming | Hu, Yang

Article Type: Research Article

Abstract: BACKGROUND: As a critical m6A RNA methylation regulator, HNRNPC has been revealed to serve as potential biomarkers in various human cancers. The specific expression and significance of HNRNPC in colorectal cancer remain unknown. OBJECTIVE: This study aimed to confirm HNRNPC expression level and evaluate its function in colorectal cancer progression. METHODS: 101 paired tissue samples were collected from colorectal cancer patients. HNRNPC levels in colorectal cancer were detected using PCR. CCK8 and transwell assays were conducted to estimate the effect of HNRNPC on cell growth and metastasis with the regulation of HNRNPC by …cell transfection. RESULTS: Upregulated HNRNPC was observed in colorectal cancer compared with normal tissues and cells. The higher HNRNPC levels in tumor tissues were associated with the advanced TNM stage and positive lymph node metastasis. Meanwhile, HNRNPC upregulation could indicate adverse outcomes of colorectal cancer patients. In vitro , the knockdown of HNRNPC significantly suppressed the proliferation, migration, and invasion of colorectal cancer cells. CONCLUSIONS: Upregulated HNRNPC served as a biomarker for the prognosis and development of colorectal cancer, which provides a novel therapeutic target for colorectal cancer. Show more

Keywords: N6-methyladenosine (m6A), HNRNPC, colorectal cancer, prognosis, progression

DOI: 10.3233/THC-230429

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1445-1453, 2024

Authors: Cui, Ling | Gao, Lina | Geng, Huanhuan | Zhang, Huiru | Wei, Hongyan

Article Type: Research Article

Abstract: BACKGROUND: Mild cognitive impairment (MCI) is a mild memory or cognitive impairment. OBJECTIVE: To explore the relationship between serum klotho (K1) protein and insulin-like growth factor-1 and mild cognitive impairment in the elderly in order to provide accurate and appropriate indicators for clinical diagnosis and treatment of MCI. METHODS: This randomized stratified study adopted a multistage cluster sampling method. 161 elderly patients with mild cognitive impairment were included as the MCI group, and 161 healthy people matched with the MCI group in gender, age and education were selected as the control group. …RESULTS: The levels of serum K1 protein and insulin-like growth factor-1 in the MCI group were lower than those in the control group (P < 0.05). Both IGF-1 and K1 had predictive value for MCI (P < 0.05). The area under the curve (AUC) of IGF-1 for predicting MCI was 0.859 (95% CI: 0.790∼ 0.929), and the AUC of K1 for predicting MCI was 0.793 (95% CI: 0.694∼ 0.892). The value of joint prediction of the two indicators was the highest, with an AUC of 0.939 (95% CI: 0.896–0.993). CONCLUSION: High serum K1 and insulin-like growth factor-1 are the protective factors of cognitive impairment in MCI patients. Both IGF-1 and serum K1 proteins have predictive value for MCI, and the combination of the two indicators has the highest predictive value. Show more

Keywords: Mild cognitive impairment, klotho protein, serum insulin-like growth factor-1

DOI: 10.3233/THC-230462

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1455-1462, 2024

Authors: Seget, Sebastian | Chobot, Agata | Rusak, Ewa | Ochab, Agnieszka | Bielawska, Anna | Polanska, Joanna | Jarosz-Chobot, Przemysława

Article Type: Research Article

Abstract: BACKGROUND: Given the steadily rising incidence of type 1 diabetes (T1D), particularly among the youngest preschool children, coupled with well-documented challenges of achieving and maintaining optimal metabolic control in this age group, there is a growing need for advanced technological devices. OBJECTIVE: To evaluate glycaemic control in children below the age of seven with type 1 diabetes (T1D) and assess the safety of the advanced hybrid closed loop (AHCL) system in comparison to the previous treatment method, a sensor-augmented pump with predictive low-glucose suspend (SAP-PLGS). METHOD: Data from 10 children (aged 2.60–6.98 years) …with T1D who transitioned to the AHCL system from SAP-PLGS were analysed. SAP-PLGS records from two weeks prior to the initiation of AHCL were compared with records from the initial four weeks post-switch (excluding the training period). These data were examined at two 2-week intervals and compared with records from two weeks post six-month usage of the AHCL. RESULTS: A significant decrease in the average nighttime glucose concentration was observed compared to pre-AHCL values (p = 0.001, concordance W = 0.53). The Glucose Management Indicator (GMI) value significantly decreased from 6.88 ± 0.37% to 6.52 ± 0.32% (p = 0.018, rbc = 0.93) immediately following the device switch and stabilized at 6.50 ± 0.28% (p = 0.001, W = 0.53) and 6.55 ± 0.41% (p = 0.001, W = 0.53) at subsequent stages of the study. An improvement was also observed in mean glucose values for time spent < 54 mg/dl, while the proportion of time within this range was maintained, both during the day (p < 0.001, W = 0.58) and at night (p = 0.002, W = 0.83). CONCLUSION: The AHCL MiniMed 780GTM system improved glycaemic control in the studied group of children under seven years of age with T1D compared to previous SAP-PLGS therapy. It proved to be safe for delivering insulin in this age group. Show more

Keywords: Type 1 diabetes, advanced hybrid closed-loop system, young children, hybrid closed-loop

DOI: 10.3233/THC-230490

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1463-1472, 2024

Authors: Liu, Dong-Xu | Wu, Ke-Han | Zang, Xi-Yan | Lu, Jia-Yi | Liu, Ming-Yue | Li, Chun-Ming | Gao, Li

Article Type: Research Article

Abstract: BACKGROUND: Oral squamous cell carcinoma (OSCC) is an infiltrative malignancy characterized by a significantly elevated recurrence rate. Dickkopf-related protein 1 (DKK1), which plays an oncogene role in many cancers, acts as an inhibitor of the Wingless protein (Wnt) signaling pathway. Currently, there is a lack of consensus regarding the role of DKK1 in OSCC or its clinical significance. OBJECTIVE: To examine the role and effect of DKK1 in OSCC. METHODS: The identification of differentially expressed genes (DEGs) in OSCC was conducted by utilizing databases such as The Cancer Genome Atlas (TCGA) and Gene …Expression Omnibus (GEO). A comprehensive analysis of gene expression profile interactions (GEPIA) and Kaplan-Meier curve were conducted to investigate the associations among DEGs, patient survival and prognosis in individuals with OSCC. The biological function of DKK1 in OSCC was investigated by using molecular biology approaches. RESULTS: The expression of DKK1 was found to be upregulated in OSCC tissues at various stages. High levels of DKK1 expression exhibited a positive correlation with the overall survival (OS) and progression-free survival (PFS) rates among OSCC patients. DKK1 knockdown suppressed the proliferation and induced apoptotic response in OSCC cells. Moreover, DKK1 exerted a positive regulatory effect on HMGA2 expression, thereby modulating cell growth and apoptosis in OSCC. The expression of DKK1 was found to be positively correlated with the infiltration of immune cells in patients with OSCC. Additionally, higher levels of CD4 + T cells were associated with improved 5-year survival rates. CONCLUSION: DKK1 is a prognostic biomarker for patients with OSCC. Show more

Keywords: Dickkopf-related protein 1, HMGA2, immune status, Oral squamous cell carcinoma

DOI: 10.3233/THC-230527

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1473-1488, 2024

Authors: Lu, Ting | Ma, Hongxia | Shang, Lijing

Article Type: Research Article

Abstract: BACKGROUND: It is recommended to use non-invasive positive pressure ventilation in elderly patients with heart failure combined with obstructive sleep apnea syndrome (OSAS). OBJECTIVE: To study the therapeutic effect of non-invasive positive pressure ventilation on elderly patients with heart failure complicated with OSAS. METHODS: Using the random number table method, 119 elderly patients with heart failure complicated with OSAS who were admitted to our hospital from April 2020 to April 2021 were divided into the observation (60 cases) and control (59 cases) groups. On the basis of conventional drug treatment, patients in the …observation group were treated with non-invasive positive pressure ventilation, and patients in the control group were treated with low-flow oxygen inhalation. The sleep quality, hemoglobin, red blood cells, erythropoietin, pro-brain natriureticpeptide (pro-BNP) levels and blood pressure were compared. RESULTS: After treatment, levels of hemoglobin, erythrocytes, erythropoietin, pro-BNP, blood pressure and sleep apnea-hypopnea index in the observation group were lower before treatment and in the control group in the same period. The oxygen saturation was higher before treatment and the control group in the same period (P < 0.05). The overall satisfaction with sleep quality in the observation group was higher (P < 0.05). CONCLUSION: Non-invasive positive pressure ventilation can improve blood oxygen saturation and sleep quality in elderly patients with heart failure complicated with OSAS, and reduce pro-BNP level. Show more

Keywords: Non-invasive positive pressure ventilation, elderly, heart failure, obstructive sleep apnea syndrome, sleep quality

DOI: 10.3233/THC-230554

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1489-1502, 2024

Authors: Jia, Limin | Zhang, Chenguang | Fu, Xin | Chen, Caihua | Zheng, Hongkui | Yang, Caifang

Article Type: Research Article

Abstract: BACKGROUND: The use of indwelling closed thoracic drainage tubes in the wedge resection of the lungs is of great significance to postoperative recovery. However, there are potential risks. OBJECTIVE: To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. METHODS: A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer …system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t -test to compare the differences between the two groups. RESULTS: There were no statistically significant differences in terms of age, gender and sweating between the two groups. Compared with the control group, the unplanned extubation rate of the experimental group was lower (χ 2 = 8.513; P = 0.004), the indwelling time of the drainage tube was shorter (t = 2.108; P = 0.037), the cumulative material cost was lower (t = 3.778; P < 0.001), the time cost was also lower (Z = 2.717; P = 0.008), the degree of comfort was higher (Z = 2.752; P = 0.006), and the degree of pain was lower (Z = 4.019; P < 0.001). The incidence of subcutaneous emphysema was significantly lower in the experimental group than in the control group (χ 2 = 8.513; P = 0.004). CONCLUSION: The use of the triple-buffer system to fix small-diameter (18 F) thoracic closed drainage tubes can reduce the unplanned extubation rate, indwelling time of the drainage tube and the incidence of adverse reactions. Show more

Keywords: Lung wedge resection, small-diameter closed thoracic drainage tube, fixed method

DOI: 10.3233/THC-230558

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1503-1513, 2024

Authors: Martins, Hélder Domiciano Dantas | de Lucena, Cassiane Pereira | da Silva, Quemuel Pereira | Dantas, Maria Vitória Oliveira | Costa, Maria do Desterro Andrêzza Souza | de Lucena, Edson Hilan Gomes | Bonan, Paulo Rogério Ferreti

Article Type: Research Article

Abstract: BACKGROUND: Teledentistry is considered a good tool in the diagnostic process. In oral medicine, there is a low number of trained professionals and dentists have difficulty in diagnosing and treating oral lesions. OBJECTIVE: We aimed to perform a cross-sectional evaluation based on the mobile application for oral diagnosis using a mobile application in a Brazilian State. METHODS: This is a retrospective, cross-sectional, observational study of the data of the “Telehealth in Stomatology in Paraíba” carried out between May 2021 and November 2022. RESULTS: The app has a team of …16 consultants (Ph.D. professors, postgraduate students, residents, and dentists). In addition, there are 289 registered professionals, with a mean age of 33.7 years, predominantly female (70.2%), working in primary care (79.2%), and general practitioners (42.6%). Regarding the cases, the app has 194 cases, and reactive lesions are the most suggested hypotheses reported by dentists (24.5%) and consultants (22.3%). We had an overall concordance rate of 64.1%. CONCLUSION: The application is easily accessible and has an assistance network that helps with early diagnosis. In addition, it has good coverage with users in more than 50% of the cities in the state. Thus, applications that provide specialized care to distant areas are important for better public health. Show more

Keywords: Telemedicine, diagnosis, oral, biomedical technology

DOI: 10.3233/THC-230584

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1515-1522, 2024

Authors: Kim, Sun Kyung | Lee, Youngho | Hwang, Hye Ri | Park, Su Yeon

Article Type: Research Article

Abstract: BACKGROUND: The in-depth understanding of human anatomy is the foundation for safety in nursing practice. Augmented reality is an emerging technology that can be used for integrative learning in nursing education. OBJECTIVE: The study aimed to develop a human anatomy-based skill training system and pilot test its usability and feasibility. METHODS: Twenty-seven nursing students participated in 3D anatomy-based skill training for intramuscular injection and Levin tube feeding using HoloLens 2. Various user interfaces including pictures, videos, animation graphics, and annotation boxes assisted users with a comprehensive understanding of the step-by-step procedures for these …techniques. A one-group pre-post test was conducted to observe changes in skill performance competency, usability, and learning satisfaction. RESULTS: After study participation, a statistically significant improvement in skill performance competency (p < 0.05) was observed. The usability results showed that students were satisfied with the usefulness of the program (9.55 ± 0.49) and scored highly for the intention to participate in other educational programs (9.62 ± 0.59). A high level of learning satisfaction was achieved (9.55 ± 0.49), with positive responses in fostering students’ engagement and excitement in the application of cutting-edge technology. CONCLUSION: The 3D anatomy-based nursing skill training demonstrated good potential to improve learning outcomes and facilitate engagement in self-directed practice. This can be integrated into undergraduate nursing education as an assistant teaching tool, contributing to the combination of knowledge and practice. Show more

Keywords: HoloLens 2, augmented reality, nursing, 3D, human anatomy, practice

DOI: 10.3233/THC-230586

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1523-1533, 2024

Authors: Hamid, Suraya | Roslan, Muhammad Hamirul Hamizan | Norman, Azah Anir | Ghani, Norjihan Abdul

Article Type: Research Article

Abstract: BACKGROUND: Several studies focus on the use of emerging technologies to support and monitor health but are centred around the elderly group of people. Meanwhile, the average elderly popularly known as the middle-aged have not been put into consideration regarding the subject matter. OBJECTIVE: This article focuses on the use behaviour and acceptance of emerging technologies that can assist in providing a middle-aged population with a healthy lifestyle. METHODS: This study collected the primary data through an online questionnaire survey to empirically evaluate final 169 respondents. The analysis for this study was done …utilising SmartPLS software via partial least squares structural equation modelling. RESULTS: The results indicate that 9 out of 11 were tested as supported hypotheses. All supported hypotheses showed the strong relationship between acceptance and user behaviour with emerging technology. CONCLUSION: The experience of acceptance and behaviour of using emerging technology in a healthy lifestyle was found as an important determinant of outcome in preparing the middle-aged for their elderly age by adapting emerging technology as early as possible. Show more

Keywords: Emerging technology, healthy lifestyle, middle aged, health, acceptance

DOI: 10.3233/THC-230604

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1535-1554, 2024

Authors: Ding, Ling | Tao, Xinyan | Zhou, Jingjing

Article Type: Research Article

Abstract: BACKGROUND: Comprehensive geriatric assessment (CGA) has been used in inpatient, outpatient, and emergency patients in Western countries and is an important evaluation tool in medicine. In China, the application of CGA to multiple single diseases has achieved satisfactory intervention effects. OBJECTIVE: To explore the effect of CGA on postoperative quality of life (QoL), psychological state, neurological recovery, and self-efficacy in patients with cerebral hemorrhage. METHODS: In this randomized controlled trial, a total of 133 postoperative patients with cerebral hemorrhage who were treated and nursed in our hospital between March 2019 and March 2021 …were randomly assigned to a control group (68 patients) and an observation group (65 patients). The control group was given a general comprehensive care intervention. The observation group was evaluated using an electronic medical record-based CGA system that assessed patient prognosis and was given individualized interventions based on the CGA findings. The postoperative QoL, psychological state, neurological recovery, and self-efficacy of the two groups were compared. RESULTS: After the intervention, self-decompression, self-decision-making, and positive attitudes of the observation group were higher than those of the control group. However, the National Institute of Health Stroke Scale score of the observation group was lower than that of the control group, the Self-rating anxiety scale and self-rating depression scale scores of the observation group were lower than those of the control group, and the social support score was significantly higher in the observation group than in the control group. After the intervention, the mental vitality, social interaction, emotional restriction, and mental status scores of the observation group were significantly higher than those of the control group. CONCLUSION: Comprehensive evaluation of patients with cerebral hemorrhage based on a CGA, targeting the individual factors that affect the prognosis of patients, and formulating and implementing individualized nursing intervention programs based on the CGA results can effectively relieve the symptoms of cerebral hemorrhage, reduce anxiety and depression, and improve the QoL of patients with cerebral hemorrhage. Show more

Keywords: Intracerebral hemorrhage, comprehensive geriatric assessment, quality of life, neurological function, self-efficacy

DOI: 10.3233/THC-230611

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1555-1567, 2024

Authors: An, Peng | Liu, Junjie | Yu, Mengxing | Wang, Jinsong | Wang, Zhongqiu

Article Type: Research Article

Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic airway diseases in the world. OBJECTIVE: To predict the degree of mixed venous oxygen saturation (SvO2 ) impairment in patients with COPD by modeling using clinical-CT radiomics data and to provide reference for clinical decision-making. METHODS: A total of 236 patients with COPD diagnosed by CT and clinical data at Xiangyang No. 1 People’s Hospital (n = 157) and Xiangyang Central Hospital (n = 79) from June 2018 to September …2021 were retrospectively analyzed. The patients were divided into group A (SvO⩾ 2 62%, N = 107) and group B (SvO< 2 62%, N = 129). We set up training set and test set at a ratio of 7/3 and time cutoff spot; In training set, Logistic regression was conducted to analyze the differences in general data (e.g. height, weight, systolic blood pressure), laboratory indicators (e.g. arterial oxygen saturation and pulmonary artery systolic pressure), and CT radiomics (radscore generated using chest CT texture parameters from 3D slicer software and LASSO regression) between these two groups. Further the risk factors screened by the above method were used to establish models for predicting the degree of hypoxia in COPD, conduct verification in test set and create a nomogram. RESULTS: Univariate analysis demonstrated that age, smoking history, drinking history, systemic systolic pressure, digestive symptoms, right ventricular diameter (RV), mean systolic pulmonary artery pressure (sPAP), cardiac index (CI), pulmonary vascular resistance (PVR), 6-min walking distance (6MWD), WHO functional classification of pulmonary hypertension (WHOPHFC), the ratio of forced expiratory volume in the first second to the forced vital capacity (FEV1%), and radscore in group B were all significantly different from those in group A (P < 0.05). Multivariate regression demonstrated that age, smoking history, digestive symptoms, 6MWD, and radscore were independent risk factors for SvO2 impairment. The combined model established based on the abovementioned indicators exhibited a good prediction effect [AUC: 0.903; 95%CI (0.858–0.937)], higher than the general clinical model [AUC: 0.760; 95%CI (0.701–0.813), P < 0.05] and laboratory examination-radiomics model [AUC: 0.868; 95%CI (0.818–0.908), P = 0.012]. The newly created nomogram may be helpful for clinical decision-making and benefit COPD patients. CONCLUSION: SvO2 is an important indicator of hypoxia in COPD, and it is highly related to age, 6MWD, and radscore. The combined model is helpful for early identification of SvO2 impairment and adjustment of COPD treatment strategies. Show more

Keywords: Cardiac function, cardiac index, chronic obstructive pulmonary disease (COPD), digestive symptoms, hemodynamics, mixed venous oxygen saturation (SvO2), pulmonary systolic pressure, WHO functional classification of pulmonary hypertension

DOI: 10.3233/THC-230619

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1569-1582, 2024

Authors: Butter, Christian | Klein, Gunnar | Grönefeld, Gerian | Böcker, Dirk | Suling, Anna | Buchholz, Anika | Felk, Angelika | Hauser, Tino | Wegscheider, Karl | Bänsch, Dietmar

Article Type: Research Article

Abstract: BACKGROUND: Both highly specialized heart centres and less specialized hospitals care for patients with implantable ICDs/CRT-Ds with remote monitoring. OBJECTIVE: To investigate potential differences in patient treatment according to centre’s ICD implantation volume. METHODS: Based on their 2012 ICD/CRT-D implantation volume, centres enrolled in the NORDIC ICD trial in Germany were assigned to one of three groups: high- (HV, n = 345), medium- (MV, n = 340) or low-volume (LV, n = 189). RESULTS: The …HV-centres had a significant higher CRT-D proportion (41.7%; LV: 36.5%; MV: 23.2%; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001), significant shorter median procedure duration (49 min; MV: 58 min; LV: 60 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) but significant longer median hospital stay (4 days; MV and LV: 3 days; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) compared to MV- and LV-centres. The X-ray exposure was shorter in MV/HV-centres (MV: 3.4 min; HV: 3.6 min; LV: 5.5 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001). Only 3.5% (LV: 2.6%; HV: 3.5%; MV: 4.1%) patients received at least one delivered inappropriate shock and 2.5% (HV: 2.0%; LV: 2.6%; MV: 2.9%) patients had withheld inappropriate ICD shocks without subsequent inappropriate shock delivery within 24.5 months of median follow-up. CONCLUSION: Implantation volume-dependent differences were observed in the device selection, procedure duration and x-ray exposure duration. Remote monitoring in combination with adequate response pattern prevented imminent inappropriate shocks in all three groups. Show more

Keywords: Defibrillators, implantable, cardiac resynchronization therapy, hospitals, high-volume, hospitals, low-volume, home monitoring

DOI: 10.3233/THC-230641

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1583-1593, 2024

Authors: Lee, Hung-Fu | Liao, Pei-Hung

Article Type: Research Article

Abstract: BACKGROUND: Improved access to media and medical knowledge has elicited stronger public health awareness. OBJECTIVE: This study developed a smart drug interaction reminder system for patients to increase knowledge and reduce nurse workload. METHODS: This study used a single-group pre-test/post-test design and applied mining techniques to analyze the weight and probability of interaction among various medicines. Data were collected from 258 participants at a teaching hospital in northern Taiwan using convenience sampling. An app was used to give patients real-time feedback to obtain access to information and remind them of their health issues. …In addition to guiding the patients on medications, this app measured the nurses’ work satisfaction and patients’ knowledge of drug interaction. RESULTS: The results indicate that using information technology products to assist the app’s real-time feedback system promoted nurses’ work satisfaction, improved their health education skills, and helped patients to better understand drug interactions. CONCLUSION: Using information technology to provide patients with real-time inquiring functions has a significant effect on nurses’ load reduction. Thus, smart drug interaction reminder system apps can be considered suitable nursing health education tools and the SDINRS app can be integrated into quantitative structure-activity relationship intelligence in the future. Show more

Keywords: Drug interaction, data mining, reminder systems, nurses, application

DOI: 10.3233/THC-230650

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1595-1608, 2024

Authors: Yang, Xin-Lei | Ni, Dong-He | Yu, Yang | Zhao, Jin-Cui | Lin, Rui | Xiu, Chao | Chang, Zhe-Xing

Article Type: Research Article

Abstract: BACKGROUND: Breast cancer has the second highest mortality rate of all cancers and occurs mainly in women. OBJECTIVE: To investigate the relationship between magnetic resonance imaging (MRI) radiomics features and histological grade of invasive ductal carcinoma (IDC) of the breast and to evaluate its diagnostic efficacy. METHODS: The two conventional MRI quantitative indicators, i.e. the apparent diffusion coefficient (ADC) and the initial enhancement rate, were collected from 112 patients with breast cancer. The breast cancer lesions were manually segmented in dynamic contrast-enhanced MRI (DCE-MRI) and ADC images, the differences in radiomics features between …Grades I, II and III IDCs were compared and the diagnostic efficacy was evaluated. RESULTS: The ADC values (0.77 ± 0.22 vs 0.91 ± 0.22 vs 0.92 ± 0.20, F = 4.204, p < 0.01), as well as the B_sum_variance (188.51 ± 67.803 vs 265.37 ± 77.86 vs 263.74 ± 82.58, F = 6.040, p < 0.01), L_energy (0.03 ± 0.02 vs 0.13 ± 0.11 vs 0.12 ± 0.14, F = 7.118, p < 0.01) and L_sum_average (0.78 ± 0.32 vs 16.34 ± 4.23 vs 015.45 ± 3.74, F = 21.860, p < 0.001) values of patients with Grade III IDC were significantly lower than those of patients with Grades I and II IDC. The B_uniform (0.15 ± 0.12 vs 0.11 ± 0.04 vs 0.12 ± 0.03, F = 3.797, p < 0.01) and L_SRE (0.85 ± 0.07 vs 0.78 ± 0.03 vs 0.79 ± 0.32, F = 3.024, p < 0.01) values of patients with Grade III IDC were significantly higher than those of patients with Grades I and II IDC. All differences were statistically significant (p < 0.05). The ADC radiomics signature model had a higher area-under-the-curve value in identifying different grades of IDC than the ADC value model and the DCE radiomics signature model (0.869 vs 0.711 vs 0.682). The accuracy (0.812 vs 0.647 vs 0.710), specificity (0.731 vs 0.435 vs 0.342), positive predictive value (0.815 vs 0.663 vs 0.669) and negative predictive value (0.753 vs 0.570 vs 0.718) of the ADC radiomics signature model were all significantly better than the ADC value model and the DCE radiomics signature model. CONCLUSION: ADC values and breast MRI radiomics signatures are significant in identifying the histological grades of IDC, with the ADC radiomics signatures having greater value. Show more

Keywords: Invasive ductal carcinoma, magnetic resonance imaging, radiomics, histological grading

DOI: 10.3233/THC-230671

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1609-1618, 2024

Authors: Wang, Gang | Zhang, Hao-Cheng | Zhang, Si-Jin | Yao, Yan-Yi | Zhao, Yan | Wang, Zeng | Zhang, Ting

Article Type: Research Article

Abstract: BACKGROUND: Coronary artery disease can be quantified by measuring the fat attenuation index (FAI). OBJECTIVE: To explore the correlations between FAI, high-risk plaque and the degree of coronary artery stenosis. METHODS: The clinical data of patients with coronary atherosclerosis who underwent a coronary computed tomography (CT) angiography examination between July 2020 and June 2023 were selected for retrospective analysis. These patients were classified into a high-risk plaque group and non-high-risk plaque group according to the presence of CT high-risk plaque. The diagnostic value of FAI and FAI combined with the degree of stenosis …was evaluated for CT high-risk plaque. RESULTS: Differences in age, body mass index, smoking history, FAI and the degree of stenosis between the two groups were statistically significant (all P < 0.05). The results of a binary logistic regression analysis revealed that FAI (odds ratio (OR): 1.131, 95% confidence interval (CI): 1.101–1.173, P < 0.001) and the degree of stenosis (OR: 1.021, 95% CI: 1.012–1.107, P < 0.001) were risk factors for high-risk plaque. CONCLUSION: The FAI can be used to monitor the inflammation level of the coronary artery; the higher the FAI is, the higher the risk of plaque and degree of stenosis. Show more

Keywords: Coronary computed tomography angiography, peripheral coronary adipose tissue, fat attenuation index, plaque

DOI: 10.3233/THC-230676

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1619-1628, 2024

Authors: Lei, Jie | Huang, YiJun | Chen, YangLin | Xia, Linglin | Yi, Bo

Article Type: Research Article

Abstract: BACKGROUND: Rapid and accurate segmentation of tumor regions from rectal cancer images can better understand the patient’s lesions and surrounding tissues, providing more effective auxiliary diagnostic information. However, cutting rectal tumors with deep learning still cannot be compared with manual segmentation, and a major obstacle to cutting rectal tumors with deep learning is the lack of high-quality data sets. OBJECTIVE: We propose to use our Re-segmentation Method to manually correct the model segmentation area and put it into training and training ideas. The data set has been made publicly available. Methods: A total of 354 rectal …cancer CT images and 308 rectal region images labeled by experts from Jiangxi Cancer Hospital were included in the data set. Six network architectures are used to train the data set, and the region predicted by the model is manually revised and then put into training to improve the ability of model segmentation and then perform performance measurement. RESULTS: In this study, we use the Resegmentation Method for various popular network architectures. CONCLUSION: By comparing the evaluation indicators before and after using the Re-segmentation Method, we prove that our proposed Re-segmentation Method can further improve the performance of the rectal cancer image segmentation model. Show more

Keywords: Medical image, rectal cancer, data set, semantic segmentation

DOI: 10.3233/THC-230690

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1629-1640, 2024

Authors: Wang, Yu | Li, Jun | Shi, Yulin | Jiang, Tao | Tu, Liping | Xu, Jiatuo

Article Type: Research Article

Abstract: BACKGROUND: The sublingual vein (SV) is a specialized diagnostic method used in Traditional Chinese Medicine (TCM). Despite its ability to objectively reflect blood flow, SV is often overlooked in clinical practice. OBJECTIVE: This study aims to analyze the core characteristics of SV and investigate the in-depth relationship between its digital characteristics and hypertension. The goal is to find a link between SV and hypertension and break out of the current situation. METHODS: Modern digital analysis techniques were applied to the traditional SV diagnostic theory. In a controlled study with 204 participants, the digital …characteristics of SV were documented using TFDA-1, and its color value was analyzed using TDAS. Morphological characteristics of SV, such as trunklength, width, and tortuosity, were examined by combining computer vision with expert interpretation. This involved the application of automatic ranging methods and a rectangular approximation algorithm, which are novel approaches in the field of TCM. The t -test and Mann-Whitney U test were used to analyze the digital characteristics of SV in hypertension. Binary logistic regression and neural network models were established using machine learning to explore the deep relationship between SV characteristics and hypertension. RESULTS: There was a significant difference of the tortuosity of SV between the two groups (Z = - 2.629, p = 0.009). The results revealed thick width of SV (OR = 2.64, 95% CI: 1.02–6.79) was the risk factor for hypertension. Addition of SV characteristics improved overall percent correct for hypertension prediction to 80%. CONCLUSION: TCM method of diagnosis of SV has been greatly expanded in terms of technical means, and the close relationship between SV and hypertension has been found in clinical data. Show more

Keywords: Sublingual veins, digital characteristics, hypertension

DOI: 10.3233/THC-230695

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1641-1656, 2024

Authors: Bao, Zhi-Guo | Zhou, Qing | Zhao, Sen | Ren, Wen-Yan | Du, Sen | Li, Yan | Wang, Hang-Yu

Article Type: Research Article

Abstract: BACKGROUND: Acute pancreatitis (AP) is a severe condition with complications that can impact multiple organ systems throughout the body. Specifically, the diffusion of peripancreatic effusion to the pleural cavity is a significant phenomenon in AP. However, its pathways and implications for disease severity are not fully understood. OBJECTIVE: This study aims to investigate the anatomical routes of peripancreatic effusion diffusion into the pleural cavity in patients with AP and to analyze the correlation between the severity of pleural effusion (PE) and the computed tomography severity index (CTSI) and acute physiology and chronic health evaluation II (APACHE …II) scoring system. METHODS: 119 patients with AP admitted to our institution were enrolled in this study (mean age 50 years, 74 male and 45 female). Abdominal CT was performed, and the CTSI and APACHE II index were used to evaluate the severity of the AP, Meanwhile, the prevalence and semiquantitative of PE were also mentioned. The anatomical pathways of peripancreatic effusion draining to pleural were analyzed. Finally, the correlation relationship between the severity of AP and the PE was analyzed. RESULTS: In 119 patients with AP, 74.8% of patients had PE on CT. The anatomic pathways of peripancreatic effusion draining to pleural included esophageal hiatus in 33.7% of patients, aortic hiatus in 6.7% of patients and inferior vena cava hiatus in 3.37% of patients. The rating of PE on CT was correlated with CTSI scores (r = 0.449, P = 0.000) and was slightly correlated with the APACHE II scores (r = 0.197, P = 0.016). CONCLUSION: PE is a common complication of AP, which can be caused by anatomic pathways such as diaphragmatic hiatus. Due to its correlation with the CTSI score, the PE may be a supplementary indicator in determining the severity of AP. Show more

Keywords: Acute pancreatitis, pleural effusion, anatomical pathways, CT

DOI: 10.3233/THC-230702

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1657-1666, 2024

Authors: Su, Shunqing | Xiong, Disheng | Zeng, Zhijian | Ding, Xiumei | Kuang, Jinan | Lin, Yuechun | Wu, Yongwei

Article Type: Research Article

Abstract: BACKGROUND: Pressure ulcers remain a worldwide problem. OBJECTIVE: To introduce an intermittent and feasible wound treatment method for the treatment of pressure ulcers in elderly patients. METHODS: This surgical procedure was performed on eight elderly patients suffering from pressure ulcers. Microskin measuring 0.1 × 0.1 centimeters was cut from a small amount of thin skin and then grafted onto the wound surface in conjunction with closed negative pressure therapy. RESULTS: Seven patients had their wounds closed after a single surgery, while one patient required two surgeries to …close the wound. CONCLUSION: Autologous microskin implantation for the treatment of pressure ulcers in the elderly is an effective method to close the wound, which can prevent the elderly from living with wounds in their later years and is a viable treatment option. Show more

Keywords: Elderly patients, pressure ulcers, skin grafts, vacuum sealing drainage, wound repair

DOI: 10.3233/THC-230707

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1667-1673, 2024

Authors: Lin, Wan-Rong | Liu, Wei-Qing | Meng, Xuan-Yu | Liu, Xiao-Ting | Kou, Zhi-Yong | Li, Wen-Liang | Yang, Jun

Article Type: Research Article

Abstract: BACKGROUND: Despite the advancement of new screening strategies and the advances in pharmacological therapies, the cancerization rates of familial adenomatous polyposis (FAP) are stable and even increased in the last years. Therefore, it necessitates additional research to characterize and understand the underlying mechanisms of FAP. OBJECTIVE: To determine the genes that drive the pathogenesis of familial adenomatous polyposis (FAP). METHODS: We performed on a cohort (GSE111156) gene profile, which consist of four group of gene expressions (the gene expressions of cancer, adenoma and normal tissue of duodenal cancer from patients with FAP were …defined as Case N, Case A and Case C respectively, while that of adenoma tissue from patients with FAP who did not have duodenal cancer was Ctrl A). Tracking Tumor Immunophenotype (TIP) website was applied to reveal immune infiltration profile and signature genes of FAP. We merged the genes of key module (pink and midnight module) with signature genes to obtained the biomarkers related with FAP pathogenesis. The expression of these five biomarkers in FAP intratumoral region (IT) and tumor rim (TR) was detected with Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). RESULTS: In total, 220, 23 and 63 DEGs were determined in Cases C, A and N, in comparison to Ctrl A. In total, 196 and 10 DEGs were determined in Cases C and A, separately, as compared to Case N. A total of four biomarkers including CCL5, CD3G, CD2 and TLR3 were finally identified associated with pink module, while only one biomarker (KLF2) associated with midnight module was identified. All biomarkers were evidently raised in FAP IT tissues utilizing qRT-PCR. CONCLUSION: We identified five potential biomarkers for pathogenesis of FAP to understand the fundamental mechanisms of FAP progression and revealed some probable targets for the diagnosis or treatment of FAP. Show more

Keywords: Familial adenomatous polyposis, bioinformatics, driver gene, WGCNA, DEGs

DOI: 10.3233/THC-230719

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1675-1696, 2024

Authors: Sayed, Mohammed E. | Jain, Saurabh | Jokhadar, Hossam F. | Alshahrani, Ahid Amer | AlResayes, Saad Saleh | Alqahtani, Saeed M. | Alqarni, Hatem | Anab, Najwa Ali | Alsubeaie, Nouf H. | Alsubaie, Shaa H. | Khalid, Asaad | Franco, Rocco | Minervini, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Provisional fixed dental prosthesis (FDP) plays an important role during fixed prosthodontic therapy till the definitive. Discoloration of materials used for provisional FDPs can cause patient dissatisfaction and may create doubt about the color stability of the definitive FDP. Surface roughness is the other major property to be taken into consideration for provisional FDP materials. Smokeless tobacco is reported to affect the color stability and surface roughness of different prosthetic materials. OBJECTIVE: The aim of the current study was to evaluate the effect of two types of smokeless tobacco (black and white) on color stability …and surface roughness of 3D printed, CAD/CAM milled, and conventional provisional FDP resin materials. METHODS: A total of 144 disc-shaped specimens were fabricated using four techniques CAD/CAM subtractive technique (milling), CAD/CAM additive technique (3D Printing), and conventional technique using autopolymerized PMMA, and autopolymerized Bis-acrylic resins. Each group was subdivided into three subgroups of twelve specimens each, and were submerged into three solutions (artificial salivary substitute, black smokeless tobacco, white smokeless tobacco). The change in color and surface roughness was evaluated and the data collected were statistically analyzed. RESULTS: It was observed that black smokeless tobacco caused the maximum color change and the effect was highest in autopolymerized PMMA resin specimens (Δ E = 9.343 ± 0.489), followed by 3D printed (Δ E = 7.187 ± 0.391), autopolymerized Bis-acryl (Δ E = 6.464 ± 0.453) and milled (Δ E = 4.978 ± 0.227). White smokeless tobacco was found to cause a maximum change in surface roughness and the effect was highest in autopolymerized Bis-acryl specimens (Δ Ra = 0.321 ± 0.015 μ m), followed by autopolymerized PMMA (Δ Ra = 0.297± 0.015 μ m), 3D printed (Δ Ra = 0.191 ± 0.019 μ m), and milled (Δ Ra = 0.168 ± 0.014 μ m). Statistically significant (p -value < 0.05) differences were observed among all techniques and solutions. CONCLUSIONS: The change in color and surface roughness were maximum in the case of FDPs prepared using autopolymerizing resins, followed by 3D printed, and CAD/CAM milled reins. Show more

Keywords: Smokeless Tobacco, PMMA; 3D printing, CAD/CAM Milling, color stability, surface roughness, Provisional fixed dental prosthesis

DOI: 10.3233/THC-230723

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1697-1711, 2024

Authors: Wang, Ping | Shen, Yue | Chen, Jinghan | Li, Qianwen | Tong, Lin | Li, Xitao

Article Type: Research Article

Abstract: BACKGROUND: Beamforming is vital for medical ultrasound imaging systems. The generalized sidelobe canceller (GSC) beamforming can improve the image quality of lateral resolution, but its performance improvement in contrast and robustness is limited. OBJECTIVE: This paper proposes an improved generalized sidelobe canceller algorithm based on multi-apodization with cross-correlation (MAXB-IGSC), which aims to improve the contrast and robustness of ultrasound imaging while maintaining the high image resolution and background speckle quality of GSC. METHODS: The proposed MAXB-IGSC uses multiple pairs of complementary received apodization functions to process the echo data individually to obtain multiple …pairs of data sets. The average of their normalized cross-correlation coefficients is then calculated and utilized to determine the adaptive subarray length of the GSC covariance matrix and weights the output of the improved GSC. RESULTS: The MAXB-IGSC improves the contrast ratio (CR) by 171.18% in anechoic cyst simulation and by 91.23%/130.97%/171.76% in geabr_0 (a dataset from the University of Michigan) experiment compared with GSC, respectively. Furthermore, MAXB-IGSC exhibits significant noise immunity, which greatly improves the robustness of the imaging. The technology also maintains the brightness and uniformity of the background speckle. CONCLUSION: The proposed MAXB-IGSC has potential for obtaining high-quality ultrasound images in clinical applications. Show more

Keywords: Ultrasound imaging, cross-correlation coefficient, adaptive subarray length, robustness

DOI: 10.3233/THC-230724

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1713-1731, 2024

Authors: Pan, Yanyan | Wu, Xiujuan | Zhu, Miao | Zhang, Tingting | Gao, Lanlan | Zhu, Yamei | Mao, Huijuan | Lv, Xiaolin | Sun, Guozhen

Article Type: Research Article

Abstract: BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the …Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P < 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P < 0.05), and negatively correlated with self-care compliance (r = - 0.35, P < 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P < 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P < 0.05). High RAAQ was associated with high VAS (b = 0.11, 95% CI: 0.05, 0.18), DTI (b = 0.28, 95% CI: 0.17, 0.38), SXI (b = 0.24, 95% CI: 0.14, 0.34) and TDS (b = 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception. Show more

Keywords: End-stage renal disease, maintenance hemodialysis, thirst, RAAQ, RABQ

DOI: 10.3233/THC-230749

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1733-1743, 2024

Authors: Gao, Jing | Zhang, Chao | Xin, Hong

Article Type: Research Article

Abstract: BACKGROUND: Using a COOK® Cervical Ripening Balloon (CCRB) for cervical maturity has become a common clinical practice for the induction of labour (IOL). OBJECTIVE: To develop and validate a predictive instrument that could estimate the risk of a caesarean after IOL in term pregnancies with CCRB treatment. METHODS: The medical records of 415 pregnant women requiring IOL from January 2018 to October 2022 were retrospectively reviewed and randomly selected for training (290) and validation (125) sets in a 7:3 ratio. A model for predicting the risk of a caesarean was virtualised by …a nomogram using logistic regression analysis. RESULTS: After completing the multivariate analysis, parity (odds ratio [OR] = 0.226; p = 0.017), modified Bishop score at induction (OR = 0.688; p = 0.005) and the artificial rupture of membranes (OR = 0.436; p = 0.010) were identified as the predictors for implementing a caesarean delivery after IOL. The decision curve analysis showed that the model achieved a net benefit across all threshold probabilities. CONCLUSION: We successfully constructed a nomogram for caesarean delivery after IOL in pregnancies with CCRB treatment using factors including parity, modified Bishop score at induction and the artificial rupture of membrane. Show more

Keywords: Induction of labour, caesarean delivery, nomogram, Bishop score, cervical ripening balloon

DOI: 10.3233/THC-230761

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1745-1755, 2024

Authors: Hu, Huijun | Ma, Yanfang | Cheng, Aiai | Zhang, Zengqiang

Article Type: Research Article

Abstract: BACKGROUND: There have been studies on the use of cognitive behavioral nursing intervention (CBNI) but the main subjects were patients with secondary glaucoma and there are fewer studies on the care of congenital glaucoma. OBJECTIVE: To explore the clinical value of cognitive behavioral nursing model in patients with congenital glaucoma. METHODS: One hundred and fifty-three postoperative patients with congenital glaucoma treated in our hospital between January 2021 and December 2022 were prospectively selected for the study and randomly divided into a control group (n = 77) and an …observation group (n = 76). The control group was given routine nursing, and the observation group was given cognitive behavioral nursing mode on the basis of the control group. Anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), Connor-Davidson toughness scale, and treatment adherence evaluation scale were used to evaluate the psychological state, mental toughness, treatment adherence, treatment effect and nursing care satisfaction in the two groups before and after 2 weeks of intervention. The efficacy of the treatment was also assessed by determining the visual acuity (VA), intraocular pressure (IOP), and mean defective (MD) value of the visual field of the two groups of patients. RESULTS: After nursing, the SDS score (46.33 ± 6.16 versus 53.21 ± 5.94) and SAS score (44.41 ± 5.6 versus 52.82 ± 6.31) in the observation group were lower than those in the control group (P < 0.05). The scores of optimism (11.55 ± 1.90 versus 8.20 ± 1.95), self-improvement (22.05 ± 3.60 versus 17.60 ± 4.30), tenacity (37.45 ± 3.10 versus 28.90 ± 4.55) and total score (71.35 ± 8.00 versus 56.85 ± 8.50) in the observation group were higher than those in the control group (P < 0.05). After care, the VA of the observation group (0.95 ± 0.22) was greater than that of the control group (0.84 ± 0.16), and the IOP (14.25 ± 0.58 versus 15.89 ± 0.67) and the MD (5.42 ± 0.46 versus 6.68 ± 0.49) of the observation group were less than that of the control group. The difference between the two groups was statistically significant (P < 0.05). The compliance (96.05% versus 85.71%) and nursing satisfaction (96.10% versus 85.71%) of the observation group were higher than those of the control group (P < 0.05). CONCLUSION: Cognitive-behavioural nursing care for glaucoma patients can improve patients’ mental toughness, improve visual acuity, reduce intraocular pressure and mean visual field defect values, and have a positive effect on enhancing patients’ treatment adherence and nursing satisfaction. Show more

Keywords: Cognitive behavioral nursing, congenital glaucoma, compliance, self-management

DOI: 10.3233/THC-230772

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1757-1766, 2024

Authors: Gu, Bao-Di | Wang, Yun | Ding, Rong

Article Type: Research Article

Abstract: BACKGROUND: Malnutrition is a widespread problem in critically ill patients with neurological disorders. OBJECTIVE: The purpose of this study is to investigate the effect of a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support on the outcome metrics in patients with neurological disorders who are critically ill. METHODS: We enrolled 84 participants who were hospitalized in the intensive care unit (ICU) of Yancheng No. 1 People’s Hospital for neurological disorders between June 2018 and December 2021. The participants were randomly assigned to the control group and the test …group. The control group received traditional nutritional support, while the test group was treated with a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support. We collected the general information, feeding tolerance (FT), nutritional risk score, and laboratory indicators before intervention, after intervention for one week, and after intervention for 2 weeks, and other data of the participants. RESULTS: After the intervention, the test group scored significantly lower than the control group in the incidence of gastroparesis and diarrhea, as well as the NUTRIC score, with statistically significant differences (P < 0.001). The prealbumin levels in the test group increased progressively prior to intervention, after intervention for one week, and after intervention for two weeks. Compared to the control group, the test group had higher prealbumin levels prior to intervention, after intervention for one week, and after intervention for two weeks, with statistically significant differences (P < 0.001). CONCLUSION: We developed a multidisciplinary collaborative nutritional treatment model based on a standard unit for nutritional support. This model can improve neural function, FT, and pertinent outcome indicators and is generally applicable. Show more

Keywords: Nervous system diseases, nutrition therapy, patient care team

DOI: 10.3233/THC-230791

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1767-1780, 2024

Authors: Guo, Julong | Ning, Yachan | Pan, Dikang | Wu, Sensen | Gao, Xixiang | Wang, Cong | Guo, Lianrui | Gu, Yongquan

Article Type: Research Article

Abstract: BACKGROUND: Endothelial dysfunction, the earliest stage of atherosclerosis, can be caused by smoking, but its molecular mechanism requires further investigation. OBJECTIVE: This study aimed to use bioinformatics analysis to identify potential mechanisms involved in smoking-related atherosclerotic endothelial dysfunction. METHODS: The transcriptome data used for this bioinformatics analysis were obtained from the Gene Expression Omnibus (GEO) database. The GSE137578 and GSE141136 datasets were used to identify common differentially expressed genes (co-DEGs) in endothelial cells treated with oxidized low-density lipoprotein (ox-LDL) and tobacco. The co-DEGs were annotated using Gene Ontology (GO) and Kyoto Encyclopedia of …Genes and Genomics (KEGG) databases. Additionally, a protein-protein interaction (PPI) network was constructed to visualize their interactions and screen for hub genes. GSE120521 dataset was used to verify the expression of hub genes in unstable plaques. The miRNA expression profile GSE137580 and online databases (starBase 2.0, TargetScan 8.0 and DGIdb v4.2.0) were used to predict the related non-coding RNAs and drugs. RESULTS: A total of 232 co-DEGs were identified, including 113 up-regulated genes and 119 down-regulated genes. These DEGs were primarily enriched in detrimental autophagy, cell death, transcription factors, and cytokines, and were implicated in ferroptosis, abnormal lipid metabolism, inflammation, and oxidative stress pathways. Ten hub genes were screened from the constructed PPI network, including up-regulated genes such as FOS, HMOX1, SQSTM1, PTGS2, ATF3, DDIT3, and down-regulated genes MCM4, KIF15, UHRF1, and CCL2. Importantly, HMOX1 was further up-regulated in unstable plaques (p = 0.034). Finally, a regulatory network involving lncRNA/circRNA-miRNA-hub genes and drug-hub genes was established. CONCLUSION: Atherosclerotic endothelial dysfunction is associated with smoking-induced injury. Through bioinformatics analysis, we identified potential mechanisms and provided potential therapeutic targets. Show more

Keywords: Atherosclerosis, smoke, tobacco, endothelial cells, genes

DOI: 10.3233/THC-230796

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1781-1794, 2024

Authors: Ozcelik, Neslihan | Kıvrak, Mehmet | Kotan, Abdurrahman | Selimoğlu, İnci

Article Type: Research Article

Abstract: BACKGROUND: Lung cancer is the most common type of cancer, accounting for 12.8% of cancer cases worldwide. As initially non-specific symptoms occur, it is difficult to diagnose in the early stages. OBJECTIVE: Image processing techniques developed using machine learning methods have played a crucial role in the development of decision support systems. This study aimed to classify benign and malignant lung lesions with a deep learning approach and convolutional neural networks (CNNs). METHODS: The image dataset includes 4459 Computed tomography (CT) scans (benign, 2242; malignant, 2217). The research type was retrospective; the case-control …analysis. A method based on GoogLeNet architecture, which is one of the deep learning approaches, was used to make maximum inference on images and minimize manual control. RESULTS: The dataset used to develop the CNNs model is included in the training (3567) and testing (892) datasets. The model’s highest accuracy rate in the training phase was estimated as 0.98. According to accuracy, sensitivity, specificity, positive predictive value, and negative predictive values of testing data, the highest classification performance ratio was positive predictive value with 0.984. CONCLUSION: The deep learning methods are beneficial in the diagnosis and classification of lung cancer through computed tomography images. Show more

Keywords: Lung cancer, deep learning, convolutional neural network, GoogLeNet

DOI: 10.3233/THC-230810

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1795-1805, 2024

Authors: Cao, Xu | Pei, Xiaomei

Article Type: Research Article

Abstract: BACKGROUND: Diabetic kidney disease (DKD) is an important microvascular complication of diabetes mellitus (DM). OBJECTIVE: This study aimed to develop predictive nomograms to estimate the risk of DKD in patients with type 2 diabetes mellitus (T2DM). METHODS: The medical records of patients with T2DM in our hospital from March 2022 to March 2023 were retrospectively reviewed. The enrolled patients were randomly selected for training and validation sets in a 7:3 ratio. The models for predicting risk of DKD were virtualized by the nomograms using logistic regression analysis. RESULTS: Among the …enrolled 597 patients, 418 were assigned to the training set, while 179 were assigned to the validation set. Using the predictors included glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), presence of diabetic retinopathy (DR) and duration of diabetes (DD), we constructed a full model (model 1) for predicting DKD. And using the laboratory indexes of HbA1c, HDL-C, and cystatin C (Cys-C), we developed a laboratory-based model (model 2). The C-indexes were 0.897 for model 1 and 0.867 for model 2, respectively. The calibration curves demonstrated a good agreement between prediction and observation in the two models. The decision curve analysis (DCA) curves showed that the two models achieved a net benefit across all threshold probabilities. CONCLUSION: We successfully constructed two prediction models to evaluate the risk of DKD in patients with T2DM. The two models exhibited good predictive performance and could be recommended for DKD screening and early detection. Show more

Keywords: Diabetic kidney disease, type 2 diabetes mellitus, nomogram, risk factor, glycated hemoglobin A1c

DOI: 10.3233/THC-230811

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1807-1818, 2024

Authors: Wang, Luo | Li, Xin | Dong, Xue-Juan | Yu, Xiao-Ling | Zhang, Jing | Cheng, Zhi-Gang | Han, Zhi-Yu | Liu, Fang-Yi | Yu, Jie | Liang, Ping

Article Type: Research Article

Abstract: BACKGROUND: Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC). OBJECTIVE: This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC. METHODS: This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio …of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy. RESULTS: The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: p = 0.036; recurrent HCC: p = 0.026). For patients with primary HCC, the recurrence frequency was reduced (p = 0.002), and recurrence interval (19 months vs. 9 months, p < 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients ⩽ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3+ (p = 0.049), CD8/CD28+ (p = 0.045) were elevated. CONCLUSION: Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients ⩽ 60 years old or with moderately-differentiated HCC or co-infected with HBV. Show more

Keywords: Hepatocellular carcinoma, immunotherapy, ablation, dendritic cell, cytokine killer

DOI: 10.3233/THC-230871

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1819-1834, 2024

Authors: Bai, Yuan | He, Fang | Yu, Ying | Li, Jia

Article Type: Research Article

Abstract: BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) have been shown to die mainly due to disease-induced acute respiratory distress syndrome (ARDS). Prone position ventilation (PPV) is an important ventilation strategy in the management of patients with ARDS. OBJECTIVE: To investigate the application of PPV in ventilation strategies for patients with COVID-19. METHODS: Three hundred patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Shanxi Bethune Hospital from January 2020 to June 2021 were retrospectively collected. Based on body position and conscious state, all patients were divided into three groups: intubation prone …position group (n = 110), awake prone position group (n = 90) and supine position group (n = 100); The acute physiology and chronic health evaluation II (APACHE-II) scores, blood gas indicators, complications and other relevant clinical indicators were compared among the three groups. One-way ANOVA was used to compare means between multiple groups for quantitative information that conformed to a normal distribution. Repeated measures ANOVA was used for repeated measures data. Component comparisons were made using the Kruskal-Wallis H rank sum test for non-normally distributed quantitative data. RESULTS: One-way repeated-measures ANOVA main effect analysis showed different effects of different treatments on PaO2 in patients with COVID-19 (F treatment = 256.231, P < 0.05), with the order of awake prone position group > intubation prone position group > supine position group. The effects of the three different treatments on P/F in patients with COVID-19 (F treatment = 311.661, P < 0.05), with the order of awake prone position group > supine position group > intubation prone position group; Moreover, the three treatments had different effects on APACHE II scores in patients with COVID-19 (F treatment = 201.342, P < 0.05), with the order of intubation prone position group > supine position group > awake prone position group. CONCLUSION: Intubation prone position and awake prone position can improve lung function to some extent in patients with COVID-19, and should be applied as early as possible in patients with COVID-19-induced ARDS. Show more

Keywords: Prone position ventilation, supine position, coronavirus disease 2019, lung function, efficacy

DOI: 10.3233/THC-230874

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1835-1846, 2024

Authors: Zhang, Hua | Wang, Ning | Zhang, Xiao-Yan | Liu, Cong | Zhang, Jing

Article Type: Research Article

Abstract: BACKGROUND: The use of telemonitoring electrocardiogram (ECG) improves the detection rate of various arrhythmias as it offers an extended recording time and does not impose activity restrictions. However, many community hospitals lack the resources to conduct this test due to a lack of cardiac function specialists and antiquated screening equipment. OBJECTIVE: To establish a digital ECG telemonitoring system and remote consultation service between tertiary hospitals and community medical service stations to improve diagnosis and treatment effectiveness. METHODS: We used the PI ECG telemonitoring data acquisition system, with a personal digital assistant (PDA) or …computer serving as the platform for ECG acquisition, storage, display, printing, and transmission. We introduced this system to standardize the storage and transmission of ECG telemonitoring data, and ensure accurate transmission, reproducibility, and preservation of data. RESULTS: The implementation of the PI ECG telemonitoring data acquisition system enabled the sharing of remote ambulatory electrocardiography data between Beijing Shijitan Hospital and its affiliated community hospitals. This has resulted in reduced waiting times for patients to receive reports (from 0.3 to 1 hour, to 0.1 or less), shortened consultation times (from 2 hours to 0.1 hour), and improved patient satisfaction with consultations (> 20% of the patients reported they were highly satisfied). The system successfully combined the goals of intelligence, real-time synchronization, and efficiency, revolutionizing ECG telemonitoring diagnosis in the network era. CONCLUSION: Sharing digital telematics information between tertiary and community hospitals enables a tiered approach to diagnosis and treatment and allows for more efficient, accurate, and convenient remote diagnostics. Show more

Keywords: Community-based medical and health services, digital telemonitoring electrocardiography for diagnosis and treatment, information sharing, tiered diagnosis and treatment

DOI: 10.3233/THC-230914

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1847-1857, 2024

Authors: Badnjević, Almir | Pokvić, Lejla Gurbeta | Smajlhodžić-Deljo, Merima | Spahić, Lemana | Bego, Tamer | Meseldžić, Neven | Prnjavorac, Lejla | Prnjavorac, Besim | Bedak, Omer

Article Type: Research Article

Abstract: BACKGROUND: With the end of the coronavirus disease 2019 (COVID-19) pandemic, it becomes intriguing to observe the impact of innovative digital technologies on the diagnosis and management of diseases, in order to improve clinical outcomes for patients. OBJECTIVE: The research aims to enhance diagnostics, prediction, and personalized treatment for patients across three classes of clinical severity (mild, moderate, and severe). What sets this study apart is its innovative approach, wherein classification extends beyond mere disease presence, encompassing the classification of disease severity. This novel perspective lays the foundation for a crucial decision support system during patient …triage. METHODS: An artificial neural network, as a deep learning technique, enabled the development of a complex model based on the analysis of data collected during the process of diagnosing and treating 1000 patients at the Tešanj General Hospital, Bosnia and Herzegovina. RESULTS: The final model achieved a classification accuracy of 82.4% on the validation data set, which testifies to the successful application of the artificial neural network in the classification of clinical outcomes and therapy in patients infected with viral infections. CONCLUSION: The results obtained show that expert systems are valuable tools for decision support in healthcare in communities with limited resources and increased demands. The research has the potential to improve patient care for future epidemics and pandemics. Show more

Keywords: COVID-19, artificial intelligence, medical techniques, classification, digitization, prediction

DOI: 10.3233/THC-230917

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1859-1870, 2024

Authors: Zou, Li | Dong, Wei | Ai, Ying | Li, Yantao | Cheng, Yun | Feng, Yun

Article Type: Research Article

Abstract: BACKGROUND: Recurrent spontaneous abortion affects approximately 1–2% of reproductive-age women, with roughly half of RSA cases classified as unexplained recurrent spontaneous abortion (URSA). Genetic polymorphisms in eNOS gene have been shown to have significant implications across various disease processes. Nevertheless, the potential impact of eNOS gene polymorphisms on the susceptibility to URSA in Yunnan population has yet to be explored or documented. OBJECTIVE: This study aims to investigate the potential association between specific variations in the eNOS gene (VNTR 4b/a, - 786T > C, and + 894G > …T) and the risk of URSA in Yunnan population. METHODS: A total of 243 URSA patients and 241 healthy females are involved in this study. We conducted amplification of the eNOS gene fragment and performed sanger sequencing to detect the specific eNOS gene polymorphisms, including VNTR 4b/a, - 786T > C, and + 894G > T. Using a multivariate logistic regression model, we evaluate the potential association between eNOS gene polymorphisms (VNTR 4b/a, - 786T > C, and + 894G > T) and the risk of URSA. Furthermore, serum NO levels were measured in URSA patients. RESULTS: The presence of VNTR 4a, - 786C, and + 894T alleles was found to be associated with an increased risk of URSA. Additionally, our study revealed a significant association between the G-C-4b haplotype of the investigated eNOS gene polymorphisms and a predisposition to URSA. Notably, these eNOS polymorphisms were shown to reduce serum NO levels in URSA patients. CONCLUSION: This study provides evidence supporting the association between eNOS gene polymorphisms, VNTR 4b/a, - 786T > C, and + 894G > T, and the occurrence of URSA in Yunnan Province, China. Show more

Keywords: eNOS, URSA, VNTR 4b/a, -786T > C, +894G > T

DOI: 10.3233/THC-230934

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1871-1879, 2024

Authors: Zhou, Quan | Chen, Xurui

Article Type: Research Article

Abstract: BACKGROUND: The need for personalised care in the long-term management of patient health is paramount due to the variability in individual features and responses to specific medication. With the availability of large quantities of electronic patient records, big data analysis presents a valuable opportunity to gain insights into disease presentation and patient impact. OBJECTIVE: This study aims to utilise data science in the medical field to extract unknown information from databases, validate previously obtained data, and enhance personalised patient care. METHODS: An analytics suite is developed for monitoring patient health and treating cholesterol, …thyroid, and diabetes disorders. This suite employs exploratory, predictive, and visual analytics to categorise patient data into multiple tiers and forecast related complication risk and treatment response. RESULTS: The study found that the analytics suite could successfully identify correlations between various biological indicators of patients and disorders. The suite also showcased potential in predicting health risks and responses to treatments. CONCLUSION: The analytics employed in this study suggest advanced methods of data analysis, which could serve as potential decision-making tools for healthcare providers. These methods might lead to improved treatment outcomes, contributing significantly to personalised patient care. Show more

Keywords: Data analytics, neural networks, decision support system, patient monitoring, survival probability and visualization

DOI: 10.3233/THC-230980

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1881-1896, 2024

Authors: Chang, Jihui | Zhang, Shuang | Qiu, XuZhong | Huang, HaiJun | Zhang, Yun | Li, Kai

Article Type: Research Article

Abstract: BACKGROUND: Humeral fracture is a common long bone fracture in orthopedic clinical diagnosis and treatment. OBJECTIVE: To investigate the local temperature increase owing to changes in the specific absorption ratio (SAR) of the human body caused by humeral bone nails during magnetic resonance imaging (MRI). METHODS: A refined geometric model of the upper body was constructed via data segmentation and post-processing using the digital human image dataset. Finally, the geometric model was imported into COMSOL, a 3-T magnetic resonance coil was built, and the operating frequency (128 MHz) was set to analyze the …SAR of the bone-nail pair and temperature changes. RESULTS: The analysis of the changes after bone-nail implantation under different tissue conditions revealed that the SAR and temperature after implantation and fixation were three times higher than those before, and the areas with abrupt changes in SAR and temperature were primarily concentrated in the bone-nail area. CONCLUSION: In MRI, metal implants can cause local elevation of the SAR near the implant in the human body, resulting in a temperature increase around the implant. Consequently, long-term scanning can damage the human body. Show more

Keywords: Bone nails, magnetic resonance imaging, temperature rise effect, specific absorption ratio, digital human

DOI: 10.3233/THC-230995

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1897-1907, 2024

Authors: Loganathan, Prakash Kannan | Dorkins, Charles | Marlow, George | Zahra, James | Tulsianey, Mudit A. | Rowles, Toby J. | Chadwick, Paula

Article Type: Research Article

Abstract: BACKGROUND: Newborn hypothermia at birth remains as global challenge across all settings. The prevention of delivery room hypothermia at birth could potentially reduce neonatal morbidity and mortality. OBJECTIVE: To compare the heat conservation efficacy of Neohelp and Neowrap and evaluate the heat production efficacy of trans-warmer infant mattress (TWM) in a laboratory setting. METHODS: A beaker of water was heated at 60 ∘ C was covered by Neohelp or two layers of Neowrap and left to cool in an open room for 90 minutes and calculated the decay constant. Using …infra-red camera, we measured the maximum temperature and time taken to reach the temperature in the TWM. RESULTS: Neowrap took 863 seconds for the temperature to drop from 37∘ C to 35∘ C, compared with 941 seconds with Neohelp. When activated TWM reached a maximum temperature of 39.3 ± 0.1∘ C. It took 30 seconds when the activator was placed in the centre, compared with 88 seconds when it was at the corner. CONCLUSION: Compared to Neowrap, Neohelp had better heat conservation properties. Activating the metal disk from the TWM center would deliver quicker heat. Show more

Keywords: Hypothermia, neohelp, neowrap, trans-warmer mattress

DOI: 10.3233/THC-231001

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1909-1914, 2024

Authors: Wang, Xiangyun | Chen, Yuanjing | Ai, Hongjun | Li, Panpan | Zhu, Chengjie | Yuan, Jiaying

Article Type: Research Article

Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory complication among the elderly, and its severity can escalate to respiratory failure as the disease progresses. OBJECTIVE: To evaluate the application value of non-invasive ventilation in the clinical treatment of patients with COPD and lung cancer. This study assesses its therapeutic effects and its impact on patients’ quality of life (QoL) as measured by the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. METHODS: A retrospective analysis was conducted on clinical data from 102 patients with COPD and lung cancer. Patients were divided into …two groups: the control group (n = 48), who received conventional treatment, and the observation group (n = 54), who received non-invasive positive pressure ventilation (NIPPV) in addition to conventional treatment. Relevant indicators of curative effect, including blood gas indices, incidence of dyspnoea, improvements in mental health and appetite, and FACT-L QoL scores, were analysed at 2 weeks, 1 month, and 6 months post-treatment. RESULTS: At 2 weeks post-treatment, the observation group who had used NIPPV showed significant improvements in blood gas indices, dyspnoea, mental state and self-care ability compared with the control group (p < 0.05). At 1 month, these benefits persisted and included improved maintenance of body weight (p < 0.05). By 6 months, the observation group had a lower incidence of pulmonary encephalopathy (p < 0.05), and QoL, as measured by the FACT-L scale, improved significantly in the observation group but declined in the control group (p < 0.05). CONCLUSION: NIPPV demonstrates significant efficacy in treating COPD patients with lung cancer, particularly in enhancing curative effects and improving patients’ QoL. Show more

Keywords: Non-invasive ventilation, lung cancer, respiratory failure, quality of life

DOI: 10.3233/THC-231063

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1915-1923, 2024

Authors: Netto, Ann Nita | Abraham, Lizy | Philip, Saji

Article Type: Research Article

Abstract: BACKGROUND: Cardiac diseases are highly detrimental illnesses, responsible for approximately 32% of global mortality [1]. Early diagnosis and prompt treatment can reduce deaths caused by cardiac diseases. In paediatric patients, it is challenging for paediatricians to identify functional murmurs and pathological murmurs from heart sounds. OBJECTIVE: The study intends to develop a novel blended ensemble model using hybrid deep learning models and softmax regression to classify adult, and paediatric heart sounds into five distinct classes, distinguishing itself as a groundbreaking work in this domain. Furthermore, the research aims to create a comprehensive 5-class paediatric phonocardiogram (PCG) …dataset. The dataset includes two critical pathological classes, namely atrial septal defects and ventricular septal defects, along with functional murmurs, pathological and normal heart sounds. METHODS: The work proposes a blended ensemble model (HbNet-Heartbeat Network) comprising two hybrid models, CNN-BiLSTM and CNN-LSTM, as base models and Softmax regression as meta-learner. HbNet leverages the strengths of base models and improves the overall PCG classification accuracy. Mel Frequency Cepstral Coefficients (MFCC) capture the crucial audio signal characteristics relevant to the classification. The amalgamation of these two deep learning structures enhances the precision and reliability of PCG classification, leading to improved diagnostic results. RESULTS: The HbNet model exhibited excellent results with an average accuracy of 99.72% and sensitivity of 99.3% on an adult dataset, surpassing all the existing state-of-the-art works. The researchers have validated the reliability of the HbNet model by testing it on a real-time paediatric dataset. The paediatric model’s accuracy is 86.5%. HbNet detected functional murmur with 100% precision. CONCLUSION: The results indicate that the HbNet model exhibits a high level of efficacy in the early detection of cardiac disorders. Results also imply that HbNet has the potential to serve as a valuable tool for the development of decision-support systems that aid medical practitioners in confirming their diagnoses. This method makes it easier for medical professionals to diagnose and initiate prompt treatment while performing preliminary auscultation and reduces unnecessary echocardiograms. Show more

Keywords: Blended ensemble, mel frequency cepstral coefficient, meta-learner, phonocardiogram, softmax regression

DOI: 10.3233/THC-231290

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1925-1945, 2024

Authors: Liu, Lili

Article Type: Research Article

Abstract: BACKGROUND: Osteoporosis is a medical disorder that causes bone tissue to deteriorate and lose density, increasing the risk of fractures. Applying Neural Networks (NN) to analyze medical imaging data and detect the presence or severity of osteoporosis in patients is known as osteoporosis classification using Deep Learning (DL) algorithms. DL algorithms can extract relevant information from bone images and discover intricate patterns that could indicate osteoporosis. OBJECTIVE: DCNN biases must be initialized carefully, much like their weights. Biases that are initialized incorrectly might affect the network’s learning dynamics and hinder the model’s ability to converge to …an ideal solution. In this research, Deep Convolutional Neural Networks (DCNNs) are used, which have several benefits over conventional ML techniques for image processing. METHOD: One of the key benefits of DCNNs is the ability to automatically Feature Extraction (FE) from raw data. Feature learning is a time-consuming procedure in conventional ML algorithms. During the training phase of DCNNs, the network learns to recognize relevant characteristics straight from the data. The Squirrel Search Algorithm (SSA) makes use of a combination of Local Search (LS) and Random Search (RS) techniques that are inspired by the foraging habits of squirrels. RESULTS: The method made it possible to efficiently explore the search space to find prospective values while using promising areas to refine and improve the solutions. Effectively recognizing optimum or nearly optimal solutions depends on balancing exploration and exploitation. The weight in the DCNN is optimized with the help of SSA, which enhances the performance of the classification. CONCLUSION: The comparative analysis with state-of-the-art techniques shows that the proposed SSA-based DCNN is highly accurate, with 96.57% accuracy. Show more

Keywords: Osteoporosis, classification, accuracy, optimization, bias, neural network, and squirrel search

DOI: 10.3233/THC-231517

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1947-1965, 2024

Authors: Sun, Yi | Ren, Tao | Ji, Xueli

Article Type: Research Article

Abstract: BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). …Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization. Show more

Keywords: Hyperbaric oxygen therapy-specialized care, hyperbaric oxygen, cerebral infarction, motor function, mental state

DOI: 10.3233/THC-231643

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1967-1976, 2024

Authors: Wu, Mingzhen | Luan, Jixin | Zhang, Di | Fan, Hua | Qiao, Lishan | Zhang, Chuanchen

Article Type: Research Article

Abstract: BACKGROUND: Histopathological evaluation is currently the gold standard for grading gliomas; however, this technique is invasive. OBJECTIVE: This study aimed to develop and validate a diagnostic prediction model for glioma by employing multiple machine learning algorithms to identify risk factors associated with high-grade glioma, facilitating the prediction of glioma grading. METHODS: Data from 1114 eligible glioma patients were obtained from The Cancer Genome Atlas (TCGA) database, which was divided into a training set (n = 781) and a test set (n = 333). …Fifty machine learning algorithms were employed, and the optimal algorithm was selected to construct a prediction model. The performance of the machine learning prediction model was compared to the clinical prediction model in terms of discrimination, calibration, and clinical validity to assess the performance of the prediction model. RESULTS: The area under the curve (AUC) values of the machine learning prediction models (training set: 0.870 vs. 0.740, test set: 0.863 vs. 0.718) were significantly improved from the clinical prediction models. Furthermore, significant improvement in discrimination was observed for the Integrated Discrimination Improvement (IDI) (training set: 0.230, test set: 0.270) and Net Reclassification Index (NRI) (training set: 0.170, test set: 0.170) from the clinical prognostic model. Both models showed a high goodness of fit and an increased net benefit. CONCLUSION: A strong prediction accuracy model can be developed using machine learning algorithms to screen for high-grade glioma risk predictors, which can serve as a non-invasive prediction tool for preoperative diagnostic grading of glioma. Show more

Keywords: Glioma, machine learning, prediction model, grading, risk predictors

DOI: 10.3233/THC-231645

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1977-1990, 2024

Authors: Muniasamy, Anandhavalli | Begum, Arshiya | Sabahath, Asfia | yaqub, Humara | Karunakaran, Gauthaman

Article Type: Research Article

Abstract: BACKGROUND: Coronary heart disease (CHD) is one of the deadliest diseases and a risk prediction model for cardiovascular conditions is needed. Due to the huge number of features that lead to heart problems, it is often difficult for an expert to evaluate these huge features into account. So, there is a need of appropriate feature selection for the given CHD dataset. For early CHD detection, deep learning modes (DL) show promising results in the existing studies. OBJECTIVE: This study aimed to develop a deep convolution neural network (CNN) model for classification with a selected number of …efficient features using the LASSO (least absolute shrinkage and selection operator) technique. Also, aims to compare the model with similar studies and analyze the performance of the proposed model using accuracy measures. METHODS: The CHD dataset of NHANES (National Health and Nutritional Examination Survey) was examined with 49 features using LASSO technique. This research work is an attempt to apply an improved CNN model for the classification of the CHD dataset with huge features CNN model with feature extractor consists of a fully connected layer with two convolution 1D layers, and classifier part consists of two fully connected layers with SoftMax function was trained on this dataset. Metrics like accuracy recall, specificity, and ROC were used for the evaluation of the proposed model. RESULTS: The feature selection was performed by applying the LASSO model. The proposed CNN model achieved 99.36% accuracy, while previous studies model achieved over 80 to 92% accuracy. CONCLUSION: The application of the proposed CNN with the LASSO model for the classification of CHD can speed up the diagnosis of CHD and appears to be effective in predicting cardiovascular disease based on risk features. Show more

Keywords: Coronary heart disease, deep learning, machine learning, LASSO, convolutional neural network

DOI: 10.3233/THC-231807

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1991-2007, 2024