Technology and Health Care - Volume 32, issue 6

Authors: Rajeshkumar, C. | Soundar, K. Ruba

Article Type: Research Article

Abstract: BACKGROUND: Due to the increasing prevalence of respiratory diseases and the importance of early diagnosis. The need for non-invasive and touchless medical diagnostic solutions has become increasingly crucial in modern healthcare to detect lung abnormalities. OBJECTIVE: Existing methods for lung abnormality detection often rely on invasive and time-consuming procedures limiting their effectiveness in real-time diagnosis. This work introduces a novel Touchless Lung Abnormality (TO-LAB) detection model utilizing universal software radio peripherals (USRP) and machine learning algorithms. METHODS: The TO-LAB model integrates a blood pressure meter and an RGB-D depth-sensing camera to gather individual …data without physical contact. Heart rate (HR) is analyzed through image conversion to IPPG signals, while blood pressure (BP) is obtained via analog conversion from the blood pressure meter. This touchless imaging setup facilitates the extraction of essential signal features crucial for respiratory pattern analysis. Advanced computer vision algorithms like Mel-frequency cepstral coefficients (MFCC) and Principal Component Analysis (PCA) process the acquired data to focus on breathing abnormalities. These features are then combined and inputted into a machine learning-based Multi-class SVM for breathing activity analysis. The Multi-class SVM categorizes breathing abnormalities as normal, shallow, or elevated based on the fused features. The efficiency of this TO-LAB model is evaluated with the simulated and real-time data. RESULTS: According to the findings, the proposed TO-LAB model attains the maximum accuracy of 96.15% for real time data; however, the accuracy increases to 99.54% for simulated data for the efficient classification of breathing abnormalities. CONCLUSION: From this analysis, our model attains better results in simulated data but it declines the accuracy while processing with real-time data. Moreover, this work has a significant medical impact since it presents a solution to the problem of gathering enough data during the epidemic to create a realistic model with a large dataset. Show more

Keywords: Breathing abnormality, touchless detection, universal software radio peripherals, machine learning, multi-class SVM

DOI: 10.3233/THC-240149

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4309-4330, 2024

Authors: Ni, Boye | Jin, Huaping | Wu, Wei

Article Type: Research Article

Abstract: BACKGROUND: According to the Global Burden of Disease Study the prevalence of stroke worldwide has significantly increased from 1990 to 2019, making it the second leading cause of death worldwide. Approximately 70%–80% of stroke patients are unable to live independently due to disability. OBJECTIVE: To explore the therapeutic effect of proprioceptive neuromuscular facilitation (PNF) combined with muscle energy technique (MET) on post-stroke dysphagia. METHODS: A total of 122 stroke patients with dysphagia admitted to our hospital from January 2017 to December 2020 were divided into the control group (n = …61) and the study group (n = 61). Patients in the control group received conventional rehabilitation plans, while those in the study group were given a combined therapy of MET and PNF. Standard Swallowing Function Assessment Scale (SSA), Videofluoroscopic Swallow Study (VFSS), Swallowing Quality of Life (SWAL-QOL) scores, Water Swallow Test (WST) grading, and efficacy indicators were compared between two group with t -tests, Wilcoxon signed-rank test, χ 2 test or Fisher’s exact probability test. RESULTS: After treatment, the study group showed lower SSA score (P = 0.036), and VFSS, P = 0.013 than the control group. The changes in SSA score (P = 0.013) and VFSS score (P < 0.001) in the study group were greater than the control group. Furthermore, after treatment, both the study group and the control group showed a decrease in WST grading (P < 0.001); and the degree of post-treatment WST grading decline in the study group was higher (P = 0.009). Besides, after treatment, the SWAL-QOL score of the study group was higher than the control group (P < 0.001); and the effective rate of patients in the study group was higher than that in the control group (P = 0.021). CONCLUSION: Compared with traditional rehabilitative training strategies, PNF combined with MET can effectively improve swallowing function, and enhance the quality of life in patients with post-stroke dysphagia. Show more

Keywords: Proprioceptive neuromuscular facilitation, muscle energy technique, stroke, dysphagia

DOI: 10.3233/THC-240220

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4331-4342, 2024

Authors: Lu, Jieting | Sun, Xiaoling | Zhang, Yun

Article Type: Research Article

Abstract: BACKGROUND: Nursing management considers nursing quality management at its core. Evaluation indexes of nursing quality not only control nursing quality, measure work enthusiasm, and judge the difference in nursing levels but also help nurses accurately understand the satisfaction degree of patients. OBJECTIVE: To analyze pediatric tumor nursing quality evaluation indexes and establish a scientific and rigorous index system of children’s nursing quality. METHODS:   Based on the “structure-process-result” in this study, the Delphi method was used to carry out questionnaire investigations and opinion collection for domestic experts in pediatrics, pediatric oncology internal medicine, and pediatric oncology …surgical care and clinical aspects two times. In addition, the Kendall coordination coefficient and analytic hierarchy process were used to determine the content of indicators at all levels, set the weight, and finally establish the quality index system of pediatric tumor nursing. RESULTS: The response rate of 27 experts in the first round of the questionnaire was 100%, Ca0.77, Cs,0.73, Cr0.75, and the W value of the expert coordination coefficient was 0.315. In the second round of 27 expert consultations, the reply rate was 96%, Ca0.81, Cs0.80, Cr0.805, and the specialist coordination coefficient W value was 0.369. After two rounds of consultation, the importance evaluation scores of each indicator ranged from 3.31 to 4.88 and 3.29 to 5.00, respectively, and more than 94.7% of the indicators’ importance evaluation scores were higher than 3.50. Finally, 3 Level-1 indicators, 12 Level-2 indicators, and 54 Level-3 indicators are established. CONCLUSION: This study has established a simple, comprehensive, and scientific quality index system for pediatric tumor nursing, highlighted the characteristics of pediatric tumor nursing, and provided an evaluation system for specialized nursing of pediatric tumors to more standardized pediatric tumor nursing and contribute to the sustainable and scientific development of pediatric tumor nursing. Show more

Keywords: Pediatric tumor, tumor nursing, quality indexes, Delphi method, health care, semi-structured interview method, oncology nurses

DOI: 10.3233/THC-240252

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4343-4351, 2024

Authors: Tian, Wei | Zhang, Sheng | Gao, Yuan | Wang, Yan | Cui, Qianqian

Article Type: Research Article

Abstract: BACKGROUND: Irrational pharmacotherapy and increasing pharmacy costs remain major concerns in healthcare systems. Pharmacists are expected to employ diagnosis-related group (DRG) data to analyse inpatient pharmacy utilization. OBJECTIVE: This project aimed to pilot an efficient pharmacist-led programme to analyse factors related to pharmacy expenses, evaluate the rational use of drugs in batch processing, and make further interventions based on DRG data. METHODS: Patients from the OB25 (caesarean section without comorbidities or complications) DRG were selected in 2018, and the most relevant factors were identified through statistical analysis. Interventions were implemented by sending monthly …reports on prescribing data and drug review results for the same DRGs to the department starting in 2019. Pre–post comparisons were conducted to demonstrate changes in pharmacy costs and appropriateness at a tertiary teaching hospital with 2,300 beds in China. RESULTS: A total of 1,110 patients were identified from the OB25 DRG data in 2018. Multivariate linear analysis indicated that the number of items prescribed and wards substantially influenced pharmacy expenditure. Drugs labelled as vital, essential, and non-essential revealed that 46.6% of total pharmacy costs were spent on non-essential drugs, whereas 38.7% were spent on vital drugs. The use of inappropriate pharmaceuticals and drug items was substantially reduced, and the average pharmacy cost after intervention was 336.7 RMB in 2020. The benefit–cost ratio of the programme was 9.86. CONCLUSION: Interventions based on DRG data are highly efficient and feasible for reducing inpatient pharmacy costs and non-essential drug use. Show more

Keywords: Diagnosis-related groups, rational use of drugs, cost savings, prescribing behaviour, pharmacist intervention

DOI: 10.3233/THC-240284

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4353-4363, 2024

Authors: Pélissier, Léna | Beraud, Duane | Pereira, Bruno | Couret, Alexis | Isacco, Laurie | Thivel, David

Article Type: Research Article

Abstract: BACKGROUND: Exploring the independent effect of mechanical discharge in response to weight loss (WL) seems necessary but remains highly challenging from a methodological point. Anti-gravity treadmills could be relevant to simulate a mechanical WL by body weight support (BWS), but their reliability remains unclear to properly explore exercise energy metabolism, especially at low degrees of alleviations. OBJECTIVE: The study aimed to evaluate the accuracy and reproducibility of an anti-gravity treadmill to generate BWS, and the reproducibility of cardiometabolic responses to an exercise performed at low degrees of BWS on this device. METHODS: Observed …BWS of 18 normal-weight males was obtained twice at seven degrees of target BWS (i.e., 0, 3, 6, 9, 12, 15, 18%) using a digital scale inside the anti-gravity treadmill, and was compared to the expected BWS. Then, 15 of them performed 5-min bout of low-intensity walking exercise at these degrees of BWS in a randomized order, separated by 4-min rest. The exercise was identically repeated on three occasions separated by a minimum of 3 days. Energy metabolism and heart rate (HR) were measured throughout the exercise by indirect calorimetry and a HR monitor, respectively. RESULTS: The observed BWS were significantly different from the expected BWS (p < 0.001), and there was a high inter- and intra-individual variability in BWS generated by the anti-gravity treadmill. Results showed an overall good reliability of VO2 (intraclass correlation coefficients (ICC) values ranging from 0.67 to 0.85) and HR (ICC > 0.8) in response to exercise. An effect of the degree of BWS was observed for VO2 (p < 0.001), illustrating reduced values at 15% and 18% of BWS compared to 0, 3, and 6%. CONCLUSIONS: Such device might not be adapted to simulate low degrees of WL in normal-weight males, particularly when it comes to the exploration of energy metabolism. Show more

Keywords: Lower-body positive pressure, accuracy, alleviation, exercise, energy metabolism

DOI: 10.3233/THC-240314

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4365-4380, 2024

Authors: H, Summia Parveen | S, Karthik | R, Sabitha

Article Type: Research Article

Abstract: BACKGROUND: Early pregnancy thyroid function assessment in mothers is covered. The benefits of using load-specific reference ranges are well-established. OBJECTIVE: We pondered whether the categorization of maternal thyroid function would change if multiple blood samples obtained early in pregnancy were used. Even though binary classification is a common goal of current disease diagnosis techniques, the data sets are small, and the outcomes are not validated. Most current approaches concentrate on model optimization, focusing less on feature engineering. METHODS: The suggested method can predict increased protein binding, non-thyroid syndrome (NTIS) (simultaneous non-thyroid disease), autoimmune …thyroiditis (compensated hypothyroidism), and Hashimoto’s thyroiditis (primary hypothyroidism). In this paper, we develop an automatic thyroid nodule classification system using a multi-scale vision transformer and image enhancement. Graph equalization is the chosen technique for image enhancement, and in our experiments, we used neural networks with four-layer network nodes. This work presents an enhanced linguistic coverage neuro-fuzzy classifier with chosen features for thyroid disease feature selection diagnosis. The training procedure is optimized, and a multi-scale vision transformer network is employed. Each hop connection in Dense Net now has trainable weight parameters, altering the architecture. Images of thyroid nodules from 508 patients make up the data set for this article. Sets of 80% training and 20% validation and 70% training and 30% validation are created from the data. Simultaneously, we take into account how the number of training iterations, network structure, activation function of network nodes, and other factors affect the classification outcomes. RESULTS: According to the experimental results, the best number of training iterations is 500, the logistic function is the best activation function, and the ideal network structure is 2500-40-2-1. CONCLUSION: K-fold validation and performance comparison with previous research validate the suggested methodology’s enhanced effectiveness. Show more

Keywords: Maternal thyroid disease, multi-scale vision transformer, improved linguistic hedges, neural-fuzzy classifier

DOI: 10.3233/THC-240362

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4381-4402, 2024

Authors: Xu, Leilei | Hua, Fu | Li, Changhua | Xu, Tong

Article Type: Research Article

Abstract: BACKGROUND: Laparoscopic and robotic-assisted techniques have gained popularity, and endometrial cancer (EC) remains a significant health problem among women. OBJECTIVE: Minimally invasive surgical (MIS) therapy options for early endometrial cancer will be evaluated for their effectiveness and safety is the aim of this paper. We also investigate the differences in oncologic outcomes between MIS and open surgery (OS) for individuals with early-stage EC. The patient was diagnosed with early-stage EC and treated with laparoscopic surgery and was the focus of a retrospective analysis. 162 patients with early EC were analyzed, with diagnoses occurring between 2002 and …2022. METHODS: The patients were fragmented into two groups, one for OS and another for laparoscopic procedures. The total tumor excision and recurrence rates were identical across the two methods, indicating similar oncologic results. Rates of complications were likewise comparable across the two groups. RESULTS: The quality of life ratings of patients with robotic-assisted surgery was higher than those with laparoscopic surgery. Sixty-two (62.2%) of the 162 patients in this research had OS, whereas Fifty-six (57.8%) had MIS. The probability of recurrence of EC from stages III to IV was significanitly higher in women who had OS. CONCLUSION: Minimally invasive procedures were shown to be effective in treating early-stage EC, and while these findings provide support for their usage, larger multicenter randomized controlled studies are required to verify these results and further examine possible long-term advantages. Patients with early-stage EC, regardless of histologic type, had superior survival rates with MIS compared to OS. Show more

Keywords: Early stage, endometrial cancer (EC), adjuvant treatment, minimally invasive surgery (MIS), open surgery (OS)Highlights•Certain patients with endometrial cancer at an early stage may be candidates for minimally invasive surgical. •There are several benefits to treating early endometrial cancer with minimally invasive surgical.•Selecting patients for minimally invasive treatments of early-stage endometrial cancer and performing thorough preoperative evaluations are essential for maximizing the probability of success.

DOI: 10.3233/THC-240439

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4403-4415, 2024

Authors: Cheng, Changfeng | Wang, Jiening | Yang, Kun | Wu, Xubo | Ren, Xue | Liu, Tiantian | Zhao, Zhongzhi | Zhang, Beibei | Ma, Bitao | Jiang, Liming

Article Type: Research Article

Abstract: BACKGROUND: Knee osteoarthritis is a common degenerative joint disease where a single treatment method often fails to fully alleviate symptoms. Hence, finding effective non-invasive combined treatment approaches is particularly crucial. OBJECTIVE: The efficacy of treating knee osteoarthritis with hip abductors exercise training combined with repetitive transcranial magnetic stimulation was assessed through functional scales and objective evaluation methods. METHODS: In this four-week randomized clinical trial, 160 patients meeting inclusion criteria were randomly assigned 1:1 to group A to receive oral celecoxib and group B to receive a combination of hip abductors exercise training and …repeated transcranial magnetic stimulation. The primary outcome was the western Ontario and McMaster universities osteoarthritis index. The secondary outcomes include Visual Analogue Scale, knee outcome survey activities of daily living scale, Active Range of Motion, and the Quadriceps Angle, the tibiofemoral angle, peak adductor moment, the integrated electromyography and root mean square of the surface electromyography of the lower extremity muscles. Paired sample t test was used for Within-Group comparison of outcome indicators, and independent sample t test was used for Between-Group comparison. RESULTS: Of the 160 randomly assigned patients, 150 completed the study. After 4 weeks, the WOMAC index decreased from 61 ± 10.83 to 40.55 ± 7.58 in the combined treatment group and from 60.97 ± 10.18 to 47.7 ± 10.13 in the celecoxib group. The effect of the combined treatment group was significantly higher than that in the celecoxib group (P < 0.001). In the combined treatment group, the score of knee joint daily living scale increased (P < 0.001), the active range of motion increased (P < 0.001), the quadriceps angle decreased (P < 0.001), the tibiofemoral angle increased (P < 0.001), and the peak adduction moment decreased (P < 0.001), integrated electromyography and root mean square increased (P < 0.001), and the effect was better than that of celecoxib group (P < 0.001). The visual analog scale score in celecoxib group was lower (P < 0.001) and knee outcome survey activities of daily living scale was higher (P < 0.001). The incidence of treatment-related adverse events was 10% in the celecoxib group and 2.5% in the combined treatment group, all of which were mild. CONCLUSIONS: Hip abductors exercise training combined with repetitive transcranial magnetic stimulation can enhance abduction muscle strength, improve mobility, reduce joint pain, and enhance quality of life. This combined approach shows superior clinical effectiveness compared to oral celecoxib. Show more

Keywords: Knee osteoarthritis, hip abductors exercise training, repetitive transcranial magnetic stimulation, surface electromyography, celecoxib

DOI: 10.3233/THC-240456

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4417-4430, 2024

Authors: Wang, Zhanchao | Wang, Wei | Zuo, Bin | Lu, Hua

Article Type: Research Article

Abstract: BACKGROUND: Osteoarthritis (OA) and osteoporosis (OS) are the most common orthopedic diseases. OBJECTIVE: To identify important genes as biomarkers for the pathogenesis of OA and OS. METHODS: Microarray data for OA and OS were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) between the OA and healthy control groups and between the OS and healthy control groups were identified using the Limma software package. Overlapping hub DEGs were selected using MCC, MNC, DEGREE, and EPC. Weighted gene co-expression network analysis (WGCNA) was used to mine OA- and OS-related modules. Shared …hub DEGs were identified, human microRNA disease database was used to screen microRNAs associated with OA and OS, and an miRNA-target gene network was constructed. Finally, the expression of shared hub DEGs was evaluated. RESULTS: A total of 104 overlapping DEGs were identified in both the OA and OS groups, which were mainly related to inflammatory biological processes, such as the Akt and TNF signaling pathways Forty-six hub DEGs were identified using MCC, MNC, DEGREE, and EPC modules using different algorithms. Seven modules with 392 genes that highly correlated with disease were identified in the WGCNA. Furthermore, 10 shared hub DEGs were identified between the OA and OS groups, including OGN, FAP, COL6A3, THBS4, IGFBP2, LRRC15, DDR2, RND3, EFNB2, and CD48. A network consisting of 8 shared hub DEGs and 55 miRNAs was constructed. Furthermore, CD48 was significantly upregulated in the OA and OS groups, whereas EFNB2, DR2, COL6A3, and RND3 were significantly downregulated in OA and OS. Other hub DEGs were significantly upregulated in OA and downregulated in OS. CONCLUSIONS: The ten genes may be promising biomarkers for modulating the development of both OA and OS. Show more

Keywords: Osteoarthritis, osteoporosis, hub DEGs

DOI: 10.3233/THC-240574

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4431-4444, 2024

Authors: Yu, Qing | Hu, Jing

Article Type: Research Article

Abstract: BACKGROUND: The number of cesarean sections performed is increasing every year, and obstetric anesthesia is of great interest to physicians and research scholars because of its specificity, high risk, and high complication rate. OBJECTIVE: To investigate the effects of combined spinal epidural anesthesia (CSEA) with different intervertebral spaces during cesarean section on anesthesia effect, anesthesia onset time, anesthesia recovery time, maternal adverse reactions, and neonates. METHODS: Ninety-two women who underwent cesarean section in our hospital from September 2022 to February 2023 were selected as the study subjects and randomly divided them into two …groups (group A and group B), 46 women in each group. Group A underwent CSEA via an L2-3 gap and group B underwent CSEA via an L3-4 gap puncture. The anesthesia effect, anesthesia onset time, sensory recovery time, adverse effects, and neonatal Apgar score were compared between the two groups. RESULTS: When CSEA was performed from L2-3, the anesthesia efficiency was higher, but the difference was not statistically significant. When anesthesia was performed by puncture from L2-3, the onset of anesthesia and recovery time was shorter, and the incidence of intraoperative maternal nausea and vomiting, hypotension, respiratory depression, and other adverse reactions was low with a statistically significant difference. However, the Apgar scores of the neonates in the two groups have no difference. CONCLUSIONS: When CSEA is induced via L2-3 interspace, anesthesia has a rapid onset of action, shorter recovery time, and few maternal adverse effects, without affecting the final anesthetic outcome. Show more

Keywords: Combined spinal-epidural anesthesia, intervertebral spaces, cesarean section, difference

DOI: 10.3233/THC-240599

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4445-4452, 2024