Technology and Health Care - Volume 32, issue 6

Authors: Hsiao, Min-Chien | Yen, Yu-Chun | Wang, Chun-Hsiang | Chen, Yen-Nien | Wang, Shun-Ping | Su, Kuo-Chih

Article Type: Research Article

Abstract: BACKGROUND: To avoid risks of mucosal infection from contact lenses removal, a contact lens plunger is often used. OBJECTIVE: Given various types of contact lens plungers available on the market, no study has yet been done on mechanical effects of the contact lens plunger on contact lens removal. Here, this study used finite element analysis to investigate the effects of plunger size and plunger position on the removal of soft and rigid gas permeable (RGP) contact lenses. METHODS: First, we established finite element analysis models for the plunger, contact lens, cornea, and aqueous …humor. The plunger is made of mostly silicone rubber, and the contact lenses are mainly made of soft and hard material. The part of the plunger used for removal was located either at the central or the edged position, with pulling 1 mm distance. The main parameters observation indicators of in this study were the reaction force at the fixed end of the cornea, aqueous humor, the von Mises stress of the plunger, the contact lenses, and the cornea. RESULTS: Results of this study showed that when a plunger of a larger diameter was used, the reaction force of the plunger was also larger, especially when applied to RGP lenses, which required a slightly larger force (∼ 0.27 N). Also, when removing a RGP lens from the edge, there was a greater stress at the edge of the contact lens (2.5799 MPa), and this caused a higher stress on both the cornea (0.0165 MPa) and the aqueous humor (0.00114 MPa). CONCLUSIONS: When using a plunger with a larger diameter to remove a RGP lens, although a larger force required, the relatively larger contact area likely reduced the stress on the cornea and aqueous humor, thereby reducing the risk of eye injury. In addition, when removing a RGP lens, the results of this study recommended it to be removed from the plunger edge, as that facilitated the removal of contact lens. Show more

Keywords: Plunger design, contact lenses, finite element analysis, biomechanics

DOI: 10.3233/THC-231983

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4109-4121, 2024

Authors: Chen, Changsheng | Zhang, Yu | Lin, Yuda | Shen, Chong | Zhang, Zhe | Wu, Zhouliang | Qie, Yunkai | Zhao, Gangjian | Hu, Hailong

Article Type: Research Article

Abstract: BACKGROUND: Bone morphogenetic proteins (BMPs) are a group of cancer-related proteins vital for development and progression of certain cancer types. Nevertheless, function of BMP family in pan-cancer was not detailedly researched. OBJECTIVE: Investigating expression pattern and prognostic value of the BMPs family (BMP1-8A and BMP8B) expression across multiple cancer types. METHODS: Our research integrated multi-omics data for exploring potential associations between BMPs expression and prognosis, clinicopathological characteristics, copy number or somatic mutations, immune characteristics, tumor microenvironment (TME), tumor mutation burden (TMB), microsatellite instability (MSI), immune checkpoint genes and drug sensitivity in The Cancer …Genome Atlas (TCGA) tumors. Furthermore, association of BMPs expression and immunotherapy effectiveness was investigated in some confirmatory cohorts (GSE111636, GSE78220, GSE67501, GSE176307, IMvigor210 and mRNA sequencing data from currently undergoing TRUCE01 clinical research included), and biological function and potential signaling pathways of BMPs in bladder cancer (BCa) was explored via Gene Set Enrichment Analysis (GSEA). Eventually, immune infiltration analysis was done via BMPs expression, copy number or somatic mutations in BCa, as well as validation of the expression levels by reverse transcription-quantitative PCR and western blot, and in vitro functional experiments of BMP8A. RESULTS: Discoveries displayed BMPs expression was related to prognosis, clinicopathological characteristics, mutations, TME, TMB, MSI and immune checkpoint genes of TCGA tumors. Anticancer drug sensitivity analysis displayed BMPs were associated with various drug sensitivities. What’s more, it was discovered that expression level of certain BMP family members related to objective response to immunotherapy. By GSEA, we discovered multiple immune-associated functions and pathways were enriched. Immune infiltration analysis on BCa also displayed significant associations among BMPs copy number variations, mutation status and infiltration level of diverse immune cells. Furthermore, differential expression validation and in vitro phenotypic experiment indicated that BMP8A significantly promoted BCa cell proliferation, migration and invasion. CONCLUSIONS: Current results confirmed significance of both BMPs expression and genomic alteration in the prognosis and treatment of diverse cancer types, and suggested that BMPs may be vital for BCa and can possibly be utilized as biomarkers for immunotherapy. Show more

Keywords: Bone morphogenetic proteins, pan-cancer analysis, bladder cancer, tumor microenvironment, prognosis

DOI: 10.3233/THC-232004

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4123-4175, 2024

Authors: Tu, Jin-Peng | Shi, Xiao-Feng | Wang, Hui | Zhao, Jie | Wang, Xin | Mo, Chun-Bai | Song, Wen-Li

Article Type: Research Article

Abstract: BACKGROUND: Renal failure is one of the most common chronic complications of diabetes. Simultaneous pancreas-kidney transplantation (SPK) is considered the preferred treatment for individuals with diabetes and chronic renal failure. This procedure has demonstrated efficacy in enhancing the quality of life for patients and minimizing the complications associated with diabetes. OBJECTIVE: In this study, we analyzed the incidence and safety of complications in different thrombosis prevention techniques post simultaneous pancreas-kidney transplantation (SPK). METHODS: Patients who underwent SPK between January 2019 and December 2022 were selectively categorized into two groups: the heparin group and the …non-heparin group depending on the utilization of low molecular weight heparin. The occurrence of complications and clinical outcomes were subsequently calculated in each group. RESULTS: In this study, we included a total of 58 recipients who underwent SPK, with 36 in the heparin group and 22 in the non-heparin group. Among the 58 participants, there were 3 cases of pancreatic thrombosis complications, with 2 cases (5.6%) in the heparin group and 1 case (4.6%) in the non-heparin group, and the differences were not statistically significant (P > 0.05). Regarding gastrointestinal bleeding, there were 17 cases out of the total 58 patients, with 14 cases (38.9%) in the heparin group and 3 cases (13.6%) in the non-heparin group, and the difference was statistically significant (P < 0.05). CONCLUSION: After surgery, the use of low molecular weight heparin anticoagulation may increase the likelihood of experiencing gastrointestinal bleeding. Prior to the surgery, a comprehensive evaluation of the coagulation status and medical history of the patient should be performed, enabling stratification of risks involved. Based on this assessment, either low-molecular-weight heparin or aspirin should be selected as a preventive measure against thrombosis. Show more

Keywords: Heparin, simultaneous pancreas-kidney transplantation (SPK), thrombosis

DOI: 10.3233/THC-232037

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4177-4185, 2024

Authors: Fragidis, Leonidas | Tsamoglou, Sofia | Kosmidis, Kosmas | Aggelidis, Vassilios

Article Type: Research Article

Abstract: BACKGROUND: The global implementation of Electronic Health Records has significantly enhanced the quality of medical care and the overall delivery of public health services. The incorporation of Evidence-Based Medicine offers numerous benefits and enhances the efficacy of decision-making in areas such as prevention, prognosis, diagnosis, and therapeutic approaches. OBJECTIVE: The objective of this paper is to propose an architectural design of an Evidence-Based Medicine information system based on the Electronic Health Record, taking into account the existing and future level of interoperability of health information systems in Greece. METHODS: A study of the …suggested evidence-based medicine architectures found in the existing literature was conducted. Moreover, the interoperability architecture of health information systems in Greece was analyzed. The architecture design reviewed by specialized personnel and their recommendations were incorporated into the final design of the proposed architecture. RESULTS: The proposed integrated architecture of an Evidence-Based Medicine system based on the Electronic Health Record integrates and utilizes citizens’ health data while leveraging the existing knowledge available in the literature. CONCLUSIONS: Taking into consideration the recently established National Interoperability Framework, which aligns with the European Interoperability Framework, the proposed realistic architectural approach contributes to improving the quality of healthcare provided through the ability to make safe, timely and accurate decisions by physicians. Show more

Keywords: Electronic health records, evidence-based medicine, clinical decision support systems, health information systems

DOI: 10.3233/THC-232042

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4187-4201, 2024

Authors: Gao, Peng | Chen, Lijun | He, Linbo | Lei, Jiang | Luo, Menglu | Gu, Li

Article Type: Research Article

Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease globally, characterized by obstructive ventilatory disorder under pulmonary function tests. Recent years have witnessed a yearly increase in the prevalence of COPD. OBJECTIVE: To investigate the impact of respiratory virus infections on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to perform sequencing typing and mutation analysis of viruses with high detection rate. METHODS: A total of 1523 inpatients with AECOPD admitted to our hospital from April 1,2020 to March 30,2022 were collected and divided into two groups: the …infected group (n = 532) and the non-infected group (n = 991). The related indexes between the two groups were collected and compared (including clinical characteristics and laboratory tests that blood cell count, PCT, CRP, adenovirus, respiratory syncytial virus, rhinovirus, influenza A virus, influenza B virus, etc.). RESULTS: In the infected group, the proportion of patients with palpitations (49.44% VS 8.07%, P < 0.001), lipid metabolism abnormalities (18.42% VS 39.96%, P < 0.001), heart failure (39.85% VS 29.87%, P < 0.001), disease duration (17.48 ± 7.47 VS 12.45 ± 11.43 d, P < 0.001), and poor prognosis (69.55% VS 17.15%, P < 0.001) were higher than those in the non-infected group; Adenovirus (ADV) accounted for 75.94% (404/532) of all infected viruses. 31 virus strains could be categorized into 16 ADV-C1, one ADV-C5, two ADV-B3, three ADV-B7, two ADV-D17, two ADV-D19, and five ADV-D27, which were similar to the serotypes reported in severe pneumonia. Furthermore, three strains of C1 adenovirus were found to be highly homologous to the original strain AF534906 by sequencing, and the phylogenetic trees of the three main structural genes were all on the same branch as the original strain. Base mutations and amino acid variants were found in each structural gene segment. In clinical data, it’s found that patients with mutations are worse than those without mutations. CONCLUSION: Respiratory viruses are common in patients with poor prognosis of AECOPD, especially adenovirus, respiratory syncytial virus. Respiratory virus infections will lead to the deterioration of patients with AECOPD, accompanied by longer treatment cycles and poor prognosis. Show more

Keywords: Chronic obstructive pulmonary disease, respiratory virus infections, genotyping

DOI: 10.3233/THC-240010

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4203-4221, 2024

Authors: R, Seethalakshmi | S, Hariharan | Karnan, Hemalatha | V, Keerthana | V, Akshara

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerosis is a condition which disrupts blood flow due to plaque build-up inside the arteries. Under conditions where consecutive plaques are prevailing blood hammer principle is exhibited. OBJECTIVE: The pressure and shear stress produced at an infinitesimal area act as the governing equation for stent modeling. The leading order pressure lays the foundation for the design of cardiac stents with definite dimensions. METHOD: The designed stent was encapsulated inside a crimper validated through ANSYS-static and transient structural simulation to derive the total deformation, equivalent strain, and stress exerted on the stent. Five …different biomaterials stainless steel 316, cobalt, chromium, platinum, and Poly lactic acid were selected for the material assessment. RESULT: Static and Transient structural analysis for a period of 1 and 10 secs was implemented for a stent with and without a crimper. The material performance in terms of total deformation, equivalent stress, and strain are analyzed. CONCLUSION: The paper envisions the dynamics of blood hammer in atherosclerosis that provides the changes in the pressure and clotting process. It shows the promising results of the stent behavior in varied forces which gives valuable insights for future improvement in stent design and material selection. Show more

Keywords: Atherosclerosis, blood hammer, stent, transient

DOI: 10.3233/THC-240051

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4223-4238, 2024

Authors: Bhatt, Ashish | Nigam, Vineeta Saxena

Article Type: Research Article

Abstract: BACKGROUND: Brain tumor is an extremely dangerous disease with a very high mortality rate worldwide. Detecting brain tumors accurately is crucial due to the varying appearance of tumor cells and the dimensional irregularities in their growth. This poses a significant challenge for detection algorithms. Currently, there are numerous algorithms utilized for this purpose, ranging from transform-based methods to those rooted in machine learning techniques. These algorithms aim to enhance the accuracy of detection despite the complexities involved in identifying brain tumor cells. The major limitation of these algorithms is the mapping of extracted features of a brain tumor in …the classification algorithms. OBJECTIVE: To employ a combination of transform methods to extract texture feature from brain tumor images. METHODS: This paper employs a combination of transform methods based on sub band decomposition for texture feature extraction from MRI scans, hybrid feature optimization methods using firefly and glow-worm algorithms for selection of feature, employment of MKSVM algorithm and stacking ensemble classifier for classification and application of the feature of fusion of different feature extraction methods. RESULTS: The algorithm under consideration has been put into practice using MATLAB, utilizing datasets from BRATS (Brain Tumor Segmentation) for the years 2013, 2015, and 2018. These datasets serve as the foundation for testing and validating the algorithm’s performance across different time periods, providing a comprehensive assessment of its effectiveness in detecting brain tumors. The proposed algorithm achieves maximum detection accuracy, detection sensitivity and specificity up to 98%, 99% and 99.5% respectively. The experimental outcomes showcase the efficiency of the algorithm in detection of brain tumor. CONCLUSION: The proposed work mainly contributes in brain tumor detection in the following aspects: a) use of combination of transform methods for texture feature extraction from MRI scans b) hybrid feature selection methods using firefly and glow-worm optimization algorithms for selection of feature c) employment of MKSVM algorithm and stacking ensemble classifier for classification and application of the feature of fusion of different feature extraction methods. Show more

Keywords: Brain tumor, transform function, feature fusion, optimization, machine learning algorithm

DOI: 10.3233/THC-240052

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4239-4256, 2024

Authors: Hwang, Daon | Cho, Ki Hun

Article Type: Research Article

Abstract: BACKGROUND: Traditional canes have no special functions besides weight support, and their long-term use may cause secondary damage to the musculoskeletal system and gait deviation. OBJECTIVE: This study aimed to investigate the usability of the cane-combined weight support feedback device (CWSFD) to identify areas requiring improvement and the current level of satisfaction. METHODS: As a collet-type device, the CWSFD has a structure allowing attachment and detachment at the lower end of a traditional mono cane. To assess the level of satisfaction and areas of improvement regarding the novel CWSFD, a usability test was …conducted on 10 physical therapists with ⩾ 20 years of clinical experience. The usability test comprised a satisfaction survey questionnaire to determine the level of satisfaction, and an in-depth interview to identify the points of improvement. RESULTS: The usability test demonstrated a moderate or higher level of satisfaction in all tested items, and the in-depth interview revealed that the device should have a lower weight with a greater diversity of feedback. CONCLUSIONS: We anticipate that by implementing the respective improvements, a novel device will be developed in the future; for its commercialization, studies to verify the clinical effectiveness are warranted. Show more

Keywords: Cane, gait, satisfaction, usability test, weight support

DOI: 10.3233/THC-240056

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4257-4265, 2024

Authors: K, Gayathri | N, Uma Maheswari | R, Venkatesh | B, Ganesh Prabu

Article Type: Research Article

Abstract: BACKGROUND: The left ventricle segmentation (LVS) is crucial to the assessment of cardiac function. Globally, cardiovascular disease accounts for the majority of deaths, posing a significant health threat. In recent years, LVS has gained important attention due to its ability to measure vital parameters such as myocardial mass, end-diastolic volume, and ejection fraction. Medical professionals realize that manually segmenting data to evaluate these processes takes a lot of time, effort when diagnosing heart diseases. Yet, manually segmenting these images is labour-intensive and may reduce diagnostic accuracy. OBJECTIVE/METHODS: This paper, propose a combination of different deep neural networks for …semantic segmentation of the left ventricle based on Tri-Convolutional Networks (Tri-ConvNets) to obtain highly accurate segmentation. CMRI images are initially pre-processed to remove noise artefacts and enhance image quality, then ROI-based extraction is done in three stages to accurately identify the LV. The extracted features are given as input to three different deep learning structures for segmenting the LV in an efficient way. The contour edges are processed in the standard ConvNet, the contour points are processed using Fully ConvNet and finally the noise free images are converted into patches to perform pixel-wise operations in ConvNets. RESULTS/CONCLUSIONS: The proposed Tri-ConvNets model achieves the Jaccard indices of 0.9491 ± 0.0188 for the sunny brook dataset and 0.9497 ± 0.0237 for the York dataset, and the dice index of 0.9419 ± 0.0178 for the ACDC dataset and 0.9414 ± 0.0247 for LVSC dataset respectively. The experimental results also reveal that the proposed Tri-ConvNets model is faster and requires minimal resources compared to state-of-the-art models. Show more

Keywords: Left ventricle, convolutional neural networks, deep learning, region of interest, MRI

DOI: 10.3233/THC-240062

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4267-4289, 2024

Authors: Zhang, Hongru | Wang, Chen | Yang, Ning

Article Type: Research Article

Abstract: BACKGROUND: Early identification of sepsis has been shown to significantly improve patient prognosis. OBJECTIVE: Therefore, the aim of this meta-analysis is to systematically evaluate the diagnostic efficacy of machine-learning algorithms for sepsis prediction. METHODS: Systematic searches were conducted in PubMed, Embase and Cochrane databases, covering literature up to December 2023. The keywords included machine learning, sepsis and prediction. After screening, data were extracted and analysed from studies meeting the inclusion criteria. Key evaluation metrics included sensitivity, specificity and the area under the curve (AUC) for diagnostic accuracy. RESULTS: The …meta-analysis included a total of 21 studies with a data sample size of 4,158,941. Overall, the pooled sensitivity was 0.82 (95% confidence interval [CI] = 0.70–0.90; P < 0.001; I 2 = 99.7%), the specificity was 0.91 (95% CI = 0.86–0.94; P < 0.001; I 2 = 99.9%), and the AUC was 0.94 (95% CI = 0.91–0.96). The subgroup analysis revealed that in the emergency department setting (6 studies), the pooled sensitivity was 0.79 (95% CI = 0.68–0.87; P < 0.001; I 2 = 99.6%), the specificity was 0.94 (95% CI 0.90–0.97; P < 0.001; I 2 = 99.9%), and the AUC was 0.94 (95% CI = 0.92–0.96). In the Intensive Care Unit setting (11 studies), the sensitivity was 0.91 (95% CI = 0.75–0.97; P < 0.001; I 2 = 98.3%), the specificity was 0.85 (95% CI = 0.75–0.92; P < 0.001; I 2 = 99.9%), and the AUC was 0.93 (95% CI = 0.91–0.95). Due to the limited number of studies in the in-hospital and mixed settings (n < 3), no pooled analysis was performed. CONCLUSION: Machine-learning algorithms have demonstrated excellent diagnostic accuracy in predicting the occurrence of sepsis, showing potential for clinical application. Show more

Keywords: Sepsis, machine learning, prediction, meta-analysis

DOI: 10.3233/THC-240087

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4291-4307, 2024

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

Authors: K. P, Ajitha Gladis | D, Roja Ramani | N, Mohana Suganthi | P, Linu Babu

Article Type: Research Article

Abstract: BACKGROUND: Gastrointestinal tract (GIT) diseases impact the entire digestive system, spanning from the mouth to the anus. Wireless Capsule Endoscopy (WCE) stands out as an effective analytic instrument for Gastrointestinal tract diseases. Nevertheless, accurately identifying various lesion features, such as irregular sizes, shapes, colors, and textures, remains challenging in this field. OBJECTIVE: Several computer vision algorithms have been introduced to tackle these challenges, but many relied on handcrafted features, resulting in inaccuracies in various instances. METHODS: In this work, a novel Deep SS-Hexa model is proposed which is a combination two different deep …learning structures for extracting two different features from the WCE images to detect various GIT ailment. The gathered images are denoised by weighted median filter to remove the noisy distortions and augment the images for enhancing the training data. The structural and statistical (SS) feature extraction process is sectioned into two phases for the analysis of distinct regions of gastrointestinal. In the first stage, statistical features of the image are retrieved using MobileNet with the support of SiLU activation function to retrieve the relevant features. In the second phase, the segmented intestine images are transformed into structural features to learn the local information. These SS features are parallelly fused for selecting the best relevant features with walrus optimization algorithm. Finally, Deep belief network (DBN) is used classified the GIT diseases into hexa classes namely normal, ulcer, pylorus, cecum, esophagitis and polyps on the basis of the selected features. RESULTS: The proposed Deep SS-Hexa model attains an overall average accuracy of 99.16% in GIT disease detection based on KVASIR and KID datasets. The proposed Deep SS-Hexa model achieves high level of accuracy with minimal computational cost in the recognition of GIT illness. CONCLUSIONS: The proposed Deep SS-Hexa Model progresses the overall accuracy range of 0.04%, 0.80% better than GastroVision, Genetic algorithm based on KVASIR dataset and 0.60%, 1.21% better than Modified U-Net, WCENet based on KID dataset respectively. Show more

Keywords: Gastrointestinal tract, wireless capsule endoscopy, mobile network, structural and statistical features, deep belief network

DOI: 10.3233/THC-240603

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4453-4473, 2024

Authors: Teng, Xiaohuan | Sun, Yanrong | Zhao, Landi | Kang, Yingxian

Article Type: Research Article

Abstract: BACKGROUND: In 2019, approximately 330 million individuals in China were affected by cardiovascular diseases, with 11.4 million cases specifically attributed to coronary artery disease (CAD). A national public health report indicated that the mortality rate for CAD ranged from 121.59 to 130.14 per 100,000 individuals in 2019. The treatments for CAD include lifestyle changes, medications, percutaneous coronary intervention (PCI) and coronary artery bypass grafting. OBJECTIVE: To investigate the management effect of a digital health program in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). METHODS: This retrospective study compares …blood pressure, blood glucose, low-density lipoprotein cholesterol (LDL-C), medication adherence, lifestyle modification, and readmission rate between digital health users and traditional follow-up in post-PCI CAD patients. RESULTS: In this study of 698 CAD patients, the 6-month readmission rate of all patients was 27.4%, with digital health users showing lower rates than those in traditional follow-up (22.6% vs. 32.1%, p = 0.005). Digital health users had significantly higher target achievements rates in blood pressure (79.7% vs. 54.7%, p < 0.001), blood glucose (98.9% vs. 82.5%, p < 0.001) and LDL-C level (71.3% vs. 52.7%, p < 0.001) at 6-month post-PCI. The digital health group had more patients adopting lifestyle changes, including quitting smoking, maintaining a healthy diet, and exercising regularly. In risk factor analysis, digital health utilization (OR = 0.60, 95%CI: 0.40–0.90, p = 0.014) and multivessel disease (double: OR = 1.72, 95%CI: 1.09—2.72, p = 0.02; triple: OR = 2.59, 95%CI: 1.61–4.17, p < 0.001) were independent predictors of CAD-related cardiovascular readmissions. CONCLUSIONS: Post-PCI patients using digital health platforms exhibited improved blood pressure, glucose, and LDL-C control, greater treatment adherence, enhanced lifestyle changes, and reduced six-month readmission rates versus those with traditional follow-up. Show more

Keywords: Coronary artery disease, PCI, disease management, digital health

DOI: 10.3233/THC-240621

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4475-4484, 2024

Authors: Radhakrishnan, Menaka | Ramamurthy, Karthik | Shanmugam, Saranya | Prasanna, Gaurav | S, Vignesh | Y, Surya | Won, Daehan

Article Type: Research Article

Abstract: BACKGROUND: Autism Spectrum Disorder (ASD) is a condition with social interaction, communication, and behavioral difficulties. Diagnostic methods mostly rely on subjective evaluations and can lack objectivity. In this research Machine learning (ML) and deep learning (DL) techniques are used to enhance ASD classification. OBJECTIVE: This study focuses on improving ASD and TD classification accuracy with a minimal number of EEG channels. ML and DL models are used with EEG data, including Mu Rhythm from the Sensory Motor Cortex (SMC) for classification. METHODS: Non-linear features in time and frequency domains are extracted and ML …models are applied for classification. The EEG 1D data is transformed into images using Independent Component Analysis-Second Order Blind Identification (ICA-SOBI), Spectrogram, and Continuous Wavelet Transform (CWT). RESULTS: Stacking Classifier employed with non-linear features yields precision, recall, F1-score, and accuracy rates of 78%, 79%, 78%, and 78% respectively. Including entropy and fuzzy entropy features further improves accuracy to 81.4%. In addition, DL models, employing SOBI, CWT, and spectrogram plots, achieve precision, recall, F1-score, and accuracy of 75%, 75%, 74%, and 75% respectively. The hybrid model, which combined deep learning features from spectrogram and CWT with machine learning, exhibits prominent improvement, attained precision, recall, F1-score, and accuracy of 94%, 94%, 94%, and 94% respectively. Incorporating entropy and fuzzy entropy features further improved the accuracy to 96.9%. CONCLUSIONS: This study underscores the potential of ML and DL techniques in improving the classification of ASD and TD individuals, particularly when utilizing a minimal set of EEG channels. Show more

Keywords: Independent component analysis – Second Order Blind Identification (ICA – SOBI), Continuous Wavelet transform (CWT), stacking classifier, hybrid model, spectrogram, electroencephalogram

DOI: 10.3233/THC-240644

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4485-4503, 2024

Authors: Cui, Lin | Zhang, Xueyan | Wen, Yingying | Li, Cuihua | Zhang, Jianyun | Cui, XiWei | Sun, Hao | Chang, Liu

Article Type: Research Article

Abstract: BACKGROUND: Endoscopic submucosal dissection (ESD) is a well-established treatment for gastrointestinal tumors and enables en bloc resection. Adequate counter traction with good visualization is important for safe and effective dissection. OBJECTIVE: Based on magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD), we would like to explore the feasibility of magnetic hydrogel as an internal magnetic anchor that can be injected into the submucosa through an endoscopic needle to assist colonic endoscopic submucosal dissection. METHODS: This prospective trial was conducted on 20 porcine colons ex vivo. We injected magnetic hydrogel into submucosa of the porcine colons …ex vivo for MAG-ESD to evaluate the traction effect and operation satisfaction. RESULTS: Magnetic hydrogel assisted ESD was successfully performed on 20 porcine colons ex vivo. Adequate counter traction with good visualization was successfully obtained during the procedure of dissection. CONCLUSION: Magnetic hydrogel assisted MAG-ESD is feasible and effective. Show more

Keywords: Magnetic surgery, magnetic hydrogel, magnetic anchor-guided endoscopic submucosal dissection, colonic tumorsMain points:•Magnetic hydrogel can play the role of target magnet during ESD, which can provide adequate counter traction with good visualization and effective dissection;•Magnetic hydrogel can make ESD more simple and efficient, shorten the procedure time, improve the endoscopists’ satisfaction, especially for ESD beginners more friendly.

DOI: 10.3233/THC-240653

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4505-4514, 2024

Authors: Zhao, Zhifeng | Yua, Yadong

Article Type: Research Article

Abstract: BACKGROUND: Lung cancer (LC) is one of the leading causes of death worldwide. Treatment methodologies such as chemotherapy and radiotherapy have improved patient survival rates. Nevertheless, these treatments can also lead to adverse reactions and impact patients’ nutritional status and quality of life (QOL). Antibiotics are commonly used for treating infections, but there is still controversy regarding their potential adverse effects on LC patients. OBJECTIVE: This work aimed to investigate the impact of antibiotic adoption on the nutritional status and QOL of LC patients undergoing radiotherapy or chemotherapy, providing valuable insights for the clinical management of …LC. METHODS: A meta-analysis approach was employed to comprehensively evaluate the relationship by synthesizing relevant literature. Published studies were identified through searches in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. The inclusion criteria encompassed randomized controlled trials, cohort studies, and cross-sectional studies. Assessment indicators included patient weight, BMI, hemoglobin levels, and QOL. Meta-analysis was conducted using software such as the Cochrane Collaboration and RevMan5.3. Heterogeneity was evaluated using the Higgins I 2 index, where values between 25% and 50% indicate moderate heterogeneity, and values greater than 50% indicate substantial heterogeneity. RESULTS: 12 eligible studies involving 1,917 patients were finally included. LC patients who received antibiotics during radiotherapy or chemotherapy were found to have a higher risk of malnutrition. The antibiotic group exhibited a more significant decrease in body mass index (BMI) (P < 0.05) and lower serum albumin levels (P < 0.05) versus the control (C) group. Additionally, the overall QOL scores in the antibiotic group were dramatically lower than those in the C group, showing a significant difference with P < 0.05. Sensitivity analysis indicated that the overall conclusions of this work were robust and unbiased. CONCLUSION: Antibiotics in LC patients undergoing radiotherapy or chemotherapy may increase the risk of malnutrition and decrease their QOL. Hence, physicians should carefully consider antibiotics and take necessary preventive measures and supportive treatments to improve LC patients’ nutritional status and QOL. Show more

Keywords: Antibiotics, lung cancer patients, radiotherapy, chemotherapy, nutritional status, quality of life

DOI: 10.3233/THC-240660

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4515-4536, 2024

Authors: Takahashi, Hakuo | Yamashita, Shingo | Yakura, Nobuki

Article Type: Research Article

Abstract: BACKGROUND: Blood pressure (BP) naturally undergoes fluctuations and variations, particularly during anesthesia administration during surgery, hemodialysis, upper and lower gastrointestinal endoscopy, exercise testing, arterial and venous catheterization, and rehabilitation. These changes in BP may lead to life-threatening events. OBJECTIVES: The performance of the Omron HBP-M4500 device in monitoring blood pressure (BP) in the upper arm was validated according to the International Organization for Standardization (ISO) 81060-2:2018+ amendment (Amd) 1:2020 protocol. METHODS: The device was used to assess 113 participants in the inflation mode, and 107 participants in the deflation mode. All …the patients fulfilled the inclusion criteria, including the arm circumference range and systolic and diastolic BP levels, outlined in the protocol. Data validation and analysis were performed according to the manufacturer’s instructions. RESULTS: In criterion 1, the mean ± standard deviation (SD) values of the differences between the test device and reference BP were - 0.6 ± 5.80/2.8 ± 6.78 mmHg (systolic/diastolic) and - 1.0 ± 5.35/3.2 ± 6.52 mmHg for the inflation and deflation modes, respectively. These data fulfilled the ISO81060-2:2018+ Amd1:2020 requirements of ⩽ 5 ± ⁣ ⩽ 8 mmHg. In criterion 2, the differences were - 0.6 ± 4.44/2.8 ± 6.26 and - 1.0 ± 3.84/3.2 ± 6.09 mmHg for the inflation and deflation modes, respectively, fulfilling criterion 2 with SD values of ⩽ 6.91 and ⩽ 6.87 for systolic BP and ⩽ 6.34 and ⩽ 6.14 for diastolic BP in the inflation and deflation modes, respectively. These two criteria were fulfilled in both studies. CONCLUSION: The Omron HBP-M4500 device, either in inflation or deflation mode, fulfilled the criteria outlined in the ISO protocol. Therefore, this device is valuable for BP measurement in clinical and hospital settings. Show more

Keywords: Blood pressure monitoring device, validation study, international protocol

DOI: 10.3233/THC-240676

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4537-4544, 2024

Authors: Mansoor, C.M.M. | Chettri, Sarat Kumar | Naleer, H.M.M.

Article Type: Research Article

Abstract: BACKGROUND: Heart disease is a severe health issue that results in high fatality rates worldwide. Identifying cardiovascular diseases such as coronary artery disease (CAD) and heart attacks through repetitive clinical data analysis is a significant task. Detecting heart disease in its early stages can save lives. The most lethal cardiovascular condition is CAD, which develops over time due to plaque buildup in coronary arteries, causing incomplete blood flow obstruction. Machine Learning (ML) is progressively used in the medical sector to detect CAD disease. OBJECTIVE: The primary aim of this work is to deliver a state-of-the-art approach …to enhancing CAD prediction accuracy by using a DL algorithm in a classification context. METHODS: A unique ML technique is proposed in this study to predict CAD disease accurately using a deep learning algorithm in a classification context. An ensemble voting classifier classification model is developed based on various methods such as Naïve Bayes (NB), Logistic Regression (LR), Decision Tree (DT), XGBoost, Random Forest (RF), Convolutional Neural Network (CNN), Support Vector Machine (SVM), K Nearest Neighbor (KNN), Bidirectional LSTM and Long Short-Term Memory (LSTM). The performance of the ensemble models and a novel model are compared in this study. The Alizadeh Sani dataset, which consists of a random sample of 216 cases with CAD, is used in this study. Synthetic Minority Over Sampling Technique (SMOTE) is used to address the issue of imbalanced datasets, and the Chi-square test is used for feature selection optimization. Performance is assessed using various assessment methodologies, such as confusion matrix, accuracy, recall, precision, f1-score, and auc-roc. RESULTS: When a novel algorithm achieves the highest accuracy relative to other algorithms, it demonstrates its effectiveness in several ways, including superior performance, robustness, generalization capability, efficiency, innovative approaches, and benchmarking against baselines. These characteristics collectively contribute to establishing the novel algorithm as a promising solution for addressing the target problem in machine learning and related fields. CONCLUSION: Implementing the novel model in this study significantly improved performance, achieving a prediction accuracy rate of 92% in the detection of CAD. These findings are competitive and on par with the top outcomes among other methods. Show more

Keywords: Machine learning, coronary artery disease, heart disease, feature selection, classification

DOI: 10.3233/THC-240740

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4545-4569, 2024

Authors: Liu, Fengjie | Wang, Buquan | Mao, Chenggang

Article Type: Research Article

Abstract: BACKGROUND: Allergic Rhinitis (AR), a prevalent condition in otorhinolaryngology, is mediated by Type 1 hypersensitivity through IgE, characterized by Type 2 inflammatory response and eosinophil infiltration in the nasal mucosa. Since AR disease exhibits significant heterogeneity in symptom severity, an objective assessment of AR severity may facilitate better individualized treatment. OBJECTIVE: To explore the changes in peripheral blood IL-9, Th9, and BAFF levels of allergic rhinitis (AR) in patients and the clinical significance associated with it. METHODS: A retrospective study selected 80 AR patients admitted from January 2022 to October 2022 as the …case group, dividing them into mild and moderate-to-severe groups based on symptom scores. Concurrently, 50 patients without AR, who were treated for nasal bone fractures or underwent septoplasty, were selected as the group for comparison. Alterations in the expression levels of peripheral blood IL-9, Th9, and BAFF were analyzed and compared among the different groups. The diagnostic value of serum BAFF for the severity of AR was analyzed using the receiver operating characteristic (ROC) curve. RESULTS: Noticeable variations were observed in clinical variables among the three groups such as, total IgE levels, peripheral blood eosinophil count and proportion, TNSS, and VAS (P < 0.05), while no statistically significant differences were observed in other variables (P > 0.05). The comparison of IL-9, Th9, and BAFF among the three groups revealed statistically significant differences (P < 0.05). Analysis using multivariate logistic regression revealed that IL-9 (OR = 2.365), Th9 (OR = 2.186), BAFF (OR = 2.307) were influencing factors of moderate-to-severe AR (P < 0.05). The ROC curve indicated that the AUC for the diagnosis of moderate-to-severe AR by IL-9, Th9, BAFF were 0.770, 0.734, 0.761, respectively, and the combined detection AUC was 0.888, an area under the curve higher than individual testing. CONCLUSION: Changes in peripheral blood IL-9, Th9, and BAFF levels in AR patients may function as indicators to assess the level of severity in diagnostic procedures. Show more

Keywords: Allergic rhinitis, peripheral blood, IL-9, Th9, BAFF, clinical significance

DOI: 10.3233/THC-240756

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4571-4580, 2024

Authors: Cai, Zhuhua | Guo, Xueke | Zheng, Ge | Xiang, Junmiao | Liu, Lingyun | Lin, Dongmei | Deng, Xiaohui

Article Type: Research Article

Abstract: BACKGROUND: Elevated levels of tumor necrosis factor-alpha (TNF-α ) have been associated with adverse pregnancy outcomes, specifically recurrent pregnancy loss (RPL). These elevated levels may be associated with the presence of autoantibodies. Although TNF-α inhibitors have shown promise in improving pregnancy rates, further research is needed to comprehend their impact and mechanisms in RPL patients. OBJECTIVE: This study aims to investigate the association between elevated TNF-α levels and autoantibodies in RPL patients, as well as evaluate the effect of TNF-α inhibition on pregnancy outcomes. …METHODS: A total of 249 RPL patients were included in this study. Serum levels of TNF-α , autoantibodies, and complement were measured and monitored. Among these patients, 138 tested positive for TNF-α , while 111 tested negative. The medical records of these patients were retrospectively evaluated. Additionally, 102 patients with elevated TNF-α levels were treated with TNF-α inhibitors, and their pregnancy outcomes were assessed. RESULTS: TNF-α -positive RPL patients had higher levels of complement C1q, anti-cardiolipin (ACL)-IgA, ACL-IgM ,ACL-IgG, thyroglobulin antibody, and Anti-phosphatidylserine/prothrombin IgM antibody, as well as a higher positive rate of antinuclear antibodies compared to TNF-α -negative patients (23.19% vs. 12.6%, P < 0.05). Conversely, complement C3 were lower in TNF-α -positive patients (t test, P < 0.05). The use of TNF-α inhibitors led to a reduction in the early abortion rate (13.7% vs. 44.4%, P < 0.001) and an improvement in term delivery rate (52.0% vs. 27.8%, P = 0.012). Furthermore, patients who used TNF-α inhibitors before 5 weeks of pregnancy had a lower early abortion rate (7.7% vs. 24.3%, P = 0.033) and a higher term delivery rate (69.2% vs. 48.6%, P = 0.033). CONCLUSION: TNF-α plays a role in the occurrence and development of RPL, and its expression is closely associated with autoantibodies and complements. TNF-α inhibitors increase the term delivery rate in TNF-α -positive RPL patients, and their use before 5 weeks of pregnancy may more beneficial. Show more

Keywords: Antinuclear antibodies, anti-phospholipid antibodies, estrogen, human chorionic gonadotropin, pregnancy, pregnancy outcome, tumor necrosis factor

DOI: 10.3233/THC-240757

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4581-4591, 2024

Authors: Hu, Xia | Jiang, Huiqing | Liu, Peizhen | Li, Zhiquan | Zhang, Ruiying

Article Type: Research Article

Abstract: BACKGROUND: The Stepped Care Model (SCM) is an evidence-based treatment approach that tailors treatment intensity based on patients’ health status, aiming to achieve the most positive treatment outcomes with the least intensive and cost-effective interventions. Currently, the effectiveness of the Stepped Care Model in postoperative rehabilitation for TKA (Total Knee Arthroplasty) patients has not been reported. OBJECTIVE: The present study aimed to investigate whether the stepped care model could improve early-stage self-report quality of life and knee function after total knee arthroplasty via a prospective randomized controlled design. METHODS: It was a mono-center, …parallel-group, open-label, prospective randomized controlled study. Patients who aging from 60–75 years old as well as underwent unilateral primary total knee arthroplasty due to end-stage knee osteoarthritis between 2020.06 to 2022.02 were enrolled. Participants were randomized and arranged into two groups in a 1:1 allocation. The control group was given traditional rehabilitation guidance, while the stepped care model group was given continued stepped care. Hospital for special surgery knee score, daily living ability (ADL), knee flexion range, and adverse events at 1, 3, and 6 months after total knee arthroplasty were recorded. RESULTS: 88 patients proceeded to the final analysis. There was no significant difference of age, gender, length of stay, BMI, and educational level between the two groups at the baseline. After specific stepped care model interventions, patients showed significant improvements in HHS in 1 month (85.00 (82.25, 86.00) vs. 80.00 (75.00, 83.00), p < 0.001), 3 months (88.00 (86.00, 92.00) vs. 83.00 (76.75, 85.00), p < 0.001), and 6 months (93.00 (90.25, 98.00) vs. 88.00 (84.25, 91.75), p < 0.001) when compared with the control group. Similar results were also found in both daily living ability and knee flexion angle measurements. No adverse event was observed during the follow-up. CONCLUSION: The present study found that the stepped care model intervention significantly improved early-stage knee function and self-reported life quality after total knee arthroplasty due to knee osteoarthritis. Female patients and those less than 70 years old benefit more from the stepped care model intervention after total knee arthroplasty. Show more

Keywords: Stepped care model, total knee arthroplasty, randomized controlled trail, knee function, life quality

DOI: 10.3233/THC-240780

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4593-4601, 2024

Authors: Wang, Ping | Ma, Shumei | Wang, Xuelian

Article Type: Research Article

Abstract: BACKGROUND: Soft ureteroscopic holmium laser lithotripsy is becoming increasingly popular as the preferred method for treating mid-to-lower ureteral stones. Studies have indicated that the size, composition, hardness, and fragility of the stones can impact the treatment’s effectiveness. OBJECTIVE: To explore the relationship between stone volume, average CT value and operation time and efficiency before ureteral soft lens laser lithotripsy. METHODS: Our study on 126 patients undergoing ureteroscopic holmium laser lithotripsy for ureteral calculi from May 2020 to January 2022 categorized them into groups based on stone volume and CT value. We compared surgical …outcomes and analyzed correlations between stone characteristics, operation parameters, and stone clearance rate to identify independent risk factors influencing treatment efficacy. RESULTS: Group A demonstrated significantly shorter operation durations and lower blood loss compared to Group B, along with higher single stone clearance rates and fewer postoperative complications. Similarly, Group C exhibited shorter operation times, reduced blood loss, higher stone clearance rates, and lower complication rates than Group D. Preoperative stone volume and CT value correlated positively with operation time and stone clearance rate, with both factors identified as independent risk factors affecting ureteral stone clearance following holmium laser lithotripsy. CONCLUSION: The stone volume and average CT value before ureteral soft lens laser lithotripsy show a positive correlation with operation time and efficiency, indicating that larger stone volumes and higher CT values lead to slower lithotripsy speeds and reduced operation efficiency. Furthermore, preoperative stone volume and average CT value are identified as independent risk factors for residual stones. Show more

Keywords: Ureteral soft lens laser lithotripsy, stone volume, stone CT value, operation time, operation efficiency

DOI: 10.3233/THC-240794

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4603-4612, 2024

Authors: Milovanovic, Aleksandar | Isailovic, Velibor | Saveljic, Igor | Filipovic, Nenad

Article Type: Research Article

Abstract: BACKGROUND: Fractional flow reserve (FFR) determined invasively has been globally accepted as the gold standard for determining the functional significance of coronary artery stenoses. However, despite its great importance, the invasive method has certain disadvantages, including the risk of vascular injuries, the need for vasodilation, and significant medical costs. That is why great attention was paid to the development of non-invasive methods that would enable reliable diagnosis without exposing patients to the risk of unwanted consequences. OBJECTIVE: This paper aimed to create and verify an alternative, less resource- and time-demanding, non-invasive solution. METHODS: …The determination of FFR is based on the application of the fundamental laws of fluid dynamics. All energy losses in the coronary artery with stenosis were identified and analyzed in detail. A three-dimensional model of a coronary artery was generated using the corresponding angiographic images. Finally, the pressure due to stenosis was calculated and the FFR was determined. RESULTS: The results obtained using the proposed analytical method were compared with available experimental data for 40 patients who experienced the invasive coronary angiography. The coefficient of determination, mean difference and standard deviation values are determined to be 0.726, - 0.017 and 0.056, respectively. These values were slightly higher for FFR values above 0.80. CONCLUSION: The FFR calculated by the proposed analytical method has a relatively good correlation with clinical data, which leads to the conclusion that it can provide a reliable assessment of the functional significance of coronary stenosis. Show more

Keywords: Coronary artery stenosis, analytical method, fractional flow reserve

DOI: 10.3233/THC-240803

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4613-4626, 2024

Authors: Ren, Die | Cai, Fei | Zhu, Mengqi | Zheng, Yijun | Chen, Wei

Article Type: Research Article

Abstract: BACKGROUND: Breast-conserving surgery is an important treatment for breast cancer, which not only eradicates the disease, but also protects the integrity of the breast, however, postoperative nausea and vomiting often bother patients. OBJECTIVE: This study examines the effects of evidence-based nursing practices on nausea and vomiting in patients after breast-conserving surgery, with the aim of providing new perspectives for clinical nursing practice. METHODS: One hundred and sixty patients who underwent breast-conserving surgery from January 2023 to December 2023 in Fudan University Shanghai Cancer Center were enrolled. The patients were divided into an intervention …group (evidence-based nursing group) and a control group (conventional nursing group) using the random number table method, both groups comprised 80 patients. The control group used conventional nursing methods, and the intervention group added evidence-based nursing intervention on this basis. Comparative analysis focused on the incidence of nausea and vomiting, quality of life metrics, and postoperative satisfaction. RESULTS: In the intervention group, notably lower incidence rates of postoperative nausea and vomiting were observed compared to the control group within both the 0–24 hour and 24–48-hour postoperative periods (P < 0.05). Furthermore, the intervention group exhibited significantly higher scores across all five dimensions as well as the overall score of the FACT-B scale in comparison to the control group (P < 0.05), accompanied by heightened satisfaction with the nursing staff. CONCLUSION: This study demonstrated the positive clinical intervention effects of evidence-based nursing measures and emphasized their importance in improving postoperative nausea and vomiting and quality of life. Future studies are expected to incorporate evidence-based nursing practices into nursing care to improve patient recovery and overall quality of care. Show more

Keywords: Breast cancer, breast-conserving surgery, evidence-based nursing practices, nausea and vomiting, interventions

DOI: 10.3233/THC-240814

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4627-4636, 2024

Authors: Cerrito, Adrien | Fang, Juan | Schertenleib, Simón Javier Gamero | Hunt, Kenneth James | Schmitt, Kai-Uwe

Article Type: Research Article

Abstract: BACKGROUND: Physical inactivity is prevalent among hospitalized patients and the daytime spent lying should be utilised for exercise. However, implementing new interventions in hospitals’ complex daily routines is difficult and requires a participatory approach. OBJECTIVE: Exploring clinical settings and clinicians’ perspectives regarding exercise in hospitalized patients to gauge the potential of further development of an in-bed training device and to formulate development goals. METHODS: A User-Centered Design approach was employed, consisting of work shadowing and focus groups with physiotherapists and nurses. Content and network analyses of the focus group data were performed. Personas …were then developed and used to create clinical scenarios. RESULTS: Some clinicians perceived in-bed exercise counterproductive, while others recognized potential for unsupervised training. The most important design characteristics appeared to be a small size, low weight and simplicity of use to facilitate storage, transportation, and administration, respectively. The scenarios revealed that the device’s use could increase the physical activity time by 1.4%, although it would also increase the working time of clinicians. CONCLUSION: The study highlighted the difficulties in developing a usable training device but encouraged the authors to pursue their efforts under the strict condition of following the formulated development goals. Show more

Keywords: Sedentary behavior, exercise, hospitalization, user-centered design

DOI: 10.3233/THC-240816

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4637-4651, 2024

Authors: Li, Qiang | Lu, Yingjun

Article Type: Research Article

Abstract: BACKGROUND: The POSSUM scoring system, widely employed in assessing surgical risks, offers a simplified and objective approach for the prediction of complications and mortality in patient. Despite its effectiveness in various surgical fields, including orthopedics and cardiovascular surgery, yet its utilization in elderly patients undergoing colorectal cancer surgery is infrequent. OBJECTIVE: To analyze the predictive value of POSSUM scoring system for postoperative complications and mortality in elderly with colorectal cancer. METHODS: 306 elderly colorectal cancer patients were grouped according to the complications and death within 30 days after surgery. Among them, 108 cases …in complication group, 198 cases in non-complication group, 16 cases in death group and 290 cases in survival group. POSSUM scores of all subjects were obtained and its predictive value for postoperative complications and mortality of elderly was conducted by ROC curve. RESULTS: No apparent difference were observed in complications and mortality among patients with different disease types, operation types and operation timing (P > 0.05). The R2 in complication group was higher than non-complication group (P < 0.05). The R1 in death group were higher than survival group (P < 0.05). The AUC of R2 for predicting postoperative complications was 0.955 with a sensitivity of 88.89% and a specificity of 94.44% and the AUC of R1 for evaluating postoperative mortality of elderly with colorectal cancer was 0.783 with a sensitivity of 56.25% and a specificity of 82.93%. CONCLUSION: POSSUM score system has a certain predictive value for postoperative complications and mortality in elderly with colorectal cancer. However, the predicted mortality rate is higher than actual mortality rate. Show more

Keywords: Colorectal cancer, POSSUM scoring system, postoperative complications and mortality, predictive value

DOI: 10.3233/THC-240849

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4653-4660, 2024

Authors: Wang, Bo | Chen, Min | Wu, Yan | Qin, Xiaosai | Meng, Manshi

Article Type: Research Article

Abstract: BACKGROUND: The conventional round suture needle poses a significant risk of needle stick injuries among surgical physicians, identified as a global occupational hazard by the World Health Organization, increasing hospital costs and exposure to bloodborne pathogens. While novel blunt suture needles have shown promise in reducing these risks, their adoption is limited domestically, prompting a study to compare their efficacy against traditional sharp needles in reducing needle stick injuries among surgical physicians. OBJECTIVE: To investigate suture needle stick injuries among surgical doctors during operations and assess the application effectiveness of a novel blunt suture needle. …METHODS: A total of 106 surgical department physicians from March 2021 to February 2023 participated in the study. After completing a questionnaire survey on suture needle injuries during surgery, the participants were divided into two groups. Over a 6-month intervention period, the control group used regular round needles while the study group utilized novel blunt suture needles. Subsequently, suture needle injury incidence rates and economic hygiene benefits were compared between the two groups. RESULTS: The suture needle injury questionnaire survey showed that over the past 6 months, among 106 surgical department physicians, 20 needle stick injuries occurred, yielding an incidence rate of 18.87%. The highest incidence (65.00%) was during suturing incisions longer than 10 cm, primarily when visibility was poor (70.00%). Surgeons linked most injuries (60.00%) to prolonged surgical duration causing fatigue. Although 85.00% detected injuries within 1 minute, only 40.00% were reported, often due to perceived reporting complexity. Following intervention, the study group had significantly fewer injuries per surgery and lower occupational exposure costs compared to the control group (p < 0.05). CONCLUSION: Surgical department physicians commonly sustain suture needle injuries while suturing incisions of 5–10 cm length under poor visibility, exacerbated by prolonged surgical duration. Despite detecting most injuries within 1 minute, only 40% are reported. The implementation of novel blunt suture needles significantly decreases injury rates, resulting in reduced occupational exposure costs and favorable safety and economic hygiene outcomes. Show more

Keywords: Operating room, surgical physicians, blunt suture needle, suture needle stick injury, economic hygiene benefits

DOI: 10.3233/THC-240906

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4661-4670, 2024

Authors: Yu, Lu | Yan, Ruping | Yang, Deling | Xia, Chengxing | Zhang, Zhixian

Article Type: Research Article

Abstract: BACKGROUND: Both radical prostatectomy and radiation therapy are effective in controlling the condition of patients with hormone-resistant prostate cancer (HRPCa). However, there is limited research on the prognosis and quality of life of HRPCa patients after different treatment modalities. OBJECTIVE: To explore the efficacy of radical prostatectomy (RP) and radiotherapy (RT), when treating high-risk prostate cancer (HRPCa). METHODS: Overall 103 HRPCa patients were included and were divided into RP group and RT group according to different treatment methods. The propensity score matching method (PSM) was used to balance the baseline data of the …two groups and match 34 patients in each group. The prognosis, quality of life, and basic efficacy of patients were compared. RESULTS: After intervention, the disease-free survival rate of the RT group was higher than that of the RP group (79.41% vs. 55.88%, p = 0.038). Quality of life scores between the two treatment methods had no difference before intervention (p > 0.05), but higher in RT group than that of the RP group after intervention (p < 0.05). After treatment, there was no statistically significant difference in total effective rate of treatment between two groups (44.12% vs. 58.82%, p > 0.05), but the disease control rate was significantly higher in RT group (94.12% vs. 76.47%, p = 0.040). CONCLUSION: Radical radiotherapy is effective in the clinical treatment of HRPCa patients, with a higher disease-free survival rate and improved quality of life after treatment, and is worth promoting. Show more

Keywords: Radical prostatectomy, radical radiotherapy, disease-free survival rate, quality of life

DOI: 10.3233/THC-240910

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4671-4679, 2024

Authors: Zhang, Yongmin | Wang, Dongbin | Gong, Hao | Tang, Haosen | Dong, Guangqi | Wang, Bin | Xia, Honggang

Article Type: Research Article

Abstract: BACKGROUND: Rib fractures are one of the most common blunt injuries, accounting for approximately 10% of all trauma patients and 60% of thoracic injuries. Multiple rib fractures, especially flail chest, can cause local chest wall softening due to the loss of rib support, leading to paradoxical breathing, severe pain, and a high likelihood of accompanying lung contusions. OBJECTIVE: This study investigates the mechanical properties of a new polymer material rib internal fixator to provide theoretical data for its clinical use. METHODS: We conducted in vitro mechanical tests on 20 fresh caudal fin sheep …ribs, using different fracture models across four randomly assigned groups (five ribs per group). The fixators were assessed using non-destructive three-point bending, torsion, and unilateral compression tests, with results averaged. Additionally, finite element analysis compared stress and strain in the polymer fixators and titanium alloy rib plates during bending and torsion tests. RESULTS: In vitro tests showed that the polymer fixators handled loads effectively up to a maximum without increase beyond a certain displacement. Bending and torsion tests via finite element analysis showed the polymer material sustained lower maximum equivalent stresses (84.455 MPa and 14.426 MPa) compared to titanium alloy plates (219.88 MPa and 46.47 MPa). CONCLUSION: The polymer rib fixator demonstrated sufficient strength for rib fracture fixation and was superior in stress management compared to titanium alloy plates in both bending and torsion tests, supporting its potential clinical application. Show more

Keywords: Rib fracture, internal fixation, rib internal fixator, biomechanics, finite element analysis

DOI: 10.3233/THC-240928

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4681-4694, 2024

Authors: Gong, Feifei | Wang, Hui | Shan, Zhixuan | Zhuang, Shaoyu | Xia, Huakuan | Tang, Liyu

Article Type: Research Article

Abstract: BACKGROUND: Oral cancer has a high worldwide incidence and mortality rate showing an upward trend year by year, predominantly occurring in emerging countries. Oral squamous cell carcinoma (OSCC) is one of the main types of oral cancer, accounting for more than 90% of all cases in oral cancer. OBJECTIVE: To evaluate the diagnostic value of 8-hydroxy-2’-deoxyguanosine (8-OHdG), 8-iso-Prostaglandin F2alpha (8-iso-PGF2α ) and tumor necrosis factor (TNF)-α as biomarkers in the early carcinogenesis of erosive oral lichen planus (EOLP) by measuring their levels in the blood of patients with EOLP and oral …squamous cell carcinoma (OSCC). METHODS: A total of 69 patients were enrolled in this case-control study [including an OSCC group (n = 23), an EOLP group (n = 23), and an age- and gender-matched healthy control group (n = 23)]. Blood levels of 8-OHdG, 8-iso-PGF2α and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA). Statistical differences in these indicators among the three groups were analyzed. RESULTS: Plasma levels of 8-OHdG and 8-iso-PGF2α in the OSCC group were significantly higher than those in both the EOLP group and the control group (all P < 0.05); no significant statistical difference was found between the EOLP group and the control group. Serum levels of TNF-α in both the OSCC and EOLP groups were elevated compared with the control group, showing significant differences among all three groups (all P < 0.05). Receiver operating characteristic (ROC) curves revealed that plasma 8-OHdG and 8-iso-PGF2α levels and serum TNF-α levels had diagnostic effects on early carcinogenesis in EOLP patients. When these indicators were combined for diagnosis, the diagnostic effect was enhanced, with an area under the ROC curve (AUC) values of 0.819. CONCLUSION: 8-OHdG, 8-iso-PGF2α and TNF-α may serve as biological indicators for monitoring the early carcinogenesis of EOLP, and the diagnostic effect was augmented when these indicators were combined. Show more

Keywords: OSCC, erosive oral lichen planus, 8-OHdG, 8-iso-PGF2α, TNF-α

DOI: 10.3233/THC-240930

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4695-4705, 2024

Authors: Du, Huihui | Zhu, Kaiquan

Article Type: Research Article

Abstract: BACKGROUND: Laryngeal cancer is a malignant tumor that originates from the mucous membrane of the larynx. Currently, the specific involvement mechanism of copper death in laryngeal cancer patients has not been deeply studied. OBJECTIVE: This study aims to explore the molecular characteristics and clinical survival significance of copper death-related genes in laryngeal cancer. METHODS: Relevant transcriptomes and clinical data were retrieved and downloaded from the GEO database. Differential expression genes related to laryngeal cancer and copper death were selected, and the immune function, clinical risk correlation, and survival prognosis were analyzed. …RESULTS: The differential analysis results showed that the differential expression genes related to laryngeal cancer and Cu-proptosis included SLC31A1 and ATP7B, and there was interaction between the immune cell groups in the differential genes of copper death in laryngeal cancer. Decreasing the expression of the gene ANXA5 or increasing the expression of the gene SERPINH1 can increase the susceptibility to laryngeal cancer. CONCLUSION: Copper death-related genes can affect the survival prognosis of laryngeal cancer patients. Detection of changes in their expression can provide new diagnostic and treatment directions for the progression of early-stage laryngeal cancer. Show more

Keywords: Laryngeal cancer, copper death, ANXA5, machine learning, GEO

DOI: 10.3233/THC-240932

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4707-4725, 2024

Authors: Veihelmann, A. | Beck, F. | Huth, J. | Spetzger, U. | Schulze-Pellengahr, C. | Teske, W.

Article Type: Research Article

Abstract: BACKGROUND: It is estimated that a significant number of spinal surgeries are performed, but many patients do not often benefit. OBJECTIVE: Our aim was to determine how effective minimally invasive pain procedures (MIP) are in chronic low back pain (CLBP) patients with proven degenerative causes (specific low back pain). METHODS: 386 eligible patients with CLBP/sciatica resistant to conservative therapy and scheduled for open surgery were screened, and 167 could be enrolled in this study. Indications for MIP in the remaining 150 individuals were made by one experienced spinal surgeon. Before and 6 months …after the intervention, the numeric rating scale (NRS) and Oswestry Disability Index (ODI) were recorded. MIP was performed, such as radiofrequency of the facet and SI-joint, intradiscal electrothermal therapy in case of discogenic pain, as well as epidural neuroplasty in patients with disc herniation/epidural fibrosis. RESULTS: There was a statistically significant decrease in NRS (p < 0.05), as well as a significant increase in ODI (p < 0.001) 6 months after the procedures. This was also true for the results of all different pain generators and subsequent performed procedures alone. CONCLUSIONS: The indication of MIP should be routinely reviewed in patients with CLBP to avoid potentially open surgery and a burden on healthcare costs. Show more

Keywords: Minimal invasive surgical procedures, low back pain mechanical, disc herniation, sciatica, discogenic pain

DOI: 10.3233/THC-241003

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4727-4741, 2024

Authors: Yao, Chunying | Ma, Qiubo | Shi, Ying | Zhang, Na | Pang, Lei

Article Type: Research Article

Abstract: BACKGROUND: Membranous nephropathy (MN), also known as membranous glomerulonephritis, is a leading cause of adult nephrotic syndrome. The main pathological features encompass the deposition of immune complexes within the glomerular basement membrane epithelial cells, thickening of the basement membrane, and fusion of the foot process. OBJECTIVE: This study aims to investigate the role of the immune and inflammatory modulator miR-223 in the immunosuppressive and anti-inflammatory effects of cyclophosphamide (CTX) on membranous nephropathy (MN). METHODS: miR-223 mimetics or inhibitors was used to regulate miR-223 levels. LPS induced inflammatory cell model and cell polarization. CTX …was used to treat Lipopolysaccharides (LPS) induced inflammatory response and polarization. Cationic bovine serum albumin (c-BSA) induced BALB/c mouse MN model, while CTX was used to treat c-BSA induced MN. RESULTS: The miR-223 level in LPS induced inflammatory model cells was lower than that in control cells. The levels of inflammatory factors in LPS+ miR-223 mimetics and CTX+ miR-223i cells were lower than those in LPS and miR-223i cells. The protein levels of LPS+ miR-223 mimic, CTX+ miR-223i macrophage M2 phenotype markers Arginase-1 (Arg1), transforming growth factor β 1 (TGF-β 1), anti-inflammatory factors interleukin-4 (IL4) and interleukin-13 (IL13) were significantly higher than those of LPS and miR-223i. The effect of CTX was confirmed in a BALB/c mouse MN model induced by cationic bovine serum albumin (c-BSA). CONCLUSION: CTX upregulates the expression of miR-223, promotes polarization of M2 macrophages, alleviates the inflammatory response and renal injury of MN. Show more

Keywords: Cyclophosphamide, membranous nephropathy, macrophage, miR-223, inflammatory response

DOI: 10.3233/THC-241175

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4743-4756, 2024

Article Type: Other

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4757-4757, 2024

Authors: Lin, Chi | Yu, Chang Wu | Wang, Ning

Article Type: Editorial

DOI: 10.3233/THC-248052

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4759-4764, 2024

Authors: S.S., Akilan | Devprasad, Kayathri Devi | J, Raja Sekar

Article Type: Research Article

Abstract: BACKGROUND: Wireless Body Area Networks (WBANs) are integral to modern healthcare systems, providing continuous health monitoring and real-time data transmission. The sensitivity of medical data being transmitted makes security a significant concern in WBANs. OBJECTIVE: This study explores the application of the Elliptic Curve Cryptography (ECC)-based Diffie-Hellman Key Exchange (ECDH) algorithm to enhance security within WBANs. METHOD: The study investigates the suitability of ECC for this context and evaluates the performance and security implications of implementing ECDH in WBANs. RESULTS: The findings reveal that ECDH provides a robust and computationally …efficient solution for secure key exchange in WBANs, addressing inherent vulnerabilities. CONCLUSION: The adoption of ECC-based ECDH is poised to bolster data confidentiality and integrity in WBANs, promoting trust and widespread use of these networks in healthcare applications. This research contributes to the growing body of knowledge regarding security measures in WBANs and opens new avenues for the secure transmission of sensitive medical information. Show more

Keywords: Wireless Body Area Networks (WBANs), security, Elliptic Curve Cryptography (ECC), Diffie-Hellman key exchange (DHE), ECDH

DOI: 10.3233/THC-231614

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4765-4784, 2024

Authors: Wu, Weihua | Chen, Jie | An, Peng | Feng, Yangmei | Li, Chen | Zhang, Meiqi | Yu, Zhenfei

Article Type: Research Article

Abstract: BACKGROUND: The kidney is the most vulnerable organ in severe patients. In severe cases, the fatality rate of acute kidney damage is as high as 30% ∼ 60%. Severe ultrasound is a non-invasive method to evaluate renal blood flow. It can give a semi-quantitative score of renal blood flow and measure the Resistance Index (RI), which can reflect renal artery blood flow to a certain extent. OBJECTIVE: There is little literature on hemodynamic regulation in septic shock patients, but almost no research report on the relationship between hemodynamics and RI exists. Therefore, this …paper proposed the analysis of severe ultrasound and gene diagnosis in cardiac index and peripheral vascular RI of shock patients. METHODS: This paper mainly expounded on detecting renal function parameters and RI in patients with viral shock to understand further the correlation between them and renal flow and RI. RESULTS: It could be seen from the experimental results that the P values before and after resuscitation in the two groups with and without elevated Cardiac Output (CO) were 0.41 and 0.12, respectively, which were more significant than 0.05. CONCLUSION: RI had no apparent relationship with CO, and RI could not be used as an evaluation index for patients with early septic shock. Show more

Keywords: Severe ultrasound, shock patients, gene diagnosis, genetic algorithm

DOI: 10.3233/THC-231859

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4785-4800, 2024

Authors: Yu, Limei | Wang, Yuxia | Chen, Yun | Wang, Yakun | Zhang, Haida | Zhang, Meiqi | Li, Chen

Article Type: Research Article

Abstract: BACKGROUND: The incidence of brain injury is increasing year by year, and it has become one of the major diseases threatening human life in today’s society. From the perspective of the causes of brain injury, it is mainly due to falls from high places, traffic accidents, etc. Severe brain injury patients often lose consciousness. In recent years, the emergence of integrated traditional Chinese and Western medicine has provided a new approach and new ideas for the treatment of craniocerebral trauma. OBJECTIVE: The article systematically and scientifically expounded the role of Xingnaojing injection in the treatment of …brain injury by comparing the GCS (Glasgow Coma Scale) score, changes in intracranial pressure, the incidence of complications after brain injury, the transformation from moderate brain injury to severe brain injury, and recovery of consciousness. METHODS: For the problem of gene polymorphism in patients with brain injury, this article discussed the role of APOE2 (Apolipoprotein E2), ε 3, ε 4 in brain injury. All patients had a clear history of trauma and received strict nervous system examination and CT scanning when they were admitted to the hospital. After craniocerebral trauma surgery or conservative therapy, patients should take a Xingnaojing injection of 30 ml and a 0.9% sodium chloride injection of 250 ml after admission. After the operation, respiratory tract nursing should be strengthened, and patients who cannot eat should be given nasal feeding, acupuncture, and physiotherapy to prevent bedridden complications. RESULTS: The probability of epilepsy after brain injury was 27%. CONCLUSION: The article would help to evaluate the degree of brain damage and prognosis of patients. Show more

Keywords: Xingnaojing injection, craniocerebral injury, gene polymorphism, quantitative evaluation

DOI: 10.3233/THC-231864

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4801-4818, 2024

Authors: Li, Jun | Li, Rong

Article Type: Research Article

Abstract: BACKGROUND: Double rocking jump rope training can effectively enhance physical recovery, adaptability to exercise load, and lower limb muscle strength of badminton players in sports colleges, thus offering valuable insights for improving training methods in sports colleges and universities. OBJECTIVE: To investigate the effect of double rocking jump rope training on the lower limb muscle strength of badminton players specializing in badminton in sports colleges. METHODS: An experimental study was conducted through a ten-week teaching intervention experiment with badminton players. Relevant heart rate indexes and badminton related lower limb muscle strength indexes were …measured before and after the experiment. The data of the measured relevant indexes were statistically and analytically analyzed. At the end of the experiment, the physical recovery level and the heart’s adaptability to the exercise load of the control group were improved, and the lower limb muscle strength test indexes and sports performance were better than before the experiment. In the experimental group, badminton players’ physical function, anaerobic metabolism of the body and other aspects also improved. RESULTS: The physical function of the experimental group of badminton players, the energy supply capacity of the body anaerobic metabolism and aerobic work capacity all have an enhancement effect, enabling badminton players to adapt to large exercise loads quickly and improve the recovery rate of physical fitness. CONCLUSION: The introduction of double rocking jump rope into badminton training classes in sports colleges and universities as a means of lower limb muscle strength training is conducive to improving the level of lower limb muscle strength of special badminton players, enriching the teaching and training means of lower limb muscle strength in sports colleges and universities, and broadening the research field of lower limb muscle strength in badminton in sports colleges and universities. Show more

Keywords: Double rocking jump rope, badminton, lower limb muscle strength, AdaBoost algorithm optimization

DOI: 10.3233/THC-231868

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4819-4836, 2024

Authors: Yu, Hongxia

Article Type: Research Article

Abstract: BACKGROUND: The use of complementary therapies to relieve the side effects of chemotherapy in lung cancer patients is becoming increasingly popular. Practices from traditional Chinese medicine, such as acupoint massage and five-tone therapy, have demonstrated potential in alleviating symptoms such as nausea and vomiting experienced during chemotherapy. OBJECTIVE: This study aims to determine the effectiveness of combining five-tone therapy with acupoint massage in reducing chemotherapy-related symptoms in lung cancer patients. The main objective is to determine how these complementary therapies affect the quality of life and well-being of people undergoing chemotherapy for lung cancer. …METHODS: In this paper, 80 patients diagnosed with lung cancer who needed chemotherapy drugs were randomly divided into 2 groups, 40 patients. The first was treatment; the second was control. Chemotherapy drugs were combined with a 5-hydroxytryptamine blocker (granisetron), and acupoint massage was combined with pentatone therapy to prevent nausea, vomiting, and other gastrointestinal reactions. A 5-hydroxytryptamine blocker (granisetron) was combined with chemotherapy drugs to prevent nausea, vomiting, and other gastrointestinal reactions. Moreover, the difference in treatment effect was observed. RESULTS: Among 40 cases in treatment, 13 cases were clinically controlled, 15 cases were markedly effective, 9 cases were effective, and 3 cases were ineffective. The total effective rate was 92.50%; among 40 cases in control, 6 cases were clinically controlled, 16 cases were markedly effective, 12 cases were practical, and 6 cases were invalid. The total effective rate was 85.00%. CONCLUSION: By integrating traditional Chinese medicine techniques, healthcare professionals can augment the supportive care offered to those undergoing chemotherapy for lung cancer. Show more

Keywords: Acupoint massage, pentatonic therapy, treatment, chemotherapy drugs, vomiting

DOI: 10.3233/THC-231890

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4837-4856, 2024

Authors: Li, Chenxi | Li, Jian | Lu, Yao | Hou, Jiahui | Zhi, Zhaoyu | Zhao, Baocun | Zhang, Xiumei

Article Type: Research Article

Abstract: BACKGROUND: Volumetric modulated arc therapy (VMAT) guided by ultrasound is a novel radiation therapy technique that facilitates the delineation of the tumor target area under image guidance, enhancing the precision of radiation therapy and maximizing the protection of surrounding tissues. OBJECTIVE: The objective of this paper is to investigate the effectiveness of VMAT under ultrasonic guidance for cervical cancer patients and its impact on radiotherapy dosage and prognosis. METHODS: A retrospective analysis encompassed 128 instances of cervical cancer patients who were admitted to our medical facility between April 2019 and April 2021. The …patients were categorized into an observation cohort and a control cohort, depending on variations in treatment modalities post-admission. The control group underwent conventional radiotherapy, whereas the observation group received VMAT guided by ultrasound. Clinical efficacy, average radiation dosages (in the radiotherapy target area, rectum, and bladder), radiotherapy-related toxicities during treatment, and one-year survival rates were compared between the two groups. Additionally, variances in pre- and post-treatment serum levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and carbohydrate antigen 724 (CA724) were subjected to assessment. RESULTS: When compared to the control group (64.52%), the observation cohort’s comprehensive effectiveness rate was considerably greater (80.30%). The observation group saw lower average radiation exposures and a reduction in the post-treatment concentrations of CEA, SCC-Ag, and CA724. The overall incidence of adverse effects from radiation treatment also declined. The observation group had a greater one-year survival rate (90.48%) than the control group (73.33%). When comparing the observation cohort to the control group, Kaplan-Meier survival analysis showed a significantly higher one-year survival rate (Log-Rank = 6.530, P = 0.011). CONCLUSION: VMAT guided by ultrasound for patients with cervical cancer demonstrates promising short- and long-term treatment outcomes. It also leads to improvements in serum CEA, SCC-Ag, and CA724 levels, as well as reductions in the average radiation dosages to the radiotherapy target area, rectum, and bladder. This approach warrants attention from clinicians in clinical practice. Show more

Keywords: Cervical cancer, intensity-modulated radiation therapy, ultrasound, radiation dosage, prognosis

DOI: 10.3233/THC-231977

Citation: Technology and Health Care, vol. 32, no. 6, pp. 4857-4868, 2024