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Price: EUR 150.00Authors: 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. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Hong, Haisen | Sha, Mo | Chen, Zhangxin | Li, Yanwei | Kang, Liangqi
Article Type: Research Article
Abstract: BACKGROUND: Femoral neck fractures, which are fractures occurring from the femoral head to the base of the femoral neck, are prevalent in the elderly population. With the progression of societal aging, the incidence of femoral neck fractures has been steadily increasing, making it a significant global issue that urgently needs to be addressed. OBJECTIVE: To compare the efficacy and safety of dynamic hip screw (DHS) with anti-rotation screw and femoral neck system (FNS) internal fixation for the treatment of Garden II–IV type femoral neck fractures. METHODS: A total of 90 patients with Garden …II–IV type femoral neck fractures were randomly assigned to either the control group (n = 45) treated with DHS and anti-rotation screw or the experimental group (n = 45) treated with FNS. Surgical outcomes, including incision size, blood loss, operation time, fluoroscopy frequency, and fracture healing time, were compared. Postoperative complication rates, reoperation rates, Harris scores, and visual analogue scale (VAS) scores were also assessed. RESULTS: The experimental group demonstrated significantly reduced incision length, blood loss, operation time, and fluoroscopy frequency compared to the control group (P < 0.01). No significant differences were observed in fracture healing time, Garden classification, or fracture reduction outcomes between the two groups (P > 0.05). At 6 months post-treatment, both groups showed significant improvements in Harris scores and VAS scores compared to pre-treatment (P < 0.05), with no significant differences between the groups (P > 0.05). The rates of internal fixation failure, nonunion, and avascular necrosis of the femoral head, as well as overall incidence of postoperative complications and reoperation rates, showed no significant differences between the two groups (P > 0.05). CONCLUSIONS: Both DHS with anti-rotation screw and FNS internal fixation demonstrated comparable efficacy and safety profiles in the treatment of Garden II–IV type femoral neck fractures. The experimental group showed advantages in terms of reduced incision length, blood loss, operation time, and fluoroscopy frequency, while maintaining similar clinical outcomes and complication rates. Show more
Keywords: Femoral neck fractures, Garden II–IV classification, dynamic hip screw (DHS), anti-rotation screw, femoral neck system (FNS), internal fixation
DOI: 10.3233/THC-231547
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Wang, Jing | Yin, Liang
Article Type: Research Article
Abstract: BACKGROUND: More than a million people are affected by brain tumors each year; high-grade gliomas (HGGs) and low-grade gliomas (LGGs) present serious diagnostic and treatment hurdles, resulting in shortened life expectancies. Glioma segmentation is still a significant difficulty in clinical settings, despite improvements in Magnetic Resonance Imaging (MRI) and diagnostic tools. Convolutional neural networks (CNNs) have seen recent advancements that offer promise for increasing segmentation accuracy, addressing the pressing need for improved diagnostic and therapeutic approaches. OBJECTIVE: The study intended to develop an automated glioma segmentation algorithm using CNN to accurately identify tumor components in MRI …images. The goal was to match the accuracy of experienced radiologists with commercial instruments, hence improving diagnostic precision and quantification. METHODS: 285 MRI scans of high-grade gliomas (HGGs) and low-grade gliomas (LGGs) were analyzed in the study. T1-weighted sequences were utilised for segmentation both pre-and post-contrast agent administration, along with T2-weighted sequences (with and without Fluid Attenuation by Inversion Recovery [FAIRE]). The segmentation performance was assessed with a U-Net network, renowned for its efficacy in medical image segmentation. DICE coefficients were computed for the tumour core with contrast enhancement, the entire tumour, and the tumour nucleus without contrast enhancement. RESULTS: The U-Net network produced DICE values of 0.7331 for the tumour core with contrast enhancement, 0.8624 for the total tumour, and 0.7267 for the tumour nucleus without contrast enhancement. The results align with previous studies, demonstrating segmentation accuracy on par with professional radiologists and commercially accessible segmentation tools. CONCLUSION: The study developed a CNN-based automated segmentation system for gliomas, achieving high accuracy in recognising glioma components in MRI images. The results confirm the ability of CNNs to enhance the accuracy of brain tumour diagnoses, suggesting a promising avenue for future research in medical imaging and diagnostics. This advancement is expected to improve diagnostic processes for clinicians and patients by providing more precise and quantitative results. Show more
Keywords: Biomedical imaging, CNN, deep learning, glioma, neuroimages, MRI
DOI: 10.3233/THC-240158
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 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. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Niu, Haiying | He, Huijie | Zhao, Zilong | Lu, Xuemei | Zhao, Gang
Article Type: Research Article
Abstract: BACKGROUND: Asthma is a major public health concern due to its persistent inflammation of the airways. The intricate and widely variable epidemiology of asthma among nations and populations is a result of the interplay between genetic, environmental, and socioeconomic factors. OBJECTIVE: This study aims to investigate whether VitD supplementation can reduce the frequency of exacerbations (including the frequency of exacerbations requiring systemic corticosteroids and the frequency of exacerbations necessitating trips to the hospital or emergency room, or both) and improve pulmonary function (clinical indicators such as the FEV1% predicted value). METHODS: Computers were …used to search Pubmed, Medline, ISI Web of Science, Embase, Cachrane Library, CNKI, CBM, VIP, and the Wanfang Database. Asthma/asthma, VitD/VitD, lung function/lung function, retrieval time is from database setup to October 8, 2021, to search all randomized controlled trials (RCTs) on the effect of VitD on human asthma and to retroactively incorporate references to literature were all included in the search criteria. After rigorous screening, quality evaluation, and data extraction of the included literature by two reviewers independently, heterogeneity tests and sensitivity analyses were performed. RESULTS: The findings show that a total of 12 relevant studies meeting the inclusion criteria were finally included, including 649 cases in the experimental group and 646 cases in the control group. VitD intervention reduced the number of asthma exacerbations, including the rate of exacerbations requiring systemic corticosteroid therapy and the rate of acute exacerbations requiring emergency department or hospital visits or both. CONCLUSIONS: In the outcome of lung function (FEV1% predicted value), it was shown that VitD supplementation improved lung function; in the outcome of serum 25-hydroxyVitD levels, it was shown that VitD supplementation increased serum 25-hydroxyVitD levels. Show more
Keywords: Asthma, VitD, FEV, lung function, 25-hydroxyVitD
DOI: 10.3233/THC-231462
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-24, 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. Pre-press, no. Pre-press, pp. 1-8, 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. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Kong, Yang | Wang, Yizhi | Yang, Qifan | Ye, Song
Article Type: Research Article
Abstract: BACKGROUND: Bibliometric analysis of liver cancer research, particularly in immunotherapy, reveals crucial insights. The US leads in liver cancer mortality but ranks fifth globally. OBJECTIVE: Scopus database analysis identified 2,349 papers, with the top 100 ranging from 127 to 4,959 citations. Notably, “Microenvironmental Regulation of Tumours Progression and Metastasis” in the Journal of Nature Medicine garnered the highest citations. METHODS: Journals like the Journal of Hepatology, Hepatology, and Nature Reports Clinical Oncology contributed significantly. Understanding molecular mechanisms and prognostic indicators is paramount for advancing combination therapies. RESULTS: For better patient …outcomes, research trends in liver cancer immunotherapy point to improved treatment protocols, knowledge of the tumor microenvironment, combining therapies, predicting disease course, international cooperation, sophisticated surgical techniques, early detection, oncolytic virotherapy, and patient-centered care. CONCLUSIONS: This research underscores immunotherapy’s pivotal role and encourages further exploration, offering valuable insights into liver cancer treatment trends. Show more
Keywords: Liver cancer, immunotherapy, bibliometric analysis, research trends, oncology
DOI: 10.3233/THC-241111
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Alsaleh, Hadeel
Article Type: Research Article
Abstract: BACKGROUND: Schwann cell sheaths are the source of benign, slowly expanding tumours known as acoustic neuromas (AN). The diagnostic and treatment approaches for AN must be patient-centered, taking into account unique factors and preferences. OBJECTIVE: The purpose of this study is to investigate how machine learning and artificial intelligence (AI) can revolutionise AN management and diagnostic procedures. METHODS: A thorough systematic review that included peer-reviewed material from public databases was carried out. Publications on AN, AI, and deep learning up until December 2023 were included in the review’s purview. RESULTS: …Based on our analysis, AI models for volume estimation, segmentation, tumour type differentiation, and separation from healthy tissues have been developed successfully. Developments in computational biology imply that AI can be used effectively in a variety of fields, including quality of life evaluations, monitoring, robotic-assisted surgery, feature extraction, radiomics, image analysis, clinical decision support systems, and treatment planning. CONCLUSION: For better AN diagnosis and treatment, a variety of imaging modalities require the development of strong, flexible AI models that can handle heterogeneous imaging data. Subsequent investigations ought to concentrate on reproducing findings in order to standardise AI approaches, which could transform their use in medical environments. Show more
Keywords: Artificial intelligence, diagnosis, acoustic neuroma, impact, management
DOI: 10.3233/THC-232043
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Huang, Yucheng | Ma, Xuan | Wu, Shilei | Chen, Ming | Wang, Junwen | Jiao, Jing
Article Type: Research Article
Abstract: BACKGROUND: Current treatments do not support direct exposure of fracture fragments, resulting in the inability to directly observe the articular surface during surgery for accurate reduction and firm fixation. OBJECTIVE: The aim of the study was to explore the treatment effect of digital virtual reduction combined with individualized guide plate of lateral tibial condyle osteotomy on tibial plateau fracture involving the lateral posterior condyle collapse. METHODS: 41 patients with tibial plateau fracture involving the lateral posterior condyle collapse were recruited in the trial. All patients underwent Computed Tomography (CT) scanning before operation. After …operation, fracture reduction was evaluated using Rasmussen score and function of knee joint was assessed using hospital for special surgery (HSS) score. RESULTS: 41 patients were followed-up 6–26 months (mean, 15.2 months). Fracture reduction was good after operation, with an average of 13.3 weeks of fracture healing without serious complications. The excellent and good rate was 97.6%. The joint movement degree was - 5∘ ∼ 0∘ ∼ 135∘ with an average of 125.5∘ . CONCLUSIONS: Digital virtual reduction combined with individualized guide plate of lateral tibial condyle osteotomy was effectively for treating tibial plateau fracture involving the lateral posterior condyle collapse. Show more
Keywords: 3D printing, tibial fracture, osteotomy, fracture fixation
DOI: 10.3233/THC-240704
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Yang, Zhongpeng | Tang, Yucong | Shan, Shuxiang
Article Type: Research Article
Abstract: BACKGROUND: Tuberculosis (TB), primarily caused by Mycobacterium tuberculosis , remains a significant global health concern. Targeted Next-Generation Sequencing (tNGS) has emerged as a rapid and comprehensive diagnostic tool for tuberculosis, offering advantages over traditional methods and serving as an effective alternative for drug susceptibility testing and the detection of drug-resistant tuberculosis. OBJECTIVE: This study aimed to retrospectively analyze the clinical characteristics of pulmonary tuberculosis patients. After explore the application value of targeted next-generation sequencing technology in this patient population, providing valuable insights for clinical diagnosis and treatment. METHODS: In this retrospective study, we …analyzed data from 65 patients with laboratory-confirmed tuberculosis admitted to Tianjin Baodi Hospital from November 14, 2020, to February 1, 2023. Patients underwent bronchoalveolar lavage fluid (BALF) testing, including acid-fast staining, culture, and tNGS. Biopsies and histopathological examinations were performed on some patients, along with comprehensive radiological assessments for all. RESULTS: Among the 65 pulmonary tuberculosis patients, targeted next-generation sequencing detected pathogens in bronchoalveolar lavage fluid with a positivity rate of 93.8%, significantly higher than traditional methods such as acid-fast staining, culture, and pathology. Compared to bronchoalveolar lavage fluid smear, targeted next-generation sequencing demonstrated significantly higher diagnostic sensitivity (98.46% vs. 26.15%) and accuracy (98.46% vs. 26.15%). CONCLUSION: Targeted next-generation sequencing, with its high sensitivity and specificity compared to traditional methods, provides unique advantages in detecting pathogens among these patients, highlighting its importance in disease management. Show more
Keywords: Pulmonary tuberculosis, bronchoalveolar lavage, pathology, targeted next-generation sequencing
DOI: 10.3233/THC-240823
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 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. Pre-press, no. Pre-press, pp. 1-10, 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. Pre-press, no. Pre-press, pp. 1-15, 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. Pre-press, no. Pre-press, pp. 1-14, 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. Pre-press, no. Pre-press, pp. 1-10, 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. Pre-press, no. Pre-press, pp. 1-14, 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. Pre-press, no. Pre-press, pp. 1-10, 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. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Leinum, Lisbeth R. | Baandrup, Anders O. | Gögenur, Ismail | Krogsgaard, Marianne | Azawi, Nessn
Article Type: Research Article
Abstract: BACKGROUND: Innovations in healthcare technologies have the potential to address challenges, including the monitoring of fluid balance. OBJECTIVE: This study aims to evaluate the functionality and accuracy of a digital technology compared to standard manual documentation in a real-life setting. METHODS: The digital technology, LICENSE, was designed to calculate fluid balance using data collected from devices measuring urine, oral and intravenous fluids. Participating patients were connected to the LICENSE system, which transmitted data wirelessly to a database. These data were compared to the nursing staff’s manual measurements documented in the electronic patient record …according to their usual practice. RESULTS: We included 55 patients in the Urology Department needing fluid balance charting and observed them for an average of 22.9 hours. We found a mean difference of - 44.2 ml in total fluid balance between the two methods. Differences ranged from - 2230 ml to 2695 ml, with a divergence exceeding 500 ml in 57.4% of cases. The primary source of error was inaccurate or omitted manual documentation. However, errors were also identified in the oral LICENSE device. CONCLUSIONS: When used correctly, the LICENSE system performs satisfactorily in measuring urine and intravenous fluids, although the oral device requires revision due to identified errors. Show more
Keywords: Water-electrolyte balance, monitoring, physiologic, digital technology, automation, equipment design
DOI: 10.3233/THC-231303
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 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. Pre-press, no. Pre-press, pp. 1-10, 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. Pre-press, no. Pre-press, pp. 1-16, 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. Pre-press, no. Pre-press, pp. 1-9, 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. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Chen, Xiaoqun | Song, Yingliang
Article Type: Research Article
Abstract: BACKGROUND: Matrine has been reported inhibitory effects on ovarian cancer (OC) cell progression, development, and apoptosis. However, the molecular targets of matrine against OC and the underlying mechanisms of action remain elusive. OBJECTIVE: This study endeavors to unveil the potential targets of matrine against OC and to explore the intricate relationships between these targets and the pathogenesis of OC. METHODS: The effects of matrine on the OC cells (A2780 and AKOV3) viability, apoptosis, migration, and invasion was investigated through CCK-8, flow cytometry, wound healing, and Transwell analyses, respectively. Next, Matrine-related targets, OC-related genes, …and ribonucleic acid (RNA) sequence data were harnessed from publicly available databases. Differentially expressed analyses, protein-protein interaction (PPI) network, and Venn diagram were involved to unravel the core targets of matrine against OC. Leveraging the GEPIA database, we further validated the expression levels of these core targets between OC cases and controls. Mendelian randomization (MR) study was implemented to delve into potential causal associations between core targets and OC. The AutoDock software was used for molecular docking, and its results were further validated using RT-qPCR in OC cell lines. RESULTS: Matrine reduced the cell viability, migration, invasion and increased the cell apoptosis of A2780 and AKOV3 cells (P < 0.01). A PPI network with 578 interactions among 105 candidate targets was developed. Finally, six core targets (TP53, CCND1, STAT3, LI1B, VEGFA, and CCL2) were derived, among which five core targets (TP53, CCND1, LI1B, VEGFA, and CCL2) differential expressed in OC and control samples were further picked for MR analysis. The results revealed that CCND1 and TP53 were risk factors for OC. Molecular docking analysis demonstrated that matrine had good potential to bind to TP53, CCND1, and IL1B. Moreover, matrine reduced the expression of CCND1 and IL1B while elevating P53 expression in OC cell lines. CONCLUSIONS: We identified six matrine-related targets against OC, offering novel insights into the molecular mechanisms underlying the therapeutic effects of matrine against OC. These findings provide valuable guidance for developing more efficient and targeted therapeutic approaches for treating OC. Show more
Keywords: Ovarian cancer, Matrine, Mendelian randomization, target, molecular docking
DOI: 10.3233/THC-231051
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 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. Pre-press, no. Pre-press, pp. 1-17, 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. Pre-press, no. Pre-press, pp. 1-22, 2024
Authors: Gao, Wenlong | Zeng, Zhimei | Ma, Xiaojie | Ke, Yongsong | Zhi, Minqian
Article Type: Research Article
Abstract: BACKGROUND: The morbidity and mortality of heart disease are increasing in middle-aged and elderly people in China. It is necessary to explore relationships and interactive associations between heart disease and its risk factors in order to prevent heart disease. OBJECTIVE: To establish a Bayesian network model of heart disease and its influencing factors in middle-aged and elderly people in China, and explore the applicability of the elite-based structure learner using genetic algorithm based on ensemble learning (EN-ESL-GA) algorithm in etiology analysis and disease prediction. METHODS: Based on the 2013 national tracking survey data …from China Health and Retirement Longitudinal Study (CHARLS) database, EN-ESL-GA algorithm was used to learn the Bayesian network structure. Then we input the data and the learned network structure into the Netica software for parameter learning and inference analysis. RESULTS: The Bayesian network model based on the EN-ESL-GAalgorithm can effectively excavate the complex network relationships and interactive associations between heart disease and its risk factors in middle-aged and elderly people in China. CONCLUSIONS: The Bayesian network model based on the EN-ESL-GA algorithm has good applicability and application prospect in the prediction of diseases prevalence risk. Show more
Keywords: Bayesian networks, heart disease, influence factors, middle-aged and elderly people
DOI: 10.3233/THC-231215
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ping, Yuxia
Article Type: Research Article
Abstract: BACKGROUND: In recent years, artificial intelligence (AI) technology has been continuously advancing and finding extensive applications, with one of its core technologies, machine learning, being increasingly utilized in the field of healthcare. OBJECTIVE: This research aims to explore the role of Artificial Intelligence (AI) technology in psychological counseling and utilize machine learning algorithms to predict counseling outcomes. METHODS: Firstly, by employing natural language processing techniques to analyze user conversations with AI chatbots, researchers can gain insights into the psychological states and needs of users during the counseling process. This involves detailed analysis using …text analysis, sentiment analysis, and other relevant techniques. Subsequently, machine learning algorithms are used to establish predictive models that forecast counseling outcomes and user satisfaction based on data such as user language, emotions, and behavior. These predictive results can assist counselors or AI chatbots in adjusting counseling strategies, thereby enhancing counseling effectiveness and user experience. Additionally, this study explores the potential and prospects of AI technology in the field of psychological counseling. RESULTS: The research findings indicate that the designed machine learning models achieve an accuracy rate of approximately 89% in analyzing psychological conditions. This demonstrates significant innovation and breakthroughs in AI technology. Consequently, AI technology will gradually become a highly important tool and method in the field of psychological counseling. CONCLUSION: In the future, AI chatbots will become more intelligent and personalized, providing users with precise, efficient, and convenient psychological counseling services. The results of this research provide valuable technical insights for further improving AI-supported psychological counseling, contributing positively to the application and development of AI technology. Show more
Keywords: Artificial intelligence, machine learning, natural language, psychological counseling, sentiment analysis
DOI: 10.3233/THC-230809
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Wu, Qian | Zang, Ruiqi | Zhang, Yong
Article Type: Research Article
Abstract: BACKGROUND: Pregnancy is an important process in women’s life, which is widely concerned by women. In recent years, the incidence of premature delivery (PTD) becomes more and more higher due to the development of auxiliary reproduction and ovulation induction technologies and the changes of pregnant women’s lifestyle and physical quality. PTD not only affects postpartum recovery and causes great physical pains, but it also has adverse effects on the birth state of neonates and even leads to neonatal death OBJECTIVE: The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination …of placenta for premature delivery (PTD) were investigated and the correlation between PTD and infection was analyzed. METHODS: 120 pregnant women with PTD or high-risk factors for PTD admitted to The Affiliated Hospital of Southwest Medical University between February 2020 and March 2022 were included as the subjects and underwent pathological examination of placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation on the predictive values of pathological examination of placenta and TVUS. What’s more, 36 subjects in PTD group and 84 in normal delivery group (control group) underwent pathological examination of placenta for the analysis of the correlation between PTD and infection. RESULTS: The joint inspection method showed significantly better sensitivity, specificity, PPV, and NPV compared to single CL or pathological examination of the placenta (P < 0.05). Among pregnant women, those with CL ⩽ 30 mm and positive placental pathology had a higher proportion compared to those with CL > 30 mm and negative placental pathology (P < 0.05). Furthermore, the incidence of Ureaplasma Urealyticum (UU), Chlamydia Trachomatis (CT), and Chorioamnionitis (CA) in vaginal discharge of the preterm delivery (PTD) group was significantly higher than that of the control group (P < 0.05). CONCLUSION: The combination of CL ⩽ 30 mm and positive placental pathology could effectively predict PTD and placental infection was notably correlated with the occurrence of PTD. Show more
Keywords: Transvaginal ultrasonography, cervix length, pathological examination of placenta, premature delivery, infection
DOI: 10.3233/THC-240079
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 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. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: MA, Sreema | A, Jayachandran | Perumal T, Sudarson Rama
Article Type: Research Article
Abstract: BACKGROUND: Segmentation of retinal fragments like blood vessels, Optic Disc (OD), and Optic Cup (OC) enables the early detection of different retinal pathologies like Diabetic Retinopathy (DR), Glaucoma, etc. OBJECTIVE: Accurate segmentation of OD remains challenging due to blurred boundaries, vessel occlusion, and other distractions and limitations. These days, deep learning is rapidly progressing in the segmentation of image pixels, and a number of network models have been proposed for end-to-end image segmentation. However, there are still certain limitations, such as limited ability to represent context, inadequate feature processing, limited receptive field, etc., which lead to …the loss of local details and blurred boundaries. METHODS: A multi-dimensional dense attention network, or MDDA-Net, is proposed for pixel-wise segmentation of OD in retinal images in order to address the aforementioned issues and produce more thorough and accurate segmentation results. In order to acquire powerful contexts when faced with limited context representation capabilities, a dense attention block is recommended. A triple-attention (TA) block is introduced in order to better extract the relationship between pixels and obtain more comprehensive information, with the goal of addressing the insufficient feature processing. In the meantime, a multi-scale context fusion (MCF) is suggested for acquiring the multi-scale contexts through context improvement. RESULTS: Specifically, we provide a thorough assessment of the suggested approach on three difficult datasets. In the MESSIDOR and ORIGA data sets, the suggested MDDA-NET approach obtains accuracy levels of 99.28% and 98.95%, respectively. CONCLUSION: The experimental results show that the MDDA-Net can obtain better performance than state-of-the-art deep learning models under the same environmental conditions. Show more
Keywords: Deep learning, dense prediction networks, fundus images, segmentation
DOI: 10.3233/THC-230310
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 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. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Khaleel Sallam Ma’aitah, Mohammad | Helwan, Abdulkader
Article Type: Research Article
Abstract: BACKGROUND: Deep learning has demonstrated superior performance over traditional methods for the estimation of heart rates in controlled contexts. However, in less controlled scenarios this performance seems to vary based on the training dataset and the architecture of the deep learning models. OBJECTIVES: In this paper, we develop a deep learning-based model leveraging the power of 3D convolutional neural networks (3DCNN) to extract temporal and spatial features that lead to an accurate heart rates estimation from RGB no pre-defined region of interest (ROI) videos. METHODS: We propose a 3D DenseNet with a 3D …temporal transition layer for the estimation of heart rates from a large-scale dataset of videos that appear more hospital-like and real-life than other existing facial video-based datasets. RESULTS: Experimentally, our model was trained and tested on this less controlled dataset and showed heart rate estimation performance with root mean square error (RMSE) of 8.68 BPM and mean absolute error (MAE) of 3.34 BPM. CONCLUSION: Moreover, we show that such a model can also achieve better results than the state-of-the-art models when tested on the VIPL-HR public dataset. Show more
Keywords: Heart rate, deep learning, rPPG, 3D convolutional neural networks, no pre-defined region of interest (ROI)
DOI: 10.3233/THC-241104
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Quan, Wentao | Guo, Xudong | Cui, Haipo | Luo, Linlaisheng | Li, Mengyun
Article Type: Research Article
Abstract: BACKGROUND: Multi-channel acquisition systems of brain neural signals can provide a powerful tool with a wide range of information for the clinical application of brain computer interfaces. High-throughput implantable systems are limited by size and power consumption, posing challenges to system design. OBJECTIVE: To acquire more comprehensive neural signals and wirelessly transmit high-throughput brain neural signals, a FPGA-based acquisition system for multi-channel brain nerve signals has been developed. And the Bluetooth transmission with low-power technology are utilized. METHODS: To wirelessly transmit large amount of data with limited Bluetooth bandwidth and improve the accuracy …of neural signal decoding, an improved sharing run length encoding (SRLE) is proposed to compress the spike data of brain neural signal to improve the transmission efficiency of the system. The functional prototype has been developed, which consists of multi-channel data acquisition chips, FPGA main control module with the improved SRLE, a wireless data transmitter, a wireless data receiver and an upper computer. And the developed functional prototype was tested for spike detection of brain neural signal by animal experiments. RESULTS: From the animal experiments, it shows that the system can successfully collect and transmit brain nerve signals. And the improved SRLE algorithm has an excellent compression effect with the average compression rate of 5.94%, compared to the double run-length encoding, the FDR encoding, and the traditional run-length encoding. CONCLUSION: The developed system, incorporating the improved SRLE algorithm, is capable of wirelessly capturing spike signals with 1024 channels, thereby realizing the implantable systems of High-throughput brain neural signals. Show more
Keywords: Brain nerve signal, wireless transmission, multi-channel system, improved SRLE, compression ratio
DOI: 10.3233/THC-231401
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Čehić, Ermin | Cerovac, Anis | Zulović, Tarik | Begić, Edin
Article Type: Research Article
Abstract: BACKGROUND: Thanks to modern methods of assisted reproduction (ART), parenthood has become an attainable goal for couples in which the male partner has experienced spinal cord injury (SCI). OBJECTIVE: The aim of our study was to determine the success of the treatment of infertile patients with SCI with intracytoplasmic sperm injection (ICSI) of cryopreserved sperm obtained by the testicular sperm aspiration (TESA) procedure. METHODS: In this retrospective study 156 infertile couples were included, in which the male partner is primarily infertile due to azoospermia. Infertile couples were divided into two groups. The first …group (n = 82) includes men with SCI, and the second (n = 74) men with obstructive azoospermia (OA) as the cause of infertility. All infertile men were examined and processed in the diagnostic procedure, and based on the urological findings, surgical extraction of sperm from the testicles was indicated. Exclusion criteria were the age of women over 40 and men over 45. RESULTS: We found that the quality of sperm was worse in the group with SCI, compared to the group with OA, but without statistical significance. Zenica and Johnsen score (p = 0.001; p = 0.000) showed worse semen characteristics in the group with SCI. There were no significant differences in the average number of embryos (p = 0.698), pregnancy rates per cycle (p = 0.979) and pregnancy rates per embrio transfer (ET), clinical pregnancy rates per ET (p = 0.987) and delivery rates per ET (p = 0.804) in couples with SCI, compared to couples with OA. CONCLUSION: Based on the results of this research, the TESA and ICSI procedures can be recommended as a successful method in the treatment of male infertility caused by azoospermia due to SCI. Show more
Keywords: Azoospermia, male, pregnancy rate, sperm motility, sperm retrieval, spinal cord injuries
DOI: 10.3233/THC-240518
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 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. Pre-press, no. Pre-press, pp. 1-23, 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. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Wang, Zuoshan | Wang, Shilin | Wang, Manya | Sun, Yan
Article Type: Research Article
Abstract: BACKGROUND: Healthcare is crucial to patient care because it provides vital services for maintaining and restoring health. As healthcare technology evolves, cutting-edge tools facilitate faster diagnosis and more effective patient treatment. In the present age of pandemics, the Internet of Things (IoT) offers a potential solution to the problem of patient safety monitoring by creating a massive quantity of data about the patient through the linked devices around them and then analyzing it to estimate the patient’s current status. Utilizing the IoT-based meta-heuristic algorithm allows patients to be remotely monitored, resulting in timely diagnosis and improved care. Meta-heuristic algorithms …are successful, resilient, and effective in solving real-world enhancement, clustering, predicting, and grouping. Healthcare organizations need an efficient method for dealing with big data since the prevalence of such data makes it challenging to analyze for diagnosis. The current techniques used in medical diagnostics have limitations due to imbalanced data and the overfitting issue. OBJECTIVE: This study introduces the particle swarm optimization and convolutional neural network to be used as a meta-heuristic optimization method for extensive data analysis in the IoT to monitor patients’ health conditions. METHOD: Particle Swarm Optimization is used to optimize the data used in the study. Information for a diabetes diagnosis model that includes cardiac risk forecasting is collected. Particle Swarm Optimization and Convolutional Neural Networks (PSO-CNN) results effectively make illness predictions. Support Vector Machine has been used to predict the possibility of a heart attack based on the classification of the collected data into projected abnormal and normal ranges for diabetes. RESULTS: The results of the simulations reveal that the PSO-CNN model used to predict diabetic disease increased in accuracy by 92.6%, precision by 92.5%, recall by 93.2%, F1-score by 94.2%, and quantization error by 4.1%. CONCLUSION: The suggested approach could be applied to identify cancer cells. Show more
Keywords: Healthcare, disease diagnosis, meta-heuristic algorithm, IoT, patient monitoring, Particle Swarm Optimization, convolutional neural network, diabetes, cardiac risk forecasting, support vector machine, cancer cells
DOI: 10.3233/THC-231755
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 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. Pre-press, no. Pre-press, pp. 1-11, 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. Pre-press, no. Pre-press, pp. 1-19, 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. Pre-press, no. Pre-press, pp. 1-22, 2024
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. Pre-press, no. Pre-press, pp. 1-13, 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. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Chen, Bin | Yi, Yinqiao | Zhang, Chengxiu | Yan, Yulin | Wang, Xia | Shui, Wen | Zhou, Minzhi | Yang, Guang | Ying, Tao
Article Type: Research Article
Abstract: BACKGROUND: The anal sphincter complex comprises the anal sphincter and the U-shaped deep and superficial puborectalis muscle. As an important supporting structure of the posterior pelvic floor, together with its surrounding tissues and muscles, the anal sphincter complex maintains the normal physiological functions of defecation and continence. OBJECTIVE: The plane required for diagnosing anal sphincter injury and the diagnosis of anal sphincter integrity through pelvic floor ultrasound are highly dependent on sonographers’ experience. We developed a deep learning (DL) tool for the automatic diagnosis of anal sphincter integrity via pelvic floor ultrasound. METHODS: …A 2D detection network was trained to detect the bounding box of the anal sphincter. The pelvic floor ultrasound image and its corresponding oval mask were input into a 2D classification network to determine the integrity of the anal sphincter. The average precision (AP) and intersection over union (IoU) were used to evaluate the performance of anal sphincter detection. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the classification model. RESULTS: The Pearson correlation coefficients (r values) of the topmost and bottommost layers detected by the CNN and sonographers were 0.932 and 0.978, respectively. The best DL model yielded the highest area under the curve (AUC) of 0.808 (95% CI: 0.698–0.921) in the test cohort. The results from the CNN agreed well with the diagnostic results of experienced sonographers. CONCLUSIONS: We proposed, for the first time, a CNN to obtain the plane required for diagnosing anal sphincter injury on the basis of pelvic floor ultrasound and for preliminarily diagnosing anal sphincter injury. Show more
Keywords: Anal sphincter, convolutional neural network, deep learning, pelvic floor, artificial intelligence
DOI: 10.3233/THC-240569
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 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. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Sheela, K. Selva | Justus, Vivek | Asaad, Renas Rajab | Kumar, R. Lakshmana
Article Type: Research Article
Abstract: BACKGROUND: Liver cancer poses a significant health challenge due to its high incidence rates and complexities in detection and treatment. Accurate segmentation of liver tumors using medical imaging plays a crucial role in early diagnosis and treatment planning. OBJECTIVE: This study proposes a novel approach combining U-Net and ResNet architectures with the Adam optimizer and sigmoid activation function. The method leverages ResNet’s deep residual learning to address training issues in deep neural networks. At the same time, U-Net’s structure facilitates capturing local and global contextual information essential for precise tumor characterization. The model aims to enhance …segmentation accuracy by effectively capturing intricate tumor features and contextual details by integrating these architectures. The Adam optimizer expedites model convergence by dynamically adjusting the learning rate based on gradient statistics during training. METHODS: To validate the effectiveness of the proposed approach, segmentation experiments are conducted on a diverse dataset comprising 130 CT scans of liver cancers. Furthermore, a state-of-the-art fusion strategy is introduced, combining the robust feature learning capabilities of the UNet-ResNet classifier with Snake-based Level Set Segmentation. RESULTS: Experimental results demonstrate impressive performance metrics, including an accuracy of 0.98 and a minimal loss of 0.10, underscoring the efficacy of the proposed methodology in liver cancer segmentation. CONCLUSION: This fusion approach effectively delineates complex and diffuse tumor shapes, significantly reducing errors. Show more
Keywords: Adam optimizer, CT scans, deep learning, U-Net, ResNet
DOI: 10.3233/THC-230931
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Anjikumar, Tamarapalli | Chakravarthy, A.S.N.
Article Type: Research Article
Abstract: BACKGROUND: In the Healthcare (HC) sector, the usage of Wireless Sensor Healthcare Networks (WSHN) is attaining specific importance. The sensor device is implanted into the patient’s body, and the sensed health information of patients is transformed via data aggregating devices like mobile devices, cameras, and so on, to the doctors. Thus, the early signs of diseases are identified, and remote monitoring of the patient’s health is carried out by the physician on time. This aids in improving the health condition of the people and reduces the severity of disorders. But, the security gap in HC remains unresolved, despite various …advantages. OBJECTIVE: This work proposes secured data communication in WSHN using Exponential Message Digest5 (EXP-MD5) and Diffie Hellman Secret Key-based Elliptic Curve Cryptography (DHSK-ECC) techniques. METHODS: Primarily, the patient registers their details in the Hospital Cloud Server (HCS). With hospital ID and patient ID, public and private keys are generated during registration. Afterward, by utilizing the Navie Shuffling (NS) technique, n Cr combinations are created and shuffled. After shuffling, any of the randomly selected combinations are encoded utilizing the American Standard Code for Information Interchange (ASCII) code. For patient authentication, the ASCII code is further converted into a Quick Response(QR) code. Upon successful registration, the patient logs in to HCS. The patient can book for doctor’s appointment if the login details are verified with those of the registered details. On consulting the doctor at the pre-informed time, the digital signature is created utilizing the Universal Unique Salt-based Digital Signature Algorithm (UUS-DSA) for authenticating the patient details. Further, for providing accessibility to all the authorized patients, the registered patients on HCS are considered as nodes. Then, an authorized path is created using the EXP-MD5 technique to protect each individual patient’s details. The patient’s IoT data is sensed, followed by authorized path creation. The data is encrypted via the DHSK-ECC algorithm for secure data transmission. Lastly, all the information is stored in HCS, so that the patient’s health condition is regularly monitored by the doctor and the needy advice is suggested to the patients in the future. Also, hash matching is carried out when the doctor needs to access data. RESULTS: The proposed technique’s efficacy is validated by the performance analysis in comparison with other conventional techniques. CONCLUSION: In this proposed research, the authentication is performed in multiple scenarios to enhance data security and user privacy. The patient details are authenticated during registration and verification to access the online consultation only by the authorized person. Further, the patient health information is encrypted in the proposed work after consultation so that the intrusion of medical records by malicious users and data tampering is prevented. Also, the sensed data gathered from patients are transferred to the HCS by creating the authorized path, which further enhances the security of patient data. Thus, the data communication of the WSHN is well-secured in this work through multi-level authentication and improved cryptography techniques. Show more
Keywords: Data security, privacy-preserving, healthcare networks, Universal Unique Salt-based Digital Signature Algorithm (UUS-DSA), Hospital Cloud Server (HCS), Diffie Hellman Secret Key-based Elliptic Curve Cryptography (DHSK-ECC)
DOI: 10.3233/THC-240790
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-23, 2024
Authors: Tan, Yan | Yan, Zhenjiao | Chen, Minhong | Wang, Yinglan
Article Type: Research Article
Abstract: BACKGROUND: Fondaparinux sodium can prevent and treat acute illnesses and venous thromboembolism in patients undergoing surgery. At present, no studies have reported on treating subchorionic hematoma combined with protein S deficiency using fondaparinux sodium. OBJECTIVE: To investigate the clinical efficacy of fondaparinux sodium in the treatment of patients with subchorionic hematoma combined with protein S deficiency. METHODS: This single-center, open-ended, and prospective study enrolled 78 patients with subchorionic hematoma and protein S deficiency. They were randomly assigned to the treatment and control groups. The control group received conventional treatment, and the observation group received subepithelial …injections of fondaparinux sodium (2.5 mg/day) based on conventional treatment. After 30 days of continuous treatment, the hematoma was evaluated by ultrasonography. RESULTS: After treatment with fondaparinux sodium, a significant improvement in subchorionic hematoma was observed in the observation group compared with that in the control group (p < 0.05). A substantial improvement in prothrombin time and activated partial thromboplastin time was observed in the observation group after fondaparinux sodium treatment (p < 0.05). Furthermore, after fondaparinux sodium treatment, the duration of hematoma maintenance and incidence of adverse pregnancy outcomes were significantly reduced in the observation group compared with that in the control group (p < 0.05). CONCLUSION: With a favorable safety profile, fondaparinux sodium is effective in treating subchorionic hematoma combined with protein S deficiency. The results provide new ideas and methods for treating this disease, which is worthy of further promotion and application in clinical practice. Show more
Keywords: Fondaparinux sodium, subchorionic hematoma, protein S deficiency, therapeutic effect, hypercoagulability, coagulation function
DOI: 10.3233/THC-241035
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Zhao, Jie | Liu, Jianqiang | Wang, Shijie | Zhang, Pinzheng | Yu, Wenxue | Yang, Chunfeng | Zhang, Yudong | Chen, Yang
Article Type: Research Article
Abstract: BACKGROUND: In radiography procedures, radiographers’ suboptimal positioning and exposure parameter settings may necessitate image retakes, subjecting patients to unnecessary ionizing radiation exposure. Reducing retakes is crucial to minimize patient X-ray exposure and conserve medical resources. OBJECTIVE: We propose a Digital Radiography (DR) Pre-imaging All-round Assistant (PIAA) that leverages Artificial Intelligence (AI) technology to enhance traditional DR. METHODS: PIAA consists of an RGB-Depth (RGB-D) multi-camera array, an embedded computing platform, and multiple software components. It features an Adaptive RGB-D Image Acquisition (ARDIA) module that automatically selects the appropriate RGB camera based on the distance …between the cameras and patients. It includes a 2.5D Selective Skeletal Keypoints Estimation (2.5D-SSKE) module that fuses depth information with 2D keypoints to estimate the pose of target body parts. Thirdly, it also uses a Domain expertise (DE) embedded Full-body Exposure Parameter Estimation (DFEPE) module that combines 2.5D-SSKE and DE to accurately estimate parameters for full-body DR views. RESULTS: Optimizes DR workflow, significantly enhancing operational efficiency. The average time required for positioning patients and preparing exposure parameters was reduced from 73 seconds to 8 seconds. CONCLUSIONS: PIAA shows significant promise for extension to full-body examinations. Show more
Keywords: Digital radiography, patient positioning, deep learning, domain expertise, human pose estimation, automatic exposure control, RGB-D camera
DOI: 10.3233/THC-240639
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Gayathri D, Bala | Sangeetha, D.
Article Type: Research Article
Abstract: BACKGROUND: In the modern medical industry, sensors and other medical electronic equipment such as ECG, thermometers, etc. that measure vitals like blood pressure, body temperature, heartbeat, and blood cells are used to record patient data. The information gathered helps to create a patient profile, which in turn helps doctors treat patients appropriately and helps users gain insights into their health. But, the information collected is regionally specific and not worldwide. Thus, this may create problems in transparency, integrity, and much more. The medical details of patients collected are stored in a simple database which appears to be a centralized …application that is prone to be modified or hacked by intruders and also suffers from fault tolerance. OBJECTIVE: This paper aims to solve this problem using Blockchain and Data Possession methodologies. METHODS: Blockchain helps to store multiple copies of data in a decentralized fashion. Thus, a secured model could be implemented using blockchain in which the patient’s data can be securely sent to any medical professional, thus promoting transparency, security, and integrity. RESULTS: Provable Data Possession helps the users to verify that their information is intact and has not been tampered. It can be achieved using cryptography which encrypts the information of the patients stored. CONCLUSION: This paper will be beneficial for the medical department and the public such that it will be beneficial in terms of transparency, scalability, and security. Show more
Keywords: Blockchain, provable data possession, SQL injection attacks, machine learning, neural networks, cryptography
DOI: 10.3233/THC-240921
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-23, 2024
Authors: Han, Yongmei | Liu, Xinyu | Meng, Xinwan
Article Type: Research Article
Abstract: BACKGROUND: This study aimed to investigate the effects of the Kidney-Tonifying and Blood-Activating Formula on combating the downregulation of integrin β 3 and integrin β 5 in mouse placental tissue induced by phospholipid antibodies. OBJECTIVE: This study aimed to investigate the effects of kidney-tonifying and blood-activating formulations on combating the downregulation of integrin β 3 and integrin β 5 in mouse placental tissue induced by phospholipid antibodies. METHODS: Mice in the phospholipid antibody group and phospholipid antibody + kidney-tonifying and blood-activating formula …group underwent repeated implantation experiments, and the expression of integrin β 3 and integrin β 5 in placental tissue was observed. The effects of the kidney-tonifying and blood-activating formula on mouse placental tissue were evaluated through biochemical index tests, histopathological observations, and immunohistochemical staining. RESULTS: After intervention with the kidney-tonifying and blood-activating formula, the expression of integrin β 3 and integrin β 5 in placental tissue was notably upregulated, and placental structure was restored. Kidney-Tonifying and Blood-Activating Formula significantly improved abnormal biochemical indices and exerted a remarkable protective effect on placental tissue pathology. CONCLUSION: The kidney-tonifying and blood-activating formula effectively counteracted the downregulation of integrin β 3 and integrin β 5 in mouse placental tissue induced by phospholipid antibodies and alleviated placental tissue pathology through structural improvement and protection. Therefore, kidney-tonifying and blood-activating formulas may serve as potential therapeutic agents for recurrent implantation failure, offering new insights and approaches for clinical treatment. Show more
Keywords: Kidney-tonifying and blood-activating formula, phospholipid antibodies, recurrent implantation failure, placental tissue, integrin β3, integrin β5
DOI: 10.3233/THC-241179
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Wang, Bing | Wu, Zehui | Liu, Gang | Liu, Ben | Yang, Wanchao | Yang, Chao | Shi, Lianghui
Article Type: Research Article
Abstract: BACKGROUND: Advancements in laparoscopic technology have popularized laparoscopic total gastrectomy over traditional open surgery, yet postoperative complications like anastomotic leakage and stenosis persist, particularly in esophagojejunostomy. To address this, since 2017, the authors have introduced the “Pant-Shaped” esophagojejunostomy as an improvement over the classic Roux-en-Y method, especially beneficial for patients with small intestinal diameters or those with gastric body cancer or Siewert III. OBJECTIVE: To assess the viability and safety of employing ‘Pant-Shaped’ anastomosis following laparoscopic-assisted total gastrectomy. METHODS: A method of descriptive case study was used. In our department of the First …Affiliated Hospital of Wannan Medical College, records of 210 patients who underwent laparoscopic-assisted total gastrectomy for gastric body cancer or adenocarcinoma at the junction of esophagus and jejunum with “Pant-Shaped” anastomosis between January 2017 and December 2022 were examined. Clinicopathological features and postoperative conditions were also examined and assessed. RESULTS: The mean age of the 164 male and 46 female research participants was 69.2 ± 8.3 years. There was a mean estimated blood loss of 63.4 ± 29.7 ml, an anastomosis time of 25.9 ± 3.0 minutes, an operation time of 208.2 ± 40.4 minutes, and a postoperative hospital stay of 12.2 ± 8.0 days. Nine patients (4.3%) experienced postoperative problems (Clavien-Dindo > grade II), including two episodes of anastomotic leakage that were resolved with irrigation and drainage, anti-infection therapy, and nutritional assistance. After an unforeseen reoperation, two cases of duodenal stump leaking were resolved. Anastamotic hemorrhage was treated with hemostasis and blood transfusion, and the patient made a full recovery. Due to a Peterson’s hernia, one patient required emergent open surgery. three months subsequent to LATG. CONCLUSIONS: The “Pant-Shaped” anastomosis method after laparoscopic-assisted total gastrectomy is simple, easy to promote, and has fewer complications. It is a safe and feasible modified method for esophagojejunostomy, especially suitable for patients with poor intestinal dilation and contraction ability and small jejunal diameter. Show more
Keywords: Laparoscopy, gastric cancer, gastrectomy, anastomosis, Roux-en-Y
DOI: 10.3233/THC-241093
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zhan, Jing | Li, Li | Cao, Zheng | Sheng, Gaoan | Lou, Weiwei | Sheng, Lieping | Yao, Litao
Article Type: Research Article
Abstract: BACKGROUND: Fiber post (FP) reinforced restoration was widespread in endodontically treated teeth, of which the retention was closely related to fit and operation process. However, the question whether the fit and self-etching adhesive (SED) affect the success of FP restoration still remained unclear. OBJECTIVE: This research aimed to assess how the fit and self-etching adhesive (SED) impact the pull-out bond strength (BS) of glass fiber-reinforced composite posts from the root canal dentin. METHODS: Eighty lower first premolars underwent simulated endodontic treatment, after which their canals were shaped to accommodate a size three RelyX …fiber post (FP) (diameter 1.9 mm). They were then divided into 4 equal groups [Unfit post and no SEA (Group UN), Fit post and no SEA (Group FN), Unfit post with SEA (Group UA) and Fit post with SEA (Group FA)] using two different sized FPs and SEA. Cement thickness was acquired by histological analysis and stereomicroscopy. Each sample was tested for pull-out strength through a universal testing machine. Based on the pull-out test, the failure types were observed and scored by visualizing through a stereomicroscope. RESULTS: Group FA demonstrated significantly greater BS compared to Group UN and Group UA, with Group UN showing a statistically significant difference at p < 0.01 and Group UA at p < 0.05. Main failure types in Group FA were Type II, which illustrated that the cement detachment mainly occurred from the post-cement interface. Therefore, Group FA possessed the STRONGEST BS and was most suitable for FP-reinforced crown restorations. CONCLUSIONS: Both the fit and SEA enhanced the pull-out BS. The SEA was critical for BS promotion when the mechanical retention was inadequate. Show more
Keywords: Bond strength, fiber post, fit, self-etching adhesive
DOI: 10.3233/THC-241020
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Su, Hui | Lan, Xiaoyang | Cao, Ya | Zhang, Mingjie | Chen, Xiaoyan | Lan, Chen
Article Type: Research Article
Abstract: BACKGROUND: Epidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention. OBJECTIVE: In this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated. METHODS : Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024. RESULTS: The mean age of the fifty-nine patients at symptom onset was 40.8 ± …9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 sacns with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months. CONCLUSION: CT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region. Show more
Keywords: Spontaneous intracranial hypotension, epidural blood patch, cervical region, CT-guided, extensive fluid collections
DOI: 10.3233/THC-241366
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Chen, Shuo | Wu, Peixian | Peng, Weiqun | Zhang, Hongai
Article Type: Research Article
Abstract: BACKGROUND: The relationship between metabolically healthy obesity (MHO) and cardiovascular disease (CVD) risk remains debated. The critical point may be the lack of consensus on MHO’s definition and diagnostic criteria. OBJECTIVE: This study aimed to investigate the association of MHO status with arteriosclerosis-CVD (ASCVD) risk in Chinese under new diagnostic criteria. METHODS: Participants aged 35–79 in the 2009 China Health and Nutrition Survey cohort were included. The 10-year ASCVD risk was predicted by the prediction for ASCVD risk in China, and participants with a predicted risk of ⩾ 10% were …classified into the high-risk group. The Bayesian network (BN) models were constructed to characterize the multivariable probabilistic connections between metabolically obesity phenotypes and ASCVD risk. RESULTS: The 10-year ASCVD risk score and the proportion of individuals at ASCVD high risk were significantly different between metabolically obesity phenotypes (P < 0.001). BN reasoning results showed that MHO individuals were not significantly associated with a 10-year ASCVD risk. Among metabolically unhealthy individuals, the conditional probability of high ASCVD risk increased with the Body Mass Index (BMI), with the conditional probability of high ASCVD risk was 24.63% (95% CI: 22.81–26.55%), 32.97% (95% CI: 30.75–35.27%) and 40.2% (95% CI: 36.64–43.86%) for metabolically unhealthy normal weight (MUNW), metabolically healthy overweight weight (MHOW), and metabolically unhealthy obesity (MUO) group, respectively. Subgroup analysis showed that MHO individuals were at increased risk of CVD compared with metabolically healthy normal weight (MHNW) individuals only in females. CONCLUSION: These results showed that there was no significant increase in ASCVD risk of MHO phenotype based on the new diagnostic criteria, suggesting that MHO is in a relatively healthy state. Show more
Keywords: Metabolically healthy obesity, atherosclerosis cardiovascular disease, Bayesian networks
DOI: 10.3233/THC-241472
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Kapoor, Yagyesh | Hasija, Yasha
Article Type: Research Article
Abstract: BACKGROUND: Machine learning offers diverse options for effectively managing blood glucose levels in diabetes patients. Selecting the right ML algorithm is critical given the array of available choices. Integrating data from IoT devices presents promising opportunities to enhance real-time blood glucose management models. OBJECTIVE: This meta-analysis aims to evaluate the effectiveness of machine learning models utilizing IoT device data for predicting blood glucose levels. METHODS: We systematically searched electronic databases for studies published between 2019 and 2023. We excluded studies lacking ML model derivation or performance metrics. The Quality Assessment of Diagnostic Accuracy …Studies tool assessed study quality. Our primary outcomes compared ML models for BG level prediction across different prediction horizons (PHs). RESULTS: We analyzed ten eligible studies across prediction horizons of 15, 30, 45, and 60 minutes. ML models exhibited mean absolute RMSE values of 15.02 (SD 1.45), 21.488 (SD 2.92), 30.094 (SD 3.245), and 35.89 (SD 6.4) mg/dL, respectively. Random Forest demonstrated superior performance across these PHs. CONCLUSION: We observed significant heterogeneity across all subgroups, indicating diverse sources of variability. As the PH lengthened, the RMSE for blood glucose prediction by the ML model increased, with Random Forest showing the highest relative performance among the ML models. Show more
Keywords: Machine learning, diabetes, CGM, Internet of Things, blood glucose, hyperglycemia
DOI: 10.3233/THC-241403
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Yin, Huimin | Yan, Zhanjie | Zhao, Fangcheng
Article Type: Research Article
Abstract: BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is currently an important chronic liver disease threatening human life and health. OBJECTIVE: To investigate the risk factors of hepatocellular carcinoma (HCC) associated with nonalcoholic fatty liver disease (NAFLD) by systematic review. METHODS: We conducted a systematic review and meta-analysis. A systematic search of Chinese and English databases (PubMed, Web of Science, Cochrane Library, China national knowledge infrastructure (CNKI), Wanfang database, and VIP database) was performed until June 30, 2023. Studies were included to investigate the risk factors for HCC in patients with NAFLD. Quality evaluation was …performed using the Newcastle-Ottawa Literature Quality Evaluation Scale, and then hazard ratios (HRs) for different influencing factors were combined. RESULTS: We reviewed the results of 12 high-quality cohort studies involving 738,934 patients with NAFLD and 1,480 developed HCC. A meta-analysis based on a random-effects model showed that advanced age (HR = 1.81, 95% CI: 1.51–2.17), male gender (HR = 2.51, 95% CI: 1.67–3.78), hypertension (HR = 1.87, 95% CI: 1.05–3.33), and diabetes (HR = 2.27, 95% CI: 1.63–3.16) were risk factors for HCC in NAFLD, and the differences were statistically significant. However, there was no statistically significant effect of current smoking (HR = 1.45, 95% CI: 0.72–2.92) and dyslipidemia (HR = 1.03, 95% CI: 0.72–1.47) on HCC incidence in this study. CONCLUSION: Age, sex, hypertension and diabetes are risk factors for HCC in NAFLD patients. Diabetic NAFLD patients have a 2.27-fold increased risk of HCC, and health education and intervention for elderly, male, NAFLD patients with diabetes and hypertension need to be strengthened to promote a reduction in the risk of HCC. Show more
Keywords: Nonalcoholic fatty liver disease, hepatocellular carcinoma, risk factors, meta-analysis
DOI: 10.3233/THC-231331
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Muniasamy, Anandhavalli
Article Type: Research Article
Abstract: BACKGROUND: A daily activity routine is vital for overall health and well-being, supporting physical and mental fitness. Consistent physical activity is linked to a multitude of benefits for the body, mind, and emotions, playing a key role in raising a healthy lifestyle. The use of wearable devices has become essential in the realm of health and fitness, facilitating the monitoring of daily activities. While convolutional neural networks (CNN) have proven effective, challenges remain in quickly adapting to a variety of activities. OBJECTIVE: This study aimed to develop a model for precise recognition of human activities to …revolutionize health monitoring by integrating transformer models with multi-head attention for precise human activity recognition using wearable devices. METHODS: The Human Activity Recognition (HAR) algorithm uses deep learning to classify human activities using spectrogram data. It uses a pretrained convolution neural network (CNN) with a MobileNetV2 model to extract features, a dense residual transformer network (DRTN), and a multi-head multi-level attention architecture (MH-MLA) to capture time-related patterns. The model then blends information from both layers through an adaptive attention mechanism and uses a SoftMax function to provide classification probabilities for various human activities. RESULTS: The integrated approach, combining pretrained CNN with transformer models to create a thorough and effective system for recognizing human activities from spectrogram data, outperformed these methods in various datasets – HARTH, KU-HAR, and HuGaDB produced accuracies of 92.81%, 97.98%, and 95.32%, respectively. This suggests that the integration of diverse methodologies yields good results in capturing nuanced human activities across different activities. The comparison analysis showed that the integrated system consistently performs better for dynamic human activity recognition datasets. CONCLUSION: In conclusion, maintaining a routine of daily activities is crucial for overall health and well-being. Regular physical activity contributes substantially to a healthy lifestyle, benefiting both the body and the mind. The integration of wearable devices has simplified the monitoring of daily routines. This research introduces an innovative approach to human activity recognition, combining the CNN model with a dense residual transformer network (DRTN) with multi-head multi-level attention (MH-MLA) within the transformer architecture to enhance its capability. Show more
Keywords: Wearable sensors, human activity recognition, dense-residual connection, attention, CNN, transformers
DOI: 10.3233/THC-241064
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: M.G, Sumithra | Venkatesan, Chandran
Article Type: Research Article
Abstract: BACKGROUND: The identification of infection in diabetic foot ulcers (DFUs) is challenging due to variability within classes, visual similarity between classes, reduced contrast with healthy skin, and presence of artifacts. Existing studies focus on visual characteristics and tissue classification rather than infection detection, critical for assessing DFUs and predicting amputation risk. OBJECTIVE: To address these challenges, this study proposes a deep learning model using a hybrid CNN and Swin Transformer architecture for infection classification in DFU images. The aim is to leverage end-to-end mapping without prior knowledge, integrating local and global feature extraction to improve detection …accuracy. METHODS: The proposed model utilizes a hybrid CNN and Swin Transformer architecture. It employs the Grad CAM technique to visualize the decision-making process of the CNN and Transformer blocks. The DFUC Challenge dataset is used for training and evaluation, emphasizing the model’s ability to accurately classify DFU images into infected and non-infected categories. RESULTS: The model achieves high performance metrics: sensitivity (95.98%), specificity (97.08%), accuracy (96.52%), and Matthews Correlation Coefficient (0.93). These results indicate the model’s effectiveness in quickly diagnosing DFU infections, highlighting its potential as a valuable tool for medical professionals. CONCLUSION: The hybrid CNN and Swin Transformer architecture effectively combines strengths from both models, enabling accurate classification of DFU images as infected or non-infected, even in complex scenarios. The use of Grad CAM provides insights into the model’s decision process, aiding in identifying infected regions within DFU images. This approach shows promise for enhancing clinical assessment and management of DFU infections. Show more
Keywords: Diabetic foot ulcer, infection classification, convolutional neural network, Swin Transformer, Grad CAM
DOI: 10.3233/THC-241444
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Wang, Guoyu | Han, Yang | Zhuang, Juhua | Mai, Zhongchao | Xia, Wei | Ye, Ying
Article Type: Research Article
Abstract: BACKGROUND: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-attributed mortality and the primary liver malignancy in the world. Echinacoside is a phenylethanoid glycoside derived from traditional Chinese medicinal herbs which possessed multiple health benefits on humans, including anti-tumor effects. OBJECTIVE: This study aimed to demonstrate the function of echinacoside in HCC progression and the involvement of miR-30c-5p/FOXD1/KLF12 axis. METHODS: The HepG2 cells were treated by different dose of echinacoside, miR-30c-5p mimic, miR-30c-5p inhibitor, and FOXD1 overexpression lentiviruses or siRNA individually or simultaneously. The cell invasion and migration were measured by transwell …assay. RNA and protein levels were tested by RT-PCR and western blot, respectively. The regulatory function of miR-30c-5p on Forkhead box D1 (FOXD1), FOXD1 on Krüppel-like factor 12 (KLF12) was tested by luciferase reporter assay or/and ChIP assay. Meanwhile, a liver cancer lung metastasis mice model was used to examine the functions of echinacoside and miR-30c-5p on HCC metastasis in vivo . Moreover, the correlations among miR-30c-5p, FOXD1, KLF12, and HCC prognosis was analyzed using clinical sample and TCGA database. RESULTS: Based on both in vitro and in vivo investigations, we found that echinacoside could inhibit HCC cell migration, invasiveness, and tumor metastasis, and associated with the enhanced miR-30c-5p/FOXD1/KLF12 axis. Furthermore, through analyzing the interactions among intermediate molecules, we revealed that miR-30c-5p, FOXD1, and KLF12üere clinically relevant with each other in HCC patients, correlated with HCC prognosis, and regulated by echinacoside to contribute in the inhibition of HCC progression. CONCLUSIONS: These findings suggest that echinacoside could inhibit HCC progression, and the mechanism related to the enhanced miR-30c-5p/FOXD1/KLF12 axis. Moreover, the abovementioned intermediate molecules might serve as prospective biomarkers for HCC prognosis. Show more
Keywords: Echinacoside, microRNA, FOXD1, KLF12, hepatocellular carcinoma
DOI: 10.3233/THC-241449
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Song, Jie | Lan, Ruihong | Yin, Dahua | Wang, Ling | Gong, Humin
Article Type: Research Article
Abstract: BACKGROUND: Folic acid supplementation has been shown to provide benefits in preventing neural tube defects and other birth defects, as well as reducing adverse pregnancy outcomes. OBJECTIVE: This study aimed to examine the impact of various folic acid supplementation methods on pregnancy. METHODS: TaqMan-MGB technology was used to detect polymorphisms in the folate metabolism-related genes, MTHFR C677T and A1298C. Blood-related biochemical indicators, including HCY levels and history of adverse pregnancy, were examined in relation to different exposure factors (MTHFR gene polymorphism, HCY levels, and adverse pregnancy history) and their impact on pregnancy outcomes. …Various forms of folic acid intervention were implemented in a population with an adverse pregnancy history and high HCY levels to analyze the effects of reducing HCY levels and improving pregnancy outcomes. RESULTS: Exposure factors, such as adverse pregnancy history, HCY, and medium-to-high risk of gene metabolism, were closely associated with pregnancy outcomes. Interestingly, methylfolate efficiently reduced the serum HCY levels. More importantly, the methylfolate group exhibited a significantly lower incidence of adverse pregnancies than the synthetic folic acid group. CONCLUSION: In this study, the risk factors, including adverse pregnancy history, HCY, and medium-to-high risk of gene metabolism, were confirmed to lead to the poorer pregnancy outcomes in our cohort. 5-methyltetrahydrofolate may be an effective approach for decreasing the incidence of adverse pregnancy outcomes. Show more
Keywords: MTHFR, HCY, adverse pregnancy history, pregnancy outcome, folic acid
DOI: 10.3233/THC-241034
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Wang, Mengxing | Xia, Tian | Wang, Ying
Article Type: Research Article
Abstract: BACKGROUND: Dental pulpitis significantly impacts oral function and quality of life. Treatments like direct pulp capping aim to preserve pulp vitality. OBJECTIVE: This study aims to investigate the application value of Nd:YAG laser irradiation in preserving pulp vitality in children with caries-induced pulpitis. METHODS: This study, conducted from June 2019 to June 2023, included 89 children undergoing pulp vitality preservation treatment for caries-induced pulpitis. The children were divided into two groups using sealed envelopes: 44 in the control group received pulp capping treatment, while the study group received Nd:YAG laser-assisted pulp capping treatment. …The efficacy, oral indicators, oral function, changes in root apex diameter and root length, changes in gingival crevicular fluid inflammatory factors, and incidence of complications were compared between the two groups before and 3 months after treatment. RESULTS: The total effective rates were 97.78% in the study group and 95.45% in the control group, with no significant difference between the groups (p > 0.05). Before treatment, there were no differences in gingival index, plaque index, and probing bleeding index between the groups (p > 0.05). After treatment, both groups showed decreased periodontal indexes compared to before treatment, with the study group showing lower values than the control group (p < 0.05). Chewing and biting function scores were similar between the groups before and after treatment (p > 0.05), but both groups showed decreased scores after treatment (p < 0.05). The study group had a higher percentage decrease in root apex diameter and a greater increase in root length compared to the control group (p < 0.05). During treatment, one case of tooth discoloration occurred in the study group (2.27%), while the control group had two cases of tooth discoloration and one case of secondary caries, resulting in a complication rate of 6.67%. There was no significant difference in the incidence of complications between the groups (p > 0.05). CONCLUSION: Nd:YAG laser irradiation effectively preserves pulp vitality in children with caries-induced pulpitis, improving periodontal health, reducing root apex diameter, and increasing root length with high safety. Show more
Keywords: Nd: YAG laser, caries-induced pulpitis, children, oral function
DOI: 10.3233/THC-241233
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Ji, Yanping | Ding, Qingbin | Bu, Tianyi | Wang, Kun | Zhang, Jing | Wang, Xue
Article Type: Research Article
Abstract: BACKGROUND: Cirrhosis is one of the most common clinical diseases in the world. The patient with cirrhosis has many complications, such as spontaneous peritonitis, hepatic encephalopathy. Malnutrition is one of the most common complications in patients with cirrhosis, and it is also a key factor affecting the prognosis of patients. However, the research on cirrhosis malnutrition is relatively scarce. OBJECTIVE: This study aimed to explore the new factors of the liver cirrhosis with the nutritional status. METHODS: A total of 370 patients with liver cirrhosis were admitted to the Fourth Affiliated Hospital of …Harbin Medical University from January 2019 to January 2023 were selected. Patients were assigned to the malnourished group and normal group. The weight, height, mid arm circumference (MAC) and triceps skinfold thickness (TSF) of the two groups were measured. Body mass index (BMI) and mid-arm muscle circumference (MAMC) were calculated. Furthermore, the Health Literacy Management Scale (HeLMS), biochemical indexes, incidence of complications, disease grade were also counted and the Royal Free Hospital-Nutrition Prioritization Tool were used to evaluate the nutritional status of the patient. RESULTS: A total of 370 patients was included in this study, including 177 malnutrition patients, accounting for 45.29%, and the scores and total scores of the patients in the malnutrition group were lower than those in the normal group. The measured values of Na+ , Alb, PA, T-Bil, TC, TLC, Hb, and RBC were all lower than those of the normal group, and the difference was statistically significant. The overall complication rate of the patients in the malnourished group was 89.61%, and that of the normal group was 39.78%. Multifactorial logistic regression analysis was performed with nutritional level as the dependent variable (normal = 0, malnutrition = 1), and the above indicators of variability (Na+ , Alb, PA, T-Bil, TC, PT, Hb, RBC, HG, and HeLMS scores) as the independent variables. The results showed that Na+ , Hb were the influencing factors of nutritional level (P < 0.05). CONCLUSION: The incidence of malnutrition in cirrhotic patients included in this study was at a moderate level, and the nutritional literacy of these patients was low. In addition, the level of serum sodium, Hemoglobin can affect the nutritional level of patients with cirrhosis. Show more
Keywords: Cirrhosis, malnutrition, correlation factor
DOI: 10.3233/THC-241180
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ruan, Yingqing | Liu, Ping | Qiu, Minjie
Article Type: Research Article
Abstract: BACKGROUND: Stress urinary incontinence (SUI), a prevalent condition among middle-aged and elderly women in China, is characterized by the involuntary leakage of urine during instances of increased abdominal pressure [1]. Although SUI is not life-threatening, it substantially impacts patients’ physical and psychological well-being, impairs their social interactions, and diminishes their overall quality of life. OBJECTIVE: The aim of this study was to evaluate and compare the clinical efficacy of tension-free vaginal tape-ischiopubic ramus (TVT-IR) and transobturator tension-free vaginal tape (TVT-O) in the treatment of female stress urinary incontinence (SUI). METHODS: A retrospective analysis …of clinical data from 83 female SUI patients was conducted, dividing them into a TVT-IR group (n = 41) and a TVT-O group (n = 42) based on the surgical procedures employed. Perioperative indices, surgical efficacy, complications, symptom improvement pre- and post-operation (3 months), urodynamic measurements, and indices related to pelvic floor function and quality of life were compared between the two groups. RESULTS: The TVT-IR group had significantly shorter operative time than the TVT-O group (P < 0.05). Three months after surgery, both groups had significantly lower frequency of incontinence, incontinence score, and number of nocturnal urination, significantly higher Pdet, ALPP, Qmax, and MUCP, significantly higher class I and class II fiber muscle strength and muscle potential, and significantly higher I-QOL scores (P < 0.05). The aforementioned indicators were superior in the TVT-IR group compared to the TVT-O group three months after surgery (P < 0.05). CONCLUSION: Both TVT-IR and TVT-O are effective in treating SUI, with comparable complication rates. Show more
Keywords: Female stress urinary incontinence, tension-free vaginal tape-ischiopubic ramus, transobturator tension-free vaginal tape, quality of life
DOI: 10.3233/THC-241247
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhang, Shanwen | Bao, Zhimin | Liao, Taotao | Pei, Zhenying | Yang, Shiyu | Zhao, Chunjiao | Zhang, Yuping
Article Type: Research Article
Abstract: BACKGROUND: Although intracoronary electrocardiography (IC-ECG) offers direct electrophysiological insights into myocardial ischemia caused by insufficient coronary blood supply, compared to common diagnostic methods like electrocardiography (ECG), it lacks widespread adoption and robust clinical research. OBJECTIVE: To analyze the value and accuracy of intracoronary electrocardiogram in myocardial ischemia diagnosis in coronary heart disease patients. METHODS: Three hundred patients treated at our hospital were included in the study. Patients were categorized into non-ischemic group A (Fraction Flow Reserve [FFR] > 0.8) and ischemic group B (FFR < 0.75) based …on FFR examination results. Both groups underwent IC-ECG examination. The ischemic group received percutaneous coronary intervention (PCI) treatment followed by another FFR examination, dividing them into non-ischemic subgroup B1 (FFR > 0.8) and ischemic subgroup B2 (FFR < 0.75). Both subgroups underwent IC-ECG examination. Receiver operating curves were constructed using FFR to assess the clinical utility of different IC-ECG parameters. RESULTS: Group A patients showed a significant decrease in ST-segment shift at J-point, ST-segment integral, T-peak, T-wave integral, and T-peak to end-time, while the Corrected Q-T interval (QTc-time) was significantly higher in the B group (p < 0.05). The parameters, including ST-segment shift at J-point, ST-segment integral, T-wave integral, T-peak, T-peak to end-time, and QTc-time, were found to have clinical significance in predicting the occurrence of myocardial ischemia (p < 0.05). CONCLUSION: Intracoronary electrocardiogram QT interval dispersion and Q-T peak (QTp) interval dispersion have a high diagnostic accuracy for myocardial ischemia in coronary heart disease. Show more
Keywords: Intracoronary electrocardiogram, coronary heart disease, myocardial ischemia, diagnostic value, accuracy
DOI: 10.3233/THC-240837
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Fei, Biyan | Zhan, Lili | Gou, Jingqi | Wu, Yanping | Sun, Haili
Article Type: Research Article
Abstract: BACKGROUND: Discussed based on the network interactive platform of structured care for patients with chronic renal failure (CRF) in the process of hemodialysis. OBJECTIVE: This study seeks to elucidate the application value of structured nursing, deployed through network interaction platforms, in sustaining patients undergoing maintenance hemodialysis. METHODS: A total of 62 patients diagnosed with Chronic Renal Failure (CRF) between April 2022 and August 2023 were randomly allocated into two distinct care groups: conventional and structured nursing care based on a web-interactive platform. Both cohorts were comparatively analyzed with respect to psychological states, quality …of life within therapeutic interventions, and relationships with complications. Renal function indicators, including Creatinine Clearance (Ccr), Serum Creatinine (SCr), and Blood Urea Nitrogen (BUN), were subjected to Pearson analysis to appraise their predictive value in prognostication, while Receiver Operating Characteristic (ROC) curve analysis was constructed to further discern their diagnostic precision. RESULTS: Post-intervention, notable improvements were observed in the emotional states of patients in both cohorts, with the structured care group exhibiting significantly lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores (p < 0.05). Furthermore, patients under the web-interactive structured nursing regimen demonstrated superior overall adherence, a reduced incidence rate of complications, and markedly higher scores in quality of life assessments compared to those under conventional care (p < 0.05). The derived cut-off values for Ccr, SCr, and BUN were 32.5 ml/min, 251.5 umol/L, and 14.5 mmol/L, respectively, with sensitivities and specificities pegged at 0.645% and 0.645% for Ccr, 0.774% and 0.548% for SCr, and 0.774% and 0.774% for BUN. The corresponding areas under the ROC curve (AUC) for each parameter were 0.816, 0.653, and 0.856, respectively. CONCLUSION: Comprehensive hemodialysis care for patients with chronic renal failure can improve self-care ability to improve quality of life and reduce the incidence of complications, which has great potential for clinical progress and is worthy of further research. Show more
Keywords: Comprehensive nursing, chronic renal failure, hemodialysis, clinical care outcomes, quality of life
DOI: 10.3233/THC-241021
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Luo, Haichao | Chen, Ran | Wang, Changying | Chen, Qitian
Article Type: Research Article
Abstract: BACKGROUND: Targeted therapy and immunotherapy has brought new hope to patients with lung adenocarcinoma (LUAD) with their applications. However, the prognosis of LUAD patients is still unpromising. OBJECTIVE: It is particularly important to find the biomarkers that can predict the prognosis of LUAD. In our previous study, we found that patients with high expression of LINC02390 had a better prognosis. The clinical significance of LINC02390 and its potential target genes, CLECL1 and CD69, in the prognosis of LUAD and its role in the immune microenvironment were explored. METHODS: Through the survival analysis, LINC02390 …and its potential target genes, CLECL1 and CD69, were identified as good prognostic factors for LUAD. According to GO and KEGG analyses, LINC02390-related genes were identified potentially involved in immune-related signaling pathways. Gene mutations and their relationship with immune cell infiltration were verified through the online cbioportal and TIMER database. RESULTS: CD69 was found to positively associate with CD8 + T cells and CLECL1 was also positively associated with CD4 + T cells. A high expression of CD69 in CD8 + T cells was identified through the single-cell sequencing dataset GSE111894. Finally, CLECL1 and CD69 were lowly expressed in clinical tissue samples with LUAD by immunohistochemical staining. CONCLUSIONS: LINC02390 and its possible target genes, CLECL1 and CD69, may be potential targets for the immunotherapy in LUAD patients. Show more
Keywords: LINC02390, CLECL1, CD69, lung adenocarcinoma, immune microenvironment, immunotherapy
DOI: 10.3233/THC-241452
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: He, Xuwei | Lou, Tianzheng | Zhang, Ning | Zhu, Bin | Zeng, Danyi | Chen, Hua
Article Type: Research Article
Abstract: BACKGROUND: Due to the high-risk nature of sepsis, emergency departments urgently need a simple evaluation method to assess the degree of inflammation and prognosis in sepsis patients, providing a reference for diagnosis and treatment. OBJECTIVE: To investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) combined with the blood urea nitrogen-to-serum albumin ratio (BAR) in sepsis. METHODS: A total of 377 sepsis patients admitted to Lishui People’s Hospital from June 2022 to June 2023 were selected as the study subjects. Based on their prognosis, they were divided into a survival group (255 cases) …and a death group (82 cases). The clinical data of the two groups were compared. Multivariate logistic analysis was used to identify factors influencing sepsis prognosis, and ROC curve analysis was used to assess the predictive efficacy of NLR, BAR, and their combination. RESULTS: Compared with survivors, non-survivors had higher NLR and BAR, with statistically significant differences (p < 0.05). After adjusting for confounding factors, NLR (OR = 1.052) and BAR (OR = 1.095) were found to be independent prognostic factors for sepsis patients (both p < 0.05). The AUC of NLR combined with BAR was 0.798 (95% CI 0.745–0.850, p < 0.05), higher than the AUC of NLR alone (0.776) and BAR alone (0.701). CONCLUSIONS: The combination of NLR and BAR has a high predictive value for the prognosis of sepsis patients. Its simple calculation makes it particularly suitable for use in emergency departments. Show more
Keywords: Neutrophil-to-lymphocyte ratio, blood urea nitrogen to serum albumin ratio, sepsis, prognosis
DOI: 10.3233/THC-241415
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zhou, Yan | Liu, Yubao | Han, Yutong | Yan, Hongxia
Article Type: Research Article
Abstract: BACKGROUND: Intensive care unit acquired weakness (ICU-AW) is a secondary neuromuscular complication in critically ill patients, characterized by profound weakness in all four limbs. Studies have shown that bundles of care are nursing strategies that combine a series of evidence-based interventions, which collectively optimize patients’ clinical outcomes compared to individual interventions. OBJECTIVE: This study aims to conduct a meta-analysis of the effects of bundle interventions on ICU-AW deeply exploring the characteristics of bundle interventions, patient outcomes related to ICU-AW, and primarily investigating the effects of bundle interventions on ICU-AW. The main focus is to explore the …clinical value of bundle interventions in treatment of ICU-acquired weakness in patients. METHODS: Computer and manual searches were conducted using keywords to retrieve relevant studies on the effects of bundle interventions on ICU-AW from databases such as PubMed, Web of Science, Cochrane Library and EMbase. The search period ranged from database inception to the present. The control group received standard ICU care, including basic nursing, while the intervention group received bundle nursing interventions. RESULTS: A total of 10 randomized controlled trials (RCTs) involving 1545 participants (790 in the intervention group and 755 in the control group) were included. Meta-analysis results showed that the intervention group had significantly higher muscle strength (MD = 7.41, 95% CI: 6.65–8.16, P < 0.00001) and daily living ability (MD = 34.01, 95% CI: 32.54–35.48, P < 0.00001) than the control group. Additionally, the incidence of ICU-AW (OR = 0.39, 95% CI: 0.26–0.59, P < 0.00001), mechanical ventilation time (MD = - 3.71, 95% CI: - 3.58∼ - 2.76, P < 0.0001), and ICU length of stay (MD = - 2.73, 95% CI: - 3.14∼ - 2.31, P < 0.00001) were significantly lower in the intervention group than in the control group. CONCLUSION: ICU-AW has a severe negative impact on the recovery and functional restoration of ICU patients, increasing the treatment complexity for healthcare providers and the mortality and disability rates for patients. The bundled care approach may help reduce the incidence of ICU-AW, promote the restoration of daily activity function, enhance muscle strength, and reduce ICU stay and mechanical ventilation time for ICU patients. However, the long-term effects of bundle interventions still require further in-depth research. Show more
Keywords: Nursing interventions, muscle weakness, intensive care unit, incidence, meta-analysis
DOI: 10.3233/THC-241542
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Lin, Ai-Ling | Hou, Jian-Hua
Article Type: Research Article
Abstract: BACKGROUND: This study explores the influence of Diagnosis-Related Groups (DRG) payment reform on hospital cost control and offers pertinent cost management strategies for public hospitals. It situates the research by elucidating the significance of the DRG payment method and comparing its advantages and drawbacks with the traditional ‘pay per project’ model. OBJECTIVE: The primary aim is to assess the impact of DRG payment reform on hospital cost control and propose effective cost management strategies for public hospitals. The objective is to provide insights into DRG payment implications and attempt practical recommendations for its implementation in the …public healthcare sector. METHODS: Employing a comprehensive approach, the study analyzes DRG payment, delineates advantages and drawbacks, and proposes cost management strategies. Methods include staff training, an information management platform, disease analysis, and optimized cost accounting. The study highlights the potential for improved medical diagnosis and treatment through industry-finance integration. RESULTS: Findings reveal advantages and limitations of DRG payment, emphasizing strategies for optimizing hospital operations. Enhanced medical diagnosis and treatment procedures through industry-finance integration contribute to overall cost control effectiveness. CONCLUSION: The study serves as a practical guide for implementing DRG payment reforms, offering valuable insights for policymakers and healthcare professionals in navigating the complexities of cost control in public healthcare. Show more
Keywords: DRG payment method, hospital cost control, public hospital, cost management, integration of industry and finance
DOI: 10.3233/THC-240110
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 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. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Jandric, Milka | Zlojutro, Biljana | Momcicevic, Danica | Dragic, Sasa | Kovacevic, Tijana | Djajic, Vlado | Stojiljkovic, Milos P. | Loncar-Stojiljkovic, Dragana | Skrbic, Ranko | Djuric, Dragan M. | Kovacevic, Pedja
Article Type: Research Article
Abstract: BACKGROUND: Critically ill COVID-19 patients are usually subjected to clinical, laboratory, and radiological diagnostic procedures resulting in numerous findings. Utilizing these findings as indicators for disease progression or outcome prediction is particularly intriguing. OBJECTIVES: Exploring the significance of dynamic changes in haematological and biochemical parameters in predicting the mortality of critically ill COVID-19 patients. METHODS: The present study was a prospective and observational study involving mechanically ventilated 75 critically ill adult COVID-19 patients with hypoxemic respiratory failure. The collected data included baseline patient characteristics, treatment options, outcome, and laboratory findings at admission and …7 days after. The dynamics of the obtained findings were compared between survivors and non-survivors. RESULTS: The 28-day survival rate was 61.3%. In the group of non-survivors significant dynamic changes were found for C-reactive protein (p = 0.001), interleukin-6 (p < 0.001), lymphocyte (p = 0.003), neutrophil-lymphocyte ratio (p = 0.003), platelets (p < 0.001), haemoglobin (p < 0.001), iron (p = 0.012), and total iron-binding capacity (p < 0.001). Statistically significant changes over time were found for ferritin (p = 0.010), D-dimer (p < 0.001), hs-troponin T (p < 0.002), lactate dehydrogenase (p = 0.001), glucose (p = 0.023), unsaturated iron-binding capacity (p = 0.008), and vitamin D (p < 0.001). CONCLUSION: The dynamic changes in inflammatory, haematological and biochemical parameters can predict disease severity, and outcome. Show more
Keywords: COVID-19, intensive care, outcome, prediction, laboratory parameters
DOI: 10.3233/THC-241006
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 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. Pre-press, no. Pre-press, pp. 1-19, 2024
Authors: Li, Han | Li, Hui | Tian, Yiyang | Hu, Xiefeng | Hu, Xianhui | Qin, Xin | Yin, Yong
Article Type: Research Article
Abstract: BACKGROUND: Laparoscopic partial nephrectomy (LPN) is a standard surgical treatment option for renal tumors. Prior to LPN, it is necessary to evaluate the tumor condition and develop a surgical plan using precise imaging. OBJECTIVE: To explore the clinical application value of 3D virtual model (3DVM) in LPN. METHODS: A total of 80 patients with renal tumor who underwent LPN were measured. Patients were divided into three cohorts (A, B, C) according to the difficulty of surgery. Each group was further divided into the test and control groups based on the application of preoperative …3DVM. Surgical safety and efficacy were assessed, and a questionnaire was developed to investigate the opinions of patients and physicians on 3DVM. RESULTS: The duration of LPN and intraoperative renal artery occlusion were significantly different between the test and control groups in both cohorts A and B (P < 0.05). In cohort C, the surgical duration, duration of intraoperative renal artery occlusion, length of stay, time to postoperative ambulation, intraoperative bleeding, incidence of postoperative bleeding were significantly between the two groups (P < 0.05). The analysis both of patients and physicians questionnaire scores were statistically significant (P < 0.05). CONCLUSIONS: 3DVM contributes to safer and more effective LPN. It benefits both doctors and patients. Show more
Keywords: Renal cell carcinoma, renal cancer, laparoscopic partial nephrectomy, 3D virtual model
DOI: 10.3233/THC-240421
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Xiang, Qiong | Chen, Jia-Jia | Feng, Ni-Na | Li, Xian-Hui
Article Type: Research Article
Abstract: BACKGROUND: With the continuous advancement of medical technology, the survival rate of preterm infants is gradually improving, However, due to the underdeveloped function of various organs and systems, preterm infants are often exposed to light, noise, medical as well as nursing operations and other stimuli during their hospitalization in neonatal intensive care unit (NICU); it is highly susceptible to a number of problems, such as pain, unstable vital signs, growth retardation, and sleep disruption. OBJECTIVE: This article reviews the research progress of music intervention in nursing of premature infants in NICU with both traditional and conventional …care. METHODS: This article reviews the research background, methodology/design, and measurement/application effects of music interventions, including Chinese and Western traditional music, in the care of preterm infants in NICU. All scholarly literature retrieved from MEDLINE\ PubMed, Science Citation Index Expanded, Google scholar, CNKI scholar, Scopus and PubsHub. RESULTS: As a simple and effective non-pharmacological intervention, music intervention can effectively alleviate neonatal surgical pain, increase heart rate and oxygen saturation, promote sleep, growth and development, and improve neurological development. CONCLUSIONS: This review provide theoretical references for clinical practice. Show more
Keywords: Music intervention, music therapy, music medicine, premature infants, neonatal intensive care unit
DOI: 10.3233/THC-241263
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Tang, Yizhi | Chen, Peng | Tang, Tian | Luo, Zhihui | Wang, Xuelian | Ma, Xinxin | Jin, Lijia
Article Type: Research Article
Abstract: BACKGROUND: Accurate sentinel lymph node (SLN) characterization is essential for breast cancer management, prompting advancements in imaging technologies such as contrast-enhanced ultrasound (CEUS) and sound touch quantification (STQ) to enhance diagnostic precision. OBJECTIVE: To explore the value of perfusion characteristics evaluated by CEUS combined with STQ parameters in diagnosing the properties of sentinel lymph node (SLN) in breast cancer. METHODS: A total of 91 breast cancer patients (91 SLNs) admitted to the hospital from February 2022 to December 2023 were selected for this study. Among them, 26 patients with metastatic SLN confirmed by …surgery and pathology were included in the metastatic SLN group, and 65 patients with non-metastatic SLN were included in the non-metastatic SLN group. Preoperative examination results of CEUS and STQ were retrospectively analyzed. The diagnostic efficacy of perfusion characteristics evaluated by CEUS and STQ parameters for the properties of SLN in breast cancer was analyzed using the receiver operating characteristics (ROC) curve. Statistical methods such as chi-square tests and logistic regression analysis were employed to analyze the data. RESULTS: Enhancement patterns differed significantly between the metastatic SLN and non-metastatic SLN groups (p < 0.05). ROC curve analysis indicated that CEUS perfusion characteristics had an AUC value of 0.823 for diagnosing SLN properties, with a sensitivity of 84.62% and specificity of 70.77% using type I as the critical value. Additionally, STQ measurement showed significantly higher values in the metastatic SLN group (44.18 ± 6.53 kPa) compared to the non-metastatic SLN group (34.69 ± 6.81 kPa) (t = 6.075, p < 0.001). The AUC value for STQ parameters in diagnosing metastatic SLN was 0.849, with a sensitivity of 73.08% and specificity of 92.31% using 42.40 kPa as the critical value. Though the AUC value of STQ measurement was higher than CEUS perfusion characteristics alone, the difference was not statistically significant (Z = 0.393, p = 0.695). Moreover, combining CEUS perfusion characteristics with STQ parameters yielded an AUC value of 0.815 for diagnosing SLN properties, showing no significant difference compared to diagnosis with CEUS or STQ parameters alone (Z = 0.149, 0.516, p = 0.882, 0.606). CONCLUSION: Combined use of perfusion characteristics evaluated by CEUS and STQ parameters can significantly improve the diagnostic specificity of SLN in breast cancer. It is worthy of clinical promotion. Show more
Keywords: Breast cancer, sentinel lymph node, diagnosis, contrast-enhanced ultrasound, sound touch quantification
DOI: 10.3233/THC-241232
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Jundaeng, Jarupat | Chamchong, Rapeeporn | Nithikathkul, Choosak
Article Type: Research Article
Abstract: BACKGROUND: Artificial intelligence (AI) acts as the state-of-the-art in periodontitis diagnosis in dentistry. Current diagnostic challenges include errors due to a lack of experienced dentists, limited time for radiograph analysis, and mandatory reporting, impacting care quality, cost, and efficiency. OBJECTIVE: This review aims to evaluate the current and future trends in AI for diagnosing periodontitis. METHODS: A thorough literature review was conducted following PRISMA guidelines. We searched databases including PubMed, Scopus, Wiley Online Library, and ScienceDirect for studies published between January 2018 and December 2023. Keywords used in the search included “artificial intelligence,” …“panoramic radiograph,” “periodontitis,” “periodontal disease,” and “diagnosis.” RESULTS: The review included 12 studies from an initial 211 records. These studies used advanced models, particularly convolutional neural networks (CNNs), demonstrating accuracy rates for periodontal bone loss detection ranging from 0.76 to 0.98. Methodologies included deep learning hybrid methods, automated identification systems, and machine learning classifiers, enhancing diagnostic precision and efficiency. CONCLUSIONS: Integrating AI innovations in periodontitis diagnosis enhances diagnostic accuracy and efficiency, providing a robust alternative to conventional methods. These technologies offer quicker, less labor-intensive, and more precise alternatives to classical approaches. Future research should focus on improving AI model reliability and generalizability to ensure widespread clinical adoption. Show more
Keywords: Artificial intelligence, panoramic radiograph, periodontitis, periodontal disease, diagnosis
DOI: 10.3233/THC-241169
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Li, Chunbo | Li, Kejun
Article Type: Research Article
Abstract: BACKGROUND: Scientific treatments for postpartum urinary incontinence, including pelvic floor muscle exercises (such as Kegel exercises) and infrared therapy, can effectively improve pelvic floor and urethral function, thus enhancing quality of life. However, clinical research on the combined use of these interventions for postpartum urinary incontinence is limited. OBJECTIVE: To investigate the combining efficacy of pelvic floor muscle exercises with infrared physiotherapy on postpartum urinary incontinence. METHODS: Clinical information of 102 patients with postpartum urinary incontinence (June 2021–June 2022) were collected and analyzed. Patients were randomly divided into control (conventional intervention) and observation …(pelvic floor muscle exercises combined with infrared physiotherapy) groups, with 52 and 50 cases respectively. We compared pelvic floor muscle strength, urodynamic indicators, leakage volume, quality of life, and overall clinical efficacy between the two groups. RESULTS: Before intervention, both groups had similar pelvic floor function scores and urodynamic indicators. Post-intervention, the pelvic floor function scores in the observation group were significantly lower than control. The urodynamic indicator levels of the observation group were markedly higher than control after 2 months of intervention. Leakage volume was similar before intervention, while the observation group had significantly lower volumes after 1 and 2 months of intervention. Quality of life scores were similar initially, but after 2 months, the observation group scored higher. The observation group showed notably better pelvic floor rehabilitation at 2 months post-intervention. CONCLUSION: Combining pelvic floor muscle exercise with infrared physiotherapy has been shown to be a highly effective approach in enhancing pelvic floor muscle strength and improving the quality of life for postpartum women experiencing urinary incontinence. This combined therapy also demonstrates positive effects on urodynamic indicators, reducing leakage volume, and facilitating pelvic floor rehabilitation. Show more
Keywords: Pelvic floor muscle exercise, infrared physiotherapy, postpartum urinary incontinence, quality of life
DOI: 10.3233/THC-240831
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhang, Xian | Yang, Xia | Li, Yanhong
Article Type: Research Article
Abstract: BACKGROUND: Bronchopulmonary dysplasia (BPD) ranks among preterm infants’ most common and severe respiratory diseases. Lung ultrasound scores (LUS) play a vital role in predicting early BPD and guiding treatment and intervention strategies for affected patients. OBJECTIVE: Performed a meta-analysis to assess the diagnostic LUS for newborns with BPD. METHODS: Online electronic databases such as MEDLINE, CINAHL, the Cochrane Library, and Web of Science were used to retrieve relevant research until May 2023. A total of 117 literatures were collected, and ten eligible articles were selected for meta-analysis. RESULTS: Meta-analysis was …performed on 10 studies (1274 neonates). LUS at 7 days after birth (7 days of life, DOL 7) showed good diagnostic accuracy for any type of BPD, moderate and severe BPD. DOL 7 was more accurate in predicting all types of BPD (AUC = 0.87, sensitivity = 0.75, specificity = 0.83) than moderate and severe BPD (AUC = 0.80, sensitivity = 0.69, specificity = 0.79). There was no statistical significance between DOL 7 and DOL 14 in their accuracy for predicting all types of BPD (difference in AUC = 0.04, p = 0.068). There was no notable distinction between DOL 7 and DOL 14 in their accuracy for predicting moderate and severe BPD (difference in AUC = - 0.04, p = 0.104). CONCLUSIONS: The diagnostic efficacy of LUS on DOL 7 in predicting the occurrence of all types of BDP and moderate-severe BPD is determined. This will facilitate rapid and accurate detection and timely treatment, thereby reducing the risk of neonatal mortality and sequelae. Show more
Keywords: Bronchopulmonary dysplasia, lung ultrasound scores, prediction, newborns
DOI: 10.3233/THC-240832
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Pandey, Anand | Singh, Ajeet | Boyapati, Prasanthi | Chaturvedi, Abhay | Purushotham, N. | M, Sangeetha
Article Type: Research Article
Abstract: BACKGROUND: Heart disease represents the leading cause of death globally. Timely diagnosis and treatment can prevent cardiovascular issues. An Electrocardiograms (ECG) serves as a diagnostic tool for identifying heart difficulties. Cardiovascular Disease (CVD) often gets identified through ECGs. Deep learning (DL) garners attention in healthcare due to its potential in swiftly diagnosing ECG anomalies, crucial for patient monitoring. Conversely, automatic CVD detection from ECGs poses a challenging task, wherein rule-based diagnostic models usually achieve top-notch performance. These models encounter complications in supervision vast volumes of diverse data, demanding widespread analysis and medical capability to ensure precise CVD diagnosis. …OBJECTIVE: This study aims to enhance cardiovascular disease diagnosis by combining symptom-based detection and ECG analysis. METHODS: To enhance these experiments, we built a novel automated prediction method based on a Feed Forward Neural Network (FFNN) model. The fundamental objective of our method is to develop the accuracy of ECG diagnosis. Our strategy employs chaos theory and destruction analysis to combine optimum deep learning features with a well-organized set of ECG properties. In addition, we use the constant-Q non-stationary Gabor transform (CQNGT) to convert one-dimensional ECG data into a two-dimensional picture. A pre-trained FFNN processes this image. To identify significant features from the FFNN output that correspond with the ECG data, we employ pairwise feature proximity. RESULTS: According to experimental findings, the suggested system, FFNN-CQNGT, surpasses other state-of-the-art systems in terms of precision of 94.89%, computational efficiency of 2.114 ms, accuracy of 95.55%, specificity of 93.77%, and sensitivity of 93.99% and MSE 40.32%. CONCLUSION: Contributing an automated ECG-based DL system based on FFNN-CQNGT for early-stage cardiovascular disease identification and classification holds great potential for both patient care and public health. Show more
Keywords: Cardiovascular Disease (CVD), Electrocardiograms (EEG), Feed Forward Neural Network (FFNN), constant-Q non-stationary Gabor transform (CQNGT)
DOI: 10.3233/THC-240543
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Chen, Wending | Wang, Jialin | Wang, Luyang | Hu, Wenwen | Chen, Xinzhong | Jin, Lin
Article Type: Research Article
Abstract: BACKGROUND: Perioperative depth monitoring techniques, such as electroencephalography bispectral index (BIS), entropy index, and auditory evoked potential, are commonly used to assess anesthesia depth. However, the influence of patient positioning changes, particularly in gynecological surgeries where a head-down position is often required, on the accuracy of these monitoring indices remains unexplored. OBJECTIVE: The aim of the our study was to observe the impact of patient position changes on the monitoring value of entropy and BIS to identify a more sensitive method of anaesthesia depth monitoring for gynaecological surgery patients. METHODS: We conducted a …study involving 40 women undergoing general anesthesia, during which routine monitoring of vital signs, including electrocardiogram (ECG), heart rate (HR), noninvasive arterial blood pressure (NIBP), oxyhemoglobin saturation (SpO2 ), and end-expiratory carbon dioxide (PetCO2 ), was initiated. Entropy and BIS devices were affixed to the patients’ foreheads after alcohol sterilization to record brain activity. Tracheal intubation was performed following anesthesia induction. Throughout anesthesia maintenance, the value of BIS and response entropy (RE) were monitored and maintained between 40 and 50 by adjusting the infusion rate of propofol and remifentanil with Target Controlled Infusion (TCI, Mintopharmacokinetics model). Dosing for infusion control utilized corrected weight (height-105). Data were recorded before and after position changes, including tilting the operating table to head-down positions of 15 and 25 degrees, returning to a supine position, and elevating the head to 15 and 25-degree angles. BIS and entropy values at different time points were compared between the groups. RESULTS: Both BIS and entropy values increased from supine to head-down position and decreased from supine to head-up position, with entropy changes preceding those of BIS. Heart rate increased after head-up and decreased after head-down, while mean blood pressure (MBP) exhibited the opposite effect on heart rate. Significant correlations were found between heart rate and BIS (correlation coefficient: - 0.43) and RE (correlation coefficient: - 0.416), as well as between MBP and BIS (correlation coefficient: 0.346) and RE (correlation coefficient: 0.384). CONCLUSION: Changes in patient position can significantly affect the value of RE and BIS, as changes in entropy occur earlier than changes in the BIS. Show more
Keywords: Bispectral index, entropy, RE, arterial blood pressure, heart rate
DOI: 10.3233/THC-241026
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Lin, Chunqin | Huang, Yanru | Lin, Qiansen
Article Type: Research Article
Abstract: BACKGROUND: Tonsillectomy and/or adenoidectomy can treat children with obstructive sleep apnea/hypopnea syndrome (OSAHS). OBJECTIVE: This study investigated the effects of tonsillectomy and/or adenoidectomy on cognitive function and brain structure in children with OSAHS. METHODS: This study included 40 obstructive sleep apnea/hypopnea syndrome children and 40 healthy children. The cognitive function and brain structure changes of OSAHS children before and after surgery and 40 healthy children were evaluated by the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) and the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), as well as brain resting-state fMRI functional …magnetic resonance imaging (rs-fMRI). RESULTS: Children with OSAHS showed higher Swanson, Nolan, and Pelham Rating Scale and lower Integrated Visual and Auditory Continuous Performance Test scores than healthy peers, indicating cognitive impairment. Post-surgery, there was a significant improvement in cognitive function, evidenced by decreased Swanson, Nolan, and Pelham Rating Scale and increased Integrated Visual and Auditory Continuous Performance Test scores. Compared to healthy children, OSAHS children displayed altered ReHo values in certain brain regions, such as decreased values in the right angular gyrus, right precuneus, left parahippocampal gyrus, and left middle frontal gyrus, but increased values in the right posterior cerebellum. After surgery, ReHo values increased in regions like the right precuneus, right temporal lobe, right posterior cingulate gyrus, and left limbic lobe, suggesting neurological changes associated with treatment. CONCLUSIONS: Children with obstructive sleep apnea/hypopnea syndrome had cognitive impairment and abnormal changes in multiple brain regions. Tonsillectomy and/or adenoidectomy could improve cognitive function and contribute to the reconstruction of brain function and structure in children with obstructive sleep apnea/hypopnea syndrome. Show more
Keywords: OSAHS, ReHo, SNAP-IV, IVA-CPT, rs-fMRI, cognitive function
DOI: 10.3233/THC-241028
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Xiong, Yi-Ying | Chen, Chao-Yang | Li, Xiang | Yue, Xin-Xin | Zhao, Ze-Yu
Article Type: Research Article
Abstract: BACKGROUND: Patients with tracheotomy are often monitored in the anesthesia recovery room after reoperation. During this period, oxygen therapy is necessary, and the existing tracheostomy oxygen supply device has many defects. OBJECTIVE: To evaluate the efficacy of a self-made tracheostomy oxygen delivery device on oxygen therapy during postoperative anesthesia recovery. METHODS: Patients were randomly divided into two groups, E and C, with 30 patients in each group, and admitted to the post-anesthesia care unit (PACU). Patients in group E received oxygen through a self-made tracheostomy oxygen delivery device, while patients in group C …were supplied oxygen through a unilateral nasal cannula. Respiration (R), pulse oximetry (SpO2 ), and the number of patients on ventilators were recorded at the time of admission (T0 ) and one hour after admission (T1 ). Rapid dry blood gas analyses were performed on 0.6 ml samples of arterial blood collected at T0 and T1 . RESULTS: Compared to group C, patients in group E had significantly higher arterial partial pressure of oxygen (PaO2 ), arterial oxygen saturation (SaO2 ), total carbon dioxide (T-CO2 ), and actual bicarbonate (AB), while arterial partial pressure of carbon dioxide (PaCO2 ) was significantly reduced (P < 0.01 or < 0.05). Compared to T0 , PaO2 decreased in both groups at T1 , PaCO2 decreased in group E, while SaO2 , T-CO2 , and AB decreased in group C (P < 0.01 or < 0.05). CONCLUSION: We found that using the self-made tracheostomy oxygen delivery device in postoperative anesthesia recovery had advantages such as a secure connection to the tracheostoma, adjustable oxygen concentration, air filtration, and the ability to switch oxygen supply between the ventilator and humidifier. Show more
Keywords: Anesthesia recovery, general anesthesia, oxygen delivery device, oxygen therapy, self-made, tracheostomy
DOI: 10.3233/THC-241184
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
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