Technology and Health Care - Volume Pre-press, issue Pre-press

Authors: Shao, Liang | Gao, Ying | Zhang, Dan | Yang, Mengdan | Jiang, Mimi | Li, Hongfeng | Yan, Yanting

Article Type: Research Article

Abstract: BACKGROUND: non-small cell lung cancer (NSCLC) accounts for more than 80% of all lung cancer populations. Stereotactic radiotherapy (SBRT) is mainly suitable for early NSCLC patients who are not suitable for surgery or refuse surgery. OBJECTIVE: To analyze the effects of stereotactic radiotherapy (SBRT) plus immunotherapy for non-small cell lung cancer (NSCLC) patients on their immune status and survival quality. METHODS: NSCLC patients admitted to our hospital from 2019–2022 were divided into 61 cases in control group (SBRT) and 60 cases in observation group (SBRT plus immunotherapy) by the randomized numerical table method …to compare the efficacy, the level of tumor markers in the serum, the level and activity of the immune cells in the peripheral blood and the Kahlil’s functional status (KPS) scores. RESULTS: The observation group had a higher efficacy rate than that of the control group (P < 0.05). There was no statistical difference between the two groups in serum tumor marker content, immune cell level and activity in peripheral blood and KPS score before treatment (P > 0.05). After treatment, serum tumor markers were lower than those in control group, and immune cell level, NK cell-related activity and KPS score were higher than those in control group (P < 0.05). CONCLUSION: SBRT plus immunotherapy can reduce the level of various tumor markers, improve the immune status and quality of survival for NSCLC patients. Show more

Keywords: Stereotactic radiotherapy, immunotherapy, non-small cell lung cancer, immune status, survival quality

DOI: 10.3233/THC-241177

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Liu, Bo | Wang, Kebing | Ye, Si

Article Type: Research Article

Abstract: BACKGROUND: Accurately identifying the branches of pulmonary segmental vessels and bronchi, as well as adjacent structures, and determining the spatial location of lesions within pulmonary segments, are major challenges for thoracic surgeons. The application of three-dimensional reconstruction technology holds promise in addressing this issue. OBJECTIVE: To evaluate the clinical value of three-dimensional reconstruction in thoracoscopic segmental surgery. METHODS: Seventy-seven patients who underwent thoracoscopic segmental surgery combined with three-dimensional reconstruction at our hospital from January 1, 2020, to August 31, 2023, were retrospectively analyzed. Preoperative chest enhanced CT scans were conducted, and MIMICS software …aided in reconstructing DICOM format original data for patients with pulmonary nodules to facilitate intraoperative nodule localization. Accurate segmental pneumonectomy was performed by comparing preoperative anatomical identification of target segmental arteries, veins, and bronchi, with surgical details and postoperative outcomes recorded, including intraoperative pulmonary resection distribution, operation time, blood loss, chest tube drainage, extubation time, hospital stay, and complications. RESULTS: Following preoperative three-dimensional reconstruction, successful segmental lung surgeries were performed, predominantly with single segmental resection (92.2%), and a minority with combined segmentectomy (7.8%). Median operation time was 130225 minutes, with intraoperative blood loss at 70100 mL and postoperative chest tube drainage at 347 mL (159690 mL). Median extubation time and hospital stay were 4 days and 7 days, respectively. Complications within the 3-month follow-up affected 11.7% of cases, including persistent pulmonary leakage (7.1%), pulmonary infection (4.3%), atelectasis (4.3%), and pleural effusion (1.4%), with no fatalities. CONCLUSION: Preoperative 3D reconstruction can help the operator to perform safe, efficient and accurate thoracoscopic segmental pneumonectomy, which is worth popularizing in clinic. Show more

Keywords: Segmental resection, pulmonary nodules, lung cancer, thoracoscopic three-dimensional reconstruction

DOI: 10.3233/THC-240786

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

Authors: Li, Pengxin | Peng, Sheng | Song, Zhenghuan | Tan, Jing | Gu, Lianbing

Article Type: Research Article

Abstract: BACKGROUND: Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2–4 times compared with that in patients without diabetes. OBJECTIVE: This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus METHODS: This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and …then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA) RESULTS: This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CONCLUSIONS: CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study’s findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery. Show more

Keywords: Diabetes mellitus, general anesthesia, CGRP, SP

DOI: 10.3233/THC-240907

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024

Authors: Han, Zhen | Liu, Yangan | Tan, Ming | Hua, Zhaolai | Dai, Chun

Article Type: Research Article

Abstract: BACKGROUND: Surgery remains the most effective treatment for colon cancer. However, there are still controversies regarding the tumor treatment effect, prognosis, and perioperative impact of complete mesocolic excision (CME) surgery in colon carcinoma resection. OBJECTIVE: This study aims to compare laparoscopic complete mesocolic excision (LCME) and traditional open D2 radical surgery in colon carcinoma resection through a retrospective analysis using 1:1 propensity score matching (PSM). METHODS: 98 cases undergoing LCME or open D2 colon carcinoma resection at our hospital from January 2014 to November 2021 were retrospectively collected. After excluding cases and 1:1 matching using …PSM based on baseline clinical data, 86 patients were assigned in research queue. 43 patients were in each group. Two groups were compared for general clinical baseline indicators. Surgical results and postoperative adverse events of patients were also compared. Disease-free survival (DFS) rate and overall survival (OS) rate was analyzed. RESULTS: After 1:1 PSM matching, there was no statistically significant differences in baseline data between the LCME group and D2 group (P > 0.05). LCME was characterized by longer total duration of surgery (P < 0.001), less intraoperative bleeding volume (P < 0.001), more postoperative drainage fluid volume (P < 0.001), greater number of lymph nodes retrieved (P = 0.014). No statistically differences was observed regarding intraoperative blood transfusion, hospital stay, Clavien-Dindo complicating disease classification (all P > 0.05), 1 and 3-year DFS rate (P = 0.84) and OS rate (P ⩾ 0.1). CONCLUSION: LCME had a longer duration of surgery but less intraoperative bleeding volume and more postoperative drainage fluid volume and retrieved lymph nodes compared to D2 radical surgery. LCME surgery is comparable to D2 surgery in terms of postoperative prognosis, but LCME surgery shows a positive trend in the overall survival curve. Show more

Keywords: Laparoscopic complete mesocolic excision, traditional D2 radical surgery, Colonic Neoplasms, propensity score matching

DOI: 10.3233/THC-241149

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Yang, Ping | Wu, Xiaoneng

Article Type: Research Article

Abstract: BACKGROUND: The objective performance evaluation of an athlete is essential to allow detailed research into elite sports. The automatic identification and classification of football teaching and training exercises overcome the shortcomings of manual analytical approaches. Video monitoring is vital in detecting human conduct acts and preventing or reducing inappropriate actions in time. The video’s digital material is classified by relevance depending on those individual actions. OBJECTIVE: The research goal is to systematically use the data from an inertial measurement unit (IMU) and data from computer vision analysis for the deep Learning of football teaching motion recognition …(DL-FTMR). There has been a search for many libraries. The studies included have examined and analyzed training through profound model construction learning methods. Investigations show the ability to distinguish the efficiency of qualified and less qualified officers for sport-specific video-based decision-making assessments. METHODS: Video-based research is an effective way of assessing decision-making due to the potential to present changing in-game decision-making scenarios more environmentally friendly than static picture printing. The data showed that the filtering accuracy of responses is improved without losing response time. This observation indicates that practicing with a video monitoring system offers a play view close to that seen in a game scenario. It can be an essential way to improve the perception of selection precision. This study discusses publicly accessible training datasets for Human Activity Recognition (HAR) and presents a dataset that combines various components. The study also used the UT-Interaction dataset to identify complex events. RESULTS: Thus, the experimental results of DL-FTMR give a performance ratio of 94.5%, behavior processing ratio of 92.4%, athletes energy level ratio of 92.5%, interaction ratio of 91.8%, prediction ratio of 92.5%, sensitivity ratio of 93.7%, and the precision ratio of 94.86% compared to the optimized convolutional neural network (OCNN), Gaussian Mixture Model (GMM), you only look once (YOLO), Human Activity Recognition- state-of-the-art methodologies (HAR-SAM). CONCLUSION: This finding proves that exercising a video monitoring system that provides a play view similar to that seen in a game scenario can be a valuable technique to increase selection accuracy perception. Show more

Keywords: Football, training, deep learning, video surveillance, skills, detection

DOI: 10.3233/THC-231860

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2024

Authors: Sun, Rui | Hao, Jianfeng | Li, Qian | Xie, Weinan | Hu, Xiaoyan | Chen, Zhenzhen | Liu, Zhi | Yuan, Ling

Article Type: Research Article

Abstract: BACKGROUND: NiaoDuQing Particle is the first Chinese herbal medicine approved by the China Food and Drug Administration for the treatment of chronic kidney disease. It has been used in clinical practice in China for over twenty years. However, there is limited literature reporting on the long-term therapeutic effects of NiaoDuQing Particles on chronic kidney disease patients. OBJECTIVE: This research aimed to comprehensively assess the therapeutic effect of NiaoDuQing Particles (NDQP) on chronic kidney disease patients based on clinical data analysis. METHODS: This study was carried out on a total of 148 participants diagnosed …with different types of chronic kidney disease. Demographics information, chronic kidney disease classification and chronic kidney disease diganostic indicators were collected and analyzed before and after NiaoDuQing Particles treatment for 3, 6, 9, 12 and 18 months respectively. RESULTS: In all 148 patients, mean eGFR value was increased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean uric acid value was decreased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean urea nitrogen value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). While mean creatinine value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 6 (P < 0.05). CONCLUSIONS: NiaoDuQing Particles could maintain the stable state of chronic kidney disease patients for up to 18 months especially in improving diagnostic indicators like eGFR, uric acid and urea nitrogen. Show more

Keywords: Chronic kidney disease, NiaoDuQing particles, eGFR, uric acid, urea nitrogen

DOI: 10.3233/THC-241029

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-240803

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Hua, Defeng | Chen, Yan

Article Type: Research Article

Abstract: BACKGROUND: The present study investigated the association between cerebrovascular diseases and sepsis, including its occurrence, progression, and impact on mortality. However, there is currently a lack of predictive models for 28-day mortality in patients with cerebrovascular disease associated with sepsis. OBJECTIVE: The objective of this study is to examine the mortality rate within 28 days after discharge in this population, while concurrently developing a corresponding predictive model. METHODS: The data for this retrospective cohort study were obtained from the MIMIC-IV database. Patients with sepsis and cerebrovascular disease in the ICU were included. Laboratory …indicators, vital signs, and demographic data were collected within 24 hours of ICU admission. Mortality rates within 28 days after discharge were calculated based on patient death times. Logistic regression analysis was used to identify potential variables for a predictive model. A nomogram visualized the prediction model. The performance of the model was evaluated using ROC curves, Calibration plots, and DCA. RESULTS: The study enrolled a total of 2660 patients diagnosed with cerebrovascular disease complicated by sepsis, consisting of 1434 males (53.91%) with a median age of 70.97 (59.60, 80.73). Among this cohort of patients, a total of 751 fatalities occurred within 28 days following discharge. The multivariate regression analysis revealed that age, creatinine, arterial oxygen partial pressure (Pa O2), arterial carbon dioxide partial pressure (Pa CO2), respiratory rate, white blood cell (WBC) count, Body Mass Index (BMI), and race demonstrated potential predictive variables. The aforementioned model yielded an area under the ROC curve of 0.744, accompanied by a sensitivity of 66.2% and specificity of 71.2%. Furthermore, both calibration plots and DCA demonstrated robust performance in practical applications. CONCLUSION: The proposed prediction model allows clinicians to promptly assess the mortality risk in patients with cerebrovascular disease complicated by sepsis within 28 days after discharge, facilitating early intervention strategies. Consequently, clinicians can implement additional advantageous medical interventions for individuals with cerebrovascular disease and sepsis. Show more

Keywords: Predictive model, 28-day mortality, sepsis, cerebrovascular disease

DOI: 10.3233/THC-241150

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Wu, Weichuan | Li, Chengyan | Men, Donghai | Li, Xiaopeng | Huang, Baqi

Article Type: Research Article

Abstract: BACKGROUND: Multiple studies have shown that early decompressive surgery in patients with intracerebral hemorrhage can effectively limit hematoma expansion, reduce perihematomal edema, and improve prognosis. However, these studies are limited by small sample sizes and short follow-up times. OBJECTIVE: To analyze the effect of early decompressive surgery on the long-term prognosis of patients with cerebral hemorrhage and identify the influencing factors for poor prognosis. METHODS: A retrospective analysis of 78 patients with cerebral hemorrhage admitted between January 2020 and December 2022 was conducted. Patients were divided into early and delayed surgery groups for comparison of …outcomes such as mortality rate, modified Rankin Scale score, and Short Form-36 scores. Additionally, factors influencing long-term prognosis were analyzed through logistic regression based on significant differences observed between groups. RESULTS: The early decompressive surgery group showed superior outcomes with lower mortality rates, modified Rankin Scale (mRS) scores, hematoma expansion rates, and perihematomal edema volumes compared to the delayed surgery group (P < 0.05). Additionally, age, preoperative Glasgow Coma Scale (GCS) score, preoperative hematoma volume, and a history of hypertension or diabetes were identified as independent prognostic factors for patients with cerebral hemorrhage, with odds ratios (ORs) greater than 1. CONCLUSIONS: Early decompressive surgery can improve the long-term prognosis and quality of life of patients with cerebral hemorrhage, reduce mortality rates, and decrease hematoma expansion and perihematomal edema. Older patients, those with higher preoperative hematoma volume and GCS score, and those with coexisting hypertension and diabetes should be given special attention to decrease the occurrence of adverse prognosis. Show more

Keywords: Early decompressive surgery, cerebral hemorrhage, long-term prognosis, influencing factors

DOI: 10.3233/THC-240766

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Zhang, Xibing | Yang, Fuli | Han, Lei | Su, Qiuming | Gao, Yang | Wu, Ruichao | Wang, Duo | Li, Wang | Zheng, Kepu | Liu, Fang | Ran, Jianghua

Article Type: Research Article

Abstract: BACKGROUND: Liver fibrosis is a progressive liver disease with increasing incidence, yet its underlying pathogenic mechanisms remain incompletely understood. OBJECTIVE : This study aims to explore potential therapeutic targets for liver fibrosis using weighted gene co-expression network analysis (WGCNA) and experimental validation. METHODS: We retrieved the microarray data (GSE174099) from the GEO database and performed differential expression analysis and WGCNA to identify co-expression modules associated with liver fibrosis. A module with the highest correlation to liver fibrosis was selected for further analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway …enrichment analyses were conducted to investigate the biological functions and signaling pathways of the identified genes. Protein-protein interaction (PPI) networks were constructed using the STRING database. The correlation between core genes and immune cells was analyzed with the CIBERSORT algorithm. Additionally, pathological and molecular biology experiments were performed to validate the expression levels of core genes in liver tissue, including HE and Masson staining, immunohistochemistry, RT-qPCR, and Western blotting. RESULTS: We identified a total of 86 intersecting genes from the differential expression analysis and WGCNA. GO enrichment analysis revealed that these genes were involved in processes such as cellular response to cAMP, collagen-containing extracellular matrix, and G protein-coupled receptor binding. KEGG pathway analysis highlighted the involvement of these genes in pathways like Cell Adhesion Molecules and the PI3K-Akt signaling pathway. Using Cytoscape software, we identified four core genes: Cftr, Cldn4, Map2, and Spp1. Pathological examinations showed that the experimental group exhibited significant fibrous tissue proliferation compared to the control group. Immunohistochemistry, RT-qPCR, and Western blotting analyses confirmed that these core genes were significantly upregulated in the experimental group (P < 0.05). CONCLUSION: This study identified four key genes (Cftr, Cldn4, Map2, Spp1) that are significantly associated with liver fibrosis. These genes are upregulated in liver fibrosis and could potentially as biomarkers for diagnosis and targets for therapeutic interventions. Show more

Keywords: Liver fibrosis, WGCNA, protein-protein interaction, signal transduction, gene expression

DOI: 10.3233/THC-241142

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

Authors: Chen, Yumei | Chen, Yanbin

Article Type: Research Article

Abstract: BACKGROUND: Although literature suggests that exercise can improve symptoms in Parkinson’s Disease (PD) patients, research on the effects of aerobic exercise and resistance training (AE&RT) in early-stage PD remains limited. Understanding the synergistic effects of these exercise modalities can provide valuable insights for optimizing exercise interventions for PD patients, particularly in the early stages of the disease, where interventions may have the greatest impact on long-term functional outcomes. OBJECTIVE: This study aimed to investigate the effects of a combined AE&RT program on motor function, postural stability, and cognitive processing speed in early stage PD patients. …METHODS: A total of 236 participants with early-stage PD were assigned to either the Aerobic Exercise Group (AE group) (n = 112) or the AE&RT Group (n = 124) inthis controlled randomized trial. The study employed a one-year supervised exercise program, with the AE Group participating in aerobic activities and the AE&RT Group engaging in combined AE&RT. Outcome measures included symptom improvement, motor function, postural stability, cognitive processing speed, peak oxygen consumption, quality of life evaluation, and the incidence of adverse events. RESULTS: The AE&RT Group demonstrated greater improvements in tremor, muscle rigidity, gait instability, sleep problems, and hyposmia compared to the AE Group. Additionally, the combined exercise group exhibited better cognitive processing speed, as well as enhanced motor function and postural stability. Peak oxygen consumption was significantly higher in the AE&RT Group. However, the quality of life evaluation indicated a statistically higher quality of life in the AE Group. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION: The findings suggest that the integration of AE&RT in early-stage PD patients leads to more comprehensive improvements in motor symptoms, cognitive function, postural stability, and cardiovascular fitness compared to aerobic exercise alone. These results have important implications for developing tailored exercise interventions to enhance the physical and cognitive well-being of individuals with early-stage PD. Show more

Keywords: Aerobic exercise, resistance exercise, postural stability, cognitive processing speed, parkinson’s disease

DOI: 10.3233/THC-240821

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Yu, Qing | Hu, Jing

Article Type: Research Article

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

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

DOI: 10.3233/THC-240599

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024

Authors: Liu, Mingsheng | Huang, Zhixiong | Wang, Xiaoyun | You, Pingdi | Cai, Xiaying

Article Type: Research Article

Abstract: BACKGROUND: Non-specific lower back pain (NLBP) is treated with a variety of therapies, including health education, exercise therapy, soft tissue release, psychological interventions, and shockwave therapy. However, some studies have shown that core stability training or fascial release therapy alone is not effective in the treatment of low back pain. BJECTIVE: The aim of this study was to investigate the effects of core stability training on patients’ inflammatory cytokine levels and lumbar muscle temperature when combined with fascial release for the treatment of non-specific low back pain. METHODS: In this study, a total …of 60 patients with non-specific low back pain who were treated in Mindong Hospital of Ningde City between December 2021 and January 2023 were selected and randomly and equally divided into a control group (30 cases) and an experimental group (30 cases). The control group received core stability training, while the experimental group added fascial release surgery to this. We compared and assessed the pain visual analog score (VAS), Oswestry dysfunction index (ODI), lumbar spine mobility (including anterior flexion, posterior extension, left flexion, and right flexion), as well as levels of inflammatory factors IL-6, TNF-a, and muscle tissue temperature in the two groups. RESULTS: This study has been successfully implemented and covered 60 patients throughout the trials. Upon comparison, the two groups did not show statistically significant differences in baseline data such as age, gender and duration of disease (p > 0.05). After four weeks of treatment, the test group showed statistically significant (p < 0.05) differences in VAS scores, ODI scores, and IL-6 and TNF-a levels that were significantly lower than those of the control group. It is worth mentioning that the muscle tissue temperature of the patients in the test group, as well as their performance in lumbar anterior flexion, posterior extension, left flexion, and right flexion mobility, were significantly better than those of the control group, and these differences also showed statistical significance (p < 0.05). CONCLUSION: The combination of core stability training and fascial release demonstrates significant clinical results in the treatment of nonspecific lower back pain. Through medical thermography and serum inflammatory factor testing, we were able to assess the treatment effect more objectively, providing a strong basis for future clinical practice. Show more

Keywords: Core stability training, fascial release, nonspecific low back pain, inflammatory factors, thermal imaging technology

DOI: 10.3233/THC-240902

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

Authors: Gu, Lei | Zhen, Yun | Huang, Zhenlin | Chen, Tianbao | Li, Fuxiong | Kaipeng, Chen

Article Type: Research Article

Abstract: BACKGROUND: sTREM-1H and miR-126 play crucial roles in inflammation and immune responses, yet their involvement in patients with pulmonary infection following cranial injury remains understudied. OBJECTIVE: The distribution of pathogens causing infection in patients with pulmonary infection after craniocerebral injury was explored, and the changes in the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and miR-126 in peripheral blood were analyzed. METHODS: In this study, 60 patients (study group) with postoperative lung infection in craniocerebral injury treated from January 2019 to December 2, 2021, and 60 patients without lung infection …were selected as the control group. The study group received anti-infection treatment. The infection pathogen of the study group was tested, and the changes of sTREM-1 and miR-126 levels in the peripheral blood of the study and control groups were recorded to explore the diagnosis and predictive Value of prognostic death. RESULTS: 66 pathogens were detected, including 18 gram-positive bacteria, 42 gram-negative bacteria, and 6 fungi. The sTREM-1 level was higher than the control group, and the miR-126 level was lower than the control group. By ROC curve analysis, the diagnostic AUC values of both patients were 0.907 and 0.848, respectively (P < 0.05). Compared to those in the study group, patients had decreased sTREM-1 levels and increased miR-126 levels after treatment (P < 0.05). Compared with the survival group, patients in the death group had increased sTREM-1 levels and decreased miR-126 levels, and ROC curve analysis, the predicted AUC death values were 0.854 and 0.862, respectively. CONCLUSION: Gram-negative bacteria, with increased peripheral sTREM-1 levels and decreased miR-126 levels. The levels of sTREM-1 and miR-126 have specific diagnostic and prognostic Values for pulmonary infection after craniocerebral injury. However, the study’s conclusions are drawn from a limited sample and short-term data, which might limit their broader applicability. Future studies with larger populations and longitudinal designs are required to confirm these findings and determine these biomarkers’ robustness across different settings. Further research should also explore how these biomarkers influence patient outcomes in craniocerebral injuries. Show more

Keywords: Craniocerebral injury, lung infection, pathogen distribution, soluble Toll-like receptor-stimulated gene 1, miR-126

DOI: 10.3233/THC-240749

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-241175

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Bhatt, Ashish | Nigam, Vineeta Saxena

Article Type: Research Article

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

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

DOI: 10.3233/THC-240052

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 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: Mansoor, C.M.M. | Chettri, Sarat Kumar | Naleer, H.M.M.

Article Type: Research Article

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

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

DOI: 10.3233/THC-240740

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-25, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-240780

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-232042

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-232004

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-53, 2024

Authors: Hwang, Daon | Cho, Ki Hun

Article Type: Research Article

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

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

DOI: 10.3233/THC-240056

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-240644

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-240603

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-240621

Citation: Technology and Health Care, vol. 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: 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: 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: Li, Chenxi | Li, Jian | Lu, Yao | Hou, Jiahui | Zhi, Zhaoyu | Zhao, Baocun | Zhang, Xiumei

Article Type: Research Article

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

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

DOI: 10.3233/THC-231977

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-231614

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2024

Authors: Zhong, Fengxing | Yin, Xiuping | Liu, Xinxin | Zhang, Qiming

Article Type: Research Article

Abstract: BACKGROUND: Understanding how pharmaceutical formulas target specific illnesses is crucial for developing effective treatments. Enriching ion channel data is a critical first step in comprehending a formula’s mechanism of action. OBJECTIVE: This study aims to explore the effective disease spectrum of the Qi Yu granule formula through network pharmacology analysis and backtracking, and analyze its potential curative effects on liver and spleen system diseases, particularly depression and breast cancer. METHODS: Using pharmacological tools and database analysis, the ion channel data of the formula’s components were investigated. The effective disease spectrum was determined, and …diseases related to liver and gallbladder, liver depression, and spleen deficiency were identified. Network pharmacology analysis was conducted to backtrack diseases, target gene proteins, and drug compositions. The extraction technology of volatile oil from medicinal herbs was experimentally studied to optimize the preparation process. RESULTS: The effective disease spectrum analysis identified potential curative effects of the Qi Yu granule formula on various diseases, including breast cancer. Backtracking revealed relationships between diseases, target gene proteins, and drug compositions. Experimental studies on volatile oil extraction provided insights into optimizing the preparation process. CONCLUSION: The study underscores the potential therapeutic benefits of the Qi Yu granule formula for liver and spleen system diseases. By integrating network pharmacology analysis and experimental research, this study offers valuable insights into the formulation and efficacy of the Qi Yu granules, paving the way for further exploration and optimization of TCM formulations. Show more

Keywords: Qi Yu granules, liver stagnation, edible plants, network pharmacology, spleen deficiency syndrome

DOI: 10.3233/THC-232034

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

Authors: Hao, Huawen | Qiao, Wei | Wu, Yaguang

Article Type: Research Article

Abstract: BACKGROUND: The rapid growth of cities has been accompanied by problems with urban air quality, making air pollution challenging to manage. In this situation, people focus on indoor building materials to improve air quality. OBJECTIVE: In this paper, a novel bola-type surfactant was synthesized and used as a template, using ethyl orthosilicate and sodium meta-aluminate as the silicon and aluminum source, in the ratio of n (NaOH ): n (NaAIO2 ): n (SiO2 ): n (SDA ): n (H2 O) as 30:2.5:120:5:4800. …METHODS: Hydrothermal preparation of ZSM-5 molecular sieves with a nanosheet structure (H-ZSM-5) was accomplished. The manufactured lamellar ZSM-5 molecular sieves were examined using X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and adsorption and desorption techniques. RESULTS: Traditional microporous ZSM-5 had a considerably lower static adsorption of formaldehyde molecules. The findings demonstrated that the nano-lamellar H-ZSM-5 molecular sieve can purify and eliminate larger molecular VOCs inside because it has the ability to adsorb larger molecular diameter VOCs. Additionally, the effectiveness of the adsorption was assessed using toluene vapour molecules with higher molecular diameters. CONCLUSION: The findings demonstrate that the nanosheet H-ZSM-5 molecular sieve can remove bigger molecule VOCs from indoor air and can be utilised to purify indoor spaces. This study offers a fresh approach to indoor environmental cleanup by demonstrating the capability of nano-lamellar H-ZSM-5 molecular sieves for molecular adsorption. Show more

Keywords: Bola-type surfactant, H-ZSM-5, formaldehyde, toluene, adsorption

DOI: 10.3233/THC-240187

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024

Authors: Chen, Pan | Wang, Xiaojie | Yan, Pijun | Jiang, Chunxia | Lei, Yi | Miao, Ying

Article Type: Research Article

Abstract: BACKGROUND: Dysfunctions in metabolism and endocrine systems are outcomes of disruptions in human physiological processes, often leading to disease onset. External factors can hinder the human body’s innate capacity for self-regulation and healing, particularly when immune responses are compromised, allowing these factors to interfere with normal bodily functions directly. OBJECTIVE: To explore the effect of uric acid expression water in blood on the occurrence of atrial fibrillation in patients with hyperthyroidism, the expression level of uric acid in the blood and other physiological indexes were compared between patients with no symptoms of atrial fibrillation and patients …with hyperthyroidism with symptoms of atrial fibrillation, to find the correlation between them. METHODS: A group of 112 hyperthyroidism patients who were admitted to our hospital from September 2019 to March 2020 were chosen and split into two groups. The control group consisted of 56 individuals (21 men and 35 women) aged between 16 and 86 years old, with an average age of 46.23 years (± 7.63). The observation group consisted of 56 individuals (24 males and 32 females) between 15 and 79 years, with an average age of 53.44 years (± 8.91). RESULTS: In the patients who were not treated with drugs before hospitalization the disease course and symptoms varied. The patients’ clinical medical and demographic data were recorded and the patients’ physiological indexes were obtained through blood tests and analysis. The differences between the two groups were analyzed by renal function, blood lipid index, thyroid function, and cardiac ultrasound, and these influencing factors were analyzed by regression analysis. The research adhered to ethical norms and ensured clear data presentation by using a rigorous technique to compare uric acid levels and physiological indicators among various patient groups. CONCLUSION: The study concentrated on the validation, repeatability, and contextual interpretation of data to provide a robust and rigorously scientific comparison. The most common is the increase of uric acid in the blood, which can induce other diseases, and atrial fibrillation is one of the most common diseases of cardiovascular diseases. Show more

Keywords: Uric acid level, serum, atrial fibrillation, hyperthyroidism, endocrine

DOI: 10.3233/THC-232028

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024

Authors: Wu, Xiaoqian | Chen, Cheng | Quan, Lili

Article Type: Research Article

Abstract: BACKGROUND: Traditional methods have the limitations of low accuracy and inconvenient operation in analyzing students’ abnormal behavior. Hence, a more intuitive, flexible, and user-friendly visualization tool is needed to help better understand students’ behavior data. OBJECTIVE: In this study a visual analysis and interactive interface of students’ abnormal behavior based on a clustering algorithm were examined and designed. METHODS: Firstly, this paper discusses the development of traditional methods for analyzing students’ abnormal behavior and visualization technology and discusses its limitations. Then, the K-means clustering algorithm is selected as the solution to find potential …abnormal patterns and groups from students’ behaviors. By collecting a large number of students’ behavior data and preprocessing them to extract relevant features, a K-means clustering algorithm is applied to cluster the data and obtain the clustering results of students’ abnormal behaviors. To visually display the clustering results and help users analyze students’ abnormal behaviors, a visual analysis method and an interactive interface are designed to present the clustering results to users. The interactive functions are provided, such as screening, zooming in and out, and correlation analysis, to support users’ in-depth exploration and analysis of data. Finally, the experimental evaluation is carried out, and the effectiveness and practicability of the proposed method are verified by using big data to obtain real student behavior data. RESULTS: The experimental results show that this method can accurately detect and visualize students’ abnormal behaviors and provide intuitive analysis results. CONCLUSION: This paper makes full use of the advantages of big data to understand students’ behavior patterns more comprehensively and provides a new solution for students’ management and behavior analysis in the field of education. Future research can further expand and improve this method to adapt to more complex students’ behavior data and needs. Show more

Keywords: Clustering algorithm, student behavior, big data, visual analysis, interactive interface

DOI: 10.3233/THC-232054

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024

Authors: Li, Jun | Li, Rong

Article Type: Research Article

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

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

DOI: 10.3233/THC-231868

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

Authors: Wang, Kai | Zhu, Dongming | Chang, Zimin | Wu, Zhiyong

Article Type: Research Article

Abstract: BACKGROUND: The Ultimate Fighting Championship (UFC) stands as a prominent global platform for professional mixed martial arts, captivating audiences worldwide. With its continuous growth and globalization efforts, UFC events have garnered significant attention and achieved commendable results. However, as the scale of development expands, the operational demands on UFC events intensify. At its core, UFC thrives on the exceptional performances of its athletes, which serve as the primary allure for audiences. OBJECTIVE: This study aims to enhance the allure of UFC matches and cultivate exceptional athletes by predicting athlete performance on the field. To achieve this, …a recurrent neural network prediction model based on Bidirectional Long Short-Term Memory (BiLSTM) is proposed. The model seeks to leverage athlete portraits and characteristics for performance prediction. METHODS: The proposed methodology involves constructing athlete portraits and analyzing athlete characteristics to develop the prediction model. The BiLSTM-based recurrent neural network is utilized for its ability to capture temporal dependencies in sequential data. The model’s performance is assessed through experimental analysis. RESULTS: Experimental results demonstrate that the athlete performance prediction model achieved an overall accuracy of 0.7524. Comparative analysis reveals that the proposed BiLSTM model outperforms traditional methods such as Linear Regression and Multilayer Perceptron (MLP), showcasing superior prediction accuracy. CONCLUSION: This study introduces a novel approach to predicting athlete performance in UFC matches using a BiLSTM-based recurrent neural network. By leveraging athlete portraits and characteristics, the proposed model offers improved accuracy compared to classical methods. Enhancing the predictive capabilities in UFC not only enriches the viewing experience but also contributes to the development of exceptional athletes in the sport. Show more

Keywords: Recurrent neural network, UFC, athlete performance, winning percentage forecast, evaluation algorithm, deep learning, BiLSTM, XGBoost

DOI: 10.3233/THC-232000

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Liang, Han | Li, Hao | Xia, Nan | Chen, Jingjing | Gao, Linlin | Liu, Hao | Lyu, Ping | Guo, Xiaolin | Yang, Ziwei

Article Type: Research Article

Abstract: BACKGROUND: Long noncoding RNAs (lncRNAs) participate in diseases, especially tumorigenesis, including gastric cancer (GC). Although lncRNAs in GC tissues have been extensively studied in previous research, the possible significance of circulating lncRNAs in diagnosing GC is still unknown. OBJECTIVE: The present work investigated lncRNAs ZFPM2-AS1 and XIST with high expression in GC tissues proved as potential plasma biomarkers from 20 early GC cases, 100 GC cases, and 90 normal subjects. METHODS: The possible correlation between ZFPM2-AS1 and XIST expression levels was analyzed with general characteristics and clinicopathological features. The performance in diagnosis was …assessed according to receiver operating characteristic (ROC) analysis. RESULTS: According to the results, XIST and ZFPM2-AS1 expression remarkably increased within GC plasma relative to normal subjects (P < 0.01); besides, lncRNA XIST expression after surgery had a tendency of downregulation compared with preoperative levels (P < 0.05). Moreover, the area under ROC curve (AUC) values were 0.62 for ZFPM2-AS1 and 0.68 for XIST, while the pooled AUC value of CA-724 and two lncRNAs was 0.751. CONCLUSION: Circulating lncRNAs ZFPM2-AS1 and XIST can serve as the candidate plasma biomarkers used to diagnose GC. Show more

Keywords: Long noncoding RNA, gastric cancer, ZFPM2-AS1, XIST, diagnosis, plasma, biomarker

DOI: 10.3233/THC-232033

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Wen, Yi | Li, Xinyan | Shu, Wan | Zhang, Hong | Shen, Zhefan | Huang, Zhaoxia

Article Type: Review Article

Abstract: BACKGROUND: About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4–6 couples. It is thus essential to find effective psychological treatment. OBJECTIVE: To conduct a systematic review of previous meta-analyses on mindfulness-based therapy outcomes in infertile female patients and a meta-analysis of studies nested within these meta-analyses. METHODS: Randomized controlled trials (RCTS) on the efficacy of mindset-based interventions in infertile female patients were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNI, VIP Database, and Wanfang Database until March 1, 2023. Two …researchers screened the literature, extracted data according to inclusion and exclusion criteria, and conducted quality control according to Cochrane Handbook 5.1.0. When there was ambiguity, a third party determined it. The meta-analysis was performed using RevMan 5.3 software. RESULT: 14 randomized controlled trials involving 1784 patients were included. Meta-analysis showed that compared with conventional care, mindfulness-based intervention can effectively relieve anxiety in female infertility patients [SMD = - 2.25, 95% CI (- 2.90, - 1.60), P < 0.00001], depression [SMD = - 2.25, 95% CI (- 2.99, - 1.52), P < 0.00001], perceived stress [SMD = - 0.99, 95% CI (- 1.27, - 0.71), P < 0.00001], improved quality of life, physiological function [MD = 14.03, 95% CI (11.98, 16.07), P < 0.00001], Role limitations due to physical problems [MD = 11.30, 95% CI (5.71, 16.90), P < 0.0001], vitality [MD = 11.55, 95% CI (9.46, 13.65), P < 0.00001], mental health [MD = 17.32, 95% CI (15.29, 19.35), P < 0.00001]. CONCLUSION: Existing evidence shows that mindfulness therapy can effectively relieve the anxiety and depression of infertile women, reduce the level of stress, and improve the quality of life and sleep quality. However, due to the limited quantity and quality of the literature, multi-center, large-sample, and high-quality randomized controlled studies should be conducted in the future. Show more

Keywords: Mindfulness-based therapy, infertility, women, meta-analysis, evidence-based nursing, randomized controlled trial (RCTS), RF dimension

DOI: 10.3233/THC-240174

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024

Authors: Tigga, Neha Prerna | Garg, Shruti | Goyal, Nishant | Raj, Justin | Das, Basudeb

Article Type: Research Article

Abstract: BACKGROUND: Brain variations are responsible for developmental impairments, including autism spectrum disorder (ASD). EEG signals efficiently detect neurological conditions by revealing crucial information about brain function abnormalities. OBJECTIVE: This study aims to utilize EEG data collected from both autistic and typically developing children to investigate the potential of a Graph Convolutional Neural Network (GCNN) in predicting ASD based on neurological abnormalities revealed through EEG signals. METHODS: In this study, EEG data were gathered from eight autistic children and eight typically developing children diagnosed using the Childhood Autism Rating Scale at the Central Institute …of Psychiatry, Ranchi. EEG recording was done using a HydroCel GSN with 257 channels, and 71 channels with 10-10 international equivalents were utilized. Electrodes were divided into 12 brain regions. A GCNN was introduced for ASD prediction, preceded by autoregressive and spectral feature extraction. RESULTS: The anterior-frontal brain region, crucial for cognitive functions like emotion, memory, and social interaction, proved most predictive of ASD, achieving 87.07% accuracy. This underscores the suitability of the GCNN method for EEG-based ASD detection. CONCLUSION: The detailed dataset collected enhances understanding of the neurological basis of ASD, benefiting healthcare practitioners involved in ASD diagnosis. Show more

Keywords: Autism, graph convolution neural network, electroencephalogram, deep learning, brain region

DOI: 10.3233/THC-240550

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-25, 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: Jiang, Yangzheng | Yang, Jiantao | Tian, Hui | Jiang, Chuan | Wang, Hongzhu

Article Type: Research Article

Abstract: BACKGROUND: Flatfoot (pes planus) is a common foot deformity, and its causes are mainly related to age, gender, weight, and genetics. Previous studies have shown that custom-made insoles could have a positive effect in improving plantar pressure and symptoms in individuals with flexible flatfeet, but it remains to be explored whether they can still show benefits in daily walking on different slopes. OBJECTIVE: This study aims to investigate a custom-made insole based on plantar pressure redistribution and to verify its effectiveness by gait analysis on different slopes. METHODS: We recruited 10 subjects and …compared the peak pressure and impulse in each area between custom-made insole (CI) and ordinary insole (OI) groups. RESULTS: The results illustrate that CI raises the pressure in T area, improves the ability of the subjects to move forward in the slope walking, which was beneficial to gait stability. CONCLUSION: The redistribution of pressure in MF and MH area is promoted to provide active protection for subjects. Meanwhile, CI could decrease the impulse in MF area during uphill and level walking, which effectively reduces the accumulation of fatigue during gait. Moreover, avoiding downhill walking could be able to protect foot from injury in daily life. Show more

Keywords: Flatfoot, custom-made insole, slope, pressure, impulse

DOI: 10.3233/THC-231785

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024

Authors: Li, Zhaoxi | Guo, Xiaohui | Shi, Wei | He, Rongxia | Zhong, Hua

Article Type: Research Article

Abstract: BACKGROUND: Electronic foetal monitoring (EFM), a method to monitor foetal intrauterine conditions and foetal reserve capacity, is the most extensively used intrauterine monitoring technology in obstetrics. OBJECTIVE: This study aims to compare the Thoth wearable foetal electrocardiogram (foetal ECG [FECG]) monitoring system with a traditional Doppler foetal heart monitoring system before labour to investigate their respective values in clinical application. METHODS: A total of 393 pregnant women admitted to our hospital between 2020 and 2022 participated in this study. They were recruited using the convenience sampling method. We employed a paired design to …assess the confusion rate, trend overlap, and foetal heart rate/ECG monitoring consistency, whereas a completely randomised design was used to measure pregnancy outcome indicators. The participants were divided into two groups using a random number table: the Thoth group (n = 196) and the traditional Doppler group (n = 197). Each group was monitored using the corresponding system. RESULTS: The Thoth monitor demonstrated a lower confusion rate compared with the traditional Doppler monitor (0.25% vs 2.04%; χ 2 = 5.508, P = 0.019). The trend overlap in foetal heart rates was consistently 100%, with 91.2% of readings showing a consistency rate of ⩾ 95%. Additionally, the Thoth monitor recorded a higher cumulative interruption time in the foetal heart rate curve (12.13 ± 2.22 vs 21.02 ± 2.34; t = 18.471, P < 0.001) and more abnormal ECGs (21.21 ± 4.32 vs 18.21 ± 2.91; t = 7.582, P < 0.001) than the traditional Doppler system. CONCLUSION: The Thoth wearable FECG monitor offers several advantages over the traditional Doppler foetal heart monitoring system. These include a reduced confusion rate, more accurate data collection, a lower rate of clinical misjudgement, reduced workload for medical staff, and enhanced comfort during vaginal delivery. The rates of emergency caesarean sections and neonatal asphyxia in the Thoth group were marginally lower than those in the Doppler group, which may be attributed to issues such as ECG disconnection or interference from the maternal heart rate. Show more

Keywords: Foetal heart monitoring, foetal ECG monitor, Thoth wearable device, Doppler device, heart rates

DOI: 10.3233/THC-231752

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024

Authors: Abu-Izneid, Tareq | Rauf, Abdur | Naz, Saima | Ibrahim, Muhammad | Muhammad, Naveed | Wadood, Abdul | Ajmal, Amar | Hemeg, Hassan A. | Fahad, Shah | Thiruvengadam, Muthu | Venkidasamy, Baskar

Article Type: Research Article

Abstract: BACKGROUND: Ficus benghalensis has been used by local health care practitioners to treat pain, inflammation, rheumatism, and other health issues. OBJECTIVE: In this study, the crude extract and diverse fractions, along with the isolated compound of F. benghalensis were examined for their roles as muscle relaxants, analgesics, and sedatives. METHODS: The extract and isolated compound 1 were screened for muscle-relaxant, analgesic, and sedative actions. The acetic acid-mediated writhing model was utilized for analgesic assessment, the muscle relaxant potential was quantified through traction and inclined plan tests, and the open field test was …applied for sedative effects. RESULTS: The extract/fractions (25, 50, and 100 mg/kg) and isolated compounds (2.5, 5, 10, and 20 mg/kg) were tested at various doses. A profound (p < 0.001) reduce in the acetic acid-mediated writhing model was observed against carpachromene (64.44%), followed by ethyl acetate (60.67%) and methanol (58.42%) fractions. A marked (p < 0.001) muscle relaxant activity was noticed against the isolated compound (71.09%), followed by ethyl acetate (66.98%) and methanol (67.10%) fractions. Regarding the sedative effect, a significant action was noted against the isolated compound (71.09%), followed by ethyl acetate (66.98%) and methanol (67.10%) fractions. Furthermore, the binding modes of the isolated compounds were explored using molecular docking. The molecular docking study revealed that the isolated compound possessed good binding affinity for COX2 and GABA. Our isolated compound may possess inhibitory activity against COX2 and GABA receptors. CONCLUSION: The extract and isolated compounds of Ficus benghalensis can be used as analgesics, muscle relaxants, and sedatives. However, detailed molecular and functional analyses are essential to ascertain their function as muscle relaxants, analgesics, and sedatives. Show more

Keywords: Ficus benghalensis, Moraceae, carpachromene, analgesic, muscle relaxant, sedative, molecular docking

DOI: 10.3233/THC-231703

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024

Authors: Wu, Cuiying | Li, Yunjun | Luo, Yongchun | Dai, Yiwu | Qin, Jiazhen | Liu, Ning | Xu, Ruxiang | Li, Xuezhen | Zhang, Peng

Article Type: Research Article

Abstract: BACKGROUND: Low-grade gliomas (LGG) are a variety of brain tumors that show different clinical outcomes. The methylation of the GSTM5 gene has been noted in the development of LGG, however, its prognostic importance remains uncertain. OBJECTIVE: The objective of this study was to examine the correlation between GSTM5 DNA methylation and clinical outcomes in individuals diagnosed with LGG. METHODS: Analysis of GSTM5 methylation levels in LGG samples was conducted using data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets. The overall survival based on GSTM5 methylation status was evaluated …using Kaplan-Meier curves. The DNA methylation heatmap for particular CpG sites in the GSTM5 gene was visualized using the “pheatmap” R package. RESULTS: The study analyzed that LGG tumors had higher levels of GSTM5 methylation than normal tissues. There was an inverse relationship discovered between GSTM5 expression and methylation. LGG patients with hypermethylation of GSTM5 promoter experienced a positive outcome. Age, grade, and GSTM5 methylation were determined as independent prognostic factors in LGG through both univariate and multivariate Cox regression analyses. CONCLUSION: Methylation of GSTM5 DNA, specifically at certain CpG sites, is linked to a positive outlook in patients with LGG. Utilizing the “pheatmap” R package to visualize GSTM5 methylation patterns offers important information for identifying prognostic markers and therapeutic targets in low-grade gliomas. Show more

Keywords: Low-grade glioma, glutathione S-transferase mu class 5 (GSTM5), prognosist, methylaion, immune cells

DOI: 10.3233/THC-231316

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

Authors: Zheng, Chichao | Tang, Yi | Wang, Yadan | Wang, Yuanguo | Peng, Hu

Article Type: Research Article

Abstract: BACKGROUND: Ultrasound imaging has been widely used in clinical examination because of portability, safety, and low cost. However, there are still some main challenges of imaging quality that remain in conventional ultrasound systems. OBJECTIVE: Improving image quality of SA-based methods using an improved imaging mode named far-focus compound (FSC) imaging. METHODS: A far-focus compound (FSC) imaging based on full-aperture transmission and full-aperture reception is proposed in this paper. In transmission, it uses the full aperture to transmit the focused beam to ensure image resolution and emission of sound field energy. In reception, the …full aperture is used to receive the reflected beam to ensure the image quality. A lag-one coherence-based zero-cross factor (LOCZF) is then implemented in FSC for improvement of contrast ratio (CR). The LOCZF uses lag-one coherence as zero-cross factor’s adaptive coefficient. Comparisons were made with several other weighting techniques by performing simulations and experiments for performance evaluation. RESULTS: Results confirm that LOCZF applied to FSC offers a good image contrast and simultaneously the speckle pattern. For simulated cysts, CR improvement of LOCZF reaches 194.1%. For experimental cysts, CR improvement of LOCZF reaches 220%. From the in-vivo result, compared with FSC, CR improvement of LOCZF reaches 112.7%. CONCLUSION: Proved gCNR performance. In addition, the LOCZF method shows good performance in experiments. The proposed method can be used as an effective weighting technique for improvement of image quality in ultrasound imaging. Show more

Keywords: Ultrasonic imaging, far-focus compound imaging, reversal-squart zero-cross factor, lag-one coherence-based zero-cross factor

DOI: 10.3233/THC-231452

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024

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

Article Type: Research Article

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

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

DOI: 10.3233/THC-231859

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 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