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

Authors: Cho, Juchul | Lee, Eunsang | Lee, Seungwon

Article Type: Research Article

Abstract: BACKGROUND: Although commonly used in clinical settings, evidence regarding the beneficial effectiveness of joint mobilization and therapeutic exercise in patients with stroke is still lacking. OBJECTIVE: This study aimed to investigate the effects of mid-thoracic spine mobilization and therapeutic exercise on dynamic balance and inspiratory function in patients with subacute stroke. METHODS: The participants included 33 patients with subacute stroke. Participants were randomly allocated to 1 of 2 groups: (1) a group that received segmental mobilization (T4-8), and (2) a group that received foam roller exercises (T4-8). Outcome measure included the limits …of stability (LOS), inspiratory function, and global rating of change (GRC). RESULTS: The improvement in inspiratory function was statistically significant at 4 and 6 weeks after the initiation of the intervention and changes in the LOS were statistically significant at 6 weeks in the mobilization group (p < 0.05). In addition, 15 of 17 (88.2%) participants in the mobilization group, compared to 9 of 16 participants (56.2%) in the exercise group, indicated a GRC score of + 4 or higher at the 4-week follow-up. CONCLUSIONS: This study demonstrates that patients with subacute stroke who receive mid-thoracic spine mobilization demonstrate effective short-term improvements in LOS and GRC. Show more

Keywords: Stroke, mobilization, exercise, inspiratory function, rehabilitation

DOI: 10.3233/THC-181467

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2019

Authors: Liu, Jun | Peng, Yun | Li, Ling | Chen, Zhen | Zhang, Yingchun

Article Type: Research Article

Abstract: BACKGROUND: Screening tools are critical in the early prevention of cervical cancers. Acetic-acid based colposcopy test provides an affordable solution but is often challenged by the lack of experienced doctors in under-developed districts. OBJECTIVE: To evaluate the feasibility of an internet-based expert system to better utilize the expert knowledge. METHODS: A centralized internet-based expert system was developed to upload acetowhite images acquired by an integrated colposcopy device at remote healthcare centers. The detection rates of high grade cervical intraepithelial neoplasia (CIN) during two consecutive years (installed in the second year) were collected at …two study sites and twelve control sites. RESULTS: No difference in the detection rate was observed between study and control sites at baseline (year 1); however, greater detection rates were found at study sites after introducing the internet-based expert system (year 2). Comparing the detection rates at each site between year 1 and year 2, the study site exhibited improved detection rates. User feedbacks suggested “great learning experience from expert feedback” as the most recognized benefits. CONCLUSIONS: This study shows the feasibility of an internet-based expert system in screening cervical cancers and lays the foundation to future population-level application in under-developed districts. Show more

Keywords: Cervix cancer, screening, visual inspection with acetic acid, internet-based expert system, cervical intraepithelial neoplasia

DOI: 10.3233/THC-181577

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2019

Authors: Lu, Ziwei | You, Zhiqun | Xie, Daohai | Wang, Zhongling

Article Type: Research Article

Abstract: BACKGROUND: It is difficult to distinguish solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (AM) by conventional imaging.As far as we know,diffusion weighting imaging may identify them effectively. OBJECTIVE: The purpose of this study was to determine the role of apparent diffusion coefficient (ADC) values to distinguish and predict prognosis of solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) (WHOII) and atypical meningioma (AM). METHODS: Preoperative diffusion-weighted imaging (DWI) of 30 cases with histopathologic and immunhistochemical testified SFT/HPC WHOII (n = 11) and AM (n = …19) were performed retrospectively. The ADC values of lesion, peritumoral edema, normal white matter and lesion NADC ratio (lesion ADC values/ADC values of normal white matter (NWN ADC)) were compared. The immunhistochemical markers (Ki-67, CD34, Vim, EMA, GFAP, S-100, PR, CD56) were compared. The correlation between the ADC values and Ki-67 index was evaluated. RESULTS: The mean lesion ADC values of SFT/HPC (1.15 ± 0.04 × 10 - 3  mm 2 /s) was significantly higher than that of AM (0.80 ± 0.04 × 10 - 3  mm 2 /s) (t = 23.824, p < 0.05). The mean NADC ratio was lower for AM (1.03 ± 0.06) compared with SFT/HPC (1.51 ± 0.05) (t = 23.105, p < 0.05). The mean edema ADC for SFT/HPC (1.47 ± 0.06 × 10 - 3  mm 2 /s) was lower compared with AM (1.68 ± 0.05 × 10 - 3  mm 2 /s) (t = - 9.926, p < 0.05 ). There was no statistical difference between the two groups of NWM ADC (t = - 1.475, p > 0.05) . The mean Ki-67 of SFT/HPC (7.18 ± 2.60%) was lower than the mean Ki-67 of AM (13.58 ± 4.50%) (t = - 4.934, p < 0.05). The CD34 showed statistically differences between two groups (X 2 = 13.659, p < 0.05). The EMA also showed statistically differences between two groups (X 2 = 4.474, p < 0.05). Vim,GFAP, S-100, PR, CD56 showed no statistical difference in the two group (p > 0.05). The pearson analysis indicated that there was a negative correlation between lesion ADC and Ki-67 in SFT/HPC group (r = - 0.770, p < 0.05) and AM group (r = - 0.727, p < 0.05). There was also a negative correlation between lesion NADC ratio and Ki-67 in SFT/HPC group (r = - 0.673, p < 0.05) and AM group (r = - 0.707, p < 0.05). There was a positive correlation between edema ADC and Ki-67 in SFT/HPC group (r = 0.819, p < 0.05) and AM group (r = 0.942, p < 0.05). Furthermore,there was no correlation between NWM A DC and Ki-67 in SFT/HPC group (r = - 0.403, p > 0.05) and AM group (r = 0.202, p > 0.05). CONCLUSIONS: The lesion ADC, lesion NADC ratio and edema ADC can distinguish the SFT/HPC WHO II from AM and be helpful to predict prognosis of the two tumors before operation. Further more, histopathologic and immunhistochemical can make a definite diagnosis of the two tumors. Show more

Keywords: Solitary of fibrous tumor/hemangiopericytoma, atypical meningioma, ADC, Ki-67, CD34, EMA

DOI: 10.3233/THC-181447

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2019

Authors: Raffenaud, Amanda | Gurupur, Varadraj | Fernandes, Steven L. | Yeung, Tina

Article Type: Research Article

Abstract: BACKGROUND: Telemedicine is an alternative to traditional face-to-face doctor-patient office visits. Although telemedicine is becoming more prevalent, few studies have looked at the perceived favorability rate among patients utilizing telemedicine over the traditional office visit to a provider’s office considering data samples from more than 5 clinics in northern Louisiana. OBJECTIVE: This study aims to measure patient favorability of using telemedicine to receive care. This study looks at the perceived positive and negative favorability rates of patients in the oncology settings. The researchers analyzed how age, income level, and education level influenced the perceived patient favorability …rates and their willingness to utilize telemedicine. METHODS: The investigators used Chi-Square analysis to identify favorability with respect to age education and income levels. In addition to this Artificial Neural Networks were used to identify the threshold for favorability with respect to age, income, and education. RESULTS: Chi-Square tests of association showed that of the variables analyzed, only education level had a statistically significant relationship with a patient’s favorability rate of telemedicine utilization. While our neural network analysis indicated that the threshold for income, age, and education are $34,999, 66 years, and a college degree. CONCLUSION: In this article the investigators have successfully demonstrated the use of Artificial Neural Networks in identifying favorability of telemedicine used in addition to the traditional statistical methods such as Chi-Square. Thereby, creating a path for future research using advanced computational techniques like Artificial Neural Networks in analyzing human behavior. Show more

Keywords: Chi-Square analysis, telemedicine, teleoncology, neural networks

DOI: 10.3233/THC-181293

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2019

Authors: Niederer, Peter

Article Type: Other

DOI: 10.3233/THC-181575

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-, 2018

Authors: Saeedi-Moghadam, Mahdi | Pouladian, Majid | Faghihi, Reza | Lotfi, Mehrzad

Article Type: Research Article

Abstract: BACKGROUND/OBJECTIVE: There are two routine pulse-sequences for single voxel spectroscopy (SVS), point resolved spectroscopy (PRESS) and stimulated echo acquisition mode (STEAM). Although STEAM has several advantages in comparison to PRESS, signal/noise ratio (SNR) superiority of PRESS makes it the first choice for SVS. Application of Fast Padé transform (FPT) instead of Fast Furrier transform (FFT) might increase the SNR of the signal produced by STEAM pulse-sequence and therefore allows the benefits of its advantages. We aimed to evaluate and compare the noise root mean square (RMS) and SNR provided by STEAM pulse-sequence using both FPT and FFT. …MATERIALS AND METHOD: A gelatin-based phantom was constructed in a 19-cm acrylic cylinder. The phantom had two normal/tumoral parts. The SVS was performed using a 3T MRI scanner. STEAM pulse-sequence were used with the following parameters: TR = 2000 ms, TM = 10 ms, and three TEs of 20, 135 and 270 ms with two data-points of 1024 and 512 and voxel-size of 1 cm 3 . The raw data were extracted and processed using both FFT and FPT estimators to produce the spectrum. The noise RMS and SNR of Cho and Cr metabolites were assessed. RESULTS: According to the results, noise RMS of spectra provided by FPT were decreased between 3619.01–14252.94% in comparison to FFT (p < 0.00001). The SNR of Cr1 and Cho peaks of the spectra provided by FPT were increased more than 96.80 and 97.18, respectively (0.00006 < p < 0.02). DISCUSSION: The difference of noise RMS’s provided by FPT are thousands percent less than FFT. This enormous decrease in noise provides a good increase of SNR. While the range of Cr1 and Cho SNR by FFT are between 41.55–120.32 the range of SNRs of these peaks provided by FPT are between 1719.99–9744.79, which implies a significant difference between the efficiency of FPT and FFT. CONCLUSION: This study showed that application of FPT in comparison to FFT can increase the spectra SNR and so that its usage can be helpful during the application of STEAM pulse-sequence which results in lower SNR in comparison to PRESS pulse-sequence. Thus, we should make use of the advantages of STEAM pulse-sequence. Show more

Keywords: Magnetic resonance spectroscopy, Fast Padé Transform, Fast Furrier Transform, STEAM pulse sequence, signal to noise ratio

DOI: 10.3233/THC-181535

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2018

Authors: Deng, Jing | Lei, Lei | Zhang, Hui-Lan | Luo, Yu

Article Type: Research Article

Abstract: BACKGROUND: Previous research regarding the humanistic care ability of Chinese medical professionals was limited to small groups of nurses or students. More systemic analyses involving more general medical professionals are scarce and urgently needed. OBJECTIVE: To survey the sense and ability of humanistic care on medical professionals in China and to identify the potential influencing factors. METHODS: A novel scale of humanistic care indicators was developed. Based on the new scale, a questionnaire was designed, tested and used to survey a total of 928 medical professionals recruited from three hospitals in the Chinese …Western city Chongqing. Chi-square test was used for single factor analyses. For multiple factor analyses, multivariate logistic regression was performed. RESULTS: Our selected group of medical professionals scored nearly 4 or above on a 1–5 scale for all our query items related to the sense and ability of humanistic care. The main factors affecting humanistic care ability of medical professionals in Chongqing include gender, nature of department/division, modes of employment and participation in humanistic care ability training and so on. CONCLUSIONS: In general, the participants in our study group had a humanistic care ability score lower than the aimed value, suggesting that the ability of humanistic care of these medical professional was not satisfactory. The study also shows that one effective way to enhance the humanistic care ability is to provide more targeted training. Show more

Keywords: Humanistic care, sense and ability, influencing factor, medical education

DOI: 10.3233/THC-181389

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2018

Authors: Martinek, Radek | Kahankova, Radana | Martin, Boris | Nedoma, Jan | Fajkus, Marcel

Article Type: Research Article

Abstract: This paper introduces a comprehensive fetal Electrocardiogram (fECG) Signal Extraction and Analysis Virtual Instrument that integrates various methods for detecting the R-R Intervals (RRIs) as a means to determine the fetal Heart Rate (fHR) and therefore facilitates fetal Heart Rate Variability (HRV) signal analysis. Moreover, it offers the capability to perform advanced morphological fECG signal analysis called ST segment Analysis (STAN) as it seamlessly allows the determination of the T-wave to QRS complex ratio (also called T/QRS) in the fECG signal. The integration of these signal processing and analytical modules could help clinical researchers and practitioners to noninvasively monitor and …detect the life threatening hypoxic conditions that may arise in different stages of pregnancy and more importantly during delivery and could therefore lead to the reduction of unnecessary C-sections. In our experiments we used real recordings from a Fetal Scalp Electrode (FSE) as well as maternal abdominal electrodes. This Virtual Instrument (Toolbox) not only serves as a desirable platform for comparing various fECG extraction signal processing methods, it also provides an effective means to perform STAN and HRV signal analysis based on proven ECG morphological as well as Autonomic Nervous System (ANS) indices to detect hypoxic conditions. Show more

Keywords: Fetal ECG (fECG), maternal ECG (mECG), abdominal ECG (aECG), feature extraction, STAN analysis (T:QRS ratio), fetal Heart Rate (fHR), fetal Heart Rate Variability (HRV)

DOI: 10.3233/THC-181375

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-31, 2018

Authors: Wang, Yong | Xiao, Guohong | Dell’Era, Alex | Zheng, Zhenfeng

Article Type: Research Article

Abstract: The aim of this work was to describe the physical principles behind the reverberation artifacts in ultrasound imaging and list the correct interpretation. This work focuses on the understanding of the principle of reverberation imaging artifacts.

Keywords: Ultrasound propagation, reverberation, imaging, artifacts

DOI: 10.3233/THC-181457

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-4, 2018

Authors: Phan, Dinh-Van | Chan, Chien-Lung | Pan, Ren-Hao | Yang, Nan-Ping | Hsu, Hsiu-Chen | Ting, Hsien-Wei | Lai, K. Robert | Lin, Kai-Biao

Article Type: Research Article

Abstract: BACKGROUND: Sleep is a natural periodic state of rest for body and mind and daily sleep affects physical and mental health. However, it is essential to address intensity of sleep characteristics affecting the memory capacity of humans positively or negatively. OBJECTIVE: Using wearable devices to observe and assess the effect of daily sleep on memory capacity of college students. METHODS: This study assessed the daily sleep characteristics and memory capacity of 39 college students who used wrist-worn devices. The spatial span test (SST) was used to evaluate the memory capacity. RESULTS: …The study indicated a negative correlation between memory capacity and awake count on the test date and during the week before the test date (r = - 0.153 (95% CI: - 0.032, - 0.282), r = - 0.391 (95% CI: - 0.520, - 0.235), respectively). However, the minutes asleep on the test date and during the week before the test date positively affected memory capacity (r = 0.127 (95% CI: 0.220, 0.025), r = 0.370 (95% CI: 0.208, 0.500), respectively). In addition, spending ⩾ 6 hours and 42 minutes asleep on the test date or ⩾ 6 hours and 37 minutes asleep per day on average during the week before the test date resulted in a better memory capacity. CONCLUSIONS: A lower awake count led to a higher memory capacity in college students, as did more minutes asleep. Show more

Keywords: Wearable devices, daily sleep, memory, college student

DOI: 10.3233/THC-181350

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2018