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

Authors: Mei, Hai-Long | Yao, Yao | Huang, Ying | Zhou, Ke | Wang, Zhi-Lie | Chen, Hou-Qiong

Article Type: Research Article

Abstract: BACKGROUND: Patellar fractures are common intra-articular fractures. Arthroscopically assisted reduction and fixation has been shown to advantageous in the treatment of patellar fractures. OBJECTIVE: This study aimed to investigate the effect of arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation on the treatment of patellar fractures. METHODS: Thirty-four patients with acute closed patellar fractures enrolled in the study and were managed by arthroscopically assisted percutaneous minimally invasive Kirschner wire tension band fixation under epidural anesthesia. Among these patients, 24 were males, and ten were females. The mean age of these patients …was 38 ± 0.8 years (range: 25–62 years). Of these patients, 20 had transverse fractures, five had longitudinal fractures, four had marginal oblique fractures, and five had multifragmentary upper and lower pole. Fracture causes: 25 were caused by falls, and nine were caused by traffic accidents. The time from injury to operation was 6–48 hours, with an average of 23 hours. The average post-operative follow-up was 12.8 months, and at the end of follow-up, the Boestman scoring system was used to evaluate knee joint function. RESULTS: All the wounds healed by first intention, and no infections, skin necrosis, joint stiffness, or other complications occurred. Three months after operation, the tension band wire had broken in one patient, but the fracture had united, and this did not affect the prognosis. In eight patients, the average circumference at 10 cm above the patella was 0.6 cm less on the injured side than on the contralateral side. The average Boestman score was 27.5. The final result was excellent in 25 patients, good in eight patients, and acceptable in one patient. CONCLUSION: Arthroscopic management of simple patellar fracture with percutaneous minimally invasive Kirschner wire tension band fixation is less invasive than open operation, while still leading to firm fixation, and is conducive to early functional training and functional recovery, and thus is an effective method of management for patellar fractures. Show more

Keywords: Patellar fracture, arthroscopy, percutaneous, tension band, internal fixation

DOI: 10.3233/THC-220133

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2022

Authors: Luschi, Alessio | Villa, Eleonora Annamaria Borsani | Gherardelli, Monica | Iadanza, Ernesto

Article Type: Research Article

Abstract: BACKGROUND: Navigation portable applications have largely grown during the last years. However, the majority of them works just for outdoor positioning and routing, due to their architecture based upon Global Positioning System signals. Real-Time Positioning System intended to provide position estimation inside buildings is known as Indoor Positioning System (IPS). OBJECTIVE: This paper presents an IPS implemented as a mobile application that can guide patients and visitors throughout a healthcare premise. METHODS: The proposed system exploits the geolocation capabilities offered by existing navigation frameworks for determining and displaying the user’s position. A hybrid …mobile application architecture has been adopted because it allows to deploy the code to multiple platforms, simplifying maintenance and upgrading. RESULTS: The developed application features two different working modes for on-site and off-site navigation, which offer both the possibility of actual navigation within the hospital, or planning a route from a list of available starting points to the desired target, without being within the navigable area. Tests have been conducted to evaluate the performance and the accuracy of the system. CONCLUSION: The proposed application aims to overcome the limitations of Global Navigation Satellite System by using magnetic fingerprinting in combination with sensor fusion simultaneously. This prevents to rely on a single technology, reducing possible system failures and increasing the scalability. Show more

Keywords: Indoor Positioning System, RTLS, wayfinding, sensor fusion, health care

DOI: 10.3233/THC-220146

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-25, 2022

Authors: Wu, Zhongping | Huang, Ruibo | Zhong, Liping | Zheng, Jinping | Gao, Yi

Article Type: Research Article

Abstract: BACKGROUND: Peak expiratory flow meters (PEFMs) have emerged as primary tools used for diagnosing and monitoring a range of respiratory diseases including asthma and chronic obstructive pulmonary disease, and the performance of these meters will thus impact disease evaluation. OBJECTIVE: The aim of this study was therefore to assess the technical performance of mechanical and electronic PEFMs commonly used in clinical practice. METHODS: The accuracy, repeatability, airflow resistance, frequency response, and linearity of five electronic and seven mechanical PEFMs were measured using a standard flow/volume simulator in accordance with nine A-waveforms and three …B-waveforms defined in ISO 23747:2015 issued by the International Standards Organization (ISO). RESULTS: The accuracy, repeatability, linearity, airflow resistance, and frequency response pass rates for these 12 different PEFM brands were 41.67%, 75.00%, 50.00%, 75.00%, and 25.00%, respectively. Just 16.67% (2/12) of the tested PEFMs met all evaluated criteria, whereas the remaining PEFMs partially met these criteria. There were no significant differences between the two tested PEFM types in the low flow rate waveform test (P > 0.05), although there were significant differences in the medium and high flow rate waveform test (P < 0.05). In addition, the overall PEFMs test had poor accuracy and good repeatability, although most of the repeatability errors occurred in the BTPS state. CONCLUSION: PEFMs commonly used in clinical settings exhibit variable technical performance, and relevant departments need to strengthen PEFM quality control and management in China. Show more

Keywords: Peak expiratory flow meter, standard flow/volume simulator, quality control, ISO 23747:2015

DOI: 10.3233/THC-220122

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Ceballos-Juárez, Rosselin Gabriela | Pichardo-Carmona, Elias Yojairi | Mendieta-Zerón, Hugo | Echeverría, Juan Carlos | Reyes-Lagos, José Javier

Article Type: Research Article

Abstract: BACKGROUND: It is known that acceleration and deceleration patterns in heart rate variability (HRV) are asymmetrically distributed in healthy subjects. Accordingly, novel approaches for assessing the asymmetrical properties of HRV, such as the multiscale asymmetry (MSA), have been applied in the perinatal field. OBJECTIVE: To study the asymmetry of accelerations and decelerations of maternal short-term cardiac dynamics of thirty-six normotensive and preeclamptic women during labor/nonlabor by MSA analysis. METHODS: The RR interval time series obtained from these participants were classified into four groups: normotensive (control) without labor C-NL, n = …10; control with labor C-L, n = 10; and two preeclamptic groups with absence or presence of labor P-NL, n = 6; and P-L, n = 10, respectively. Multiscale indices of heart rate asymmetry (HRA) such as Porta (P%), Guzik (G%) and Ehlers (E) were used to explore the changes of HRA in the normotensive and preeclamptic groups in the presence or absence of labor. RESULTS: The main result of this study shows that preeclamptic women manifest decreased magnitude of decelerations of heart rate dynamics compared to normotensive women indicated by G% and E. We speculate that a lower cardiac parasympathetic response may be manifested in preeclamptic women during labor/nonlabor compared to normotensive women. CONCLUSIONS: These observations represented a new insight into the autonomic cardiovascular regulation in preeclampsia, which could contribute to the perinatal field in the future. Show more

Keywords: Pre-Eclampsia, Autonomic regulation, Asymmetry, Labor, HRV

DOI: 10.3233/THC-220042

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2022

Authors: Alsubaiy, Ebrahim Fihaid

Article Type: Research Article

Abstract: BACKGROUND: The provisional crowns (PR) play an important role during the course of fixed prosthesis treatment. The fitting of PR varies and depends on various factors. OBJECTIVE: The aim of the study was to evaluate the marginal and internal fit of PR produced by three-dimensional (3D) printing technique and to compare those with PR made by the milling technique by using micro computed tomography (μ CT) on three commonly used finish line designs. METHOD: Ninety study models were made using metal die of #14 tooth (i.e. maxillary 1 st …premolar molar) prepared for full veneer crown with three different finish line chamfer (C), rounded shoulder (RS) and rounded shoulder with bevel (RSB). PR was fabricated on each study model, using milling (MiL group, n = 45), and 3D printing technique (3D-P group, n = 45). Marginal and internal fit of each study model was measured by micro computed tomography, at 7 Zones Pr-1- Pr-7 on each finish line. Recorded data were statistically analysed by one-way analysis of variance (ANOVA) and using Dunnett t -Test (p > 0.05). RESULTS: The mean gap at margins was minimum for provisional crowns in 3D-P group in any finish line with minimum in rounded shoulder with bevel at zone Pr-1 30.9 ± 5.3 and at zone Pr-7 32.7 ± 5.3. In the axial region, i.e. zone Pr-2, the smallest gap was recorded in the 3D-P group and in the occlusal region, for zone Pr-3, 4 and 5, the maximum gap was recorded in the MiL group. CONCLUSION: The provisional crowns fabricated by 3D printed technique have better marginal and internal fit than the provisional crowns made by milling technique. Show more

Keywords: Provisional restoration, additive manufacturing, 3D printing, CAD-CAM, micro-CT

DOI: 10.3233/THC-220304

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Hsieh, Jui-Chien | Shih, Hsing | Xin, Ling-Lin | Yang, Chung-Chi | Han, Chi-Lu

Article Type: Research Article

Abstract: BACKGROUND: Because clinically used 12-lead electrocardiography (ECG) devices have high falsepositive errors in automatic interpretations of atrial fibrillation (AF), they require substantial improvements before use. OBJECTIVE: A clinical 12-lead ECG pre-processing method with a parallel convolutional neural network (CNN) model for 12-lead ECG automatic AF recognition is introduced. METHODS: Raw AF diagnosis data from a 12-lead ECG device were collected and analyzed by two cardiologists to differentiate between true- and false-positives. Using a stationary wavelet transform (SWT) and independent component analysis (ICA) noise reduction was conducted and baseline wandering was corrected for the …raw signals. AF patterns were learned and predicted using a parallel CNN deep learning (DL) model. (1) The proposed method alleviates the decreased ECG QRS amplitude enhances the signal-to-noise ratio and clearly shows atrial and ventricular activities. (2) After training, the CNNbased AF detector significantly reduced false-positive errors. The precision of AF diagnosis increased from 77.3% to 94.0 ± 1.5% as compared to ECG device interpretation. For AF screening, the model showed an average sensitivity of 96.8 ± 2.2%, specificity of 79.0 ± 5.8%, precision of 94.0 ± 1.5%, F1-measure of 95.2 ± 1.0%, and overall accuracy of 92.7 ± 1.5%. CONCLUSIONS: The method can bridge the gap between the research and clinical practice The ECG signal pre-processing and DL-based AF interpretation can be rapidly implemented clinically. Show more

Keywords: 12-lead ECG, atrial fibrillation, stationary wavelet transform, independent component analysis, convolutional neural network, deep learning

DOI: 10.3233/THC-212925

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2022

Authors: Zhou, Xinyi | Dong, Chunshan | Zhang, Jun | Sun, Peng | Lu, Qiang | Ma, Xiang

Article Type: Research Article

Abstract: BACKGROUND: Lung-protective ventilation (LPV) strategies have been considered as best practice in the care of critically patients. OBJECTIVE: This study aimed to investigate the effects individualized perioperative LPV with a positive end-expiratory pressure (PEEP) and low tidal volumes (V T ) based on a target airway plateau pressure (Pplat) in patients during and after an operation compared with conventional ventilation in elderly patients during abdominal surgery. METHODS: Sixty-one elderly patients with American Society of Anesthesiologists (ASA) I to III undergoing open abdominal surgery received either conventional ventilation (8 ml/kg - …1 V T ; CV group) or LPV (V T was adjusted to a target Pplat [⩽ 20 cm H 2 O]) in the volume-controlled mode with PEEP (9 cm H 2 O; LPV group) ventilation. RESULTS: Patients in the LPV group showed significantly lower pH values (7.30 ± 0.07 vs. 7.38 ± 0.05, P < 0.001) and respiratory indexes than that of CV group (0.806 ± 0.339 vs. 0.919 ± 0.300, P = 0.043) at the end of surgery. Compared with the CV group, the dynamic lung compliance (33.39 ± 3.163 vs. 30.15 ± 2.572, P < 0.001) was significantly higher, and the body temperature remained significantly more favorable in the LPV group (35.9 ± 0.3 vs. 35.1 ± 0.4, P < 0.001). Patients in the LPV group had significantly faster postoperative recovery than that of the CV group (P < 0.001). CONCLUSIONS: The study showed that LPV could be beneficial for ventilation, core body temperature, and postoperative recovery in elderly patients with healthy lungs. Show more

Keywords: Tidal volume, positive end-expiratory pressure, airway plateau pressure, lung function, postoperative recovery

DOI: 10.3233/THC-220144

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2022

Authors: Okawa, Ryuya | Yasui, Go | Mihara, Ban | Hayashi, Norio

Article Type: Research Article

Abstract: BACKGROUND: The failure of cerebrospinal fluid (CSF) signal suppression in postmortem fluid-attenuated inversion recovery (FLAIR) of the brain is a problem. OBJECTIVE: The present study was to clarify the relationship between the temperature of deceased persons and CSF T 1 , and to optimize the postmortem brain FLAIR imaging method using synthetic MRI. METHODS: Forehead temperature was measured in 15 deceased persons. Next, synthetic MRI of the brain was performed, the CSF T 1 was measured, and the optimal TI was calculated. Two types of FLAIR …images were obtained with the clinical and optimal TI. The relationship between forehead temperature and the CSF T 1 and optimal TI was evaluated. The optimized FLAIR images were physically and visually evaluated. RESULTS: The CSF T 1 and optimal TI were strongly correlated with forehead temperature. Comparing the average SNR and CNR ratios and visual evaluation scores of the two FLAIR images, those captured with the optimal TI showed statistically lower SNR, higher CNR, and higher visual evaluation scores (p < 0.01). CONCLUSIONS: Synthetic MRI enables the quantification of the CSF T 1 resulting from postmortem temperature decreases and calculation of the optimal TI, which could aid in improving the failure of CSF signal suppression and in optimizing postmortem brain FLAIR imaging. Show more

Keywords: Synthetic magnetic resonance imaging, autopsy imaging, inversion time, cerebrospinal fluid, fluid-attenuated inversion recovery

DOI: 10.3233/THC-220230

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2022

Authors: Zhang, Wenxin | Qu, Shoufang | Chen, Qiong | Yang, Xuexi | Yu, Jing | Zeng, Shuang | Chu, Yuxing | Zou, Hao | Zhang, Zhihong | Wang, Xiaowen | Jing, Ruilin | Wu, Yingsong | Liu, Zhipeng | Xu, Ren | Wu, Chunyan | Huang, Chuanfeng | Huang, Jie

Article Type: Research Article

Abstract: BACKGROUND: Along with the dramatic development of molecular diagnostic testing for the detection of oncogene variations, reference materials (RMs) have become increasingly important in performance evaluation of genetic testing. OBJECTIVE: In this study, we built an RMs for genetic testing based on next-generation sequencing (NGS). METHOD: Solid tumor tissues were selected as the samples of RMs for preparation. NGS were used to determine and validate the variants and the mutation frequency in DNA samples. Digital PCR was used to determine the copy numbers of RNA samples. The performance of the RMs were validated …by six laboratories. RESULTS: Thirty common genetic alterations were designed based on these RMs. RMs consisted of a positive reference, a limit of detection reference, and a negative reference. The validation results confirmed the performance of the RMs. CONCLUSION: These RMs may be an attractive tool for the development, validation, and quality monitoring of molecular genetic testing. Show more

Keywords: Reference materials, genetic testing, quality control, oncogene variants

DOI: 10.3233/THC-220102

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Tiwari, Alok | Tripathi, Sumit | Pandey, Dinesh Chandra | Sharma, Neeraj | Sharma, Shiru

Article Type: Research Article

Abstract: BACKGROUND: The infection caused by the SARS-CoV-2 (COVID-19) pandemic is a threat to human lives. An early and accurate diagnosis is necessary for treatment. OBJECTIVE: The study presents an efficient classification methodology for precise identification of infection caused by COVID-19 using CT and X-ray images. METHODS: The depthwise separable convolution-based model of MobileNet V2 was exploited for feature extraction. The features of infection were supplied to the SVM classifier for training which produced accurate classification results. RESULT: The accuracies for CT and X-ray images are 99.42% and 98.54% respectively. The …MCC score was used to avoid any mislead caused by accuracy and F1 score as it is more mathematically balanced metric. The MCC scores obtained for CT and X-ray were 0.9852 and 0.9657, respectively. The Youden’s index showed a significant improvement of more than 2% for both imaging techniques. CONCLUSION: The proposed transfer learning-based approach obtained the best results for all evaluation metrics and produced reliable results for the accurate identification of COVID-19 symptoms. This study can help in reducing the time in diagnosis of the infection. Show more

Keywords: Transfer learning, COVID-19, MobileNet V2, deep learning

DOI: 10.3233/THC-220114

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2022