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Price: EUR 150.00Authors: Qiu, Bin | Chen, Hang | Zhang, Enke | Ma, Fuchun | An, Gaili | Zong, Yuan | Shang, Liang | Zhang, Yulian | Zhu, Huolan
Article Type: Research Article
Abstract: BACKGROUND: The incidence of type 2 diabetes is rapidly increasing worldwide. Studies have shown that it is also associated with cancer-related morbidities. Early detection of cancer in patients with type 2 diabetes is crucial. OBJECTIVE: This study aimed to construct a model to predict cancer risk in patients with type 2 diabetes. METHODS: This study collected clinical data from a total of 5198 patients. A cancer risk prediction model was established by analyzing 261 items from routine laboratory tests. We screened 107 risk factors from 261 clinical tests based on the importance of …the characteristic variables, significance of differences between groups (P < 0.05), and minimum description length algorithm. RESULTS: Compared with 16 machine learning classifiers, five classifiers based on the decision tree algorithm (CatBoost, light gradient boosting, random forest, XGBoost, and gradient boosting) had an area under the receiver operating characteristic curve (AUC) of > 0.80. The AUC for CatBoost was 0.852 (sensitivity: 79.6%; specificity: 83.2%). CONCLUSION: The constructed model can predict the risk of cancer in patients with type 2 diabetes based on tumor biomarkers and routine tests using machine learning algorithms. This is helpful for early cancer risk screening and prevention to improve patient outcomes. Show more
Keywords: Type 2 diabetes, cancer risk, machine learning, prediction model
DOI: 10.3233/THC-230385
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Li, Yan | Qu, Qizhi | Yue, Yuxue | Guo, Yuxuan | Yi, Xiuna
Article Type: Research Article
Abstract: BACKGROUND: Although cone beam computed tomography (CBCT) plays an important role in the diagnosis and treatment of oral diseases, its image segmentation method needs to be further improved, and there are still objections about the clinical application effect of general anesthesia (GA) on children’s dental fear (CDF). OBJECTIVE: This study aimed to investigate the application value of CBCT based on intelligent computer segmentation model in oral diagnosis and treatment of children in the context of biomedical signals, and to analyze the alleviating effect of GA on CDF. METHODS: Based on the regional level …set (CV) algorithm, the local binary fitting (LBF) model was introduced to optimize it, and the tooth CBCT image segmentation model CV-LBF was established to compare the segmentation accuracy (SA), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), over segmentation rate (OR), and under segmentation rate (UR) between these model and other algorithms. 82 children with CDF were divided into general anesthesia group (GAG) (n = 38) and controls (n = 44) according to the voluntary principle of their families. Children in GAG were treated with GA and controls with protective fixed intervention. Children’s fear survey schedule-dental subscale (CFSS-DS) and Venham scores were counted before intervention in the two groups. CFSS-DS scores were recorded at 2 hours after intervention and after recovery in children in GAG. CFSS-DS and Venham scores were performed in all children 1 week after surgery. RESULTS: The results showed that the S A value of CV-LBF algorithm was higher than that of region growing algorithm (P < 0.05). OR, UR, MSSD, and ASSD values of CV-LBF algorithm were evidently lower than those of other algorithms (P < 0.05). CFSS-DS scores were lower in GAG than in controls 2 hours after intervention and at return visits after 1 week of intervention (P < 0.001), and Venham scores were lower in GAG than in controls after intervention (P < 0.001). After intervention, the proportion of children with Venham grade 0, 1, 2, and 3 was obviously higher in GAG than in controls (P < 0.001), while the proportion of children with Venham grade 4 and 5 was clearly higher in controls than in GAG (P < 0.001). CONCLUSION: The results revealed that the computer intelligent segmentation model CV-LBF has potential application value in CBCT image segmentation of children’s teeth, and GA can effectively alleviate anxiety of children with CDF and can be used as biomedical signals. Show more
Keywords: Artificial intelligence, cone beam computed tomography (CBCT), oral cavity in children, general anesthesia, children’s dental fear
DOI: 10.3233/THC-230099
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Seget, Sebastian | Chobot, Agata | Rusak, Ewa | Ochab, Agnieszka | Bielawska, Anna | Polanska, Joanna | Jarosz-Chobot, Przemysława
Article Type: Research Article
Abstract: BACKGROUND: Given the steadily rising incidence of type 1 diabetes (T1D), particularly among the youngest preschool children, coupled with well-documented challenges of achieving and maintaining optimal metabolic control in this age group, there is a growing need for advanced technological devices. OBJECTIVE: To evaluate glycaemic control in children below the age of seven with type 1 diabetes (T1D) and assess the safety of the advanced hybrid closed loop (AHCL) system in comparison to the previous treatment method, a sensor-augmented pump with predictive low-glucose suspend (SAP-PLGS). METHOD: Data from 10 children (aged 2.60–6.98 years) …with T1D who transitioned to the AHCL system from SAP-PLGS were analysed. SAP-PLGS records from two weeks prior to the initiation of AHCL were compared with records from the initial four weeks post-switch (excluding the training period). These data were examined at two 2-week intervals and compared with records from two weeks post six-month usage of the AHCL. RESULTS: A significant decrease in the average nighttime glucose concentration was observed compared to pre-AHCL values (p = 0.001, concordance W = 0.53). The Glucose Management Indicator (GMI) value significantly decreased from 6.88 ± 0.37% to 6.52 ± 0.32% (p = 0.018, rbc = 0.93) immediately following the device switch and stabilized at 6.50 ± 0.28% (p = 0.001, W = 0.53) and 6.55 ± 0.41% (p = 0.001, W = 0.53) at subsequent stages of the study. An improvement was also observed in mean glucose values for time spent < 54 mg/dl, while the proportion of time within this range was maintained, both during the day (p < 0.001, W = 0.58) and at night (p = 0.002, W = 0.83). CONCLUSION: The AHCL MiniMed 780G TM system improved glycaemic control in the studied group of children under seven years of age with T1D compared to previous SAP-PLGS therapy. It proved to be safe for delivering insulin in this age group. Show more
Keywords: Type 1 diabetes, advanced hybrid closed-loop system, young children, hybrid closed-loop
DOI: 10.3233/THC-230490
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Park, Joo-Hee | Jeon, Hye-Seon | Kim, Ji-Hyun | Kim, Ye Jin | Moon, Gyeong Ah
Article Type: Review Article
Abstract: BACKGROUND: Virtual reality (VR)-based physical exercise is an innovative and effective intervention strategy for healthcare in older adults. OBJECTIVE: This meta-analysis aimed to clarify the effects of VR-based balance exercise programs on various balancing abilities of older adults. In addition, the effect size of each variable was computed by total exercise time, sensor type, avatar presence, and feedback type to determine influencing factors that lead to the success of VR-based rehabilitation programs. METHODS: The databases searched were PubMed/Medline, CINAHL, NDSL, and Google Scholar. Inclusion criteria were: (1) independent older adults; (2) non-immersive VR exercise; …(3) randomized controlled design; (4) both balance and gait data; and (5) written in English and Korean. The studies without information to compute effect sizes were excluded. Standardized mean difference was used to analyze the effect size (d). RESULTS: Twenty-five studies were finally included in this study. The main findings of this meta-analysis were as follows: (1) Non-immersive VR-based balance exercises are moderately and largely effective for improving overall balance function, (2) VR balance exercise was more effective for static balance than for gait, (3) VR exercise is more effective when avatars are presented and KP is provided as feedback. CONCLUSION: Total exercise time and mode of feedback are influencing factors that affect the effectiveness of VR-based balance exercises. Show more
Keywords: Balance, exercising, gait, meta-analysis, virtual reality
DOI: 10.3233/THC-230156
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Kim, Sun Kyung | Lee, Youngho | Wang, Hye Ri H. | Park, Su Yeon
Article Type: Research Article
Abstract: BACKGROUND: The in-depth understanding of human anatomy is the foundation for safety in nursing practice. Augmented reality is an emerging technology that can be used for integrative learning in nursing education. OBJECTIVE: The study aimed to develop a human anatomy-based skill training system and pilot test its usability and feasibility. METHODS: Twenty-seven nursing students participated in 3D anatomy-based skill training for intramuscular injection and Levin tube feeding using HoloLens 2. Various user interfaces including pictures, videos, animation graphics, and annotation boxes assisted users with a comprehensive understanding of the step-by-step procedures for these …techniques. A one-group pre-post test was conducted to observe changes in skill performance competency, usability, and learning satisfaction. RESULTS: After study participation, a statistically significant improvement in skill performance competency (p < 0.05) was observed. The usability results showed that students were satisfied with the usefulness of the program (9.55 ± 0.49) and scored highly for the intention to participate in other educational programs (9.62 ± 0.59). A high level of learning satisfaction was achieved (9.55 ± 0.49), with positive responses in fostering students’ engagement and excitement in the application of cutting-edge technology. CONCLUSION: The 3D anatomy-based nursing skill training demonstrated good potential to improve learning outcomes and facilitate engagement in self-directed practice. This can be integrated into undergraduate nursing education as an assistant teaching tool, contributing to the combination of knowledge and practice. Show more
Keywords: HoloLens 2, augmented reality, nursing, 3D, human anatomy, practice
DOI: 10.3233/THC-230586
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Lee, Kyoung Jin | Lee, Jung Chan
Article Type: Research Article
Abstract: BACKGROUND: Elastomeric pumps have a curved infusion rate profile over infusion time. Chemically driven pumps can overcome such limitations of elastomeric pumps and infuse constantly. However, studies on the pharmacokinetic benefit of chemically-driven pumps are insufficient. OBJECTIVE: This study aimed to determine effects of constant infusion with a chemically-driven pump on plasma drug concentrations compared to elastomeric pumps. METHODS: Infusion rate profiles of a chemically driven pump and two elastomeric pumps were measured in vitro tests under three height conditions of drug reservoir. Plasma drug concentrations were estimated using a pharmacokinetic model …of 5-fluorouracil (5FU). RESULTS: The chemically-driven pump was more accurate than elastomeric pumps during the total infusion time (Root-mean-square-error (RMSE): 3% vs. 13%) which thus reduced its deviation of plasma 5FU concentration over time to one-fifth of that with an elastomeric pump. The chemically-driven pump had less than 5% of RMSE despite the influence of height difference. CONCLUSION: Although chemically-driven pumps maintained plasma 5FU concentration successfully and elastomeric pumps did not, both pumps were proper for 5FU infusion because the time-dependent changes in infusion rate did not affect the area under the curve. Chemically driven pumps would be more advantageous for drugs that are sensitive to their plasma concentrations. Show more
Keywords: Infusion pumps, disposable equipment, 5-fluorouracil, pharmacokinetics
DOI: 10.3233/THC-230227
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Zou, Li | Dong, Wei | Ai, Ying | Li, Yantao | Cheng, Yun | Feng, Yun
Article Type: Research Article
Abstract: BACKGROUND: Recurrent spontaneous abortion affects approximately 1–2% of reproductive-age women, with roughly half of RSA cases classified as unexplained recurrent spontaneous abortion (URSA). Genetic polymorphisms in eNOS gene have been shown to have significant implications across various disease processes. Nevertheless, the potential impact of eNOS gene polymorphisms on the susceptibility to URSA in Yunnan population has yet to be explored or documented. OBJECTIVE: This study aims to investigate the potential association between specific variations in the eNOS gene (VNTR 4b/a, - 786T > C, and + 894G > …T) and the risk of URSA in Yunnan population. METHODS: A total of 243 URSA patients and 241 healthy females are involved in this study. We conducted amplification of the eNOS gene fragment and performed sanger sequencing to detect the specific eNOS gene polymorphisms, including VNTR 4b/a, - 786T > C, and + 894G > T. Using a multivariate logistic regression model, we evaluate the potential association between eNOS gene polymorphisms (VNTR 4b/a, - 786T > C, and + 894G > T) and the risk of URSA. Furthermore, serum NO levels were measured in URSA patients. RESULTS: The presence of VNTR 4a, - 786C, and + 894T alleles was found to be associated with an increased risk of URSA. Additionally, our study revealed a significant association between the G-C-4b haplotype of the investigated eNOS gene polymorphisms and a predisposition to URSA. Notably, these eNOS polymorphisms were shown to reduce serum NO levels in URSA patients. CONCLUSION: This study provides evidence supporting the association between eNOS gene polymorphisms, VNTR 4b/a, - 786T > C, and + 894G > T, and the occurrence of URSA in Yunnan Province, China. Show more
Keywords: eNOS, URSA, VNTR 4b/a, -786T > C, +894G > T
DOI: 10.3233/THC-230934
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Begic, Zijo | Djukic, Milan | Begic, Edin | Aziri, Buena | Mladenovic, Zorica | Iglica, Amer | Sabanovic-Bajramovic, Nirvana | Begic, Nedim | Kovacevic-Preradovic, Tamara | Stanetic, Bojan | Badnjevic, Almir
Article Type: Review Article
Abstract: BACKGROUND: Left atrial (LA) strain analysis has emerged as a noninvasive technique for assessing LA function and early detection of myocardial deformation. Recently, its application has also shown promise in the pediatric population, spanning diverse cardiac conditions that demand accurate and sensitive diagnostic measures. OBJECTIVE: This research endeavors to explore the role of LA strain parameters and contribute to the growing body of knowledge in pediatric cardiology, paving the way for more effective and tailored approaches to patient care. METHODS: A comprehensive literature review was conducted to gather evidence from studies using echocardiographic …strain imaging techniques across pediatric populations. RESULTS: LA strain parameters exhibited greater sensitivity than conventional atrial function indicators, with early detection of diastolic dysfunction and LA remodeling in pediatric cardiomyopathy, children with multisystem inflammatory syndrome, rheumatic heart disease, as well as childhood renal insufficiency and obesity offering prognostic relevance as potential markers in these pediatric subpopulations. However, there remains a paucity of evidence concerning pediatric mitral valve pathology, justifying further exploration. CONCLUSION: LA strain analysis carries crucial clinical and prognostic implications in pediatric cardiac conditions, with reliable accuracy and sensitivity to early functional changes. Show more
Keywords: Left atrium, echocardiography, cardiac diseases
DOI: 10.3233/THC-231087
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Badnjević, Almir | Pokvić, Lejla Gurbeta | Smajlhodžić-Deljo, Merima | Spahić, Lemana | Bego, Tamer | Meseldžić, Neven | Prnjavorac, Lejla | Prnjavorac, Besim | Bedak, Omer
Article Type: Research Article
Abstract: BACKGROUND: With the end of the coronavirus disease 2019 (COVID-19) pandemic, it becomes intriguing to observe the impact of innovative digital technologies on the diagnosis and management of diseases, in order to improve clinical outcomes for patients. OBJECTIVE: The research aims to enhance diagnostics, prediction, and personalized treatment for patients across three classes of clinical severity (mild, moderate, and severe). What sets this study apart is its innovative approach, wherein classification extends beyond mere disease presence, encompassing the classification of disease severity. This novel perspective lays the foundation for a crucial decision support system during patient …triage. METHODS: An artificial neural network, as a deep learning technique, enabled the development of a complex model based on the analysis of data collected during the process of diagnosing and treating 1000 patients at the Tešanj General Hospital, Bosnia and Herzegovina. RESULTS: The final model achieved a classification accuracy of 82.4% on the validation data set, which testifies to the successful application of the artificial neural network in the classification of clinical outcomes and therapy in patients infected with viral infections. CONCLUSION: The results obtained show that expert systems are valuable tools for decision support in healthcare in communities with limited resources and increased demands. The research has the potential to improve patient care for future epidemics and pandemics. Show more
Keywords: COVID-19, artificial intelligence, medical techniques, classification, digitization, prediction
DOI: 10.3233/THC-230917
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Hamid, Suraya | Roslan, Muhammad Hamirul Hamizan | Norman, Azah Anir | Ghani, Norjihan Abdul
Article Type: Research Article
Abstract: BACKGROUND: Several studies focus on the use of emerging technologies to support and monitor health but are centred around the elderly group of people. Meanwhile, the average elderly popularly known as the middle-aged have not been put into consideration regarding the subject matter. OBJECTIVE: This article focuses on the use behaviour and acceptance of emerging technologies that can assist in providing a middle-aged population with a healthy lifestyle. METHODS: This study collected the primary data through an online questionnaire survey to empirically evaluate final 169 respondents. The analysis for this study was done …utilising SmartPLS software via partial least squares structural equation modelling. RESULTS: The results indicate that 9 out of 11 were tested as supported hypotheses. All supported hypotheses showed the strong relationship between acceptance and user behaviour with emerging technology. CONCLUSION: The experience of acceptance and behaviour of using emerging technology in a healthy lifestyle was found as an important determinant of outcome in preparing the middle-aged for their elderly age by adapting emerging technology as early as possible. Show more
Keywords: Emerging technology, healthy lifestyle, middle aged, health, acceptance
DOI: 10.3233/THC-230604
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2023
Authors: Wang, Ping | Shen, Yue | Chen, Jinghan | Li, Qianwen | Tong, Lin | Li, Xitao
Article Type: Research Article
Abstract: BACKGROUND: Beamforming is vital for medical ultrasound imaging systems. The generalized sidelobe canceller (GSC) beamforming can improve the image quality of lateral resolution, but its performance improvement in contrast and robustness is limited. OBJECTIVE: This paper proposes an improved generalized sidelobe canceller algorithm based on multi-apodization with cross-correlation (MAXB-IGSC), which aims to improve the contrast and robustness of ultrasound imaging while maintaining the high image resolution and background speckle quality of GSC. METHODS: The proposed MAXB-IGSC uses multiple pairs of complementary received apodization functions to process the echo data individually to obtain multiple …pairs of data sets. The average of their normalized cross-correlation coefficients is then calculated and utilized to determine the adaptive subarray length of the GSC covariance matrix and weights the output of the improved GSC. RESULTS: The MAXB-IGSC improves the contrast ratio (CR) by 171.18% in anechoic cyst simulation and by 91.23%/130.97%/171.76% in geabr_0 (a dataset from the University of Michigan) experiment compared with GSC, respectively. Furthermore, MAXB-IGSC exhibits significant noise immunity, which greatly improves the robustness of the imaging. The technology also maintains the brightness and uniformity of the background speckle. CONCLUSION: The proposed MAXB-IGSC has potential for obtaining high-quality ultrasound images in clinical applications. Show more
Keywords: Ultrasound imaging, cross-correlation coefficient, adaptive subarray length, robustness
DOI: 10.3233/THC-230724
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2023
Authors: Lee, Hung Fu | Liao, Pei-Hung
Article Type: Research Article
Abstract: BACKGROUND: Improved access to media and medical knowledge has elicited stronger public health awareness. OBJECTIVE: This study developed a smart drug interaction reminder system for patients to increase knowledge and reduce nurse workload. METHODS: This study used a single-group pre-test/post-test design and applied mining techniques to analyze the weight and probability of interaction among various medicines. Data were collected from 258 participants at a teaching hospital in northern Taiwan using convenience sampling. An app was used to give patients real-time feedback to obtain access to information and remind them of their health issues. …In addition to guiding the patients on medications, this app measured the nurses’ work satisfaction and patients’ knowledge of drug interaction. RESULTS: The results indicate that using information technology products to assist the app’s real-time feedback system promoted nurses’ work satisfaction, improved their health education skills, and helped patients to better understand drug interactions. CONCLUSION: Using information technology to provide patients with real-time inquiring functions has a significant effect on nurses’ load reduction. Thus, smart drug interaction reminder system apps can be considered suitable nursing health education tools and the SDINRS app can be integrated into quantitative structure-activity relationship intelligence in the future. Show more
Keywords: Drug interaction, data mining, reminder systems, nurses, application
DOI: 10.3233/THC-230650
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Shukla, Prashant Kumar | Maheshwary, Priti | Kundu, Shakti | Mondal, Dipannita | Kumar, Ankit | Joshi, Shubham | Pareek, Piyush Kumar
Article Type: Research Article
Abstract: BACKGROUND: Understanding complex systems is made easier with the tools provided by the theory of nonlinear dynamic systems. It provides novel ideas, algorithms, and techniques for signal processing, analysis, and classification. Presently, these ideas are being applied to the investigation of how physiological signals evolve. OBJECTIVE: The study applies nonlinear dynamics theory to electroencephalogram (EEG) signals to better comprehend the range of alcoholic mental states. One of the main contributions of this paper is an algorithm for automatically distinguishing between sober and drunken EEG signals based on their salient features. METHODS: The study …utilized various entropy-based features, including ApEn, SampEn, Shannon and Renyi entropies, PE, TS, FE, WE, and KSE, to extract information from EEG signals. To identify the most relevant features, the study employed ranking methods like T -test, Wilcoxon, and Bhattacharyya, and trained SVM classifiers with the selected features. The Bhattacharyya ranking method was found to be the most effective in achieving high classification accuracy, sensitivity, and specificity. RESULTS: Classification accuracy of 95.89%, the sensitivity of 94.43%, and specificity of 96.67% are achieved by the SVM classifier with radial basis function (RBF) for polynomial Kernel using the Bhattacharyya ranking method. CONCLUSION: From the result, it is clear that the model serves as a cost-effective and accurate decision-support tool for doctors in diagnosing alcoholism and for rehabilitation centres to monitor the effectiveness of interventions aimed at mitigating or reversing brain damage caused by alcoholism. Show more
Keywords: EEG, ApEn, SampEn, PE, TS, FE, WE, KSE, SVM
DOI: 10.3233/THC-220771
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Deng, Li-Hua | Yao, Ting-Ting | Jin, Hai-Yan | Li, Yi | Zong, Yi | Chen, Mei-Gui | Chen, Peng
Article Type: Research Article
Abstract: BACKGROUND: The nursing model of establishing a chemotherapy safety management supervisory group has guaranteed the safety and effectiveness of intravenous chemotherapy while reducing the adverse effects of chemotherapy and improving patient satisfaction and quality of life. OBJECTIVE: To explore the impact of establishing a nursing supervision group on improving the safety management of patients receiving chemotherapy in the oncology department. METHODS: We selected a total of 60 patients who underwent chemotherapy at the oncology department between January and June 2021 and assigned them to the control group. They received conventional chemotherapy safety management …nursing care. We selected another 60 patients undergoing chemotherapy in the oncology department between July and December 2021 and assigned them to the observation group. They received a nursing intervention model facilitated by the chemotherapy safety supervision team. We compared the intervention effects in the two groups. RESULTS: Patient satisfaction was significantly higher in the observation group than in the control group (P < 0.05); the incidence of post-chemotherapy nausea and vomiting was significantly lower in the observation group than in the control group (P < 0.05); and the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients in the observation group were reduced (P < 0.05) and significantly lower than in the control group (P < 0.05). We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30 (EORTC-QLQ-C30) and found a statistically significant difference in the quality of life of patients before the nursing intervention and on the day of discharge (P < 0.05). CONCLUSION: The establishment of a chemotherapy safety management supervisory group was effective in reducing the incidence of post-chemotherapy nausea and vomiting as well as the patient’s psychological burden; it could also improve the quality of life of patients and their satisfaction with nursing care. Show more
Keywords: Dedicated safety supervisors, nausea and vomiting, patient satisfaction, patients receiving chemotherapy, quality of life
DOI: 10.3233/THC-220686
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Zhou, Xuan | Li, Zhen-Fei | Guo, Xuan-Zhu | Wei, Qiao | Niu, Ya-Nan | Li, Meng | Xia, Jia-Ning | Chen, Li-Ping
Article Type: Research Article
Abstract: BACKGROUND: The first-line treatment for cervical dystonia (CD) consists of repeated intramuscular injections of botulinum toxin (BoNT). However, the efficacy in some patients may be unsatisfactory and they may discontinue treatment. OBJECTIVE: To examine the factors associated with the maximum rate of remission in patients with CD after initial botulinum neurotoxin type A (or botulinum toxin type A abbreviated as BTX-A or BoNT-A) treatment. METHODS: Patients with CD who received BoNT-A injections were evaluated using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Tsui scale, with follow-up endpoints lasting until the …start of the second injection. Patients who did not receive a second injection of BoNT-A were followed up for at least 5 months. The maximum remission rates were determined using the lowest Tsui and TWSTRS total scores during the follow-up period. We obtained basic information about these patients such as age, gender, duration of disease, presence of additional disease, types of torticollis, presence of anxiety, depression, tremors, single-photon emission computed tomography (SPECT) findings, injected dose, and so on from their medical records. RESULTS: A total of 70 patients with CD participated in this study, with males comprising 35.7% (25 individuals) with an average age of 45 ± 14 years old. The duration of disease was an independent risk factor for determining whether a complete remission has been attained using the Tsui scale (odds ratio [OR] = 0.978, 95% confidence interval [CI]: 0.959–0.997, P = 0.026). The optimal cut-off point for predicting patients who were unable to achieve complete remission based on duration of disease was 7.5 months (AUG = 0.711). Patients with CD with additional disease had greater difficulty achieving complete remission than those with CD alone based on TWSTRS assessments (P = 0.049). During the study, approximately 17% of all participants reported experiencing adverse reactions that lasted between 1 to 3 weeks before disappearing. CONCLUSION: BoNT is an effective and safe method for treating CD. The maximum remission rates of patients after their first injections are influenced by the duration of their disease. Thus, treatment using BoNT injections must be administered as soon as possible. Show more
Keywords: Botulinum neurotoxin (BoNT), cervical dystonia, efficacy, maximum remission rate, spasmodic torticollis
DOI: 10.3233/THC-231182
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Ding, Ling | Tao, Xinyan | Zhou, Jingjing
Article Type: Research Article
Abstract: BACKGROUND: Comprehensive geriatric assessment (CGA) has been used in inpatient, outpatient, and emergency patients in Western countries and is an important evaluation tool in medicine. In China, the application of CGA to multiple single diseases has achieved satisfactory intervention effects. OBJECTIVE: To explore the effect of CGA on postoperative quality of life (QoL), psychological state, neurological recovery, and self-efficacy in patients with cerebral hemorrhage. METHODS: In this randomized controlled trial, a total of 133 postoperative patients with cerebral hemorrhage who were treated and nursed in our hospital between March 2019 and March 2021 …were randomly assigned to a control group (68 patients) and an observation group (65 patients). The control group was given a general comprehensive care intervention. The observation group was evaluated using an electronic medical record-based CGA system that assessed patient prognosis and was given individualized interventions based on the CGA findings. The postoperative QoL, psychological state, neurological recovery, and self-efficacy of the two groups were compared. RESULTS: After the intervention, self-decompression, self-decision-making, and positive attitudes of the observation group were higher than those of the control group. However, the National Institute of Health Stroke Scale score of the observation group was lower than that of the control group, the Self-rating anxiety scale and self-rating depression scale scores of the observation group were lower than those of the control group, and the social support score was significantly higher in the observation group than in the control group. After the intervention, the mental vitality, social interaction, emotional restriction, and mental status scores of the observation group were significantly higher than those of the control group. CONCLUSION: Comprehensive evaluation of patients with cerebral hemorrhage based on a CGA, targeting the individual factors that affect the prognosis of patients, and formulating and implementing individualized nursing intervention programs based on the CGA results can effectively relieve the symptoms of cerebral hemorrhage, reduce anxiety and depression, and improve the QoL of patients with cerebral hemorrhage. Show more
Keywords: Intracerebral hemorrhage, comprehensive geriatric assessment, quality of life, neurological function, self-efficacy
DOI: 10.3233/THC-230611
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Hu, Huijun | Ma, Yanfang | Cheng, Aiai | Zhang, Zengqiang
Article Type: Research Article
Abstract: BACKGROUND: There have been studies on the use of cognitive behavioral nursing intervention (CBNI) but the main subjects were patients with secondary glaucoma and there are fewer studies on the care of congenital glaucoma. OBJECTIVE: To explore the clinical value of cognitive behavioral nursing model in patients with congenital glaucoma. METHODS: One hundred and fifty-three postoperative patients with congenital glaucoma treated in our hospital between January 2021 and December 2022 were prospectively selected for the study and randomly divided into a control group (n = 77) and an …observation group (n = 76). The control group was given routine nursing, and the observation group was given cognitive behavioral nursing mode on the basis of the control group. Anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), Connor-Davidson toughness scale, and treatment adherence evaluation scale were used to evaluate the psychological state, mental toughness, treatment adherence, treatment effect and nursing care satisfaction in the two groups before and after 2 weeks of intervention. The efficacy of the treatment was also assessed by determining the visual acuity (VA), intraocular pressure (IOP), and mean defective (MD) value of the visual field of the two groups of patients. RESULTS: After nursing, the SDS score (46.33 ± 6.16 versus 53.21 ± 5.94) and SAS score (44.41 ± 5.6 versus 52.82 ± 6.31) in the observation group were lower than those in the control group (P < 0.05). The scores of optimism (11.55 ± 1.90 versus 8.20 ± 1.95), self-improvement (22.05 ± 3.60 versus 17.60 ± 4.30), tenacity (37.45 ± 3.10 versus 28.90 ± 4.55) and total score (71.35 ± 8.00 versus 56.85 ± 8.50) in the observation group were higher than those in the control group (P < 0.05). After care, the VA of the observation group (0.95 ± 0.22) was greater than that of the control group (0.84 ± 0.16), and the IOP (14.25 ± 0.58 versus 15.89 ± 0.67) and the MD (5.42 ± 0.46 versus 6.68 ± 0.49) of the observation group were less than that of the control group. The difference between the two groups was statistically significant (P < 0.05). The compliance (96.05% versus 85.71%) and nursing satisfaction (96.10% versus 85.71%) of the observation group were higher than those of the control group (P < 0.05). CONCLUSION: Cognitive-behavioural nursing care for glaucoma patients can improve patients’ mental toughness, improve visual acuity, reduce intraocular pressure and mean visual field defect values, and have a positive effect on enhancing patients’ treatment adherence and nursing satisfaction. Show more
Keywords: Cognitive behavioral nursing, congenital glaucoma, compliance, self-management
DOI: 10.3233/THC-230772
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Orsi, Alexander D. | Mathew, Manu | Plaskos, Christopher | Wakelin, Edgar A. | Slotkin, Eric M. | Coffey, Simon | Ponder, Corey E. | Keggi, John K. | McMahon, Stephen J.
Article Type: Research Article
Abstract: BACKGROUND: Passive smartphone-based apps are becoming more common for measuring patient progress after total hip arthroplasty (THA). Optimum activity levels during early THA recovery have not been well documented. OBJECTIVES: Correlations between step-count and patient reported outcome measures (PROMs) during early recovery were explored. This study also investigated how demographics impact step-count during early post-operative recovery. METHODS: Smartphone captured step-count data from 666 THA patients was retrospectively reviewed. Mean age was 64 ± 11 years. 55% were female. Mean BMI was 29 ± 8kg/m 2 …. Mean daily step-count was calculated for each patient over four time-windows: 60 days prior to surgery (preop), 42–49 days postop (6 weeks), 91–98 days postop (3 months), and 183–197 days postop (6 months). Spearman correlation coefficients and linear regression were used to assess the association between PROMs (HOOS-12, HOOS-Jr, and UCLA) were performed. Patients were separated into three step-count levels: low (< 2500 steps/day), medium (2500–5500 steps/day), and high (> 5500 steps/day). Age > 65 years, BMI > 35 kg/m 2 , and sex were used for demographic comparisons. Post hoc analyses were performed using Welch’s unequal variances t -tests, or Wilcoxon rank-sum tests, both with Bonferroni corrections, where appropriate when comparing between groups. Chi-squared analyses were also used when comparing categorical variables. RESULTS: UCLA correlated with step-count at all time-windows (p < 0.001). HOOS12-Function correlated with step-count preoperatively, at 6 weeks, and at 3 months (p < 0.001). High step-count individuals had improved UCLA scores compared to low step-count individuals preoperatively (Δ 1.5, p < 0.001), at 6 weeks (Δ 0.9, p < 0.001), at 3 months (Δ 1.4, p < 0.001), and at 6 months (Δ 1.4, p < 0.001). High step-count individuals had improved HOOS12-Function scores compared to low step-count individuals preoperatively (Δ 9.6, p < 0.001), at 6 weeks (Δ 5.3, p < 0.001), and at 3 months (Δ 6.1, p < 0.001). Males had greater step-count at all time points (p < 0.001). Younger patients and low BMI patients had greater step-count across all time points (p < 0.001). CONCLUSION: High step-count improved PROMs scores compared to low step-count. Early post-operative step-count was significantly impacted by age, sex, and BMI. Generic recovery profiles may not be appropriate across diverse populations. Show more
Keywords: Total hip arthroplasty, smartphone, step-count, PROMs, remote patient monitoring
DOI: 10.3233/THC-231203
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: DeClaire, Jeffrey H. | Wakelin, Edgar A. | Chattinger, Kayla | Plaskos, Christopher
Article Type: Research Article
Abstract: BACKGROUND: Early complications in total knee arthroplasty (TKA) associated with modern robotics platforms integrated with digital balancing technology have not been investigated. OBJECTIVE: The objective was to compare 90-day complication rates between a manual technique and a modern robotic-assisted ligament balancing TKA platform. METHODS: 895 primary TKA procedures from a single surgeon were retrospectively reviewed (614 manual TKA, 281 using a modern robotics platform with an integrated digitally controlled ligament balancing device). Post-operative complications within the 90-day episode of care were recorded by the Michigan Arthroplasty Registry Collaborative Quality Initiative. Differences in complication …rates between techniques were further divided into inpatient hospital, outpatient hospital, and ambulatory surgery center (ASC) cohorts. RESULTS: In the pooled hospital cohort and inpatient hospital cohort, ‘Return to OR’ was significantly lower for the robotic assisted group (1.3% vs 5.2% and 0% vs 4.9%, respectively, p < 0.0370). Specifically, the need for manipulation under anesthesia (MUA) was reduced for the robotics group (0.0% vs 2.5%, p = 0.0352). No differences in overall complication rate or cause of complication was found between manual and robotics cases for the hospital outpatient and ASC cohorts (p ⩾ 0.68). CONCLUSION: Within the hospital setting, robotic assisted ligament balancing technology was associated with reduced 90-day postoperative complications for ‘Return to OR’ and MUA. Show more
Keywords: Total knee arthroplasty, robotics, soft tissue, complications, hospital, ambulatory surgical center, ASC
DOI: 10.3233/THC-231198
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Guo, Julong | Ning, Yachan | Pan, Dikang | Wu, Sensen | Gao, Xixiang | Wang, Cong | Guo, Lianrui | Gu, Yongquan
Article Type: Research Article
Abstract: BACKGROUND: Endothelial dysfunction, the earliest stage of atherosclerosis, can be caused by smoking, but its molecular mechanism requires further investigation. OBJECTIVE: This study aimed to use bioinformatics analysis to identify potential mechanisms involved in smoking-related atherosclerotic endothelial dysfunction. METHODS: The transcriptome data used for this bioinformatics analysis were obtained from the Gene Expression Omnibus (GEO) database. The GSE137578 and GSE141136 datasets were used to identify common differentially expressed genes (co-DEGs) in endothelial cells treated with oxidized low-density lipoprotein (ox-LDL) and tobacco. The co-DEGs were annotated using Gene Ontology (GO) and Kyoto Encyclopedia of …Genes and Genomics (KEGG) databases. Additionally, a protein-protein interaction (PPI) network was constructed to visualize their interactions and screen for hub genes. GSE120521 dataset was used to verify the expression of hub genes in unstable plaques. The miRNA expression profile GSE137580 and online databases (starBase 2.0, TargetScan 8.0 and DGIdb v4.2.0) were used to predict the related non-coding RNAs and drugs. RESULTS: A total of 232 co-DEGs were identified, including 113 up-regulated genes and 119 down-regulated genes. These DEGs were primarily enriched in detrimental autophagy, cell death, transcription factors, and cytokines, and were implicated in ferroptosis, abnormal lipid metabolism, inflammation, and oxidative stress pathways. Ten hub genes were screened from the constructed PPI network, including up-regulated genes such as FOS, HMOX1, SQSTM1, PTGS2, ATF3, DDIT3, and down-regulated genes MCM4, KIF15, UHRF1, and CCL2. Importantly, HMOX1 was further up-regulated in unstable plaques (p = 0.034). Finally, a regulatory network involving lncRNA/circRNA-miRNA-hub genes and drug-hub genes was established. CONCLUSION: Atherosclerotic endothelial dysfunction is associated with smoking-induced injury. Through bioinformatics analysis, we identified potential mechanisms and provided potential therapeutic targets. Show more
Keywords: Atherosclerosis, smoke, tobacco, endothelial cells, genes
DOI: 10.3233/THC-230796
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Hoveidaei, Amir Human | Esmaeili, Sina | Ghaseminejad-Raeini, Amirhossein | Pirahesh, Seyed Kasra | Hoveidaei, Armin | Sandiford, Nemandra A. | Lahner, Nina | Citak, Mustafa
Article Type: Review Article
Abstract: BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a viable alternative to total knee arthroplasty (TKA) for osteoarthritis patients with single-compartment involvement, with advantages including accelerated recovery, reduced pain, and improved function. Robotic-assisted UKA (rUKA) is a promising development that ensures precise implant positioning and limb alignment. However, concerns about complications remain. OBJECTIVE: This study looks at patient satisfaction as a key metric for determining the efficacy of rUKA versus manual UKA (mUKA). METHODS: The search strategy for this study followed PRISMA. Using precise keywords, PubMed, Scopus, Web of Science, and the Cochrane library were …searched. English articles were searched until August 2, 2023. Selection criteria included mUKA and rUKA patient satisfaction studies. The NOS scale evaluated study quality. Meta-analysis was done with R and heterogeneity analysis. RESULTS: This systematic review examined 5 studies with 1060 UKAs (532 robotic-assisted and 528 manual). Variable satisfaction assessment methods were used. Three studies found no difference in patient satisfaction after robotic-assisted UKA, but two found a higher satisfaction. Meta-analysis showed robotic-assisted UKA improved patient satisfaction (OR = 1.72 [1.25–2.37]). Overall, most studies showed low risk of bias, except one with higher bias. CONCLUSION: This review suggests that robotic assistance may enhance patient satisfaction in UKA procedures. Show more
Keywords: Arthroplasty, replacement, knee, medical device, patient satisfaction, robotic surgical procedures
DOI: 10.3233/THC-231216
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Liu, Dong-Xu | Wu, Ke-Han | Zang, Xi-Yan | Lu, Jia-Yi | Liu, Ming-Yue | Li, Chun-Ming | Gao, Li
Article Type: Research Article
Abstract: BACKGROUND: Oral squamous cell carcinoma (OSCC) is an infiltrative malignancy characterized by a significantly elevated recurrence rate. Dickkopf-related protein 1 (DKK1), which plays an oncogene role in many cancers, acts as an inhibitor of the Wingless protein (Wnt) signaling pathway. Currently, there is a lack of consensus regarding the role of DKK1 in OSCC or its clinical significance. OBJECTIVE: To examine the role and effect of DKK1 in OSCC. METHODS: The identification of differentially expressed genes (DEGs) in OSCC was conducted by utilizing databases such as The Cancer Genome Atlas (TCGA) and Gene …Expression Omnibus (GEO). A comprehensive analysis of gene expression profile interactions (GEPIA) and Kaplan-Meier curve were conducted to investigate the associations among DEGs, patient survival and prognosis in individuals with OSCC. The biological function of DKK1 in OSCC was investigated by using molecular biology approaches. RESULTS: The expression of DKK1 was found to be upregulated in OSCC tissues at various stages. High levels of DKK1 expression exhibited a positive correlation with the overall survival (OS) and progression-free survival (PFS) rates among OSCC patients. DKK1 knockdown suppressed the proliferation and induced apoptotic response in OSCC cells. Moreover, DKK1 exerted a positive regulatory effect on HMGA2 expression, thereby modulating cell growth and apoptosis in OSCC. The expression of DKK1 was found to be positively correlated with the infiltration of immune cells in patients with OSCC. Additionally, higher levels of CD4 + T cells were associated with improved 5-year survival rates. CONCLUSION: DKK1 is a prognostic biomarker for patients with OSCC. Show more
Keywords: Dickkopf-related protein 1, HMGA2, immune status, Oral squamous cell carcinoma
DOI: 10.3233/THC-230527
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Akçaalan, Serhat | Akbulut, Batuhan | Çağlar, Ceyhun | Innocenti, Matteo | Uğurlu, Mahmut | Dogan, Metin | Akkaya, Mustafa
Article Type: Research Article
Abstract: BACKROUND: Periprosthetic joint infection (PJI) is a very important complication that occurs after total joint replacement. Diagnosing PJI is at least as difficult as this disease. There is no biomarker that alone can diagnose PJI. OBJECTIVE: This study aimed to evaluate the effectiveness of large unstained cell percentage (%LUC) in diagnosing PJI and deciding on re-implantation in two stage septic exchange arthroplasty. METHODS: Patients who underwent revision arthroplasty between 2019 and 2023 were screened retrospectively. These patients were grouped as those who underwent two-stage septic exchange and those who underwent aseptic exchange. Prosthesis …removal from the patients who underwent two-stage septic exchange, before spacer application, and on the 3rd post-operative day after spacer application, Blood parameters were collected at the 1st month and before the second stage after the spacer application, and before the revision surgery from the patients who underwent aseptic exchange. White blood cell, neutrophil percentage, %LUC, albumin, sedim and CRP values were checked and recorded one by one from all patients. RESULTS: The data of a total of 233 patients, including 133 patients in the two stage septic exchange group and 100 patients in the aseptic exchange group, were included in the study. When the predictive value of %LUC in PJI was accepted as cut-off 1.75, the sensitivity was 69.2% and the specificity was 73%. The change in %LUC over time in patients who underwent two-stage septic exchange was statistically significant (p = 0.0001). A positive correlation was found between the value of .%LUC after spacer application and the value of CRP before prosthesis protrusion/spacer application surgery, and the Spearman correlation coefficient was found to be 0.005. CONCLUSION: %LUC value can be a promising biomarker for the diagnosis of PJI by considering both sensitivity and specificity rates. Apart from this, it is an easily accessible and effective biomarker for re-implantation decision making and evaluation of response to treatment, especially in two-stage septic exchange surgeries. Show more
Keywords: Periprosthetic joint infection, %LUC, biomarker, two stage, septic exchange
DOI: 10.3233/THC-230903
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Lin, Wan-Rong | Liu, Wei-Qing | Meng, Xuan-Yu | Liu, Xiao-Ting | Kou, Zhi-Yong | Li, Wen-Liang | Yang, Jun
Article Type: Research Article
Abstract: BACKGROUND: Despite the advancement of new screening strategies and the advances in pharmacological therapies, the cancerization rates of familial adenomatous polyposis (FAP) are stable and even increased in the last years. Therefore, it necessitates additional research to characterize and understand the underlying mechanisms of FAP. OBJECTIVE: To determine the genes that drive the pathogenesis of familial adenomatous polyposis (FAP). METHODS: We performed on a cohort (GSE111156) gene profile, which consist of four group of gene expressions (the gene expressions of cancer, adenoma and normal tissue of duodenal cancer from patients with FAP were …defined as Case N, Case A and Case C respectively, while that of adenoma tissue from patients with FAP who did not have duodenal cancer was Ctrl A). Tracking Tumor Immunophenotype (TIP) website was applied to reveal immune infiltration profile and signature genes of FAP. We merged the genes of key module (pink and midnight module) with signature genes to obtained the biomarkers related with FAP pathogenesis. The expression of these five biomarkers in FAP intratumoral region (IT) and tumor rim (TR) was detected with Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). RESULTS: In total, 220, 23 and 63 DEGs were determined in Cases C, A and N, in comparison to Ctrl A. In total, 196 and 10 DEGs were determined in Cases C and A, separately, as compared to Case N. A total of four biomarkers including CCL5, CD3G, CD2 and TLR3 were finally identified associated with pink module, while only one biomarker (KLF2) associated with midnight module was identified. All biomarkers were evidently raised in FAP IT tissues utilizing qRT-PCR. CONCLUSION: We identified five potential biomarkers for pathogenesis of FAP to understand the fundamental mechanisms of FAP progression and revealed some probable targets for the diagnosis or treatment of FAP. Show more
Keywords: Familial adenomatous polyposis, bioinformatics, driver gene, WGCNA, DEGs
DOI: 10.3233/THC-230719
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2023
Authors: Jadhav, Shreya | Jhaveri, Aditi | Pawar, Ajinkya M. | Bhardwaj, Anuj | Vinay, Vineet | di Blasio, Marco | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Forensic odontology is a subfield of forensics that can assist in determining age, gender, and other demographic factors. OBJECTIVE: The focus of this research is to ascertain age by tooth volume ratio of permanent maxillary canines using a CBCT scan. METHODS: In this retrospective investigation, 1000 CBCT images were gathered and focused on only fully developed maxillary canines. For each of the maxillary canines, the researchers measured and calculated the volume of the pulp chamber, root canal, and entire tooth using the ITK Snap programme. The pulp volume to tooth volume ratio …was computed. The equation AGE = 59.208 - (583.652 x pulp volume/tooth volume) was then used to compute age. The samples were divided into 5 age groups; 13–20, 21–30, 31–40, 41–50, and 51–60. The age was calculated for samples in each group and it was compared to the actual age. RESULTS: Between individuals’ actual age and computed age, the study discovered a statistically significant positive association. While groups 3, 4, and 5 demonstrated positive but weaker correlations (r = 0.854, r = 0.658, and r = 0.612, respectively), groups 1 and 2 displayed statistically significant strong positive correlations (r = 0.987 and r = 0.923, respectively). The average total discrepancy between the age that was computed and the actual age was 2.45 1.344. CONCLUSION: The study found a statistically significant positive correlation between computed age and actual age, with the younger age groups 1 (13–20) and 2 (21–30) showing the strongest relationships. This underlines its potential success in court, particularly when dealing with young criminals. Show more
Keywords: Age estimation, canines, cone-beam computed tomography, forensic odontology, pulp tooth volume
DOI: 10.3233/THC-230555
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Wang, Yu | Li, Jun | Shi, Yulin | Jiang, Tao | Tu, Liping | Xu, Jiatuo
Article Type: Research Article
Abstract: BACKGROUND: The sublingual vein (SV) is a specialized diagnostic method used in Traditional Chinese Medicine (TCM). Despite its ability to objectively reflect blood flow, SV is often overlooked in clinical practice. OBJECTIVE: This study aims to analyze the core characteristics of SV and investigate the in-depth relationship between its digital characteristics and hypertension. The goal is to find a link between SV and hypertension and break out of the current situation. METHODS: Modern digital analysis techniques were applied to the traditional SV diagnostic theory. In a controlled study with 204 participants, the digital …characteristics of SV were documented using TFDA-1, and its color value was analyzed using TDAS. Morphological characteristics of SV, such as trunklength, width, and tortuosity, were examined by combining computer vision with expert interpretation. This involved the application of automatic ranging methods and a rectangular approximation algorithm, which are novel approaches in the field of TCM. The t -test and Mann-Whitney U test were used to analyze the digital characteristics of SV in hypertension. Binary logistic regression and neural network models were established using machine learning to explore the deep relationship between SV characteristics and hypertension. RESULTS: There was a significant difference of the tortuosity of SV between the two groups (Z = - 2.629, p = 0.009). The results revealed thick width of SV (OR = 2.64, 95% CI: 1.02–6.79) was the risk factor for hypertension. Addition of SV characteristics improved overall percent correct for hypertension prediction to 80%. CONCLUSION: TCM method of diagnosis of SV has been greatly expanded in terms of technical means, and the close relationship between SV and hypertension has been found in clinical data. Show more
Keywords: Sublingual veins, digital characteristics, hypertension
DOI: 10.3233/THC-230695
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Butter, Christian | Klein, Gunnar | Grönefeld, Gerian | Böcker, Dirk | Suling, Anna | Buchholz, Anika | Felk, Angelika | Hauser, Tino | Wegscheider, Karl | Bänsch, Dietmar
Article Type: Research Article
Abstract: BACKGROUND: Both highly specialized heart centres and less specialized hospitals care for patients with implantable ICDs/CRT-Ds with remote monitoring. OBJECTIVE: To investigate potential differences in patient treatment according to centre’s ICD implantation volume. METHODS: Based on their 2012 ICD/CRT-D implantation volume, centres enrolled in the NORDIC ICD trial in Germany were assigned to one of three groups: high- (HV, n = 345), medium- (MV, n = 340) or low-volume (LV, n = 189). RESULTS: The …HV-centres had a significant higher CRT-D proportion (41.7%; LV: 36.5%; MV: 23.2%; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001), significant shorter median procedure duration (49 min; MV: 58 min; LV: 60 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) but significant longer median hospital stay (4 days; MV and LV: 3 days; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) compared to MV- and LV-centres. The X-ray exposure was shorter in MV/HV-centres (MV: 3.4 min; HV: 3.6 min; LV: 5.5 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001). Only 3.5% (LV: 2.6%; HV: 3.5%; MV: 4.1%) patients received at least one delivered inappropriate shock and 2.5% (HV: 2.0%; LV: 2.6%; MV: 2.9%) patients had withheld inappropriate ICD shocks without subsequent inappropriate shock delivery within 24.5 months of median follow-up. CONCLUSION: Implantation volume-dependent differences were observed in the device selection, procedure duration and x-ray exposure duration. Remote monitoring in combination with adequate response pattern prevented imminent inappropriate shocks in all three groups. Show more
Keywords: Defibrillators, implantable, cardiac resynchronization therapy, hospitals, high-volume, hospitals, low-volume, home monitoring
DOI: 10.3233/THC-230641
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Alotaibi, Hanan | Al-Otibi, Fatimah | Alharbi, Raedah | ALshwuaiman, Ghada | Altwaijri, Shahad | Alfouzan, Afnan | Altaweel, Sara | Alshehri, Huda | Binrayes, Abdulaziz | Labban, Nawaf
Article Type: Research Article
Abstract: BACKGROUND: Denture stomatitis, frequently encountered, is generally addressed symptomatically, with limited exploration of preventive approaches involving antifungal medicinal plants. OBJECTIVE: This study assessed the impact of Artemisia sieberi extracts on the candida growth of conventional and digitally processed acrylic materials. METHOD: Thirty acrylic resin discs (3 mm thickness × 10 mm diameter) were prepared by conventional or CAD/CAM technology (milling and 3D printing). The resin discs were exposed to simulated brushing, thermocycling, and immersion in Artemisia sieberi extract for 8 hours. The surface roughness of the discs was assessed at …baseline and after immersion in Artemisia sieberi extract. Candida growth was quantified through colony-forming units (CFU/mL). Data was analyzed using SPSS v.22 (α ⩽ 0.05). RESULTS: Irrespective of the material type, the post-immersion surface roughness was significantly higher compared to pre-immersion values (p < 0.05). Candida growth was significantly higher in conventional acrylic materials than digitally fabricated acrylics (p < 0.05). At × 3, Ra and CFU were found to be moderately positive and non-significantly correlated (R = 0.664, p = 0.149). At × 4, Ra and CFU were found to be weak positive and non-significantly correlated (R = 0.344, p = 0.503). CONCLUSION: Artemisia sieberi extracts had a notable impact on digitally fabricated denture acrylics, reducing candida albicans growth compared to conventional heat-cured acrylic. This suggests a potential role for these extracts in improving denture hygiene and preventing denture stomatitis, particularly in the context of digitally fabricated dentures. Show more
Keywords: 3D printing, candida growth, roughness, colony forming units
DOI: 10.3233/THC-231767
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Wang, Qiuyang | An, Peng | Song, Lina | Liu, Junjie | Liu, Jisheng
Article Type: Research Article
Abstract: BACKGROUND: Nasopharyngeal carcinoma (NC) is one of the prevalent malignancies of the head and neck region with poor prognosis. OBJECTIVE: The aim of this study is to establish a predictive model for assessing NC prognosis based on clinical and MR radiomics data, subsequently to develop a nomogram for practical application. METHODS: Retrospective analysis was conducted on clinical and imaging data collected between May 2010 and August 2018, involving 211 patients diagnosed with histologically confirmed NC who received concurrent chemoradiotherapy or radical surgery in Xiangyang No. 1 People’s Hospital. According to 5–10 years of …follow-up results, the patients were divided into two groups: the study group (n = 76), which experienced recurrence, metastasis, or death, and the control group (n = 135), characterized by normal survival. Training and testing subsets were established at a 7:3 ratio, with a predefined time cutoff. In the training set, three prediction models were established: a clinical data model, an imaging model, and a combined model using the integrated variation in clinical characteristics along with MR radiomics parameters (Delta-Radscore) observed before and after concurrent chemoradiotherapy. Model performance was compared using Delong’s test, and net clinical benefit was assessed via decision curve analysis (DCA). Then, external validation was conducted on the test set, and finally a nomogram predicting NC prognosis was created. RESULTS: Univariate analysis identified that the risk factors impacting the prognosis of NC included gender, pathological type, neutrophil to lymphocyte ratio (NLR), degree of tumor differentiation, MR enhancement pattern, and Delta-Radscore (P < 0.05). The combined model established based on the abovementioned factors exhibited significantly higher predictive performance [AUC: 0.874, 95% CI (0.810–0.923)] than that of the clinical data model [AUC: 0.650, 95% CI (0.568–0.727)] and imaging model [AUC: 0.824, 95% CI (0.753–0.882)]. DCA also demonstrated superior clinical net benefit in the combined model, a finding further verified by results from the test set. The developed nomogram, based on the combined model, exhibited promising performance in clinical applications. CONCLUSION: The Delta-Radscore derived from MR radiomics data before and after concurrent chemoradiotherapy helps enhance the performance of the NC prognostic model. The combined model and resultant nomogram provide valuable support for clinical decision-making in NC treatment, ultimately contributing to an improved survival rate. Show more
Keywords: Delta radiomics, nasopharyngeal cancer, predictive models, nomogram, decision curves, magnetic resonance imaging (MR)
DOI: 10.3233/THC-231173
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Zuo, Wanzhao | Li, Jing | Zuo, Mingyan | Li, Miao | Zhou, Shuang | Cai, Xing
Article Type: Research Article
Abstract: BACKGROUND: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD)-peripheral bronchogenic carcinoma (COPD-PBC) and inflammatory masses. OBJECTIVE: This study aims to predict COPD-PBC based on clinical data and preoperative Habitat-based enhanced CT radiomics (HECT radiomics) modeling. METHODS: A retrospective analysis was conducted on clinical imaging data of 232 cases of postoperative pathological confirmed PBC or inflammatory masses. The PBC group consisted of 82 cases, while the non-PBC group consisted of 150 cases. A training set and a testing set were established using a 7:3 ratio and a time cutoff point. In …the training set, multiple models were established using clinical data and radiomics texture changes within different enhanced areas of the CT mass (HECT radiomics). The AUC values of each model were compared using Delong’s test, and the clinical net benefit of the models was tested using decision curve analysis (DCA). The models were then externally validated in the testing set, and a nomogram of predicting COPD-PBC was created. RESULTS: Univariate analysis confirmed that female gender, tumor morphology, CEA, Cyfra21-1, CT enhancement pattern, and Habitat-Radscore B/C were predictive factors for COPD-PBC (P < 0.05). The combination model based on these factors had significantly higher predictive performance [AUC: 0.894, 95% CI (0.836–0.936)] than the clinical data model [AUC: 0.758, 95% CI (0.685–0.822)] and radiomics model [AUC: 0.828, 95% CI (0.761–0.882)]. DCA also confirmed the higher clinical net benefit of the combination model, which was validated in the testing set. The nomogram developed based on the combination model helped predict COPD-PBC. CONCLUSION: The combination model based on clinical data and Habitat-based enhanced CT radiomics can help differentiate COPD-PBC, providing a new non-invasive and efficient method for its diagnosis, treatment, and clinical decision-making. Show more
Keywords: Nomograms, retrospective studies, antigen CYFRA21.1, area under curve, radiomics, tomography, X-ray computed, clinical decision-making, pulmonary disease, chronic obstructive
DOI: 10.3233/THC-231980
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Hu, Qinghua | Li, Min | Jiang, Linwen | Liu, Mei
Article Type: Research Article
Abstract: BACKGROUND: Photoplethysmography (PPG) signals are sensitive to motion-induced interference, leading to the emergence of motion artifacts (MA) and baseline drift, which significantly affect the accuracy of PPG measurements. OBJECTIVE: The objective of our study is to effectively eliminate baseline drift and high-frequency noise from PPG signals, ensuring that the signal’s critical frequency components remain within the range of 1 ∼ 10 Hz. METHODS: This paper introduces a novel hybrid denoising method for PPG signals, integrating Variational Mode Decomposition (VMD) with an improved wavelet threshold function. The method initially employs VMD to …decompose PPG signals into a set of narrowband intrinsic mode function (IMF) components, effectively removing low-frequency baseline drift. Subsequently, an improved wavelet thresholding algorithm is applied to eliminate high-frequency noise, resulting in denoised PPG signals. The effectiveness of the denoising method was rigorously assessed through a comprehensive validation process. It was tested on real-world PPG measurements, PPG signals generated by the Fluke ProSim™ 8 Vital Signs Simulator with synthesized noise, and extended to the MIMIC-III waveform database. RESULTS: The application of the improved threshold function let to a substantial 11.47% increase in signal-to-noise ratio (SNR) and an impressive 26.75% reduction in root mean square error (RMSE) compared to the soft threshold function. Furthermore, the hybrid denoising method improved SNR by 15.54% and reduced RMSE by 37.43% compared to the improved threshold function. CONCLUSION: This study proposes an effective PPG denoising algorithm based on VMD and an improved wavelet threshold function, capable of simultaneously eliminating low-frequency baseline drift and high-frequency noise in PPG signals while faithfully preserving their morphological characteristics. This advancement establishes the foundation for time-domain feature extraction and model development in the domain of PPG signal analysis. Show more
Keywords: Variational mode decomposition, denoising, improved wavelet thresholding, photoplethysmography
DOI: 10.3233/THC-231996
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
Authors: Zhao, Qiuling | Huang, Shengqiang | Yang, Lin | Chen, Ting | Qiu, Xiuliang | Huang, Ruyi | Dong, Liangliang | Liu, Wenbin
Article Type: Research Article
Abstract: BACKGROUND: Rituximab resistance is one of the great challenges in the treatment of diffuse large B-cell lymphoma (DLBCL), but relevant biomarkers and signalling pathways remain to be identified. Coptis chinensis and its active ingredients have antitumour effects; thus, the potential bioactive compounds and mechanisms through which Coptis chinensis acts against rituximab-resistant DLBCL are worth exploring. OBJECTIVE: To elucidate the core genes involved in rituximab-resistant DLBCL and the potential therapeutic targets of candidate monomers of Coptis chinensis. METHODS: Using the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), the Similarity Ensemble Approach …and Swiss Target Prediction, the main ingredients and pharmacological targets of Coptis chinensis were identified through database searches. Through the overlap between the pharmacological targets of Coptis chinensis and the core targets of rituximab-resistant DLBCL, we identified the targets of Coptis chinensis against rituximab-resistant DLBCL and constructed an active compound-target interaction network. The targets and their corresponding active ingredients of Coptis chinensis against rituximab-resistant DLBCL were molecularly docked. RESULTS: Berberine, quercetin, epiberberine and palmatine, the active components of Coptis chinensis, have great potential for improving rituximab-resistant DLBCL via PIK3CG. CONCLUSION: This study revealed biomarkers and Coptis chinensis-associated molecular functions for rituximab-resistant DLBCL. Show more
Keywords: Rituximab, resistance, differentially expressed genes, WGCNA, Coptis chinensis, network pharmacology
DOI: 10.3233/THC-230738
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Li, Yang | Chen, Qianxi | Zhu, Tao | Lu, Shaohuan | Liang, Canhua | Wang, Guangzhao | Wu, Xuefeng | Meng, Guangyi
Article Type: Research Article
Abstract: BACKGROUND: How to comprehensively evaluate the rationality of drug use is a challenging issue. OBJECTIVE: To establish the evaluation index of the effective use of tislelizumab, so as to ensure its higher rationality and normalization in clinical application. METHODS: Based on the indications, drug instructions, and relevant guidelines of the National Basic Medical Insurance Restriction Catalogue, a retrospective analysis and evaluation of 286 cases of using tislelizumab injection in our hospital from January to December 2022 were conducted using the weighted technique for order of preference by similarity to ideal solution (TOPSIS) method. …RESULTS: Among the 286 medical records evaluated, the main irrational manifestations were inappropriate indications (90 cases, 31.47%), auxiliary examination and laboratory examination did not meet the minimum requirements of combination chemotherapy drugs (40 cases, 13.99%), the drug course was not standard (39 cases, 13.64%). Among the included cases, 57.34% were reasonable cases (C i ⩾ 0.8), 10.84% were basic reasonable cases (0.6 ⩽ C i < 0.8), and 31.82% were unreasonable cases (C i < 0.6). CONCLUSION: The TOPSIS method, with its attribute hierarchical model (AHM)-weighted approach, can be employed as the rational assessment technique for the injection of tislelizumab. The clinical application of tislelizumab in our hospital is still insufficient, which needs to be further improved management. Show more
Keywords: Drug use evaluation, weighted TOPSIS, Tislelizumab, attribute hierarchical model
DOI: 10.3233/THC-231574
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Han, Shi-Lei | Li, Na
Article Type: Research Article
Abstract: BACKGROUND: Prosthodontics are often performed to treat patients with malocclusion and dentition defects. However, single prosthodontics cannot properly correct the disharmony of teeth, dental arch and other parts affected by malocclusion, and some patients may have difficulty in recovering the occlusal function due to poor prosthodontics. OBJECTIVE: This study aims to investigate the effect of orthodontics combined with fibre-reinforced composite resin-bonded fixed partial denture (FRC-RBFPD) on anterior dentition defects with minimal vertical intermaxillary space. METHODS: Sixty-two patients with anterior dentition defects with minimal vertical mandibular space admitted to our hospital between March 2021 …and May 2023 were enrolled in this study. The participants were divided into the observation group (31 cases) and the control group (31 cases), according to the treatment plan. The control group was treated with traditional therapy, and the observation group was treated with orthodontic combined FRC-RBFPD therapy. Periodontal conditions (periodontal pocket depth [PD], the plaque index [PLI], the sulcus bleeding index [SBI]), levels of inflammatory factors in gingival crevicular fluid (high mobility group box 1 [HMGB1]), myeloid cell triggering receptor-1 (TREM-1), monocyte chemoattractant protein-1 (MCP-1), pain (visual analogue scale [VAS]), the clinical response rate and the incidence of adverse reactions were collected and compared. RESULTS: After 1, 3, 5 and 9 months following treatment, the scores of the PD, PLI, SBI, HMGB1, VAS, TREM-1 and MCP-1 in the observation group were found to be lower than those in the control group (F PD treatment = 352.532, F PLI score treatment = 112.341, F SBI score treatment = 79.479, F VAS score treatment = 96.132, F HMGB1 treatment = 52.532, F TREM-1 score treatment = 64.593, F MCP-1 score treatment = 53.582, and they were all statistically significant P < 0.05). There was a statistically significant difference in the response rate between the two groups (97.77% vs. 80.65%, χ 2 = 4.026, P = 0.045). No statistically significant difference was observed in the incidence of adverse reactions between the two groups (6.45% vs. 16.13%, χ 2 = 1.449, P = 0.229). CONCLUSION: Orthodontics combined with FRC-RBFPD shows an ideal restorative effect on patients with anterior dentition defects and minimal vertical intermaxillary space. Show more
Keywords: Orthodontics, fibre-reinforced composite resin-bonded fixed partial denture, dentition defects, tooth restoration
DOI: 10.3233/THC-231889
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Xu, Chun-Guang | Yang, Li-Xia | Zhu, Rui | Zhang, Jie | Li, Yan | Chao, Chun-Fang
Article Type: Research Article
Abstract: BACKGROUND: Psychrophilic bacteria can survive in a unique living environment. OBJECTIVE: To explore the mechanism of low temperature adaptation and the physiological function of thermophilic metabolic genes. METHOD: Serratia marcescens strain F13 stored in microbial laboratory was cultured at 5 ∘ C, 10 ∘ C and 25 ∘ C respectively, and the obtained strains were sequenced by high-throughput transcriptome. Serratia marcescens strain CAV1761 was used as the reference strain. The data produced by transcriptome sequencing were statistically analyzed by biostatistics software such as …soapnuke, soap and edger. The differentially expressed genes were found based on the gene expression, and analyzed by Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. RESULTS: The results showed that there were 718 differential genes in F13-10 vs F13-5 comparison group, 1614 differential genes in F13-25 vs F13-5 comparison group and 1636 differential genes in F13-25 vs F13-10 comparison group. GO function enrichment analysis showed that the GO term mainly enriched by different genes in the three comparison groups was mostly related to the migration and transport of cellular or subcellular components, cell localization and transmembrane transporter activity, as well as cilia or flagella dependent cell movement. In the enrichment analysis of KEGG pathway, the three comparison groups all enriched the largest number of differential genes in the branch pathway of KEGG metabolism, followed by the branch pathway of environmental information processing. CONCLUSION: In F13-10 vs F13-5, the differential genes were mainly concentrated in 20 pathways such as ATP-binding cassette transport (ABC) transporters, thiamine metabolism and flagella assembly; In F13-25 vs F13-5, the differential genes are mainly concentrated in 20 pathways, such as (ABC) transporters, arginine and proline metabolism, two-component system and so on; In F13-25 vs F13-10, the differential genes are mainly concentrated in 20 pathways such as various types of glycan synthesis, two-component system and arginine metabolism. Show more
Keywords: Low temperature bacteria, transcriptome analysis, psychrophilic mechanism
DOI: 10.3233/THC-231022
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Wang, Zhen | Zhu, Darong | Hu, Guangzhu | Shi, Xiaobei
Article Type: Research Article
Abstract: BACKGROUND: The study of coronary artery calcification (CAC) may assist in identifying additional coronary artery problem protective factors. On the contrary side, due to the wide variety of CAC as individuals, CAC research is difficult. Due to this, evaluating data for investigation is becoming complicated. OBJECTIVE: To use a multi-layer perceptron, we investigated the accuracy and reliability of synthetic CAC coursework or hazard classification in pre or alors chest computerized tomography (CT) of arrangements resolutions in this analysis. method: Photographs of the chest from similar individuals as well as calcium-just and non-gated pictures …were incorporated. This cut thickness ordered CT pictures (bunch A: 1 mm; bunch B: 3 mm). The CAC rating was determined utilizing calcification score picture information, and became standard for tests. While the control treatment’s machine learning program was created using 170 computed tomography pictures and evaluated using 144 scans, group A’s machine learning algorithm was created using 150 chest CT diagnostic tests. RESULTS: 334 external related pictures (100 μ m: 117; 0.5 mm x: 117) of 117 individuals and 612 inside design organizing (1 mm: 294; mm3: 314) of 406 patients were surveyed. Pack B had 0.94, however, tests An and b had 0.90 (95% CI: 0.85–0.93) ICCs between significant learning and gold expenses (0.92–0.96). Dull Altman plots agreed well. A machine teaching approach successfully identified 71% of cases in category A is 81% of patients in section B again for cardiac risk class. CONCLUSION: Regression risk evaluation algorithms could assist in categorizing cardiorespiratory individuals into distinct risk groups and conveniently personalize the treatments to the patient’s circumstances. The models would be based on information gathered through CAC. On both 1 and 3-mm scanners, the automatic determination of a CAC value and cardiovascular events categorization that used a depth teaching approach was reliable and precise. The layer thickness of 0.5 mm on chest CT was slightly less accurate in CAC detection and risk evaluation. Show more
Keywords: Coronary artery calcification (CAC), CT images, CT diagnostic tests, artificial neural network, calcification score image data
DOI: 10.3233/THC-231273
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-23, 2024
Authors: Pan, Wan | Zhou, Yan | Ji, Yueping | Zhou, Lianfang | Wang, Li
Article Type: Research Article
Abstract: OBJECTIVE: In order to improve nursing quality management and protect patient medical safety, it is necessary to change the default mode and completely integrate information technology and nursing quality control utilising lean management. METHODS: A database was created, the nurse quality control scoring standard was entered into the computer and after the inspection, and various inspection reports were entered into the computer to precisely and promptly preserve data. The computer was then utilised to precisely assess the intensity and quality of nursing work, compute, count, and analyse the stored data, output the quality of nursing work …in each department as a report, and adopt lean management for the gathered issues. RESULTS: To reach the objective of raising nursing quality, data analysis makes it simple to identify flaws and consistently strengthen the weak points. In order to create an information-based nursing quality control system with a simple and effective method as well as results that are scientific and objective, lean management is brought into the construction process. Show more
Keywords: Lean management, information based nursing quality control system, experience
DOI: 10.3233/THC-230730
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhu, Li-Jun | Lin, Hui | Wu, Xiao-Tong | Shi, Shao-Hua | Qiao, Xi
Article Type: Research Article
Abstract: BACKGROUND: Diarrhea is a prevalent complication after renal transplantation. OBJECTIVE: To examine the risk factors for diarrhea after renal transplantation, evaluate their combined predictive values, and analyze the prognosis. METHODS: Clinical data of patients who underwent allogeneic renal transplantation in the Second People’s Hospital of Shanxi Province from January 2019 to March 2020 were retrospectively analyzed, cases were screened and grouped, independent risk factors for diarrhea after renal transplantation were analyzed by univariate analysis and multivariate analysis, and their predictive value was evaluated by receiver operating characteristic (ROC) curve. The survival time of …recipient grafts in diarrhea and non-diarrhea groups were evaluated by Kaplan-Meier and log-rank test. RESULTS: We included 166 recipients in the study and the incidence of diarrhea was 25.9%; univariate and logistic regression multivariate analyses revealed that independent risk factors for diarrhea in recipients were that the type of renal transplant donor was DCD (donation after circulatory death), immunity induction was onducted with basiliximab + antithymocyte globulin (ATG), and ATG alone, the type of mycophenolic acid (MPA) used was mycophenolate mofetil capsules, and delayed graft function (DGF) occurred after transplantation. The ROC curve indicated that the combination of the four factors had good accuracy in predicting the occurrence of diarrhea in recipients. The graft survival rate two years after the operation in the diarrhea group was significantly lower than that in the non-diarrhea group. CONCLUSION: Diarrhea affected the two-year survival rate of the graft. The type of donor, immunity induction scheme, and the type of MPA and DGF were independent risk factors for diarrhea in recipients, and the combination of the four factors had good prognostic prediction value. Show more
Keywords: Delayed graft function, diarrhea, mycophenolic acid, renal transplantation, type of donor
DOI: 10.3233/THC-230579
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Maheshkumar, Hima | Meenakshi, Srinivasa Iyer | Rao, Shyla Dureja, Raghunath Nagasundara | Shivakumar, Ganiga Channaiah | Marrapodi, Maria Maddalena | Cervino, Gabriele | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Polymethyl methacrylate (PMMA) is a commonly used denture base material, but susceptibility to fracture under functional loading remains a challenge. OBJECTIVE: This preliminary screening study aims to investigate the potential of sericin and fibroin as reinforcing agents in the PMMA denture base material. METHODS: The flexural and impact strengths of PMMA incorporated with 0.01% sericin, and 0.01% each of sericin and fibroin, were evaluated. The control group consisted of PMMA without any additives. The maximum load and energy required to break the samples were measured. Statistical analysis was performed using one-way ANOVA …test and Scheffe Post Hoc tests to compare mean values between subgroups. RESULTS: The results indicated significant improvement in the flexural and impact strengths of PMMA with the addition of sericin and fibroin. The subgroups with 0.01% sericin, and 0.01% each of sericin and fibroin, demonstrated higher mean values in load and energy measurements compared to the control group. The statistical analysis confirmed the significance of these findings. CONCLUSION: The addition of 0.01% sericin and 0.01% each of sericin and fibroin to PMMA denture-based resin material significantly increases its flexural and impact strengths. These preliminary findings suggest the potential of sericin and fibroin as effective reinforcing agents in PMMA denture base materials, thereby enhancing their biomechanical properties. Show more
Keywords: PMMA, denture base material, sericin, fibroin, flexural strength, impact strength, reinforcing agents
DOI: 10.3233/THC-231772
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Netto, Ann Nita | Abraham, Lizy | Philip, Saji
Article Type: Research Article
Abstract: BACKGROUND: Cardiac diseases are highly detrimental illnesses, responsible for approximately 32% of global mortality [1]. Early diagnosis and prompt treatment can reduce deaths caused by cardiac diseases. In paediatric patients, it is challenging for paediatricians to identify functional murmurs and pathological murmurs from heart sounds. OBJECTIVE: The study intends to develop a novel blended ensemble model using hybrid deep learning models and softmax regression to classify adult, and paediatric heart sounds into five distinct classes, distinguishing itself as a groundbreaking work in this domain. Furthermore, the research aims to create a comprehensive 5-class paediatric phonocardiogram (PCG) …dataset. The dataset includes two critical pathological classes, namely atrial septal defects and ventricular septal defects, along with functional murmurs, pathological and normal heart sounds. METHODS: The work proposes a blended ensemble model (HbNet-Heartbeat Network) comprising two hybrid models, CNN-BiLSTM and CNN-LSTM, as base models and Softmax regression as meta-learner. HbNet leverages the strengths of base models and improves the overall PCG classification accuracy. Mel Frequency Cepstral Coefficients (MFCC) capture the crucial audio signal characteristics relevant to the classification. The amalgamation of these two deep learning structures enhances the precision and reliability of PCG classification, leading to improved diagnostic results. RESULTS: The HbNet model exhibited excellent results with an average accuracy of 99.72% and sensitivity of 99.3% on an adult dataset, surpassing all the existing state-of-the-art works. The researchers have validated the reliability of the HbNet model by testing it on a real-time paediatric dataset. The paediatric model’s accuracy is 86.5%. HbNet detected functional murmur with 100% precision. CONCLUSION: The results indicate that the HbNet model exhibits a high level of efficacy in the early detection of cardiac disorders. Results also imply that HbNet has the potential to serve as a valuable tool for the development of decision-support systems that aid medical practitioners in confirming their diagnoses. This method makes it easier for medical professionals to diagnose and initiate prompt treatment while performing preliminary auscultation and reduces unnecessary echocardiograms. Show more
Keywords: Blended ensemble, mel frequency cepstral coefficient, meta-learner, phonocardiogram, softmax regression
DOI: 10.3233/THC-231290
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Sun, Yi | Ren, Tao | Ji, Xueli
Article Type: Research Article
Abstract: BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). …Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization. Show more
Keywords: Hyperbaric oxygen therapy-specialized care, hyperbaric oxygen, cerebral infarction, motor function, mental state
DOI: 10.3233/THC-231643
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Maheshwaran, Bipin | Chokkatt, Jerry Joe | Shenoy, Amrutha | Ganapathy, Dhanraj | Yadalam, Pradeep Kumar | Marrapodi, Maria Maddalena | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Titanium nanoparticles (NPs) offer promising applications in the treatment and prevention of inflammatory disorders due to their unique physicochemical characteristics. However, additional research is necessary to attain a thorough comprehension and validate the efficacy of this approach in dental practice. OBJECTIVE: This study scrutinizes the anti-inflammatory properties of a dental varnish infused with ginger and rosemary extracts mediated by titanium dioxide (TiO2) nanoparticles. METHODS: A herbal dental varnish was formulated by integrating ginger and rosemary extracts with titanium dioxide nanoparticles at concentrations of 10, 20, 30, 40, and 50 μ L. …Anti-inflammatory properties were assessed through Bovine Serum Albumin denaturation and membrane stabilization assays, comparing results with a control group. RESULTS: The results reveal concentration-dependent antioxidant and anti-inflammatory properties in the test group when compared to the control group. The BSA assay corroborates increased percent inhibition with rising titanium dioxide nanoparticle concentrations. In line with existing literature, titanium dioxide nanoparticles enhance dental material properties. CONCLUSION: The bioactive compounds in ginger and rosemary, such as phenolic compounds and terpenes, contribute to anti-inflammatory and antioxidant effects of the varnish. Additionally, the therapeutic potential of titanium dioxide nanoparticles in addressing inflammatory diseases underscores their significance in this formulation. Show more
Keywords: Preventive dentistry, nanoparticles, titanium dioxide, green synthesis, antioxidant
DOI: 10.3233/THC-231994
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Huang, Yu | Wu, Mei | Li, Jian-Di | Qin, Zhen | Huang, Ke-Qiang | Cui, Jin-Zhu | Ou, Hai-Ling
Article Type: Research Article
Abstract: BACKGROUND: Vesicle-associated membrane protein 7 (VAMP7) plays oncogenic roles in cancers. However, its clinical significance in breast cancer (BC) tissues remains unknown. OBJECTIVE: To elucidate the clinical implications of VAMP7, as well as its involvement in the tumor microenvironment and molecular pathways of breast cancer. METHODS: BC (n = 100) and non-cancerous breast tissues (n = 100) were collected for an immunohistochemical experiment (1:200). The protein expression level of VAMP7 was determined by using a semi-quantitative scoring method. High-throughput RNA-sequencing data of BC tissues …were analyzed to confirm the mRNA expression trend of VAMP7. Additionally, the largest BC prognosis cohort data were collected to mine the potential impact VAMP7 has on BC progression. The association between VAMP7 and the microenvironment of BC was evaluated by using a CIBERSORT algorithm. Moreover, we explored the co-expressed molecular mechanisms of VAMP7 in BC by calculating Pearson correlation coefficients and overexpressed genes. Finally, the biological mechanism underlying the relationship between VAMP7 and the key pathways was also explored using gene set enrichment analysis (GSEA). Potential therapeutic strategies were predicted targeting VAMP7. RESULTS: VAMP7 protein was significantly over-expressed in BC tissue than that in controls (p < 0.001). Compared with 459 normal breast tissues and 113 non-cancerous breast tissues, the expression level of VAMP7 mRNA was significantly increased in 1111 BC tissues. CD 4 +T cells, macrophages, and naïve B cells had a higher infiltration rate in BC tissues with high VAMP7 expression, while regulatory T cells and CD 8 +T cells had a lower infiltration rate. Over-expressed VAMP7 was associated with macrophages activation and transition from M1 to M2 polarization. Upregulated VAMP7 could predicted poorer OS, DMFS, PPS, and RFS outcomes. Upregulated VAMP7 co-expressed genes were significantly enriched in the cell cycle checkpoints. GSEA confirmed that over-expressed VAMP7 are markedly associated with functional enrichment in cell cycle related categories, including mitotic spindle, G2M checkpoint, and E2F targets. KU-55933 was predicted as a putative therapeutic drug for BC targeting VAMP7. CONCLUSIONS: VAMP7 was upregulated in BC tissue and correlated with poor prognosis of BC patients. VAMP7 may promote BC progression by targeting the cell cycle pathway. Show more
Keywords: Breast cancer, vesicle-associated membrane protein 7, immunohistochemistry, molecular mechanisms
DOI: 10.3233/THC-230832
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Authors: Rogers, Nathan | Rullán, Pedro J. | Pasqualini, Ignacio | Khan, Shujaa T. | Klika, Alison K. | Surace, Peter A. | Molloy, Robert M. | Piuzzi, Nicolas S. | Bloomfield, Michael
Article Type: Research Article
Abstract: BACKGROUND: The value of robotic-assisted total hip arthroplasty (rTHA) has yet to be determined compared to conventional manual THA (mTHA). OBJECTIVE: Evaluate 90-day inpatient readmission rates, rates of reoperation, and clinically significant improvement of patient-reported outcome measures (PROMs) at 1-year in a cohort of patients who underwent mTHA or rTHA through a direct anterior (DA) approach. METHODS: A single-surgeon, prospective institutional cohort of 362 patients who underwent primary THA for osteoarthritis via the DA approach between February 2019 and November 2020 were included. Patient demographics, surgical time, discharge disposition, length of stay, acetabular …cup size, 90-day inpatient readmission, 1-year reoperation, and 1-year PROMs were collected for 148 manual and 214 robotic THAs, respectively. RESULTS: Patients undergoing rTHA had lower 90-day readmission (3.74% vs 9.46%, p = 0.04) and lower 1-year reoperation (0.93% vs 4.73% mTHA, p = 0.04). rTHA acetabular cup sizes were smaller (rTHA median 52, interquartile range [IQR] 50; 54, mTHA median 54, IQR 52; 58, p < 0.001). Surgical time was longer for rTHA (114 minutes vs 101 minutes, p < 0.001). At 1-year post-operatively, there was no difference in any of the PROMs evaluated. CONCLUSION: Robotic THA demonstrated lower 90-day readmissions and 1-year reoperation rates than manual THA via the DA approach. PROMs were not significantly different between the two groups at one year. Show more
Keywords: THA, direct anterior approach, HOOS, satisfaction, value of robotics
DOI: 10.3233/THC-231646
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Kasiviswanathan, Sivachandar | Vijayan, Thulasi Bai
Article Type: Research Article
Abstract: BACKGROUND: Artificial Intelligence (AI) plays a pivotal role in the diagnosis of health conditions ranging from general well-being to critical health issues. In the realm of health diagnostics, an often overlooked but critical aspect is the consideration of cost-sensitive learning, a facet that this study prioritizes over the non-invasive nature of the diagnostic process whereas the other standard metrics such as accuracy and sensitivity reflect weakness in error profile. OBJECTIVE: This research aims to investigate the total cost of misclassification (Total Cost) by decision rule Machine Learning (ML) algorithms implemented in Java platforms such as DecisionTable, …JRip, OneR, and PART. An augmented dataset with conjunctiva images along candidates’ demographic and anthropometric features under supervised learning is considered with a specific emphasis on cost-sensitive classification. METHODS: The opted decision rule classifiers use the text features, additionally the image feature ‘a* value of CIELAB color space’ extracted from the conjunctiva digital images as input attributes. The pre-processing consists of amalgamating text and image features on a uniform scale, normalizing. Then the 10-fold cross-validation enables the classification of samples into two categories: the presence or absence of the anemia. This study utilizes the Cost Ratio (ρ ) extracted from the cost matrix to meticulously monitor the Total Cost in four different cost ratio methodologies namely Uniform (U), Uniform Inverted (UI), Non-Uniform (NU), and Non-Uniform Inverted (NUI). RESULTS: It has been established that the PART classifier stands out as the top performer in this binary classification task, yielding the lowest mean total cost of 629.9 compared to other selected classifiers. Moreover, it demonstrates a comparatively lower standard deviation 335.9, and lower total cost across all four different cost ratio methodologies. The ranking of algorithm performance goes as follows: PART, JRIP, DecisionTable, and OneR. CONCLUSION: The significance of adopting a cost-sensitive learning approach is emphasized showing the PART classifier’s consistent performance within the proposed framework for learning the anemia dataset. This emphasis on cost-sensitive learning not only enhances the recommendations in diagnosis but also holds the potential for substantial cost savings and makes it a noteworthy focal point in the advancement of AI-driven health care. Show more
Keywords: Cost matrix, cost ratio, cost sensitive classifier, decision rule classifier, DecisionTable, JRip, OneR, PART
DOI: 10.3233/THC-231946
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Wang, Luo | Li, Xin | Dong, Xue-Juan | Yu, Xiao-Ling | Zhang, Jing | Cheng, Zhi-Gang | Han, Zhi-Yu | Liu, Fang-Yi | Yu, Jie | Liang, Ping
Article Type: Research Article
Abstract: BACKGROUND: Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC). OBJECTIVE: This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC. METHODS: This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio …of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy. RESULTS: The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: p = 0.036; recurrent HCC: p = 0.026). For patients with primary HCC, the recurrence frequency was reduced (p = 0.002), and recurrence interval (19 months vs. 9 months, p < 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients ⩽ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3+ (p = 0.049), CD8/CD28+ (p = 0.045) were elevated. CONCLUSION: Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients ⩽ 60 years old or with moderately-differentiated HCC or co-infected with HBV. Show more
Keywords: Hepatocellular carcinoma, immunotherapy, ablation, dendritic cell, cytokine killer
DOI: 10.3233/THC-230871
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Alhussaini, Khalid | Aleid, Adham | Alsadon, Omar | Aldohbeyb, Ahmed A. | Aljelaifie, Rakan | Javed, Ravish
Article Type: Research Article
Abstract: BACKGROUND: Adequate equipment maintenance is necessary to ensure efficient dental care facilities and satisfactory medical equipment performance. OBJECTIVE: This study aimed to assess maintenance practices and manpower adequacy in private dental centres (DCs) across Riyadh, Saudi Arabia. METHODS: A questionnaire was designed to evaluate equipment maintenance and manpower strength based on international and national standards. Thirty-three private DCs were visited in-person with the designed questionnaire to conduct the study. The Chi-square test and t -test were performed. RESULTS: Only 21 dental centres had a scheduled maintenance plan for …medical equipment, whereas the rest had no plan. Furthermore, only 22 DCs maintained equipment maintenance records, while 11 DCs did not have any records. Additionally, the study found a lack of trained personnel to handle medical equipment and overall inadequate maintenance practices. Significant differences were observed between the responses for many questions (p < 0.05). CONCLUSION: These findings increase health risks to both the patient and the user. To address these issues, DC administrators should implement stricter measures to adhere to local DCs standards and hire qualified personnel who can periodically maintain and repair medical equipment. Show more
Keywords: Medical devices, equipment readiness, patient safety, healthcare, manpower requirement, private dental center
DOI: 10.3233/THC-231177
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Wang, Zhi | Xu, Lei | Sun, Lin | Jiang, Xin | Wang, Juan
Article Type: Research Article
Abstract: BACKGROUND: Coronary atherosclerotic heart disease (CAHD) is the leading cause of death in developed countries. OBJECTIVE: This study aimed to explore the correlation between the properties of coronary atherosclerotic plaque and blood lipids using computed tomography angiography (CTA). METHODS: A total of 83 patients with coronary heart disease were included in this study (males: 50; females: 33; average age: [59 ± 8] years old). They were classified into the stable angina group and unstable angina group. Atherosclerotic plaques were classified as fatty plaques (soft plaques), fibrous plaques, and calcified plaques …based on the computed tomography (CT) values. SPSS 17.0 statistical software was used to analyze the correlation between the properties of angina and the CT values of atherosclerotic plaques, blood lipids, and plaque properties, and then compared between the stable and unstable angina groups. RESULTS: There were statistically significant differences in plaque properties between the stable and unstable angina groups (P < 0.001). During CTA examination, we found statistically significant differences in the CT density values of atherosclerotic plaques between the stable and unstable angina groups (P < 0.001). There were statistically significant differences between the properties of angina and the level of blood lipids (P < 0.05). CONCLUSION: Anginal properties negatively correlated with calcified plaques and positively correlated with non-calcified plaques. Calcified plaques negatively correlated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), and positively correlated with high-density lipoprotein cholesterol (HDL-C). Non-calcified plaques negatively correlated with HDL-C and positively correlated with TC, LDL-C, and TG. Show more
Keywords: Angina, atherosclerotic plaques, blood lipids, coronary artery, multi-slice spiral CT
DOI: 10.3233/THC-231036
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Tomasevic, Smiljana | Anic, Milos | Arsic, Branko | Gakovic, Branko | Filipovic, Nenad | Djukic, Tijana
Article Type: Research Article
Abstract: BACKGROUND: Ultrasound is one of the non-invasive techniques that are used in clinical diagnostics of carotid artery disease. OBJECTIVE: This paper presents software methodology that can be used in combination with this imaging technique to provide additional information about the state of patient-specific artery. METHODS: Overall three modules are combined within the proposed methodology. A clinical dataset is used within the deep learning module to extract the contours of the carotid artery. This data is then used within the second module to perform the three-dimensional reconstruction of the geometry of the carotid bifurcation …and ultimately this geometry is used within the third module, where the hemodynamic analysis is performed. The obtained distributions of hemodynamic quantities enable a more detailed analysis of the blood flow and state of the arterial wall and could be useful to predict further progress of present abnormalities in the carotid bifurcation. RESULTS: The performance of the deep learning module was demonstrated through the high values of relevant common classification metric parameters. Also, the accuracy of the proposed methodology was shown through the validation of results for the reconstructed parameters against the clinically measured values. CONCLUSION: The presented methodology could be used in combination with standard clinical ultrasound examination to quickly provide additional quantitative and qualitative information about the state of the patient’s carotid bifurcation and thus ensure a treatment that is more adapted to the specific patient. Show more
Keywords: Convolutional neural networks, 3D reconstruction, blood flow, patient-specific geometry, validation against clinical data
DOI: 10.3233/THC-231306
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
Authors: Liu, Lili
Article Type: Research Article
Abstract: BACKGROUND: Osteoporosis is a medical disorder that causes bone tissue to deteriorate and lose density, increasing the risk of fractures. Applying Neural Networks (NN) to analyze medical imaging data and detect the presence or severity of osteoporosis in patients is known as osteoporosis classification using Deep Learning (DL) algorithms. DL algorithms can extract relevant information from bone images and discover intricate patterns that could indicate osteoporosis. OBJECTIVE: DCNN biases must be initialized carefully, much like their weights. Biases that are initialized incorrectly might affect the network’s learning dynamics and hinder the model’s ability to converge to …an ideal solution. In this research, Deep Convolutional Neural Networks (DCNNs) are used, which have several benefits over conventional ML techniques for image processing. METHOD: One of the key benefits of DCNNs is the ability to automatically Feature Extraction (FE) from raw data. Feature learning is a time-consuming procedure in conventional ML algorithms. During the training phase of DCNNs, the network learns to recognize relevant characteristics straight from the data. The Squirrel Search Algorithm (SSA) makes use of a combination of Local Search (LS) and Random Search (RS) techniques that are inspired by the foraging habits of squirrels. RESULTS: The method made it possible to efficiently explore the search space to find prospective values while using promising areas to refine and improve the solutions. Effectively recognizing optimum or nearly optimal solutions depends on balancing exploration and exploitation. The weight in the DCNN is optimized with the help of SSA, which enhances the performance of the classification. CONCLUSION: The comparative analysis with state-of-the-art techniques shows that the proposed SSA-based DCNN is highly accurate, with 96.57% accuracy. Show more
Keywords: Osteoporosis, classification, accuracy, optimization, bias, neural network, and squirrel search
DOI: 10.3233/THC-231517
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2024
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