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

Authors: Grevenstein, David | Schafigh, Darius | Oikonomidis, Stavros | Eysel, Peer | Brochhausen, Christoph | Spies, Christian Karl | Oppermann, Johannes

Article Type: Research Article

Abstract: BACKGROUND: Lesions of articular cartilage represent a crucial risk factor for the early development of osteoarthritis. Autologous chondrocyte implantation (ACI) is a well-established procedure in therapy of those lesions in the knee. The aim of the presented study is to detect differences in short-term radiological outcome depending on defect localization (femoral condyle vs. retropatellar) after spheroid-based ACI. OBJECTIVE: This study aimed to demonstrate that radiological outcome after spheroid-based ACI in the knee is independent of defect localization. METHODS: MRI-scans after retropatellar ACI and ACI of the medial/lateral femoral condyle, with a preoperative Outerbridge …grade of III or IV were evaluated regarding MOCART 2.0. RESULTS: The mean defect-size was 5.0 ± 1.8 cm 2 , with a minimum size of 2 cm 2 and a maximum size of 9 cm 2 . Scans were performed 7.7 months (± 3.1 months) postoperatively. The mean MOCART 2.0 score was 78.5 ± 15.6. No statistically significant influence neither of the localization (p = 0.159), the gender (p = 0.124) nor defect size (< 5 cm 2 vs. ⩾ 5 cm 2 ; p = 0.201) could be observed. CONCLUSIONS: The presented data demonstrate good to excellent radiological short-term results after spheroid-based ACI. Data indicates, that at least radiological results are independent of gender, defect-size and defect-localization. Show more

Keywords: Knee, cartilage, autologous chondrocyte implantation, spheroids, osteoarthritis, ACI

DOI: 10.3233/THC-213066

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Eisele, Robert M. | Scherber, Philipp R. | Schlüter, Monika | Drews, Thorsten | Glanemann, Matthias | Gäbelein, Gereon

Article Type: Research Article

Abstract: BACKGROUND: Thermoablation is an attractive treatment of thyroid nodules for its minimal-invasiveness. It remains unclear whether results and morbidity meet the patients’ expectations. OBJECTIVE: The aim of the presented study is to show data obtained after microwave thyroid ablation from a patients’ perspective. METHODS: Indications and preoperative diagnosis were chosen according to international guidelines. Thermoablation was achieved using a CE certified microwave system. The procedures heeded the published recommendations of the European Federation of Societies for Ultrasound in Medicine and Biology. Follow-up included ultrasound, laboratory parameters and a standardized questionnaire. RESULTS: …Thirty patients were enrolled into the study. All patients reported an improvement of complaints following the procedure. Scar formation occurred in 3 cases (10%) with 0.5 ± 1.3 mm length and 0.4 ± 1.0 mm width. No cosmetic, neurological, vocal or pharyngeal complication occurred. Energy required for non-functioning nodules (n = 15, 50%) was 2.56 ± 3.41 kJ/mL, for autonomous adenoma (n = 8, 27%) 0.96 kJ/mL (p < 0.05, t -test). CONCLUSION: The presented data summarize an initial experience in selected patients and resemble excellent patient reported outcome with minimal morbidity. These preliminary data indicate the majority of patients satisfied with the procedure. Further trials will be required to endorse these findings. Show more

Keywords: Thyroid ablation, thermoablation of thyroid nodules, microwave thyroid ablation

DOI: 10.3233/THC-213181

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2021

Authors: Pakniyat, Najmeh | Babini, Mohammad Hossein | Kulish, Vladimir V. | Namazi, Hamidreza

Article Type: Research Article

Abstract: BACKGROUND: Analysis of the heart activity is one of the important areas of research in biomedical science and engineering. For this purpose, scientists analyze the activity of the heart in various conditions. Since the brain controls the heart’s activity, a relationship should exist among their activities. OBJECTIVE: In this research, for the first time the coupling between heart and brain activities was analyzed by information-based analysis. METHODS: Considering Shannon entropy as the indicator of the information of a system, we recorded electroencephalogram (EEG) and electrocardiogram (ECG) signals of 13 participants (7 M, 6 …F, 18–22 years old) in different external stimulations (using pineapple, banana, vanilla, and lemon flavors as olfactory stimuli) and evaluated how the information of EEG signals and R-R time series (as heart rate variability (HRV)) are linked. RESULTS: The results indicate that the changes in the information of the R-R time series and EEG signals are strongly correlated (ρ = - 0.9566). CONCLUSION: We conclude that heart and brain activities are related. Show more

Keywords: Heart, brain, Shannon entropy, electrocardiogram signals, ECG, electroencephalogram signals, EEG, HRV, heart rate variability, information content

DOI: 10.3233/THC-213136

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2021

Authors: Raja Sree, S. | Kunthavai, A.

Article Type: Research Article

Abstract: BACKGROUND: Breast cancer is a major disease causing panic among women worldwide. Since gene mutations are the root cause for cancer development, analyzing gene expressions can give more insights into various phenotype of cancer treatments. Breast Cancer subtype prediction from gene expression data can provide more information for cancer treatment decisions. OBJECTIVE: Gene expressions are complex for analysis due to its high dimensional nature. Machine learning algorithms such as k-Nearest Neighbors, Support Vector Machine (SVM) and Random Forest are used with selection of features for prediction of breast cancer subtypes. Prediction accuracy of the existing methods …are affected due to high dimensional nature of gene expressions. The objective of the work is to propose an efficient algorithm for the prediction of breast cancer subtypes from gene expression. METHODS: For subtype prediction, a novel Hubness Weighted Support Vector machine algorithm (HWSVM) using bad hubness score as a weight measure to handle the outliers in the data has been proposed. Based on the various subtypes, features are projected into seven different feature sets and Ensemble based Hubness Aware Weighted Support Vector Machine (HWSVMEns) is implemented for breast cancer subtype prediction. RESULTS: The proposed algorithms have been compared with the classical SVM and other traditional algorithms such as Random Forest, k-Nearest Neighbor algorithms and also with various gene selection methods. CONCLUSIONS: Experimental results show that the proposed HWSVM outperforms other algorithms in terms of accuracy, precision, recall and F1 score due to the hubness weightage scheme and the ensemble approach. The experiments have shown an average accuracy of 92% across various gene expression datasets. Show more

Keywords: Breast cancer subtypes, high-dimensional data, hubness, gene selection, support vector machine

DOI: 10.3233/THC-212825

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2021

Authors: Sircan-Kucuksayan, Aslinur | Eray, Oktay | Buyukaksu, Murat | Gumus, Birce | Dursun, Oguz | Canpolat, Murat

Article Type: Research Article

Abstract: BACKGROUND: Venous oxygen saturation reflects venous oxygenation status and can be used to assess treatment and prognosis in critically ill patients. A novel method that can measure central venous oxygen saturation (ScvO 2 ) non-invasively may be beneficial and has the potential to change the management routine of critically ill patients. OBJECTIVE: The study aims to evaluate the potential of sublingual venous oxygen saturation (SsvO 2 ) to be used in the estimation of ScvO 2 . METHODS: We have developed two different approaches …to calculate SsvO 2 . In the first one, near-infrared spectroscopy (NIRS) measurements were performed directly on the sublingual veins. In the second approach, NIRS spectra were acquired from the sublingual tissue apart from the sublingual veins, and arterial oxygen saturation was measured using a pulse oximeter on the fingertip. RESULTS: Twenty-six healthy subjects were included in the study. In the first and second approaches, average SsvO 2 values were 75.0% ± 1.8 and 75.8% ± 2.1, respectively. The results of the two different approaches were close to each other and similar to ScvO 2 of healthy persons (> 70%). CONCLUSION: Oxygen saturation of sublingual veins has the potential to be used in intensive care units, non-invasively and in real-time, to estimate ScvO 2 . Show more

DOI: 10.3233/THC-202793

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Hossen, Abdulnasir

Article Type: Research Article

Abstract: BACKGROUND: Autonomic function can be estimated non-invasively using heart rate variability (HRV). HRV of patients undergoing coronary artery bypass grafting (CABG) is investigated in time-domain and frequency-domain before and after CABG to study the effect of operation on the status of patients. OBJECTIVE: The main purpose of this work is to evaluate the effect of CABG surgery on patients with ischemic heart disease (IHD) before operation, and to monitor the status of patients on day 6 and day 30 after the CABG operation. METHODS: The statistical signal characterization (SSC) technique is used in …this work in order to derive different morphology-based parameters to indirectly describe time-domain and frequency-domain HRV parameters in 24 patients undergoing CABG operation, before the operation (Group 1: G1), 6 days after operation (Group 2: G2) and 30 days after operation (Group 3: G3). The data is obtained from the Sultan Qaboos University Hospital in Oman. RESULTS: The SSC parameters Mean(mt) and Mean(dt) are reduced in all 24 patients and in 23 out of 24 patients in G2 compared to G1 (6-days after operation compared with before operation), respectively. Comparing G3 to G1 the reduction in Mean(mt) and Mean(dt) is noted in 18 of the 24 patients. CONCLUSIONS: The parameters Mean(mt) and Mean(dt) are successful parameters to follow the HRV for patients undergoing CABG surgery. A relation between those SSC parameters and the HRV time-domain and frequency-domain parameters is investigated in this paper to understand the physiological behavior of the patients. Show more

Keywords: HRV, CABG, statistical signal characterization, signal morphology, time-domain, frequency-domain

DOI: 10.3233/THC-212952

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2021

Authors: Vagnini, Alessandro | Furone, Roberta | Zanotti, Giulia | Adamo, Paola | Temporiti, Federico | Gatti, Roberto

Article Type: Brief Report

Abstract: BACKGROUND: Optoelectronic systems and force platforms represent the gold standard for postural sway assessment, but pose disadvantages in terms of equipment, cost and preparation time. OBJECTIVE: Wearable inertial measurement units (IMUs) have been proposed to overcome these issues, but have never been compared to an optoelectronic system. The study aim was therefore to investigate agreement between inertial measurement unit and optoelectronic system in postural sway assessment. METHODS: Thirty healthy volunteers performed four balance tasks. IMU was placed on the sacrum (S2) with a retroreflective marker over the sensor and subjects’ performance was simultaneously …recorded by both systems. Total (TOT), anterior-posterior (AP) and medial-lateral (ML) length of trace, range, speed, root mean squared (RMS), and confidence ellipse were computed. RESULTS: ICCs revealed excellent correlations for Length-TOT, Length-AP and Speed-AP, good correlation for Length-ML, Speed-ML, Confidence Ellipse, Range-AP and RMS-AP, and moderate correlation for range-ML and RMS-ML. Bland-Altman plot showed greater estimation for Length-TOT, Length-AP, Speed-AP, confidence ellipse and RMS-AP using optoelectronic system, and for Length-ML, Range-AP, Range-ML, Speed-ML, RMS-ML using IMU. Both systems revealed the same differences among tasks. CONCLUSION: The excellent to good agreement of IMU for length of trace and speed parameters and its user-friendly application suggest its potential implementations in clinical practice. Show more

Keywords: Optoelectronic system, Inertial Measurement Unit, postural sway

DOI: 10.3233/THC-212924

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2021

Authors: Shawki, Mamdouh M. | Azmy, Mohamed Moustafa | Salama, Mohammed | Shawki, Sanaa

Article Type: Research Article

Abstract: BACKGROUND: The early detection of human breast cancer represents a great chance of survival. Malignant tissues have more water content and higher electrolytes concentration while they have lower fat content than the normal. These cancer biochemical characters provide malignant tissue with high electric permittivity (ε ´ ) and conductivity (σ ). OBJECTIVE: To examine if the dielectric behavior of normal and malignant tissues at low frequencies (α dispersion) will lead to the threshold (separating) line between them and find the threshold values of capacitance and resistance. These data …are used as input for deep learning neural networks, and the outcomes are normal or malignant. METHODS: ε ´ and σ in the range of 50 Hz to 100 KHz for 15 human malignant tissues and their corresponding normal ones have been measured. The separating line equation between the two classes is found by mathematical calculations and verified via support vector machine (SVM). Normal range and the threshold value of both normal capacitance and resistance are calculated. RESULTS: Deep learning analysis has an accuracy of 91.7%, 85.7% sensitivity, and 100% specificity for instant and automatic prediction of the type of breast tissue, either normal or malignant. CONCLUSIONS: These data can be used in both cancer diagnosis and prognosis follow-up. Show more

Keywords: Breast cancer, dielectric properties, deep learning neural network, α dispersion

DOI: 10.3233/THC-213096

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2021

Authors: Fröschen, Frank S. | Randau, Thomas M. | Gravius, Nadine | Wirtz, Dieter C. | Gravius, Sascha | Walter, Sebastian G.

Article Type: Research Article

Abstract: BACKGROUND: Severe acetabular bone loss in revision total hip arthroplasty (RTHA), both with or without pelvic discontinuity, remains a great challenge in orthopaedic surgery. OBJECTIVE: The aim of this study was to evaluate risk factors for failure of custom-made acetabular implants in RTHA. METHODS: Seventy patients with severe acetabular bone loss (Paprosky Type III) and pelvic discontinuity, who required RTHA, were included in our study. All prostheses were constructed based on a thin-layer computed-tomography (CT) scan of the pelvis. The treatment was considered unsuccessful in the event of periprosthetic joint infection (PJI) or …aseptic loosening (AL) with need for explantation of the custom-made acetabular implant. RESULTS: The average follow-up was 41.9 ± 34.8 months (range 1.5–120). Implant survival at last follow-up was 75.7% (53 of 70). Explantation was necessary in 17 cases (15 PJI; 2 AL). Previous PJI as reason for RTHA (p = 0.025; OR 3.56 (95% CI: 1.14; 11.21)), additional revision of femoral components (p = 0.003; OR 8.4 (95% CI: 1.75; 40.42)), rheumatoid disease (p = 0.039; OR 3.43 (95% CI: 1.01; 11.40)), elevated preoperative CRP > 15.2 mg/l (p = 0.015; AUC: 0.7) and preoperative haemoglobin < 10.05 (p = 0.022; AUC: 0.69) were statistically significant risk factors associated with treatment failure. Age and BMI were not statistically significant contributing to implant failure. CONCLUSION: Risk factors for treatment failure were a previous PJI, additional revision of femoral component, rheumatoid disease, elevated preoperative CRP and low preoperative haemoglobin. Awareness of these risk factors will help to improve future treatment standards. Show more

Keywords: Revision total hip arthroplasty, pelvic discontinuity, acetabular bone loss, custom-made implant, risk factor, treatment failure, periprosthetic joint infection, aseptic loosening

DOI: 10.3233/THC-202236

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Parker, Monica W. | Davis, Crystal | White, Kaylin | Johnson, Devon | Golden, Matt | Zola, Stuart

Article Type: Research Article

Abstract: BACKGROUND: African Americans living with dementia are considered less likely to seek formal institutionalized elder care and more likely to be managed in the home by family-member caregivers. Assistive technologies (the use of smart visual devices like tablets and phones) can be used effectively to guide memory-impaired individuals with a sequence of pictures showing steps to complete activities of daily living, e.g., bathing, toileting, dressing. Assistive technology so far has not been generally embraced in African American communities. OBJECTIVES: Determine, if African American family caregivers, given the opportunity, would embrace the use of assistive technology and …if they would perceive its use beneficial. METHODS: We assessed a group of eight family caregivers’ overall care-burden scores, and their user-satisfaction scores after using assistive technology for three months. RESULTS: We found significant reduction in caregiver burden, positive changes in behavior and emotion scores, and high ratings on user satisfaction. CONCLUSIONS: The findings reported here comprise the first systematic study of the use of assistive technology by caregivers in an underserved population. They set the stage for exploring meaningful strategies and variables that will better engage underserved populations to take advantage of assistive technologies available in healthcare. Show more

Keywords: Caregiving, African Americans, dementia, assistive technology, quality of life, activities of daily living

DOI: 10.3233/THC-213049

Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2021