Technology and Health Care - Volume Pre-press, issue Pre-press
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ISSN 0928-7329 (P)
ISSN
1878-7401 (E)
Impact Factor 2023: 1.6
Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: The main goal of sports science is to monitor sports injuries. Nevertheless, the existing sports injury monitoring projects have many expensive instruments and excessively extended monitoring periods, which makes it difficult to expand sports injury monitoring on a large scale. OBJECTIVE: The advancement of machine learning algorithms opens up new avenues for the tracking of sports injuries. METHODS: A training set of sports injuries was created using the Discrete Wavelet Transform (DWT) and Random Forest algorithms. Next, a basic analytic framework was created based on the lower-body movement of runners, and an…athlete’s injury likelihood monitoring system was established. First off, the wearable gyroscope device can efficiently plot the motion displacement curve and monitor the three-dimensional mechanics of the athlete’s hips, thighs, and calves. Secondly, the system has a higher computational efficiency and an advantage over other classifier-based systems in terms of testing and training times RESULTS: The suggested system framework identifies athletes’ injury propensity, providing preventive recommendations based on displacement curves, and offering a low total cost and high testing accuracy, making it easy to implement and cost-effective. CONCLUSION: All things considered, the sports injury monitoring device is very accurate and reasonably priced, making it appropriate for widespread use.
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Abstract: BACKGROUND: Given the increasing numbers of young patients with knee osteoarthritis there is a need for treatments that can postpone a joint prosthesis (total knee replacement). OBJECTIVE: As an alternative to the effective yet invasive knee joint distraction procedure, a knee orthosis was developed aiming to unload the affected knee and improving synovial fluid flow. The aim of this study was to examine the effectiveness of using a load-reducing orthosis for two months on functioning, pain, and disease progression (e.g. amount of damaged cartilage) in patients with symptomatic osteoarthritis of the knee for at least one…year. METHODS: This is an interventional single-center pilot study. Ten patients with symptomatic osteoarthritis of one knee (5 males/5 females; median age 57; age range 42–59) used a custom-made orthosis for 60 days during daily life activities that involved knee loading (e.g. standing, walking, but not during stair climbing). Cycling was not allowed. Clinical outcomes were assessed up to 24 months after intervention at 6 timepoints using patient reported-outcome measures Western Ontario and McMaster Universities Osteoarthritis (WOMAC) range 0–100; Visual Analogue Scale (VAS), range 0–100 for pain. Minimum joint space width (mJSW) was assessed using knee images digital analysis (KIDA) and articular cartilage volume with magnetic resonance imaging (MRI) using custom software at baseline and at 12 and 24 months follow-up. RESULTS: Clinically beneficial effects were found for functioning (WOMAC improvement compared to baseline ranged between 18 points at 3 months follow-up and 31 points at 12 months follow-up, with only the 24-months follow-up (improvement of 27 points) not reaching statistical significance (p < 0.05)) and for pain (VAS improvement compared to baseline at follow-up time points ranged between 41–56 points; all p < 0.05). No improvements in mJSW- or MRI-derived parameters were found. CONCLUSION: This study demonstrates that use of a custom-made knee-unloading orthosis for 60 days can result in improved functional ability and decrease in pain in relatively young patients with knee osteoarthritis. No effect on disease progression could be evidenced.
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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.
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Keywords: Lean management, information based nursing quality control system, experience
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.
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Keywords: Delayed graft function, diarrhea, mycophenolic acid, renal transplantation, type of donor
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.
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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.
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Keywords: Preventive dentistry, nanoparticles, titanium dioxide, green synthesis, antioxidant
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.
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Keywords: Breast cancer, vesicle-associated membrane protein 7, immunohistochemistry, molecular mechanisms
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.
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Keywords: THA, direct anterior approach, HOOS, satisfaction, value of robotics
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.
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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.
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Keywords: Medical devices, equipment readiness, patient safety, healthcare, manpower requirement, private dental center