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Price: EUR 150.00Authors: Incesoy, Mustafa Alper | Yildiz, Fatih | Pulatkan, Mehmet Anil | Yesiller, Omer Faruk | Toluk, Ozlem | Erdem, Ahmet Can | Tuncay, Ibrahim
Article Type: Research Article
Abstract: BACKGROUND: With the restoration of the natural hip biomechanics, a successful total hip arthroplasty (THA) and long-term survival is pursued. Although robotic THA (rTHA) has been developed to increase accuracy of implant positioning, leg lengths and offsets, discussions about its radiological and clinical advantages over conventional THA (cTHA) continues. OBJECTIVE: The aim of this study was to compare clinical and radiological outcomes of robotic and conventional THA. METHODS: This retrospective study compares functional and radiological outcomes of 82 rTHA with a matched group of 82 cTHA in terms of age, sex, body mass …index and preoperative functional scores. The minimum follow up was 12 months for all patients. Functional outcomes were Harris Hip Score (HHS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) evaluated pre- and postoperatively. Radiological evaluations included position of cup placement according to Lewinnek and Callanan safe zones, Canal Fill Ratio (CFR), Leg Length Discrepancy (LLD), Lateral offset (LO) and Femoral Component Alignment (FCA). Complications were also evaluated. RESULTS: In the rTHA group, 91.5% (75 out of 82) of the acetabular cups were positioned within the safe zone whereas it was 63.4% (52 out of 82) for the cTHA group (p < 0.001). According to Callanan, they were 84.1% and 50%, respectively (p < 0.001). Between the groups, no statistically significant difference was found in CFR, LLD, HO, FCA, AI, AA, WOMAC, HHS and major complication rates. CONCLUSION: rTHA is superior to cTHA in terms of accuracy and reproducibility of the cup placement, however no apparent clinical benefit was found in short term follow. Show more
Keywords: Total hip arthroplasty, robot-assisted surgery, component positioning, robotic total hip replacement
DOI: 10.3233/THC-231111
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Rossi, Stefano Marco Paolo | Sangaletti, Rudy | Andriollo, Luca | Matascioli, Luca | Benazzo, Francesco
Article Type: Research Article
Abstract: BACKGROUND: Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants. OBJECTIVE: The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant. METHODS: Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled. Patients included in the …study showed a minimum 15 degrees varus or 10 degrees valgus deviation. RESULTS: 20 cases were varus knees and 10 cases were valgus knees. Postoperative neutral alignment was defined as 0 ∘ ± 2.5 ∘ . A CCK implant was used in 20 cases while a Constrained Posterior Stabilized implant was used in 10 cases. A neutral alignment was achieved in all patients. At a minimum 6 months follow up (f-u 6–30 months) clinical outcomes including ROM, KSS, HSS, OKS and WOMAC showed significant improvement and no major complications were registered. CONCLUSIONS: The robotic system showed the achievement of a mechanical alignment with reliable radiographic outcomes and clinical results in the treatment of major deformities of the lower limb with the use of higher constrained implants at short term follow up. Further follow up and studies are necessary to confirm and verify these promising outcomes. Show more
Keywords: Robotics, knee, major deformities, varus, valgus, constaint, computer-aided surgical planning, orthopedic surgery
DOI: 10.3233/THC-231261
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Tekeli, Seçkin Özgür | Köse, Özkan | Yapar, Dilek | Tekeli, Feyza Yağmur | Asoğlu, Mehmet Melih | Kartal, Emre Mücahit
Article Type: Research Article
Abstract: BACKGROUND: The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. OBJECTIVE: This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. METHODS: This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. RESULTS: Of the participants, 49.2% (n = 1,683) were diagnosed …with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p < 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5–2.0; p < 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. CONCLUSIONS: The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65. Show more
Keywords: Vitamin D, knee, osteoarthritis, female sex, biomedical imaging, elderly healthcare, orthopedic surgery
DOI: 10.3233/THC-230802
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
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: 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: 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: Dayama, Nikhil Vitthal | Ali, Mariyam | Gaur, Abhishek | Pandey, Kaushik Kumar | Alqahtani, Nasser M. | Alfarsi, Mohammed A. | Zarbah, Mohammad A. | Chaturvedi, Saurabh | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Bonding between metal and ceramic is one of the most important aspects of a successful prosthesis. Various methods have been recommended for preparing the metal surface to enhance the bond between metal and ceramic including the use of a metal bonding agent. OBJECTIVE: This study aims to evaluate and compare the shear bond strength of the metal-ceramic (M-C) interface after combinations of various surface treatments including the application of a metal bonding agent. METHOD: 40 Ni-Cr alloy specimens were made and divided into 4 groups of 10 each based on the combination …of surface treatments. Sandblasting, surface grinding, and Oxidation heat treatment (OHT) were performed on specimens from Group 1 (Control). In addition, Group 2 specimens received ultrasonic cleaning, Group 3 steam cleaning, and Group 4 metal bonding agent application. Following surface treatments on all specimens, porcelain build-up was performed, and shear bond strength was tested in a Digital Universal testing machine. The statistical tests used were independent t -test and ANOVA. RESULTS: Results revealed that Group 4 specimens had the highest mean value of shear bond strength of 39.087 MPa while Group 3 specimens showed the least mean shear bond strength of 18.154 MPa with highly statistically significant results (p < 0.001). CONCLUSION: The surface treatments and application of bonding agent to metal prior to porcelain application resulted in increased shear bond strength of the metal-ceramic interface. Show more
Keywords: Metal bonding agent, shear bond strength, surface treatments, alloys, composition, metal-ceramic
DOI: 10.3233/THC-231003
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Ong, Christian B. | Buchan, Graham B.J. | Hecht II, Christian J. | Kendoff, Daniel O. | Homma, Yasuhiro | Kamath, Atul F.
Article Type: Research Article
Abstract: BACKGROUND: Patient obesity is a risk factor for poor acetabular cup positioning in total hip arthroplasty (THA). OBJECTIVE: To assess the impact of using a novel, fluoroscopy-based robotic THA system on acetabular cup placement in obese versus non-obese patients. METHODS: A review of 105 consecutive manual unassisted (mTHA) (47 Obese/58 Non-obese) and 102 robotic-assisted (RA-THA) (50 Obese/52 Non-obese) primary, direct anterior approach THA procedures was conducted. All cases were performed by a single surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, or rheumatoid arthritis. Obesity was defined as a Body Mass Index …(BMI) ⩾ 30 kg/m 2 . Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone. RESULTS: Obese patients in the mTHA cohort had larger cup inclination angles on average compared to non-obese patients (44.82 ∘ ± 6.51 vs. 41.39 ∘ ± 6.75; p = 0.009). Obese mTHA patients were less likely to have cup placement within the Lewinnek zone compared to non-obese mTHA patients (0.48 vs. 0.67; p = 0.027). Obesity had no effect on the accuracy of RA-THA. CONCLUSION: Obesity affects the placement of the acetabular component in manual THA. The novel, fluoroscopy-based robotic THA system in this study demonstrated accurate cup placement regardless of obesity status. Show more
Keywords: Arthroplasty, hip, acetabulum, robotic-assisted surgery, obesity
DOI: 10.3233/THC-231127
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Fink, Bernd | Hoyka, Marius | Blersch, Benedikt | Baum, Hannsjörg | Sax, Florian Hubert
Article Type: Research Article
Abstract: BACKGROUND: Graphic type differentiation of cell count data of synovial aspirates is a new method for the diagnosis of early and late periprosthetic joint infection. OBJECTIVE: The aim of the study was to analyse if the same 6 LMNE-types can be differentiated in the new Yumizen H500 cell counter as it was the case for the old cell counter ABX Pentra XL 80 of previous publications, to verify if the erythrocyte and thrombocyte curves of the new device give additional information and to calculate the difference of cell count in LMNE-type I and III (with abrasion) …in the cell counter and in the manual counting chamber (Neubauer improved). METHODS: 450 aspirates of 152 total hip arthroplasties and 298 knee arthroplasties obtained for the diagnosis of periprosthetic joint infection were analysed with the Yumizen H500. RESULTS: All LMNE-matrices of the 450 aspirates could assigned to one of the six LMNE-types. There were 76 LMNE-type I, 72 LMNE-type II, 14 LMNE-type III, 241 LMNE-type IV, 36 LMNE-type V and 12 LMNE-type VI. The erythrocyte and thrombocyte distribution curves were very helpful for differentiation of hematoma and infection. The cell count in the manual counting procedure was lower than in the cell counter: for the LMNE-type I (abrasion type) the median of the difference was 925/μ L (median) and for the LMNE-type III (combined type of infection and abrasion) 3570/μ L (median). CONCLUSION: The described graphic type differentiation is a new and helpful method for differentiation of hematoma and early PJI as well as abrasion and late PJI. Show more
Keywords: Leucocyte count, synovia, periprosthetic joint infection, cell counter
DOI: 10.3233/THC-231006
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Ong, Christian B. | Buchan, Graham B.J. | Hecht II, Christian J. | Homma, Yasuhiro | Harmon, Daniel J. | Kendoff, Daniel O. | Petterwood, Joshua | Kamath, Atul F.
Article Type: Research Article
Abstract: BACKGROUND: Robotic assistance in total hip arthroplasty (RA-THA) has been shown to minimize laterality-based differences in acetabular cup positioning. OBJECTIVE: To determine if the use of a novel, fluoroscopy-based RA-THA system mitigates differences in acetabular cup placement between left (L) and right (R) side hip procedures, when compared to manual, fluoroscopic-assisted technique. METHODS: We conducted a retrospective review of 106 consecutive mTHA (40 L/66 R) and 102 RA-THA (48 L/54 R) primary direct anterior approach procedures. All cases were performed by a single right-hand-dominant surgeon, for a pre-operative diagnosis of osteoarthritis, avascular necrosis, …or rheumatoid arthritis. Outcomes included acetabular cup inclination and anteversion, and the proportion of cups within the Lewinnek safe-zone. RESULTS: The average inclination of mTHA L cases was smaller than that of mTHA R cases (41.10 ∘ ± 7.38 vs. 43.97 ∘ ± 6.27; p = 0.04). For RA-THA, L and R cup angles were similar. There were fewer overall mTHA hips within the Lewinnek safe-zone compared to RA-THA (0.59 vs. 0.78; p = 0.003), as well as fewer mTHA R cases than RA-THA R cases (0.59 vs. 0.80; p = 0.03) within safe zone. CONCLUSION: Use of a novel, fluoroscopy-based robotic system mitigates laterality-based differences in acetabular cup placement that were observed in a manual, fluoroscopic-assisted cohort. Show more
Keywords: Arthroplasty, hip, acetabulum, robotic-assisted surgery, functional laterality
DOI: 10.3233/THC-231126
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
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: Álvarez Valdivielso, Ainhoa | Akkaya, Mustafa | Mau, Hans | Luo, T. David | Gehrke, Thorsten | Citak, Mustafa
Article Type: Research Article
Abstract: BACKGROUND: Surgeons still face difficulties when performing aseptic acetabular revision on patients with extensive defects. Advances in three-dimensional printing technology (3DP) have afforded to the surgeons to create a patient-specific implant matching the morphology and topography of the defect. OBJECTIVE: The aim of the current research was to determine the survivorship in the treatment of acetabular bone defects with pelvic discontinuity (PD). METHODS: In order to reconstruct Paprosky type III defects with PD, twenty-three patients underwent revision total hip arthroplasty (THA) utilizing 3D-printed implants (Mobelife). The primary outcomes were the implant-associated failure rate …correlated with survivorship. As secondary variables, complications and the effect of age, sex, comorbidities, history of infections and the presence of other lower limb arthroplasties on a new revision were analyzed. RESULTS: Patients were followed out to a mean of 67.22 ± 39.44 months (range, 0.9–127 months). Mobelife implant mean survival was 102.57 ± 9.90 months (95% CI 83.17–121.96). The cohort’s implant one-year survival rate was 87%; at ten years, it dropped to 78.3%. There were four revisions: three due to periprosthetic joint infection (PJI) and one case due to aseptic loosening. Cox regression analysis did not identify any variable as predictor of failure. CONCLUSION: The use of 3DP patient-specific acetabular components has shown encouraging results and it is a viable treatment option for addressing acetabular defects with combined PD in aseptic THA revision. Show more
Keywords: Acetabular bone loss, Paprosky type III bone defect, pelvic discontinuity, patient-specific implants, 3D printing
DOI: 10.3233/THC-231647
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Li, Chenxi | Li, Jian | Lu, Yao | Hou, Jiahui | Zhi, Zhaoyu | Zhao, Baocun | Zhang, Xiumei
Article Type: Research Article
Abstract: BACKGROUND: Volumetric modulated arc therapy (VMAT) guided by ultrasound is a novel radiation therapy technique that facilitates the delineation of the tumor target area under image guidance, enhancing the precision of radiation therapy and maximizing the protection of surrounding tissues. OBJECTIVE: The objective of this paper is to investigate the effectiveness of VMAT under ultrasonic guidance for cervical cancer patients and its impact on radiotherapy dosage and prognosis. METHODS: A retrospective analysis encompassed 128 instances of cervical cancer patients who were admitted to our medical facility between April 2019 and April 2021. The …patients were categorized into an observation cohort and a control cohort, depending on variations in treatment modalities post-admission. The control group underwent conventional radiotherapy, whereas the observation group received VMAT guided by ultrasound. Clinical efficacy, average radiation dosages (in the radiotherapy target area, rectum, and bladder), radiotherapy-related toxicities during treatment, and one-year survival rates were compared between the two groups. Additionally, variances in pre- and post-treatment serum levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and carbohydrate antigen 724 (CA724) were subjected to assessment. RESULTS: When compared to the control group (64.52%), the observation cohort’s comprehensive effectiveness rate was considerably greater (80.30%). The observation group saw lower average radiation exposures and a reduction in the post-treatment concentrations of CEA, SCC-Ag, and CA724. The overall incidence of adverse effects from radiation treatment also declined. The observation group had a greater one-year survival rate (90.48%) than the control group (73.33%). When comparing the observation cohort to the control group, Kaplan-Meier survival analysis showed a significantly higher one-year survival rate (Log-Rank = 6.530, P = 0.011). CONCLUSION: VMAT guided by ultrasound for patients with cervical cancer demonstrates promising short- and long-term treatment outcomes. It also leads to improvements in serum CEA, SCC-Ag, and CA724 levels, as well as reductions in the average radiation dosages to the radiotherapy target area, rectum, and bladder. This approach warrants attention from clinicians in clinical practice. Show more
Keywords: Cervical cancer, intensity-modulated radiation therapy, ultrasound, radiation dosage, prognosis
DOI: 10.3233/THC-231977
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Barberis, Luca | Sabatini, Luigi | Pellegrino, Andrea | Galletta, Claudia | Risitano, Salvatore | Capella, Marcello | Massè, Alessandro | Schiraldi, Marco | Indelli, Pier Francesco
Article Type: Research Article
Abstract: BACKGROUND: Bicruciate-retaining (BCR) total knee arthroplasty (TKA) has seen renewed interest due to the potential for more natural knee kinematics with anterior cruciate ligament (ACL) retention. OBJECTIVE: The present study attempts to determine differences in the 2-year survivorship and patient-reported outcomes between two surgical strategies (traditional instrumentation versus robotics) applied to the extensive use of a modern, 2nd generation BCR TKA design. METHODS: We performed a retrospective study with prospectively collected data of 113 patients who underwent primary TKA between 2018 and 2020 using a 2nd generation BCR TKA implant. Patient …demographics, PROMS, and intra/post-operative complications were collected. Patients were also evaluated according to the use or not of robotics. A Kaplan-Meier analysis was used to evaluate revision-free survival at follow up. RESULTS: 102 patients were enrolled: 90 received traditional surgery and 12 robotic-assisted surgery. The mean age was 68 years (SD 7.76) with an average BMI of 29.6 kg/m2 (SD 3.56). The mean follow up (FU) was 32.4 ± 6.2 months (range 24–45 months). Survivorship at 2 years was 98% (95% CI: 92.4–99.5). Revisions/reoperations were performed for anterior cruciate ligament (ACL) tear (1/4), pain (1/4), arthrofibrosis (1/4) and acute periprosthetic joint infection (PJI) (1/4). At final FU, 92 patients (90.2%) considered themselves satisfied, showing a mean OKS of 40.6 (SD 5.1) and a mean FKS of 76.7 (SD 11.8). No differences in the outcome were found between traditional and robotic-assisted procedures. CONCLUSION: The modern BCR design evaluated in this study achieved excellent results in terms of implant survivorship, low rate of reoperation and clinical results, independently from the use of enabling technologies. Show more
Keywords: Arthroplasty, replacement, knee, anterior cruciate ligament, TKA, BCR, instability
DOI: 10.3233/THC-231608
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: S.S., Akilan | Devprasad, Kayathri Devi | J, Raja Sekar
Article Type: Research Article
Abstract: BACKGROUND: Wireless Body Area Networks (WBANs) are integral to modern healthcare systems, providing continuous health monitoring and real-time data transmission. The sensitivity of medical data being transmitted makes security a significant concern in WBANs. OBJECTIVE: This study explores the application of the Elliptic Curve Cryptography (ECC)-based Diffie-Hellman Key Exchange (ECDH) algorithm to enhance security within WBANs. METHOD: The study investigates the suitability of ECC for this context and evaluates the performance and security implications of implementing ECDH in WBANs. RESULTS: The findings reveal that ECDH provides a robust and computationally …efficient solution for secure key exchange in WBANs, addressing inherent vulnerabilities. CONCLUSION: The adoption of ECC-based ECDH is poised to bolster data confidentiality and integrity in WBANs, promoting trust and widespread use of these networks in healthcare applications. This research contributes to the growing body of knowledge regarding security measures in WBANs and opens new avenues for the secure transmission of sensitive medical information. Show more
Keywords: Wireless Body Area Networks (WBANs), security, Elliptic Curve Cryptography (ECC), Diffie-Hellman key exchange (DHE), ECDH
DOI: 10.3233/THC-231614
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2024
Authors: Zhong, Fengxing | Yin, Xiuping | Liu, Xinxin | Zhang, Qiming
Article Type: Research Article
Abstract: BACKGROUND: Understanding how pharmaceutical formulas target specific illnesses is crucial for developing effective treatments. Enriching ion channel data is a critical first step in comprehending a formula’s mechanism of action. OBJECTIVE: This study aims to explore the effective disease spectrum of the Qi Yu granule formula through network pharmacology analysis and backtracking, and analyze its potential curative effects on liver and spleen system diseases, particularly depression and breast cancer. METHODS: Using pharmacological tools and database analysis, the ion channel data of the formula’s components were investigated. The effective disease spectrum was determined, and …diseases related to liver and gallbladder, liver depression, and spleen deficiency were identified. Network pharmacology analysis was conducted to backtrack diseases, target gene proteins, and drug compositions. The extraction technology of volatile oil from medicinal herbs was experimentally studied to optimize the preparation process. RESULTS: The effective disease spectrum analysis identified potential curative effects of the Qi Yu granule formula on various diseases, including breast cancer. Backtracking revealed relationships between diseases, target gene proteins, and drug compositions. Experimental studies on volatile oil extraction provided insights into optimizing the preparation process. CONCLUSION: The study underscores the potential therapeutic benefits of the Qi Yu granule formula for liver and spleen system diseases. By integrating network pharmacology analysis and experimental research, this study offers valuable insights into the formulation and efficacy of the Qi Yu granules, paving the way for further exploration and optimization of TCM formulations. Show more
Keywords: Qi Yu granules, liver stagnation, edible plants, network pharmacology, spleen deficiency syndrome
DOI: 10.3233/THC-232034
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Ji, Jiajia | Zhu, Min | Bao, Mengqian | Xu, Lamei | Yuan, Hui
Article Type: Research Article
Abstract: BACKGROUND: To enhance the self-management ability of elderly diabetes mellitus (DM) patients, priority should be given to the accurate evaluation of their current self-management ability, and then provide corresponding guidance. OBJECTIVE: To explore the application value of Diabetes Self-Management Behaviors among Older Koreans (DSMB-O) in self-management of elderly patients with type 2 diabetes mellitus (T2DM). METHODS: Using convenient sampling, this study retrospectively collected the clinical data of 215 elderly patients with T2DM who were admitted to our hospital from June 2020 to June 2022. Enrolled patients were divided into an effective-control group (n …= 80) and an ineffective-control group (n = 135) based on whether the glycated hemoglobin (HbA1C) was < 7.5% for further comparison of the collected data. RESULTS: There were statistically significant differences in the comparison of the proportion of diabetes mellitus (DM) course (χ 2 = 26.000, P < 0.001), DSMB-O score (17.67 ± 4.07 VS 14.67 ± 4.70 points, t = 4.582, P < 0.001), and Summary Diabetes Self Care Activity (SDSCA) score (43.16 ± 11.17 VS 37.58 ± 12.47 points, t = 5.492, P < 0.001) between the two groups. The total score of DSMB-O was negatively correlated with both HbA1c (r = - 0.281, P < 0.001) and complications (r = - 0.193, P = 0.004); moreover, the total score of SDSCA was also negatively correlated with both HbA1c (r = - 0.234, P < 0.001) and complications (r = - 0.153, P = 0.025). Among various dimensions of DSMB-O, active exercise (OR = 0.699, 95%CI: 0.541 ∼ 0.902) and blood glucose monitoring (OR = 0.603, 95%CI: 0.431 ∼ 0.817) were protective factors for T2DM patients with HbA1c levels < 7.5%. The area under the curve (AUC) of SDSCA score and DSMB-O score predicting self-management level in elderly T2DM patients was 0.643 (95%CI: 0.611 ∼ 0.756) and 0.716 (95%CI: 0.689∼ 0.774), respectively. CONCLUSION: DSMB-O exhibits a higher accuracy in predicting the self-management level of elderly patients with T2DM than that of SDSCA. Regular exercise, medication, blood glucose monitoring, and reducing the risk of complications are all intimately associated with the control of blood glucose. Show more
Keywords: Elderly, Type 2 diabetes, self-management behavior, influencing factors, health effects
DOI: 10.3233/THC-240138
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhao, Mei | Zhou, Hengyu | Wang, Jing | Liu, Yongyue | Zhang, Xiaoqing
Article Type: Research Article
Abstract: BACKGROUND: The theory of Chinese medicine (TCM) constitution contributes to the optimisation of individualised healthcare programmes. However, at present, TCM constitution identification mainly relies on inefficient questionnaires with subjective bias. Efficient and accurate TCM constitution identification can play an important role in individualised medicine and healthcare. OBJECTIVE: Building an efficient model for identifying traditional Chinese medicine constitutions using objective tongue features and machine learning techniques. METHODS: The DS01-A device was applied to collect tongue images and extract features. We trained and evaluated five machine learning models: Support Vector Machine (SVM), Decision Tree (DT), …Random Forest (RF), LightGBM (LGBM), and CatBoost (CB). Among these, we selected the model with the best performance as the base classifier for constructing our heterogeneous ensemble learning model. Using various performance metrics, including classification accuracy, precision, recall, F1 score, and area under curve (AUC), to comprehensively evaluate model performance. RESULTS: A total of 1149 tongue images were obtained and 45 features were extracted, forming dataset 1. RF, LGBM, and CB were selected as the base learners for the RLC-Stacking. On dataset 1, RLC-Stacking1 achieved an accuracy of 0.8122, outperforming individual classifiers. After feature selection, the classification accuracy of RLC-Stacking2 improved to 0.8287, an improvement of 0.00165 compared to RLC-Stacking1. RLC-Stacking2 achieved an accuracy exceeding 0.85 for identifying each TCM constitution type, indicating excellent identification performance. CONCLUSION: The study provides a reliable method for the accurate and rapid identification of TCM constitutions and can assist clinicians in tailoring individualized medical treatments based on personal constitution types and guide daily health care. The information extracted from tongue images serves as an effective marker for objective TCM constitution identification. Show more
Keywords: Traditional Chinese Medicine Constitution, constitution identification, tongue features, machine learning, ensemble learning
DOI: 10.3233/THC-240128
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Hao, Huawen | Qiao, Wei | Wu, Yaguang
Article Type: Research Article
Abstract: BACKGROUND: The rapid growth of cities has been accompanied by problems with urban air quality, making air pollution challenging to manage. In this situation, people focus on indoor building materials to improve air quality. OBJECTIVE: In this paper, a novel bola-type surfactant was synthesized and used as a template, using ethyl orthosilicate and sodium meta-aluminate as the silicon and aluminum source, in the ratio of n (NaOH ): n (NaAIO2 ): n (SiO2 ): n (SDA ): n (H2 O) as 30:2.5:120:5:4800. …METHODS: Hydrothermal preparation of ZSM-5 molecular sieves with a nanosheet structure (H-ZSM-5) was accomplished. The manufactured lamellar ZSM-5 molecular sieves were examined using X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and adsorption and desorption techniques. RESULTS: Traditional microporous ZSM-5 had a considerably lower static adsorption of formaldehyde molecules. The findings demonstrated that the nano-lamellar H-ZSM-5 molecular sieve can purify and eliminate larger molecular VOCs inside because it has the ability to adsorb larger molecular diameter VOCs. Additionally, the effectiveness of the adsorption was assessed using toluene vapour molecules with higher molecular diameters. CONCLUSION: The findings demonstrate that the nanosheet H-ZSM-5 molecular sieve can remove bigger molecule VOCs from indoor air and can be utilised to purify indoor spaces. This study offers a fresh approach to indoor environmental cleanup by demonstrating the capability of nano-lamellar H-ZSM-5 molecular sieves for molecular adsorption. Show more
Keywords: Bola-type surfactant, H-ZSM-5, formaldehyde, toluene, adsorption
DOI: 10.3233/THC-240187
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Njezic, Sasa | Zivic, Fatima | Savic, Slobodan | Petrovic, Nenad | Pesic, Zivana Jovanovic | Stefanovic, Anja | Milenkovic, Strahinja | Grujovic, Nenad
Article Type: Research Article
Abstract: BACKGROUND: The biological properties of silicone elastomers such as polydimethylsiloxane (PDMS) have widespread use in biomedicine for soft tissue implants, contact lenses, soft robots, and many other small medical devices, due to its exceptional biocompatibility. Additive manufacturing of soft materials still has significant challenges even with major advancements that have occurred in development of these technologies for customized medical devices and tissue engineering. OBJECTIVE: The aim of this study was to develop a mathematical model of tangential stress in relation to shear stress, shear rate, 3D printing pressure and velocity, for non-Newtonian gels and fluids that …are used as materials for 3D printing. METHOD: This study used FENE (finitely extensible nonlinear elastic model) model, for non-Newtonian gels and fluids to define the dependences between tangential stress, velocity, and pressure, considering viscosity, shear stress and shear rates as governing factors in soft materials friction and adhesion. Experimental samples were fabricated as showcases, by SLA and FDM 3D printing technologies: elastic polymer samples with properties resembling elastic properties of PDMS and thermoplastic polyurethane (TPU) samples. Experimental 3D printing parameters were used in the developed analytical solution to analyse the relationships between governing influential factors (tangential stress, printing pressure, printing speed, shear rate and friction coefficient). Maple software was used for numerical modelling. RESULTS: Analytical model applied on a printed elastic polymer, at low shear rates, exhibited numerical values of tangential stress of 0.208–0.216 N m - 2 at printing velocities of 0.9 to 1.2 mm s - 1 , while the coefficient of friction was as low as 0.09–0.16. These values were in accordance with experimental data in literature. Printing pressure did not significantly influence tangential stress, whereas it was slightly influenced by shear rate changes. Friction coefficient linearly increased with tangential stress. CONCLUSION: Simple analytical model of friction for elastic polymer in SLA 3D printing showed good correspondence with experimental literature data for low shear rates, thus indicating possibility to use it for prediction of printing parameters towards desired dimensional accuracy of printed objects. Further development of this analytical model should enable other shear rate regimes, as well as additional soft materials and printing parameters. Show more
Keywords: Soft materials, tangential stress model, shear rate, friction coefficient, FENE (finitely extensible nonlinear elastic model), 3D printing
DOI: 10.3233/THC-240209
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2024
Authors: Lv, Guodong | Wang, Yuntao
Article Type: Review Article
Abstract: BACKGROUND: The widespread use of antibiotics has led to a gradual adaptation of bacteria to these drugs, diminishing the effectiveness of treatments. OBJECTIVE: To comprehensively assess the research progress of antibiotic resistance prediction models based on machine learning (ML) algorithms, providing the latest quantitative analysis and methodological evaluation. METHODS: Relevant literature was systematically retrieved from databases, including PubMed, Embase and the Cochrane Library, from inception up to December 2023. Studies meeting predefined criteria were selected for inclusion. The prediction model risk of bias assessment tool was employed for methodological quality assessment, and a …random-effects model was utilised for meta-analysis. RESULTS: The systematic review included a total of 22 studies with a combined sample size of 43,628; 10 studies were ultimately included in the meta-analysis. Commonly used ML algorithms included random forest, decision trees and neural networks. Frequently utilised predictive variables encompassed demographics, drug use history and underlying diseases. The overall sensitivity was 0.57 (95% CI: 0.42–0.70; p < 0.001; I 2 = 99.7%), the specificity was 0.95 (95% CI: 0.79–0.99; p < 0.001; I2 = 99.9%), the positive likelihood ratio was 10.7 (95% CI: 2.9–39.5), the negative likelihood ratio was 0.46 (95% CI: 0.34–0.61), the diagnostic odds ratio was 23 (95% CI: 7–81) and the area under the receiver operating characteristic curve was 0.78 (95% CI: 0.74–0.81; p < 0.001), indicating a good discriminative ability of ML models for antibiotic resistance. However, methodological assessment and funnel plots suggested a high risk of bias and publication bias in the included studies. CONCLUSION: This meta-analysis provides a current and comprehensive evaluation of ML models for predicting antibiotic resistance, emphasising their potential application in clinical practice. Nevertheless, stringent research design and reporting are warranted to enhance the quality and credibility of future studies. Future research should focus on methodological innovation and incorporate more high-quality studies to further advance this field. Show more
Keywords: Antibiotics, machine learning, meta-analysis, prediction
DOI: 10.3233/THC-240119
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Begic, Zijo | Djukic, Milan | Begic, Edin | Aziri, Buena | Begic, Nedim | Badnjevic, Almir
Article Type: Research Article
Abstract: BACKGROUND: Left atrial strain (LAS) analysis represents a newer non-invasive, sensitive and specific technique for assessing left atrial (LA) function and early detection of its deformation and dysfunction. However, its applicability in mitral regurgitation (MR) in pediatric population remains unexplored, raising pertinent questions regarding its potential role in evaluating the severity and progression of the disease. OBJECTIVE: To investigate the impact of chronic MR in children and adolescents on LA remodeling and function. METHODS: The study included 100 participants. Patients with primary and secondary chronic MR lasting at least 5 years fit our …inclusion criteria. The exclusion criteria from the study were: patients with functional mitral regurgitation due to primary cardiomyopathies, patients with artificial mitral valve, patients with MR who had previously undergone surgery due to obstructive lesions of the left heart (aortic stenosis, coarctation of the aorta), patients with significant atrial rhythm disorders (atrial fibrillation, atrial flutter). The echocardiographic recordings were conducted by two different cardiologists. Outcome data was reported as mean and standard deviation (SD) or median and interquartile range (Q1–Q3). RESULTS: The study included 100 participants, of whom 50 had MR and the remaining 50 were without MR. The average age of all participants was 15.8 ± 1.2 years, with a gender distribution of 37 males and 63 females. There was a significant difference in the values of LA volume index (LAVI), which were higher in patients with MR (p = 0.0001), S/D ratio (and parameters S and D; p = 0.001, p = 0.0001, p = 0.013), mitral annulus radius (p = 0.0001), E/A ratio (p = 0.0001), as well as septal e’ (m/s), lateral e’ (m/s), and average E/e’ ratio, along with the values of TV peak gradient and LV global longitudinal strain (%). There was no significant difference in LA strain parameters, nor in LA stiffness index (LASI). CONCLUSION: Our findings revealed significant differences in several echocardiographic parameters in pediatric patients with MR relative to those without MR, providing insight into the multifaceted cardiac structural and functional effects of MR in this vulnerable population. Show more
Keywords: Left atrium, mitral regurgitation, echocardiography, fibrosis
DOI: 10.3233/THC-240768
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Yao, Ni | Hu, Hang | Han, Chuang | Nan, Jiaofen | Li, Yanting | Zhu, Fubao
Article Type: Research Article
Abstract: BACKGROUND: The incidence of kidney tumors is progressively increasing each year. The precision of segmentation for kidney tumors is crucial for diagnosis and treatment. OBJECTIVE: To enhance accuracy and reduce manual involvement, propose a deep learning-based method for the automatic segmentation of kidneys and kidney tumors in CT images. METHODS: The proposed method comprises two parts: object detection and segmentation. We first use a model to detect the position of the kidney, then narrow the segmentation range, and finally use an attentional recurrent residual convolutional network for segmentation. RESULTS: Our …model achieved a kidney dice score of 0.951 and a tumor dice score of 0.895 on the KiTS19 dataset. Experimental results show that our model significantly improves the accuracy of kidney and kidney tumor segmentation and outperforms other advanced methods. CONCLUSION: The proposed method provides an efficient and automatic solution for accurately segmenting kidneys and renal tumors on CT images. Additionally, this study can assist radiologists in assessing patients’ conditions and making informed treatment decisions. Show more
Keywords: Computed tomography, kidney segmentation, deep learning, medical image processing
DOI: 10.3233/THC-232009
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Harel, Daphna | Lubetzky, Anat Vilnai
Article Type: Research Article
Abstract: BACKGROUND: Standing is a basic human function that healthy adults take for granted, yet it is a complex perceptual-motor process that requires sensation of position and motion from the sensory systems. OBJECTIVE: We assessed agreement between center of pressure data from a laboratory force-platform and head position data from an HTC Vive head-mounted display (HMD) for the evaluation of standing postural control. We investigated the impact of different statistical choices when assessing the relationship between two measurements. Specifically: 1) How does correlation and agreement statistics relate before and after logarithmic transformation? 2) Is there systemic or …proportional bias between the force-platform and HMD measurements? METHODS: We tested 37 adults (26 controls, 11 with unilateral vestibular hypofunction) standing on foam, observing a static or dynamic visual scene projected from the HMD. We quantified anterior-posterior and medio-lateral sway via Directional Path, Root Mean Square Velocity, Variance, and Power Spectral Density (PSD) from a force-platform and the HMD. RESULTS: Intra-class correlations (ICCs) were moderate-to-good for the non-transformed data and good-to-excellent after logarithmic transformation for all outcomes except for PSD above 1 Hz. Correlations were higher than ICCs. Bland-Altman plots indicated proportional bias but not after logarithmic transformation. CONCLUSIONS: Both devices correlated linearly, and measure people’s postural responses but cannot be used interchangeably, mostly because they appear to diverge with larger sway as evident on Bland-Altman plots of non-transformed data. Agreement between devices was excellent for low frequency movement but poor for high frequency small corrective movements. Show more
Keywords: Virtual reality, Bland-Altman, correlations, postural control, balance
DOI: 10.3233/THC-231338
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Chen, Han | Yang, Qiaorui | Yu, Fangjie | Shen, Yunxiang | Xia, Hong | Yang, Mengfan | Yin, Riping | Shen, Yiwei | Fan, Junfen | Fan, Zhenliang
Article Type: Research Article
Abstract: BACKGROUND: It is still unknown whether unsaturated fatty acids (UFA) have the same effect on preventing cognitive impairment in chronic kidney disease (CKD) patients as in healthy people. OBJECTIVE: To investigate the protective effect of dietary UFA intake and proportion on cognitive impairment in patients with CKD. METHODS: We extracted data from the National Health and Nutrition Examination Survey (NHANES, 2011–2014) on participants with a previous diagnosis of CKD and at least one complete cognitive assessment (Consortium to Establish a Registry for Alzheimer’s Disease test, Animal Fluency Test and Digit Symbol Substitution Test). …We used the lower quartile of the total scores of these three tests as the cut-off point, and divided the participants into two groups of normal cognitive performance and low cognitive performance to extract participants’ intake of various UFA from the NHANES dietary module. Show more
DOI: 10.3233/THC-240671
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Chen, Pan | Wang, Xiaojie | Yan, Pijun | Jiang, Chunxia | Lei, Yi | Miao, Ying
Article Type: Research Article
Abstract: BACKGROUND: Dysfunctions in metabolism and endocrine systems are outcomes of disruptions in human physiological processes, often leading to disease onset. External factors can hinder the human body’s innate capacity for self-regulation and healing, particularly when immune responses are compromised, allowing these factors to interfere with normal bodily functions directly. OBJECTIVE: To explore the effect of uric acid expression water in blood on the occurrence of atrial fibrillation in patients with hyperthyroidism, the expression level of uric acid in the blood and other physiological indexes were compared between patients with no symptoms of atrial fibrillation and patients …with hyperthyroidism with symptoms of atrial fibrillation, to find the correlation between them. METHODS: A group of 112 hyperthyroidism patients who were admitted to our hospital from September 2019 to March 2020 were chosen and split into two groups. The control group consisted of 56 individuals (21 men and 35 women) aged between 16 and 86 years old, with an average age of 46.23 years (± 7.63). The observation group consisted of 56 individuals (24 males and 32 females) between 15 and 79 years, with an average age of 53.44 years (± 8.91). RESULTS: In the patients who were not treated with drugs before hospitalization the disease course and symptoms varied. The patients’ clinical medical and demographic data were recorded and the patients’ physiological indexes were obtained through blood tests and analysis. The differences between the two groups were analyzed by renal function, blood lipid index, thyroid function, and cardiac ultrasound, and these influencing factors were analyzed by regression analysis. The research adhered to ethical norms and ensured clear data presentation by using a rigorous technique to compare uric acid levels and physiological indicators among various patient groups. CONCLUSION: The study concentrated on the validation, repeatability, and contextual interpretation of data to provide a robust and rigorously scientific comparison. The most common is the increase of uric acid in the blood, which can induce other diseases, and atrial fibrillation is one of the most common diseases of cardiovascular diseases. Show more
Keywords: Uric acid level, serum, atrial fibrillation, hyperthyroidism, endocrine
DOI: 10.3233/THC-232028
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Wu, Xiaoqian | Chen, Cheng | Quan, Lili
Article Type: Research Article
Abstract: BACKGROUND: Traditional methods have the limitations of low accuracy and inconvenient operation in analyzing students’ abnormal behavior. Hence, a more intuitive, flexible, and user-friendly visualization tool is needed to help better understand students’ behavior data. OBJECTIVE: In this study a visual analysis and interactive interface of students’ abnormal behavior based on a clustering algorithm were examined and designed. METHODS: Firstly, this paper discusses the development of traditional methods for analyzing students’ abnormal behavior and visualization technology and discusses its limitations. Then, the K-means clustering algorithm is selected as the solution to find potential …abnormal patterns and groups from students’ behaviors. By collecting a large number of students’ behavior data and preprocessing them to extract relevant features, a K-means clustering algorithm is applied to cluster the data and obtain the clustering results of students’ abnormal behaviors. To visually display the clustering results and help users analyze students’ abnormal behaviors, a visual analysis method and an interactive interface are designed to present the clustering results to users. The interactive functions are provided, such as screening, zooming in and out, and correlation analysis, to support users’ in-depth exploration and analysis of data. Finally, the experimental evaluation is carried out, and the effectiveness and practicability of the proposed method are verified by using big data to obtain real student behavior data. RESULTS: The experimental results show that this method can accurately detect and visualize students’ abnormal behaviors and provide intuitive analysis results. CONCLUSION: This paper makes full use of the advantages of big data to understand students’ behavior patterns more comprehensively and provides a new solution for students’ management and behavior analysis in the field of education. Future research can further expand and improve this method to adapt to more complex students’ behavior data and needs. Show more
Keywords: Clustering algorithm, student behavior, big data, visual analysis, interactive interface
DOI: 10.3233/THC-232054
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
Article Type: Research Article
Abstract: BACKGROUND: Double rocking jump rope training can effectively enhance physical recovery, adaptability to exercise load, and lower limb muscle strength of badminton players in sports colleges, thus offering valuable insights for improving training methods in sports colleges and universities. OBJECTIVE: To investigate the effect of double rocking jump rope training on the lower limb muscle strength of badminton players specializing in badminton in sports colleges. METHODS: An experimental study was conducted through a ten-week teaching intervention experiment with badminton players. Relevant heart rate indexes and badminton related lower limb muscle strength indexes were …measured before and after the experiment. The data of the measured relevant indexes were statistically and analytically analyzed. At the end of the experiment, the physical recovery level and the heart’s adaptability to the exercise load of the control group were improved, and the lower limb muscle strength test indexes and sports performance were better than before the experiment. In the experimental group, badminton players’ physical function, anaerobic metabolism of the body and other aspects also improved. RESULTS: The physical function of the experimental group of badminton players, the energy supply capacity of the body anaerobic metabolism and aerobic work capacity all have an enhancement effect, enabling badminton players to adapt to large exercise loads quickly and improve the recovery rate of physical fitness. CONCLUSION: The introduction of double rocking jump rope into badminton training classes in sports colleges and universities as a means of lower limb muscle strength training is conducive to improving the level of lower limb muscle strength of special badminton players, enriching the teaching and training means of lower limb muscle strength in sports colleges and universities, and broadening the research field of lower limb muscle strength in badminton in sports colleges and universities. Show more
Keywords: Double rocking jump rope, badminton, lower limb muscle strength, AdaBoost algorithm optimization
DOI: 10.3233/THC-231868
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Lu, Jian-Lin | Yuan, Xiao-Yan | Zhang, Jin-Shan | Li, Yuan
Article Type: Research Article
Abstract: BACKGROUND: Ever since the GALAD (gender-age-Lens culinaris agglutinin-reactive alpha-fetoprotein-alpha-fetoprotein-des-gamma-carboxy prothrombin) logistic regression model was established to diagnose hepatocellular carcinoma (HCC), there has been no high-level evidence that evaluates and summarizes it. OBJECTIVE: This meta-analysis was performed to assess the diagnostic ability of the GALAD model. METHODS: The following databases were systematically searched for original diagnostic studies on HCC: PubMed, Embase, Medline, the Web of Science, Cochrane Library, China National Knowledge Infrastructure Wanfang (China), Wiper and the Chinese BioMedical Literature Database. After screening the search results according to our criteria, the Quality Assessment …of Diagnostic Accuracy Studies 2 tool was used to evaluate the methodologic qualities, and statistical software were used to output the statistics. RESULTS: Ultimately, 10 studies were included and analyzed. The results revealed the pooled sensitivity and specificity of the GALAD model to be 0.86 (95% confidence interval [CI]: 0.82, 0.90) and 0.90 (95% CI: 0.87, 0.92), respectively, for all-stage HCC. The area under the curve (AUC) was 0.94. For early-stage HCC, the pooled sensitivity and specificity of the GALAD model were 0.83 (95% CI: 0.78, 0.87) and 0.81 (95% CI: 0.78, 0.83), respectively. The AUC was 0.90. CONCLUSION: This meta-analysis confirmed that the GALAD model has excellent diagnostic performance for early-stage and all-stage HCC and can maintain high sensitivity and specificity in early-stage HCC. Therefore, the GALAD model is qualified for screening early-stage canceration from chronic liver disease. Show more
Keywords: HCC, logistic models, biomarkers, diagnostic efficiency, early detection of cancer
DOI: 10.3233/THC-231470
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: De Mauro, Domenico | Salber, Jochen | Stimolo, Davide | Florian, Ende | Citak, Mustafa
Article Type: Review Article
Abstract: BACKGROUND: In periprosthetic joint infections (PJIs), the surgeon’s role becomes pivotal in addressing the infection locally, necessitating the surgical removal of infected and necrotic tissue. Opportunity to enhance the visualization of infected tissue during surgery could represent a game-changing innovation. OBJECTIVE: The aim of this narrative review is to delineate the application of intraoperative fluorescence imaging for targeting infected tissues in PJIs. METHODS: A systematic review, adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, was carried out. The search included multiple online database; MEDLINE, Scopus, and Web of …Science. For data extraction the following were evaluated: (i) diagnosis of musculoskeletal infection; (ii) use of intraoperative fluorescence imaging; (iii) infected or necrotic tissues as target. RESULTS: Initially, 116 studies were identified through online database searches and reference investigations. The search was narrowed down to a final list of 5 papers for in-depth analysis at the full-text level. Subsequently, 2 studies were included in the review. The study included a total of 13 patients, focusing on cases of fracture-related infections of the lower limbs. CONCLUSION: The primary and crucial role for orthopedic surgeons in PJIs is the surgical debridement and precise removal of necrotic and infected tissue. Technologies that enable clear and accurate visualization of the tissue to be removed can enhance the eradication of infections, thereby promoting healing. A promising avenue for the future involves the potential application of intraoperative fluorescence imaging in pursuit of this objective. Show more
Keywords: Intraoperative fluorescence imaging, periprosthetic joint infections, total joint arthroplasty, necrotic tissue, 5-aminolevulinic acid
DOI: 10.3233/THC-240479
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zhang, Xinliang | Wang, Lin | Li, Mei | Dong, Shimin
Article Type: Research Article
Abstract: BACKGROUND: Investigating the secondary sepsis of pneumonia is of great significance for rapid diagnosis and early treatment of sepsis. OBJECTIVE: This study aimed to investigate the predictive value of micro ribonucleic acids (miRNA) 7110-5p and miR-223-3p in sepsis secondary to pneumonia. A miRNA microarray was used to analyze the differences in miRNA expression between patients with pneumonia and those with sepsis secondary to pneumonia. METHODS: The study included a total of 50 patients with pneumonia and 42 patients with sepsis secondary to pneumonia. Quantitative polymerase chain reaction analysis was conducted to measure the …circulating miRNA expression levels in patients and assess their correlations with clinical characteristics and prognosis. In this study, nine miRNAs – hsa-miR-4689-5p, hsa-miR-4621-5p, hsa-miR-6740-5p, hsa-miR-7110-5p, hsa-miR-765, hsa-miR-940, hsa-miR-213-5p, hsa-miR-223-3p, and hsa-miR-122 – met the screening criteria of having a fold change ⩾ 2 or < 0.5; p < 0.01 indicated significant differences in the results. RESULTS: The expression levels of miR-7110-5p and miR-223-3p differed between the two patient groups, being up-regulated in the plasma of patients with sepsis secondary to pneumonia. miR-7110-5p and miR-223-3p showed higher expression levels in both patients with pneumonia and sepsis compared to healthy controls. Moreover, the receiver operating characteristic curve revealed that the areas under the curve for predicting pneumonia using miR-7110-5p were 0.781 while those for predicting sepsis secondary to pneumonia were 0.862. For miR-223-3p, the corresponding values for predicting pneumonia and sepsis secondary to pneumonia were 0.879 and 0.924, respectively. However, there were no significant differences in the levels of miR-7110-5p and miR-223-3p between the plasma of survived and deceased patients with sepsis. CONCLUSIONS: MiR-7110-5p and miR-223-3p have the potential to serve as biological indicators for predicting sepsis secondary to pneumonia. Show more
Keywords: miR-7110-5p, miR-223-3p, pneumonia, sepsis secondary to pneumonia
DOI: 10.3233/THC-231137
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Wang, Kai | Zhu, Dongming | Chang, Zimin | Wu, Zhiyong
Article Type: Research Article
Abstract: BACKGROUND: The Ultimate Fighting Championship (UFC) stands as a prominent global platform for professional mixed martial arts, captivating audiences worldwide. With its continuous growth and globalization efforts, UFC events have garnered significant attention and achieved commendable results. However, as the scale of development expands, the operational demands on UFC events intensify. At its core, UFC thrives on the exceptional performances of its athletes, which serve as the primary allure for audiences. OBJECTIVE: This study aims to enhance the allure of UFC matches and cultivate exceptional athletes by predicting athlete performance on the field. To achieve this, …a recurrent neural network prediction model based on Bidirectional Long Short-Term Memory (BiLSTM) is proposed. The model seeks to leverage athlete portraits and characteristics for performance prediction. METHODS: The proposed methodology involves constructing athlete portraits and analyzing athlete characteristics to develop the prediction model. The BiLSTM-based recurrent neural network is utilized for its ability to capture temporal dependencies in sequential data. The model’s performance is assessed through experimental analysis. RESULTS: Experimental results demonstrate that the athlete performance prediction model achieved an overall accuracy of 0.7524. Comparative analysis reveals that the proposed BiLSTM model outperforms traditional methods such as Linear Regression and Multilayer Perceptron (MLP), showcasing superior prediction accuracy. CONCLUSION: This study introduces a novel approach to predicting athlete performance in UFC matches using a BiLSTM-based recurrent neural network. By leveraging athlete portraits and characteristics, the proposed model offers improved accuracy compared to classical methods. Enhancing the predictive capabilities in UFC not only enriches the viewing experience but also contributes to the development of exceptional athletes in the sport. Show more
Keywords: Recurrent neural network, UFC, athlete performance, winning percentage forecast, evaluation algorithm, deep learning, BiLSTM, XGBoost
DOI: 10.3233/THC-232000
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Gao, Fei | Wang, Yongcun | Li, Hao | Yin, Jilai
Article Type: Research Article
Abstract: BACKGROUND: Cervical cancer (CC) is a common female malignancy, with a global incidence rate second only to breast cancer. OBJECTIVE: To propose a new idea for early treatment and auxiliary diagnosis of CC by exploring the diagnostic and prognostic implications of serum miR-182 in CC. METHODS: We enrolled 70 CC patients, 35 cervical intraepithelial neoplasia (CIN) patients and 35 healthy controls (HCs), who visited The First Affiliated Hospital of Hainan Medical College Hospital between January 2015 and April 2016. miR-182 expression was quantified by real-time quantitative PCR and compared among the three groups. …The correlation of serum miR-182 expression with patients’ clinical features was evaluated. The receiver operating characteristic curve (ROC) and the Kaplan-Meier method were used to evaluate the early diagnostic value and prognostic value of serum miR-182. Cox regression analysis was performed to determine serum miR-182 expression and its important role in predicting CC patients’ prognosis. RESULTS: Serum miR-182 expression was determined to be 0.345 ± 0.094, 0.369 ± 0.076, and 0.586 ± 0.157 in CC patients, CIN patients, and HCs, respectively (P < 0.001). Serum miR-182 expression had an obvious association with lymph node metastasis and pathological differentiation (P < 0.05). The area under the ROC curve (AUC) of serum miR-182 was 0.709 (95% CI: 0.622–0.795), the critical value was 0.456, the sensitivity was 81.4%, and the specificity was 52.9%. CC patients were grouped as either the low- (miR-182 < 0.3) or high-level group (miR-182 ⩾ 0.03) based on serum miR-182 levels, and a Cox regression model of OS was established. Serum miR-182 expression was identified as a factor independently influencing CC patients’ OS (P = 0.028); the death risk of the high-level group was 3.246 times that of the low-level group. CONCLUSION: Serum miR-182 expression is not only a biomarker for early diagnosis of CC, but also one of the independent factors influencing the survival and prognosis of CC patients. Show more
Keywords: Serum miR-182, cervical cancer, diagnosis, prognosis
DOI: 10.3233/THC-231681
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Kara, Seher | Nokay, Aziz Emre
Article Type: Review Article
Abstract: BACKGROUND: Total knee arthroplasty (TKA) is a common procedure for treating end-stage degenerative knee osteoarthritis (OA). Despite the generally excellent outcomes, postoperative complications such as loss of muscle strength and joint limitation can occur. Therefore, postoperative physical rehabilitation is crucial for regaining strength, functionality, and managing pain. Various rehabilitation strategies employ different methods to reduce pain severity, regain muscle strength, assist patients in returning to daily activities, and increase functionality. In recent years, technological advancements have transformed rehabilitation methods. In addition to traditional applications, new methods have been incorporated into treatment plans. OBJECTIVE: This study aimed …to evaluate novel physical rehabilitation methods and options following OA. METHODS: A literature review was conducted to identify and investigate recent and commonly used novel rehabilitation methods. The search terms “Total Knee Arthroplasty,” “New Rehabilitation TKA,” “Novel Rehabilitation” “Novel Rehabilitation in Arthroplasty” and “Technology Knee Rehabilitation” were searched across PubMed and Google Scholar databases, covering literature from the past 15 years. Studies on telerehabilitation, functional electric stimulation, virtual reality, yoga, and their reported outcomes were evaluated using specific keywords. The results of various studies on novel rehabilitation methods were gathered and compared to traditional treatment plans based on functionality and applicability. RESULTS: Several studies reported that telerehabilitation was not inferior to traditional rehabilitation, with some showing positive outcomes. Telerehabilitation following TKA demonstrated positive effects on functionality and patient satisfaction. Functional electric stimulation showed significant improvements in muscle strength and pain reduction. Virtual reality demonstrated superior effects on proprioception and posture outcomes. The use of yoga in rehabilitation also resulted in improved proprioception and pain reduction. CONCLUSION: In addition to traditional rehabilitation methods, new approaches have shown significant positive outcomes for patients who have received TKA. We are in an era of digital development, and as such, new rehabilitation techniques, particularly those involving digital advancements, will continue to emerge. With the trend toward personalized approaches in medicine, more new techniques or methods will be incorporated into rehabilitation plans, leading to better recovery outcomes from TKA. Show more
Keywords: TKA, rehabilitation, technology, telerehabilitation, virtual reality, functional electric stimulation, novel methods in rehabilitation
DOI: 10.3233/THC-240628
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Mittal, Priya | Jadhav, Ganesh Ranganath | Abdul Kader M, Mohammed | Al-Qarni, Mohammed A. | Sindi, Abdulelah Sameer | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry. OBJECTIVE: To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics. METHOD: Preclinical dental students (n = 50) were divided into two groups. The students in group I (n = …25) attended a hands-on live demonstration performed by one faculty while students in group II (n = 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups. RESULTS: The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p = 0.000133). CONCLUSION: Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics. Show more
Keywords: Dental undergraduates, educational measurement, education, dental, hands-on demonstration, video recording
DOI: 10.3233/THC-231757
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Cen, Gengyu | Xia, Yumei | Liang, Zhijian
Article Type: Research Article
Abstract: BACKGROUND: Stroke is one of the leading causes of disability and mortality worldwide. OBJECTIVE: To identify the regulatory network of microRNAs (miRNAs) and mRNAs to clarify molecular mechanisms in stroke. METHODS: Four miRNA datasets and two mRNA datasets of stroke were downloaded from the GEO database. R-Studio was utilized to analyze differentially expressed miRNAs (DEmiRNAs) and mRNAs (DEmRNAs) in the blood of stroke and control patients. FunRich software was utilized to conduct GO and biological pathway analysis on DEmiRNAs, and to search for transcription factors (TFs) of DEmiRNAs. Subsequently, we used miRDB, miRTarBase, …and TargetScan to identify DEmiRNAs target genes and intersected with DEmRNAs to find common target genes. The miRNA-mRNA regulatory network of common target genes was constructed by using the Cytoscape. The biological and functional roles of target genes in the regulatory network were predicted using GO and KEGG pathway analyses. RESULTS: 464 DEmiRNAs and 329 DEmRNAs were screened. The top ten TFs (SP1, SP4, EGR1, TCF3, NKX6-1, ZFP161, RREB1, MEF2A, NFIC, POU2F1) were visualized. 16747 target genes of DEmiRNAs were predicted. Target genes were intersected with DEmRNAs, 107 common target genes and 162 DEmiRNAs regulating these common genes were obtained, and then a regulatory network was constructed. Target genes of the regulatory network were primarily enriched in VEGF signaling pathway, lipid and atherosclerosis, T cell receptor signaling pathway. CONCLUSION: This study found that VEGF signaling pathway, lipid and atherosclerosis, T cell receptor signaling pathway are implicated in the biological process of stroke by constructing the regulatory network of miRNAs-mRNAs, which may have guide significance for the pathogenesis and treatment of stroke. Show more
Keywords: Stroke, microRNAs, mRNAs, molecular mechanisms, bioinformatics analysis
DOI: 10.3233/THC-231357
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Cheng, Weigen | Xu, Cheng | Wang, Fen | Ding, Yongmin | Tu, Jianglong | Xia, Linglin
Article Type: Research Article
Abstract: BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder, which can cause serious damage to multiple human systems. Although polysomnography (PSG) is the current gold standard for diagnosis, it is complex and expensive. Therefore, it is of great significance to find a simple, economical and rapid primary screening and diagnosis method to replace PSG for the diagnosis of OSA. OBJECTIVE: The purpose of this study is to propose a new method for the diagnosis and classification of OSA, which is used to automatically detect the duration of sleep apnea hypopnea events (AHE), so …as to estimate the ratio(S) of the total duration of all-night AHE to the total sleep time only based on the sound signal of sleep respiration, and to identify OSA. METHODS: We performed PSG tests on participants and extracted relevant sleep breathing sound signal data. This study is carried out in two stages. In the first stage, the relevant PSG report data of eligible subjects were recorded, the total duration of AHE in each subject’s data was extracted, and the S value was calculated to evaluate the severity of OSA. In the second stage, only the sleep breath sound signal data of the same batch of subjects were used for automatic detection, and the S value in the sleep breath sound signal was extracted, and the S value was compared with the PSG diagnosis results to calculate the accuracy of the experimental method. RESULTS: Among 225 subjects. Using PSG as the reference standard, the S value extracted from the PSG diagnostic data report can accurately diagnose OSA(accuracy rate 99.56%) and distinguish its severity (accuracy rate 95.11%). The accuracy of the S value detected in the sleep breathing sound signal in the diagnosis of severe OSA reached 100%. CONCLUSION: The results show that the experimental parameter S value is feasible in OSA diagnosis and classification. OSA can be identified and evaluated only by sleep breathing sounds. This method helps to simplify the diagnostic grading of traditional OSA and lays a foundation for the subsequent development of simple diagnostic grading equipment. Show more
Keywords: Obstructive sleep apnea, sound, Duration, diagnosis and classification
DOI: 10.3233/THC-231900
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Liang, Dakai | Liang, Dandan | Liu, Jin | Zheng, Yiying | Huang, Dehua | Li, Zeliang | Huang, Xiaoyu | Chen, Jiyan
Article Type: Research Article
Abstract: BACKGROUND: Despite the considerable progress made in preventative methods, medication, and interventional therapies, it remains evident that cardiovascular events (CVEs) continue to be the primary cause of both death and morbidity among individuals diagnosed with coronary artery disease (CAD). OBJECTIVE: To compare the connection between lipoprotein a (Lp[a]), fibrinogen (Fib), and both parameters combined with all-cause mortality to detect their value as prognostic biomarkers. METHODS: This is a retrospective study. Patients diagnosed with CAD between January 2007 and December 2020 at the Guangdong Provincial People’s Hospital (China) were involved in the study. 43,367 patients …met the eligibility criteria. The Lp(a) and Fib levels were distributed into three tertile groups (low, medium, and high). All of the patients included in the study were followed up for all-cause mortality. Kaplan–Meier and Cox regression were performed to determine the relationship between Lp(a), Fib, and all-cause mortality. A concordance statistics model was developed to detect the impact of Fib and Lp(a) in terms of anticipating poor outcomes in patients with CAD. RESULTS: Throughout a median follow-up of 67.0 months, 6,883 (15.9%) patients died. Participants with high Lp(a) (above 27.60 mg/dL) levels had a significantly higher risk for all-cause mortality than individuals with low Lp(a) levels (below 11.13 mg/dL; adjusted hazard ratio [aHR] 1.219, 95% confidence interval [CI]: 1.141–1.304, p < 0.001). Similarly, patients with high Fib levels (above 4.32 g/L) had a significantly greater risk of developing all-cause mortality compared with those with reduced Fib levels (below 3.41 g/L; aHR 1.415, 95% CI: 1.323–1.514, p < 0.001). Patients with raised Lp(a) and Fib levels had the maximum risk for all-cause mortality (aHR 1.702; 95% CI: 1.558–1.859, p < 0.001). When considered together, Lp(a) and Fib caused a significant elevation of the concordance statistic by 0.009 (p < 0.05), suggesting a higher value for predicting mortality when combining the two indicators. CONCLUSION: High Lp(a) and Fib levels could be used as predictive biomarkers for all-cause mortality in individuals with CAD. The prediction accuracy for all-cause mortality improved after combining the two parameters. Show more
Keywords: Lipoprotein(a), fibrinogen, coronary artery disease, all-cause mortality
DOI: 10.3233/THC-240005
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Sun, Yuyan | Li, Qian
Article Type: Research Article
Abstract: BACKGROUND: Dental extraction or tooth extraction is a common clinical radical treatment surgery. OBJECTIVE: To explore the efficacy and safety of remimazolam in tooth extraction surgery in a randomized, single-blind, multi-center clinical trial. METHOD: Patients who underwent tooth extraction surgery at Jinan Stomatological Hospital from April 2022 to March 2023 were selected as the research subjects, and they were divided into a control group and an observation group using the random arrangement table method. The patients in the control group were anesthetized with midazolam, and the patients in the observation group were anesthetized …with remimazolam. Collect the general demographic data of the patients, use the propensity score matching method (PSM) to balance the baseline data of the two groups, and use t -test, chi-square test, and analysis of variance to compare the hemodynamics, anesthesia maintenance period indicators, and alertness/Sedation scores and occurrence of adverse reactions. RESULT: PSM matching was performed according to a 1:1 ratio, and 40 patients were included in the observation and control groups. There was no statistical significance in the baseline data of the two groups. Compared with T0 , the hemodynamic indexes of both groups of patients increased at T1 , T2 , T3 , T4 , and T5 (P < 0.05), but the indexes at T0 and T2 were the same. The same (P > 0.05), and the indicators of the observation group at T1 , T3 , T4 , and T5 were higher than those of the control group (P < 0.05); the administration time of the two groups of patients was the same (P > 0.05), but the observation group The recovery time and onset of effect were shorter than those in the control group (P < 0.05); at T0 , the clinical behavior scores of the two groups of patients were the same (P > 0.05), and at T1 , the scores of the observation group were lower than those of the control group (P < 0.05); at T0 and T1 , the alertness/sedation scores of the patients in the observation group were lower than those in the control group, but at T2 , the scores of the patients in the observation group were higher than those in the control group (P < 0.05); the total clinical adverse reactions of the patients in the observation group were The incidence rate (5.00%) was lower than that of the control group (30.00%) (P < 0.05). CONCLUSION: The use of remimazolam during tooth extraction can stabilize the patient’s hemodynamics, shorten the recovery and onset time, stabilize the patient’s behavior, have an excellent soothing effect, have fewer adverse reactions, and be safer, so it is worthy of use. Show more
Keywords: Remazolam, tooth extraction, sedation, safety, single-masked, multi-center
DOI: 10.3233/THC-240237
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Xu, Bi-Qing | Si, Qin | Feng, Yin-Ping | Guo, Jing | Jiang, Li-Ping
Article Type: Research Article
Abstract: BACKGROUND: Patients who have been treated with mechanical ventilation for more than 72 hours are susceptible to symptoms such as hypoxia and respiratory muscle fatigue after weaning, which may result in weaning difficulty and delay, as well as an increased incidence of negative emotions such as anxiety and depression. Correct pulmonary rehabilitation exercise technique and timing can improve the weaning success rate, reduce the disability rate, and reduce the incidence of pulmonary infection, as well as reduce medical expenses. OBJECTIVE: This article provides a review of pulmonary rehabilitation interventions for mechanically ventilated patients, searching relevant literature …through databases such as CNKI and PubMed, aiming to provide guidance for the successful weaning of mechanically ventilated patients. METHODS: We selected articles related to pulmonary rehabilitation interventions for mechanically ventilated patients from CNKI (China National Knowledge Infrastructure) and PubMed over the years. RESULTS: This article provides a comprehensive review of the research on lung rehabilitation for patients who are mechanically ventilated during the weaning process in an effort to serve as a guide for a successful transition from mechanical ventilation. CONCLUSION: Early pulmonary rehabilitation training can effectively increase the pulmonary function level and ventilation function of patients and reduce the duration of mechanical ventilation and hospitalization, and is an effective, safe, and feasible treatment method. Show more
Keywords: Mechanical ventilation, pulmonary rehabilitation, research progress, weaning
DOI: 10.3233/THC-231562
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Vater, Adrian Matthias | Lamby, Philipp | Moncher, Johanna | Schmidt, Karsten | Jordan, Martin | Jakubietz, Michael | Meffert, Rainer | Jakubietz, Rafael
Article Type: Research Article
Abstract: BACKGROUND: Coverage of soft tissue defects following surgery at the trochanteric area is challenging. Revision surgery in case of compromised wound healing may lead to soft tissue defects requiring reconstruction with pedicled or free flaps. Previous access to the hip joint may jeopardize neurovascular structures relevant to the flap. OBJECTIVE: In this study, we evaluated if the use of a pedicled anterior lateral thigh (ALT) flap is a valuable option for soft tissue reconstruction. METHODS: In this retrospective study, seven patients were included. Defect etiology was tumor resection in one case, screw osteosynthesis …in another case and total hip arthroplasty in three cases. All patients underwent reconstruction by proximal pedicled anterior lateral thigh (ALT) flap. RESULTS: Pedicled ALT flap was a safe procedure in all cases. One patient showed delayed wound healing with need for additional surgery. No further complications were observed. CONCLUSIONS: Pedicled ALT flap transfer represents a reliable option for soft tissue coverage in the trochanteric area after primary surgery such as hip arthroplasty, osteosynthesis or tumor resection. Show more
Keywords: ALT flap, trochanteric defect, reconstructive surgery, revision surgery, hip arthroplasty, plastic surgery
DOI: 10.3233/THC-240381
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Liao, Liangchuang | Zhang, Guoan | Hu, Mingwei
Article Type: Research Article
Abstract: BACKGROUND: Human gait pattern recognition and compliance control are key technologies for achieving high coordination and assistance between exoskeleton robots and human movements. OBJECTIVE: In order to improve the adaptability of exoskeleton robots to the human body, this paper proposes an exoskeleton compliance control strategy based on dual interaction torque phase separation control method. METHODS: A support phase swing phase split control strategy based on dual interaction torque is proposed. Utilize the interaction force of human joints and adopt a model-based method to control the support phase. By utilizing the interaction force of exoskeleton …joints and using a torque closed-loop method to control the swing phase, a multi-state control method of motion is achieved. RESULTS: A lower limb exoskeleton knee joint testing platform is built to verify the proposed human gait recognition The effectiveness of human-machine interaction force identification and human-machine coupling system compliance control technology. CONCLUSION: The proposed control method can effectively adjust joint torque, enabling the exoskeleton robot to maintain balance and stability during the entire walking phase. Show more
Keywords: Exoskeleton robots, compliance control, pattern recognition
DOI: 10.3233/THC-240050
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2024
Authors: Li, Chao | He, Gang | Mi, Zeyu | Huang, Daxin | Hu, Yulin
Article Type: Research Article
Abstract: BACKGROUND: Currently, surgery is the mainstay of the clinical treatment of vestibular migraine. OBJECTIVE: To investigate the clinical efficacy and safety of using transesophageal echocardiography-guided interventional closure of the patent foramen ovale (PFO) in the treatment of vestibular migraine. METHODS: The study included 52 patients with vestibular migraine who were admitted to our hospital between June 2019 and June 2021. All selected patients underwent a transesophageal echocardiography-guided interventional closure of the PFO and were followed up for one year after surgery. We observed the clinical efficacy and surgical success rate one year after …surgery and compared the improvement in clinical symptoms and perioperative safety at different time points. RESULTS: The overall remission rate and the surgical success rate for the 52 patients with vestibular migraine one year after surgery were 86.54% and 96.15%, respectively. Compared to the pre-surgery levels, there was a significant progressively decreasing trend in the scores on the Headache Impact Test-6 (HIT-6), Visual Analogue Scale (VAS), Migraine Disability Assessment (MIDAS) questionnaire, frequency of headaches, and duration of headaches in patients with vestibular migraine at 1, 3, and 6 months after surgery (P < 0.05). Among the 52 patients, one developed atrial fibrillation three hours after surgery, which then spontaneously converted to sinus rhythm, and none of the other patients had adverse outcomes such as hematoma at the puncture site during the perioperative period. CONCLUSION: Transesophageal echocardiography-guided interventional closure of the PFO for treating vestibular migraine significantly improved the symptoms of migraine in patients, with a high surgical success rate, significant clinical efficacy, and favorable safety. Show more
Keywords: Efficacy, interventional closure, patent foramen ovale, safety, transesophageal echocardiography, vestibular migraine
DOI: 10.3233/THC-231815
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Liang, Han | Li, Hao | Xia, Nan | Chen, Jingjing | Gao, Linlin | Liu, Hao | Lyu, Ping | Guo, Xiaolin | Yang, Ziwei
Article Type: Research Article
Abstract: BACKGROUND: Long noncoding RNAs (lncRNAs) participate in diseases, especially tumorigenesis, including gastric cancer (GC). Although lncRNAs in GC tissues have been extensively studied in previous research, the possible significance of circulating lncRNAs in diagnosing GC is still unknown. OBJECTIVE: The present work investigated lncRNAs ZFPM2-AS1 and XIST with high expression in GC tissues proved as potential plasma biomarkers from 20 early GC cases, 100 GC cases, and 90 normal subjects. METHODS: The possible correlation between ZFPM2-AS1 and XIST expression levels was analyzed with general characteristics and clinicopathological features. The performance in diagnosis was …assessed according to receiver operating characteristic (ROC) analysis. RESULTS: According to the results, XIST and ZFPM2-AS1 expression remarkably increased within GC plasma relative to normal subjects (P < 0.01); besides, lncRNA XIST expression after surgery had a tendency of downregulation compared with preoperative levels (P < 0.05). Moreover, the area under ROC curve (AUC) values were 0.62 for ZFPM2-AS1 and 0.68 for XIST, while the pooled AUC value of CA-724 and two lncRNAs was 0.751. CONCLUSION: Circulating lncRNAs ZFPM2-AS1 and XIST can serve as the candidate plasma biomarkers used to diagnose GC. Show more
Keywords: Long noncoding RNA, gastric cancer, ZFPM2-AS1, XIST, diagnosis, plasma, biomarker
DOI: 10.3233/THC-232033
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zheng, Xuna | Wang, Xianglong | Zhu, Pin
Article Type: Research Article
Abstract: BACKGROUND: With the improvement of the level of science and technology, diagnosis and treatment technology of ophthalmology has continuously improved, especially with the rise of optical coherence tomography. Alternative methods have enabled clinicians to obtain more information and make greater breakthroughs in the occurrence and development of many ophthalmic diseases. OBJECTIVE: To investigate changes in retinal structure in the macular area of senile diabetic cataract patients undergoing cataract phacoemulsification. METHODS: This was a prospective cohort study. A total of 68 cataract patients (78 eyes) who voluntarily received phacoemulsification combined with intraocular lens implantation …in the Department of Ophthalmology of our hospital from December 2018 to December 2021 were selected. They were divided into A (diabetic) and B (non-diabetic) according to whether they were complicated with diabetes. There were 24 cases (28 eyes) in A and 44 cases (50 eyes) in B. Cataract patients were collected before and after surgery. Day, 1 week, and 1 month, data on the average thickness of the fovea retina and thickness of the retinal nerve fiber layer around the optic disc (average thickness, nasal thickness, topic side thickness, upper thickness, and lower thickness) were statistically analyzed analyze. RESULTS: The average retinal thickness of the macular fovea in Group A was found to be greater than that of Group B, however, there was no statistically significant difference between the two groups. At week one and week thirty, Group A’s layer of retinal nerve fibers surrounding the optic disc thickened; there was no discernible difference between the two groups. One week and one month following surgery, however, showed a one-week difference in upper thickness compared to preoperative days. There was no discernible change between the preoperative and 1-day times. CONCLUSION: Both diabetic cataract patients and simple age-related cataract patients will have different degrees of increased foveal retinal thickness after surgery. However, the foveal retinal thickness of patients with diabetes increases more. Show more
Keywords: Optical coherence tomography angiography, phacoemulsification, senile cataract, blood flow density, retinal thickness, foveal avascular area
DOI: 10.3233/THC-231966
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Wang, Tong-Yue | Guo, Jin-Yuan | Zhou, Zhen | Li, Shi-Yi | Li, Shao-Bing | Xu, Shu-Lan
Article Type: Research Article
Abstract: BACKGROUND: The substitution of missing teeth with implants is a dependable and anticipated therapeutic approach. Despite numerous studies affirming long-term success rates, there exists a spectrum of potential biological and aesthetic complications. OBJECTIVE: The primary objective of this study was to assess patient responses subsequent to surgical interventions, with a specific emphasis on the utilization of xenogenic collagen matrix (XCM), both with and without the application of a stent secured over healing abutments, in the context of keratinized gingival mucosa augmentation. The principal aim was to evaluate and draw comparisons between the clinical outcomes resulting from these …two procedural approaches, with a particular focus on critical parameters encompassing post-operative complications, patient comfort, and the overall efficacy in achieving successful keratinized tissue augmentation. methods: Sixty patients were selected for this study. The patients were divided into three groups: A, B, and a control group, with each group comprising 20 participants. We used XCM in experimental group A, XCM covered with surgical stent in experimental group B, and free gingival graft (FGG) in the control group. After the surgical procedure, patients were required to complete a visual analogue scale (VAS) questionnaire for post-operative complications, and a quality of life (QOL) questionnaire on days 1, 3, and 7. RESULTS: Patients in the experimental groups A and B demonstrated markedly improved outcomes when compared with the control group. Assessments conducted on days 1, 3, and 7 demonstrated diminished levels of pain, bleeding, and swelling in both experimental groups, with experimental group B showing the least discomfort. The incorporation of XCM, either with or without stents, was associated with a reduction in analgesic consumption, underscoring its favorable influence on post-operative comfort, notwithstanding the exception of halitosis in experimental group B. CONCLUSION: Using XCM with or without a stent for keratinized tissue augmentation has better post-operative outcomes associated with reduced swelling, bleeding, and pain based on the QOL survey. This study provides data to support the clinical application of XCM and stents. Show more
Keywords: Collagen matrix, dental implants, keratinized mucosa, stents
DOI: 10.3233/THC-231863
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Lee, Soo Yong | Choi, Yu Sik | Kim, Min Hyuk | Chang, Woo Nam
Article Type: Research Article
Abstract: BACKGROUND: Despite the explosive increase in interest regarding Robot-Assisted Walking Training (RAWT) for stroke patients, very few studies have divided groups according to the severity levels of patients and conducted studies on the effects of RAWT. OBJECTIVE: The purpose of this study was to present a definite basis for physical therapy using the robot-assisted walking device through a more detailed comparison and analysis and to select the optimal target of RAWT. METHODS: This study was designed as a prospective and randomized controlled trial to investigate the effect of RAWT on balance, motor …function, and Activities of Daily Living (ADL) depending on severity levels in stroke patients. 100 participants were randomly divided into study and control groups in equal numbers. The study group was 49 and the control group was 47. One from the study group and three from the control group were eliminated. The study period is four weeks in total, and RAWT is performed five times a week for 40 minutes only for study group. During the same period, all group members had 30 minutes of Conventional Physiotherapy (CP) five times a week. RESULTS: The results of this study clearly confirmed that RAWT combined with CP produces more significant improvement in patients with stroke than the CP alone. And they indicated that RAWT had a more considerable effect in the poor or fair trunk control group for trunk balance and in the high fall risk group for balance. In motor function, RAWT showed its value in the severe and marked motor impairment group. The total or severe dependence group in ADL experienced more improvements for RAWT. CONCLUSION: This study can be concluded that the lower the level of physical functions, the more effective it responds to RAWT. As demonstrated in the results of this study, the potential of current robotic technology appears to be greatest at very low functional levels of stroke patients. Patients with low functional levels among stroke patients may benefit from robot rehabilitation. Show more
Keywords: ADL, balance, motor function, robot-assisted walking training, stroke
DOI: 10.3233/THC-232015
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Liu, Lei | Guo, Jing | Ding, Kun | Zhou, Guang-Nao | Feng, Yin-Ping | Zhang, Na-Na
Article Type: Research Article
Abstract: BACKGROUND: Globally, pulmonary tuberculosis is a significant public health and social problem. OBJECTIVE: We investigated the factors influencing the hospitalization cost of patients with pulmonary tuberculosis and grouped cases based on a decision tree model to provide a reference for enhancing the management of diagnosis-related groups (DRGs) of this disease. METHODS: The data on the first page of the medical records of patients with the primary diagnosis of pulmonary tuberculosis were extracted from the designated tuberculosis hospital. The influencing factors of hospitalization cost were determined using the Wilcoxon rank sum test and multiple …linear stepwise regression analysis, and the included cases were grouped using the chi-squared automated interaction test decision tree model, with these influential factors used as classification nodes. In addition, the included cases were grouped according to the ZJ-DRG grouping scheme piloted in Zhejiang Province, and the differences between the two grouping methods were compared. RESULTS: The length of hospital stay, respiratory failure, sex, and age were the determining factors of the hospitalization cost of patients with pulmonary tuberculosis, and these factors were incorporated into the decision tree model to form eight case combinations. The reduction in variance (RIV) using this grouping method was 60.60%, the heterogeneity between groups was high, the coefficients of variance ranged from 0.29 to 0.47, and the intra-group difference was small. The patients were also divided into four groups based on the ZJ-DRG grouping scheme piloted in Zhejiang Province. The RIV using this grouping method was 55.24, the differences between groups were acceptable, the coefficients of variance were 1.00, 0.61, 0.77, and 0.87, respectively, and the intra-group difference was significant. CONCLUSION: When the pulmonary tuberculosis cases were grouped according to the duration of hospital stay, respiratory failure, and age, the results were rather reasonable, providing a reference for DRG management and cost control of this disease. Show more
Keywords: Decision tree model, disease-related diagnostic grouping, hospitalization costs, influencing factors, pulmonary, tuberculosis
DOI: 10.3233/THC-231827
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Thomas, Anvin | Jose, Rejath | Syed, Faiz | Wei, Ong Chi | Toma, Milan
Article Type: Research Article
Abstract: BACKGROUND: Cardiovascular diseases remain a leading cause of global morbidity and mortality, with heart attacks and strokes representing significant health challenges. The accurate, early diagnosis and management of these conditions are paramount in improving patient outcomes. The specific disease, cardiovascular occlusions, has been chosen for the study due to the significant impact it has on public health. Cardiovascular diseases are a leading cause of mortality globally, and occlusions, which are blockages in the blood vessels, are a critical factor contributing to these conditions. OBJECTIVE: By focusing on cardiovascular occlusions, the study aims to leverage machine learning …to improve the prediction and management of these events, potentially helping to reduce the incidence of heart attacks, strokes, and other related health issues. The use of machine learning in this context offers the promise of developing more accurate and timely interventions, thus improving patient outcomes. METHODS: We analyze diverse datasets to assess the efficacy of various machine learning algorithms in predicting heart attacks and strokes, comparing their performance to pinpoint the most accurate and reliable models. Additionally, we classify individuals by their predicted risk levels and examine key features that correlate with the incidence of cardiovascular events. The PyCaret machine learning library’s Classification Module was key in developing predictive models which were evaluated with stratified cross-validation for reliable performance estimates. RESULTS: Our findings suggest that machine learning can significantly improve the prediction accuracy for heart attacks and strokes, facilitating earlier and more precise interventions. We also discuss the integration of machine learning models into clinical practice, addressing potential challenges and the need for healthcare professionals to interpret and apply these predictions effectively. CONCLUSIONS: The use of machine learning for risk stratification and the identification of modifiable factors may empower preemptive approaches to cardiovascular care, ultimately aiming to reduce the occurrence of life-threatening events and improve long-term patient health trajectories. Show more
Keywords: Machine learning, cardiovascular diseases, heart attack, stroke, predictive modeling, risk factors, clinical decision-making
DOI: 10.3233/THC-240582
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
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