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Price: EUR 150.00Authors: Selvakumar, K. | Lokesh, S.
Article Type: Research Article
Abstract: BACKGROUND: Medical imaging techniques have improved to the point where security has become a basic requirement for all applications to ensure data security and data transmission over the internet. However, clinical images hold personal and sensitive data related to the patients and their disclosure has a negative impact on their right to privacy as well as legal ramifications for hospitals. OBJECTIVE: In this research, a novel deep learning-based key generation network (Deep-KEDI) is designed to produce the secure key used for decrypting and encrypting medical images. METHODS: Initially, medical images are pre-processed by …adding the speckle noise using discrete ripplet transform before encryption and are removed after decryption for more security. In the Deep-KEDI model, the zigzag generative adversarial network (ZZ-GAN) is used as the learning network to generate the secret key. RESULTS: The proposed ZZ-GAN is used for secure encryption by generating three different zigzag patterns (vertical, horizontal, diagonal) of encrypted images with its key. The zigzag cipher uses an XOR operation in both encryption and decryption using the proposed ZZ-GAN. Encrypting the original image requires a secret key generated during encryption. After identification, the encrypted image is decrypted using the generated key to reverse the encryption process. Finally, speckle noise is removed from the encrypted image in order to reconstruct the original image. CONCLUSION: According to the experiments, the Deep-KEDI model generates secret keys with an information entropy of 7.45 that is particularly suitable for securing medical images. Show more
Keywords: Medical image encryption, speckle noise, deep learning, zigzag pattern, generative adversarial network
DOI: 10.3233/THC-231927
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Dou, Fengjiao | Tian, Qingxiu | Zhang, Ran
Article Type: Research Article
Abstract: BACKGROUND: Gestational diabetes, a frequent pregnancy complication marked by elevated maternal blood glucose, can cause serious adverse effects for both mother and fetus, including increased amniotic fluid and risks of fetal asphyxia, hypoxia, and premature birth. OBJECTIVE: To construct a predictive model to analyze the risk factors for macrosomia in deliveries with gestational diabetes. METHODS: From January 2021 to February 2023, 362 pregnant women with gestational diabetes were selected for the study. They were followed up until delivery. Based on newborn birth weight, the participants were divided into the macrosomia group (birth weight ⩾ …4000 g) and the non-macrosomia group (birth weight < 4000 g). The data of the two groups of pregnant women were compared. ROC curves were plotted to analyze the predictive value of multiple factors for the delivery of macrosomic infants among pregnant women with gestational diabetes. A logistic regression model was constructed to identify the risk factors for delivering macrosomic infants and the model was tested. RESULTS: A total of 362 pregnant women with gestational diabetes were included, of which 58 (16.02%) had babies with macrosomia. The macrosomia group exhibited higher metrics in several areas compared to those without: pre-pregnancy BMI, fasting glucose, 1 h and 2 h OGTT sugar levels, weight gain during pregnancy, and levels of triglycerides, LDL-C, and HDL-C, all with significant differences (P < 0.05). ROC analysis revealed predictive value for macrosomia with AUCs of 0.761 (pre-pregnancy BMI), 0.710 (fasting glucose), 0.671 (1 h OGTT), 0.634 (2 h OGTT), 0.850 (weight gain), 0.837 (triglycerides), 0.742 (LDL-C), and 0.776 (HDL-C), indicating statistical significance (P < 0.05). Logistic regression identified high pre-pregnancy BMI, fasting glucose, weight gain, triglycerides, and LDL-C levels as independent risk factors for macrosomia, with odds ratios of 2.448, 2.730, 1.884, 16.919, and 5.667, respectively, and all were statistically significant (P < 0.05). The model’s AUC of 0.980 (P < 0.05) attests to its reliability and stability. CONCLUSION: The delivery of macrosomic infants in gestational diabetes may be related to factors such as body mass index before pregnancy, blood-glucose levels, gain weight during pregnancy, and lipid levels. Clinical interventions targeting these factors should be implemented to reduce the incidence of macrosomia. Show more
Keywords: Gestational diabetes, delivery, macrosomia, risk factors, predictive model
DOI: 10.3233/THC-240679
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Gao, Wenlong | Zeng, Zhimei | Ma, Xiaojie | Ke, Yongsong | Zhi, Minqian
Article Type: Research Article
Abstract: BACKGROUND: The morbidity and mortality of heart disease are increasing in middle-aged and elderly people in China. It is necessary to explore relationships and interactive associations between heart disease and its risk factors in order to prevent heart disease. OBJECTIVE: To establish a Bayesian network model of heart disease and its influencing factors in middle-aged and elderly people in China, and explore the applicability of the elite-based structure learner using genetic algorithm based on ensemble learning (EN-ESL-GA) algorithm in etiology analysis and disease prediction. METHODS: Based on the 2013 national tracking survey data …from China Health and Retirement Longitudinal Study (CHARLS) database, EN-ESL-GA algorithm was used to learn the Bayesian network structure. Then we input the data and the learned network structure into the Netica software for parameter learning and inference analysis. RESULTS: The Bayesian network model based on the EN-ESL-GAalgorithm can effectively excavate the complex network relationships and interactive associations between heart disease and its risk factors in middle-aged and elderly people in China. CONCLUSIONS: The Bayesian network model based on the EN-ESL-GA algorithm has good applicability and application prospect in the prediction of diseases prevalence risk. Show more
Keywords: Bayesian networks, heart disease, influence factors, middle-aged and elderly people
DOI: 10.3233/THC-231215
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ping, Yuxia
Article Type: Research Article
Abstract: BACKGROUND: In recent years, artificial intelligence (AI) technology has been continuously advancing and finding extensive applications, with one of its core technologies, machine learning, being increasingly utilized in the field of healthcare. OBJECTIVE: This research aims to explore the role of Artificial Intelligence (AI) technology in psychological counseling and utilize machine learning algorithms to predict counseling outcomes. METHODS: Firstly, by employing natural language processing techniques to analyze user conversations with AI chatbots, researchers can gain insights into the psychological states and needs of users during the counseling process. This involves detailed analysis using …text analysis, sentiment analysis, and other relevant techniques. Subsequently, machine learning algorithms are used to establish predictive models that forecast counseling outcomes and user satisfaction based on data such as user language, emotions, and behavior. These predictive results can assist counselors or AI chatbots in adjusting counseling strategies, thereby enhancing counseling effectiveness and user experience. Additionally, this study explores the potential and prospects of AI technology in the field of psychological counseling. RESULTS: The research findings indicate that the designed machine learning models achieve an accuracy rate of approximately 89% in analyzing psychological conditions. This demonstrates significant innovation and breakthroughs in AI technology. Consequently, AI technology will gradually become a highly important tool and method in the field of psychological counseling. CONCLUSION: In the future, AI chatbots will become more intelligent and personalized, providing users with precise, efficient, and convenient psychological counseling services. The results of this research provide valuable technical insights for further improving AI-supported psychological counseling, contributing positively to the application and development of AI technology. Show more
Keywords: Artificial intelligence, machine learning, natural language, psychological counseling, sentiment analysis
DOI: 10.3233/THC-230809
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Nanda, Ashok Kumar | Thilagavathy, R. | Gayatri Devi, G.S.K. | Chaturvedi, Abhay | Jalda, Chaitra Sai | Inthiyaz, Syed
Article Type: Research Article
Abstract: BACKGROUND: Dengue fever is rapidly becoming Malaysia’s most pressing health concern, as the reported cases have nearly doubled over the past decade. Without efficacious antiviral medications, vector control remains the primary strategy for battling dengue, while the recently introduced tetravalent immunization is being evaluated. The most significant and dangerous risk increasing recently is vector-borne illnesses. These illnesses induce significant human sickness and are transmitted by blood-feeding arthropods such as fleas, parasites, and mosquitos. A thorough grasp of various factors is necessary to improve prediction accuracy and typically generate inaccurate and unstable predictions, as well as machine learning (ML) models, …weather-driven mechanisms, and numerical time series. OBJECTIVE: In this research, we propose a novel method for forecasting vector-borne disease risk using Radial Basis Function Networks (RBFNs) and the Darts Game Optimizer (DGO) algorithm. METHODS: The proposed approach entails training the RBFNs with historical disease data and enhancing their parameters with the DGO algorithm. To prepare the RBFNs, we used a massive dataset of vector-borne disease incidences, climate variables, and geographical data. The DGO algorithm proficiently searches the RBFN parameter space, fine-tuning the model’s architecture to increase forecast accuracy. RESULTS: RBFN-DGO provides a potential method for predicting vector-borne disease risk. This study advances predictive demonstrating in public health by shedding light on effectively controlling vector-borne diseases to protect human populations. We conducted extensive testing to evaluate the performance of the proposed method to standard optimization methods and alternative forecasting methods. CONCLUSION: According to the findings, the RBFN-DGO model beats others in terms of accuracy and robustness in predicting the likelihood of vector-borne illness occurrences. Show more
Keywords: Deep learning (DL), dengue fever, radial basis function networks, darts game optimizer, vector-borne disease
DOI: 10.3233/THC-240046
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Oh, Sungyeon | Ko, Chang-Yong | Lee, Jaewon | Nekar, Daekook M. | Kang, Hyeyoon | Kim, Hansung | Yu, Jaeho
Article Type: Research Article
Abstract: BACKGROUND: Delayed onset muscle soreness (DOMS) is one of the most prevalent musculoskeletal symptoms in individuals engaged in strenuous exercise programs. OBJECTIVE: This study investigated the effects of wearable low-intensity continuous ultrasound on muscle biomechanical properties during DOMS. METHODS: Twenty volunteers were distributed into a wearable ultrasound stimulation group (WUG) (n = 10) and medical ultrasound stimulation group (MUG) (n = 10). All subjects performed wrist extensor muscle strength exercises to induce DOMS. At the site of pain, ultrasound of frequency 3 MHz …was applied for 1 h or 5 min in each subject of the WUG or MUG, respectively. Before and after ultrasound stimulation, muscle biomechanical properties (tone, stiffness, elasticity, stress relaxation time, and creep) and body temperature were measured, and pain was evaluated. RESULTS: A significant decrease was found in the tone, stiffness, stress relaxation time, and creep in both groups after ultrasound stimulation (all p < 0.05). A significant decrease in the pain and increases in temperature were observed in both groups (all p < 0.05). No significant differences were observed between the groups in most evaluations. CONCLUSION: The stiffness and pain caused by DOMS were alleviated using a wearable ultrasound stimulator. Furthermore, the effects of the wearable ultrasound stimulator were like those of a medical ultrasound stimulator. Show more
Keywords: Wearable low-intensity continuous ultrasound, muscle biomechanical properties, delayed onset muscle soreness, biomechanics, medical devices
DOI: 10.3233/THC-231947
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Stjepić, Maja Kovačević | Rifatbegović, Zijah | Cerovac, Anis | Agić, Mirha | Mehmedović, Zlatan | Habek, Dubravko | Vranić, Semir | Ahmetašević, Emir | Trnačević, Senaid
Article Type: Research Article
Abstract: BACKGROUND: Despite improvements, survival rates for gastric cancer remain low, even in developed countries, confirming the role of primary and secondary prevention. OBJECTIVE: This study aims to demonstrate the role of additional suspension sutures on the esophagojejunal anastomosis (EJA) to strengthen the anastomosis, i.e., relieve the mechanical suture. METHODS: A retrospective cohort study was conducted from 2011 to 2022 at the Clinic for Surgery, University Clinical Center Tuzla, Bosnia and Herzegovina. The experimental group consisted of patients placed with a suspension suture at the esophagojejunal anastomosis (EJA) site after total gastrectomy. The control …group was patients without a suspension suture. The clinical and laboratory parameters available from the medical history were analyzed, X-ray passage, surgical complications, non-surgical complications, the length of hospitalization, the postoperative course, time of onset of postoperative complications, postoperative radiological follow-up and endoscopic postoperative follow-up were then analyzed. RESULTS: A total of 212 patients were included in the study: 87 in the experimental group with suspension sutures on the EJA and 125 in the control group without suspension sutures on the EJA. The two cohorts did not differ in other clinicopathologic parameters except perineural invasion, which was more prevalent in the control group. Patients in both groups were anemic and elevated values of C reactive protein (CRP) and decreased levels of proteins, albumin and globulin, with no significant difference between the two groups. The most common general complication was pleural effusion (28%), followed by pneumonia (∼ 22%). The most common complication in the experimental group was an intraabdominal abscess, while in the control group, it was a surgical wound infection. CONCLUSION: Our study did not show a statistically significant difference between the two analyzed EJA techniques created with a circular stapler, when it comes to postoperative course and outcome in patients with gastric cancer. Show more
Keywords: Gastric cancer, surgery, postoperative outcome
DOI: 10.3233/THC-231467
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Chen, Ruijuan | Wang, Rui | Fei, Jieying | Huang, Lengjie | Bi, Xun | Wang, Jinhai
Article Type: Research Article
Abstract: BACKGROUND: Mental fatigue has become a non-negligible health problem in modern life, as well as one of the important causes of social transportation, production and life accidents. OBJECTIVE: Fatigue detection based on traditional machine learning requires manual and tedious feature extraction and feature selection engineering, which is inefficient, poor in real-time, and the recognition accuracy needs to be improved. In order to recognize daily mental fatigue level more accurately and in real time, this paper proposes a mental fatigue recognition model based on 1D Convolutional Neural Network (1D-CNN), which inputs 1D raw ECG sequences of 5 s duration …into the model, and can directly output the predicted fatigue level labels. METHODS: The fatigue dataset was constructed by collecting the ECG signals of 22 subjects at three time periods: 9:00–11:00 a.m., 14:00–16:00 p.m., and 19:00–21:00 p.m., and then inputted into the 19-layer 1D-CNN model constructed in the present study for the classification of mental fatigue in three grades. RESULTS: The results showed that the model was able to recognize the fatigue levels effectively, and its accuracy, precision, recall, and F1 score reached 98.44%, 98.47%, 98.41%, and 98.44%, respectively. CONCLUSION: This study further improves the accuracy and real-time performance of recognizing multi-level mental fatigue based on electrocardiography, and provides theoretical support for real-time fatigue monitoring in daily life. Show more
Keywords: Mental fatigue, short-time electrocardiographic sequence, deep learning, 1D convolutional neural network
DOI: 10.3233/THC-240129
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Mansoor, C.M.M. | Chettri, Sarat Kumar | Naleer, H.M.M.
Article Type: Research Article
Abstract: BACKGROUND: Heart disease is a severe health issue that results in high fatality rates worldwide. Identifying cardiovascular diseases such as coronary artery disease (CAD) and heart attacks through repetitive clinical data analysis is a significant task. Detecting heart disease in its early stages can save lives. The most lethal cardiovascular condition is CAD, which develops over time due to plaque buildup in coronary arteries, causing incomplete blood flow obstruction. Machine Learning (ML) is progressively used in the medical sector to detect CAD disease. OBJECTIVE: The primary aim of this work is to deliver a state-of-the-art approach …to enhancing CAD prediction accuracy by using a DL algorithm in a classification context. METHODS: A unique ML technique is proposed in this study to predict CAD disease accurately using a deep learning algorithm in a classification context. An ensemble voting classifier classification model is developed based on various methods such as Naïve Bayes (NB), Logistic Regression (LR), Decision Tree (DT), XGBoost, Random Forest (RF), Convolutional Neural Network (CNN), Support Vector Machine (SVM), K Nearest Neighbor (KNN), Bidirectional LSTM and Long Short-Term Memory (LSTM). The performance of the ensemble models and a novel model are compared in this study. The Alizadeh Sani dataset, which consists of a random sample of 216 cases with CAD, is used in this study. Synthetic Minority Over Sampling Technique (SMOTE) is used to address the issue of imbalanced datasets, and the Chi-square test is used for feature selection optimization. Performance is assessed using various assessment methodologies, such as confusion matrix, accuracy, recall, precision, f1-score, and auc-roc. RESULTS: When a novel algorithm achieves the highest accuracy relative to other algorithms, it demonstrates its effectiveness in several ways, including superior performance, robustness, generalization capability, efficiency, innovative approaches, and benchmarking against baselines. These characteristics collectively contribute to establishing the novel algorithm as a promising solution for addressing the target problem in machine learning and related fields. CONCLUSION: Implementing the novel model in this study significantly improved performance, achieving a prediction accuracy rate of 92% in the detection of CAD. These findings are competitive and on par with the top outcomes among other methods. Show more
Keywords: Machine learning, coronary artery disease, heart disease, feature selection, classification
DOI: 10.3233/THC-240740
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-25, 2024
Authors: Badnjević, Almir | Zebić, Emina Zejnilović
Article Type: Editorial
DOI: 10.3233/THC-248050
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Hu, Xia | Jiang, Huiqing | Liu, Peizhen | Li, Zhiquan | Zhang, Ruiying
Article Type: Research Article
Abstract: BACKGROUND: The Stepped Care Model (SCM) is an evidence-based treatment approach that tailors treatment intensity based on patients’ health status, aiming to achieve the most positive treatment outcomes with the least intensive and cost-effective interventions. Currently, the effectiveness of the Stepped Care Model in postoperative rehabilitation for TKA (Total Knee Arthroplasty) patients has not been reported. OBJECTIVE: The present study aimed to investigate whether the stepped care model could improve early-stage self-report quality of life and knee function after total knee arthroplasty via a prospective randomized controlled design. METHODS: It was a mono-center, …parallel-group, open-label, prospective randomized controlled study. Patients who aging from 60–75 years old as well as underwent unilateral primary total knee arthroplasty due to end-stage knee osteoarthritis between 2020.06 to 2022.02 were enrolled. Participants were randomized and arranged into two groups in a 1:1 allocation. The control group was given traditional rehabilitation guidance, while the stepped care model group was given continued stepped care. Hospital for special surgery knee score, daily living ability (ADL), knee flexion range, and adverse events at 1, 3, and 6 months after total knee arthroplasty were recorded. RESULTS: 88 patients proceeded to the final analysis. There was no significant difference of age, gender, length of stay, BMI, and educational level between the two groups at the baseline. After specific stepped care model interventions, patients showed significant improvements in HHS in 1 month (85.00 (82.25, 86.00) vs. 80.00 (75.00, 83.00), p < 0.001), 3 months (88.00 (86.00, 92.00) vs. 83.00 (76.75, 85.00), p < 0.001), and 6 months (93.00 (90.25, 98.00) vs. 88.00 (84.25, 91.75), p < 0.001) when compared with the control group. Similar results were also found in both daily living ability and knee flexion angle measurements. No adverse event was observed during the follow-up. CONCLUSION: The present study found that the stepped care model intervention significantly improved early-stage knee function and self-reported life quality after total knee arthroplasty due to knee osteoarthritis. Female patients and those less than 70 years old benefit more from the stepped care model intervention after total knee arthroplasty. Show more
Keywords: Stepped care model, total knee arthroplasty, randomized controlled trail, knee function, life quality
DOI: 10.3233/THC-240780
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Fragidis, Leonidas | Tsamoglou, Sofia | Kosmidis, Kosmas | Aggelidis, Vassilios
Article Type: Research Article
Abstract: BACKGROUND: The global implementation of Electronic Health Records has significantly enhanced the quality of medical care and the overall delivery of public health services. The incorporation of Evidence-Based Medicine offers numerous benefits and enhances the efficacy of decision-making in areas such as prevention, prognosis, diagnosis, and therapeutic approaches. OBJECTIVE: The objective of this paper is to propose an architectural design of an Evidence-Based Medicine information system based on the Electronic Health Record, taking into account the existing and future level of interoperability of health information systems in Greece. METHODS: A study of the …suggested evidence-based medicine architectures found in the existing literature was conducted. Moreover, the interoperability architecture of health information systems in Greece was analyzed. The architecture design reviewed by specialized personnel and their recommendations were incorporated into the final design of the proposed architecture. RESULTS: The proposed integrated architecture of an Evidence-Based Medicine system based on the Electronic Health Record integrates and utilizes citizens’ health data while leveraging the existing knowledge available in the literature. CONCLUSIONS: Taking into consideration the recently established National Interoperability Framework, which aligns with the European Interoperability Framework, the proposed realistic architectural approach contributes to improving the quality of healthcare provided through the ability to make safe, timely and accurate decisions by physicians. Show more
Keywords: Electronic health records, evidence-based medicine, clinical decision support systems, health information systems
DOI: 10.3233/THC-232042
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Chen, Changsheng | Zhang, Yu | Lin, Yuda | Shen, Chong | Zhang, Zhe | Wu, Zhouliang | Qie, Yunkai | Zhao, Gangjian | Hu, Hailong
Article Type: Research Article
Abstract: BACKGROUND: Bone morphogenetic proteins (BMPs) are a group of cancer-related proteins vital for development and progression of certain cancer types. Nevertheless, function of BMP family in pan-cancer was not detailedly researched. OBJECTIVE: Investigating expression pattern and prognostic value of the BMPs family (BMP1-8A and BMP8B) expression across multiple cancer types. METHODS: Our research integrated multi-omics data for exploring potential associations between BMPs expression and prognosis, clinicopathological characteristics, copy number or somatic mutations, immune characteristics, tumor microenvironment (TME), tumor mutation burden (TMB), microsatellite instability (MSI), immune checkpoint genes and drug sensitivity in The Cancer …Genome Atlas (TCGA) tumors. Furthermore, association of BMPs expression and immunotherapy effectiveness was investigated in some confirmatory cohorts (GSE111636, GSE78220, GSE67501, GSE176307, IMvigor210 and mRNA sequencing data from currently undergoing TRUCE01 clinical research included), and biological function and potential signaling pathways of BMPs in bladder cancer (BCa) was explored via Gene Set Enrichment Analysis (GSEA). Eventually, immune infiltration analysis was done via BMPs expression, copy number or somatic mutations in BCa, as well as validation of the expression levels by reverse transcription-quantitative PCR and western blot, and in vitro functional experiments of BMP8A. RESULTS: Discoveries displayed BMPs expression was related to prognosis, clinicopathological characteristics, mutations, TME, TMB, MSI and immune checkpoint genes of TCGA tumors. Anticancer drug sensitivity analysis displayed BMPs were associated with various drug sensitivities. What’s more, it was discovered that expression level of certain BMP family members related to objective response to immunotherapy. By GSEA, we discovered multiple immune-associated functions and pathways were enriched. Immune infiltration analysis on BCa also displayed significant associations among BMPs copy number variations, mutation status and infiltration level of diverse immune cells. Furthermore, differential expression validation and in vitro phenotypic experiment indicated that BMP8A significantly promoted BCa cell proliferation, migration and invasion. CONCLUSIONS: Current results confirmed significance of both BMPs expression and genomic alteration in the prognosis and treatment of diverse cancer types, and suggested that BMPs may be vital for BCa and can possibly be utilized as biomarkers for immunotherapy. Show more
Keywords: Bone morphogenetic proteins, pan-cancer analysis, bladder cancer, tumor microenvironment, prognosis
DOI: 10.3233/THC-232004
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-53, 2024
Authors: Hwang, Daon | Cho, Ki Hun
Article Type: Research Article
Abstract: BACKGROUND: Traditional canes have no special functions besides weight support, and their long-term use may cause secondary damage to the musculoskeletal system and gait deviation. OBJECTIVE: This study aimed to investigate the usability of the cane-combined weight support feedback device (CWSFD) to identify areas requiring improvement and the current level of satisfaction. METHODS: As a collet-type device, the CWSFD has a structure allowing attachment and detachment at the lower end of a traditional mono cane. To assess the level of satisfaction and areas of improvement regarding the novel CWSFD, a usability test was …conducted on 10 physical therapists with ⩾ 20 years of clinical experience. The usability test comprised a satisfaction survey questionnaire to determine the level of satisfaction, and an in-depth interview to identify the points of improvement. RESULTS: The usability test demonstrated a moderate or higher level of satisfaction in all tested items, and the in-depth interview revealed that the device should have a lower weight with a greater diversity of feedback. CONCLUSIONS: We anticipate that by implementing the respective improvements, a novel device will be developed in the future; for its commercialization, studies to verify the clinical effectiveness are warranted. Show more
Keywords: Cane, gait, satisfaction, usability test, weight support
DOI: 10.3233/THC-240056
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Radhakrishnan, Menaka | Ramamurthy, Karthik | Shanmugam, Saranya | Prasanna, Gaurav | S, Vignesh | Y, Surya | Won, Daehan
Article Type: Research Article
Abstract: BACKGROUND: Autism Spectrum Disorder (ASD) is a condition with social interaction, communication, and behavioral difficulties. Diagnostic methods mostly rely on subjective evaluations and can lack objectivity. In this research Machine learning (ML) and deep learning (DL) techniques are used to enhance ASD classification. OBJECTIVE: This study focuses on improving ASD and TD classification accuracy with a minimal number of EEG channels. ML and DL models are used with EEG data, including Mu Rhythm from the Sensory Motor Cortex (SMC) for classification. METHODS: Non-linear features in time and frequency domains are extracted and ML …models are applied for classification. The EEG 1D data is transformed into images using Independent Component Analysis-Second Order Blind Identification (ICA-SOBI), Spectrogram, and Continuous Wavelet Transform (CWT). RESULTS: Stacking Classifier employed with non-linear features yields precision, recall, F1-score, and accuracy rates of 78%, 79%, 78%, and 78% respectively. Including entropy and fuzzy entropy features further improves accuracy to 81.4%. In addition, DL models, employing SOBI, CWT, and spectrogram plots, achieve precision, recall, F1-score, and accuracy of 75%, 75%, 74%, and 75% respectively. The hybrid model, which combined deep learning features from spectrogram and CWT with machine learning, exhibits prominent improvement, attained precision, recall, F1-score, and accuracy of 94%, 94%, 94%, and 94% respectively. Incorporating entropy and fuzzy entropy features further improved the accuracy to 96.9%. CONCLUSIONS: This study underscores the potential of ML and DL techniques in improving the classification of ASD and TD individuals, particularly when utilizing a minimal set of EEG channels. Show more
Keywords: Independent component analysis – Second Order Blind Identification (ICA – SOBI), Continuous Wavelet transform (CWT), stacking classifier, hybrid model, spectrogram, electroencephalogram
DOI: 10.3233/THC-240644
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-19, 2024
Authors: K. P, Ajitha Gladis | D, Roja Ramani | N, Mohana Suganthi | P, Linu Babu
Article Type: Research Article
Abstract: BACKGROUND: Gastrointestinal tract (GIT) diseases impact the entire digestive system, spanning from the mouth to the anus. Wireless Capsule Endoscopy (WCE) stands out as an effective analytic instrument for Gastrointestinal tract diseases. Nevertheless, accurately identifying various lesion features, such as irregular sizes, shapes, colors, and textures, remains challenging in this field. OBJECTIVE: Several computer vision algorithms have been introduced to tackle these challenges, but many relied on handcrafted features, resulting in inaccuracies in various instances. METHODS: In this work, a novel Deep SS-Hexa model is proposed which is a combination two different deep …learning structures for extracting two different features from the WCE images to detect various GIT ailment. The gathered images are denoised by weighted median filter to remove the noisy distortions and augment the images for enhancing the training data. The structural and statistical (SS) feature extraction process is sectioned into two phases for the analysis of distinct regions of gastrointestinal. In the first stage, statistical features of the image are retrieved using MobileNet with the support of SiLU activation function to retrieve the relevant features. In the second phase, the segmented intestine images are transformed into structural features to learn the local information. These SS features are parallelly fused for selecting the best relevant features with walrus optimization algorithm. Finally, Deep belief network (DBN) is used classified the GIT diseases into hexa classes namely normal, ulcer, pylorus, cecum, esophagitis and polyps on the basis of the selected features. RESULTS: The proposed Deep SS-Hexa model attains an overall average accuracy of 99.16% in GIT disease detection based on KVASIR and KID datasets. The proposed Deep SS-Hexa model achieves high level of accuracy with minimal computational cost in the recognition of GIT illness. CONCLUSIONS: The proposed Deep SS-Hexa Model progresses the overall accuracy range of 0.04%, 0.80% better than GastroVision, Genetic algorithm based on KVASIR dataset and 0.60%, 1.21% better than Modified U-Net, WCENet based on KID dataset respectively. Show more
Keywords: Gastrointestinal tract, wireless capsule endoscopy, mobile network, structural and statistical features, deep belief network
DOI: 10.3233/THC-240603
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Teng, Xiaohuan | Sun, Yanrong | Zhao, Landi | Kang, Yingxian
Article Type: Research Article
Abstract: BACKGROUND: In 2019, approximately 330 million individuals in China were affected by cardiovascular diseases, with 11.4 million cases specifically attributed to coronary artery disease (CAD). A national public health report indicated that the mortality rate for CAD ranged from 121.59 to 130.14 per 100,000 individuals in 2019. The treatments for CAD include lifestyle changes, medications, percutaneous coronary intervention (PCI) and coronary artery bypass grafting. OBJECTIVE: To investigate the management effect of a digital health program in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). METHODS: This retrospective study compares …blood pressure, blood glucose, low-density lipoprotein cholesterol (LDL-C), medication adherence, lifestyle modification, and readmission rate between digital health users and traditional follow-up in post-PCI CAD patients. RESULTS: In this study of 698 CAD patients, the 6-month readmission rate of all patients was 27.4%, with digital health users showing lower rates than those in traditional follow-up (22.6% vs. 32.1%, p = 0.005). Digital health users had significantly higher target achievements rates in blood pressure (79.7% vs. 54.7%, p < 0.001), blood glucose (98.9% vs. 82.5%, p < 0.001) and LDL-C level (71.3% vs. 52.7%, p < 0.001) at 6-month post-PCI. The digital health group had more patients adopting lifestyle changes, including quitting smoking, maintaining a healthy diet, and exercising regularly. In risk factor analysis, digital health utilization (OR = 0.60, 95%CI: 0.40–0.90, p = 0.014) and multivessel disease (double: OR = 1.72, 95%CI: 1.09—2.72, p = 0.02; triple: OR = 2.59, 95%CI: 1.61–4.17, p < 0.001) were independent predictors of CAD-related cardiovascular readmissions. CONCLUSIONS: Post-PCI patients using digital health platforms exhibited improved blood pressure, glucose, and LDL-C control, greater treatment adherence, enhanced lifestyle changes, and reduced six-month readmission rates versus those with traditional follow-up. Show more
Keywords: Coronary artery disease, PCI, disease management, digital health
DOI: 10.3233/THC-240621
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Hong, Haisen | Sha, Mo | Chen, Zhangxin | Li, Yanwei | Kang, Liangqi
Article Type: Research Article
Abstract: BACKGROUND: Femoral neck fractures, which are fractures occurring from the femoral head to the base of the femoral neck, are prevalent in the elderly population. With the progression of societal aging, the incidence of femoral neck fractures has been steadily increasing, making it a significant global issue that urgently needs to be addressed. OBJECTIVE: To compare the efficacy and safety of dynamic hip screw (DHS) with anti-rotation screw and femoral neck system (FNS) internal fixation for the treatment of Garden II–IV type femoral neck fractures. METHODS: A total of 90 patients with Garden …II–IV type femoral neck fractures were randomly assigned to either the control group (n = 45) treated with DHS and anti-rotation screw or the experimental group (n = 45) treated with FNS. Surgical outcomes, including incision size, blood loss, operation time, fluoroscopy frequency, and fracture healing time, were compared. Postoperative complication rates, reoperation rates, Harris scores, and visual analogue scale (VAS) scores were also assessed. RESULTS: The experimental group demonstrated significantly reduced incision length, blood loss, operation time, and fluoroscopy frequency compared to the control group (P < 0.01). No significant differences were observed in fracture healing time, Garden classification, or fracture reduction outcomes between the two groups (P > 0.05). At 6 months post-treatment, both groups showed significant improvements in Harris scores and VAS scores compared to pre-treatment (P < 0.05), with no significant differences between the groups (P > 0.05). The rates of internal fixation failure, nonunion, and avascular necrosis of the femoral head, as well as overall incidence of postoperative complications and reoperation rates, showed no significant differences between the two groups (P > 0.05). CONCLUSIONS: Both DHS with anti-rotation screw and FNS internal fixation demonstrated comparable efficacy and safety profiles in the treatment of Garden II–IV type femoral neck fractures. The experimental group showed advantages in terms of reduced incision length, blood loss, operation time, and fluoroscopy frequency, while maintaining similar clinical outcomes and complication rates. Show more
Keywords: Femoral neck fractures, Garden II–IV classification, dynamic hip screw (DHS), anti-rotation screw, femoral neck system (FNS), internal fixation
DOI: 10.3233/THC-231547
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Wang, Jing | Yin, Liang
Article Type: Research Article
Abstract: BACKGROUND: More than a million people are affected by brain tumors each year; high-grade gliomas (HGGs) and low-grade gliomas (LGGs) present serious diagnostic and treatment hurdles, resulting in shortened life expectancies. Glioma segmentation is still a significant difficulty in clinical settings, despite improvements in Magnetic Resonance Imaging (MRI) and diagnostic tools. Convolutional neural networks (CNNs) have seen recent advancements that offer promise for increasing segmentation accuracy, addressing the pressing need for improved diagnostic and therapeutic approaches. OBJECTIVE: The study intended to develop an automated glioma segmentation algorithm using CNN to accurately identify tumor components in MRI …images. The goal was to match the accuracy of experienced radiologists with commercial instruments, hence improving diagnostic precision and quantification. METHODS: 285 MRI scans of high-grade gliomas (HGGs) and low-grade gliomas (LGGs) were analyzed in the study. T1-weighted sequences were utilised for segmentation both pre-and post-contrast agent administration, along with T2-weighted sequences (with and without Fluid Attenuation by Inversion Recovery [FAIRE]). The segmentation performance was assessed with a U-Net network, renowned for its efficacy in medical image segmentation. DICE coefficients were computed for the tumour core with contrast enhancement, the entire tumour, and the tumour nucleus without contrast enhancement. RESULTS: The U-Net network produced DICE values of 0.7331 for the tumour core with contrast enhancement, 0.8624 for the total tumour, and 0.7267 for the tumour nucleus without contrast enhancement. The results align with previous studies, demonstrating segmentation accuracy on par with professional radiologists and commercially accessible segmentation tools. CONCLUSION: The study developed a CNN-based automated segmentation system for gliomas, achieving high accuracy in recognising glioma components in MRI images. The results confirm the ability of CNNs to enhance the accuracy of brain tumour diagnoses, suggesting a promising avenue for future research in medical imaging and diagnostics. This advancement is expected to improve diagnostic processes for clinicians and patients by providing more precise and quantitative results. Show more
Keywords: Biomedical imaging, CNN, deep learning, glioma, neuroimages, MRI
DOI: 10.3233/THC-240158
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Tian, Wei | Zhang, Sheng | Gao, Yuan | Wang, Yan | Cui, Qianqian
Article Type: Research Article
Abstract: BACKGROUND: Irrational pharmacotherapy and increasing pharmacy costs remain major concerns in healthcare systems. Pharmacists are expected to employ diagnosis-related group (DRG) data to analyse inpatient pharmacy utilization. OBJECTIVE: This project aimed to pilot an efficient pharmacist-led programme to analyse factors related to pharmacy expenses, evaluate the rational use of drugs in batch processing, and make further interventions based on DRG data. METHODS: Patients from the OB25 (caesarean section without comorbidities or complications) DRG were selected in 2018, and the most relevant factors were identified through statistical analysis. Interventions were implemented by sending monthly …reports on prescribing data and drug review results for the same DRGs to the department starting in 2019. Pre–post comparisons were conducted to demonstrate changes in pharmacy costs and appropriateness at a tertiary teaching hospital with 2,300 beds in China. RESULTS: A total of 1,110 patients were identified from the OB25 DRG data in 2018. Multivariate linear analysis indicated that the number of items prescribed and wards substantially influenced pharmacy expenditure. Drugs labelled as vital, essential, and non-essential revealed that 46.6% of total pharmacy costs were spent on non-essential drugs, whereas 38.7% were spent on vital drugs. The use of inappropriate pharmaceuticals and drug items was substantially reduced, and the average pharmacy cost after intervention was 336.7 RMB in 2020. The benefit–cost ratio of the programme was 9.86. CONCLUSION: Interventions based on DRG data are highly efficient and feasible for reducing inpatient pharmacy costs and non-essential drug use. Show more
Keywords: Diagnosis-related groups, rational use of drugs, cost savings, prescribing behaviour, pharmacist intervention
DOI: 10.3233/THC-240284
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Niu, Haiying | He, Huijie | Zhao, Zilong | Lu, Xuemei | Zhao, Gang
Article Type: Research Article
Abstract: BACKGROUND: Asthma is a major public health concern due to its persistent inflammation of the airways. The intricate and widely variable epidemiology of asthma among nations and populations is a result of the interplay between genetic, environmental, and socioeconomic factors. OBJECTIVE: This study aims to investigate whether VitD supplementation can reduce the frequency of exacerbations (including the frequency of exacerbations requiring systemic corticosteroids and the frequency of exacerbations necessitating trips to the hospital or emergency room, or both) and improve pulmonary function (clinical indicators such as the FEV1% predicted value). METHODS: Computers were …used to search Pubmed, Medline, ISI Web of Science, Embase, Cachrane Library, CNKI, CBM, VIP, and the Wanfang Database. Asthma/asthma, VitD/VitD, lung function/lung function, retrieval time is from database setup to October 8, 2021, to search all randomized controlled trials (RCTs) on the effect of VitD on human asthma and to retroactively incorporate references to literature were all included in the search criteria. After rigorous screening, quality evaluation, and data extraction of the included literature by two reviewers independently, heterogeneity tests and sensitivity analyses were performed. RESULTS: The findings show that a total of 12 relevant studies meeting the inclusion criteria were finally included, including 649 cases in the experimental group and 646 cases in the control group. VitD intervention reduced the number of asthma exacerbations, including the rate of exacerbations requiring systemic corticosteroid therapy and the rate of acute exacerbations requiring emergency department or hospital visits or both. CONCLUSIONS: In the outcome of lung function (FEV1% predicted value), it was shown that VitD supplementation improved lung function; in the outcome of serum 25-hydroxyVitD levels, it was shown that VitD supplementation increased serum 25-hydroxyVitD levels. Show more
Keywords: Asthma, VitD, FEV, lung function, 25-hydroxyVitD
DOI: 10.3233/THC-231462
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-24, 2024
Authors: Li, Qiang | Lu, Yingjun
Article Type: Research Article
Abstract: BACKGROUND: The POSSUM scoring system, widely employed in assessing surgical risks, offers a simplified and objective approach for the prediction of complications and mortality in patient. Despite its effectiveness in various surgical fields, including orthopedics and cardiovascular surgery, yet its utilization in elderly patients undergoing colorectal cancer surgery is infrequent. OBJECTIVE: To analyze the predictive value of POSSUM scoring system for postoperative complications and mortality in elderly with colorectal cancer. METHODS: 306 elderly colorectal cancer patients were grouped according to the complications and death within 30 days after surgery. Among them, 108 cases …in complication group, 198 cases in non-complication group, 16 cases in death group and 290 cases in survival group. POSSUM scores of all subjects were obtained and its predictive value for postoperative complications and mortality of elderly was conducted by ROC curve. RESULTS: No apparent difference were observed in complications and mortality among patients with different disease types, operation types and operation timing (P > 0.05). The R2 in complication group was higher than non-complication group (P < 0.05). The R1 in death group were higher than survival group (P < 0.05). The AUC of R2 for predicting postoperative complications was 0.955 with a sensitivity of 88.89% and a specificity of 94.44% and the AUC of R1 for evaluating postoperative mortality of elderly with colorectal cancer was 0.783 with a sensitivity of 56.25% and a specificity of 82.93%. CONCLUSION: POSSUM score system has a certain predictive value for postoperative complications and mortality in elderly with colorectal cancer. However, the predicted mortality rate is higher than actual mortality rate. Show more
Keywords: Colorectal cancer, POSSUM scoring system, postoperative complications and mortality, predictive value
DOI: 10.3233/THC-240849
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Veihelmann, A. | Beck, F. | Huth, J. | Spetzger, U. | Schulze-Pellengahr, C. | Teske, W.
Article Type: Research Article
Abstract: BACKGROUND: It is estimated that a significant number of spinal surgeries are performed, but many patients do not often benefit. OBJECTIVE: Our aim was to determine how effective minimally invasive pain procedures (MIP) are in chronic low back pain (CLBP) patients with proven degenerative causes (specific low back pain). METHODS: 386 eligible patients with CLBP/sciatica resistant to conservative therapy and scheduled for open surgery were screened, and 167 could be enrolled in this study. Indications for MIP in the remaining 150 individuals were made by one experienced spinal surgeon. Before and 6 months …after the intervention, the numeric rating scale (NRS) and Oswestry Disability Index (ODI) were recorded. MIP was performed, such as radiofrequency of the facet and SI-joint, intradiscal electrothermal therapy in case of discogenic pain, as well as epidural neuroplasty in patients with disc herniation/epidural fibrosis. RESULTS: There was a statistically significant decrease in NRS (p < 0.05), as well as a significant increase in ODI (p < 0.001) 6 months after the procedures. This was also true for the results of all different pain generators and subsequent performed procedures alone. CONCLUSIONS: The indication of MIP should be routinely reviewed in patients with CLBP to avoid potentially open surgery and a burden on healthcare costs. Show more
Keywords: Minimal invasive surgical procedures, low back pain mechanical, disc herniation, sciatica, discogenic pain
DOI: 10.3233/THC-241003
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Kong, Yang | Wang, Yizhi | Yang, Qifan | Ye, Song
Article Type: Research Article
Abstract: BACKGROUND: Bibliometric analysis of liver cancer research, particularly in immunotherapy, reveals crucial insights. The US leads in liver cancer mortality but ranks fifth globally. OBJECTIVE: Scopus database analysis identified 2,349 papers, with the top 100 ranging from 127 to 4,959 citations. Notably, “Microenvironmental Regulation of Tumours Progression and Metastasis” in the Journal of Nature Medicine garnered the highest citations. METHODS: Journals like the Journal of Hepatology, Hepatology, and Nature Reports Clinical Oncology contributed significantly. Understanding molecular mechanisms and prognostic indicators is paramount for advancing combination therapies. RESULTS: For better patient …outcomes, research trends in liver cancer immunotherapy point to improved treatment protocols, knowledge of the tumor microenvironment, combining therapies, predicting disease course, international cooperation, sophisticated surgical techniques, early detection, oncolytic virotherapy, and patient-centered care. CONCLUSIONS: This research underscores immunotherapy’s pivotal role and encourages further exploration, offering valuable insights into liver cancer treatment trends. Show more
Keywords: Liver cancer, immunotherapy, bibliometric analysis, research trends, oncology
DOI: 10.3233/THC-241111
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Alsaleh, Hadeel
Article Type: Research Article
Abstract: BACKGROUND: Schwann cell sheaths are the source of benign, slowly expanding tumours known as acoustic neuromas (AN). The diagnostic and treatment approaches for AN must be patient-centered, taking into account unique factors and preferences. OBJECTIVE: The purpose of this study is to investigate how machine learning and artificial intelligence (AI) can revolutionise AN management and diagnostic procedures. METHODS: A thorough systematic review that included peer-reviewed material from public databases was carried out. Publications on AN, AI, and deep learning up until December 2023 were included in the review’s purview. RESULTS: …Based on our analysis, AI models for volume estimation, segmentation, tumour type differentiation, and separation from healthy tissues have been developed successfully. Developments in computational biology imply that AI can be used effectively in a variety of fields, including quality of life evaluations, monitoring, robotic-assisted surgery, feature extraction, radiomics, image analysis, clinical decision support systems, and treatment planning. CONCLUSION: For better AN diagnosis and treatment, a variety of imaging modalities require the development of strong, flexible AI models that can handle heterogeneous imaging data. Subsequent investigations ought to concentrate on reproducing findings in order to standardise AI approaches, which could transform their use in medical environments. Show more
Keywords: Artificial intelligence, diagnosis, acoustic neuroma, impact, management
DOI: 10.3233/THC-232043
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Huang, Yucheng | Ma, Xuan | Wu, Shilei | Chen, Ming | Wang, Junwen | Jiao, Jing
Article Type: Research Article
Abstract: BACKGROUND: Current treatments do not support direct exposure of fracture fragments, resulting in the inability to directly observe the articular surface during surgery for accurate reduction and firm fixation. OBJECTIVE: The aim of the study was to explore the treatment effect of digital virtual reduction combined with individualized guide plate of lateral tibial condyle osteotomy on tibial plateau fracture involving the lateral posterior condyle collapse. METHODS: 41 patients with tibial plateau fracture involving the lateral posterior condyle collapse were recruited in the trial. All patients underwent Computed Tomography (CT) scanning before operation. After …operation, fracture reduction was evaluated using Rasmussen score and function of knee joint was assessed using hospital for special surgery (HSS) score. RESULTS: 41 patients were followed-up 6–26 months (mean, 15.2 months). Fracture reduction was good after operation, with an average of 13.3 weeks of fracture healing without serious complications. The excellent and good rate was 97.6%. The joint movement degree was - 5∘ ∼ 0∘ ∼ 135∘ with an average of 125.5∘ . CONCLUSIONS: Digital virtual reduction combined with individualized guide plate of lateral tibial condyle osteotomy was effectively for treating tibial plateau fracture involving the lateral posterior condyle collapse. Show more
Keywords: 3D printing, tibial fracture, osteotomy, fracture fixation
DOI: 10.3233/THC-240704
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Yang, Zhongpeng | Tang, Yucong | Shan, Shuxiang
Article Type: Research Article
Abstract: BACKGROUND: Tuberculosis (TB), primarily caused by Mycobacterium tuberculosis , remains a significant global health concern. Targeted Next-Generation Sequencing (tNGS) has emerged as a rapid and comprehensive diagnostic tool for tuberculosis, offering advantages over traditional methods and serving as an effective alternative for drug susceptibility testing and the detection of drug-resistant tuberculosis. OBJECTIVE: This study aimed to retrospectively analyze the clinical characteristics of pulmonary tuberculosis patients. After explore the application value of targeted next-generation sequencing technology in this patient population, providing valuable insights for clinical diagnosis and treatment. METHODS: In this retrospective study, we …analyzed data from 65 patients with laboratory-confirmed tuberculosis admitted to Tianjin Baodi Hospital from November 14, 2020, to February 1, 2023. Patients underwent bronchoalveolar lavage fluid (BALF) testing, including acid-fast staining, culture, and tNGS. Biopsies and histopathological examinations were performed on some patients, along with comprehensive radiological assessments for all. RESULTS: Among the 65 pulmonary tuberculosis patients, targeted next-generation sequencing detected pathogens in bronchoalveolar lavage fluid with a positivity rate of 93.8%, significantly higher than traditional methods such as acid-fast staining, culture, and pathology. Compared to bronchoalveolar lavage fluid smear, targeted next-generation sequencing demonstrated significantly higher diagnostic sensitivity (98.46% vs. 26.15%) and accuracy (98.46% vs. 26.15%). CONCLUSION: Targeted next-generation sequencing, with its high sensitivity and specificity compared to traditional methods, provides unique advantages in detecting pathogens among these patients, highlighting its importance in disease management. Show more
Keywords: Pulmonary tuberculosis, bronchoalveolar lavage, pathology, targeted next-generation sequencing
DOI: 10.3233/THC-240823
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Ren, Die | Cai, Fei | Zhu, Mengqi | Zheng, Yijun | Chen, Wei
Article Type: Research Article
Abstract: BACKGROUND: Breast-conserving surgery is an important treatment for breast cancer, which not only eradicates the disease, but also protects the integrity of the breast, however, postoperative nausea and vomiting often bother patients. OBJECTIVE: This study examines the effects of evidence-based nursing practices on nausea and vomiting in patients after breast-conserving surgery, with the aim of providing new perspectives for clinical nursing practice. METHODS: One hundred and sixty patients who underwent breast-conserving surgery from January 2023 to December 2023 in Fudan University Shanghai Cancer Center were enrolled. The patients were divided into an intervention …group (evidence-based nursing group) and a control group (conventional nursing group) using the random number table method, both groups comprised 80 patients. The control group used conventional nursing methods, and the intervention group added evidence-based nursing intervention on this basis. Comparative analysis focused on the incidence of nausea and vomiting, quality of life metrics, and postoperative satisfaction. RESULTS: In the intervention group, notably lower incidence rates of postoperative nausea and vomiting were observed compared to the control group within both the 0–24 hour and 24–48-hour postoperative periods (P < 0.05). Furthermore, the intervention group exhibited significantly higher scores across all five dimensions as well as the overall score of the FACT-B scale in comparison to the control group (P < 0.05), accompanied by heightened satisfaction with the nursing staff. CONCLUSION: This study demonstrated the positive clinical intervention effects of evidence-based nursing measures and emphasized their importance in improving postoperative nausea and vomiting and quality of life. Future studies are expected to incorporate evidence-based nursing practices into nursing care to improve patient recovery and overall quality of care. Show more
Keywords: Breast cancer, breast-conserving surgery, evidence-based nursing practices, nausea and vomiting, interventions
DOI: 10.3233/THC-240814
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Cerrito, Adrien | Fang, Juan | Schertenleib, Simón Javier Gamero | Hunt, Kenneth James | Schmitt, Kai-Uwe
Article Type: Research Article
Abstract: BACKGROUND: Physical inactivity is prevalent among hospitalized patients and the daytime spent lying should be utilised for exercise. However, implementing new interventions in hospitals’ complex daily routines is difficult and requires a participatory approach. OBJECTIVE: Exploring clinical settings and clinicians’ perspectives regarding exercise in hospitalized patients to gauge the potential of further development of an in-bed training device and to formulate development goals. METHODS: A User-Centered Design approach was employed, consisting of work shadowing and focus groups with physiotherapists and nurses. Content and network analyses of the focus group data were performed. Personas …were then developed and used to create clinical scenarios. RESULTS: Some clinicians perceived in-bed exercise counterproductive, while others recognized potential for unsupervised training. The most important design characteristics appeared to be a small size, low weight and simplicity of use to facilitate storage, transportation, and administration, respectively. The scenarios revealed that the device’s use could increase the physical activity time by 1.4%, although it would also increase the working time of clinicians. CONCLUSION: The study highlighted the difficulties in developing a usable training device but encouraged the authors to pursue their efforts under the strict condition of following the formulated development goals. Show more
Keywords: Sedentary behavior, exercise, hospitalization, user-centered design
DOI: 10.3233/THC-240816
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Zhang, Yongmin | Wang, Dongbin | Gong, Hao | Tang, Haosen | Dong, Guangqi | Wang, Bin | Xia, Honggang
Article Type: Research Article
Abstract: BACKGROUND: Rib fractures are one of the most common blunt injuries, accounting for approximately 10% of all trauma patients and 60% of thoracic injuries. Multiple rib fractures, especially flail chest, can cause local chest wall softening due to the loss of rib support, leading to paradoxical breathing, severe pain, and a high likelihood of accompanying lung contusions. OBJECTIVE: This study investigates the mechanical properties of a new polymer material rib internal fixator to provide theoretical data for its clinical use. METHODS: We conducted in vitro mechanical tests on 20 fresh caudal fin sheep …ribs, using different fracture models across four randomly assigned groups (five ribs per group). The fixators were assessed using non-destructive three-point bending, torsion, and unilateral compression tests, with results averaged. Additionally, finite element analysis compared stress and strain in the polymer fixators and titanium alloy rib plates during bending and torsion tests. RESULTS: In vitro tests showed that the polymer fixators handled loads effectively up to a maximum without increase beyond a certain displacement. Bending and torsion tests via finite element analysis showed the polymer material sustained lower maximum equivalent stresses (84.455 MPa and 14.426 MPa) compared to titanium alloy plates (219.88 MPa and 46.47 MPa). CONCLUSION: The polymer rib fixator demonstrated sufficient strength for rib fracture fixation and was superior in stress management compared to titanium alloy plates in both bending and torsion tests, supporting its potential clinical application. Show more
Keywords: Rib fracture, internal fixation, rib internal fixator, biomechanics, finite element analysis
DOI: 10.3233/THC-240928
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Liu, Fengjie | Wang, Buquan | Mao, Chenggang
Article Type: Research Article
Abstract: BACKGROUND: Allergic Rhinitis (AR), a prevalent condition in otorhinolaryngology, is mediated by Type 1 hypersensitivity through IgE, characterized by Type 2 inflammatory response and eosinophil infiltration in the nasal mucosa. Since AR disease exhibits significant heterogeneity in symptom severity, an objective assessment of AR severity may facilitate better individualized treatment. OBJECTIVE: To explore the changes in peripheral blood IL-9, Th9, and BAFF levels of allergic rhinitis (AR) in patients and the clinical significance associated with it. METHODS: A retrospective study selected 80 AR patients admitted from January 2022 to October 2022 as the …case group, dividing them into mild and moderate-to-severe groups based on symptom scores. Concurrently, 50 patients without AR, who were treated for nasal bone fractures or underwent septoplasty, were selected as the group for comparison. Alterations in the expression levels of peripheral blood IL-9, Th9, and BAFF were analyzed and compared among the different groups. The diagnostic value of serum BAFF for the severity of AR was analyzed using the receiver operating characteristic (ROC) curve. RESULTS: Noticeable variations were observed in clinical variables among the three groups such as, total IgE levels, peripheral blood eosinophil count and proportion, TNSS, and VAS (P < 0.05), while no statistically significant differences were observed in other variables (P > 0.05). The comparison of IL-9, Th9, and BAFF among the three groups revealed statistically significant differences (P < 0.05). Analysis using multivariate logistic regression revealed that IL-9 (OR = 2.365), Th9 (OR = 2.186), BAFF (OR = 2.307) were influencing factors of moderate-to-severe AR (P < 0.05). The ROC curve indicated that the AUC for the diagnosis of moderate-to-severe AR by IL-9, Th9, BAFF were 0.770, 0.734, 0.761, respectively, and the combined detection AUC was 0.888, an area under the curve higher than individual testing. CONCLUSION: Changes in peripheral blood IL-9, Th9, and BAFF levels in AR patients may function as indicators to assess the level of severity in diagnostic procedures. Show more
Keywords: Allergic rhinitis, peripheral blood, IL-9, Th9, BAFF, clinical significance
DOI: 10.3233/THC-240756
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Cheng, Changfeng | Wang, Jiening | Yang, Kun | Wu, Xubo | Ren, Xue | Liu, Tiantian | Zhao, Zhongzhi | Zhang, Beibei | Ma, Bitao | Jiang, Liming
Article Type: Research Article
Abstract: BACKGROUND: Knee osteoarthritis is a common degenerative joint disease where a single treatment method often fails to fully alleviate symptoms. Hence, finding effective non-invasive combined treatment approaches is particularly crucial. OBJECTIVE: The efficacy of treating knee osteoarthritis with hip abductors exercise training combined with repetitive transcranial magnetic stimulation was assessed through functional scales and objective evaluation methods. METHODS: In this four-week randomized clinical trial, 160 patients meeting inclusion criteria were randomly assigned 1:1 to group A to receive oral celecoxib and group B to receive a combination of hip abductors exercise training and …repeated transcranial magnetic stimulation. The primary outcome was the western Ontario and McMaster universities osteoarthritis index. The secondary outcomes include Visual Analogue Scale, knee outcome survey activities of daily living scale, Active Range of Motion, and the Quadriceps Angle, the tibiofemoral angle, peak adductor moment, the integrated electromyography and root mean square of the surface electromyography of the lower extremity muscles. Paired sample t test was used for Within-Group comparison of outcome indicators, and independent sample t test was used for Between-Group comparison. RESULTS: Of the 160 randomly assigned patients, 150 completed the study. After 4 weeks, the WOMAC index decreased from 61 ± 10.83 to 40.55 ± 7.58 in the combined treatment group and from 60.97 ± 10.18 to 47.7 ± 10.13 in the celecoxib group. The effect of the combined treatment group was significantly higher than that in the celecoxib group (P < 0.001). In the combined treatment group, the score of knee joint daily living scale increased (P < 0.001), the active range of motion increased (P < 0.001), the quadriceps angle decreased (P < 0.001), the tibiofemoral angle increased (P < 0.001), and the peak adduction moment decreased (P < 0.001), integrated electromyography and root mean square increased (P < 0.001), and the effect was better than that of celecoxib group (P < 0.001). The visual analog scale score in celecoxib group was lower (P < 0.001) and knee outcome survey activities of daily living scale was higher (P < 0.001). The incidence of treatment-related adverse events was 10% in the celecoxib group and 2.5% in the combined treatment group, all of which were mild. CONCLUSIONS: Hip abductors exercise training combined with repetitive transcranial magnetic stimulation can enhance abduction muscle strength, improve mobility, reduce joint pain, and enhance quality of life. This combined approach shows superior clinical effectiveness compared to oral celecoxib. Show more
Keywords: Knee osteoarthritis, hip abductors exercise training, repetitive transcranial magnetic stimulation, surface electromyography, celecoxib
DOI: 10.3233/THC-240456
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Wang, Bo | Chen, Min | Wu, Yan | Qin, Xiaosai | Meng, Manshi
Article Type: Research Article
Abstract: BACKGROUND: The conventional round suture needle poses a significant risk of needle stick injuries among surgical physicians, identified as a global occupational hazard by the World Health Organization, increasing hospital costs and exposure to bloodborne pathogens. While novel blunt suture needles have shown promise in reducing these risks, their adoption is limited domestically, prompting a study to compare their efficacy against traditional sharp needles in reducing needle stick injuries among surgical physicians. OBJECTIVE: To investigate suture needle stick injuries among surgical doctors during operations and assess the application effectiveness of a novel blunt suture needle. …METHODS: A total of 106 surgical department physicians from March 2021 to February 2023 participated in the study. After completing a questionnaire survey on suture needle injuries during surgery, the participants were divided into two groups. Over a 6-month intervention period, the control group used regular round needles while the study group utilized novel blunt suture needles. Subsequently, suture needle injury incidence rates and economic hygiene benefits were compared between the two groups. RESULTS: The suture needle injury questionnaire survey showed that over the past 6 months, among 106 surgical department physicians, 20 needle stick injuries occurred, yielding an incidence rate of 18.87%. The highest incidence (65.00%) was during suturing incisions longer than 10 cm, primarily when visibility was poor (70.00%). Surgeons linked most injuries (60.00%) to prolonged surgical duration causing fatigue. Although 85.00% detected injuries within 1 minute, only 40.00% were reported, often due to perceived reporting complexity. Following intervention, the study group had significantly fewer injuries per surgery and lower occupational exposure costs compared to the control group (p < 0.05). CONCLUSION: Surgical department physicians commonly sustain suture needle injuries while suturing incisions of 5–10 cm length under poor visibility, exacerbated by prolonged surgical duration. Despite detecting most injuries within 1 minute, only 40% are reported. The implementation of novel blunt suture needles significantly decreases injury rates, resulting in reduced occupational exposure costs and favorable safety and economic hygiene outcomes. Show more
Keywords: Operating room, surgical physicians, blunt suture needle, suture needle stick injury, economic hygiene benefits
DOI: 10.3233/THC-240906
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Takahashi, Hakuo | Yamashita, Shingo | Yakura, Nobuki
Article Type: Research Article
Abstract: BACKGROUND: Blood pressure (BP) naturally undergoes fluctuations and variations, particularly during anesthesia administration during surgery, hemodialysis, upper and lower gastrointestinal endoscopy, exercise testing, arterial and venous catheterization, and rehabilitation. These changes in BP may lead to life-threatening events. OBJECTIVES: The performance of the Omron HBP-M4500 device in monitoring blood pressure (BP) in the upper arm was validated according to the International Organization for Standardization (ISO) 81060-2:2018+ amendment (Amd) 1:2020 protocol. METHODS: The device was used to assess 113 participants in the inflation mode, and 107 participants in the deflation mode. All …the patients fulfilled the inclusion criteria, including the arm circumference range and systolic and diastolic BP levels, outlined in the protocol. Data validation and analysis were performed according to the manufacturer’s instructions. RESULTS: In criterion 1, the mean ± standard deviation (SD) values of the differences between the test device and reference BP were - 0.6 ± 5.80/2.8 ± 6.78 mmHg (systolic/diastolic) and - 1.0 ± 5.35/3.2 ± 6.52 mmHg for the inflation and deflation modes, respectively. These data fulfilled the ISO81060-2:2018+ Amd1:2020 requirements of ⩽ 5 ± ⩽ 8 mmHg. In criterion 2, the differences were - 0.6 ± 4.44/2.8 ± 6.26 and - 1.0 ± 3.84/3.2 ± 6.09 mmHg for the inflation and deflation modes, respectively, fulfilling criterion 2 with SD values of ⩽ 6.91 and ⩽ 6.87 for systolic BP and ⩽ 6.34 and ⩽ 6.14 for diastolic BP in the inflation and deflation modes, respectively. These two criteria were fulfilled in both studies. CONCLUSION: The Omron HBP-M4500 device, either in inflation or deflation mode, fulfilled the criteria outlined in the ISO protocol. Therefore, this device is valuable for BP measurement in clinical and hospital settings. Show more
Keywords: Blood pressure monitoring device, validation study, international protocol
DOI: 10.3233/THC-240676
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Leinum, Lisbeth R. | Baandrup, Anders O. | Gögenur, Ismail | Krogsgaard, Marianne | Azawi, Nessn
Article Type: Research Article
Abstract: BACKGROUND: Innovations in healthcare technologies have the potential to address challenges, including the monitoring of fluid balance. OBJECTIVE: This study aims to evaluate the functionality and accuracy of a digital technology compared to standard manual documentation in a real-life setting. METHODS: The digital technology, LICENSE, was designed to calculate fluid balance using data collected from devices measuring urine, oral and intravenous fluids. Participating patients were connected to the LICENSE system, which transmitted data wirelessly to a database. These data were compared to the nursing staff’s manual measurements documented in the electronic patient record …according to their usual practice. RESULTS: We included 55 patients in the Urology Department needing fluid balance charting and observed them for an average of 22.9 hours. We found a mean difference of - 44.2 ml in total fluid balance between the two methods. Differences ranged from - 2230 ml to 2695 ml, with a divergence exceeding 500 ml in 57.4% of cases. The primary source of error was inaccurate or omitted manual documentation. However, errors were also identified in the oral LICENSE device. CONCLUSIONS: When used correctly, the LICENSE system performs satisfactorily in measuring urine and intravenous fluids, although the oral device requires revision due to identified errors. Show more
Keywords: Water-electrolyte balance, monitoring, physiologic, digital technology, automation, equipment design
DOI: 10.3233/THC-231303
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Wang, Ping | Ma, Shumei | Wang, Xuelian
Article Type: Research Article
Abstract: BACKGROUND: Soft ureteroscopic holmium laser lithotripsy is becoming increasingly popular as the preferred method for treating mid-to-lower ureteral stones. Studies have indicated that the size, composition, hardness, and fragility of the stones can impact the treatment’s effectiveness. OBJECTIVE: To explore the relationship between stone volume, average CT value and operation time and efficiency before ureteral soft lens laser lithotripsy. METHODS: Our study on 126 patients undergoing ureteroscopic holmium laser lithotripsy for ureteral calculi from May 2020 to January 2022 categorized them into groups based on stone volume and CT value. We compared surgical …outcomes and analyzed correlations between stone characteristics, operation parameters, and stone clearance rate to identify independent risk factors influencing treatment efficacy. RESULTS: Group A demonstrated significantly shorter operation durations and lower blood loss compared to Group B, along with higher single stone clearance rates and fewer postoperative complications. Similarly, Group C exhibited shorter operation times, reduced blood loss, higher stone clearance rates, and lower complication rates than Group D. Preoperative stone volume and CT value correlated positively with operation time and stone clearance rate, with both factors identified as independent risk factors affecting ureteral stone clearance following holmium laser lithotripsy. CONCLUSION: The stone volume and average CT value before ureteral soft lens laser lithotripsy show a positive correlation with operation time and efficiency, indicating that larger stone volumes and higher CT values lead to slower lithotripsy speeds and reduced operation efficiency. Furthermore, preoperative stone volume and average CT value are identified as independent risk factors for residual stones. Show more
Keywords: Ureteral soft lens laser lithotripsy, stone volume, stone CT value, operation time, operation efficiency
DOI: 10.3233/THC-240794
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: R, Seethalakshmi | S, Hariharan | Karnan, Hemalatha | V, Keerthana | V, Akshara
Article Type: Research Article
Abstract: BACKGROUND: Atherosclerosis is a condition which disrupts blood flow due to plaque build-up inside the arteries. Under conditions where consecutive plaques are prevailing blood hammer principle is exhibited. OBJECTIVE: The pressure and shear stress produced at an infinitesimal area act as the governing equation for stent modeling. The leading order pressure lays the foundation for the design of cardiac stents with definite dimensions. METHOD: The designed stent was encapsulated inside a crimper validated through ANSYS-static and transient structural simulation to derive the total deformation, equivalent strain, and stress exerted on the stent. Five …different biomaterials stainless steel 316, cobalt, chromium, platinum, and Poly lactic acid were selected for the material assessment. RESULT: Static and Transient structural analysis for a period of 1 and 10 secs was implemented for a stent with and without a crimper. The material performance in terms of total deformation, equivalent stress, and strain are analyzed. CONCLUSION: The paper envisions the dynamics of blood hammer in atherosclerosis that provides the changes in the pressure and clotting process. It shows the promising results of the stent behavior in varied forces which gives valuable insights for future improvement in stent design and material selection. Show more
Keywords: Atherosclerosis, blood hammer, stent, transient
DOI: 10.3233/THC-240051
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Yu, Lu | Yan, Ruping | Yang, Deling | Xia, Chengxing | Zhang, Zhixian
Article Type: Research Article
Abstract: BACKGROUND: Both radical prostatectomy and radiation therapy are effective in controlling the condition of patients with hormone-resistant prostate cancer (HRPCa). However, there is limited research on the prognosis and quality of life of HRPCa patients after different treatment modalities. OBJECTIVE: To explore the efficacy of radical prostatectomy (RP) and radiotherapy (RT), when treating high-risk prostate cancer (HRPCa). METHODS: Overall 103 HRPCa patients were included and were divided into RP group and RT group according to different treatment methods. The propensity score matching method (PSM) was used to balance the baseline data of the …two groups and match 34 patients in each group. The prognosis, quality of life, and basic efficacy of patients were compared. RESULTS: After intervention, the disease-free survival rate of the RT group was higher than that of the RP group (79.41% vs. 55.88%, p = 0.038). Quality of life scores between the two treatment methods had no difference before intervention (p > 0.05), but higher in RT group than that of the RP group after intervention (p < 0.05). After treatment, there was no statistically significant difference in total effective rate of treatment between two groups (44.12% vs. 58.82%, p > 0.05), but the disease control rate was significantly higher in RT group (94.12% vs. 76.47%, p = 0.040). CONCLUSION: Radical radiotherapy is effective in the clinical treatment of HRPCa patients, with a higher disease-free survival rate and improved quality of life after treatment, and is worth promoting. Show more
Keywords: Radical prostatectomy, radical radiotherapy, disease-free survival rate, quality of life
DOI: 10.3233/THC-240910
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Gong, Feifei | Wang, Hui | Shan, Zhixuan | Zhuang, Shaoyu | Xia, Huakuan | Tang, Liyu
Article Type: Research Article
Abstract: BACKGROUND: Oral cancer has a high worldwide incidence and mortality rate showing an upward trend year by year, predominantly occurring in emerging countries. Oral squamous cell carcinoma (OSCC) is one of the main types of oral cancer, accounting for more than 90% of all cases in oral cancer. OBJECTIVE: To evaluate the diagnostic value of 8-hydroxy-2’-deoxyguanosine (8-OHdG), 8-iso-Prostaglandin F2alpha (8-iso-PGF2α ) and tumor necrosis factor (TNF)-α as biomarkers in the early carcinogenesis of erosive oral lichen planus (EOLP) by measuring their levels in the blood of patients with EOLP and oral …squamous cell carcinoma (OSCC). METHODS: A total of 69 patients were enrolled in this case-control study [including an OSCC group (n = 23), an EOLP group (n = 23), and an age- and gender-matched healthy control group (n = 23)]. Blood levels of 8-OHdG, 8-iso-PGF2α and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA). Statistical differences in these indicators among the three groups were analyzed. RESULTS: Plasma levels of 8-OHdG and 8-iso-PGF2α in the OSCC group were significantly higher than those in both the EOLP group and the control group (all P < 0.05); no significant statistical difference was found between the EOLP group and the control group. Serum levels of TNF-α in both the OSCC and EOLP groups were elevated compared with the control group, showing significant differences among all three groups (all P < 0.05). Receiver operating characteristic (ROC) curves revealed that plasma 8-OHdG and 8-iso-PGF2α levels and serum TNF-α levels had diagnostic effects on early carcinogenesis in EOLP patients. When these indicators were combined for diagnosis, the diagnostic effect was enhanced, with an area under the ROC curve (AUC) values of 0.819. CONCLUSION: 8-OHdG, 8-iso-PGF2α and TNF-α may serve as biological indicators for monitoring the early carcinogenesis of EOLP, and the diagnostic effect was augmented when these indicators were combined. Show more
Keywords: OSCC, erosive oral lichen planus, 8-OHdG, 8-iso-PGF2α, TNF-α
DOI: 10.3233/THC-240930
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Shao, Liang | Gao, Ying | Zhang, Dan | Yang, Mengdan | Jiang, Mimi | Li, Hongfeng | Yan, Yanting
Article Type: Research Article
Abstract: BACKGROUND: non-small cell lung cancer (NSCLC) accounts for more than 80% of all lung cancer populations. Stereotactic radiotherapy (SBRT) is mainly suitable for early NSCLC patients who are not suitable for surgery or refuse surgery. OBJECTIVE: To analyze the effects of stereotactic radiotherapy (SBRT) plus immunotherapy for non-small cell lung cancer (NSCLC) patients on their immune status and survival quality. METHODS: NSCLC patients admitted to our hospital from 2019–2022 were divided into 61 cases in control group (SBRT) and 60 cases in observation group (SBRT plus immunotherapy) by the randomized numerical table method …to compare the efficacy, the level of tumor markers in the serum, the level and activity of the immune cells in the peripheral blood and the Kahlil’s functional status (KPS) scores. RESULTS: The observation group had a higher efficacy rate than that of the control group (P < 0.05). There was no statistical difference between the two groups in serum tumor marker content, immune cell level and activity in peripheral blood and KPS score before treatment (P > 0.05). After treatment, serum tumor markers were lower than those in control group, and immune cell level, NK cell-related activity and KPS score were higher than those in control group (P < 0.05). CONCLUSION: SBRT plus immunotherapy can reduce the level of various tumor markers, improve the immune status and quality of survival for NSCLC patients. Show more
Keywords: Stereotactic radiotherapy, immunotherapy, non-small cell lung cancer, immune status, survival quality
DOI: 10.3233/THC-241177
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Liu, Bo | Wang, Kebing | Ye, Si
Article Type: Research Article
Abstract: BACKGROUND: Accurately identifying the branches of pulmonary segmental vessels and bronchi, as well as adjacent structures, and determining the spatial location of lesions within pulmonary segments, are major challenges for thoracic surgeons. The application of three-dimensional reconstruction technology holds promise in addressing this issue. OBJECTIVE: To evaluate the clinical value of three-dimensional reconstruction in thoracoscopic segmental surgery. METHODS: Seventy-seven patients who underwent thoracoscopic segmental surgery combined with three-dimensional reconstruction at our hospital from January 1, 2020, to August 31, 2023, were retrospectively analyzed. Preoperative chest enhanced CT scans were conducted, and MIMICS software …aided in reconstructing DICOM format original data for patients with pulmonary nodules to facilitate intraoperative nodule localization. Accurate segmental pneumonectomy was performed by comparing preoperative anatomical identification of target segmental arteries, veins, and bronchi, with surgical details and postoperative outcomes recorded, including intraoperative pulmonary resection distribution, operation time, blood loss, chest tube drainage, extubation time, hospital stay, and complications. RESULTS: Following preoperative three-dimensional reconstruction, successful segmental lung surgeries were performed, predominantly with single segmental resection (92.2%), and a minority with combined segmentectomy (7.8%). Median operation time was 130225 minutes, with intraoperative blood loss at 70100 mL and postoperative chest tube drainage at 347 mL (159690 mL). Median extubation time and hospital stay were 4 days and 7 days, respectively. Complications within the 3-month follow-up affected 11.7% of cases, including persistent pulmonary leakage (7.1%), pulmonary infection (4.3%), atelectasis (4.3%), and pleural effusion (1.4%), with no fatalities. CONCLUSION: Preoperative 3D reconstruction can help the operator to perform safe, efficient and accurate thoracoscopic segmental pneumonectomy, which is worth popularizing in clinic. Show more
Keywords: Segmental resection, pulmonary nodules, lung cancer, thoracoscopic three-dimensional reconstruction
DOI: 10.3233/THC-240786
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Li, Pengxin | Peng, Sheng | Song, Zhenghuan | Tan, Jing | Gu, Lianbing
Article Type: Research Article
Abstract: BACKGROUND: Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2–4 times compared with that in patients without diabetes. OBJECTIVE: This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus METHODS: This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and …then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA) RESULTS: This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CONCLUSIONS: CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study’s findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery. Show more
Keywords: Diabetes mellitus, general anesthesia, CGRP, SP
DOI: 10.3233/THC-240907
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Han, Zhen | Liu, Yangan | Tan, Ming | Hua, Zhaolai | Dai, Chun
Article Type: Research Article
Abstract: BACKGROUND: Surgery remains the most effective treatment for colon cancer. However, there are still controversies regarding the tumor treatment effect, prognosis, and perioperative impact of complete mesocolic excision (CME) surgery in colon carcinoma resection. OBJECTIVE: This study aims to compare laparoscopic complete mesocolic excision (LCME) and traditional open D2 radical surgery in colon carcinoma resection through a retrospective analysis using 1:1 propensity score matching (PSM). METHODS: 98 cases undergoing LCME or open D2 colon carcinoma resection at our hospital from January 2014 to November 2021 were retrospectively collected. After excluding cases and 1:1 matching using …PSM based on baseline clinical data, 86 patients were assigned in research queue. 43 patients were in each group. Two groups were compared for general clinical baseline indicators. Surgical results and postoperative adverse events of patients were also compared. Disease-free survival (DFS) rate and overall survival (OS) rate was analyzed. RESULTS: After 1:1 PSM matching, there was no statistically significant differences in baseline data between the LCME group and D2 group (P > 0.05). LCME was characterized by longer total duration of surgery (P < 0.001), less intraoperative bleeding volume (P < 0.001), more postoperative drainage fluid volume (P < 0.001), greater number of lymph nodes retrieved (P = 0.014). No statistically differences was observed regarding intraoperative blood transfusion, hospital stay, Clavien-Dindo complicating disease classification (all P > 0.05), 1 and 3-year DFS rate (P = 0.84) and OS rate (P ⩾ 0.1). CONCLUSION: LCME had a longer duration of surgery but less intraoperative bleeding volume and more postoperative drainage fluid volume and retrieved lymph nodes compared to D2 radical surgery. LCME surgery is comparable to D2 surgery in terms of postoperative prognosis, but LCME surgery shows a positive trend in the overall survival curve. Show more
Keywords: Laparoscopic complete mesocolic excision, traditional D2 radical surgery, Colonic Neoplasms, propensity score matching
DOI: 10.3233/THC-241149
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Sawan, Nozha | Ben Gassem, Afnan
Article Type: Research Article
Abstract: BACKGROUND: Esthetic orthodontic wires are preferred for their ease to fit in with natural tooth color, but their susceptibility to staining in the oral environment poses a concern. Various Coatings such as Teflon and Epoxy aim to enhance appearance and biocompatibility but may still result in discoloration. Understanding the color stability of these wires under different staining conditions is crucial for a better and enhanced treatment plan. OBJECTIVE: This study intended to assess the color stability of esthetic orthodontic wires under various staining solutions that are often used in daily life. METHOD: …Color changes of Teflon and Epoxy-coated esthetic orthodontic wires were meticulously measured at baseline, 7, 14, and 21-day intervals utilizing the precise CIE Lab* color measurement system. A total of thirty-two samples of wires from each brand were prepared (n = 8/group) and immersed in staining solutions (coffee, tea, cola, and saffron). The color change within and between the groups was statistically evaluated (p < 0.05). RESULTS: Significant variations in color stability were observed across different staining solutions. Saffron emerged as the most potent agent, inducing the most pronounced color changes, whereas cola demonstrated the least impact. Furthermore, Epoxy-coated wires consistently exhibited superior color stability compared to their Teflon-coated counterparts across all staining solutions and time intervals. CONCLUSION: This study underlines the significance for orthodontists to consider staining agents’ possible effects on orthodontic wires into account when selecting the orthodontic wires. The findings suggest that Epoxy-coated wires hold promise in mitigating discoloration issues during orthodontic therapy. Show more
Keywords: Esthetic orthodontic wire, color change, tea, coffee, cola, saffron
DOI: 10.3233/THC-240638
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Yang, Ping | Wu, Xiaoneng
Article Type: Research Article
Abstract: BACKGROUND: The objective performance evaluation of an athlete is essential to allow detailed research into elite sports. The automatic identification and classification of football teaching and training exercises overcome the shortcomings of manual analytical approaches. Video monitoring is vital in detecting human conduct acts and preventing or reducing inappropriate actions in time. The video’s digital material is classified by relevance depending on those individual actions. OBJECTIVE: The research goal is to systematically use the data from an inertial measurement unit (IMU) and data from computer vision analysis for the deep Learning of football teaching motion recognition …(DL-FTMR). There has been a search for many libraries. The studies included have examined and analyzed training through profound model construction learning methods. Investigations show the ability to distinguish the efficiency of qualified and less qualified officers for sport-specific video-based decision-making assessments. METHODS: Video-based research is an effective way of assessing decision-making due to the potential to present changing in-game decision-making scenarios more environmentally friendly than static picture printing. The data showed that the filtering accuracy of responses is improved without losing response time. This observation indicates that practicing with a video monitoring system offers a play view close to that seen in a game scenario. It can be an essential way to improve the perception of selection precision. This study discusses publicly accessible training datasets for Human Activity Recognition (HAR) and presents a dataset that combines various components. The study also used the UT-Interaction dataset to identify complex events. RESULTS: Thus, the experimental results of DL-FTMR give a performance ratio of 94.5%, behavior processing ratio of 92.4%, athletes energy level ratio of 92.5%, interaction ratio of 91.8%, prediction ratio of 92.5%, sensitivity ratio of 93.7%, and the precision ratio of 94.86% compared to the optimized convolutional neural network (OCNN), Gaussian Mixture Model (GMM), you only look once (YOLO), Human Activity Recognition- state-of-the-art methodologies (HAR-SAM). CONCLUSION: This finding proves that exercising a video monitoring system that provides a play view similar to that seen in a game scenario can be a valuable technique to increase selection accuracy perception. Show more
Keywords: Football, training, deep learning, video surveillance, skills, detection
DOI: 10.3233/THC-231860
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-20, 2024
Authors: Sun, Rui | Hao, Jianfeng | Li, Qian | Xie, Weinan | Hu, Xiaoyan | Chen, Zhenzhen | Liu, Zhi | Yuan, Ling
Article Type: Research Article
Abstract: BACKGROUND: NiaoDuQing Particle is the first Chinese herbal medicine approved by the China Food and Drug Administration for the treatment of chronic kidney disease. It has been used in clinical practice in China for over twenty years. However, there is limited literature reporting on the long-term therapeutic effects of NiaoDuQing Particles on chronic kidney disease patients. OBJECTIVE: This research aimed to comprehensively assess the therapeutic effect of NiaoDuQing Particles (NDQP) on chronic kidney disease patients based on clinical data analysis. METHODS: This study was carried out on a total of 148 participants diagnosed …with different types of chronic kidney disease. Demographics information, chronic kidney disease classification and chronic kidney disease diganostic indicators were collected and analyzed before and after NiaoDuQing Particles treatment for 3, 6, 9, 12 and 18 months respectively. RESULTS: In all 148 patients, mean eGFR value was increased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean uric acid value was decreased after NiaoDuQing Particles treatment for up to 18 months, and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). Mean urea nitrogen value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 3, 6, 9, 12 and 18 (P < 0.05). While mean creatinine value was decreased after NiaoDuQing Particles treatment for up to 18 months and was statistically significant at month 6 (P < 0.05). CONCLUSIONS: NiaoDuQing Particles could maintain the stable state of chronic kidney disease patients for up to 18 months especially in improving diagnostic indicators like eGFR, uric acid and urea nitrogen. Show more
Keywords: Chronic kidney disease, NiaoDuQing particles, eGFR, uric acid, urea nitrogen
DOI: 10.3233/THC-241029
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Milovanovic, Aleksandar | Isailovic, Velibor | Saveljic, Igor | Filipovic, Nenad
Article Type: Research Article
Abstract: BACKGROUND: Fractional flow reserve (FFR) determined invasively has been globally accepted as the gold standard for determining the functional significance of coronary artery stenoses. However, despite its great importance, the invasive method has certain disadvantages, including the risk of vascular injuries, the need for vasodilation, and significant medical costs. That is why great attention was paid to the development of non-invasive methods that would enable reliable diagnosis without exposing patients to the risk of unwanted consequences. OBJECTIVE: This paper aimed to create and verify an alternative, less resource- and time-demanding, non-invasive solution. METHODS: …The determination of FFR is based on the application of the fundamental laws of fluid dynamics. All energy losses in the coronary artery with stenosis were identified and analyzed in detail. A three-dimensional model of a coronary artery was generated using the corresponding angiographic images. Finally, the pressure due to stenosis was calculated and the FFR was determined. RESULTS: The results obtained using the proposed analytical method were compared with available experimental data for 40 patients who experienced the invasive coronary angiography. The coefficient of determination, mean difference and standard deviation values are determined to be 0.726, - 0.017 and 0.056, respectively. These values were slightly higher for FFR values above 0.80. CONCLUSION: The FFR calculated by the proposed analytical method has a relatively good correlation with clinical data, which leads to the conclusion that it can provide a reliable assessment of the functional significance of coronary stenosis. Show more
Keywords: Coronary artery stenosis, analytical method, fractional flow reserve
DOI: 10.3233/THC-240803
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Hua, Defeng | Chen, Yan
Article Type: Research Article
Abstract: BACKGROUND: The present study investigated the association between cerebrovascular diseases and sepsis, including its occurrence, progression, and impact on mortality. However, there is currently a lack of predictive models for 28-day mortality in patients with cerebrovascular disease associated with sepsis. OBJECTIVE: The objective of this study is to examine the mortality rate within 28 days after discharge in this population, while concurrently developing a corresponding predictive model. METHODS: The data for this retrospective cohort study were obtained from the MIMIC-IV database. Patients with sepsis and cerebrovascular disease in the ICU were included. Laboratory …indicators, vital signs, and demographic data were collected within 24 hours of ICU admission. Mortality rates within 28 days after discharge were calculated based on patient death times. Logistic regression analysis was used to identify potential variables for a predictive model. A nomogram visualized the prediction model. The performance of the model was evaluated using ROC curves, Calibration plots, and DCA. RESULTS: The study enrolled a total of 2660 patients diagnosed with cerebrovascular disease complicated by sepsis, consisting of 1434 males (53.91%) with a median age of 70.97 (59.60, 80.73). Among this cohort of patients, a total of 751 fatalities occurred within 28 days following discharge. The multivariate regression analysis revealed that age, creatinine, arterial oxygen partial pressure (Pa O2), arterial carbon dioxide partial pressure (Pa CO2), respiratory rate, white blood cell (WBC) count, Body Mass Index (BMI), and race demonstrated potential predictive variables. The aforementioned model yielded an area under the ROC curve of 0.744, accompanied by a sensitivity of 66.2% and specificity of 71.2%. Furthermore, both calibration plots and DCA demonstrated robust performance in practical applications. CONCLUSION: The proposed prediction model allows clinicians to promptly assess the mortality risk in patients with cerebrovascular disease complicated by sepsis within 28 days after discharge, facilitating early intervention strategies. Consequently, clinicians can implement additional advantageous medical interventions for individuals with cerebrovascular disease and sepsis. Show more
Keywords: Predictive model, 28-day mortality, sepsis, cerebrovascular disease
DOI: 10.3233/THC-241150
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Wu, Weichuan | Li, Chengyan | Men, Donghai | Li, Xiaopeng | Huang, Baqi
Article Type: Research Article
Abstract: BACKGROUND: Multiple studies have shown that early decompressive surgery in patients with intracerebral hemorrhage can effectively limit hematoma expansion, reduce perihematomal edema, and improve prognosis. However, these studies are limited by small sample sizes and short follow-up times. OBJECTIVE: To analyze the effect of early decompressive surgery on the long-term prognosis of patients with cerebral hemorrhage and identify the influencing factors for poor prognosis. METHODS: A retrospective analysis of 78 patients with cerebral hemorrhage admitted between January 2020 and December 2022 was conducted. Patients were divided into early and delayed surgery groups for comparison of …outcomes such as mortality rate, modified Rankin Scale score, and Short Form-36 scores. Additionally, factors influencing long-term prognosis were analyzed through logistic regression based on significant differences observed between groups. RESULTS: The early decompressive surgery group showed superior outcomes with lower mortality rates, modified Rankin Scale (mRS) scores, hematoma expansion rates, and perihematomal edema volumes compared to the delayed surgery group (P < 0.05). Additionally, age, preoperative Glasgow Coma Scale (GCS) score, preoperative hematoma volume, and a history of hypertension or diabetes were identified as independent prognostic factors for patients with cerebral hemorrhage, with odds ratios (ORs) greater than 1. CONCLUSIONS: Early decompressive surgery can improve the long-term prognosis and quality of life of patients with cerebral hemorrhage, reduce mortality rates, and decrease hematoma expansion and perihematomal edema. Older patients, those with higher preoperative hematoma volume and GCS score, and those with coexisting hypertension and diabetes should be given special attention to decrease the occurrence of adverse prognosis. Show more
Keywords: Early decompressive surgery, cerebral hemorrhage, long-term prognosis, influencing factors
DOI: 10.3233/THC-240766
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Paramasivam, Gokila Brindha | Ramasamy Rajammal, Rajalaxmi
Article Type: Research Article
Abstract: BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a medical condition that causes hormonal disorders in women in their childbearing years. The hormonal imbalance leads to a delayed or even absent menstrual cycle. Women with PCOS mainly suffer from extreme weight gain, facial hair growth, acne, hair loss, skin darkening, and irregular periods, leading to infertility in rare cases. Doctors usually examine ultrasound images and conclude the affected ovary but are incapable of deciding whether it is a normal cyst, PCOS, or cancer cyst manually. OBJECTIVE: To have access to the high-risk crucial PCOS and to detect the …condition and the treatment aimed at mitigating health hazards such as endometrial hyperplasia/cancer, infertility, pregnancy complications, and the long-term burden of chronic diseases such as cardiometabolic disorders linked with PCOS. METHODS: The proposed Self-Defined Convolution Neural Network method (SD_CNN) is used to extract the features and machine learning models such as SVM, Random Forest, and Logistic Regression are used to classify PCOS images. The parameter tuning is done with lesser parameters in order to overcome over-fitting issues. The self-defined model predicts the occurrence of the cyst based on the analyzed features and classifies the class labels effectively. RESULTS: The Random Forest Classifier was found to be the most reliable and accurate among Support Vector Machine (SVM) and Logistic Regression (LR), with accuracy being 96.43%. CONCLUSION: The proposed model establishes better trade-off compared to various other approaches and works effectually for PCOS prediction. Show more
Keywords: SD_CNN, follicles, grid search, recognition rate, dropout, multinomial, exponential growth, and perimeter
DOI: 10.3233/THC-230935
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-17, 2024
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