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Price: EUR 150.00Authors: Orsi, Alexander D. | Mathew, Manu | Plaskos, Christopher | Wakelin, Edgar A. | Slotkin, Eric M. | Coffey, Simon | Ponder, Corey E. | Keggi, John K. | McMahon, Stephen J.
Article Type: Research Article
Abstract: BACKGROUND: Passive smartphone-based apps are becoming more common for measuring patient progress after total hip arthroplasty (THA). Optimum activity levels during early THA recovery have not been well documented. OBJECTIVES: Correlations between step-count and patient reported outcome measures (PROMs) during early recovery were explored. This study also investigated how demographics impact step-count during early post-operative recovery. METHODS: Smartphone captured step-count data from 666 THA patients was retrospectively reviewed. Mean age was 64 ± 11 years. 55% were female. Mean BMI was 29 ± 8kg/m 2 …. Mean daily step-count was calculated for each patient over four time-windows: 60 days prior to surgery (preop), 42–49 days postop (6 weeks), 91–98 days postop (3 months), and 183–197 days postop (6 months). Spearman correlation coefficients and linear regression were used to assess the association between PROMs (HOOS-12, HOOS-Jr, and UCLA) were performed. Patients were separated into three step-count levels: low (< 2500 steps/day), medium (2500–5500 steps/day), and high (> 5500 steps/day). Age > 65 years, BMI > 35 kg/m 2 , and sex were used for demographic comparisons. Post hoc analyses were performed using Welch’s unequal variances t -tests, or Wilcoxon rank-sum tests, both with Bonferroni corrections, where appropriate when comparing between groups. Chi-squared analyses were also used when comparing categorical variables. RESULTS: UCLA correlated with step-count at all time-windows (p < 0.001). HOOS12-Function correlated with step-count preoperatively, at 6 weeks, and at 3 months (p < 0.001). High step-count individuals had improved UCLA scores compared to low step-count individuals preoperatively (Δ 1.5, p < 0.001), at 6 weeks (Δ 0.9, p < 0.001), at 3 months (Δ 1.4, p < 0.001), and at 6 months (Δ 1.4, p < 0.001). High step-count individuals had improved HOOS12-Function scores compared to low step-count individuals preoperatively (Δ 9.6, p < 0.001), at 6 weeks (Δ 5.3, p < 0.001), and at 3 months (Δ 6.1, p < 0.001). Males had greater step-count at all time points (p < 0.001). Younger patients and low BMI patients had greater step-count across all time points (p < 0.001). CONCLUSION: High step-count improved PROMs scores compared to low step-count. Early post-operative step-count was significantly impacted by age, sex, and BMI. Generic recovery profiles may not be appropriate across diverse populations. Show more
Keywords: Total hip arthroplasty, smartphone, step-count, PROMs, remote patient monitoring
DOI: 10.3233/THC-231203
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: DeClaire, Jeffrey H. | Wakelin, Edgar A. | Chattinger, Kayla | Plaskos, Christopher
Article Type: Research Article
Abstract: BACKGROUND: Early complications in total knee arthroplasty (TKA) associated with modern robotics platforms integrated with digital balancing technology have not been investigated. OBJECTIVE: The objective was to compare 90-day complication rates between a manual technique and a modern robotic-assisted ligament balancing TKA platform. METHODS: 895 primary TKA procedures from a single surgeon were retrospectively reviewed (614 manual TKA, 281 using a modern robotics platform with an integrated digitally controlled ligament balancing device). Post-operative complications within the 90-day episode of care were recorded by the Michigan Arthroplasty Registry Collaborative Quality Initiative. Differences in complication …rates between techniques were further divided into inpatient hospital, outpatient hospital, and ambulatory surgery center (ASC) cohorts. RESULTS: In the pooled hospital cohort and inpatient hospital cohort, ‘Return to OR’ was significantly lower for the robotic assisted group (1.3% vs 5.2% and 0% vs 4.9%, respectively, p < 0.0370). Specifically, the need for manipulation under anesthesia (MUA) was reduced for the robotics group (0.0% vs 2.5%, p = 0.0352). No differences in overall complication rate or cause of complication was found between manual and robotics cases for the hospital outpatient and ASC cohorts (p ⩾ 0.68). CONCLUSION: Within the hospital setting, robotic assisted ligament balancing technology was associated with reduced 90-day postoperative complications for ‘Return to OR’ and MUA. Show more
Keywords: Total knee arthroplasty, robotics, soft tissue, complications, hospital, ambulatory surgical center, ASC
DOI: 10.3233/THC-231198
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Guo, Julong | Ning, Yachan | Pan, Dikang | Wu, Sensen | Gao, Xixiang | Wang, Cong | Guo, Lianrui | Gu, Yongquan
Article Type: Research Article
Abstract: BACKGROUND: Endothelial dysfunction, the earliest stage of atherosclerosis, can be caused by smoking, but its molecular mechanism requires further investigation. OBJECTIVE: This study aimed to use bioinformatics analysis to identify potential mechanisms involved in smoking-related atherosclerotic endothelial dysfunction. METHODS: The transcriptome data used for this bioinformatics analysis were obtained from the Gene Expression Omnibus (GEO) database. The GSE137578 and GSE141136 datasets were used to identify common differentially expressed genes (co-DEGs) in endothelial cells treated with oxidized low-density lipoprotein (ox-LDL) and tobacco. The co-DEGs were annotated using Gene Ontology (GO) and Kyoto Encyclopedia of …Genes and Genomics (KEGG) databases. Additionally, a protein-protein interaction (PPI) network was constructed to visualize their interactions and screen for hub genes. GSE120521 dataset was used to verify the expression of hub genes in unstable plaques. The miRNA expression profile GSE137580 and online databases (starBase 2.0, TargetScan 8.0 and DGIdb v4.2.0) were used to predict the related non-coding RNAs and drugs. RESULTS: A total of 232 co-DEGs were identified, including 113 up-regulated genes and 119 down-regulated genes. These DEGs were primarily enriched in detrimental autophagy, cell death, transcription factors, and cytokines, and were implicated in ferroptosis, abnormal lipid metabolism, inflammation, and oxidative stress pathways. Ten hub genes were screened from the constructed PPI network, including up-regulated genes such as FOS, HMOX1, SQSTM1, PTGS2, ATF3, DDIT3, and down-regulated genes MCM4, KIF15, UHRF1, and CCL2. Importantly, HMOX1 was further up-regulated in unstable plaques (p = 0.034). Finally, a regulatory network involving lncRNA/circRNA-miRNA-hub genes and drug-hub genes was established. CONCLUSION: Atherosclerotic endothelial dysfunction is associated with smoking-induced injury. Through bioinformatics analysis, we identified potential mechanisms and provided potential therapeutic targets. Show more
Keywords: Atherosclerosis, smoke, tobacco, endothelial cells, genes
DOI: 10.3233/THC-230796
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Hoveidaei, Amir Human | Esmaeili, Sina | Ghaseminejad-Raeini, Amirhossein | Pirahesh, Seyed Kasra | Hoveidaei, Armin | Sandiford, Nemandra A. | Lahner, Nina | Citak, Mustafa
Article Type: Review Article
Abstract: BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a viable alternative to total knee arthroplasty (TKA) for osteoarthritis patients with single-compartment involvement, with advantages including accelerated recovery, reduced pain, and improved function. Robotic-assisted UKA (rUKA) is a promising development that ensures precise implant positioning and limb alignment. However, concerns about complications remain. OBJECTIVE: This study looks at patient satisfaction as a key metric for determining the efficacy of rUKA versus manual UKA (mUKA). METHODS: The search strategy for this study followed PRISMA. Using precise keywords, PubMed, Scopus, Web of Science, and the Cochrane library were …searched. English articles were searched until August 2, 2023. Selection criteria included mUKA and rUKA patient satisfaction studies. The NOS scale evaluated study quality. Meta-analysis was done with R and heterogeneity analysis. RESULTS: This systematic review examined 5 studies with 1060 UKAs (532 robotic-assisted and 528 manual). Variable satisfaction assessment methods were used. Three studies found no difference in patient satisfaction after robotic-assisted UKA, but two found a higher satisfaction. Meta-analysis showed robotic-assisted UKA improved patient satisfaction (OR = 1.72 [1.25–2.37]). Overall, most studies showed low risk of bias, except one with higher bias. CONCLUSION: This review suggests that robotic assistance may enhance patient satisfaction in UKA procedures. Show more
Keywords: Arthroplasty, replacement, knee, medical device, patient satisfaction, robotic surgical procedures
DOI: 10.3233/THC-231216
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Liu, Dong-Xu | Wu, Ke-Han | Zang, Xi-Yan | Lu, Jia-Yi | Liu, Ming-Yue | Li, Chun-Ming | Gao, Li
Article Type: Research Article
Abstract: BACKGROUND: Oral squamous cell carcinoma (OSCC) is an infiltrative malignancy characterized by a significantly elevated recurrence rate. Dickkopf-related protein 1 (DKK1), which plays an oncogene role in many cancers, acts as an inhibitor of the Wingless protein (Wnt) signaling pathway. Currently, there is a lack of consensus regarding the role of DKK1 in OSCC or its clinical significance. OBJECTIVE: To examine the role and effect of DKK1 in OSCC. METHODS: The identification of differentially expressed genes (DEGs) in OSCC was conducted by utilizing databases such as The Cancer Genome Atlas (TCGA) and Gene …Expression Omnibus (GEO). A comprehensive analysis of gene expression profile interactions (GEPIA) and Kaplan-Meier curve were conducted to investigate the associations among DEGs, patient survival and prognosis in individuals with OSCC. The biological function of DKK1 in OSCC was investigated by using molecular biology approaches. RESULTS: The expression of DKK1 was found to be upregulated in OSCC tissues at various stages. High levels of DKK1 expression exhibited a positive correlation with the overall survival (OS) and progression-free survival (PFS) rates among OSCC patients. DKK1 knockdown suppressed the proliferation and induced apoptotic response in OSCC cells. Moreover, DKK1 exerted a positive regulatory effect on HMGA2 expression, thereby modulating cell growth and apoptosis in OSCC. The expression of DKK1 was found to be positively correlated with the infiltration of immune cells in patients with OSCC. Additionally, higher levels of CD4 + T cells were associated with improved 5-year survival rates. CONCLUSION: DKK1 is a prognostic biomarker for patients with OSCC. Show more
Keywords: Dickkopf-related protein 1, HMGA2, immune status, Oral squamous cell carcinoma
DOI: 10.3233/THC-230527
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Akçaalan, Serhat | Akbulut, Batuhan | Çağlar, Ceyhun | Innocenti, Matteo | Uğurlu, Mahmut | Dogan, Metin | Akkaya, Mustafa
Article Type: Research Article
Abstract: BACKROUND: Periprosthetic joint infection (PJI) is a very important complication that occurs after total joint replacement. Diagnosing PJI is at least as difficult as this disease. There is no biomarker that alone can diagnose PJI. OBJECTIVE: This study aimed to evaluate the effectiveness of large unstained cell percentage (%LUC) in diagnosing PJI and deciding on re-implantation in two stage septic exchange arthroplasty. METHODS: Patients who underwent revision arthroplasty between 2019 and 2023 were screened retrospectively. These patients were grouped as those who underwent two-stage septic exchange and those who underwent aseptic exchange. Prosthesis …removal from the patients who underwent two-stage septic exchange, before spacer application, and on the 3rd post-operative day after spacer application, Blood parameters were collected at the 1st month and before the second stage after the spacer application, and before the revision surgery from the patients who underwent aseptic exchange. White blood cell, neutrophil percentage, %LUC, albumin, sedim and CRP values were checked and recorded one by one from all patients. RESULTS: The data of a total of 233 patients, including 133 patients in the two stage septic exchange group and 100 patients in the aseptic exchange group, were included in the study. When the predictive value of %LUC in PJI was accepted as cut-off 1.75, the sensitivity was 69.2% and the specificity was 73%. The change in %LUC over time in patients who underwent two-stage septic exchange was statistically significant (p = 0.0001). A positive correlation was found between the value of .%LUC after spacer application and the value of CRP before prosthesis protrusion/spacer application surgery, and the Spearman correlation coefficient was found to be 0.005. CONCLUSION: %LUC value can be a promising biomarker for the diagnosis of PJI by considering both sensitivity and specificity rates. Apart from this, it is an easily accessible and effective biomarker for re-implantation decision making and evaluation of response to treatment, especially in two-stage septic exchange surgeries. Show more
Keywords: Periprosthetic joint infection, %LUC, biomarker, two stage, septic exchange
DOI: 10.3233/THC-230903
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Lin, Wan-Rong | Liu, Wei-Qing | Meng, Xuan-Yu | Liu, Xiao-Ting | Kou, Zhi-Yong | Li, Wen-Liang | Yang, Jun
Article Type: Research Article
Abstract: BACKGROUND: Despite the advancement of new screening strategies and the advances in pharmacological therapies, the cancerization rates of familial adenomatous polyposis (FAP) are stable and even increased in the last years. Therefore, it necessitates additional research to characterize and understand the underlying mechanisms of FAP. OBJECTIVE: To determine the genes that drive the pathogenesis of familial adenomatous polyposis (FAP). METHODS: We performed on a cohort (GSE111156) gene profile, which consist of four group of gene expressions (the gene expressions of cancer, adenoma and normal tissue of duodenal cancer from patients with FAP were …defined as Case N, Case A and Case C respectively, while that of adenoma tissue from patients with FAP who did not have duodenal cancer was Ctrl A). Tracking Tumor Immunophenotype (TIP) website was applied to reveal immune infiltration profile and signature genes of FAP. We merged the genes of key module (pink and midnight module) with signature genes to obtained the biomarkers related with FAP pathogenesis. The expression of these five biomarkers in FAP intratumoral region (IT) and tumor rim (TR) was detected with Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). RESULTS: In total, 220, 23 and 63 DEGs were determined in Cases C, A and N, in comparison to Ctrl A. In total, 196 and 10 DEGs were determined in Cases C and A, separately, as compared to Case N. A total of four biomarkers including CCL5, CD3G, CD2 and TLR3 were finally identified associated with pink module, while only one biomarker (KLF2) associated with midnight module was identified. All biomarkers were evidently raised in FAP IT tissues utilizing qRT-PCR. CONCLUSION: We identified five potential biomarkers for pathogenesis of FAP to understand the fundamental mechanisms of FAP progression and revealed some probable targets for the diagnosis or treatment of FAP. Show more
Keywords: Familial adenomatous polyposis, bioinformatics, driver gene, WGCNA, DEGs
DOI: 10.3233/THC-230719
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2023
Authors: Jadhav, Shreya | Jhaveri, Aditi | Pawar, Ajinkya M. | Bhardwaj, Anuj | Vinay, Vineet | di Blasio, Marco | Cicciù, Marco | Minervini, Giuseppe
Article Type: Research Article
Abstract: BACKGROUND: Forensic odontology is a subfield of forensics that can assist in determining age, gender, and other demographic factors. OBJECTIVE: The focus of this research is to ascertain age by tooth volume ratio of permanent maxillary canines using a CBCT scan. METHODS: In this retrospective investigation, 1000 CBCT images were gathered and focused on only fully developed maxillary canines. For each of the maxillary canines, the researchers measured and calculated the volume of the pulp chamber, root canal, and entire tooth using the ITK Snap programme. The pulp volume to tooth volume ratio …was computed. The equation AGE = 59.208 - (583.652 x pulp volume/tooth volume) was then used to compute age. The samples were divided into 5 age groups; 13–20, 21–30, 31–40, 41–50, and 51–60. The age was calculated for samples in each group and it was compared to the actual age. RESULTS: Between individuals’ actual age and computed age, the study discovered a statistically significant positive association. While groups 3, 4, and 5 demonstrated positive but weaker correlations (r = 0.854, r = 0.658, and r = 0.612, respectively), groups 1 and 2 displayed statistically significant strong positive correlations (r = 0.987 and r = 0.923, respectively). The average total discrepancy between the age that was computed and the actual age was 2.45 1.344. CONCLUSION: The study found a statistically significant positive correlation between computed age and actual age, with the younger age groups 1 (13–20) and 2 (21–30) showing the strongest relationships. This underlines its potential success in court, particularly when dealing with young criminals. Show more
Keywords: Age estimation, canines, cone-beam computed tomography, forensic odontology, pulp tooth volume
DOI: 10.3233/THC-230555
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Wang, Yu | Li, Jun | Shi, Yulin | Jiang, Tao | Tu, Liping | Xu, Jiatuo
Article Type: Research Article
Abstract: BACKGROUND: The sublingual vein (SV) is a specialized diagnostic method used in Traditional Chinese Medicine (TCM). Despite its ability to objectively reflect blood flow, SV is often overlooked in clinical practice. OBJECTIVE: This study aims to analyze the core characteristics of SV and investigate the in-depth relationship between its digital characteristics and hypertension. The goal is to find a link between SV and hypertension and break out of the current situation. METHODS: Modern digital analysis techniques were applied to the traditional SV diagnostic theory. In a controlled study with 204 participants, the digital …characteristics of SV were documented using TFDA-1, and its color value was analyzed using TDAS. Morphological characteristics of SV, such as trunklength, width, and tortuosity, were examined by combining computer vision with expert interpretation. This involved the application of automatic ranging methods and a rectangular approximation algorithm, which are novel approaches in the field of TCM. The t -test and Mann-Whitney U test were used to analyze the digital characteristics of SV in hypertension. Binary logistic regression and neural network models were established using machine learning to explore the deep relationship between SV characteristics and hypertension. RESULTS: There was a significant difference of the tortuosity of SV between the two groups (Z = - 2.629, p = 0.009). The results revealed thick width of SV (OR = 2.64, 95% CI: 1.02–6.79) was the risk factor for hypertension. Addition of SV characteristics improved overall percent correct for hypertension prediction to 80%. CONCLUSION: TCM method of diagnosis of SV has been greatly expanded in terms of technical means, and the close relationship between SV and hypertension has been found in clinical data. Show more
Keywords: Sublingual veins, digital characteristics, hypertension
DOI: 10.3233/THC-230695
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Butter, Christian | Klein, Gunnar | Grönefeld, Gerian | Böcker, Dirk | Suling, Anna | Buchholz, Anika | Felk, Angelika | Hauser, Tino | Wegscheider, Karl | Bänsch, Dietmar
Article Type: Research Article
Abstract: BACKGROUND: Both highly specialized heart centres and less specialized hospitals care for patients with implantable ICDs/CRT-Ds with remote monitoring. OBJECTIVE: To investigate potential differences in patient treatment according to centre’s ICD implantation volume. METHODS: Based on their 2012 ICD/CRT-D implantation volume, centres enrolled in the NORDIC ICD trial in Germany were assigned to one of three groups: high- (HV, n = 345), medium- (MV, n = 340) or low-volume (LV, n = 189). RESULTS: The …HV-centres had a significant higher CRT-D proportion (41.7%; LV: 36.5%; MV: 23.2%; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001), significant shorter median procedure duration (49 min; MV: 58 min; LV: 60 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) but significant longer median hospital stay (4 days; MV and LV: 3 days; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001) compared to MV- and LV-centres. The X-ray exposure was shorter in MV/HV-centres (MV: 3.4 min; HV: 3.6 min; LV: 5.5 min; P 𝑔𝑙𝑜𝑏𝑎𝑙 < 0.001). Only 3.5% (LV: 2.6%; HV: 3.5%; MV: 4.1%) patients received at least one delivered inappropriate shock and 2.5% (HV: 2.0%; LV: 2.6%; MV: 2.9%) patients had withheld inappropriate ICD shocks without subsequent inappropriate shock delivery within 24.5 months of median follow-up. CONCLUSION: Implantation volume-dependent differences were observed in the device selection, procedure duration and x-ray exposure duration. Remote monitoring in combination with adequate response pattern prevented imminent inappropriate shocks in all three groups. Show more
Keywords: Defibrillators, implantable, cardiac resynchronization therapy, hospitals, high-volume, hospitals, low-volume, home monitoring
DOI: 10.3233/THC-230641
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
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