Technology and Health Care - Volume 32, issue 1

Authors: Li, Zhongwei | Wang, Di | Hu, Jiashou | Zhang, Guowei | Sun, Jinfeng

Article Type: Research Article

Abstract: BACKGROUND: Juxta-papillary duodenal diverticula (JPDD) are common but are usually asymptomatic, and they are often diagnosed by coincidence. OBJECTIVE: To analyse the anatomy and classification of JPDD and its relationship with biliary and pancreatic disorders, and to explore the diagnostic value of multi-slice spiral computed tomography (MSCT) in patients with JPDD. METHODS: The imaging data of patients with JPDD, which was obtained via abdominal computed tomography examination and confirmed via gastroscopy and/or upper gastrointestinal barium enema, in our hospital from 1 January 2019 to 31 December 2020 were retrospectively analysed. All patients were …scanned using MSCT, and the imaging findings, classification and grading were analysed. RESULTS: A total of 119 duodenal diverticula were detected in 96 patients, including 73 single diverticula and 23 multiple diverticula. The imaging findings were mainly cystic lesions of the inner wall of the duodenum protruding to the outside of the cavity. The thin layer showed a narrow neck connected with the duodenal cavity, and the shape and size of the diverticula were different: 67 central-type cases and 29 peripheral-type cases. There were 50 cases of type I, 33 cases of type II, 19 cases of type III and six cases of type IV. Furthermore, there were seven small, 87 medium and 14 large diverticula. The differences in the location and size of the JPDD in MSCT grading were statistically significant (P < 0.05). CONCLUSION: The MSCT method has an important diagnostic value for the classification of JPDD, and MSCT images are helpful in the clinical evaluation of patients with JPDD and the selection of treatment options. Show more

Keywords: Juxta-papillary duodenal diverticulum, Lemmel’s syndrome, multi-slice spiral computed tomography, diverticulum types

DOI: 10.3233/THC-220742

Citation: Technology and Health Care, vol. 32, no. 1, pp. 1-8, 2024

Authors: Peng, Yongyi | Wu, Zhongping | Lin, Kuiqing | Huang, Ruibo | Huang, Jinhai | Lin, Junfeng | Chen, Shubing | Zheng, Jinping | Gao, Yi

Article Type: Research Article

Abstract: BACKGROUND: At present, robust quality criteria and methods for the assessment of Peak inspiratory flow meter performance are lacking. OBJECTIVE: A standard flow-volume simulator for quality control analyses of an inhalation assessment device was utilized with different simulated resistance levels in order to propose a quality testing method and associated standard for this device type. METHODS: A standard flow-volume simulator was utilized to assess the performance of an In-Check DIAL ® (Device I) and an intelligent inhalation assessment device (Device P) at a fixed volume and flow rate. Indices …used to evaluate these two instruments included repeatability, accuracy, linearity, and impedance. RESULTS: Both devices exhibited good repeatability ( < ± 3 L/min). The difference between test results and standard simulator values for Device P was less than ± 5 L/min at resistance level R1 but higher than ± 5 L/min at resistance levels R2–5, while Device I were greater than 5 L/min at all resistance levels. The relative error for Device P was < ± 10% at resistance levels R1, R2, and R4, but > 10% at resistance levels R3 and R5. The relative error values for Device I at all five resistance levels were > 10%. Device P passed the linearity test at the R2 resistance level, while Device I partially passed the linearity test at all five resistance levels. CONCLUSION: Standard monitoring methods and standards provide a valuable approach to the more reliable clinical assessment and application of these instruments. Show more

Keywords: Peak inspiratory flow, PIF, quality criteria, inhaler, assessment devices

DOI: 10.3233/THC-220905

Citation: Technology and Health Care, vol. 32, no. 1, pp. 9-18, 2024

Authors: Shin, Sun-Shil | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND: According to previous studies, the relationship between lumbar lordosis and thoracic kyphosis or that between pelvic parameters and thoracic kyphosis have been inconsistent. OBJECTIVE: The purpose of this study was to investigate spinal sagittal alignment and its relationship to global and regional lumbar and thoracic angles, pelvic and sway angles, and C7–S1 distance measurements, followed by a detailed subgroup analysis using an inertial measurement unit system. METHODS: A total of 51 asymptomatic volunteers stood in a comfortable posture with inertial measurement units attached to the T1, T7, T12, L3, and S2 vertebrae. …T1, T7, T12, L3, and S2 sagittal angles were acquired during standing posture using the Eulerian angle coordinate system. All angles are reported as the mean of three 5-s measurements. Following the measurement of lumbar lordosis angles (T12 relative S2), participants were divided into the flat lumbar and normal lordosis groups. RESULTS: There were different correlation patterns between groups because of spinal sagittal imbalance, which was greater in the flat lumbar group than in the normal lordosis group. In addition, sacral inclination proved the ideal parameter to evaluate reciprocal balance in lumbar lordosis, showing a stronger correlation with lower than with upper lumbar lordosis. T1 was the key element in assessing thoracic kyphosis, which showed a stronger correlation with upper than with lower thoracic kyphosis. CONCLUSION: We suggest that when assessing posture, it is necessary to identify the global and regional angles and it is useful to classify spinal sagittal alignment into subgroups according to lumbar lordosis and evaluate the groups separately. Show more

Keywords: Global angle, lumbar lordosis, regional angle, sagittal balance, thoracic kyphosis

DOI: 10.3233/THC-220098

Citation: Technology and Health Care, vol. 32, no. 1, pp. 19-30, 2024

Authors: Zhao, Xiaoyan | Yang, Cuiyun | Lyu, Yuchao | Xu, Yinghao | Han, Zhihui | Zhao, Haien

Article Type: Research Article

Abstract: BACKGROUND: Pulse-inversion-based tissue harmonic imaging has been utilized for many years because it can effectively eliminate the harmonic leakage and produce low side-lobe. However, the pulse inversion method is sensitive to imaging object movements, which may result in motion artifacts. Spatial resolution and contrast were limited. OBJECTIVE: To improve ultrasound image quality by a new pulse-inversion-based tissue harmonic imaging technique. METHODS: Continuous wavelet transform is applied to investigate the correlation between mother wavelet and the received echoes from two opposite pulses. To get a better correlation, a novel mother wavelet named ‘tissue wavelet’ …is designed based on the Khokhlov-Zabolotskaya- Kuznetsov (KZK) wave equation. Radio frequency data were obtained from open Ultrasonix SonixTouch imaging system. Experiments were carried on ultrasonic tissue phantom, human carotid artery and human liver. RESULTS: The average improvement of lateral spatial resolution is 49.52% compared to pulse-inversion-based tissue second-harmonic Imaging (PIHI). Contrast ratio (CR) and contrast-to-noise ratio (CNR) increased by 5.55 dB and 1.40 dB over PIHI. Tissue wavelet performs better than Mexh and Morl wavelet in lateral spatial resolution, CR, and CNR. CONCLUSION: The proposed technique effectively improves the imaging quality in lateral spatial resolution, CR, and CNR. Show more

Keywords: Medical information science, ultrasound imaging, correlation study, wavelet transform, signal detection analysis

DOI: 10.3233/THC-220403

Citation: Technology and Health Care, vol. 32, no. 1, pp. 31-53, 2024

Authors: Chen, Huilian | Dong, Peifang | Zhong, Peng

Article Type: Research Article

Abstract: BACKGROUND: The existing patient clothing is not suitable for patients that have to maintain a prone position for a long time after vitrectomy. OBJECTIVE: To investigate the effect of a new design of patient gowns for prone position patients after vitrectomy. METHOD: This study designed a kind of patient’s gown for prone position patients. A non-randomized, concurrent, controlled study was conducted on 212 patients who met the inclusion criteria for the prone position after vitrectomy in Grade III at a Class A hospital department of ophthalmology in Zhejiang Province from April to August …2020. The experimental group (106 patients in prone position) and the control group (106 patients in common position) were managed by the same group of nurses. The study recorded and compared the comfort degree of patients’ clothing used in the course of operation rehabilitation between the two groups and the satisfaction degree of doctors with nurses to patients’ clothing used in the prone position. RESULTS: The satisfaction degree and comfort degree of patients and the health care providers in the experiment group were significantly higher than those in the control group (p < 0.001). CONCLUSION: The process of making patient gowns for prone position patients is simple, which can improve the safety and comfort of patients when they were in the prone position. The new design also facilitated the treatment and nursing procedures of the medical staff and improved satisfaction among patients and medical staff. Show more

Keywords: Prone position patient, vitrectomy, gown, satisfaction, comfort

DOI: 10.3233/THC-220455

Citation: Technology and Health Care, vol. 32, no. 1, pp. 55-62, 2024

Authors: Yuan, Youyuan | Chen, Jiaqi | Wang, Xueqi | Song, Jialu

Article Type: Research Article

Abstract: BACKGROUND: Lower extremity arteriosclerosis obliterans (ASO) is the most common occlusive disease of the peripheral blood vessels. OBJECTIVE: To explore the application effect of symptom management-based rehabilitation strategy in postoperative functional exercises in patients with lower extremity ASO. METHODS: The researchers selected 136 patients that underwent lower extremity ASO surgery for the first time in their department from January to September 2020. Patients were divided into a control group (n = 68) and an experimental group (n = 68). The control group implemented …routine discharge rehabilitation education and continuous nursing. On this basis, the experimental group applied the symptom management theory to the rehabilitation management strategy to compare the degree of pain, the ankle-brachial index, self-care ability and quality of life between the two groups before and after the intervention. RESULTS: Three months (P = 0.045) and six months (P = 0.013) after discharge, the experimental group’s degree of pain was significantly lower than that of the control group. At one month (P = 0.019), three months (P = 0.003) and six months (P = 0.000) after discharge, the experimental group recovered significantly better than the control group. At six months after discharge, the self-care ability, mood status and physical pain of the experimental group were significantly higher than in the control group (P < 0.05). CONCLUSION: The rehabilitation management strategy, which is based on symptom management theory, can effectively improve the symptoms, quality of life and self-efficacy of ASO patients in continuous care. This nursing strategy is worthy of clinical promotion. Show more

Keywords: Symptom management, rehabilitation, lower extremity arteriosclerosis obliterans, functional exercise

DOI: 10.3233/THC-220478

Citation: Technology and Health Care, vol. 32, no. 1, pp. 63-73, 2024

Authors: Chiu, Chien-Hung | Ke, Shih-Wen | Tsai, Chih-Fong | Lin, Wei-Chao | Huang, Min-Wei | Ko, Yi-Hsiu

Article Type: Research Article

Abstract: BACKGROUND: In practice, the collected datasets for data analysis are usually incomplete as some data contain missing attribute values. Many related works focus on constructing specific models to produce estimations to replace the missing values, to make the original incomplete datasets become complete. Another type of solution is to directly handle the incomplete datasets without missing value imputation, with decision trees being the major technique for this purpose. OBJECTIVE: To introduce a novel approach, namely Deep Learning-based Decision Tree Ensembles (DLDTE), which borrows the bounding box and sliding window strategies used in deep learning techniques to …divide an incomplete dataset into a number of subsets and learning from each subset by a decision tree, resulting in decision tree ensembles. METHOD: Two medical domain problem datasets contain several hundred feature dimensions with the missing rates of 10% to 50% are used for performance comparison. RESULTS: The proposed DLDTE provides the highest rate of classification accuracy when compared with the baseline decision tree method, as well as two missing value imputation methods (mean and k-nearest neighbor), and the case deletion method. CONCLUSION: The results demonstrate the effectiveness of DLDTE for handling incomplete medical datasets with different missing rates. Show more

Keywords: Data science, deep learning, decision trees, classifier ensembles, missing value imputation

DOI: 10.3233/THC-220514

Citation: Technology and Health Care, vol. 32, no. 1, pp. 75-87, 2024

Authors: Evron, Ilanit | Schwartz, Oren | Sajina, Anna | Grosman-Rimon, Liza | Dudkiewicz, Israel

Article Type: Research Article

Abstract: BACKGROUND: The Selfit system was developed to improve the mobility and gait-related functions of stroke patients by providing digital exercises and augmented reality training system. OBJECTIVE: To evaluate the effects of a digital exercise and augmented reality training system on mobility, gait-related functions and self-efficacy outcomes in stroke patients. METHODS: A randomized control trial was conducted on 25 men and women diagnosed with an early sub-acute stroke. Patients were randomly assigned to either the intervention (N = 11) or the control groups (N = …14). Patients in the intervention group received a digital exercise and augmented reality training using the Selfit system in addition to the standard physical therapy treatment. Patients in the control group were treated with a conventional physical therapy program. Timed Up and Go (TUG) test, 10-meter walk test, the Dynamic Gait Index (DGI), and the Activity-specific Balance Confidence (ABC) scale were completed before and after the intervention. Feasibility and satisfaction among patients and therapists were also assessed after the completion of the study. RESULTS: The intervention group practiced proportionally more time per session than the control group with a mean change of 19.7% following 6 sessions (p = 0.002). The intervention group showed better improvement in post-TUG score compared to the control group (p = 0.04). ABC, DGI, and the 10-meter walk test scores were not significantly different between the groups. Both therapists and participants demonstrated high satisfaction with the Selfit system. CONCLUSION: The findings suggest that Selfit holds promise as an effective intervention for improving mobility and gait-related functions among patients with an early sub-acute stroke as compared to conventional physical therapy treatments. Show more

Keywords: Stroke, gait, mobility, digital exercise, augmented reality

DOI: 10.3233/THC-220521

Citation: Technology and Health Care, vol. 32, no. 1, pp. 89-101, 2024

Authors: Thyla, B. | Bai, V. Thulasi

Article Type: Research Article

Abstract: BACKGROUND: In wireless communication standard 4G and 5G, the body centric network plays an important role for the wireless communication between various devices. OBJECTIVE: This research relates to a wide-band conformal co-planar waveguide (CPW) antenna for wearable applications. METHODS: The proposed CPW antenna is printed on 0.1 mm thick bio-compatible polymide substrate whose dielectric constant and permittivity are 3.5 and 0.02 respectively. The total area of the antenna is around 17.5 × 15 mm 2 which is significantly smaller than the wearable antennas proposed in literature. …The proposed antenna is designed to operate in new ISM band 5.8 GHz with the bandwidth of 5.3–6.3 GHz with 2:1 Voltage Standing Wave Ratio (VSWR). The antenna is printed on the flexible substrate and hence robustness of device is evaluated by bending analysis. It reveals the superior performance of the designed CPW antenna over the desired spectrum of operation. RESULTS: Specific Absorption Rate (SAR) is calculated after placing the antenna at various places of human phantom model and showed that SAR values are below 1.6 W/Kg which is the maximum margin recommended by Federal Communication Commission (FCC), i.e when tested with 1 g and 10 g of human tissue of phantom model, for the test frequency range of 5.5–6.1 GHz, SAR value falls between 0.9987 and 0.921 W/Kg respectively. The antenna also shows the radiation efficiency around 92% with overall realized gain 5.2 dBi which are substantial values for wearable applications. CONCLUSION: The outcomes of this research revealed the feasibility of the recommended antenna becoming a major contender of future Internet of Things (IoT) applications. Show more

Keywords: Conformal, co-planar antenna, industrial, scientific, medicine (ISM), wearable, Specific Absorption Rate (SAR)

DOI: 10.3233/THC-220534

Citation: Technology and Health Care, vol. 32, no. 1, pp. 103-115, 2024

Authors: Yabusaki, Yumie | Asai, Kenji | Hisakado, Hiroshi | Takano, Noriyuki

Article Type: Research Article

Abstract: BACKGROUND: Short stems are advantageous for revision as they preserve autogenous bone. At present, the method of short-stem installation is determined based on the surgeon’s experience. OBJECTIVE: To provide the guideline for installing a short stem, we aimed to investigate the alignment effect on the initial fixation of the stem, stress transfer, and the risk of failure numerically. METHODS: Models in which the caput-collum-diaphyseal (CCD) angle and flexion angle were hypothetically changed based on the two clinical cases of hip osteoarthritis were analyzed using the non-linear finite element method. RESULTS: …The medial settlement of the stem increased in the varus model and decreased in the valgus model. With varus alignment, the stresses acting on the femur were high in the distal to the femoral neck. In contrast, the stresses in the proximal to the femoral neck tend to be higher with valgus alignment, although the difference in the femur stress between varus and valgus alignment was slight. CONCLUSION: Both initial fixation and stress transmission are lower when the device was placed in the valgus model than in the actual surgical case. In order to obtain initial fixation and suppress stress shielding, it is essential to extend the contact area between the medial portion of the stem and the femur along the bone axis, and to ensure adequate contact between the lateral portion of the stem tip and the femur. Show more

Keywords: Hip joint, arthroplasty, finite element analysis, hip prosthesis, initial fixation, stress shielding

DOI: 10.3233/THC-220591

Citation: Technology and Health Care, vol. 32, no. 1, pp. 117-130, 2024