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Price: EUR 150.00Authors: Zhou, Xuan | Li, Zhen-Fei | Guo, Xuan-Zhu | Wei, Qiao | Niu, Ya-Nan | Li, Meng | Xia, Jia-Ning | Chen, Li-Ping
Article Type: Research Article
Abstract: BACKGROUND: The first-line treatment for cervical dystonia (CD) consists of repeated intramuscular injections of botulinum toxin (BoNT). However, the efficacy in some patients may be unsatisfactory and they may discontinue treatment. OBJECTIVE: To examine the factors associated with the maximum rate of remission in patients with CD after initial botulinum neurotoxin type A (or botulinum toxin type A abbreviated as BTX-A or BoNT-A) treatment. METHODS: Patients with CD who received BoNT-A injections were evaluated using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Tsui scale, with follow-up endpoints lasting until the …start of the second injection. Patients who did not receive a second injection of BoNT-A were followed up for at least 5 months. The maximum remission rates were determined using the lowest Tsui and TWSTRS total scores during the follow-up period. We obtained basic information about these patients such as age, gender, duration of disease, presence of additional disease, types of torticollis, presence of anxiety, depression, tremors, single-photon emission computed tomography (SPECT) findings, injected dose, and so on from their medical records. RESULTS: A total of 70 patients with CD participated in this study, with males comprising 35.7% (25 individuals) with an average age of 45 ± 14 years old. The duration of disease was an independent risk factor for determining whether a complete remission has been attained using the Tsui scale (odds ratio [OR] = 0.978, 95% confidence interval [CI]: 0.959–0.997, P = 0.026). The optimal cut-off point for predicting patients who were unable to achieve complete remission based on duration of disease was 7.5 months (AUG = 0.711). Patients with CD with additional disease had greater difficulty achieving complete remission than those with CD alone based on TWSTRS assessments (P = 0.049). During the study, approximately 17% of all participants reported experiencing adverse reactions that lasted between 1 to 3 weeks before disappearing. CONCLUSION: BoNT is an effective and safe method for treating CD. The maximum remission rates of patients after their first injections are influenced by the duration of their disease. Thus, treatment using BoNT injections must be administered as soon as possible. Show more
Keywords: Botulinum neurotoxin (BoNT), cervical dystonia, efficacy, maximum remission rate, spasmodic torticollis
DOI: 10.3233/THC-231182
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Orsi, Alexander D. | Mathew, Manu | Plaskos, Christopher | Wakelin, Edgar A. | Slotkin, Eric M. | Coffey, Simon | Ponder, Corey E. | Keggi, John K. | McMahon, Stephen J.
Article Type: Research Article
Abstract: BACKGROUND: Passive smartphone-based apps are becoming more common for measuring patient progress after total hip arthroplasty (THA). Optimum activity levels during early THA recovery have not been well documented. OBJECTIVES: Correlations between step-count and patient reported outcome measures (PROMs) during early recovery were explored. This study also investigated how demographics impact step-count during early post-operative recovery. METHODS: Smartphone captured step-count data from 666 THA patients was retrospectively reviewed. Mean age was 64 ± 11 years. 55% were female. Mean BMI was 29 ± 8kg/m 2 …. Mean daily step-count was calculated for each patient over four time-windows: 60 days prior to surgery (preop), 42–49 days postop (6 weeks), 91–98 days postop (3 months), and 183–197 days postop (6 months). Spearman correlation coefficients and linear regression were used to assess the association between PROMs (HOOS-12, HOOS-Jr, and UCLA) were performed. Patients were separated into three step-count levels: low (< 2500 steps/day), medium (2500–5500 steps/day), and high (> 5500 steps/day). Age > 65 years, BMI > 35 kg/m 2 , and sex were used for demographic comparisons. Post hoc analyses were performed using Welch’s unequal variances t -tests, or Wilcoxon rank-sum tests, both with Bonferroni corrections, where appropriate when comparing between groups. Chi-squared analyses were also used when comparing categorical variables. RESULTS: UCLA correlated with step-count at all time-windows (p < 0.001). HOOS12-Function correlated with step-count preoperatively, at 6 weeks, and at 3 months (p < 0.001). High step-count individuals had improved UCLA scores compared to low step-count individuals preoperatively (Δ 1.5, p < 0.001), at 6 weeks (Δ 0.9, p < 0.001), at 3 months (Δ 1.4, p < 0.001), and at 6 months (Δ 1.4, p < 0.001). High step-count individuals had improved HOOS12-Function scores compared to low step-count individuals preoperatively (Δ 9.6, p < 0.001), at 6 weeks (Δ 5.3, p < 0.001), and at 3 months (Δ 6.1, p < 0.001). Males had greater step-count at all time points (p < 0.001). Younger patients and low BMI patients had greater step-count across all time points (p < 0.001). CONCLUSION: High step-count improved PROMs scores compared to low step-count. Early post-operative step-count was significantly impacted by age, sex, and BMI. Generic recovery profiles may not be appropriate across diverse populations. Show more
Keywords: Total hip arthroplasty, smartphone, step-count, PROMs, remote patient monitoring
DOI: 10.3233/THC-231203
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: DeClaire, Jeffrey H. | Wakelin, Edgar A. | Chattinger, Kayla | Plaskos, Christopher
Article Type: Research Article
Abstract: BACKGROUND: Early complications in total knee arthroplasty (TKA) associated with modern robotics platforms integrated with digital balancing technology have not been investigated. OBJECTIVE: The objective was to compare 90-day complication rates between a manual technique and a modern robotic-assisted ligament balancing TKA platform. METHODS: 895 primary TKA procedures from a single surgeon were retrospectively reviewed (614 manual TKA, 281 using a modern robotics platform with an integrated digitally controlled ligament balancing device). Post-operative complications within the 90-day episode of care were recorded by the Michigan Arthroplasty Registry Collaborative Quality Initiative. Differences in complication …rates between techniques were further divided into inpatient hospital, outpatient hospital, and ambulatory surgery center (ASC) cohorts. RESULTS: In the pooled hospital cohort and inpatient hospital cohort, ‘Return to OR’ was significantly lower for the robotic assisted group (1.3% vs 5.2% and 0% vs 4.9%, respectively, p < 0.0370). Specifically, the need for manipulation under anesthesia (MUA) was reduced for the robotics group (0.0% vs 2.5%, p = 0.0352). No differences in overall complication rate or cause of complication was found between manual and robotics cases for the hospital outpatient and ASC cohorts (p ⩾ 0.68). CONCLUSION: Within the hospital setting, robotic assisted ligament balancing technology was associated with reduced 90-day postoperative complications for ‘Return to OR’ and MUA. Show more
Keywords: Total knee arthroplasty, robotics, soft tissue, complications, hospital, ambulatory surgical center, ASC
DOI: 10.3233/THC-231198
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Hoveidaei, Amir Human | Esmaeili, Sina | Ghaseminejad-Raeini, Amirhossein | Pirahesh, Seyed Kasra | Hoveidaei, Armin | Sandiford, Nemandra A. | Lahner, Nina | Citak, Mustafa
Article Type: Review Article
Abstract: BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a viable alternative to total knee arthroplasty (TKA) for osteoarthritis patients with single-compartment involvement, with advantages including accelerated recovery, reduced pain, and improved function. Robotic-assisted UKA (rUKA) is a promising development that ensures precise implant positioning and limb alignment. However, concerns about complications remain. OBJECTIVE: This study looks at patient satisfaction as a key metric for determining the efficacy of rUKA versus manual UKA (mUKA). METHODS: The search strategy for this study followed PRISMA. Using precise keywords, PubMed, Scopus, Web of Science, and the Cochrane library were …searched. English articles were searched until August 2, 2023. Selection criteria included mUKA and rUKA patient satisfaction studies. The NOS scale evaluated study quality. Meta-analysis was done with R and heterogeneity analysis. RESULTS: This systematic review examined 5 studies with 1060 UKAs (532 robotic-assisted and 528 manual). Variable satisfaction assessment methods were used. Three studies found no difference in patient satisfaction after robotic-assisted UKA, but two found a higher satisfaction. Meta-analysis showed robotic-assisted UKA improved patient satisfaction (OR = 1.72 [1.25–2.37]). Overall, most studies showed low risk of bias, except one with higher bias. CONCLUSION: This review suggests that robotic assistance may enhance patient satisfaction in UKA procedures. Show more
Keywords: Arthroplasty, replacement, knee, medical device, patient satisfaction, robotic surgical procedures
DOI: 10.3233/THC-231216
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Akçaalan, Serhat | Akbulut, Batuhan | Çağlar, Ceyhun | Innocenti, Matteo | Uğurlu, Mahmut | Dogan, Metin | Akkaya, Mustafa
Article Type: Research Article
Abstract: BACKROUND: Periprosthetic joint infection (PJI) is a very important complication that occurs after total joint replacement. Diagnosing PJI is at least as difficult as this disease. There is no biomarker that alone can diagnose PJI. OBJECTIVE: This study aimed to evaluate the effectiveness of large unstained cell percentage (%LUC) in diagnosing PJI and deciding on re-implantation in two stage septic exchange arthroplasty. METHODS: Patients who underwent revision arthroplasty between 2019 and 2023 were screened retrospectively. These patients were grouped as those who underwent two-stage septic exchange and those who underwent aseptic exchange. Prosthesis …removal from the patients who underwent two-stage septic exchange, before spacer application, and on the 3rd post-operative day after spacer application, Blood parameters were collected at the 1st month and before the second stage after the spacer application, and before the revision surgery from the patients who underwent aseptic exchange. White blood cell, neutrophil percentage, %LUC, albumin, sedim and CRP values were checked and recorded one by one from all patients. RESULTS: The data of a total of 233 patients, including 133 patients in the two stage septic exchange group and 100 patients in the aseptic exchange group, were included in the study. When the predictive value of %LUC in PJI was accepted as cut-off 1.75, the sensitivity was 69.2% and the specificity was 73%. The change in %LUC over time in patients who underwent two-stage septic exchange was statistically significant (p = 0.0001). A positive correlation was found between the value of .%LUC after spacer application and the value of CRP before prosthesis protrusion/spacer application surgery, and the Spearman correlation coefficient was found to be 0.005. CONCLUSION: %LUC value can be a promising biomarker for the diagnosis of PJI by considering both sensitivity and specificity rates. Apart from this, it is an easily accessible and effective biomarker for re-implantation decision making and evaluation of response to treatment, especially in two-stage septic exchange surgeries. Show more
Keywords: Periprosthetic joint infection, %LUC, biomarker, two stage, septic exchange
DOI: 10.3233/THC-230903
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: 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: Alotaibi, Hanan | Al-Otibi, Fatimah | Alharbi, Raedah | ALshwuaiman, Ghada | Altwaijri, Shahad | Alfouzan, Afnan | Altaweel, Sara | Alshehri, Huda | Binrayes, Abdulaziz | Labban, Nawaf
Article Type: Research Article
Abstract: BACKGROUND: Denture stomatitis, frequently encountered, is generally addressed symptomatically, with limited exploration of preventive approaches involving antifungal medicinal plants. OBJECTIVE: This study assessed the impact of Artemisia sieberi extracts on the candida growth of conventional and digitally processed acrylic materials. METHOD: Thirty acrylic resin discs (3 mm thickness × 10 mm diameter) were prepared by conventional or CAD/CAM technology (milling and 3D printing). The resin discs were exposed to simulated brushing, thermocycling, and immersion in Artemisia sieberi extract for 8 hours. The surface roughness of the discs was assessed at …baseline and after immersion in Artemisia sieberi extract. Candida growth was quantified through colony-forming units (CFU/mL). Data was analyzed using SPSS v.22 (α ⩽ 0.05). RESULTS: Irrespective of the material type, the post-immersion surface roughness was significantly higher compared to pre-immersion values (p < 0.05). Candida growth was significantly higher in conventional acrylic materials than digitally fabricated acrylics (p < 0.05). At × 3, Ra and CFU were found to be moderately positive and non-significantly correlated (R = 0.664, p = 0.149). At × 4, Ra and CFU were found to be weak positive and non-significantly correlated (R = 0.344, p = 0.503). CONCLUSION: Artemisia sieberi extracts had a notable impact on digitally fabricated denture acrylics, reducing candida albicans growth compared to conventional heat-cured acrylic. This suggests a potential role for these extracts in improving denture hygiene and preventing denture stomatitis, particularly in the context of digitally fabricated dentures. Show more
Keywords: 3D printing, candida growth, roughness, colony forming units
DOI: 10.3233/THC-231767
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Wang, Qiuyang | An, Peng | Song, Lina | Liu, Junjie | Liu, Jisheng
Article Type: Research Article
Abstract: BACKGROUND: Nasopharyngeal carcinoma (NC) is one of the prevalent malignancies of the head and neck region with poor prognosis. OBJECTIVE: The aim of this study is to establish a predictive model for assessing NC prognosis based on clinical and MR radiomics data, subsequently to develop a nomogram for practical application. METHODS: Retrospective analysis was conducted on clinical and imaging data collected between May 2010 and August 2018, involving 211 patients diagnosed with histologically confirmed NC who received concurrent chemoradiotherapy or radical surgery in Xiangyang No. 1 People’s Hospital. According to 5–10 years of …follow-up results, the patients were divided into two groups: the study group (n = 76), which experienced recurrence, metastasis, or death, and the control group (n = 135), characterized by normal survival. Training and testing subsets were established at a 7:3 ratio, with a predefined time cutoff. In the training set, three prediction models were established: a clinical data model, an imaging model, and a combined model using the integrated variation in clinical characteristics along with MR radiomics parameters (Delta-Radscore) observed before and after concurrent chemoradiotherapy. Model performance was compared using Delong’s test, and net clinical benefit was assessed via decision curve analysis (DCA). Then, external validation was conducted on the test set, and finally a nomogram predicting NC prognosis was created. RESULTS: Univariate analysis identified that the risk factors impacting the prognosis of NC included gender, pathological type, neutrophil to lymphocyte ratio (NLR), degree of tumor differentiation, MR enhancement pattern, and Delta-Radscore (P < 0.05). The combined model established based on the abovementioned factors exhibited significantly higher predictive performance [AUC: 0.874, 95% CI (0.810–0.923)] than that of the clinical data model [AUC: 0.650, 95% CI (0.568–0.727)] and imaging model [AUC: 0.824, 95% CI (0.753–0.882)]. DCA also demonstrated superior clinical net benefit in the combined model, a finding further verified by results from the test set. The developed nomogram, based on the combined model, exhibited promising performance in clinical applications. CONCLUSION: The Delta-Radscore derived from MR radiomics data before and after concurrent chemoradiotherapy helps enhance the performance of the NC prognostic model. The combined model and resultant nomogram provide valuable support for clinical decision-making in NC treatment, ultimately contributing to an improved survival rate. Show more
Keywords: Delta radiomics, nasopharyngeal cancer, predictive models, nomogram, decision curves, magnetic resonance imaging (MR)
DOI: 10.3233/THC-231173
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Zuo, Wanzhao | Li, Jing | Zuo, Mingyan | Li, Miao | Zhou, Shuang | Cai, Xing
Article Type: Research Article
Abstract: BACKGROUND: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD)-peripheral bronchogenic carcinoma (COPD-PBC) and inflammatory masses. OBJECTIVE: This study aims to predict COPD-PBC based on clinical data and preoperative Habitat-based enhanced CT radiomics (HECT radiomics) modeling. METHODS: A retrospective analysis was conducted on clinical imaging data of 232 cases of postoperative pathological confirmed PBC or inflammatory masses. The PBC group consisted of 82 cases, while the non-PBC group consisted of 150 cases. A training set and a testing set were established using a 7:3 ratio and a time cutoff point. In …the training set, multiple models were established using clinical data and radiomics texture changes within different enhanced areas of the CT mass (HECT radiomics). The AUC values of each model were compared using Delong’s test, and the clinical net benefit of the models was tested using decision curve analysis (DCA). The models were then externally validated in the testing set, and a nomogram of predicting COPD-PBC was created. RESULTS: Univariate analysis confirmed that female gender, tumor morphology, CEA, Cyfra21-1, CT enhancement pattern, and Habitat-Radscore B/C were predictive factors for COPD-PBC (P < 0.05). The combination model based on these factors had significantly higher predictive performance [AUC: 0.894, 95% CI (0.836–0.936)] than the clinical data model [AUC: 0.758, 95% CI (0.685–0.822)] and radiomics model [AUC: 0.828, 95% CI (0.761–0.882)]. DCA also confirmed the higher clinical net benefit of the combination model, which was validated in the testing set. The nomogram developed based on the combination model helped predict COPD-PBC. CONCLUSION: The combination model based on clinical data and Habitat-based enhanced CT radiomics can help differentiate COPD-PBC, providing a new non-invasive and efficient method for its diagnosis, treatment, and clinical decision-making. Show more
Keywords: Nomograms, retrospective studies, antigen CYFRA21.1, area under curve, radiomics, tomography, X-ray computed, clinical decision-making, pulmonary disease, chronic obstructive
DOI: 10.3233/THC-231980
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Hu, Qinghua | Li, Min | Jiang, Linwen | Liu, Mei
Article Type: Research Article
Abstract: BACKGROUND: Photoplethysmography (PPG) signals are sensitive to motion-induced interference, leading to the emergence of motion artifacts (MA) and baseline drift, which significantly affect the accuracy of PPG measurements. OBJECTIVE: The objective of our study is to effectively eliminate baseline drift and high-frequency noise from PPG signals, ensuring that the signal’s critical frequency components remain within the range of 1 ∼ 10 Hz. METHODS: This paper introduces a novel hybrid denoising method for PPG signals, integrating Variational Mode Decomposition (VMD) with an improved wavelet threshold function. The method initially employs VMD to …decompose PPG signals into a set of narrowband intrinsic mode function (IMF) components, effectively removing low-frequency baseline drift. Subsequently, an improved wavelet thresholding algorithm is applied to eliminate high-frequency noise, resulting in denoised PPG signals. The effectiveness of the denoising method was rigorously assessed through a comprehensive validation process. It was tested on real-world PPG measurements, PPG signals generated by the Fluke ProSim™ 8 Vital Signs Simulator with synthesized noise, and extended to the MIMIC-III waveform database. RESULTS: The application of the improved threshold function let to a substantial 11.47% increase in signal-to-noise ratio (SNR) and an impressive 26.75% reduction in root mean square error (RMSE) compared to the soft threshold function. Furthermore, the hybrid denoising method improved SNR by 15.54% and reduced RMSE by 37.43% compared to the improved threshold function. CONCLUSION: This study proposes an effective PPG denoising algorithm based on VMD and an improved wavelet threshold function, capable of simultaneously eliminating low-frequency baseline drift and high-frequency noise in PPG signals while faithfully preserving their morphological characteristics. This advancement establishes the foundation for time-domain feature extraction and model development in the domain of PPG signal analysis. Show more
Keywords: Variational mode decomposition, denoising, improved wavelet thresholding, photoplethysmography
DOI: 10.3233/THC-231996
Citation: Technology and Health Care, vol. Pre-press, no. Pre-press, pp. 1-22, 2024
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