Technology and Health Care最新文献

Background: Deep learning has demonstrated superior performance over traditional methods for the estimation of heart rates in controlled contexts. However, in less controlled scenarios this performance seems to vary based on the training dataset and the architecture of the deep learning models.

Objectives: In this paper, we develop a deep learning-based model leveraging the power of 3D convolutional neural networks (3DCNN) to extract temporal and spatial features that lead to an accurate heart rates estimation from RGB no pre-defined region of interest (ROI) videos.

Methods: We propose a 3D DenseNet with a 3D temporal transition layer for the estimation of heart rates from a large-scale dataset of videos that appear more hospital-like and real-life than other existing facial video-based datasets.

Results: Experimentally, our model was trained and tested on this less controlled dataset and showed heart rate estimation performance with root mean square error (RMSE) of 8.68 BPM and mean absolute error (MAE) of 3.34 BPM.

Conclusion: Moreover, we show that such a model can also achieve better results than the state-of-the-art models when tested on the VIPL-HR public dataset.

Background: Laparoscopic partial nephrectomy (LPN) is a standard surgical treatment option for renal tumors. Prior to LPN, it is necessary to evaluate the tumor condition and develop a surgical plan using precise imaging.

Objective: To explore the clinical application value of 3D virtual model (3DVM) in LPN.

Methods: A total of 80 patients with renal tumor who underwent LPN were measured. Patients were divided into three cohorts (A, B, C) according to the difficulty of surgery. Each group was further divided into the test and control groups based on the application of preoperative 3DVM. Surgical safety and efficacy were assessed, and a questionnaire was developed to investigate the opinions of patients and physicians on 3DVM.

Results: The duration of LPN and intraoperative renal artery occlusion were significantly different between the test and control groups in both cohorts A and B (P< 0.05). In cohort C, the surgical duration, duration of intraoperative renal artery occlusion, length of stay, time to postoperative ambulation, intraoperative bleeding, incidence of postoperative bleeding were significantly between the two groups (P< 0.05). The analysis both of patients and physicians questionnaire scores were statistically significant (P< 0.05).

Conclusions: 3DVM contributes to safer and more effective LPN. It benefits both doctors and patients.

Background: The incidence of arterial variations in the upper limb is variable among ethnic groups. However, there are only a few studies on the Asian population, particularly in China.

Objective: This research provided the first large data series on arterial variations in the upper limb of Chinese adults.

Methods: In this observational study, the arteries in the upper limb of consecutive patients were analyzed between July 2020 and June 2021, and the hemodynamic variables of each patient were collected.

Results: The brachial artery deviated in 6.60% of upper limbs (11.89% of patients), and the brachioradial artery (BRA) was the most frequent variation. In the wrists of all patients, the volume flow (VF) of the BRA was lower than that of the radial artery (RA). Besides, the VF of the BRA in patients with end-stage renal disease (ESRD) was lower than that in those without ESRD in the wrist. Additionally, in the forearms of patients without ESRD, the VF of the BRA was lower than that of the RA. In the upper arm of patients with ESRD, the VF of the brachial artery in patients with BRA was significantly lower than that in patients with RA.

Conclusion: The incidence of arterial variations in the upper limb of Chinese adults was 6.60% (limbs) or 11.89% (patients) in this study. In our investigation, the BRA was the most common high bifurcation of the brachial artery type. Furthermore, the Chi-squared test revealed significant differences in the distribution, which was common in the right upper limb but not in sex.

Background: Critically ill COVID-19 patients are usually subjected to clinical, laboratory, and radiological diagnostic procedures resulting in numerous findings. Utilizing these findings as indicators for disease progression or outcome prediction is particularly intriguing.

Objectives: Exploring the significance of dynamic changes in haematological and biochemical parameters in predicting the mortality of critically ill COVID-19 patients.

Methods: The present study was a prospective and observational study involving mechanically ventilated 75 critically ill adult COVID-19 patients with hypoxemic respiratory failure. The collected data included baseline patient characteristics, treatment options, outcome, and laboratory findings at admission and 7 days after. The dynamics of the obtained findings were compared between survivors and non-survivors.

Results: The 28-day survival rate was 61.3%. In the group of non-survivors significant dynamic changes were found for C-reactive protein (p= 0.001), interleukin-6 (p< 0.001), lymphocyte (p= 0.003), neutrophil-lymphocyte ratio (p= 0.003), platelets (p< 0.001), haemoglobin (p< 0.001), iron (p= 0.012), and total iron-binding capacity (p< 0.001). Statistically significant changes over time were found for ferritin (p= 0.010), D-dimer (p< 0.001), hs-troponin T (p< 0.002), lactate dehydrogenase (p= 0.001), glucose (p= 0.023), unsaturated iron-binding capacity (p= 0.008), and vitamin D (p< 0.001).

Conclusion: The dynamic changes in inflammatory, haematological and biochemical parameters can predict disease severity, and outcome.

Background: Scientific treatments for postpartum urinary incontinence, including pelvic floor muscle exercises (such as Kegel exercises) and infrared therapy, can effectively improve pelvic floor and urethral function, thus enhancing quality of life. However, clinical research on the combined use of these interventions for postpartum urinary incontinence is limited.

Objective: To investigate the combining efficacy of pelvic floor muscle exercises with infrared physiotherapy on postpartum urinary incontinence.

Methods: Clinical information of 102 patients with postpartum urinary incontinence (June 2021-June 2022) were collected and analyzed. Patients were randomly divided into control (conventional intervention) and observation (pelvic floor muscle exercises combined with infrared physiotherapy) groups, with 52 and 50 cases respectively. We compared pelvic floor muscle strength, urodynamic indicators, leakage volume, quality of life, and overall clinical efficacy between the two groups.

Results: Before intervention, both groups had similar pelvic floor function scores and urodynamic indicators. Post-intervention, the pelvic floor function scores in the observation group were significantly lower than control. The urodynamic indicator levels of the observation group were markedly higher than control after 2 months of intervention. Leakage volume was similar before intervention, while the observation group had significantly lower volumes after 1 and 2 months of intervention. Quality of life scores were similar initially, but after 2 months, the observation group scored higher. The observation group showed notably better pelvic floor rehabilitation at 2 months post-intervention.

Conclusion: Combining pelvic floor muscle exercise with infrared physiotherapy has been shown to be a highly effective approach in enhancing pelvic floor muscle strength and improving the quality of life for postpartum women experiencing urinary incontinence. This combined therapy also demonstrates positive effects on urodynamic indicators, reducing leakage volume, and facilitating pelvic floor rehabilitation.

Background: Advancements in laparoscopic technology have popularized laparoscopic total gastrectomy over traditional open surgery, yet postoperative complications like anastomotic leakage and stenosis persist, particularly in esophagojejunostomy. To address this, since 2017, the authors have introduced the "Pant-Shaped" esophagojejunostomy as an improvement over the classic Roux-en-Y method, especially beneficial for patients with small intestinal diameters or those with gastric body cancer or Siewert III.

Objective: To assess the viability and safety of employing 'Pant-Shaped' anastomosis following laparoscopic-assisted total gastrectomy.

Methods: A method of descriptive case study was used. In our department of the First Affiliated Hospital of Wannan Medical College, records of 210 patients who underwent laparoscopic-assisted total gastrectomy for gastric body cancer or adenocarcinoma at the junction of esophagus and jejunum with "Pant-Shaped" anastomosis between January 2017 and December 2022 were examined. Clinicopathological features and postoperative conditions were also examined and assessed.

Results: The mean age of the 164 male and 46 female research participants was 69.2 ± 8.3 years. There was a mean estimated blood loss of 63.4 ± 29.7 ml, an anastomosis time of 25.9 ± 3.0 minutes, an operation time of 208.2 ± 40.4 minutes, and a postoperative hospital stay of 12.2 ± 8.0 days. Nine patients (4.3%) experienced postoperative problems (Clavien-Dindo > grade II), including two episodes of anastomotic leakage that were resolved with irrigation and drainage, anti-infection therapy, and nutritional assistance. After an unforeseen reoperation, two cases of duodenal stump leaking were resolved. Anastamotic hemorrhage was treated with hemostasis and blood transfusion, and the patient made a full recovery. Due to a Peterson's hernia, one patient required emergent open surgery. three months subsequent to LATG.

Conclusions: The "Pant-Shaped" anastomosis method after laparoscopic-assisted total gastrectomy is simple, easy to promote, and has fewer complications. It is a safe and feasible modified method for esophagojejunostomy, especially suitable for patients with poor intestinal dilation and contraction ability and small jejunal diameter.

Background: Tonsillectomy and/or adenoidectomy can treat children with obstructive sleep apnea/hypopnea syndrome (OSAHS).

Objective: This study investigated the effects of tonsillectomy and/or adenoidectomy on cognitive function and brain structure in children with OSAHS.

Methods: This study included 40 obstructive sleep apnea/hypopnea syndrome children and 40 healthy children. The cognitive function and brain structure changes of OSAHS children before and after surgery and 40 healthy children were evaluated by the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) and the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), as well as brain resting-state fMRI functional magnetic resonance imaging (rs-fMRI).

Results: Children with OSAHS showed higher Swanson, Nolan, and Pelham Rating Scale and lower Integrated Visual and Auditory Continuous Performance Test scores than healthy peers, indicating cognitive impairment. Post-surgery, there was a significant improvement in cognitive function, evidenced by decreased Swanson, Nolan, and Pelham Rating Scale and increased Integrated Visual and Auditory Continuous Performance Test scores. Compared to healthy children, OSAHS children displayed altered ReHo values in certain brain regions, such as decreased values in the right angular gyrus, right precuneus, left parahippocampal gyrus, and left middle frontal gyrus, but increased values in the right posterior cerebellum. After surgery, ReHo values increased in regions like the right precuneus, right temporal lobe, right posterior cingulate gyrus, and left limbic lobe, suggesting neurological changes associated with treatment.

Conclusions: Children with obstructive sleep apnea/hypopnea syndrome had cognitive impairment and abnormal changes in multiple brain regions. Tonsillectomy and/or adenoidectomy could improve cognitive function and contribute to the reconstruction of brain function and structure in children with obstructive sleep apnea/hypopnea syndrome.

Background: Patients with tracheotomy are often monitored in the anesthesia recovery room after reoperation. During this period, oxygen therapy is necessary, and the existing tracheostomy oxygen supply device has many defects.

Objective: To evaluate the efficacy of a self-made tracheostomy oxygen delivery device on oxygen therapy during postoperative anesthesia recovery.

Methods: Patients were randomly divided into two groups, E and C, with 30 patients in each group, and admitted to the post-anesthesia care unit (PACU). Patients in group E received oxygen through a self-made tracheostomy oxygen delivery device, while patients in group C were supplied oxygen through a unilateral nasal cannula. Respiration (R), pulse oximetry (SpO2), and the number of patients on ventilators were recorded at the time of admission (T0) and one hour after admission (T1). Rapid dry blood gas analyses were performed on 0.6 ml samples of arterial blood collected at T0 and T1.

Results: Compared to group C, patients in group E had significantly higher arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2), total carbon dioxide (T-CO2), and actual bicarbonate (AB), while arterial partial pressure of carbon dioxide (PaCO2) was significantly reduced (P< 0.01 or < 0.05). Compared to T0, PaO2 decreased in both groups at T1, PaCO2 decreased in group E, while SaO2, T-CO2, and AB decreased in group C (P< 0.01 or < 0.05).

Conclusion: We found that using the self-made tracheostomy oxygen delivery device in postoperative anesthesia recovery had advantages such as a secure connection to the tracheostoma, adjustable oxygen concentration, air filtration, and the ability to switch oxygen supply between the ventilator and humidifier.

Background: Bronchopulmonary dysplasia (BPD) ranks among preterm infants' most common and severe respiratory diseases. Lung ultrasound scores (LUS) play a vital role in predicting early BPD and guiding treatment and intervention strategies for affected patients.

Objective: Performed a meta-analysis to assess the diagnostic LUS for newborns with BPD.

Methods: Online electronic databases such as MEDLINE, CINAHL, the Cochrane Library, and Web of Science were used to retrieve relevant research until May 2023. A total of 117 literatures were collected, and ten eligible articles were selected for meta-analysis.

Results: Meta-analysis was performed on 10 studies (1274 neonates). LUS at 7 days after birth (7 days of life, DOL 7) showed good diagnostic accuracy for any type of BPD, moderate and severe BPD. DOL 7 was more accurate in predicting all types of BPD (AUC = 0.87, sensitivity = 0.75, specificity = 0.83) than moderate and severe BPD (AUC = 0.80, sensitivity = 0.69, specificity = 0.79). There was no statistical significance between DOL 7 and DOL 14 in their accuracy for predicting all types of BPD (difference in AUC = 0.04, p= 0.068). There was no notable distinction between DOL 7 and DOL 14 in their accuracy for predicting moderate and severe BPD (difference in AUC =-0.04, p= 0.104).

Conclusions: The diagnostic efficacy of LUS on DOL 7 in predicting the occurrence of all types of BDP and moderate-severe BPD is determined. This will facilitate rapid and accurate detection and timely treatment, thereby reducing the risk of neonatal mortality and sequelae.

Background: Brain variations are responsible for developmental impairments, including autism spectrum disorder (ASD). EEG signals efficiently detect neurological conditions by revealing crucial information about brain function abnormalities.

Objective: This study aims to utilize EEG data collected from both autistic and typically developing children to investigate the potential of a Graph Convolutional Neural Network (GCNN) in predicting ASD based on neurological abnormalities revealed through EEG signals.

Methods: In this study, EEG data were gathered from eight autistic children and eight typically developing children diagnosed using the Childhood Autism Rating Scale at the Central Institute of Psychiatry, Ranchi. EEG recording was done using a HydroCel GSN with 257 channels, and 71 channels with 10-10 international equivalents were utilized. Electrodes were divided into 12 brain regions. A GCNN was introduced for ASD prediction, preceded by autoregressive and spectral feature extraction.

Results: The anterior-frontal brain region, crucial for cognitive functions like emotion, memory, and social interaction, proved most predictive of ASD, achieving 87.07% accuracy. This underscores the suitability of the GCNN method for EEG-based ASD detection.

Conclusion: The detailed dataset collected enhances understanding of the neurological basis of ASD, benefiting healthcare practitioners involved in ASD diagnosis.