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Effect of SBRT plus immunotherapy on immune status and survival quality of NSCLC patients: A study of combined radiotherapy and immunotherapy. SBRT 加免疫疗法对 NSCLC 患者免疫状态和生存质量的影响:放疗和免疫疗法联合疗法研究。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2025-01-01 DOI: 10.3233/THC-241177
Liang Shao, Ying Gao, Dan Zhang, Mengdan Yang, Mimi Jiang, Hongfeng Li, Yanting Yan

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.

背景:非小细胞肺癌(NSCLC)占所有肺癌患者的80%以上。立体定向放射治疗(SBRT)主要适用于不适合手术或拒绝手术的早期非小细胞肺癌患者:分析立体定向放射治疗(SBRT)加免疫治疗对非小细胞肺癌(NSCLC)患者免疫状态和生存质量的影响:采用随机数字表法将我院2019-2022年收治的NSCLC患者分为对照组(SBRT)61例和观察组(SBRT加免疫治疗)60例,比较两组患者的疗效、血清中肿瘤标志物水平、外周血中免疫细胞水平和活性以及卡氏功能状态(KPS)评分:观察组的有效率高于对照组(P< 0.05)。两组治疗前血清肿瘤标志物含量、外周血免疫细胞水平和活性、KPS评分无统计学差异(P>0.05)。治疗后,血清肿瘤标志物含量低于对照组,免疫细胞水平、NK细胞相关活性和KPS评分高于对照组(P<0.05):结论:SBRT 加免疫治疗可降低 NSCLC 患者的各种肿瘤标志物水平,改善免疫状态和生存质量。
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引用次数: 0
Effect of fit and self-etching adhesive on fiber post retention in endodontically treated teeth. 配合和自酸蚀粘合剂对根管治疗牙齿纤维桩固位的影响
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2025-01-01 DOI: 10.3233/THC-241020
Jing Zhan, Li Li, Zheng Cao, Gaoan Sheng, Weiwei Lou, Lieping Sheng, Litao Yao

Background: Fiber post (FP) reinforced restoration was widespread in endodontically treated teeth, of which the retention was closely related to fit and operation process. However, the question whether the fit and self-etching adhesive (SED) affect the success of FP restoration still remained unclear.

Objective: This research aimed to assess how the fit and self-etching adhesive (SED) impact the pull-out bond strength (BS) of glass fiber-reinforced composite posts from the root canal dentin.

Methods: Eighty lower first premolars underwent simulated endodontic treatment, after which their canals were shaped to accommodate a size three RelyX fiber post (FP) (diameter 1.9 mm). They were then divided into 4 equal groups [Unfit post and no SEA (Group UN), Fit post and no SEA (Group FN), Unfit post with SEA (Group UA) and Fit post with SEA (Group FA)] using two different sized FPs and SEA. Cement thickness was acquired by histological analysis and stereomicroscopy. Each sample was tested for pull-out strength through a universal testing machine. Based on the pull-out test, the failure types were observed and scored by visualizing through a stereomicroscope.

Results: Group FA demonstrated significantly greater BS compared to Group UN and Group UA, with Group UN showing a statistically significant difference at p< 0.01 and Group UA at p< 0.05. Main failure types in Group FA were Type II, which illustrated that the cement detachment mainly occurred from the post-cement interface. Therefore, Group FA possessed the STRONGEST BS and was most suitable for FP-reinforced crown restorations.

Conclusions: Both the fit and SEA enhanced the pull-out BS. The SEA was critical for BS promotion when the mechanical retention was inadequate.

背景:纤维桩(FP)加固修复在牙髓治疗牙中得到广泛应用,其固位与密合度和操作过程密切相关。然而,密合度和自酸蚀粘接剂(SED)是否会影响 FP 修复体的成功与否仍是一个未知数:本研究旨在评估密合度和自酸蚀粘接剂(SED)对玻璃纤维增强复合材料桩从根管牙本质拔出粘接强度(BS)的影响:方法:80 颗下第一前磨牙接受了模拟牙髓治疗,之后对其根管进行塑形,以容纳 3 号 RelyX 纤维桩 (FP)(直径 1.9 毫米)。然后,使用两种不同尺寸的纤维桩和 SEA 将它们分成 4 个相同的组[无 SEA 的不合适桩组(UN 组)、无 SEA 的合适桩组(FN 组)、有 SEA 的不合适桩组(UA 组)和有 SEA 的合适桩组(FA 组)]。水泥厚度通过组织学分析和立体显微镜获得。每个样本都通过万能试验机进行了抗拔强度测试。根据拉拔测试结果,通过体视显微镜观察失效类型并进行评分:结果:与 UN 组和 UA 组相比,FA 组的 BS 明显更高,其中 UN 组的差异显著(P< 0.01),UA 组的差异显著(P< 0.05)。FA 组的主要破坏类型为 II 型,表明水泥脱落主要发生在后水泥界面。因此,FA组的BS最强,最适合用于FP加固冠修复:结论:密合度和 SEA 都能提高拔出 BS。在机械固位不足的情况下,SEA 对于提高 BS 至关重要。
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引用次数: 0
Meta-analysis of the effects of bundle interventions on ICU-acquired weakness intervention. 捆绑式干预对重症监护室获得性虚弱干预效果的 Meta 分析。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2025-01-01 DOI: 10.3233/THC-241542
Yan Zhou, Yubao Liu, Yutong Han, Hongxia Yan

Background: Intensive care unit acquired weakness (ICU-AW) is a secondary neuromuscular complication in critically ill patients, characterized by profound weakness in all four limbs. Studies have shown that bundles of care are nursing strategies that combine a series of evidence-based interventions, which collectively optimize patients' clinical outcomes compared to individual interventions.

Objective: This study aims to conduct a meta-analysis of the effects of bundle interventions on ICU-AW deeply exploring the characteristics of bundle interventions, patient outcomes related to ICU-AW, and primarily investigating the effects of bundle interventions on ICU-AW. The main focus is to explore the clinical value of bundle interventions in treatment of ICU-acquired weakness in patients.

Methods: Computer and manual searches were conducted using keywords to retrieve relevant studies on the effects of bundle interventions on ICU-AW from databases such as PubMed, Web of Science, Cochrane Library and EMbase. The search period ranged from database inception to the present. The control group received standard ICU care, including basic nursing, while the intervention group received bundle nursing interventions.

Results: A total of 10 randomized controlled trials (RCTs) involving 1545 participants (790 in the intervention group and 755 in the control group) were included. Meta-analysis results showed that the intervention group had significantly higher muscle strength (MD = 7.41, 95% CI: 6.65-8.16, P< 0.00001) and daily living ability (MD = 34.01, 95% CI: 32.54-35.48, P< 0.00001) than the control group. Additionally, the incidence of ICU-AW (OR = 0.39, 95% CI: 0.26-0.59, P< 0.00001), mechanical ventilation time (MD =-3.71, 95% CI: -3.58∼-2.76, P< 0.0001), and ICU length of stay (MD =-2.73, 95% CI: -3.14∼-2.31, P< 0.00001) were significantly lower in the intervention group than in the control group.

Conclusion: ICU-AW has a severe negative impact on the recovery and functional restoration of ICU patients, increasing the treatment complexity for healthcare providers and the mortality and disability rates for patients. The bundled care approach may help reduce the incidence of ICU-AW, promote the restoration of daily activity function, enhance muscle strength, and reduce ICU stay and mechanical ventilation time for ICU patients. However, the long-term effects of bundle interventions still require further in-depth research.

背景:重症监护病房获得性肌无力(ICU-AW)是重症患者继发的神经肌肉并发症,其特征是四肢极度无力。研究表明,捆绑护理是结合一系列循证干预措施的护理策略,与单个干预措施相比,捆绑护理能共同优化患者的临床疗效:本研究旨在对捆绑式干预对 ICU-AW 的影响进行荟萃分析,深入探讨捆绑式干预的特点、与 ICU-AW 相关的患者预后,主要研究捆绑式干预对 ICU-AW 的影响。主要探讨捆绑式干预在治疗ICU获得性虚弱患者中的临床价值:使用关键字进行计算机和人工检索,从 PubMed、Web of Science、Cochrane Library 和 EMbase 等数据库中检索有关捆绑式干预对 ICU-AW 影响的相关研究。检索时间从数据库建立之初到现在。对照组接受包括基础护理在内的标准 ICU 护理,干预组接受捆绑护理干预:结果:共纳入了 10 项随机对照试验(RCT),涉及 1545 名参与者(干预组 790 人,对照组 755 人)。元分析结果显示,干预组的肌力(MD = 7.41,95% CI:6.65-8.16,P< 0.00001)和日常生活能力(MD = 34.01,95% CI:32.54-35.48,P< 0.00001)明显高于对照组。此外,干预组的 ICU-AW 发生率(OR = 0.39,95% CI:0.26-0.59,P< 0.00001)、机械通气时间(MD =-3.71,95% CI:-3.58∼-2.76,P< 0.0001)和 ICU 住院时间(MD =-2.73,95% CI:-3.14∼-2.31,P< 0.00001)均显著低于对照组:ICU-AW对ICU患者的康复和功能恢复有严重的负面影响,增加了医护人员治疗的复杂性,提高了患者的死亡率和致残率。捆绑式护理方法有助于降低 ICU-AW 的发生率,促进患者恢复日常活动功能,增强肌肉力量,减少 ICU 患者在 ICU 的住院时间和机械通气时间。然而,捆绑干预的长期效果仍需进一步深入研究。
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引用次数: 0
Echinacoside inhibits hepatocellular carcinoma progression by targeting the miR-30c-5p/FOXD1/KLF12 axis. 棘白甙通过靶向 miR-30c-5p/FOXD1/KLF12 轴抑制肝细胞癌进展
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241449
Guoyu Wang,Yang Han,Juhua Zhuang,Zhongchao Mai,Wei Xia,Ying Ye
BACKGROUNDHepatocellular carcinoma (HCC) is the third leading cause of cancer-attributed mortality and the primary liver malignancy in the world. Echinacoside is a phenylethanoid glycoside derived from traditional Chinese medicinal herbs which possessed multiple health benefits on humans, including anti-tumor effects.OBJECTIVEThis study aimed to demonstrate the function of echinacoside in HCC progression and the involvement of miR-30c-5p/FOXD1/KLF12 axis.METHODSThe HepG2 cells were treated by different dose of echinacoside, miR-30c-5p mimic, miR-30c-5p inhibitor, and FOXD1 overexpression lentiviruses or siRNA individually or simultaneously. The cell invasion and migration were measured by transwell assay. RNA and protein levels were tested by RT-PCR and western blot, respectively. The regulatory function of miR-30c-5p on Forkhead box D1 (FOXD1), FOXD1 on Krüppel-like factor 12 (KLF12) was tested by luciferase reporter assay or/and ChIP assay. Meanwhile, a liver cancer lung metastasis mice model was used to examine the functions of echinacoside and miR-30c-5p on HCC metastasis in vivo. Moreover, the correlations among miR-30c-5p, FOXD1, KLF12, and HCC prognosis was analyzed using clinical sample and TCGA database.RESULTSBased on both in vitro and in vivo investigations, we found that echinacoside could inhibit HCC cell migration, invasiveness, and tumor metastasis, and associated with the enhanced miR-30c-5p/FOXD1/KLF12 axis. Furthermore, through analyzing the interactions among intermediate molecules, we revealed that miR-30c-5p, FOXD1, and KLF12üere clinically relevant with each other in HCC patients, correlated with HCC prognosis, and regulated by echinacoside to contribute in the inhibition of HCC progression.CONCLUSIONSThese findings suggest that echinacoside could inhibit HCC progression, and the mechanism related to the enhanced miR-30c-5p/FOXD1/KLF12 axis. Moreover, the abovementioned intermediate molecules might serve as prospective biomarkers for HCC prognosis.
背景肝细胞癌(HCC)是导致癌症死亡的第三大原因,也是世界上最主要的肝脏恶性肿瘤。本研究旨在证明棘白苷在 HCC 进展中的功能以及 miR-30c-5p/FOXD1/KLF12 轴的参与。方法用不同剂量的棘豆苷、miR-30c-5p模拟物、miR-30c-5p抑制剂、FOXD1过表达慢病毒或siRNA单独或同时处理HepG2细胞。细胞的侵袭和迁移是通过透孔试验测定的。RNA和蛋白质水平分别通过RT-PCR和Western blot检测。荧光素酶报告实验或/和 ChIP 实验检测了 miR-30c-5p 对叉头盒 D1(FOXD1)、FOXD1 对 Krüppel 样因子 12(KLF12)的调控功能。同时,利用肝癌肺转移小鼠模型检测了棘白甙和miR-30c-5p对HCC体内转移的作用。结果基于体外和体内研究,我们发现棘白甙能抑制 HCC 细胞的迁移、侵袭性和肿瘤转移,并与 miR-30c-5p/FOXD1/KLF12 轴的增强有关。此外,通过分析中间分子之间的相互作用,我们发现miR-30c-5p、FOXD1和KLF12ü在HCC患者中具有临床相关性,与HCC预后相关,并受棘白甙调控,有助于抑制HCC的进展。此外,上述中间分子可作为HCC预后的前瞻性生物标志物。
{"title":"Echinacoside inhibits hepatocellular carcinoma progression by targeting the miR-30c-5p/FOXD1/KLF12 axis.","authors":"Guoyu Wang,Yang Han,Juhua Zhuang,Zhongchao Mai,Wei Xia,Ying Ye","doi":"10.3233/thc-241449","DOIUrl":"https://doi.org/10.3233/thc-241449","url":null,"abstract":"BACKGROUNDHepatocellular carcinoma (HCC) is the third leading cause of cancer-attributed mortality and the primary liver malignancy in the world. Echinacoside is a phenylethanoid glycoside derived from traditional Chinese medicinal herbs which possessed multiple health benefits on humans, including anti-tumor effects.OBJECTIVEThis study aimed to demonstrate the function of echinacoside in HCC progression and the involvement of miR-30c-5p/FOXD1/KLF12 axis.METHODSThe HepG2 cells were treated by different dose of echinacoside, miR-30c-5p mimic, miR-30c-5p inhibitor, and FOXD1 overexpression lentiviruses or siRNA individually or simultaneously. The cell invasion and migration were measured by transwell assay. RNA and protein levels were tested by RT-PCR and western blot, respectively. The regulatory function of miR-30c-5p on Forkhead box D1 (FOXD1), FOXD1 on Krüppel-like factor 12 (KLF12) was tested by luciferase reporter assay or/and ChIP assay. Meanwhile, a liver cancer lung metastasis mice model was used to examine the functions of echinacoside and miR-30c-5p on HCC metastasis in vivo. Moreover, the correlations among miR-30c-5p, FOXD1, KLF12, and HCC prognosis was analyzed using clinical sample and TCGA database.RESULTSBased on both in vitro and in vivo investigations, we found that echinacoside could inhibit HCC cell migration, invasiveness, and tumor metastasis, and associated with the enhanced miR-30c-5p/FOXD1/KLF12 axis. Furthermore, through analyzing the interactions among intermediate molecules, we revealed that miR-30c-5p, FOXD1, and KLF12üere clinically relevant with each other in HCC patients, correlated with HCC prognosis, and regulated by echinacoside to contribute in the inhibition of HCC progression.CONCLUSIONSThese findings suggest that echinacoside could inhibit HCC progression, and the mechanism related to the enhanced miR-30c-5p/FOXD1/KLF12 axis. Moreover, the abovementioned intermediate molecules might serve as prospective biomarkers for HCC prognosis.","PeriodicalId":48978,"journal":{"name":"Technology and Health Care","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role and mechanism of LINC02390 and its potential target genes, CLECL1 and CD69, in immune microenvironment of lung adenocarcinoma. LINC02390及其潜在靶基因CLECL1和CD69在肺腺癌免疫微环境中的作用和机制
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241452
Haichao Luo,Ran Chen,Changying Wang,Qitian Chen
BACKGROUNDTargeted therapy and immunotherapy has brought new hope to patients with lung adenocarcinoma (LUAD) with their applications. However, the prognosis of LUAD patients is still unpromising.OBJECTIVEIt is particularly important to find the biomarkers that can predict the prognosis of LUAD. In our previous study, we found that patients with high expression of LINC02390 had a better prognosis. The clinical significance of LINC02390 and its potential target genes, CLECL1 and CD69, in the prognosis of LUAD and its role in the immune microenvironment were explored.METHODSThrough the survival analysis, LINC02390 and its potential target genes, CLECL1 and CD69, were identified as good prognostic factors for LUAD. According to GO and KEGG analyses, LINC02390-related genes were identified potentially involved in immune-related signaling pathways. Gene mutations and their relationship with immune cell infiltration were verified through the online cbioportal and TIMER database.RESULTSCD69 was found to positively associate with CD8 + T cells and CLECL1 was also positively associated with CD4 + T cells. A high expression of CD69 in CD8 + T cells was identified through the single-cell sequencing dataset GSE111894. Finally, CLECL1 and CD69 were lowly expressed in clinical tissue samples with LUAD by immunohistochemical staining.CONCLUSIONSLINC02390 and its possible target genes, CLECL1 and CD69, may be potential targets for the immunotherapy in LUAD patients.
背景靶向治疗和免疫疗法的应用为肺腺癌(LUAD)患者带来了新的希望。然而,肺腺癌患者的预后仍然不容乐观。目的:寻找能够预测肺腺癌预后的生物标志物尤为重要。在我们之前的研究中,我们发现 LINC02390 高表达的患者预后较好。方法通过生存分析,LINC02390及其潜在靶基因CLECL1和CD69被确定为LUAD的良好预后因素。根据GO和KEGG分析,发现LINC02390相关基因可能参与免疫相关信号通路。结果发现CD69与CD8 + T细胞呈正相关,CLECL1与CD4 + T细胞也呈正相关。CD69 在 CD8 + T 细胞中的高表达是通过单细胞测序数据集 GSE111894 确定的。结论LINC02390 及其可能的靶基因 CLECL1 和 CD69 可能是 LUAD 患者免疫治疗的潜在靶点。
{"title":"Role and mechanism of LINC02390 and its potential target genes, CLECL1 and CD69, in immune microenvironment of lung adenocarcinoma.","authors":"Haichao Luo,Ran Chen,Changying Wang,Qitian Chen","doi":"10.3233/thc-241452","DOIUrl":"https://doi.org/10.3233/thc-241452","url":null,"abstract":"BACKGROUNDTargeted therapy and immunotherapy has brought new hope to patients with lung adenocarcinoma (LUAD) with their applications. However, the prognosis of LUAD patients is still unpromising.OBJECTIVEIt is particularly important to find the biomarkers that can predict the prognosis of LUAD. In our previous study, we found that patients with high expression of LINC02390 had a better prognosis. The clinical significance of LINC02390 and its potential target genes, CLECL1 and CD69, in the prognosis of LUAD and its role in the immune microenvironment were explored.METHODSThrough the survival analysis, LINC02390 and its potential target genes, CLECL1 and CD69, were identified as good prognostic factors for LUAD. According to GO and KEGG analyses, LINC02390-related genes were identified potentially involved in immune-related signaling pathways. Gene mutations and their relationship with immune cell infiltration were verified through the online cbioportal and TIMER database.RESULTSCD69 was found to positively associate with CD8 + T cells and CLECL1 was also positively associated with CD4 + T cells. A high expression of CD69 in CD8 + T cells was identified through the single-cell sequencing dataset GSE111894. Finally, CLECL1 and CD69 were lowly expressed in clinical tissue samples with LUAD by immunohistochemical staining.CONCLUSIONSLINC02390 and its possible target genes, CLECL1 and CD69, may be potential targets for the immunotherapy in LUAD patients.","PeriodicalId":48978,"journal":{"name":"Technology and Health Care","volume":"8 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SwinDFU-Net: Deep learning transformer network for infection identification in diabetic foot ulcer. SwinDFU-Net:用于识别糖尿病足溃疡感染的深度学习变压器网络。
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241444
Sumithra M G,Chandran Venkatesan
BACKGROUNDThe identification of infection in diabetic foot ulcers (DFUs) is challenging due to variability within classes, visual similarity between classes, reduced contrast with healthy skin, and presence of artifacts. Existing studies focus on visual characteristics and tissue classification rather than infection detection, critical for assessing DFUs and predicting amputation risk.OBJECTIVETo address these challenges, this study proposes a deep learning model using a hybrid CNN and Swin Transformer architecture for infection classification in DFU images. The aim is to leverage end-to-end mapping without prior knowledge, integrating local and global feature extraction to improve detection accuracy.METHODSThe proposed model utilizes a hybrid CNN and Swin Transformer architecture. It employs the Grad CAM technique to visualize the decision-making process of the CNN and Transformer blocks. The DFUC Challenge dataset is used for training and evaluation, emphasizing the model's ability to accurately classify DFU images into infected and non-infected categories.RESULTSThe model achieves high performance metrics: sensitivity (95.98%), specificity (97.08%), accuracy (96.52%), and Matthews Correlation Coefficient (0.93). These results indicate the model's effectiveness in quickly diagnosing DFU infections, highlighting its potential as a valuable tool for medical professionals.CONCLUSIONThe hybrid CNN and Swin Transformer architecture effectively combines strengths from both models, enabling accurate classification of DFU images as infected or non-infected, even in complex scenarios. The use of Grad CAM provides insights into the model's decision process, aiding in identifying infected regions within DFU images. This approach shows promise for enhancing clinical assessment and management of DFU infections.
背景糖尿病足溃疡(DFUs)中感染的识别具有挑战性,原因在于类内的可变性、类间的视觉相似性、与健康皮肤的对比度降低以及伪影的存在。现有的研究侧重于视觉特征和组织分类,而不是感染检测,而感染检测对于评估 DFU 和预测截肢风险至关重要。该模型采用混合 CNN 和 Swin Transformer 架构。该模型采用 Grad CAM 技术来可视化 CNN 和变换器模块的决策过程。结果该模型实现了较高的性能指标:灵敏度(95.98%)、特异度(97.08%)、准确度(96.52%)和马太相关系数(0.93)。这些结果表明了该模型在快速诊断 DFU 感染方面的有效性,凸显了其作为医疗专业人员的宝贵工具的潜力。 结论混合 CNN 和 Swin Transformer 架构有效地结合了两种模型的优势,即使在复杂的情况下,也能将 DFU 图像准确地分类为感染或非感染。Grad CAM 的使用为模型的决策过程提供了洞察力,有助于识别 DFU 图像中的感染区域。这种方法有望加强对 DFU 感染的临床评估和管理。
{"title":"SwinDFU-Net: Deep learning transformer network for infection identification in diabetic foot ulcer.","authors":"Sumithra M G,Chandran Venkatesan","doi":"10.3233/thc-241444","DOIUrl":"https://doi.org/10.3233/thc-241444","url":null,"abstract":"BACKGROUNDThe identification of infection in diabetic foot ulcers (DFUs) is challenging due to variability within classes, visual similarity between classes, reduced contrast with healthy skin, and presence of artifacts. Existing studies focus on visual characteristics and tissue classification rather than infection detection, critical for assessing DFUs and predicting amputation risk.OBJECTIVETo address these challenges, this study proposes a deep learning model using a hybrid CNN and Swin Transformer architecture for infection classification in DFU images. The aim is to leverage end-to-end mapping without prior knowledge, integrating local and global feature extraction to improve detection accuracy.METHODSThe proposed model utilizes a hybrid CNN and Swin Transformer architecture. It employs the Grad CAM technique to visualize the decision-making process of the CNN and Transformer blocks. The DFUC Challenge dataset is used for training and evaluation, emphasizing the model's ability to accurately classify DFU images into infected and non-infected categories.RESULTSThe model achieves high performance metrics: sensitivity (95.98%), specificity (97.08%), accuracy (96.52%), and Matthews Correlation Coefficient (0.93). These results indicate the model's effectiveness in quickly diagnosing DFU infections, highlighting its potential as a valuable tool for medical professionals.CONCLUSIONThe hybrid CNN and Swin Transformer architecture effectively combines strengths from both models, enabling accurate classification of DFU images as infected or non-infected, even in complex scenarios. The use of Grad CAM provides insights into the model's decision process, aiding in identifying infected regions within DFU images. This approach shows promise for enhancing clinical assessment and management of DFU infections.","PeriodicalId":48978,"journal":{"name":"Technology and Health Care","volume":"20 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension. 颈椎硬膜外血贴治疗是自发性颅内低血压的一种选择。
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241366
Hui Su,Xiaoyang Lan,Ya Cao,Mingjie Zhang,Xiaoyan Chen,Chen Lan
BACKGROUNDEpidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention.OBJECTIVEIn this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated.METHODS: Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024.RESULTSThe mean age of the fifty-nine patients at symptom onset was 40.8 ± 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 sacns with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months.CONCLUSIONCT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.
背景硬膜外血贴(EBP)是治疗自发性颅内低血压(SIH)的一种微创、有效的方法。方法:2014 年 8 月至 2024 年 3 月,中国人民解放军总医院对 59 例难治性 SIH 患者进行了计算机断层扫描(CT)引导下的颈椎 EBP 检查。结果59 例患者发病时的平均年龄为(40.8±9.5)岁。54/59(91.5%)名患者出现过正中型头痛。43/46(93.5%)例患者术前脊柱 T2 囊肿,上颈部有大量积液。45/59(76.3%)名患者在最初的颈椎 EBP 治疗后症状得到缓解,14/59(23.7%)名患者接受了进一步的颈椎 EBP 治疗。在 EBP 术后的一至三天内,11 名患者(18.6%)报告穿刺部位疼痛,15 名患者(25.4%)报告颈部疼痛。术中和术后均未发现其他并发症。在最近的随访中,所有患者均恢复良好。结论:CT 引导下的颈椎 EBP 是治疗顽固性 SIH 患者的一种有效而安全的方法,尤其适用于上颈部有大量积液的患者。
{"title":"Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension.","authors":"Hui Su,Xiaoyang Lan,Ya Cao,Mingjie Zhang,Xiaoyan Chen,Chen Lan","doi":"10.3233/thc-241366","DOIUrl":"https://doi.org/10.3233/thc-241366","url":null,"abstract":"BACKGROUNDEpidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention.OBJECTIVEIn this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated.METHODS: Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024.RESULTSThe mean age of the fifty-nine patients at symptom onset was 40.8 ± 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 sacns with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months.CONCLUSIONCT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.","PeriodicalId":48978,"journal":{"name":"Technology and Health Care","volume":"35 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revolutionizing health monitoring: Integrating transformer models with multi-head attention for precise human activity recognition using wearable devices. 革新健康监测:将变压器模型与多头注意力相结合,利用可穿戴设备精确识别人体活动。
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241064
Anandhavalli Muniasamy
BACKGROUNDA daily activity routine is vital for overall health and well-being, supporting physical and mental fitness. Consistent physical activity is linked to a multitude of benefits for the body, mind, and emotions, playing a key role in raising a healthy lifestyle. The use of wearable devices has become essential in the realm of health and fitness, facilitating the monitoring of daily activities. While convolutional neural networks (CNN) have proven effective, challenges remain in quickly adapting to a variety of activities.OBJECTIVEThis study aimed to develop a model for precise recognition of human activities to revolutionize health monitoring by integrating transformer models with multi-head attention for precise human activity recognition using wearable devices.METHODSThe Human Activity Recognition (HAR) algorithm uses deep learning to classify human activities using spectrogram data. It uses a pretrained convolution neural network (CNN) with a MobileNetV2 model to extract features, a dense residual transformer network (DRTN), and a multi-head multi-level attention architecture (MH-MLA) to capture time-related patterns. The model then blends information from both layers through an adaptive attention mechanism and uses a SoftMax function to provide classification probabilities for various human activities.RESULTSThe integrated approach, combining pretrained CNN with transformer models to create a thorough and effective system for recognizing human activities from spectrogram data, outperformed these methods in various datasets - HARTH, KU-HAR, and HuGaDB produced accuracies of 92.81%, 97.98%, and 95.32%, respectively. This suggests that the integration of diverse methodologies yields good results in capturing nuanced human activities across different activities. The comparison analysis showed that the integrated system consistently performs better for dynamic human activity recognition datasets.CONCLUSIONIn conclusion, maintaining a routine of daily activities is crucial for overall health and well-being. Regular physical activity contributes substantially to a healthy lifestyle, benefiting both the body and the mind. The integration of wearable devices has simplified the monitoring of daily routines. This research introduces an innovative approach to human activity recognition, combining the CNN model with a dense residual transformer network (DRTN) with multi-head multi-level attention (MH-MLA) within the transformer architecture to enhance its capability.
背景日常活动对整体健康和幸福至关重要,有助于身心健康。坚持体育锻炼对身体、心理和情绪都有诸多益处,在培养健康的生活方式方面发挥着关键作用。在健康和健身领域,可穿戴设备的使用已变得至关重要,它为监测日常活动提供了便利。虽然卷积神经网络(CNN)已被证明是有效的,但在快速适应各种活动方面仍存在挑战。本研究旨在开发一种精确识别人类活动的模型,通过将变压器模型与多头注意力整合在一起,利用可穿戴设备精确识别人类活动,从而彻底改变健康监测。该算法使用带有 MobileNetV2 模型的预训练卷积神经网络(CNN)来提取特征,并使用密集残差变压器网络(DRTN)和多头多级注意力架构(MH-MLA)来捕捉与时间相关的模式。结果该集成方法结合了预训练的 CNN 和变换器模型,创建了一个全面有效的系统,用于从频谱图数据中识别人类活动,在各种数据集中的表现优于其他方法--HARTH、KU-HAR 和 HuGaDB 的准确率分别为 92.81%、97.98% 和 95.32%。这表明,在捕捉不同活动中细微的人类活动时,将多种方法集成在一起会产生良好的效果。对比分析表明,集成系统在动态人类活动识别数据集方面一直表现较好。有规律的体育活动对健康的生活方式大有裨益,对身心都有好处。可穿戴设备的集成简化了对日常活动的监测。本研究引入了一种创新的人类活动识别方法,将 CNN 模型与密集残差变压器网络 (DRTN) 以及变压器架构中的多头多级注意 (MH-MLA) 相结合,以增强其能力。
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引用次数: 0
Assessing the risk factors associated with nutritional status in patients with liver cirrhosis: A case-control study. 评估与肝硬化患者营养状况相关的风险因素:病例对照研究
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241180
Yanping Ji,Qingbin Ding,Tianyi Bu,Kun Wang,Jing Zhang,Xue Wang
BACKGROUNDCirrhosis is one of the most common clinical diseases in the world. The patient with cirrhosis has many complications, such as spontaneous peritonitis, hepatic encephalopathy. Malnutrition is one of the most common complications in patients with cirrhosis, and it is also a key factor affecting the prognosis of patients. However, the research on cirrhosis malnutrition is relatively scarce.OBJECTIVEThis study aimed to explore the new factors of the liver cirrhosis with the nutritional status.METHODSA total of 370 patients with liver cirrhosis were admitted to the Fourth Affiliated Hospital of Harbin Medical University from January 2019 to January 2023 were selected. Patients were assigned to the malnourished group and normal group. The weight, height, mid arm circumference (MAC) and triceps skinfold thickness (TSF) of the two groups were measured. Body mass index (BMI) and mid-arm muscle circumference (MAMC) were calculated. Furthermore, the Health Literacy Management Scale (HeLMS), biochemical indexes, incidence of complications, disease grade were also counted and the Royal Free Hospital-Nutrition Prioritization Tool were used to evaluate the nutritional status of the patient.RESULTSA total of 370 patients was included in this study, including 177 malnutrition patients, accounting for 45.29%, and the scores and total scores of the patients in the malnutrition group were lower than those in the normal group. The measured values of Na+, Alb, PA, T-Bil, TC, TLC, Hb, and RBC were all lower than those of the normal group, and the difference was statistically significant. The overall complication rate of the patients in the malnourished group was 89.61%, and that of the normal group was 39.78%. Multifactorial logistic regression analysis was performed with nutritional level as the dependent variable (normal = 0, malnutrition = 1), and the above indicators of variability (Na+, Alb, PA, T-Bil, TC, PT, Hb, RBC, HG, and HeLMS scores) as the independent variables. The results showed that Na+, Hb were the influencing factors of nutritional level (P< 0.05).CONCLUSIONThe incidence of malnutrition in cirrhotic patients included in this study was at a moderate level, and the nutritional literacy of these patients was low. In addition, the level of serum sodium, Hemoglobin can affect the nutritional level of patients with cirrhosis.
背景肝硬化是世界上最常见的临床疾病之一。肝硬化患者有许多并发症,如自发性腹膜炎、肝性脑病等。营养不良是肝硬化患者最常见的并发症之一,也是影响患者预后的关键因素。本研究旨在探讨肝硬化营养状况的新因素。方法选取2019年1月至2023年1月哈尔滨医科大学附属第四医院收治的肝硬化患者共370例。将患者分为营养不良组和正常组。测量两组患者的体重、身高、中臂围(MAC)和肱三头肌皮褶厚度(TSF)。计算体重指数(BMI)和中臂肌围(MAMC)。结果本研究共纳入 370 例患者,其中营养不良患者 177 例,占 45.29%,营养不良组患者的评分和总分均低于正常组。Na+、Alb、PA、T-Bil、TC、TLC、Hb、RBC 的测量值均低于正常组,差异有统计学意义。营养不良组患者的总并发症发生率为 89.61%,正常组为 39.78%。以营养水平为因变量(正常=0,营养不良=1),上述变异指标(Na+、Alb、PA、T-Bil、TC、PT、Hb、RBC、HG 和 HeLMS 评分)为自变量,进行多因素逻辑回归分析。结果显示,Na+、Hb 是营养水平的影响因素(P< 0.05)。结论本研究纳入的肝硬化患者营养不良发生率处于中等水平,这些患者的营养知识水平较低。此外,血清钠、血红蛋白水平也会影响肝硬化患者的营养水平。
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引用次数: 0
Exploring the efficacy of structured nursing via web-based interaction platforms in sustaining hemodialysis patients. 探索通过网络互动平台对血液透析患者进行结构化护理的效果。
IF 1.6 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-29 DOI: 10.3233/thc-241021
Biyan Fei,Lili Zhan,Jingqi Gou,Yanping Wu,Haili Sun
BACKGROUNDDiscussed based on the network interactive platform of structured care for patients with chronic renal failure (CRF) in the process of hemodialysis.OBJECTIVEThis study seeks to elucidate the application value of structured nursing, deployed through network interaction platforms, in sustaining patients undergoing maintenance hemodialysis.METHODSA total of 62 patients diagnosed with Chronic Renal Failure (CRF) between April 2022 and August 2023 were randomly allocated into two distinct care groups: conventional and structured nursing care based on a web-interactive platform. Both cohorts were comparatively analyzed with respect to psychological states, quality of life within therapeutic interventions, and relationships with complications. Renal function indicators, including Creatinine Clearance (Ccr), Serum Creatinine (SCr), and Blood Urea Nitrogen (BUN), were subjected to Pearson analysis to appraise their predictive value in prognostication, while Receiver Operating Characteristic (ROC) curve analysis was constructed to further discern their diagnostic precision.RESULTSPost-intervention, notable improvements were observed in the emotional states of patients in both cohorts, with the structured care group exhibiting significantly lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores (p< 0.05). Furthermore, patients under the web-interactive structured nursing regimen demonstrated superior overall adherence, a reduced incidence rate of complications, and markedly higher scores in quality of life assessments compared to those under conventional care (p< 0.05). The derived cut-off values for Ccr, SCr, and BUN were 32.5 ml/min, 251.5 umol/L, and 14.5 mmol/L, respectively, with sensitivities and specificities pegged at 0.645% and 0.645% for Ccr, 0.774% and 0.548% for SCr, and 0.774% and 0.774% for BUN. The corresponding areas under the ROC curve (AUC) for each parameter were 0.816, 0.653, and 0.856, respectively.CONCLUSIONComprehensive hemodialysis care for patients with chronic renal failure can improve self-care ability to improve quality of life and reduce the incidence of complications, which has great potential for clinical progress and is worthy of further research.
摘要】目的探讨基于网络互动平台的结构化护理在慢性肾功能衰竭(CRF)患者血液透析过程中的应用价值。方法将 2022 年 4 月至 2023 年 8 月期间确诊为慢性肾功能衰竭(CRF)的 62 例患者随机分配到两个不同的护理组:常规护理组和基于网络互动平台的结构化护理组。对两组患者的心理状态、治疗干预中的生活质量以及与并发症的关系进行了比较分析。对包括肌酐清除率(Ccr)、血清肌酐(SCr)和血尿素氮(BUN)在内的肾功能指标进行了皮尔逊分析,以评估其在预后中的预测价值,同时构建了接收者操作特征曲线(ROC)分析,以进一步确定其诊断精度。结果 干预后,两组患者的情绪状态均有明显改善,结构化护理组的焦虑自评量表(SAS)和抑郁自评量表(SDS)得分明显降低(P< 0.05)。此外,与接受传统护理的患者相比,接受网络交互式结构化护理方案的患者总体依从性更好,并发症发生率更低,生活质量评估得分明显更高(P< 0.05)。得出的 Ccr、SCr 和 BUN 临界值分别为 32.5 毫升/分钟、251.5 毫摩尔/升和 14.5 毫摩尔/升,Ccr 的敏感性和特异性分别为 0.645% 和 0.645%,SCr 的敏感性和特异性分别为 0.774% 和 0.548%,BUN 的敏感性和特异性分别为 0.774% 和 0.774%。结论对慢性肾功能衰竭患者进行全面的血液透析护理,可以提高患者的自我护理能力,从而改善患者的生活质量,降低并发症的发生率,具有很大的临床推广潜力,值得进一步研究。
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Technology and Health Care
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