bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of ankle joint proprioceptive training and thermal approach on stroke patients’ trunk, balance stability and gait parameter
Authors: Kim Kyung-Hun , Kim Dong-Hoon
Published: May 2022

BACKGROUND: Numerous studies have investigated factors for trunk, balance stability and gait parameters of post-stroke patients. Evidence-based recommendations are required for the treatment of ankle proprioceptive exercise with thermal stimulation in post-stroke patients. OBJECTIVE: We investigated the effects of ankle proprioceptive exercise with thermal stimulation on the trunk stability, balance, and gait ability of post-stroke patients. METHODS: A total of 30 patients were randomly divided into the ankle proprioceptive training and thermal stimulation group (APT) and control group. The APT group performed ankle proprioceptive exercises with thermal stimulation for 60 min five times a week for eight weeks. The control group followed conservative treatment for 60 min five times a week for eight weeks. Trunk stability was measured with the trunk impairment scale (TIS) and balance tests were performed with the center of pressure (COP), limits of stability (LOS), Berg Balance Scale (BBS), and functional reach test (FRT) and gait ability was performed by OptoGait and 10 m WT. RESULTS: There was a significant difference (p< 0.05) between before and after training in both groups. The APT group showed significant improvement in both groups. CONCLUSION: This study can be used as intervention data for recovering trunk, balance stability and gait parameters in post-stroke patients.
Tai Chi for spatiotemporal gait features and dynamic balancing capacity in elderly female patients with non-specific low back pain: A six-week randomized controlled trial
Authors: Yan Zhi-Wei , Yang Zhen , Yang Jinghui , Chen Ya-Feng , Zhang Xue-Bin , Song Cheng-Lin
Published: May 2022

BACKGROUND: Non-specific low back pain (NS-LBP) is a serious public health problem. Tai Chi is promising in reducing the risk of falls and alleviating symptoms in this population. OBJECTIVE: To investigate the effect of Tai Chi on gait and dynamic balance in elderly women with NS-LBP. METHODS: 20 women (age > 65 yr.) with NS-LBP were randomly assigned to a Tai Chi group (n= 10) or a control group (n= 10). The Tai Chi group practiced Tai Chi exercise 3 times a week for 6 weeks. Each session lasted 60 minutes. Pain, spatiotemporal gait features and dynamic balancing capacity were assessed at 0 and 6 weeks. RESULTS: Compared to the control group at 6 weeks, the Tai Chi group had a significant decrease in VAS (p= 0.027) and stride width (p= 0.019), significant improvement in gait velocity, stride length (p< 0.001). Regarding dynamic balance capacity, the Tai Chi group had significant improvements in anterior (Left: p= 0.001; Right: p= 0.038), postero-lateral (Left: p< 0.001; Right: p= 0.038), and postero-medial (Left: p= 0.015; Right: p= 0.018). CONCLUSION: 6-week Tai Chi can relieve pain and improve gait and dynamic balance in elderly women with NS-LBP, which suggests Tai Chi could be a promising rehabilitation intervention to reduce the risk of falls in this population.
Downregulation of ASF1B inhibits tumor progression and enhances efficacy of cisplatin in pancreatic cancer
Authors: Kim Jae Hyeong , Youn Yuna , Lee Jong-Chan , Kim Jaihwan , Ryu Ji Kon , Hwang Jin-Hyeok
Published: May 2022

Pancreatic cancer is an aggressive and lethal cancer with the highest mortality rate. Hence, the development of new targeting and innovative treatment strategies is needed. Recent studies reported that the histone chaperone anti-silencing function 1B (ASF1B) can be used as a diagnosis and prognosis cancer biomarker. However, functional studies of ASF1B in pancreatic cancer have not been performed. This study compared expression levels of ASF1B in pancreatic cancer specimens with those of normal tissues using publicly available online databases. We found that ASF1B was commonly overexpressed in pancreatic cancer specimens, which is associated with poor prognosis. ASF1B downregulation in pancreatic cancer cells reduced their colony formation, proliferation, migration, and invasion abilities, and inhibited MMP9 activity. Furthermore, ASF1B expression downregulation increased cell cycle S-phase arrest and DNA damage though activation of the checkpoint kinases Chk1 and Chk2 pathways. Additionally, increased caspase (caspases-3 and -9) activation and PARP cleavage led to enhanced caspase-dependent apoptosis and improved cisplatin sensitivity. Collectively, our results indicate that ASF1B may serve as a potential biomarker of pancreatic cancer and a novel therapeutic target.
Exercise with blood flow restriction improves muscle strength and mass while preserving the vascular and microvascular function and structure of older adults
Authors: Lopes Karynne Grutter , Farinatti Paulo , Bottino Daniel Alexandre , de Souza Maria das Graças Coelho , Maranhão Priscila , Bouskela Eliete , Lourenço Roberto Alves , de Oliveira Ricardo Brandão
Published: May 2022

BACKGROUND: Changes in muscle mass, strength, vascular function, oxidative stress, and inflammatory biomarkers were compared in older adults after resistance training (RT) performed with low-intensity without blood flow restriction (RT-CON); low-intensity with BFR (RT-BFR); and high-intensity without BFR (RT-HI). METHODS: Thirty-two untrained individuals (72±7 y) performed a 12-week RT after being randomized into three groups: RT-CON –30% of 1 repetition maximum (RM); RT-BFR –30% of 1RM and mild BFR (50% of arterial occlusion pressure); RT-HI –70% of 1 RM. RESULTS: Improvements in handgrip strength were similar in RT-BFR (17%) and RT-HI (16%) vs. RT-CON (–0.1%), but increases in muscle mass (6% vs. 2% and –1%) and IGF-1 (2% vs. –0.1% and –1.5%) were greater (p < 0.05) in RT-BFR vs. RT-HI and RT-CON. Changes in vascular function, morphology, inflammation, and oxidative stress were similar between groups, except for time to reach maximum red blood cell velocity which showed a greater reduction (p < 0.05) in RT-BFR (–55%) vs. RT-HI (–11%) and RT-CON (–4%). CONCLUSION: RT with low intensity and mild BFR improved muscle strength and mass in older individuals while preserving vascular function. This modality should be considered an adjuvant strategy to improve muscle function in older individuals with poor tolerance to high loads.
Two-dimensional shear wave elastography with two different systems for the diagnosis of breast lesions
Authors: Yu Ji-Feng , Zhang Shen , Yin Hao-Hao , Zhou Bang-Guo , Pu Yin-Ying , Fang Yan , Du Dou , Zhang Yan , Xu Hui-Xiong
Published: May 2022

BACKGROUND: Two-dimensional (2D) - shear wave elastography (SWE) has made promising advances in the diagnostic of breast lesions. However, few studies have assessed whether the diagnostic effectiveness of different platforms employing 2D-SWE is equal or different. OBJECTIVE: To compare the diagnostic effectiveness of 2D-SWE techniques from two different systems in differentiating malignant breast lesions from benign ones. METHODS: A total of 84 breast lesions were retrospectively analyzed by experienced radiologists using 2D-SWE on two ultrasound systems, i.e. system-1 (LOGIQ E9 system, GE Healthcare, Wauwatosa, WI, USA), and system-2 (Aixplorer US system, SuperSonic Imagine, Aix-en-Provence, France). Qualitative and quantitative parameters including color sign, the maximum elasticity modulus values (E-max), the mean elasticity modulus values (E-mean) and standard deviation (E-sd) of elasticity modulus values in two 2D-SWE systems were analyzed. The diagnostic performance between system-1 and system-2 were evaluated in terms of the areas under the receiver operating characteristic curves (AUROCs). RESULTS: Among the 84 lesions in this study, 66 (78.6%) were benign and 18 (21.4%) were malignant. E-max in system-1 showed the best diagnostic performance with a cut-off value of 174.5 kPa with the associated sensitivity and specificity of 100.0% and 80.3% respectively. Meanwhile, E-sd in system-2 displayed the best diagnostic performance with a cut-off value of 12.7 kPa, with the associated sensitivity and specificity of 94.4% and 80.3% respectively. The diagnostic performance of the two 2D-SWE systems was not statistically different according to receiver operating characteristic curve (ROC) analysis of E-max, E-mean, and E-sd. CONCLUSION: For identifying breast lesions, system-1 and system-2 appear to be similar in diagnostic performance. However, different cut-off values for different parameters might be selected to obtain the best diagnostic performance for the two 2D-SWE systems.
A parallel feature selection algorithm for detection of cancer biomarkers
Authors: Razmjouei Maryam , Hamidi Hamid Reza
Published: May 2022

Biomarker plays an important role in early disease diagnosis including cancer. The World Health Organization defines a biomarker as any structure or process in the body that is measurable and affects the prognosis or outcome of the disease. Today, biomarkers can be identified using bioinformatics tools. The detection of biomarkers in the field of bioinformatics is considered more as a problem of feature selection. Many feature selection algorithms have been used for biomarker discovery however these algorithms do not have enough accuracy or have computational complexity. For this reason, the researchers discard the high accuracy algorithms because they are time consuming. We redesigned an efficient algorithm based on parallel algorithms. We used the Cancer Genome Atlas (TCGA) including breast cancer patients. The proposed algorithm has the same accuracy and increases the speed of algorithm.
Policing the smart home: The internet of things as ‘invisible witnesses’1
Authors: Urquhart Lachlan , Miranda Diana , Podoletz Lena
Published: May 2022

In this paper, we develop the concept of smart home devices as ‘invisible witnesses’ in everyday life. We explore contemporary examples that highlight how smart devices have been used by the police and unpack the socio-technical implications of using these devices in criminal investigations. We draw on several sociological, computing and forensics concepts to develop our argument. We consider the challenges of obtaining and interpreting trace evidence from smart devices; unpack the ways in which these devices are designed to be ‘invisible in use’; and reflect on the processes by which they become domesticated into everyday life. We also analyse the differentiated levels of control occupants have over smart home devices, and the surveillance impacts of making everyday life visible to third parties, particularly the police.
RETRACTED: Enhanced energy efficient routing scheme based ant colony optimization
Authors: Chithra K. , Shunmughanaathan V.K. , Karthik S. , Srihari K.
Published: May 2022

This article has been retracted. A retraction notice can be found at https://doi.org/10.3233/JIFS-219433.
Research on classification algorithm of cerebral small vessel disease based on convolutional neural network
Authors: Wan Chenxia , Fang Liqun , Cao Shaodong , Luo Jiaji , Jiang Yijing , Wei Yuanxiao , Lv Cancan , Si Weijian
Published: May 2022

The investigation on brain magnetic resonance imaging (MRI) of cerebral small vessel disease (CSVD) classification algorithm based on deep learning is particularly important in medical image analyses and has not been reported. This paper proposes an MRI classification algorithm based on convolutional neural network (MRINet), for accurately classifying CSVD and improving the classification performance. The working method includes five main stages: fabricating dataset, designing network model, configuring the training options, training model and testing performance. The actual training and testing datasets of MRI of CSVD are fabricated, the MRINet model is designed for extracting more detailedly features, a smooth categorical-cross-entropy loss function and Adam optimization algorithm are adopted, and the appropriate training parameters are set. The network model is trained and tested in the fabricated datasets, and the classification performance of CSVD is fully investigated. Experimental results show that the loss and accuracy curves demonstrate the better classification performance in the training process. The confusion matrices confirm that the designed network model demonstrates the better classification results, especially for luminal infarction. The average classification accuracy of MRINet is up to 80.95% when classifying MRI of CSVD, which demonstrates the superior classification performance over others. This work provides a sound experimental foundation for further improving the classification accuracy and enhancing the actual application in medical image analyses.
Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson’s Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis
Authors: Liebermann-Jordanidis Hannah , Roheger Mandy , Boosfeld Lukas , Franklin Jeremy , Kalbe Elke
Published: May 2022

Background: Visuo-cognitive impairment is common in patients with Parkinson’s disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson’s disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking. Objective: To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD. Methods: MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted. Results: 33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages. Conclusion: We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided. Registration: https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244
A Systematic Review on Physical Health Education Interventions for People with Parkinson’s Disease: Content, Impact, and Implementation Considerations Across the Parkinson’s Trajectory
Authors: Alushi Ledia , Alexander James , Jones Julie , Lafortune Louise
Published: May 2022

Background: Educational interventions promoting the role of physical activity (PA) aim to address knowledge, poor exercise self-efficacy, and low outcome expectations, which are well-researched barriers to PA participation in healthy and in people with chronic conditions. However, little is known about the effectiveness of educational interventions in addressing these barriers in people with Parkinson’s (PwP). Objective: To examine the content of education interventions that promote PA behavior in PwP, and to assess their effectiveness on physical and psychosocial outcomes. Methods: An electronic search (12/2021) of MEDLINE, EMBASE, CINAHL, PubMed PsycINFO, the Web of Science and the Cochrane Library was conducted from 1990 to 2021. Education interventions, alone or combined with other strategies, promoting PA in PwP were included. Quality was assessed using the Johanna Briggs Institute and National Institute of Health quality assessment tools. A narrative synthesis was performed. Results: Six studies were identified. Five interventions were comprised of education and exercise sessions. Improvement in physical and psychosocial outcomes were suggested but delineating the exact impact of education was impeded due to lack of assessment. Conclusion: Few interventions exist that provide knowledge, and skills promoting PA participation, and fewer are addressed towards newly diagnosed PwP. There is lack of assessment over the effectiveness of education as a tool to facilitate PA participation in PwP. Lack of assessment poses the risk of potentially disregarding effective interventions or adopting ineffective approaches without the evidence. Education interventions can boost PA engagement by increasing factors such as exercise self-efficacy, but further interventions are required to assess this model of relationship.
Integrated Sensing Devices for Disease Prevention and Health Alerts in Smart Homes
Authors: Haghi Mostafa , Spicher Nicolai , Wang Ju , Deserno Thomas M.
Published: May 2022

The rapid development of elderly population is changing demographics in Europe and North America and imposes barriers to healthcare systems that may reduce the quality of service. Telemedicine is a potential solution supporting the real-time and remote monitoring of subjects as well as bidirectional communication with medical personnel for care delivery at the point of perception. Smart homes are private spaces where young or elderly, healthy or diseased-suffering, or disabled individuals spend the majority of their time. Hence, turning smart homes into diagnostic spaces for continuous, real-time, and unobtrusive health monitoring allows disease prediction and prevention before the subject perceives any symptoms. According to the World Health Organization, health, well-being, and quality of life assessment require the monitoring of interwoven domains such as environmental, behavioral, physiological, and psychological. In this work, we give an overview on sensing devices and technologies utilized in smart homes, which can turn the home into a diagnostic space. We consider the integration of sensing devices from all four WHO domains with respect to raw and processed data, transmission, and synchronization. We apply the bus-based scalable intelligent system to construct a hybrid topology for hierarchical multi-layer data fusion. This enables event detection and alerting for short-time as well as prediction and prevention for long-time monitoring.
Investigating the Components of Virtual Emergency Department
Authors: Shojaei Elham , Luque Emilio , Rexachs Dolores
Published: May 2022

The prediction of the demography of Spain shows that Spain will experience an aging population soon. Aging is a condition of chronic disease resulting in overcrowding Emergency Department. Despite chronic diseases, Covid-19 became a serious issue for emergency Department staff and health care providers. All of these matters emphasized the importance of the Virtual Emergency Department which can provide faster and more affordable medical services while everyone can keep the social distance as much as possible. In this chapter, we investigated the role of IT in the healthcare system and the possible suggested solutions. We have studied the existing telemedicine, e-health, machine learning algorithms and in the end, their combination to built an integrated virtual emergency department to cover all the aspects. We have proposed a model for this integrated model and studied the possibility of success in each step including admission, triage, diagnoses, and clinical advice based on literature.
Digital Medical Interview Assistant for Radiology: Opportunities and Challenges
Authors: Denecke Kerstin , Lombardo Paolo , Nairz Knud
Published: May 2022

Background: Personal contact between radiologists and their patients is scarce due to time constraints and logistical reasons which impacts on patient knowledgeability and satisfaction, but also on examination and diagnostic quality. Objective: We illuminate medical history interviews from a radiologist’s perspective and discuss its impact on the diagnostic quality. Based on these insights, we develop a digital medical interview assistant (DMIA) for radiology that is intended to collect information helping in improving radiological diagnostics. Methods: Conditions, issues, problems in the radiological examination process are assessed to collect requirements and to specify questions for a digital medical history interview. Results: A DMIA with conversational user interface is developed using the scripting language RiveScript. It is accessible through a social media messenger (Telegram messenger). An initial assessment of usability demonstrates a good usability. Conclusion: To overcome the information gap in radiology, a DMIA can simulate an assessment interview. It is still necessary to remove existing barriers in interaction with the DMIA for example by facilitating data entry options.
Fostering Fatigue-Management in People with Post-Acute COVID-19 Syndrome – Experiences with the “Untire” App
Authors: Ruckser-Scherb Renate , Gassner Judith , Himmelbauer Carina
Published: May 2022

Background: Many patients suffering from post-acute COVID-19 syndrome must deal with fatigue. They need physical and psychological support, strengthening, and adaption of their individual lifestyle. The use of apps can foster fatigue management. Objectives: The aim of this study was to analyse experiences of patients with fatigue caused by post-acute COVID-19 syndrome after using Untire for more than two weeks. Methods: A qualitative research design was chosen to identify user-experience after using the app. Seven semi-structured interviews were conducted and qualitative content analysis according to Mayring was applied. Results: The Untire App was generally perceived as being easy to use. Patients judged the Untire App as supportive in most of the features, especially in energy measurement and relaxation exercises. Conclusion: Thus, though developed for cancer patients, this mobile health (mHealth) application is with some restrictions also suitable for patients with post-acute COVID-19 syndrome.
ELGA Outpatient Clinic Report and ELGA Telehealth Note: Two HL7-CDA®-Based Modular Electronic Documents
Authors: Sabutsch Stefan , Frohner Matthias , Kleinoscheg Gabriel , Klostermann Andrea , Svec Nina , Rainer-Sablatnig Stephan , Tanjga Nikola
Published: May 2022

Background: From 2022, the “Outpatient Clinic Report” and the “Telehealth Note” will complement the existing e-Reports in the Austrian Electronic Health Record system ELGA. Objectives: The specification of two harmonized implementation guides with standardized structure for all types of outpatient clinics in hospitals on the one hand and for telemonitoring treatments on the other hand. Methods: With the participation of expert groups, the contents were harmonized, and a data model was created. Template specifications were modelled in ART-DECOR and approved in the course of an HL7 Austria ballot. Results: Two sets of freely selectable building blocks and machine-readable content were created. Conclusion: The “Outpatient Clinic Report” and the “Telehealth Note” are currently being implemented. The use of these documents will be evaluated as well as if additional machine-readable content is needed.
External Validation of a Machine Learning Based Delirium Prediction Software in Clinical Routine
Authors: Jauk Stefanie , Veeranki Sai Pavan Kumar , Kramer Diether , Högler Stefan , Mühlecker David , Eberhartl Erwin , Schueler Arthur , Chvosta Christian , Strasser Wolfgang , Strasser Reinhold , Leodolter Werner
Published: May 2022

Background: Various machine learning (ML) models have been developed for the prediction of clinical outcomes, but there is missing evidence on their performance in clinical routine and external validation. Objectives: Our aim was to deploy and prospectively evaluate an already developed delirium prediction software in clinical routine of an external hospital. Methods: We compared updated ML models of the software and models re-trained with the external hospital’s data. The best models were deployed in clinical routine for one month, and risk predictions for all admitted patients were compared to the risk ratings of a senior physician. After using the software, clinicians completed a questionnaire assessing technology acceptance. Results: Re-trained models achieved a high discriminative performance (AUROC > 0.92). Compared to clinical risk ratings, the software achieved a sensitivity of 100.0% and a specificity of 90.6%. Usefulness, ease of use and output quality were rated positively by the users. Conclusion: A ML based delirium prediction software achieved a high discriminative performance and high technology acceptance at an external hospital using re-trained ML models.
Towards Adaptability of Just-in-Time Adaptive Interventions
Authors: Gruber Sebastian , Neumayr Bernd , Reich Siegfried , Niebauer Josef , Smeddinck Jan David
Published: May 2022

Just-in-time adaptive interventions (JITAIs) can promote behavior change in patients. It was the aim of our study to make JITAIs adaptable, i.e., to configure JITAIs for different purposes and to personalize them for different participants, whilst enabling central maintenance and integrated data analysis across deployments and individuals. We present a concept for adaptable JITAIs that was created following a design science approach. It builds on multi-level conceptual modeling and knowledge graphs and will be evaluated in user studies.
SAINTENS: Self-Attention and Intersample Attention Transformer for Digital Biomarker Development Using Tabular Healthcare Real World Data
Authors: Gutheil Julian , Donsa Klaus
Published: May 2022

Background: Deep learning currently struggles with tabular data, but it can benefit from multimodal learning. SAINT is a deep learning model for tabular data on which we base our presented developments. Objectives: In this study, we introduce SAINTENS as a new deep learning method, specifically for the in healthcare predominant tabular real world data. Methods: For this purpose, we compare SAINTENS with SAINT and the State of the Art Machine Learning methods for tabular data. We use tabular data from geriatrics to predict four different targets (dysphagia, pressure ulcers, decompensated heart failure and delirium). We determine the relevant feature sets and train the models on these sets. Results: Both SAINTENS and SAINT models are at least on the same performance level as the current State of the Art (Gradient Boosting Decision Trees). Conclusion: In combination with multimodal learning SAINTENS and SAINT may be used on real world data comprising tabular, text and image data, for discovery and development of new digital biomarkers.
Challenges and Facilitators of Using Smartphones in Educational Activities: Medical and Nursing Students’ Perspective
Authors: Sheikhtaheri Abbas , Taheri Moghadam Sharare
Published: May 2022

Background: Todays, smartphone technologies and applications are used in the medical and nursing fields. Medical and nursing students are among the groups in which the use of these tools is observed. Objectives: To investigate their views on the barriers and facilitators of the use of these technologies. Methods: Four hundred people (200 people from each group) were invited randomly. A questionnaire was used to collect data. To collect data, hospitals were referred and the questionnaires were provided to students and after completion, they were collected. Data analysis was performed using SPSS software and descriptive and inferential statistics. Results: The most important barriers from the students’ view included internet problems in the university or hospital, lack of technical support for this technology in the hospital or university, the quality of existing applications, lack of appropriate Apps in the local language, non-introduction of appropriate Apps and not knowing the right Apps. The most important facilitators were the appropriate support services in the university or hospital, placing the appropriate Apps on the department or university website, designing native Apps with the participation of experts, and introducing the appropriate Apps by professors or universities. Conclusion: The use of Apps is increasing among medical and nursing students. In this regard, attention to the existing barriers and their elimination and strengthening the facilitators, and providing the necessary technical and educational infrastructure to facilitate the useful applications should be considered by decision-makers.
Accuracy of a patient-specific instrumentation for coronal plane alignment of an anatomic alignment total knee arthroplasty system: A radiographic study
Authors: Müller Konstantin , Lerch Solveig , Sauer Bernd , Lerch Matthias
Published: May 2022

BACKGROUND: Patient-individualised anatomic alignment in total knee arthroplasty (TKA) requires exact positioning of the tibial and femoral components. Patient-specific instrumentation (PSI) may be advantageous for implantation. However, the role of PSI in the instrumentation of such knee designs has not been investigated. OBJECTIVE: The aim of this study was to investigate the accuracy of a PSI system designed for patient-individualised anatomic alignment. METHODS: Fifty-four patients from a single centre were consecutively enrolled in this study. Patient-specific femoral and tibial cutting guides were manufactured using 3D models from computed tomography (CT) scans. All patients received an anatomic TKA implant design through an extension gap first technique. Postoperative radiography was taken, and implant component alignment and leg alignment were compared to the preoperative planning. RESULTS: Thirty-four patients were evaluable. Mean differences between planned angles values obtained from CT scans and the measured radiographic values were small and not significantly different from zero. CONCLUSIONS: Implantation of an anatomic knee design that allows individual component alignment using PSI is feasible. The percentage of component misalignment in the coronal plane was remarkably low. Whether this leads to clinical benefits requires further verification.
Can tibia-first total knee arthroplasty using computer-assisted system improve anterior and posterior knee stability?
Authors: Takahashi Tsuneari , Sugimoto Kazutaka , Ae Ryusuke , Saito Tomohiro , Kimura Yuya , Kubo Tatsuya , Handa Mikiko , Takeshita Katsushi
Published: May 2022

BACKGROUND: Total knee arthroplasty (TKA) is a widely performed procedure to alleviate pain and restore function of patients with end-stage knee osteoarthritis. OBJECTIVE: The study aim was to determine if tibia-first (TF) total knee arthroplasty (TKA) using a novel computer-assisted surgery (CAS) system can yield better anterior and posterior (AP) knee stability. METHODS: Patients with knee osteoarthritis with obvious varus knee who met the indication for and underwent TKA from May 2019 to November 2020 were included. Forty-one measured resection (MR)-TKAs and 32 TF-TKAs were compared. The varus-valgus ligament balance and joint tension at a joint center-gap setting equal to the tibial-baseplate thickness were measured, and appropriate polyethylene inserts with 0∘, 30∘, 45∘, 60∘, 90∘, and 120∘ of knee flexion were placed. A Kneelax 3 arthrometer was used to measure knee AP laxity in the postoperative anesthetized patients with 30∘ and 90∘ of knee flexion. RESULTS: The horizontal gap balance was significantly closer in the TF-TKA group than the MR-TKA group for 0∘, 30∘, 45∘, and 60∘ of knee flexion. In contrast, no significant differences were observed for 90∘ and 120∘ of knee flexion. No significant differences in joint-gap tensions among all knee-flexion angles were observed. Translation was significantly smaller in the TF-TKA group than the MR-TKA group for AP laxity with 30∘ of knee flexion (8.8 ± 2.9 mm vs. 10.7 ± 3.1 mm, P= 0.0079). In contrast, no significant AP laxity was observed with 90∘ of knee flexion (7.2 ± 2.8 mm vs. 7.2 ± 3.5 mm). CONCLUSION: TF-TKA using a novel CAS system provided better AP knee stability with close to horizontal gap balances.
Assessment of arteriosclerosis based on multiscale cross approximate entropy of human finger pulse wave
Authors: Ta Na , Wei Hai-Cheng , Li Miao-Miao
Published: May 2022

BACKGROUND: Arteriosclerosis is one of the diseases that endanger human health. There is a large amount of information in pulse wave signals to reflect the degree of arteriosclerosis. OBJECTIVE: The degree of arteriosclerosis is assessed by analyzing pulse wave signal and calculating multi-scale entropy values. METHODS: A method based on the multiscale cross-approximate entropy of the pulse wave of the human finger is proposed to assess the degree of arteriosclerosis. A total of 86 subjects were divided into three groups. The data of 1000 pulse cycles were selected in the experiment, and the multiscale cross-approximate entropy was calculated for the climb time and pulse wave peak interval. Independent sample t-test analysis gives the small-scale cross-approximate entropy of the two time series of climb time and pulse wave peak interval as p< 0.001 in Groups 1 and 2. The large-scale cross-approximate entropy of the two time series of climb time and pulse wave peak interval is p< 0.017 in Groups 2 and 3. RESULTS: Using the proposed algorithm, the results showed that the small-scale cross-approximate entropy of climb time and pulse wave peak interval could reflect the degree of arteriosclerosis in the human body from the perspective of autonomic nerve function. The large-scale cross-approximate entropy of climb time and pulse wave peak interval confirmed the effect of diabetes on the degree of arteriosclerosis. CONCLUSIONS: The results demonstrate the multiscale cross-approximate entropy is a comprehensive index to evaluate the degree of human arteriosclerosis.
Osseo-densification versus conventional surgical technique in low density jaw bone: A split mouth in vivo study
Authors: Al Ahmari Nasser M.
Published: May 2022

BACKGROUND: The success of dental implants depend on implant design, surgical technique, bone density, implant morphology and postoperative care. Initial stability is utmost importance and is of concern in low density bone. The osseo-densification strategy enhance primary stability by raising density of the osteotomy site walls by non-subtractive drilling, unlike conventional technique. OBJECTIVE: The aim of this in vivo study was to assess and compare the osseo-densification implant drilling technique with conventional implant drilling in terms of primary implant stability along with other factors, plaque index, bleeding on probe, pocket depth and radiographic assessment of bone density, marginal bone loss using CBCT. METHOD: A total of 20 patients aged between 40 and 59 years were included in this research. A split-mouth configuration of 40 implants was used. In the osseo-densification group, specialized (Densah) bur kit was used to insert 20 implants on one side. In the conventional group, standard bur kit was used to insert 20 implants on the opposite side of the jaw. For each patient, clinical and radiographic assessment was performed at regular intervals at the beginning (immediately after surgery), seven months, and a year following surgery. RESULTS: With the exception of bone density, which was statistically significant in favour of the osseo-densification group immediately after surgery, primary and secondary stability, plaque index, bleeding on probe, pocket depth and even marginal bone loss were not significantly different between the two groups in this investigation. CONCLUSION: Osseo-densification technique provided a better primary stability in the low density bone cases thus, can be consider as a trustworthy treatment for speeding up the healing process while also maintaining marginal bone integrity following loading. Use of specialized bur while drilling procedure improves the density around the implants.
Community health workers’ non-technical skills for delivering primary healthcare in low-income areas
Authors: Bellas Hugo Cesar , Bulhões Bárbara , Arcuri Rodrigo , Vidal Mario Cesar Rodríguez , de Carvalho Paulo Victor Rodrigues , Jatobá Alessandro
Published: May 2022

BACKGROUND: To overcome the poor conditions of low-income areas in developing countries like Brazil, Community Health Workers (CHWs) are required to exceed the regular set of formal skills they are used to employ. OBJECTIVE: In this study, we aim at identifying the non-technical skills CHWs must develop to cope with the extraordinary situations that occur in vulnerable communities. METHODS: 41 CHWs based in two primary healthcare clinics in Brazil underwent two rounds of in-depth interviews. The analysis was carried out using the Analytical Hierarchy Process, resulting in the prioritization of social skills according to their calculated importance to house calls. RESULTS: Among the ten higher-scored skills, we find communication and advocacy skills being of high importance. Civility was found to be the most important attribute, confirming that community action relies strongly on the relationship between health professionals and the community. CONCLUSION: The results of our study contribute primarily to the improvement of community-based primary care programs as it helps to identify major skills required for community action.
Physical design of photon-counting mode γ-ray large object radiation imaging system
Authors: Dong Tao , Zhang Huaxia , Wu Zhifang
Published: May 2022

BACKGROUND:

The detectors of existing large object radiation imaging systems generally work under current-integration mode and cannot distinguish effective signals of unreacted photons from interfering signals of electronic noise and scattered photons, therefore, resulting in image quality deterioration.

OBJECTIVE:

This study aims to design a new photon-counting mode γ-ray large object radiation imaging system. Therefore, interfering signals with lower energy than effective signals can be eliminated by energy analysis. In addition, the system enables to work properly even under 30∼300Ci Co-60 intensity.

METHODS:

Based on the physical analysis of the system, the design requirements are listed. Following the requirements, the best-performing photon-counting detector based on LYSO and SiPM is used in the system. ZP-SK and (ZP)2-SK filter circuits are designed for Co-60 radiation imaging system with the highest intensity of 100Ci and 300Ci, respectively. Then, a voltage comparator and an FPGA are followed to realize the function of energy analysis and photon counting.

RESULTS:

The proposed technical solution can improve the Steel Penetration (SP) by at least 60∼70 mmFe compared with the existing current-integration system, which is equivalent to the improvement obtained by increasing the intensity of the radioactive source more than 13 to 20 times.

CONCLUSIONS:

This study demonstrates the advantages of applying the new photon-counting mode γ-ray large object radiation imaging system to improve the radiation image quality and the penetration ability, which will have enormous potential for future applications.
Pluralität der Naturverhältnisse
Authors: Graf Jakob
Published: May 2022

Die ökologische Krise macht deutlich, dass die Verhältnisse zwischen Mensch und Natur wieder zu einem zentralen Gegenstand kritischer Sozialwissenschaft und die Pluralität der gesellschaftlichen Naturverhältnisse in den Blick genommen werden müssen. Der Beitrag versteht den Kapitalismus im Anschluss an Louis Althusser als »komplex strukturiertes Ganzes«, das auf der Gleichzeitigkeit verschiedener Produktionsweisen beruht. Dies beleuchtet verschiedene und teilweise konfligierende gesellschaftliche Naturverhältnisse innerhalb kapitalistisch dominierter Gesellschaften, welche nicht nur unterschiedliche Betroffenheiten von Umweltzerstörungen und Klimawandel erzeugen, sondern auch spezifische Konfliktdynamiken und emanzipatorische Potenziale in der ökologischen Krise.
Emanzipatorische Perspektiven im »Anthropozän«
Authors: Wissen Markus , Brand Ulrich
Published: May 2022

Das wirkmächtige Anthropozän-Narrativ begreift die ökologische Krise als eine von Menschen gemachte. Dabei vernachlässigt es jedoch die herrschaftsförmige gesellschaftliche Vermittlung des menschlichen Einwirkens auf Natur. Das Anthropozän-Narrativ kann daher die Bearbeitung der ökologischen Krise nur als technologisch modernisierte Naturbeherrschung denken. Diese aber droht die ökologische Krise zu verschärfen und soziale Spaltungen zu vertiefen. Jüngere ökosozialistische Entwürfe warten mit alternativen Krisendiagnosen und -strategien auf. Sie bedürfen allerdings einer staats- und hegemonietheoretischen Fundierung und Einsichten aus der kritischen Theorie gesellschaftlicher Naturverhältnisse.
Geschlecht und das komplex gegliederte Ganze
Authors: Dück Julia
Published: May 2022

Der vorliegende Beitrag fokussiert den Zusammenhang von Geschlecht und Kapitalismus im Anschluss an Alex Demirovic. Er argumentiert, dass es zur Ausbildung spezifischer Praktiken in den Geschlechterverhältnissen kommt, diese zugleich aber Bestandteil eines gesamtgesellschaftlichen (Re-)Produktionszusammenhangs sind. In diesem Sinne verfolgt Demirovic den Anspruch, eine Gesamttheorie des Zusammenhangs verschiedener Herrschaftsverhältnisse im Kapitalismus zu entwickeln.
Radiological Improvements in Symmetry of the Lateral Atlantodental Interval and in C1 Tilt After the Application of the Atlasprofilax Method. A Case Series.
Authors: Manent Lluis , León Higuera José Gabriel , Lewis Kathleen , Angulo Orlando , Zableh Solano María Emma
Published: May 2022

We present the case of 4 subjects exhibiting asymmetry of the lateral atlantodental interval (within the accepted standard ranges of normal asymmetry) on open mouth x-ray examination. The asymmetry was clearly ameliorated after the Atlasprofilax procedure. Improvements in atlas tilt and axis spinous process deviation also were demonstrated. We discuss the preliminary validity of the Atlasprofilax non-invasive approach for treating such conditions and whether the debate on commonly accepted asymmetry in the lateral atlantodental interval should remain open and be further investigated. We further ask if such a lateral atlantodental interval asymmetry could probably be a pre-manifestation or subclinical pathomechanic condition that could underly some clinical conditions. Asymmetry in lateral atlantodental interval or odontoid-lateral mass interspaces through x-ray examination often has been found in healthy and unhealthy subjects and is associated with atlantoaxial rotatory subluxation. Its clinical relevance remains a controversial subject. Some authors affirm that this asymmetry is a normal variant. Other authors point out that such asymmetry could be considered a manifestation of pathological rotatory conditions of atlas and axis consistent with atlantoaxial rotatory subluxation and possibly lead to musculoskeletal disorders and related chronic pain ailments. X-rays provide information only on bony structures and do not visualize soft tissue structures such as suboccipital muscles and fascia. Therefore, open mouth x-rays alone may not be sufficient to determine a radiological pathological condition specially one that is not yet presenting clinical symptoms because soft tissue alterations in this region are not visualized on x-ray. Several x-ray protocols and studies have been performed on this craniocervical segment with different results and interpretations. In this case series, we examine changes in the asymmetry of the lateral atlantodental interval, atlas vertebra tilt and axis spinous process deviation before and after application of the Atlasprofilax method in four patients. This method focuses on mechanotransduction through vibropressure on soft structures of the craniocervical joint, targeting deep cervical fascia, suboccipital muscles and cartilage. The aim is to restore normal structural and metabolic patterns in the extracellular matrix. This also would imply changes in chondrocytes, telocytes, and fibroblasts through a piezoresistive effect. This effect could lead to amelioration of connective tissue alterations in the craniocervical junction involving collagen synthesis, hyaluronic acid and abnormal patterns in fibroblasts and in the microvacuolar fascia. These changes ultimately could result in an improvement in the lateral atlantodental interval and craniocervical joint position.
ON THE ORIGIN OF LUNG CANCER DEVELOPMENT
Authors: Bolgova L.S. , Tuganova T.N. , Alekseenko O.I. , Ponomarenko A.A.
Published: May 2022

In the review on the issues of histogenesis of lung cancer (LC), the significant results of experimental, pathological, immunohistochemical and molecular-biological studies are presented. However, until now, no data has been obtained that would allow scientists to come to an unambiguous decision about the origin and development of this disease. The question remains not yet fully understood, since researchers discuss the origin of LC development in a hypothetical form. This situation poses the task of further in-depth scientific research, which would make it possible to clarify the unambiguous origin of LC development, and, therefore, would allow solving the problem of its early diagnosis and create grounds for screening programs, which is of high scientific and clinical significance.
RAPID LOW-COST DETECTION OF TYPE 2CALR MUTATION BY ALLELE-SPECIFIC RT-PCR FOR DIAGNOSIS OF MYELOPROLIFERATIVE NEOPLASMS
Authors: Dybkov M.V. , Zavelevich M.P. , Gluzman D.F. , Telegeev G.D.
Published: May 2022

Background: Approximately 15% to 24% of essential thrombocythemia (ET) and 25–35% of primary myelofibrosis cases carry a mutation in the calreticulin (CALR) gene. Sanger sequencing, qPCR, high resolution melt or targeted next generation sequencing usually used to detect these mutations are expensive and require costly equipment. Nevertheless, type 1 CALR mutations are detectable by using polymerase chain reaction (PCR) and agarose gel electrophoresis. Aim: To offer the use of the allele-specific reverse transcription (RT) PCR for rapid low-cost detection of the type 2 mutation in the CALR gene. Materials and Methods: Allele-specific primers designed for detecting type 2 mutation (5-bp insertion; c.1154_1155 ins TTGTC) of the CALR gene were used for allele-specific RT-PCR analysis of cDNA of the patient with JAK2-, MPL-negative ET, whose mutation in CALR gene has been identified by Sanger sequencing. RT-PCR samples were analyzed by agarose gel electrophoresis. Results: The type 2 mutation (K385fs*47 ins5) in CALR gene was detected by Sanger sequencing in JAK2- and MPL-negative ET patient. The cDNA obtained was then re-analyzed by using allele-specific RT-PCR with newly designed primers. Normal and type 2 mutation alleles of the CALR gene were detected by gel electrophoresis. The results of allele-specific RT-PCR were consistent with the data of Sanger sequencing. Conclusion: Allele-specific RT-PCR analysis may be used for the fast low-cost detection of the major type 2 mutation (ins 5) of the CALR gene in patients with MPNs.