scholarly journals Musculoskeletal Simulation for Assessment of Effect of Movement-Based Structure-Modifying Treatment Strategies

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Tien Tuan Dao
Keyword(s):  
Vastus Lateralis ◽  
Treatment Strategies ◽  
Nonnegative Matrix ◽  
Joint Kinematics ◽  
Muscle Synergy ◽  
Patient Specific ◽  
Muscle Forces ◽  
Joint Function ◽  
Flexion Extension ◽  
The Impact

The better understanding of the complex mechanism between neural motor control and its resulting joint kinematics and muscle forces allows a better elucidation of the mechanisms behind body growth, aging progression, and disease development. This study aimed at investigating the impact of movement-based structure-modifying treatment strategies on joint kinematics, muscle forces, and muscle synergies of the gait with instrumented implant. A patient-specific musculoskeletal model was used to quantitatively assess the deviations of joint and muscle behaviors between the normal gait and 4 gait modifications (bouncy, medial thrust, midcrouch, and mtp (i.e., gait with forefoot strike)). Moreover, muscle synergy analysis was performed using EMG-based nonnegative matrix factorization. Large variation of 19 degrees and 190 N was found for knee flexion/extension and lower limb muscle forces, respectively. EMG-based muscle synergy analysis revealed that the activation levels of the vastus lateralis and tibialis anterior are dominant for the midcrouch gait. In addition, an important contribution of semimembranosus to the medial thrust and midcrouch gaits was also observed. In fact, such useful information could allow a better understanding of the joint function and muscle synergy strategies leading to deeper knowledge of joint and muscle mechanisms related to neural voluntary motor commands.

scholarly journals Motor Function Assessment of Upper Limb in Stroke Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Bingyu Pan ◽  
Zhen Huang ◽  
Tingting Jin ◽  
Jiankang Wu ◽  
Zhiqiang Zhang ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Evaluation Method ◽  
Inertial Sensor ◽  
Treatment Strategies ◽  
Nonnegative Matrix ◽  
Sensor Data ◽  
Muscle Synergy ◽  
Control Group ◽  
Stroke Patients

Background. Quantitative assessment of motor function is extremely important for poststroke patients as it can be used to develop personalized treatment strategies. This study aimed to propose an evaluation method for upper limb motor function in stroke patients. Methods. Thirty-four stroke survivors and twenty-five age-matched healthy volunteers as the control group were recruited for this study. Inertial sensor data and surface electromyography (sEMG) signals were collected from the upper limb during voluntary upward reaching. Five features included max shoulder joint angle, peak and average speeds, torso balance calculated from inertial sensor data, and muscle synergy similarity extracted from sEMG data by the nonnegative matrix factorization algorithm. Meanwhile, the Fugl–Meyer score of each patient was graded by professional rehabilitation therapist. Results. Statistically significant differences were observed among severe, mild-to-moderate, and control group of five features ( p   ≤  0.001). The features varied as the level of upper limb motor function changes since these features significantly correlated with the Fugl–Meyer assessment scale ( p   ≤  0.001). Moreover, the Bland–Altman method was conducted and showed high consistency between the evaluation method of five features and Fugl–Meyer scale. Therefore, the five features proposed in this paper can quantitatively evaluate the motor function of stroke patients which is very useful in the rehabilitation process.

Uncovering the Diversification of Tissue Engineering on the Emergent Areas of Stem Cells, Nanotechnology and Biomaterials

2020 ◽  
Vol 15 (3) ◽  
pp. 187-201 ◽  
Author(s):  
Sunil K. Dubey ◽  
Amit Alexander ◽  
Munnangi Sivaram ◽  
Mukta Agrawal ◽  
Gautam Singhvi ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Stem Cells ◽  
Immune System ◽  
Clinical Application ◽  
Cell Types ◽  
Patient Specific ◽  
Potential Strategy ◽  
Induced Pluripotent ◽  
Treat All ◽  
The Impact

Damaged or disabled tissue is life-threatening due to the lack of proper treatment. Many conventional transplantation methods like autograft, iso-graft and allograft are in existence for ages, but they are not sufficient to treat all types of tissue or organ damages. Stem cells, with their unique capabilities like self-renewal and differentiate into various cell types, can be a potential strategy for tissue regeneration. However, the challenges like reproducibility, uncontrolled propagation and differentiation, isolation of specific kinds of cell and tumorigenic nature made these stem cells away from clinical application. Today, various types of stem cells like embryonic, fetal or gestational tissue, mesenchymal and induced-pluripotent stem cells are under investigation for their clinical application. Tissue engineering helps in configuring the stem cells to develop into a desired viable tissue, to use them clinically as a substitute for the conventional method. The use of stem cell-derived Extracellular Vesicles (EVs) is being studied to replace the stem cells, which decreases the immunological complications associated with the direct administration of stem cells. Tissue engineering also investigates various biomaterials to use clinically, either to replace the bones or as a scaffold to support the growth of stemcells/ tissue. Depending upon the need, there are various biomaterials like bio-ceramics, natural and synthetic biodegradable polymers to support replacement or regeneration of tissue. Like the other fields of science, tissue engineering is also incorporating the nanotechnology to develop nano-scaffolds to provide and support the growth of stem cells with an environment mimicking the Extracellular matrix (ECM) of the desired tissue. Tissue engineering is also used in the modulation of the immune system by using patient-specific Mesenchymal Stem Cells (MSCs) and by modifying the physical features of scaffolds that may provoke the immune system. This review describes the use of various stem cells, biomaterials and the impact of nanotechnology in regenerative medicine.

The Impact of Translational Research in Breast Cancer Care: Can we Improve the Therapeutic Scenario?

2018 ◽  
Vol 18 (6) ◽  
pp. 832-836
Author(s):  
Giuseppe Buono ◽  
Francesco Schettini ◽  
Francesco Perri ◽  
Grazia Arpino ◽  
Roberto Bianco ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Translational Research ◽  
Cell Biology ◽  
Cancer Biology ◽  
Hormone Receptors ◽  
Treatment Strategies ◽  
Growth Factor Receptor ◽  
Molecular Heterogeneity ◽  
Therapeutic Implications ◽  
The Impact

Traditionally, breast cancer (BC) is divided into different subtypes defined by immunohistochemistry (IHC) according to the expression of hormone receptors and overexpression/amplification of human epidermal growth factor receptor 2 (HER2), with crucial therapeutic implications. In the last few years, the definition of different BC molecular subgroups within the IHC-defined subtypes and the identification of the important role that molecular heterogeneity can play in tumor progression and treatment resistance have inspired the search for personalized therapeutic approaches. In this scenario, translational research represents a key strategy to apply knowledge from cancer biology to the clinical setting, through the study of all the tumors “omics”, including genomics, transcriptomics, proteomics, epigenomics, and metabolomics. Importantly, the introduction of new high-throughput technologies, such as next generation sequencing (NGS) for the study of cancer genome and transcriptome, greatly amplifies the potential and the applications of translational research in the oncology field. Moreover, the introduction of new experimental approaches, such as liquid biopsy, as well as new-concept clinical trials, such as biomarker-driven adaptive studies, may represent a turning point for BC translational research. </P><P> It is likely that translational research will have in the near future a significant impact on BC care, especially by giving us the possibility to dissect the complexity of tumor cell biology and develop new personalized treatment strategies.

The effect of surgery in tenosynovial giant cell tumours as measured by patient-reported outcomes on quality of life and joint function

2019 ◽  
Vol 101-B (3) ◽  
pp. 272-280 ◽  
Author(s):  
F. G. M. Verspoor ◽  
M. J. L. Mastboom ◽  
G. Hannink ◽  
W. T. A. van der Graaf ◽  
M. A. J. van de Sande ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Giant Cell ◽  
Diffuse Type ◽  
Joint Function ◽  
Population Means ◽  
Sf 36 ◽  
Patient Reported ◽  
The Impact

Aims The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. Patients and Methods This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. Results A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years’ follow-up. Conclusion Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients’ daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272–280.

Knee Muscle Force Estimating Model Using Machine Learning Approach

2020 ◽  
Author(s):  
Anurag Sohane ◽  
Ravinder Agarwal
Keyword(s):  
Machine Learning ◽  
Random Forest ◽  
Muscle Force ◽  
Vastus Lateralis ◽  
Input Parameter ◽  
Research Work ◽  
Cost Effective ◽  
Coefficient Of Determination ◽  
Muscle Forces ◽  
Knee Muscle

Abstract Various simulation type tools and conventional algorithms are being used to determine knee muscle forces of human during dynamic movement. These all may be good for clinical uses, but have some drawbacks, such as higher computational times, muscle redundancy and less cost-effective solution. Recently, there has been an interest to develop supervised learning-based prediction model for the computationally demanding process. The present research work is used to develop a cost-effective and efficient machine learning (ML) based models to predict knee muscle force for clinical interventions for the given input parameter like height, mass and angle. A dataset of 500 human musculoskeletal, have been trained and tested using four different ML models to predict knee muscle force. This dataset has obtained from anybody modeling software using AnyPyTools, where human musculoskeletal has been utilized to perform squatting movement during inverse dynamic analysis. The result based on the datasets predicts that the random forest ML model outperforms than the other selected models: neural network, generalized linear model, decision tree in terms of mean square error (MSE), coefficient of determination (R2), and Correlation (r). The MSE of predicted vs actual muscle forces obtained from the random forest model for Biceps Femoris, Rectus Femoris, Vastus Medialis, Vastus Lateralis are 19.92, 9.06, 5.97, 5.46, Correlation are 0.94, 0.92, 0.92, 0.94 and R2 are 0.88, 0.84, 0.84 and 0.89 for the test dataset, respectively.

scholarly journals Boosting Immunity against Multiple Myeloma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1221
Author(s):  
Raquel Lopes ◽  
Bruna Velosa Ferreira ◽  
Joana Caetano ◽  
Filipa Barahona ◽  
Emilie Arnault Carneiro ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Residual Disease ◽  
Proteasome Inhibitors ◽  
Treatment Strategies ◽  
Complete Response ◽  
Drug Conjugates ◽  
Incurable Disease ◽  
Car T ◽  
Patient’S Outcome ◽  
The Impact

Despite the improvement of patient’s outcome obtained by the current use of immunomodulatory drugs, proteasome inhibitors or anti-CD38 monoclonal antibodies, multiple myeloma (MM) remains an incurable disease. More recently, the testing in clinical trials of novel drugs such as anti-BCMA CAR-T cells, antibody–drug conjugates or bispecific antibodies broadened the possibility of improving patients’ survival. However, thus far, these treatment strategies have not been able to steadily eliminate all malignant cells, and the aim has been to induce a long-term complete response with minimal residual disease (MRD)-negative status. In this sense, approaches that target not only myeloma cells but also the surrounding microenvironment are promising strategies to achieve a sustained MRD negativity with prolonged survival. This review provides an overview of current and future strategies used for immunomodulation of MM focusing on the impact on bone marrow (BM) immunome.

scholarly journals The Effects of External Loads and Muscle Forces on the Knee Joint Ligaments during Walking: A Musculoskeletal Model Study

2021 ◽  
Vol 11 (5) ◽  
pp. 2356
Author(s):  
Carlo Albino Frigo ◽  
Lucia Donno
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
Musculoskeletal Model ◽  
Optimization Approach ◽  
Muscle Forces ◽  
Collateral Ligaments ◽  
Flexion Extension ◽  
Lateral Collateral Ligaments ◽  
Gastrocnemius Muscles ◽  
External Loads

A musculoskeletal model was developed to analyze the tensions of the knee joint ligaments during walking and to understand how they change with changes in the muscle forces. The model included the femur, tibia, patella and all components of cruciate and collateral ligaments, quadriceps, hamstrings and gastrocnemius muscles. Inputs to the model were the muscle forces, estimated by a static optimization approach, the external loads (ground reaction forces and moments) and the knee flexion/extension movement corresponding to natural walking. The remaining rotational and translational movements were obtained as a result of the dynamic equilibrium of forces. The validation of the model was done by comparing our results with literature data. Several simulations were carried out by sequentially removing the forces of the different muscle groups. Deactivation of the quadriceps produced a decrease of tension in the anterior cruciate ligament (ACL) and an increase in the posterior cruciate ligament (PCL). By removing the hamstrings, the tension of ACL increased at the late swing phase, while the PCL force dropped to zero. Specific effects were observed also at the medial and lateral collateral ligaments. The removal of gastrocnemius muscles produced an increase of tension only on PCL and lateral collateral ligaments. These results demonstrate how musculoskeletal models can contribute to knowledge about complex biomechanical systems as the knee joint.

scholarly journals European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fausto Biancari ◽  
Giovanni Mariscalco ◽  
Hakeem Yusuff ◽  
Geoffrey Tsang ◽  
Suvitesh Luthra ◽  
...  
Keyword(s):  
Adverse Events ◽  
Aortic Dissection ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Type A ◽  
Salvage Procedure ◽  
Type A Aortic Dissection ◽  
Mortality And Morbidity ◽  
Link Type ◽  
The Impact

Abstract Background Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.

scholarly journals Understanding the Impact of Different Landscape-Level Fuel Management Strategies on Wildfire Hazard in Central Portugal

Forests ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 522
Author(s):  
Akli Benali ◽  
Ana C. L. Sá ◽  
João Pinho ◽  
Paulo M. Fernandes ◽  
José M. C. Pereira
Keyword(s):  
Management Strategies ◽  
Treatment Strategies ◽  
Fire Season ◽  
Burned Area ◽  
Treatment Area ◽  
Fuel Treatment ◽  
The North ◽  
Wildfire Hazard ◽  
Central Portugal ◽  
The Impact

The extreme 2017 fire season in Portugal led to widespread recognition of the need for a paradigm shift in forest and wildfire management. We focused our study on Alvares, a parish in central Portugal located in a fire-prone area, which had 60% of its area burned in 2017. We evaluated how different fuel treatment strategies may reduce wildfire hazard in Alvares through (i) a fuel break network with different extents corresponding to different levels of priority and (ii) random fuel treatments resulting from a potential increase in stand-level management intensity. To assess this, we developed a stochastic wildfire simulation system (FUNC-SIM) that integrates uncertainties in fuel distribution over the landscape. If the landscape remains unchanged, Alvares will have large burn probabilities in the north, northeast and center-east areas of the parish that are very often associated with high fireline intensities. The different fuel treatment scenarios decreased burned area between 12.1–31.2%, resulting from 1–4.6% increases in the annual treatment area and reduced the likelihood of wildfires larger than 5000 ha by 10–40%. On average, simulated burned area decreased 0.22% per each ha treated, and cost-effectiveness decreased with increasing area treated. Overall, both fuel treatment strategies effectively reduced wildfire hazard and should be part of a larger, holistic and integrated plan to reduce the vulnerability of the Alvares parish to wildfires.

scholarly journals Impact of a patient-specific national programme aimed at increasing the use of emollient moisturisers to reduce the risk of skin tears: a longitudinal cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039579
Author(s):  
Anna K Moffat ◽  
Kerrie P Westaway ◽  
Jemisha Apajee ◽  
Oliver Frank ◽  
Russell Shute ◽  
...  
Keyword(s):  
Interrupted Time Series ◽  
Self Report ◽  
Additional Patient ◽  
Patient Specific ◽  
Department Of Veterans Affairs ◽  
National Programme ◽  
Sustained Effect ◽  
Skin Tears ◽  
Comparison Groups ◽  
The Impact

ObjectivesTo evaluate the impact of a patient-specific national programme targeting older Australians and health professionals that aimed to increase use of emollient moisturisers to reduce to the risk of skin tears.DesignA prospective cohort intervention.ParticipantsThe intervention targeted 52 778 Australian Government’s Department of Veterans’ Affairs patients aged over 64 years who had risk factors for wound development, and their general practitioners (GPs) (n=14 178).Outcome measuresAn interrupted time series model compared the rate of dispensing of emollients in the targeted cohort before and up to 23 months after the intervention. Commitment questions were included in self-report forms.ResultsIn the first month after the intervention, the rate of claims increased 6.3-fold (95% CI: 5.2 to 7.6, p<0.001) to 10 emollient dispensings per 1000 patients in the first month after the intervention. Overall, the intervention resulted in 10 905 additional patient-months of treatment. The increased rate of dispensing among patients who committed to talking to their GP about using an emollient was six times higher (rate ratio: 6.2, 95% CI: 4.4 to 8.7) than comparison groups.ConclusionsThe intervention had a sustained effect over 23 months. Veterans who responded positively to commitment questions had higher uptake of emollients than those who did not.

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