Background
The objective was to evaluate a supposed clinical interdependency of myofascial trigger points and migraine in children. Such interdependency would support an interaction of spinal and ...trigeminal afferences in the trigemino‐cervical complex as a contributing factor in migraine.
Methods
Children ≤18 years with the confirmed diagnosis of migraine were prospectively investigated. Comprehensive data on medical history, clinical neurological and psychological status were gathered. Trigger points in the trapezius muscle were identified by palpation and the threshold of pressure pain at these points was measured. Manual pressure was applied to the trigger points, and the occurrence and duration of induced headache were recorded. At a second consultation (4 weeks after the first), manual pressure with the detected pressure threshold was applied to non‐trigger points within the same trapezius muscle (control). Headache and related parameters were again recorded and compared to the results of the first consultation.
Results
A total of 13 girls and 13 boys with migraine and a median age of 14.5 (Range 6.3–17.8) years took part in the study. Manual pressure to trigger points in the trapezius muscle led to lasting headache after termination of the manual pressure in 13 patients while no patient experienced headache when manual pressure was applied to non‐trigger points at the control visit (p < 0.001). Headache was induced significantly more often in children ≥12 years and those with internalizing behavioural disorder.
Conclusion
We found an association between trapezius muscle myofascial trigger points and migraine, which might underline the concept of the trigemino‐cervical complex, especially in adolescents.
Significance
In children with migraine headache can often be induced by pressure to myofascial trigger points, but not by pressure to non‐trigger points in the trapezius muscle. This supports the hypothesis of a trigemino‐cervical‐complex in the pathophysiology of migraine, which might have implications for innovative therapies in children with migraine.
Background
The use of digital therapeutic solutions for rehabilitation of conditions such as osteoarthritis provides scalable access to rehabilitation. Few validated technological solutions exist to ...ensure supervision of users while they exercise at home. Motion Coach (Kaia Health GmbH) provides audiovisual feedback on exercise execution in real time on conventional smartphones.
Objective
We hypothesized that the interrater agreement between physiotherapists and Motion Coach would be noninferior to physiotherapists’ interrater agreement for exercise evaluations in a cohort with osteoarthritis.
Methods
Patients diagnosed with osteoarthritis of the knee or hip were recruited at a university hospital to perform a set of 6 exercises. Agreement between Motion Coach and 2 physiotherapists’ corrections for segments of the exercises were compared using Cohen κ and percent agreement.
Results
Participants (n=24) were enrolled and evaluated. There were no significant differences between interrater agreements (Motion Coach app vs physiotherapists: percent agreement 0.828; physiotherapist 1 vs physiotherapist 2: percent agreement 0.833; P<.001). Age (70 years or under, older than 70 years), gender (male, female), or BMI (30 kg/m2 or under, greater than 30 kg/m2) subgroup analysis revealed no detectable difference in interrater agreement. There was no detectable difference in levels of interrater agreement between Motion Coach vs physiotherapists and between physiotherapists in any of the 6 exercises.
Conclusions
The results demonstrated that Motion Coach is noninferior to physiotherapist evaluations. Interrater agreement did not differ between 2 physiotherapists or between physiotherapists and the Motion Coach app. This finding was valid for all investigated exercises and subgroups. These results confirm the ability of Motion Coach to detect user form during exercise and provide valid feedback to users with musculoskeletal disorders.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Shoulder pain is common in manual wheelchair (MWC) users. Overuse is thought to be a major cause, but little is known about exposure to activities of daily living (ADLs). The study goal was to ...develop a method to estimate three conditions in the field: (1) non-propulsion activity, (2) MWC propulsion, and (3) static time using an inertial measurement unit (IMU).
Upper arm IMU data were collected as ten MWC users performed lab-based MWC-related ADLs. A neural network model was developed to classify data as non-propulsion activity, propulsion, or static, and validated for the lab-based data collection by video comparison. Six of the participants’ free-living IMU data were collected and the lab-based model was applied to estimate daily non-propulsion activity, propulsion, and static time.
The neural network model yielded lab-based validity measures ≥0.87 for differentiating non-propulsion activity, propulsion, and static time. A quasi-validation of one participant’s field-based data yielded validity measures ≥0.66 for identifying propulsion. Participants’ estimated mean daily non-propulsion activity, propulsion, and static time ranged from 158 to 409, 13 to 25, and 367 to 609 min, respectively. The preliminary results suggest the model may be able to accurately identify MWC users’ field-based activities. The inclusion of field-based IMU data in the model could further improve field-based classification.
Background:
Serial analysis of circulating tumor DNA (ctDNA) levels is a promising tool for both relapse prediction in the curative setting, as well as predicting clinical benefit from systemic ...treatment in metastasic colorectal cancer (mCRC). Most data in this context are derived from treatment naive patients.
Objective:
To predict progressive disease (PD) as early as possible through monitoring of changes in ctDNA levels during systemic treatment in pretreated patients with mCRC.
Design:
A prospective, single-center, observational study.
Methods:
Patients treated beyond first-line were prospectively included between February 2020 and September 2021. Blood for ctDNA detection was taken before every treatment cycle from start of treatment until first restaging by CT-scan. ctDNA was detected by mutation- (mut-ctDNA) and methylation-specific ddPCR. Receiver Operating Characteristic (ROC)-analysis was used to describe sensitivity and specificity for prediction of PD at restaging for all time points.
Results:
A total of 42 patients were included who all carried a mutation in tumor tissue. Detection rate of mut-ctDNA was 88.1% and 74.4% for meth-ctDNA. Absolute ctDNA levels before treatment were prognostic in terms of overall survival. Levels of ctDNA were significantly higher in patients with PD at restaging. Median time from start of treatment to restaging was 93 days (95% CI 88.8–96). After a median of 19 days of treatment (95% CI 16.1–20.2), a decline of either mutation- or methylation-specific ctDNA levels of ⩽58% predicted PD at restaging with a sensitivity/specificity of 92.9/85.7% and 85.7/100%, respectively. Median time to restaging was 66 days (95% CI 56.8–75.2). There was no significant increase of sensitivity/specificity at later time points of ctDNA measurements.
Conclusion:
Monitoring early changes of ctDNA levels either by mut- or meth-ctDNA allows for early prediction of PD in pretreated patients with mCRC. This has the potential to complement RECIST-based treatment assessment with the aim to switch potentially insufficient treatments as early as possible, which is of particular interest in higher treatment lines.
In this work a new method for the evaluation of UHF RFID Direction of Arrival (DoA) estimation systems is developed and demonstrated. Instead of simulating the system performance or manually ...measuring it in realistic or ideal environments, a method for the evaluation of DoA systems using received signals produced by a target simulator is proposed. The simulator generates the signals for each channel of the DoA estimator by attenuating and phase shifting the signals of an UHF RFID chip to replicate the signal propagation conditions for a chosen tag distance and arrival angle. This combines the advantages of the simulative approach and real world evaluation: it is fast, reproducible and doesn't require special measurement environments. To facilitate this method, plane and spherical wave signal models for the simulation of RFID targets are derived, multichannel phase-shifting and attenuation hardware for the simulation of such signals is presented and a demonstrative evaluation of a RFID DoA estimation system is performed, replicating evaluation scenarios in non reflective and multipath environments.
Background
Oncological esophageal surgery has evolved significantly in the last decades. From open esophagectomy over (hybrid) minimally invasive surgery, nowadays, robot-assisted minimally invasive ...esophagectomy (RAMIE) approaches are applied. Current techniques require an analysis of possible advantages and disadvantages indicating the direction towards a novel gold standard.
Methods
Robot-assisted Ivor Lewis esophagectomies, performed in the period from April 2017 to June 2019 in five German centers (Berlin, Cologne, Hamburg, Kiel, Mainz), were included in this study. Pre-, intra-, and postoperative parameters were assessed. Cases were grouped for hybrid (H-RAMIE) versus totally robot-assisted (T-RAMIE) approaches. Postoperative parameters and complications were compared using risk ratios.
Results
A total of 175 operations were performed as T-RAMIE and 67 as H-RAMIE. Patient age (median age 62 years) and sex (83.1% male) were similarly distributed in both groups. Median duration of esophagectomy was significantly lower in the T-RAMIE group (385 versus 427 min, p < 0.001). The risks of “overall morbidity” (32.0 versus 47.8%; risk ratio RR, 95% confidence interval (CI): 1.5, 1.1–2.1; p = 0.026), “anastomotic leak” (10.3 versus 22.4%; RR, CI: 2.2, 1.2–4.1; p = 0.020), and “respiratory failure” (1.1 versus 7.5%; RR, CI: 6.5, 1.3–32.9; p = 0.019) were significantly higher in case of H-RAMIE.
Conclusions
In the five participating German centers, T-RAMIE was the preferred procedure (72.3% of operations). In comparison to H-RAMIE, T-RAMIE was associated with a significantly reduced risk of postoperative morbidity, anastomotic leak, and respiratory failure as well as a significantly reduced time necessary for esophagectomy.
UHF-RFID is a mature and widespread technology that has the potential to increase the reliability and efficiency of processes in logistics and production environments. However, complex interference ...effects in indoor environments pose challenges to the implementation of reliable wireless communication systems like RFID. This work proposes a method for tag performance evaluation utilizing a coherent two-stage rating process. This enables the abstraction of physical quantities and facilitates the interpretation of tag readability. For this purpose, two well-established full-wave techniques are utilized to perform deterministic simulations of a logistical UHF-RFID use-case. The setup of large-scale simulation environments is discussed and important quantities to be considered in RFID-systems are derived. Based on the simulation results and the proposed rating method, the RFID use-case is evaluated. Results are visualized in full-3D, facilitating the identification of critical spots. Furthermore, a subsequent cross-validation of the simulation results is performed, verifying the validity of the simulation results. By performing a priori propagation analysis, issues can effectively be revealed beforehand and costly modifications after system deployment can be avoided.
Obesity is linked to inferior transplant outcome. Bariatric surgery (BS) is an established treatment of morbid obesity. We provide an overview on BS in the field of kidney (KT) and liver ...transplantation (LT). In end-stage renal disease (ESRD) and KT patients, BS seems safe and feasible. Complication rates were slightly higher compared to the non-transplant population, whereas weight loss and improvement of comorbidities were comparable. Sleeve gastrectomy (SG) was the preferred procedure before KT and superior to gastric bypass (GB) in regard to mortality and morbidity. If conducted after KT, both procedures showed comparable results. BS before LT was associated with high complication rates, in particular after GB. Albeit distinct complications, SG conducted after LT showed the best results. Immunosuppression (IS) changes after BS were rare.
The use of nonmetallic conductor materials in RF applications has recently become a highlighted issue when it comes to sustainability in the electronics industry, mainly because of the waste problems ...associated with heavy metals and the necessity of reducing and managing them. The replacement of metal in functional applications such as in electronics is therefore very important. Among these new materials, organic conductors are of great interest since they are, in general, biocompatible and biodegradable, allowing for the disposal of electronic devices, which reduces the negative environment impact caused by electronics waste. In this work, PEDOT:PSS and Carbon are investigated. Since these materials are available as conducting pastes or inks, the production of conducting patterns by printing techniques such as screen printing is possible, which can make the process less harmful to the environment, since it permits the use of organic substrates such as paper. In order to investigate the feasibility of these materials for RF signal transmission, screen printed PEDOT:PSS and Carbon transmission lines have been designed, fabricated and characterized. Results regarding conductivity, thickness, electric permittivity and S21 parameter are presented and will serve as a foundation for the development of further reaching applications utilizing organic materials.
PDF
