Wearable lower-limb joint angle estimation using a reduced inertial measurement unit (IMU) sensor set could enable quick, economical sports injury risk assessment and motion capture; however the vast ...majority of existing research requires a full IMU set attached to every related body segment and is implemented in only a single movement, typically walking. We thus implemented 3-dimensional knee and hip angle estimation with a reduced IMU sensor set during yoga, golf, swimming (simulated lower body swimming in a seated posture), badminton, and dance movements. Additionally, current deep-learning models undergo an accuracy drop when tested with new and unseen activities, which necessitates collecting large amounts of data for the new activity. However, collecting large datasets for every new activity is time-consuming and expensive. Thus, a transfer learning (TL) approach with long short-term memory neural networks was proposed to enhance the model's generalization ability towards new activities while minimizing the need for a large new-activity dataset. This approach could transfer the generic knowledge acquired from training the model in the source-activity domain to the target-activity domain. The maximum improvement in estimation accuracy (RMSE) achieved by TL is 23.6 degrees for knee flexion/extension and 22.2 degrees for hip flexion/extension compared to without TL. These results extend the application of motion capture with reduced sensor configurations to a broader range of activities relevant to injury prevention and sports training. Moreover, they enhance the capacity of data-driven models in scenarios where acquiring a substantial amount of training data is challenging.
Accurate shoulder joint angle estimation is crucial for analyzing joint kinematics and kinetics across a spectrum of movement applications including in athletic performance evaluation, injury ...prevention, and rehabilitation. However, accurate IMU-based shoulder angle estimation is challenging and the specific influence of key error factors on shoulder angle estimation is unclear. We thus propose an analytical model based on quaternions and rotation vectors that decouples and quantifies the effects of two key error factors, namely sensor-to-segment misalignment and sensor orientation estimation error, on shoulder joint rotation error. To validate this model, we conducted experiments involving twenty-five subjects who performed five activities: yoga, golf, swimming, dance, and badminton. Results showed that improving sensor-to-segment misalignment along the segment's extension/flexion dimension had the most significant impact in reducing the magnitude of shoulder joint rotation error. Specifically, a 1° improvement in thorax and upper arm calibration resulted in a reduction of 0.40° and 0.57° in error magnitude. In comparison, improving IMU heading estimation was only roughly half as effective (0.23° per 1°). This study clarifies the relationship between shoulder angle estimation error and its contributing factors, and identifies effective strategies for improving these error factors. These findings have significant implications for enhancing the accuracy of IMU-based shoulder angle estimation, thereby facilitating advancements in IMU-based upper limb rehabilitation, human-machine interaction, and athletic performance evaluation.
Abstract Background Telerehabilitation is a promising avenue for improving patient outcomes and expanding accessibility. However, there is currently no spine-related assessment for telerehabilitation ...that covers multiple exercises. Methods We propose a wearable system with two inertial measurement units (IMUs) to identify IMU locations and estimate spine angles for ten commonly prescribed spinal degeneration rehabilitation exercises (supine chin tuck head lift rotation, dead bug unilateral isometric hold, pilates saw, catcow full spine, wall angel, quadruped neck flexion/extension, adductor open book, side plank hip dip, bird dog hip spinal flexion, and windmill single leg). Twelve healthy subjects performed these spine-related exercises, and wearable IMU data were collected for spine angle estimation and IMU location identification. Results Results demonstrated average mean absolute spinal angle estimation errors of 2.59 $$^\circ$$ ∘ and average classification accuracy of 92.97%. The proposed system effectively identified IMU locations and assessed spine-related rehabilitation exercises while demonstrating robustness to individual differences and exercise variations. Conclusion This inexpensive, convenient, and user-friendly approach to spine degeneration rehabilitation could potentially be implemented at home or provide remote assessment, offering a promising avenue to enhance patient outcomes and improve accessibility for spine-related rehabilitation. Trial registration: No. E2021013P in Shanghai Jiao Tong University.
Hepatocellular carcinoma is the most common form of primary liver cancer and poses a significant challenge to the medical community because of its high mortality rate. In recent years, ferroptosis, a ...unique form of cell death, has garnered widespread attention. Ferroptosis, which is characterized by iron-dependent lipid peroxidation and mitochondrial alterations, is closely associated with the pathological processes of various diseases, including hepatocellular carcinoma. Long non-coding RNAs (lncRNAs), are a type of functional RNA, and play crucial regulatory roles in a variety of biological processes. In this manuscript, we review the regulatory roles of lncRNAs in the key aspects of ferroptosis, and summarize the research progress on ferroptosis-related lncRNAs in hepatocellular carcinoma.
The utility of pharmacist consultation for drug-induced liver injury (DILI) management has not been explored. This retrospective cohort study evaluated the impact of a pharmacist active consultation ...(PAC) service on the management and outcome in patients with DILI. Consecutive patients meeting clinical biochemical criteria for DILI were enrolled at a tertiary teaching hospital between 1 January 2020 and 30 April 2022. The Roussel Uclaf Causality Assessment Method was used to assess causality between drug use and liver injury for each suspected DILI patient. Included patients were grouped according to whether they received PAC, and a proportional hazard model with multivariate risk adjustment, inverse probability of treatment weighting (IPTW), and propensity score matching (PSM) was used to assess DILI recovery. In the PSM cohort, the quality of medical care was compared between PAC and no PAC groups. A total of 224 patients with DILI (108 who received PAC and 116 who did not) were included in the analysis. Of these patients, 11 (10%) were classified as highly probable, 58 (54%) as probable, and 39 (36%) as possible DILI in the PAC group, while six patients (5%) were classified as highly probable, 53 (46%) as probable, and 57 (49%) as possible DILI in the no PAC group (
p
= 0.089). During patient recovery, PAC was associated with a ∼10% increase in the cumulative 180-day recovery rate. The PAC group had a crude hazard ratio (HR) of 1.73 95% confidence interval (CI): 1.23–2.43,
p
= 0.001 for DILI 180-day recovery, which remained stable after multivariate risk adjustment (HR = 1.74, 95% CI: 1.21–2.49,
p
= 0.003), IPTW (HR = 1.72, 95% CI: 1.19–2.47,
p
= 0.003), and PSM (HR = 1.49, 95% CI: 1.01–2.23,
p
= 0.046). In the PSM cohort, PAC was more likely to identify suspect drugs (90% vs. 60%,
p
< 0.001) and lead to timely withdrawal of the medication (89% vs. 57%,
p
< 0.001). Thus, PAC is associated with a better quality of medical care for patients with DILI and can improve patient outcomes.
Drug-induced QT prolongation and (or) Torsade de Pointes (TdP) is a well-known serious adverse reaction (ADR) for some drugs, but the widely recognized comprehensive landscape of culprit-drug of QT ...prolongation and TdP is currently lacking.
To identify the top drugs reported in association with QT prolongation and TdP and provide information for clinical practice.
We reviewed the reports related to QT prolongation and TdP in the FDA Adverse Event Reporting System (FAERS) database from January 1, 2004 to December 31, 2022, and summarized a potential causative drug list accordingly. Based on this drug list, the most frequently reported causative drugs and drug classes of QT prolongation and TdP were counted, and the disproportionality analysis for all the drugs was conducted to in detect ADR signal. Furthermore, according to the positive-negative distribution of ADR signal, we integrated the risk characteristic of QT prolongation and TdP in different drugs and drug class.
A total of 42,713 reports in FAERS database were considered to be associated with QT prolongation and TdP from 2004 to 2022, in which 1,088 drugs were reported as potential culprit-drugs, and the largest number of drugs belonged to antineoplastics. On the whole, furosemide was the most frequently reported drugs followed by acetylsalicylic acid, quetiapine, citalopram, metoprolol. In terms of drug classes, psycholeptics was the most frequently reported drug classes followed by psychoanaleptics, analgesics, beta blocking agents, drugs for acid related disorders. In disproportionality analysis, 612 drugs showed at least one positive ADR signals, while citalopram, ondansetron, escitalopram, loperamide, and promethazine were the drug with the maximum number of positive ADR signals. However, the positive-negative distribution of ADR signals between different drug classes showed great differences, representing the overall risk difference of different drug classes.
Our study provided a real-world overview of QT prolongation and TdP to drugs, and the presentation of the potential culprit-drug list, the proportion of reports, the detection results of ADR signals, and the distribution characteristics of ADR signals may help understand the safety profile of drugs and optimize clinical practice.
TLR2 signaling plays a critical protective role against acute
(Lm) infection by up-regulating inflammatory cytokines and promoting macrophage antimicrobial capabilities. However, the underlying ...mechanism by which TLR2 regulates hepatic macrophage-mediated anti-Lm immune responses remains poorly understood. In this study, we found that both the absolute number and proportion of monocyte/macrophage (Mo/MΦ) in the liver and spleen of
mice were significantly lower compared to wild type mice. Changes in TLR2 signaling in both hepatocytes and Mo/MΦs were associated with the infiltration of Mo/MΦs in response to Lm-infection. Analyses by proteome profiler array and ELISA revealed that hepatocytes recruited Mo/MΦs via TLR2-dependent secretion of CCL2 and CXCL1, which was confirmed by receptor blocking and exogenous chemokine administration. Importantly, we found that TLR2 contributed to macrophage mobility in the liver through a TLR2/NO/F-actin pathway, facilitating the formation of macrophage-associated hepatic microabscesses. Moreover, TLR2 activation induced the expression of several PRRs on hepatic macrophages associated with the recognition of Lm and augmented macrophage bacterial clearance activity. Our findings provide insight into the intrinsic mechanisms of TLR2-induced Mo/MΦ migration and mobility, as well as the interaction between macrophages and hepatocytes in resistance to Lm infection.
Sound drug safety information is important to optimize patient management, but the widely recognized comprehensive landscape of culprit-drugs that cause severe cutaneous adverse reactions (SCARs) is ...currently lacking.
The main aim of the study is to provide a comprehensive landscape of culprit-drugs for SCARs to guide clinical practice.
We analyzed reports associated with SCARs in the FDA Adverse Event Reporting System database between 1 January 2004 and 31 December 2021 and compiled a list of drugs with potentially serious skin toxicity. According to this list, we summarized the reporting proportions of different drugs and drug classes and conducted disproportionality analysis for all the drugs. In addition, the risk characteristic of SCARs due to different drugs and drug classes was summarized by the positive-negative distribution based on the results of the disproportionality analysis.
A total of 77,789 reports in the FDA Adverse Event Reporting System database were considered SCAR-related, of which lamotrigine (6.2%) was the most reported single drug followed by acetaminophen (5.8%) and allopurinol (5.8%) and antibacterials (20.6%) was the most reported drug class followed by antiepileptics (16.7%) and antineoplastics (11.3%). A total of 1,219 drugs were reported as culprit-drugs causing SCARs in those reports, and the largest number of drugs belonged to antineoplastics. In disproportionality analysis, 776 drugs showed at least one positive pharmacovigilance signal. Drugs with the most positive signals were lamotrigine, acetaminophen, furosemide, and sulfamethoxazole/trimethoprim.
Our study provided a real-world overview of SCARs to drugs, and the investigation of SCAR positive-negative distribution across different drugs revealed its risk characteristics, which may help optimize patient management.
Infectious disease (ID) consultation can improve multidrug-resistant organism (MDRO) treatment outcomes. However, the impact of clinical pharmacists' ID consultation on MDRO therapy, especially early ...initiation, has not been reported. In this study, we try to explore the impact of the pharmacist early active consultation (PEAC) on MDRO patient management.
We conducted a prospective historical controlled study based on PEAC in MDRO patients. The retrospective control group was patients hospitalized 18 months before the PEAC initiation, and the prospective PEAC group was patients hospitalized 18 months after the PEAC initiation. Primary endpoint was 30-day all-cause mortality. Secondary outcomes were MDRO clinical outcome, duration of antibiotic use, length of stay, antibiotic consumption and antibiotic costs. Further subgroup analysis of secondary outcomes was performed by the condition at admission, MDRO pathogenicity and MDRO clinical outcome.
188 MDRO patients were included. After adjusting for potential predictors, PEAC reduced the 30-day all-cause mortality by 70% (HR 0.30, 95% CI 0.09-0.96,
= 0.042). PEAC group had clinical improvement than control group (89.47% vs. 65.59%,
< 0.001), especially in patients with non-severe clinical conditions at admission (98.41% vs. 70.18%,
< 0.001). However, no significant differences were found between groups in length of stay, antibiotics consumption, and antibiotics costs.
Early active pharmacy ID consultation can reduce 30-day all-cause mortality and improve clinical outcomes in MDRO patients.
Farmer-led agricultural innovation is increasingly viewed as a potential approach to sustainable agriculture especially promoting rural revitalization as well as mitigating agricultural non-point ...source pollution. However, little research has yet been paid to evaluating the environmental contribution caused by these emerging agricultural innovations. Using data generated in the Qingpu District of Shanghai, this paper focuses on the new agri-business entities and evaluates the impact of agricultural innovation on changes in their use of chemical fertilizers. The findings indicate that different forms of agricultural innovation have radically different outcomes. Innovation of new production technologies and sales tend to have negative impacts on the environment, while both vertical integration with manufacturing-processing-sales activities, and horizontal integration with service activities, are found to make a positive environmental contribution. The paper argues that the different sources of value added generated by innovation provide different incentives for farmers. Those with a narrow concentration on efficiency and market scale tend to intensify their output-maximized production, while those shifting to processing and service activities rely more on the quality and service centered production, which tends to create less damage to the environment.
•Agricultural innovation is becoming a critical part of sustainable agriculture, but little has been known about the environmental contributions.•Agricultural Innovation with a narrow concentration on production efficiency and market scales is found with negative environmental contributions.•Both vertical and horizontal agricultural Integrations contribute to the reduction of chemical fertilizer use.•Supporting policies are required to guide behavior changes of new agri-business entities for sustainable agricultural development.
PDF
