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Projected AR Serious Game “Painting Discovery” for Shoulder Rehabilitation: Assessment With Technicians, Physiotherapists, and Patients 用于肩部康复的投影AR严肃游戏“绘画发现”:技术人员,物理治疗师和患者的评估
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-04-02 DOI: 10.1109/JTEHM.2025.3557250
Giuseppe Turini;Marina Carbone;Sara Condino;Donato Gallone;Vincenzo Ferrari;Marco Gesi;Michelangelo Scaglione;Paolo Parchi;Rosanna Maria Viglialoro
Objective: Motivation and adherence are crucial for effective rehabilitation, yet engagement remains a challenge in upper limb physiotherapy. Serious Games (SGs) have emerged as a promising tool to enhance patient motivation. This study evaluates Painting Discovery, a projected augmented reality (AR) SG for shoulder rehabilitation, assessing engagement, ergonomics, and its potential to differentiate motor performance between healthy and those with rheumatoid arthritis, bursitis, subacromial impingement, rotator cuff tear, or calcific tendinopathy. Additionally, it examines improvements in pathological subjects following physiotherapy. Method: Sixteen healthy and seven pathological subjects participated. Engagement, ergonomics, and satisfaction were assessed using Likert-scale questionnaires. Motor performance was evaluated through completion time, speed, acceleration, and normalized jerk. Four pathological subjects underwent pre- and post-physiotherapy assessments over six weeks. Results: SG was highly engaging and ergonomic, with no significant differences based on prior video game or AR experience. The pathological group had longer completion times ( $56.49~pm ~37.85$ s vs. $39.02~pm ~24.21$ s, p < 0.001), lower acceleration ( $1.11~pm ~0.92$ m/s2 vs. $0.79~pm ~0.56$ m/s2, p < 0.001), and higher jerk ( $6.68times 107~pm ~1.37times 108$ m/s3 vs. $9.22times 106~pm ~2.51times 107$ m/s3, p = 0.025) then healthy subjects. After physiotherapy, completion time and normalized jerk indicated enhanced efficiency and control. Conclusions: Painting Discovery shows strong potential as an engaging, accessible rehabilitation tool. While effective in differentiating motor impairments, its small sample size and horizontal-plane movement focus limit broader conclusions. Future studies should expand participation, incorporate vertical-plane movements, and refine performance metrics for clinical validation.
目的:动机和坚持是有效康复的关键,但参与上肢物理治疗仍然是一个挑战。严肃游戏(Serious Games, SGs)已成为增强患者动机的一种有前景的工具。本研究评估了用于肩部康复的增强现实(AR) SG - Painting Discovery,评估了参与性、人体工程学及其区分健康人与类风湿关节炎、滑囊炎、肩胛下撞击、肩袖撕裂或钙化肌腱病患者运动表现的潜力。此外,它还检查了物理治疗后病理受试者的改善。方法:健康受试者16例,病理受试者7例。参与、人体工程学和满意度采用李克特量表问卷进行评估。运动性能通过完成时间、速度、加速度和标准抽动来评估。四名病理受试者在六周内接受了物理治疗前后的评估。结果:SG是高度参与和符合人体工程学,没有显著差异基于先前的视频游戏或AR经验。病理组完成时间较健康组长(56.49~ 37.85$ s vs. 39.02~ 24.21$ s, p < 0.001),加速度较低(1.11~pm ~0.92$ m/s2 vs. 0.79~pm ~0.56$ m/s2, p < 0.001),跳速较高(6.68 × 107~pm ~1.37 × 108$ m/s3 vs. 9.22 × 106~pm ~2.51 × 107$ m/s3, p = 0.025)。物理治疗后,完成时间和正常抽搐表明效率和控制力增强。结论:绘画发现显示出强大的潜力,作为一个有吸引力的,可访问的康复工具。虽然在区分运动障碍方面是有效的,但它的小样本量和水平平面运动焦点限制了更广泛的结论。未来的研究应扩大参与,纳入垂直平面运动,并完善临床验证的性能指标。
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引用次数: 0
Feasibility Analysis of a Portable Diaphragmatic Efficiency Monitor for CSCI Patients CSCI患者便携式膈肌效率监测仪的可行性分析
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-28 DOI: 10.1109/JTEHM.2025.3574553
Jack Curley;Esteban Gomez;Laith Adnan;Isabelle Ablao;Jayden Sumbillo;Henry York;Hakan Töreyin
Objective: This study evaluates the feasibility of a noninvasive system for monitoring diaphragmatic efficiency in people with cervical spinal cord injury (CSCI). Methods: Two versions of a portable hardware system were developed using impedance pneumography (IP) to measure tidal volume (TV) and surface electromyography (sEMG) to assess diaphragm electrical activity (EAdi). Version 1 was used to determine optimal electrode positions, while Version 2 integrated these sensor systems into a compact, portable design. Data from eight healthy male participants were analyzed to assess the correlation and accuracy of TV and respiration rate (RR) prediction using IP and the correlation between sEMG signals and maximum inspiratory pressure (MIP). Results: For IP, measurements between the upper sternum and the midclavicular line (MCL) at the 4th intercostal (IC) space showed the highest correlation with true tidal volume. For sEMG, measurements between the mid-sternum and the 6th IC space demonstrated the strongest correlation with MIP. The integrated version 2 hardware demonstrates simultaneous IP and sEMG measurement while dissipating 2.17 mW. Discussion/Conclusion: The proposed system and the results presented may lead to a practical, cost-effective solution for continuous diaphragmatic efficiency monitoring, and thus enabling home-based respiratory care of CSCI patients. Clinical and Translational Impact Statement– This work presents the feasibility of building a wearable system that can unobtrusively monitor diaphragmatic efficiency, and thus enabling noninvasive, cost-effective, and home-based respiratory care for CSCI patients, facilitating early intervention and improved long-term health outcomes. This study is categorized under the early/pre-clinical research category of the NIH Clinical spectrum.
目的:本研究评估一种无创系统监测颈脊髓损伤(CSCI)患者膈肌效率的可行性。方法:开发了两个版本的便携式硬件系统,分别使用阻抗肺成像(IP)测量潮气量(TV)和表面肌电图(sEMG)评估膈电活动(EAdi)。版本1用于确定最佳电极位置,而版本2将这些传感器系统集成到一个紧凑的便携式设计中。对8名健康男性受试者的数据进行分析,以评估TV与呼吸速率(RR)预测的相关性和准确性,以及表面肌电信号与最大吸气压(MIP)的相关性。结果:对于IP,测量胸骨上段和锁骨中线(MCL)之间的第4肋间(IC)空间与真实潮汐量的相关性最高。在表面肌电图中,胸骨中部和第六IC间隙之间的测量显示与MIP的相关性最强。集成版本2硬件在功耗为2.17 mW的情况下同时实现IP和sEMG测量。讨论/结论:所提出的系统和所提出的结果可能为连续监测膈肌效率提供一种实用、经济的解决方案,从而使CSCI患者的家庭呼吸护理成为可能。临床和转化影响声明-这项工作提出了建立一个可穿戴系统的可行性,该系统可以不引人注目地监测膈肌效率,从而为CSCI患者提供无创、经济高效的家庭呼吸护理,促进早期干预和改善长期健康结果。本研究属于美国国立卫生研究院临床光谱的早期/临床前研究类别。
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引用次数: 0
2024 Index IEEE Journal of Translational Engineering in Health and Medicine Vol. 12 卫生与医学转化工程学报,第12卷
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-24 DOI: 10.1109/JTEHM.2025.3551783
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引用次数: 0
Detection of Chronic Musculoskeletal Pain Using Voice Characteristics 利用声音特征检测慢性肌肉骨骼疼痛
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-24 DOI: 10.1109/JTEHM.2025.3553892
Masakazu Higuchi;Toshiko Iidaka;Chiaki Horii;Gaku Tanegashima;Hiroyuki Oka;Hiroshi Hashizume;Hiroshi Yamada;Munehito Yoshida;Sakae Tanaka;Noriko Yoshimura;Mitsuteru Nakamura;Shinichi Tokuno
Physical pain, particularly musculoskeletal pain, negatively impacts the activities of daily life and quality of life of elderly people. Because pain is a subjective sensation and there are no standard assessment procedures to detect pain, we attempted to quantitatively determine the actual state of chronic pain caused by musculoskeletal organs and related factors based on questionnaires. First, we studied techniques for diagnosing diseases by monitoring the involuntary characteristics of the voice. Then, we applied the technique based on voice characteristics and proposed a voice index to detect chronic musculoskeletal pain. The voice index was derived based on the assumption that physiological changes due to chronic musculoskeletal pain also affect the vocal cords. Subjects in this study were adults, 65 years of age or older, with chronic pain in the musculoskeletal system (lumbar and/or knees). A large-scale population-based cohort study was conducted in 2019. Voice characteristics were extracted from the recorded voices of the subjects, and the characteristics with similar properties were organized into several principal components using principal component analysis. The principal components were further combined using logistic regression analysis to propose a voice index that discriminates between normal subjects and subjects suffering from chronic musculoskeletal pain. A discrimination accuracy of approximately 80% was obtained using the dataset corresponding to the participants with knee pain only, and a discrimination accuracy of approximately 70% was obtained during cross-validation of the same dataset. The proposed voice index may serve as a novel tool for detecting chronic musculoskeletal pain. Clinical impact: The voice-based pain detection holds clinical significance owing to its noninvasive nature, ease of administration, and potential to efficiently assess large populations within a short time frame.
身体疼痛,特别是肌肉骨骼疼痛,对老年人的日常生活活动和生活质量产生负面影响。由于疼痛是一种主观感觉,没有标准的评估程序来检测疼痛,我们试图通过问卷调查来定量确定肌肉骨骼器官及相关因素引起的慢性疼痛的实际状态。首先,我们研究了通过监测声音的非自愿特征来诊断疾病的技术。然后,我们将该技术应用于基于声音特征的方法,并提出了一个声音指数来检测慢性肌肉骨骼疼痛。声音指数是基于慢性肌肉骨骼疼痛引起的生理变化也影响声带的假设而得出的。本研究的受试者是65岁或以上的成年人,患有肌肉骨骼系统(腰椎和/或膝盖)的慢性疼痛。2019年进行了一项大规模人群队列研究。从被试录制的声音中提取声音特征,利用主成分分析将具有相似属性的特征组织成多个主成分。使用逻辑回归分析将主成分进一步组合,提出区分正常受试者和患有慢性肌肉骨骼疼痛的受试者的声音指数。使用仅与膝关节疼痛参与者对应的数据集获得了约80%的识别准确率,并且在同一数据集的交叉验证中获得了约70%的识别准确率。提出的声音指数可以作为一种检测慢性肌肉骨骼疼痛的新工具。临床影响:基于语音的疼痛检测具有临床意义,因为它的非侵入性,易于管理,以及在短时间内有效评估大量人群的潜力。
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引用次数: 0
Unstructured Electronic Health Records of Dysphagic Patients Analyzed by Large Language Models 用大语言模型分析吞咽困难患者的非结构化电子健康记录
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-19 DOI: 10.1109/JTEHM.2025.3571255
Luisa Neubig;Deirdre Larsen;Melda Kunduk;Andreas M. Kist
Objective: Dysphagia is a common and complex disorder that complicates both diagnoses and treatment. Consequently, the associated electronic health records (EHR) are often unstructured and complex, posing challenges for systematic data analysis.Methods and procedures: In this study, we employ natural language processing (NLP) techniques and large language models (LLMs) to automatically analyze clinical narratives and extract diagnostic information from a diverse set of EHRs. Our dataset includes medical records from 486 patients, representing a group with diverse dysphagic conditions. We analyze diagnoses provided in unstructured free text that do not follow a standardized structure. We utilize clustering algorithms on the extracted diagnostic features to identify distinct groups of patients who share similar pathophysiological swallowing dysfunctions.Results: We found that basic NLP techniques often provide limited insights due to the high variability of the data. In contrast, LLMs help to bridge the gap in understanding the nuanced medical information about dysphagia and related conditions. Although applying these advanced LLM models is not straightforward, our results demonstrate that leveraging closed-source models can effectively cluster different categories of dysphagia.Conclusion: Our study provides therefore evidence that LLMs are highly promising in future dysphagia research.Clinical impact: Dysphagia is a symptom associated with various diseases, though its underlying relationships remain unclear. This study demonstrates how analyzing large volumes of electronic health records can help clarify the causes of dysphagia and identify contributing factors. By applying natural language processing, we aim to enhance both understanding and treatment, supporting clinical staff in improving individualized care by identifying relevant patient cohorts. Clinical and Translational Impact Statement: This study uses LLMs to efficiently preprocess unstructured EHRs, improving dysphagia diagnosis and patient clustering. It aligns with Clinical Research, enhancing diagnostic speed and enabling personalized treatment.
目的:吞咽困难是一种常见而复杂的疾病,其诊断和治疗都很复杂。因此,相关的电子健康记录(EHR)往往是非结构化和复杂的,给系统数据分析带来了挑战。方法和步骤:在本研究中,我们采用自然语言处理(NLP)技术和大型语言模型(LLMs)来自动分析临床叙述并从各种电子病历中提取诊断信息。我们的数据集包括来自486名患者的医疗记录,代表了患有不同吞咽障碍的人群。我们分析在没有遵循标准化结构的非结构化自由文本中提供的诊断。我们在提取的诊断特征上使用聚类算法来识别具有相似病理生理吞咽功能障碍的不同患者组。结果:我们发现,由于数据的高度可变性,基本的NLP技术通常提供有限的见解。相比之下,法学硕士有助于弥合理解有关吞咽困难和相关疾病的细微医学信息的差距。虽然应用这些先进的LLM模型并不简单,但我们的研究结果表明,利用闭源模型可以有效地聚类不同类别的吞咽困难。结论:我们的研究为llm在未来的吞咽困难研究中提供了非常有前景的证据。临床影响:吞咽困难是一种与多种疾病相关的症状,尽管其潜在的关系尚不清楚。这项研究表明,分析大量的电子健康记录可以帮助澄清吞咽困难的原因,并确定导致吞咽困难的因素。通过应用自然语言处理,我们的目标是提高理解和治疗,支持临床工作人员通过识别相关的患者队列来改善个性化护理。临床和转化影响声明:本研究使用LLMs有效预处理非结构化电子病历,改善吞咽困难的诊断和患者聚类。它与临床研究相一致,提高了诊断速度并实现了个性化治疗。
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引用次数: 0
Measurement of Peripheral Nerve Magnetostimulation Thresholds of a Head Solenoid Coil Between 200 Hz and 88.1 kHz 头部电磁线圈200 ~ 88.1 kHz周围神经磁刺激阈值的测量
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-15 DOI: 10.1109/JTEHM.2025.3570611
Alex C. Barksdale;Natalie G. Ferris;Eli Mattingly;Monika Śliwiak;Bastien Guerin;Lawrence L. Wald;Mathias Davids;Valerie Klein
Magnetic fields switching at kilohertz frequencies induce electric fields in the body, which can cause peripheral nerve stimulation (PNS). Although magnetostimulation has been extensively studied below 10 kHz, the behavior of PNS at higher frequencies remains poorly understood. This study aims to investigate PNS thresholds at frequencies up to 88.1 kHz and to explore deviations from the widely accepted hyperbolic strength-duration curve (SDC).PNS thresholds were measured in the head of 8 human volunteers using a solenoidal coil at 16 distinct frequencies, ranging from 200 Hz to 88.1 kHz. A hyperbolic SDC was used as a reference to compare the frequency-dependent behavior of PNS thresholds.Contrary to the predictions of the hyperbolic SDC, PNS thresholds did not decrease monotonically with frequency. Instead, thresholds reached a minimum near 25 kHz, after which they increased by an average of 39% from 25 kHz to 88.1 kHz across subjects. This pattern indicates a significant deviation from previously observed behavior at lower frequencies.Our results suggest that PNS thresholds exhibit a non-monotonic frequency dependence at higher frequencies, diverging from the traditional hyperbolic SDC. These findings offer critical data for refining neurodynamic models and provide insights for setting PNS safety limits in applications like MRI gradient coils and magnetic particle imaging (MPI). Further investigation is needed to understand the biological mechanisms driving these deviations beyond 25 kHz.Clinical impact—These findings call for further basic research into biological mechanisms underlying high frequency PNS threshold trends, and supports refinement of safety guidelines for MRI and MPI systems for clinical implementation.
以千赫兹频率转换的磁场会在体内产生电场,从而引起周围神经刺激(PNS)。尽管在10khz以下的磁刺激已经得到了广泛的研究,但PNS在更高频率下的行为仍然知之甚少。本研究旨在研究频率高达88.1 kHz的PNS阈值,并探索与广泛接受的双曲强度-持续时间曲线(SDC)的偏差。使用螺线管线圈,在200赫兹到88.1千赫的16种不同频率下,测量了8名人类志愿者的PNS阈值。使用双曲SDC作为参考,比较PNS阈值的频率依赖性行为。与双曲SDC的预测相反,PNS阈值并没有随频率单调降低。相反,阈值在25 kHz附近达到最低,之后,受试者的阈值从25 kHz平均增加39%至88.1 kHz。这种模式表明在较低频率下与先前观察到的行为有显著偏差。我们的研究结果表明,PNS阈值在更高的频率下表现出非单调的频率依赖性,与传统的双曲SDC不同。这些发现为完善神经动力学模型提供了关键数据,并为在MRI梯度线圈和磁颗粒成像(MPI)等应用中设置PNS安全限制提供了见解。需要进一步的研究来了解导致这些偏差超过25 kHz的生物学机制。临床影响:这些发现要求对高频PNS阈值趋势的生物学机制进行进一步的基础研究,并支持完善MRI和MPI系统的临床应用安全指南。
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引用次数: 0
Precision Oral Medicine: A DPR Segmentation and Transfer Learning Approach for Detecting Third Molar Compress Inferior Alveolar Nerve 精准口腔医学:第三磨牙压迫下牙槽神经检测的DPR分割和迁移学习方法
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-12 DOI: 10.1109/JTEHM.2025.3568922
Yuan-Jin Lin;Shih-Lun Chen;Yi-Cheng Mao;Tsung-Yi Chen;Cheng-Hao Peng;Tzu-Hsiang Tsai;Kuo-Chen Li;Chiung-An Chen;Wei-Chen Tu;Patricia Angela R. Abu
Extraction of the third molar of the mandible is one of the most common oral surgical procedures. Preoperative monitoring and assessment are crucial to mitigate neurological risks. Identifying whether the third molar in the mandible compresses the inferior alveolar nerve still relies on dental professionals, a task that is repetitive and time-consuming. Thus, the primary objective is to utilize dental panoramic radiography for image processing and classify whether the third molar compresses the inferior alveolar nerve, aiming to reduce the demand for CT images in symptom diagnosis and mitigate the risks associated with high-dose radiation. This study proposes an innovative dental panoramic radiography segmentation technique to locate the third molar position. Subsequently, an innovative edge masking enhancement method is used to extract features of the inferior alveolar nerve and the third molar. Moreover, a transformer-based image detection model to consider whether the third molar compresses the inferior alveolar nerve. The third molar position localization method achieved an accuracy rate of 97.92%, compared to recent research at least improved by 3.6% accuracy. Subsequently, innovative edge masking and image enhancement methods improve classification accuracy by 4.3%, when supplemented with computed tomography scan images for further evaluation, the maximum accuracy reached 98.45%, representing a 4.5% improvement compared to previous studies. The third molar position detection results will impact the identification of the inferior alveolar nerve compressed by the third molar. Through the innovative edge region segmentation algorithm can effectively distinguish this object, and the overall evaluation accuracy can be improved by approximately 3.8%.
下颌第三磨牙的拔除是最常见的口腔外科手术之一。术前监测和评估对于减轻神经系统风险至关重要。确定下颌骨第三磨牙是否压迫下牙槽神经仍然依赖于牙科专业人员,这是一项重复且耗时的任务。因此,本研究的主要目的是利用牙科全景x线摄影进行图像处理,判断第三磨牙是否压迫下牙槽神经,以减少症状诊断对CT图像的需求,降低高剂量辐射的风险。本研究提出一种创新的牙科全景x线摄影分割技术来定位第三磨牙的位置。随后,采用一种创新的边缘掩盖增强方法提取下牙槽神经和第三磨牙的特征。此外,基于变压器的图像检测模型来考虑第三磨牙是否压迫下牙槽神经。第三磨牙定位方法的定位准确率为97.92%,较目前研究至少提高了3.6%。随后,创新的边缘掩蔽和图像增强方法将分类准确率提高了4.3%,当补充计算机断层扫描图像进行进一步评估时,最高准确率达到98.45%,比以往的研究提高了4.5%。第三磨牙位置的检测结果会影响第三磨牙压迫下牙槽神经的识别。通过创新的边缘区域分割算法可以有效区分该目标,整体评价精度可提高约3.8%。
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引用次数: 0
Letter to the Editor on “From Concept to Clinic: Living Labs and Regulatory Sandboxes for Health System Digitalization and the Integration of Innovative Devices Into Clinical Workflows” 致编辑关于“从概念到临床:卫生系统数字化的生活实验室和监管沙盒以及将创新设备集成到临床工作流程”的信
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-12 DOI: 10.1109/JTEHM.2025.3557508
Rebecca Mathias;Anett Schönfelder;Cindy Welzel;Stephen Gilbert
Digital health and AI-enabled technologies hold the promise of addressing gaps in healthcare, but balancing rapid market access with the need for safe, functional, and user-centered solutions remains a challenge [1], [2]. Regulatory requirements for device development and market approval demand detailed documentation and predetermined protocols, which can limit the adaptability developers require for iterative improvement and real-world testing with patients and healthcare professionals [1], [3], [4]—an approach that would be highly beneficial for digital and AI-enabled technologies. As a result, key factors like clinical workflow integration, interoperability, and usability with the real range of in-use devices are often overlooked or addressed in a cursory fashion [5].
数字医疗和人工智能技术有望解决医疗保健方面的差距,但在快速进入市场与对安全、功能性和以用户为中心的解决方案的需求之间取得平衡仍然是一项挑战。设备开发和市场批准的监管要求需要详细的文档和预先确定的协议,这可能会限制开发人员对患者和医疗保健专业人员[1]、[3]、[4]进行迭代改进和实际测试所需的适应性,而这种方法对数字和支持人工智能的技术非常有益。因此,诸如临床工作流程集成、互操作性和与实际使用设备的可用性等关键因素往往被忽视或以粗略的方式解决[10]。
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引用次数: 0
A Clinical Tuning Framework for Continuous Kinematic and Impedance Control of a Powered Knee-Ankle Prosthesis 动力膝踝假体连续运动和阻抗控制的临床调谐框架
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-07 DOI: 10.1109/JTEHM.2025.3567578
Emma Reznick;T. Kevin Best;Robert D. Gregg
Objective: Configuring a prosthetic leg is an integral part of the fitting process, but the personalization of a multi-modal powered knee-ankle prosthesis is often too complex to realize in a clinical environment. This paper develops both the technical means to individualize a hybrid kinematic-impedance controller for variable-incline walking and sit-stand transitions, and an intuitive Clinical Tuning Interface (CTI) that allows prosthetists to directly modify the controller behavior. Methods and procedures: Utilizing an established method for predicting kinematic gait individuality alongside a new parallel approach for kinetic individuality, we personalize continuous-phase/task models of joint impedance (during stance) and kinematics (during swing) using tuned characteristics exclusively from level-ground walking. To take advantage of this method, we developed a CTI that translates common clinical tuning parameters into model adjustments for the walking and sit-stand controllers. We then conducted a case study where a prosthetist iteratively tuned the powered prosthesis to an above-knee amputee participant in a simulated clinical session involving sit-stand transitions and level walking, from which incline/decline walking features were automatically calibrated. Results: The prosthetist fully tuned the multi-activity prosthesis controller in under 20 min. Each iteration of tuning (i.e., observation, parameter adjustment, and model reprocessing) took 2 min on average for walking and 1 min on average for sit-stand. The tuned behavior changes were appropriately manifested in the commanded prosthesis torques, both at the manually tuned tasks and automatically tuned tasks (inclines). Conclusion: The CTI leveraged able-bodied trends to efficiently personalize a wide array of walking tasks and sit-stand transitions, demonstrating the efficiency necessary for powered knee-ankle prostheses to become clinically viable. Clinical impact: This paper introduces a clinical tuning interface that simplifies the tuning process for multimodal robotic prosthetic legs, reducing the time required from several hours to just 20 minutes thus improving clinical feasibility.
目的:假肢的配置是装配过程中不可或缺的一部分,但多模态动力膝关节-踝关节假体的个性化往往过于复杂,难以在临床环境中实现。本文开发了一种个性化的混合运动阻抗控制器的技术手段,用于可变倾斜度的行走和坐立转换,以及一个直观的临床调整界面(CTI),允许义肢医生直接修改控制器的行为。方法和步骤:利用一种已建立的预测运动学步态个性的方法以及一种新的运动个性的并行方法,我们对关节阻抗(在站立期间)和运动学(在摆动期间)的连续相位/任务模型进行了个性化,该模型仅使用平地行走的调谐特性。为了利用这种方法,我们开发了一个CTI,将常见的临床调整参数转换为步行和坐立控制器的模型调整。然后,我们进行了一个案例研究,在一个模拟的临床过程中,一名义肢专家反复调整动力义肢,让一名膝盖以上的截肢者参与其中,包括坐立转换和水平行走,从中自动校准倾斜/下降行走特征。结果:多活动义肢控制器在20分钟内完成全调优。每次调优(即观察、参数调整、模型再处理)平均耗时2分钟,坐下站立平均耗时1分钟。在手动调整任务和自动调整任务(倾斜)中,调整后的行为变化适当地体现在命令的假肢扭矩中。结论:CTI利用健全身体的趋势,有效地个性化了广泛的步行任务和坐立转换,证明了动力膝踝假体在临床上可行的必要效率。临床影响:本文介绍了一种临床调优界面,简化了多模态机器人假肢腿的调优过程,将所需时间从几个小时减少到20分钟,从而提高了临床可行性。
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引用次数: 0
Cross-Database Evaluation of Deep Learning Methods for Intrapartum Cardiotocography Classification 产时心脏学分类深度学习方法的跨数据库评价
IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-05 DOI: 10.1109/JTEHM.2025.3548401
Lochana Mendis;Debjyoti Karmakar;Marimuthu Palaniswami;Fiona Brownfoot;Emerson Keenan
Continuous monitoring of fetal heart rate (FHR) and uterine contractions (UC), otherwise known as cardiotocography (CTG), is often used to assess the risk of fetal compromise during labor. However, interpreting CTG recordings visually is challenging for clinicians, given the complexity of CTG patterns, leading to poor sensitivity. Efforts to address this issue have focused on data-driven deep-learning methods to detect fetal compromise automatically. However, their progress is impeded by limited CTG training datasets and the absence of a standardized evaluation workflow, hindering algorithm comparisons. In this study, we use a private CTG dataset of 9,887 CTG recordings with pH measurements and 552 CTG recordings from the open-access CTU-UHB dataset to conduct a cross-database evaluation of six deep-learning models for fetal compromise detection. We explore the impact of input selection of FHR and UC signals, signal pre-processing, downsampling frequency, and the influence of removing intermediate pH samples from the training dataset. Our findings reveal that using only FHR and pre-processing FHR with artefact removal and interpolation provides a significant improvement to classification performance for some model architectures while excluding intermediate pH samples did not significantly improve performance for any model. From our comparison of the six models, ResNet exhibited the strongest fetal compromise classification performance across both databases at a downsampling rate of 1Hz. Finally, class activation maps from highly contributing signal regions in the ResNet model aligned with clinical knowledge of compromised FHR patterns, highlighting the model’s interpretability. These insights may serve as a standardized reference for developing and comparing future works in this domain. Clinical and Translational Impact: This study provides a standardized workflow for comparing deep-learning methods for CTG classification. Ensuring new methods show generalizability and interpretability will improve their robustness and applicability in clinical settings.
连续监测胎儿心率(FHR)和子宫收缩(UC),也被称为心脏造影(CTG),通常用于评估分娩过程中胎儿妥协的风险。然而,考虑到CTG模式的复杂性,视觉上解释CTG记录对临床医生来说是具有挑战性的,导致灵敏度低。解决这一问题的努力集中在数据驱动的深度学习方法上,以自动检测胎儿的危害。然而,有限的CTG训练数据集和缺乏标准化的评估工作流程阻碍了他们的进展,阻碍了算法的比较。在这项研究中,我们使用一个私人CTG数据集,其中包含9,887条CTG记录,其中包括pH测量值,以及来自开放获取的CTU-UHB数据集的552条CTG记录,对胎儿损伤检测的六种深度学习模型进行了跨数据库评估。我们探讨了FHR和UC信号的输入选择、信号预处理、下采样频率以及从训练数据集中去除中间pH样本的影响。我们的研究结果表明,仅使用FHR和预处理FHR与伪影去除和插值可以显著提高某些模型架构的分类性能,而排除中间pH样本并不能显著提高任何模型的性能。从我们对六个模型的比较中,ResNet在两个数据库中表现出最强的胎儿损伤分类性能,降采样率为1Hz。最后,来自ResNet模型中高贡献信号区域的类激活图与受损FHR模式的临床知识一致,突出了模型的可解释性。这些见解可以作为开发和比较该领域未来工作的标准化参考。临床和转化影响:本研究为比较CTG分类的深度学习方法提供了一个标准化的工作流程。确保新方法具有普遍性和可解释性,将提高其在临床环境中的稳健性和适用性。
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引用次数: 0
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IEEE Journal of Translational Engineering in Health and Medicine-Jtehm
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