P. Kumar, S. Ks, Vyoma Venkatesh Grandhi, Vrinda Gupta
Background: A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations, or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remains poorly understood. Objective: The aim of this study was to consider the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants were reviewed. Important findings of consensus were highlighted, and existing controversies were revealed. Methods: This paper considered many of the research publications listed in Medical Literature Analysis and Retrieval System Online and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma spraying, grit blasting, acid etching, alkaline etching, anodization, polymer demixing, sol-gel conversion, and their corresponding surface morphologies and properties were described. Results: Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects proosteogenic cellular activities. Many studies reveal increase in bone-to-implant contact (BIC), with increased surface topography modifications on implant surfaces. Conclusions: Increased implant surface topography improves the BIC and the mechanical properties of the enhanced interface. (JMIR Biomed Eng 2019;4(1):e13237) doi: 10.2196/13237
背景：关于表面形貌对种植体骨整合的影响，有各种各样的说法。植入物表面形貌的发展是经验的，需要大量的体外和体内测试。这些测试大多没有标准化，使用了不同的表面、细胞群或动物模型。表面化学和形貌在牙种植体骨整合早期事件中的确切作用尚不清楚。目的：本研究的目的是考虑关于钛种植体表面形貌对骨整合影响的主要主张。钛种植体的骨整合率与其成分和表面粗糙度有关。综述了提高钛种植体表面粗糙度或应用骨传导涂层的不同方法。会议强调了协商一致的重要发现，并揭示了现有的争议。方法：本文参考了医学文献分析与检索系统在线收录的许多研究出版物以及生物医学研究出版物和教科书中的研究出版物。介绍了钛等离子体喷涂、喷砂、酸蚀、碱蚀、阳极氧化、聚合物分层、溶胶-凝胶转化等表面处理方法及其相应的表面形貌和性能。结果：许多体外评估不能预测体内结果或与体内结果相关。在一些培养模型中，表面形貌的增加对成骨细胞活性有积极影响。许多研究表明，随着植入物表面表面形貌修饰的增加，骨与植入物的接触（BIC）增加。结论：植入物表面形貌的增加改善了BIC和增强界面的机械性能。（JMIR Biomed Eng 2019；4（1）：e13237）doi:10.196/13237
{"title":"The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review","authors":"P. Kumar, S. Ks, Vyoma Venkatesh Grandhi, Vrinda Gupta","doi":"10.2196/13237","DOIUrl":"https://doi.org/10.2196/13237","url":null,"abstract":"Background: A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations, or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remains poorly understood. Objective: The aim of this study was to consider the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants were reviewed. Important findings of consensus were highlighted, and existing controversies were revealed. Methods: This paper considered many of the research publications listed in Medical Literature Analysis and Retrieval System Online and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma spraying, grit blasting, acid etching, alkaline etching, anodization, polymer demixing, sol-gel conversion, and their corresponding surface morphologies and properties were described. Results: Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects proosteogenic cellular activities. Many studies reveal increase in bone-to-implant contact (BIC), with increased surface topography modifications on implant surfaces. Conclusions: Increased implant surface topography improves the BIC and the mechanical properties of the enhanced interface. (JMIR Biomed Eng 2019;4(1):e13237) doi: 10.2196/13237","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47897539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Passive joint stiffness can influence the risk of injury and the ability to participate in sports and activities of daily living. However, little is known about how passive joint stiffness changes over time with intensive repetitive exercise, particularly when performing unilateral activities using the dominant upper limb. Objective: This study aimed to investigate the difference in passive wrist quasi-stiffness between the dominant and nondominant upper limb of competitive squash players, compare these results with a previous study on young unskilled subjects, and explore the impact of aging on wrist stiffness. Methods: A total of 7 healthy, right-side dominant male competitive squash players were recruited and examined using the Massachusetts Institute of Technology Wrist-Robot. Subjects were aged between 24 and 72 years (mean 43.7, SD 16.57) and had a mean of 20.6 years of squash playing experience (range 10-53 years, SD 13.85). Torque and displacement data were processed and applied to 2 different estimation methods, the fitting ellipse and the multiple regression method, to obtain wrist stiffness magnitude and orientation. Results: Young squash players (mean 30.75, SD 8.06 years) demonstrated a stiffer dominant wrist, with an average ratio of 1.51, compared with an average ratio of 1.18 in young unskilled subjects. The older squash players (mean 64.67, SD 6.35 years) revealed an average ratio of 0.86 (ie, the nondominant wrist was stiffer than the dominant wrist). There was a statistically significant difference between the magnitude of passive quasi-stiffness between the dominant and nondominant wrist of the young and older squash player groups (P=.004). Conclusions: Findings from this pilot study are novel and contribute to our understanding of the likely long-term effect of highly intensive, unilateral sports on wrist quasi-stiffness and the aging process: adults who participate in repetitive sporting exercise may experience greater joint quasi-stiffness when they are younger than 45 years and more flexibility when they are older than 60 years.
{"title":"The Impact of Aging and Hand Dominance on the Passive Wrist Stiffness of Squash Players: Pilot Study","authors":"Taya Hamilton, S. Durand, H. Krebs","doi":"10.2196/11670","DOIUrl":"https://doi.org/10.2196/11670","url":null,"abstract":"Background: Passive joint stiffness can influence the risk of injury and the ability to participate in sports and activities of daily living. However, little is known about how passive joint stiffness changes over time with intensive repetitive exercise, particularly when performing unilateral activities using the dominant upper limb. Objective: This study aimed to investigate the difference in passive wrist quasi-stiffness between the dominant and nondominant upper limb of competitive squash players, compare these results with a previous study on young unskilled subjects, and explore the impact of aging on wrist stiffness. Methods: A total of 7 healthy, right-side dominant male competitive squash players were recruited and examined using the Massachusetts Institute of Technology Wrist-Robot. Subjects were aged between 24 and 72 years (mean 43.7, SD 16.57) and had a mean of 20.6 years of squash playing experience (range 10-53 years, SD 13.85). Torque and displacement data were processed and applied to 2 different estimation methods, the fitting ellipse and the multiple regression method, to obtain wrist stiffness magnitude and orientation. Results: Young squash players (mean 30.75, SD 8.06 years) demonstrated a stiffer dominant wrist, with an average ratio of 1.51, compared with an average ratio of 1.18 in young unskilled subjects. The older squash players (mean 64.67, SD 6.35 years) revealed an average ratio of 0.86 (ie, the nondominant wrist was stiffer than the dominant wrist). There was a statistically significant difference between the magnitude of passive quasi-stiffness between the dominant and nondominant wrist of the young and older squash player groups (P=.004). Conclusions: Findings from this pilot study are novel and contribute to our understanding of the likely long-term effect of highly intensive, unilateral sports on wrist quasi-stiffness and the aging process: adults who participate in repetitive sporting exercise may experience greater joint quasi-stiffness when they are younger than 45 years and more flexibility when they are older than 60 years.","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47131450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Àngels Salvador Vergés, L. Fernández-Luque, Meltem Yıldırım, Bertran Salvador-Mata, Francesc García Cuyàs
Background: Over the past 60 years, no technique used for treating cartilage disorders has been completely successful. Bioprinting provides a highly anticipated, novel alternative solution to this problem. However, identifying barriers to this new technology is crucial in order to overcome them when bioprinting reaches the implementation stage. This kind of research has been declared essential because clinical efficacy and safety studies alone do not always lead to successful implementation. Objective: This qualitative study aimed to explore the stance of orthopedic surgeons on the use of bioprinted cartilage grafts for cartilaginous lesions. The study sought to summarize and classify the barriers and facilitators of this technique and to identify the key factors for successful implementation of bioprinted cartilage in routine clinical practice. Methods: A qualitative thematic analysis method was used to evaluate data obtained from semistructured interviews and from focus groups. Data were collected between June 2017 and February 2018. Interviews focused on the collection of expert opinions on bioprinted cartilage. Results: The perceived barriers to the adoption of this technology were (1) awareness of a lack of information on the status and possibilities of this technology, (2) uncertainty regarding compliance with current health care regulations and policies, and (3) demands for clinical evidence. The facilitators were (1) lack of surgical alternatives, (2) the perception that research is the basis of the current health system, and (3) the hope of offering a better quality of life to patients. Conclusions: The results of this study are preliminary in nature and cannot be generalized without a broader group of participants. However, the key factors identified provide a frame of reference to help understand the challenges of bioprinted cartilage and help facilitate the transition toward its clinical use. These findings will also provide information for use at multidisciplinary meetings in scientific societies; create bridges between researchers, orthopedic surgeons, and regulators; and open a debate on the funding of this technique and the business model that needs to be developed. (JMIR Biomed Eng 2019;4(1):e12148) doi: 10.2196/12148
{"title":"Perspectives of Orthopedic Surgeons on the Clinical Use of Bioprinted Cartilage: Qualitative Study","authors":"Àngels Salvador Vergés, L. Fernández-Luque, Meltem Yıldırım, Bertran Salvador-Mata, Francesc García Cuyàs","doi":"10.2196/12148","DOIUrl":"https://doi.org/10.2196/12148","url":null,"abstract":"Background: Over the past 60 years, no technique used for treating cartilage disorders has been completely successful. Bioprinting provides a highly anticipated, novel alternative solution to this problem. However, identifying barriers to this new technology is crucial in order to overcome them when bioprinting reaches the implementation stage. This kind of research has been declared essential because clinical efficacy and safety studies alone do not always lead to successful implementation. Objective: This qualitative study aimed to explore the stance of orthopedic surgeons on the use of bioprinted cartilage grafts for cartilaginous lesions. The study sought to summarize and classify the barriers and facilitators of this technique and to identify the key factors for successful implementation of bioprinted cartilage in routine clinical practice. Methods: A qualitative thematic analysis method was used to evaluate data obtained from semistructured interviews and from focus groups. Data were collected between June 2017 and February 2018. Interviews focused on the collection of expert opinions on bioprinted cartilage. Results: The perceived barriers to the adoption of this technology were (1) awareness of a lack of information on the status and possibilities of this technology, (2) uncertainty regarding compliance with current health care regulations and policies, and (3) demands for clinical evidence. The facilitators were (1) lack of surgical alternatives, (2) the perception that research is the basis of the current health system, and (3) the hope of offering a better quality of life to patients. Conclusions: The results of this study are preliminary in nature and cannot be generalized without a broader group of participants. However, the key factors identified provide a frame of reference to help understand the challenges of bioprinted cartilage and help facilitate the transition toward its clinical use. These findings will also provide information for use at multidisciplinary meetings in scientific societies; create bridges between researchers, orthopedic surgeons, and regulators; and open a debate on the funding of this technique and the business model that needs to be developed. (JMIR Biomed Eng 2019;4(1):e12148) doi: 10.2196/12148","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44268382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: One of the problems in evaluating clinical practice guidelines (CPGs) is the occurrence of knowledge gaps. These gaps may occur when evaluation logics and definitions in analytics pipelines are translated differently. Objective: The objective of this paper is to develop a systematic method that will fill in the cognitive and computational gaps of CPG knowledge components in analytics pipelines. Methods: We used locally developed CPGs that resulted in care process models (CPMs). We derived adherence definitions from the CPMs, transformed them into computationally executable queries, and deployed them into an enterprise knowledge base that specializes in managing clinical knowledge content. We developed a visual analytics framework, whose data pipelines are connected to queries in the knowledge base, to automate the extraction of data from clinical databases and calculation of evaluation metrics. Results: In this pilot study, we implemented 21 CPMs within the proposed framework, which is connected to an enterprise data warehouse (EDW) as a data source. We built a Web–based dashboard for monitoring and evaluating adherence to the CPMs. The dashboard ran for 18 months during which CPM adherence definitions were updated a number of times. Conclusions: The proposed framework was demonstrated to accommodate complicated knowledge management for CPM adherence evaluation in analytics pipelines using a knowledge base. At the same time, knowledge consistency and computational efficiency were maintained. (JMIR Biomed Eng 2019;4(1):e11659) doi: 10.2196/11659
背景：评估临床实践指南（CPG）的问题之一是知识差距的出现。当分析管道中的评估逻辑和定义被不同地翻译时，可能会出现这些差距。目的：本文的目的是开发一种系统的方法，填补分析管道中CPG知识组件的认知和计算空白。方法：我们使用本地开发的CPG，产生护理过程模型（CPM）。我们从CPM中推导出依从性定义，将其转换为可计算执行的查询，并将其部署到专门管理临床知识内容的企业知识库中。我们开发了一个可视化分析框架，其数据管道连接到知识库中的查询，以自动从临床数据库中提取数据和计算评估指标。结果：在这项试点研究中，我们在所提出的框架内实现了21个CPM，该框架连接到作为数据源的企业数据仓库（EDW）。我们建立了一个基于Web的仪表板，用于监测和评估CPM的遵守情况。该仪表盘运行了18个月，在此期间CPM遵守定义被多次更新。结论：所提出的框架已被证明可以在使用知识库的分析管道中适应CPM依从性评估的复杂知识管理。同时，保持了知识的一致性和计算效率。（JMIR Biomed Eng 2019；4（1）：e11659）doi:10.196/1659
{"title":"An Analytics Framework for Physician Adherence to Clinical Practice Guidelines: Knowledge-Based Approach","authors":"Jaehoon Lee, N. Hulse","doi":"10.2196/11659","DOIUrl":"https://doi.org/10.2196/11659","url":null,"abstract":"Background: One of the problems in evaluating clinical practice guidelines (CPGs) is the occurrence of knowledge gaps. These gaps may occur when evaluation logics and definitions in analytics pipelines are translated differently. Objective: The objective of this paper is to develop a systematic method that will fill in the cognitive and computational gaps of CPG knowledge components in analytics pipelines. Methods: We used locally developed CPGs that resulted in care process models (CPMs). We derived adherence definitions from the CPMs, transformed them into computationally executable queries, and deployed them into an enterprise knowledge base that specializes in managing clinical knowledge content. We developed a visual analytics framework, whose data pipelines are connected to queries in the knowledge base, to automate the extraction of data from clinical databases and calculation of evaluation metrics. Results: In this pilot study, we implemented 21 CPMs within the proposed framework, which is connected to an enterprise data warehouse (EDW) as a data source. We built a Web–based dashboard for monitoring and evaluating adherence to the CPMs. The dashboard ran for 18 months during which CPM adherence definitions were updated a number of times. Conclusions: The proposed framework was demonstrated to accommodate complicated knowledge management for CPM adherence evaluation in analytics pipelines using a knowledge base. At the same time, knowledge consistency and computational efficiency were maintained. (JMIR Biomed Eng 2019;4(1):e11659) doi: 10.2196/11659","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45570348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Heart rate variability (HRV) is derived from the series of R-R intervals extracted from an electrocardiographic (ECG) measurement. Ideally all components of the R-R series are the result of sinoatrial node depolarization. However, the actual R-R series are contaminated by outliers due to heart rhythm disturbances such as ectopic beats, which ought to be detected and corrected appropriately before HRV analysis. Objective: We have introduced a novel, lightweight, and near real-time method to detect and correct anomalies in the R-R series based on the singular spectrum analysis (SSA). This study aimed to assess the performance of the proposed method in terms of (1) detection performance (sensitivity, specificity, and accuracy); (2) root mean square error (RMSE) between the actual N-N series and the approximated outlier-cleaned R-R series; and (3) how it benchmarks against a competitor in terms of the relative RMSE. Methods: A lightweight SSA-based change-point detection procedure, improved through the use of a cumulative sum control chart with adaptive thresholds to reduce detection delays, monitored the series of R-R intervals in real time. Upon detection of an anomaly, the corrupted segment was substituted with the respective outlier-cleaned approximation obtained using recurrent SSA forecasting. Next, N-N intervals from a 5-minute ECG segment were extracted from each of the 18 records in the MIT-BIH Normal Sinus Rhythm Database. Then, for each such series, a number (randomly drawn integer between 1 and 6) of simulated ectopic beats were inserted at random positions within the series and results were averaged over 1000 Monte Carlo runs. Accordingly, 18,000 R-R records corresponding to 5-minute ECG segments were used to assess the detection performance whereas another 180,000 (10,000 for each record) were used to assess the error introduced in the correction step. Overall 198,000 R-R series were used in this study. Results: The proposed SSA-based algorithm reliably detected outliers in the R-R series and achieved an overall sensitivity of 96.6%, specificity of 98.4% and accuracy of 98.4%. Furthermore, it compared favorably in terms of discrepancies of the cleaned R-R series compared with the actual N-N series, outperforming an established correction method on average by almost 30%. Conclusions: The proposed algorithm, which leverages the power and versatility of the SSA to both automatically detect and correct artifacts in the R-R series, provides an effective and efficient complementary method and a potential alternative to the current manual-editing gold standard. Other important characteristics of the proposed method include the ability to operate in near real-time, the almost entirely model-free nature of the framework which does not require historical training data, and its overall low computational complexity. (JMIR Biomed Eng 2019;4(1):e10740) doi: 10.2196/10740 JMIR Biomed Eng 2019 | vol. 4 | iss. 1 | e10740 | p. 1 https://biome
背景:心率变异性(HRV)是从心电图(ECG)测量中提取的一系列R-R间隔中得出的。理想情况下，R-R系列的所有组成部分都是窦房结去极化的结果。然而，实际的R-R系列由于异位搏动等心律紊乱而受到异常值的污染，应在HRV分析之前检测并适当纠正。目的:我们介绍了一种基于奇异谱分析(SSA)的新颖、轻量级、接近实时的方法来检测和纠正R-R序列中的异常。本研究旨在从以下几个方面评估该方法的性能:(1)检测性能(灵敏度、特异性和准确性);(2)实际N-N序列与近似的剔除离群值的R-R序列之间的均方根误差(RMSE);(3)在相对均方根误差方面，它如何与竞争对手进行基准测试。方法:一个轻量级的基于ssa的变化点检测程序，通过使用具有自适应阈值的累积和控制图来改进以减少检测延迟，实时监测R-R区间的序列。一旦检测到异常，损坏的部分被替换为使用循环SSA预测获得的相应的异常值清洗近似。接下来，从MIT-BIH正常窦性心律数据库中的18条记录中提取5分钟心电图段的N-N个间隔。然后，对于每个这样的序列，在序列中的随机位置插入一个数字(随机抽取1到6之间的整数)模拟异位心跳，并在1000次蒙特卡罗运行中对结果进行平均。因此，使用与5分钟心电段相对应的18,000条R-R记录来评估检测性能，而使用另外180,000条(每条记录10,000条)来评估校正步骤中引入的误差。本研究共使用了198,000个R-R系列。结果:基于ssa的算法可靠地检测出R-R序列中的异常值，总体灵敏度为96.6%，特异性为98.4%，准确率为98.4%。此外，在清洗后的R-R序列与实际的N-N序列的差异方面，该方法比现有的校正方法平均高出近30%。结论:该算法利用SSA的功能和多功能性自动检测和纠正R-R系列中的伪影，提供了一种有效和高效的补充方法，并可能替代当前的手动编辑金标准。该方法的其他重要特征包括接近实时的操作能力、框架几乎完全无模型的特性(不需要历史训练数据)以及总体上较低的计算复杂度。[j] . JMIR Biomed Eng 2019;4(1):e10740) doi: 10.2196/107401 | e10740 | p. 1 https://biomedeng.jmir.org/2019/1/e10740/(页码不用于引用目的)Lang JMIR BIOMEDICAL ENGINEERING
{"title":"Automatic Near Real-Time Outlier Detection and Correction in Cardiac Interbeat Interval Series for Heart Rate Variability Analysis: Singular Spectrum Analysis-Based Approach","authors":"M. Lang","doi":"10.2196/10740","DOIUrl":"https://doi.org/10.2196/10740","url":null,"abstract":"Background: Heart rate variability (HRV) is derived from the series of R-R intervals extracted from an electrocardiographic (ECG) measurement. Ideally all components of the R-R series are the result of sinoatrial node depolarization. However, the actual R-R series are contaminated by outliers due to heart rhythm disturbances such as ectopic beats, which ought to be detected and corrected appropriately before HRV analysis. Objective: We have introduced a novel, lightweight, and near real-time method to detect and correct anomalies in the R-R series based on the singular spectrum analysis (SSA). This study aimed to assess the performance of the proposed method in terms of (1) detection performance (sensitivity, specificity, and accuracy); (2) root mean square error (RMSE) between the actual N-N series and the approximated outlier-cleaned R-R series; and (3) how it benchmarks against a competitor in terms of the relative RMSE. Methods: A lightweight SSA-based change-point detection procedure, improved through the use of a cumulative sum control chart with adaptive thresholds to reduce detection delays, monitored the series of R-R intervals in real time. Upon detection of an anomaly, the corrupted segment was substituted with the respective outlier-cleaned approximation obtained using recurrent SSA forecasting. Next, N-N intervals from a 5-minute ECG segment were extracted from each of the 18 records in the MIT-BIH Normal Sinus Rhythm Database. Then, for each such series, a number (randomly drawn integer between 1 and 6) of simulated ectopic beats were inserted at random positions within the series and results were averaged over 1000 Monte Carlo runs. Accordingly, 18,000 R-R records corresponding to 5-minute ECG segments were used to assess the detection performance whereas another 180,000 (10,000 for each record) were used to assess the error introduced in the correction step. Overall 198,000 R-R series were used in this study. Results: The proposed SSA-based algorithm reliably detected outliers in the R-R series and achieved an overall sensitivity of 96.6%, specificity of 98.4% and accuracy of 98.4%. Furthermore, it compared favorably in terms of discrepancies of the cleaned R-R series compared with the actual N-N series, outperforming an established correction method on average by almost 30%. Conclusions: The proposed algorithm, which leverages the power and versatility of the SSA to both automatically detect and correct artifacts in the R-R series, provides an effective and efficient complementary method and a potential alternative to the current manual-editing gold standard. Other important characteristics of the proposed method include the ability to operate in near real-time, the almost entirely model-free nature of the framework which does not require historical training data, and its overall low computational complexity. (JMIR Biomed Eng 2019;4(1):e10740) doi: 10.2196/10740 JMIR Biomed Eng 2019 | vol. 4 | iss. 1 | e10740 | p. 1 https://biome","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42007044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leia C. Shum, Bulmaro A. Valdés, H. V. D. Van der Loos
Background: As commercial motion tracking technology becomes more readily available, it is necessary to evaluate the accuracy of these systems before using them for biomechanical and motor rehabilitation applications. Objective: This study aimed to evaluate the relative position accuracy of the Oculus Touch controllers in a 2.4 x 2.4 m play-space. Methods: Static data samples (n=180) were acquired from the Oculus Touch controllers at step sizes ranging from 5 to 500 mm along 16 different points on the play-space floor with graph paper in the x (width), y (height), and z (depth) directions. The data were compared with reference values using measurements from digital calipers, accurate to 0.01 mm; physical blocks, for which heights were confirmed with digital calipers; and for larger step sizes (300 and 500 mm), a ruler with hatch marks to millimeter units. Results: It was found that the maximum position accuracy error of the system was 3.5 ± 2.5 mm at the largest step size of 500 mm along the z-axis. When normalized to step size, the largest error found was 12.7 ± 9.9% at the smallest step size in the y-axis at 6.23 mm. When the step size was <10 mm in any direction, the relative position accuracy increased considerably to above 2% (approximately 2 mm at maximum). An average noise value of 0.036 mm was determined. A comparison of these values to cited visual, goniometric, and proprioceptive resolutions concludes that this system is viable for tracking upper-limb movements for biomechanical and rehabilitation applications. The accuracy of the system was also compared with accuracy values from previous studies using other commercially available devices and a multicamera, marker-based professional motion tracking system. Conclusions: The study found that the linear position accuracy of the Oculus Touch controllers was within an agreeable range for measuring human kinematics in rehabilitative upper-limb exercise protocols. Further testing is required to ascertain acceptable repeatability in multiple sessions and rotational accuracy. (JMIR Biomed Eng 2019;4(1):e12291) doi: 10.2196/12291
{"title":"Determining the Accuracy of Oculus Touch Controllers for Motor Rehabilitation Applications Using Quantifiable Upper Limb Kinematics: Validation Study","authors":"Leia C. Shum, Bulmaro A. Valdés, H. V. D. Van der Loos","doi":"10.2196/12291","DOIUrl":"https://doi.org/10.2196/12291","url":null,"abstract":"Background: As commercial motion tracking technology becomes more readily available, it is necessary to evaluate the accuracy of these systems before using them for biomechanical and motor rehabilitation applications. Objective: This study aimed to evaluate the relative position accuracy of the Oculus Touch controllers in a 2.4 x 2.4 m play-space. Methods: Static data samples (n=180) were acquired from the Oculus Touch controllers at step sizes ranging from 5 to 500 mm along 16 different points on the play-space floor with graph paper in the x (width), y (height), and z (depth) directions. The data were compared with reference values using measurements from digital calipers, accurate to 0.01 mm; physical blocks, for which heights were confirmed with digital calipers; and for larger step sizes (300 and 500 mm), a ruler with hatch marks to millimeter units. Results: It was found that the maximum position accuracy error of the system was 3.5 ± 2.5 mm at the largest step size of 500 mm along the z-axis. When normalized to step size, the largest error found was 12.7 ± 9.9% at the smallest step size in the y-axis at 6.23 mm. When the step size was <10 mm in any direction, the relative position accuracy increased considerably to above 2% (approximately 2 mm at maximum). An average noise value of 0.036 mm was determined. A comparison of these values to cited visual, goniometric, and proprioceptive resolutions concludes that this system is viable for tracking upper-limb movements for biomechanical and rehabilitation applications. The accuracy of the system was also compared with accuracy values from previous studies using other commercially available devices and a multicamera, marker-based professional motion tracking system. Conclusions: The study found that the linear position accuracy of the Oculus Touch controllers was within an agreeable range for measuring human kinematics in rehabilitative upper-limb exercise protocols. Further testing is required to ascertain acceptable repeatability in multiple sessions and rotational accuracy. (JMIR Biomed Eng 2019;4(1):e12291) doi: 10.2196/12291","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68428666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Plante, Anna C. O'Kelly, Bruno Urrea, Zane T. Macfarlane, L. Appel, Edgar R Miller III, R. Blumenthal, S. Martin
Background: mHealth apps that measure heart rate using pulse photoplethysmography (PPG) are classified as class II (moderate-risk) Food and Drug Administration devices; therefore, these devices need clinical validation prior to public release. The Auralife Instant Blood Pressure app (AuraLife IBP app) is an mHealth app that measures blood pressure inaccurately based on a previous validation study. Its ability to measure heart rate has not been previously reported. Objective: The objective of our study was to assess the accuracy and precision of the AuraLife IBP app in measuring heart rate. Methods: We enrolled 85 adults from ambulatory clinics. Two measurements were obtained using the AuraLife IBP app, and 2 other measurements were achieved with a oscillometric device. The order of devices was randomized. Accuracy was assessed by calculating the relative and absolute mean differences between heart rate measurements obtained using each AuraLife IBP app and an average of both standard heart rate measurements. Precision was assessed by calculating the relative and absolute mean differences between individual measurements in the pair for each device. Results: The relative and absolute mean (SD) differences between the devices were 1.1 (3.5) and 2.8 (2.4) beats per minute (BPM), respectively. Meanwhile, the within-device relative and absolute mean differences, respectively, were <0.1 (2.2) and 1.7 (1.4) BPM for the standard device and −0.1 (3.2) and 2.2 (2.3) BPM for the AuraLife IBP app. Conclusions: The AuraLife IBP app had a high degree of accuracy and precision in the measurement of heart rate. This supports the use of PPG technology in smartphones for monitoring resting heart rate. (JMIR Biomed Eng 2018;3(1):e11057) doi: 10.2196/11057
背景：使用脉冲光电体积描记术（PPG）测量心率的mHealth应用程序被归类为II类（中等风险）食品和药物管理局设备；因此，这些设备在公开发布之前需要进行临床验证。Auralife即时血压应用程序（Auralife IBP应用程序）是一款mHealth应用程序，它根据之前的验证研究不准确地测量血压。它测量心率的能力以前没有报道过。目的：我们研究的目的是评估AuraLife IBP应用程序在测量心率方面的准确性和精密度。方法：我们从门诊诊所招募了85名成年人。使用AuraLife IBP应用程序进行了两次测量，另外两次测量使用示波设备进行。器械的顺序是随机的。通过计算使用每个AuraLife IBP应用程序获得的心率测量值与两个标准心率测量值的平均值之间的相对和绝对平均差来评估准确性。通过计算每种设备的成对个体测量之间的相对和绝对平均差来评估精度。结果：两种设备之间的相对平均值和绝对平均值差异分别为1.1（3.5）和2.8（2.4）次/分（BPM）。同时，标准设备的设备内相对平均差和绝对平均差分别<0.1（2.2）和1.7（1.4）BPM，AuraLife IBP应用程序的设备内平均差分别为-0.1（3.2）和2.2（2.3）BPM。结论：AuraLife IBP应用程序在心率测量方面具有较高的准确性和精密度。这支持在智能手机中使用PPG技术来监测静息心率。（JMIR Biomed Eng 2018；3（1）：e11057）doi:10.196/11057
{"title":"Auralife Instant Blood Pressure App in Measuring Resting Heart Rate: Validation Study","authors":"T. Plante, Anna C. O'Kelly, Bruno Urrea, Zane T. Macfarlane, L. Appel, Edgar R Miller III, R. Blumenthal, S. Martin","doi":"10.2196/11057","DOIUrl":"https://doi.org/10.2196/11057","url":null,"abstract":"Background: mHealth apps that measure heart rate using pulse photoplethysmography (PPG) are classified as class II (moderate-risk) Food and Drug Administration devices; therefore, these devices need clinical validation prior to public release. The Auralife Instant Blood Pressure app (AuraLife IBP app) is an mHealth app that measures blood pressure inaccurately based on a previous validation study. Its ability to measure heart rate has not been previously reported. Objective: The objective of our study was to assess the accuracy and precision of the AuraLife IBP app in measuring heart rate. Methods: We enrolled 85 adults from ambulatory clinics. Two measurements were obtained using the AuraLife IBP app, and 2 other measurements were achieved with a oscillometric device. The order of devices was randomized. Accuracy was assessed by calculating the relative and absolute mean differences between heart rate measurements obtained using each AuraLife IBP app and an average of both standard heart rate measurements. Precision was assessed by calculating the relative and absolute mean differences between individual measurements in the pair for each device. Results: The relative and absolute mean (SD) differences between the devices were 1.1 (3.5) and 2.8 (2.4) beats per minute (BPM), respectively. Meanwhile, the within-device relative and absolute mean differences, respectively, were <0.1 (2.2) and 1.7 (1.4) BPM for the standard device and −0.1 (3.2) and 2.2 (2.3) BPM for the AuraLife IBP app. Conclusions: The AuraLife IBP app had a high degree of accuracy and precision in the measurement of heart rate. This supports the use of PPG technology in smartphones for monitoring resting heart rate. (JMIR Biomed Eng 2018;3(1):e11057) doi: 10.2196/11057","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42189482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The proposed experimental design was devised to determine whether a relationship exists between the occlusal load applied and the size of the markings produced from tooth contact when dental articulating paper and T-Scan are interposed alternatively. Objective: The objective of our study was to compare the relationship between contact markings on an articulating paper and T-Scan for an applied occlusal load. Methods: In this in vitro study, dentulous maxillary and mandibular dies were mounted on a metal jig and articulating paper and T-Scan sensor were placed alternatively between the casts. Loads simulating occlusal loads began at 25 N and incrementally continued up to 450 N. The resultant markings (180 marks resulting from articulating paper and 138 from T-Scan) were photographed, and the marks were analyzed using MOTIC image analysis and sketching software. Descriptive statistical analyses were performed using one-way analysis of variance, Student t test, and Pearson correlation coefficient method. Results: Statistical interpretation of the data indicated that with articulating paper, the mark area increased nonlinearly with increasing load and there was a false-positive result. The characteristics of the paper mark appearance did not describe the amount of occlusal load present on a given tooth. The contact marking obtained using T-Scan for an applied occlusal load indicated that the mark area increased with increase in the load and provided more predictable results of actual load content within the occlusal contact. Conclusions: The size of an articulating paper mark may not be a reliable predictor of the actual load content within the occlusal contact, whereas a T-Scan provides more predictable results of the actual load content within the occlusal contact. (JMIR Biomed Eng 2018;3(1):e11347) doi: 10.2196/11347
{"title":"Relationship Between the Applied Occlusal Load and the Size of Markings Produced Due to Occlusal Contact Using Dental Articulating Paper and T-Scan: Comparative Study","authors":"Shravya Reddy, P. Kumar, Vyoma Venkatesh Grandhi","doi":"10.2196/11347","DOIUrl":"https://doi.org/10.2196/11347","url":null,"abstract":"Background: The proposed experimental design was devised to determine whether a relationship exists between the occlusal load applied and the size of the markings produced from tooth contact when dental articulating paper and T-Scan are interposed alternatively. Objective: The objective of our study was to compare the relationship between contact markings on an articulating paper and T-Scan for an applied occlusal load. Methods: In this in vitro study, dentulous maxillary and mandibular dies were mounted on a metal jig and articulating paper and T-Scan sensor were placed alternatively between the casts. Loads simulating occlusal loads began at 25 N and incrementally continued up to 450 N. The resultant markings (180 marks resulting from articulating paper and 138 from T-Scan) were photographed, and the marks were analyzed using MOTIC image analysis and sketching software. Descriptive statistical analyses were performed using one-way analysis of variance, Student t test, and Pearson correlation coefficient method. Results: Statistical interpretation of the data indicated that with articulating paper, the mark area increased nonlinearly with increasing load and there was a false-positive result. The characteristics of the paper mark appearance did not describe the amount of occlusal load present on a given tooth. The contact marking obtained using T-Scan for an applied occlusal load indicated that the mark area increased with increase in the load and provided more predictable results of actual load content within the occlusal contact. Conclusions: The size of an articulating paper mark may not be a reliable predictor of the actual load content within the occlusal contact, whereas a T-Scan provides more predictable results of the actual load content within the occlusal contact. (JMIR Biomed Eng 2018;3(1):e11347) doi: 10.2196/11347","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44541231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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