Validating a method for the estimate of gait spatio-temporal parameters with IMUs data on healthy and impaired people from two clinical centers

Instrumented gait analysis offers objective clinical outcome assessment. To this purpose, inertial measurement units (IMUs) represent nowadays a very effective solution due to their limited cost, ease of use and improved wearability. The aim of this study was to apply a well-documented IMU-based method to measure gait spatio-temporal parameters in a large number of healthy and gait-impaired subjects, and evaluate its robustness and validity across two clinical centers. Overall, the results of this work represent a robust and reliable foundation for the clinical use of the proposed IMU based method for gait parameters estimation

Pressure ulcers management: an economic evaluation

Introduction. Pressure ulcer management represents a growing problem for medical and social health care systems all over the world, particularly in European Union countries where the incidence of pressure ulcers in older persons (> 60 years of age) is predicted to rise. Objectives. The aim of this study was to provide evidence for the lower impact on economic resources of using advanced dressings for the treatment of pressure ulcers with respect to conventional simple dressings. Methods. Two different models of analysis, derived from Activity Based Costing and Health Technology Assessment, were used to measure, over a 30-day period, the direct costs incurred by pressure ulcer treatment for community-residing patients receiving integrated home care. Results. Although the mean cost per home care visit was higher in the advanced dressings patient group than in the simple dressings patient one (? 22.31 versus ? 16.03), analysis of the data revealed that the cost of using advanced dressings was lower due to fewer home care visits (22 versus 11). Conclusion. The results underline the fact that decision-makers need to improve their understanding of the advantages of taking a long-term view with regards to the purchase and use of materials. This could produce considerable savings of resources in addition to improving treatment efficacy for the benefit of patients and the health care system

Extension of the rigid‐constraint method for the heuristic suboptimal parameter tuning to ten sensor fusion algorithms using inertial and magnetic sensing

The orientation of a magneto‐inertial measurement unit can be estimated using a sensor fusion algorithm (SFA). However, orientation accuracy is greatly affected by the choice of the SFA parameter values which represents one of the most critical steps. A commonly adopted approach is to fine‐tune parameter values to minimize the difference between estimated and true orientation. However, this can only be implemented within the laboratory setting by requiring the use of a concurrent gold‐standard technology. To overcome this limitation, a Rigid‐Constraint Method (RCM) was proposed to estimate suboptimal parameter values without relying on any orientation reference. The RCM method effectiveness was successfully tested on a single‐parameter SFA, with an average error increase with respect to the optimal of 1.5 deg. In this work, the applicability of the RCM was evaluated on 10 popular SFAs with multiple parameters under different experimental scenarios. The average residual between the optimal and suboptimal errors amounted to 0.6 deg with a maximum of 3.7 deg. These encouraging results suggest the possibility to properly tune a generic SFA on different scenarios without using any reference. The synchronized dataset also including the optical data and the SFA codes are available online

An optimal procedure for stride length estimation using foot-mounted magneto-inertial measurement units

Stride length is often used to quantitatively evaluate human locomotion performance. Stride by stride estimation can be conveniently obtained from the signals recorded using miniaturized inertial sensors attached to the feet and appropriate algorithms for data fusion and integration. To reduce the detrimental drift effect, different algorithmic solutions can be implemented. However, the overall method accuracy is supposed to depend on the optimal selection of the parameters which are required to be set. This study aimed at evaluating the influence of the main parameters involved in well-established methods for stride length estimation. An optimization process was conducted to improve methods' performance and preferable values for the considered parameters according to different walking speed ranges are suggested. A parametric solution is also proposed to target the methods on specific subjects' gait characteristics. The stride length estimates were obtained from straight walking trials of five healthy volunteers and were compared with those obtained from a stereo-photogrammetric system. After parameters tuning, percentage errors for stride length were 1.9%, 2.5% and 2.6% for comfortable, slow, and fast walking conditions, respectively

Analysis of the accuracy of ten algorithms for orientation estimation using inertial and magnetic sensing under optimal conditions: One size does not fit all

The orientation of a magneto and inertial measurement unit (MIMU) is estimated by means of sensor fusion algorithms (SFAs) thus enabling human motion tracking. However, despite several SFAs implementations proposed over the last decades, there is still a lack of consensus about the best performing SFAs and their accuracy. As suggested by recent literature, the filter parameters play a central role in determining the orientation errors. The aim of this work is to analyze the accuracy of ten SFAs while running under the best possible conditions (i.e., their parameter values are set using the orientation reference) in nine experimental scenarios including three rotation rates and three commercial products. The main finding is that parameter values must be specific for each SFA according to the experimental scenario to avoid errors comparable to those obtained when the de-fault parameter values are used. Overall, when optimally tuned, no statistically significant differ-ences are observed among the different SFAs in all tested experimental scenarios and the absolute errors are included between 3.8 deg and 7.1 deg. Increasing the rotation rate generally leads to a significant performance worsening. Errors are also influenced by the MIMU commercial model. SFA MATLAB implementations have been made available online

Overcoming barriers to the effective management of severe asthma in Italy

Introduction: People with severe asthma (SA) often have poor disease control and quality of life, and are at high risk of exacerbations, lung function decline and asthma-related death. The present expert opinion article aimed to identify unmet needs in the management of SA in Italy, and propose possible solutions to address these needs. Methods: At five multidisciplinary events in Italy, attendees identified factors that interfered with the effective management of SA and suggested how these barriers could be overcome. A core group of 12 Italian experts (pulmonologists, general practitioners, allergists, payers and patients) identified the main issues and proposed possible solutions based on the results from the meetings and relevant articles from the literature. Results and Conclusions: We reviewed the gap between real-world practice and guide-lines, oral corticosteroid overuse, SA-related mortality, and barriers to effective SA treat-ment. Common themes were lack of awareness about SA among both patients and clinicians, and lack of networking/information exchange between those involved in the treatment of SA. Participants agreed on the need to implement patient education and create multidisciplinary groups of specialists to improve SA management through multidisciplinary educational initiatives, meetings with local experts, development of a flow chart for referral/connection with local experts and specialized centers. Clinical instruments that might help specialists improve SA management included referral networks, integrated care pathways, phenotyping and treatment algorithms, exacerbation tracking, and examination of electronic medical records for patients with uncontrolled asthma. The following actions need to be implemented in Italy: i) maximize the use of advanced therapies, eg, biologics; ii) increase/improve education for physicians and patients; iii) improve multidisciplinary communication and care coordination; iv) introduce regional and local protocols for SA diagnosis and treatment; and v) change the structure of healthcare services to reduce specialist waiting times and facilitate access to biologic therapies

Genome-wide association study provides insights into genes related with horn development in Nelore beef cattle.

Abstract The causal mutation for polledness in Nelore (Bos taurus indicus) breed seems to have appeared first in Brazil in 1957. The expression of the polled trait is known to be ruled by a few groups of alleles in taurine breeds; however, the genetic basis of this trait in indicine cattle is still unclear. The aim of this study was to identify genomic regions associated with the hornless trait in a commercial Nelore population. A total of 107,294 animals had phenotypes recorded and 2,238 were genotyped/imputed for 777k SNP. The weighted single-step approach for genome-wide association study (WssGWAS) was used to estimate the SNP effects and variances accounted for by 1 Mb sliding SNP windows. A centromeric region of chromosome 1 with 3.11 Mb size (BTA1: 878,631?3,987,104 bp) was found to be associated with hornless in the studied population. A total of 28 protein-coding genes are mapped in this region, including the taurine Polled locus and the IFNAR1, IFNAR2, IFNGR2, KRTAP11-1, MIS18A, OLIG1, OLIG2, and SOD1 genes, which expression can be related to the horn formation as described in literature. The functional enrichment analysis by DAVID tool revealed cytokine-cytokine receptor interaction, JAK-STAT signaling, natural killer cell mediated cytotoxicity, and osteoclast differentiation pathways as significant (P < 0.05). In addition, a runs of homozygosity (ROH) analysis identified a ROH island in polled animals with 2.47 Mb inside the region identified by WssGWAS. Polledness in Nelore cattle is associated with one region in the genome with 3.1 Mb size in chromosome 1. Several genes are harbored in this region, and they may act together in the determination of the polled/horned phenotype. Fine mapping the locus responsible for polled trait in Nelore breed and the identification of the molecular mechanisms regulating the horn growth deserve further investigation

The biocompatibility of titanium in a buffer solution: compared effects of a thin film of TiO2 deposited by MOCVD and of collagen deposited from a gel

This study aims at evaluating the biocompatibility of titanium surfaces modified according two different ways: (i) deposition of a bio-inert, thin film of rutile TiO2 by chemical vapour deposition (MOCVD), and (ii) biochemical treatment with collagen gel, in order to obtain a bio-interactive coating. Behind the comparison is the idea that either the bio-inert or the bio-active coating has specific advantages when applied to implant treatment, such as the low price of the collagen treatment for instance. The stability in buffer solution was evaluated by open circuit potential (OCP) for medium time and cyclic voltametry. The OCP stabilized after 5104 min for all the specimens except the collagen treated sample which presented a stable OCP from the first minutes. MOCVD treated samples stabilized to more electropositive values. Numeric results were statistically analysed to obtain the regression equations for long time predictable evolution. The corrosion parameters determined from cyclic curves revealed that the MOCVD treatment is an efficient way to improve corrosion resistance. Human dermal fibroblasts were selected for cell culture tests, taking into account that these cells are present in all bio-interfaces, being the main cellular type of connective tissue. The cells grew on either type of surface without phenotype modification. From the reduction of yellow, water-soluble 3-(4,5-dimethyldiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT cytotoxicity test), MOCVD treated samples offer better viability than mechanically polished Ti and collagen treated samples as well. Cell spreading, as evaluated from microscope images processed by the program Sigma Scan, showed also enhancement upon surface modification. Depending on the experimental conditions, MOCVD deposited TiO2 exhibits different nanostructures that may influence biological behaviour. The results demonstrate the capacity of integration in simulated physiologic liquids for an implant pretreated by either method