Investigating the Effectiveness of an IMU Portable Gait Analysis Device: An Application for Parkinson’s Disease Management

As part of two research projects, a small gait analysis device was developed for use inside and outside the home by patients themselves. The project PARMODE aims to record accurate gait measurements in patients with Parkinson’s disease (PD) and proceed with an in-depth analysis of the gait characteristics, while the project CPWATCHER aims to assess the quality of hand movement in cerebral palsy patients. The device was mainly developed to serve the first project with additional offline processing, including machine learning algorithms that could potentially be used for the second aim. A key feature of the device is its small size (36 mm × 46 mm × 16 mm, weight: 14 g), which was designed to meet specific requirements in terms of device consumption restrictions due to the small size of the battery and the need for autonomous operation for more than ten hours. This research work describes, on the one hand, the new device with an emphasis on its functions, and on the other hand, its connection with a web platform for reading and processing data from the devices placed on patients’ feet to record the gait characteristics of patients on a continuous basis

Commercially available sensor-based monitoring and support systems in parkinson's disease: An overview

Parkinson's disease is a progressive neurodegenerative disorder correlating with dysfunction or deprivation of brains dopaminergic neurons, lack of dopamine, and the formation of abnormal protein particles. There are several clinical tests for detection of Parkinson's disease, but nowadays a demand is rising for an objective assessment of symptoms and health-related outcomes. The rapid development of sensor-based technological devices permits conducting measurements without bias that they are able to be used in scientific research and clinical practice. This paper provides a technical overview of the available commercial wearable systems for monitoring and supporting Parkinson's disease management, taking into account their validity and reliability. The understanding of the current state-of-the-art could help patients and clinicians significantly improve Parkinson's disease management by minimizing health care costs and increasing patient's quality of life. © 2021 Bharati Vidyapeeth, New Delhi. Copy Right in Bulk will be transferred to IEEE by Bharati Vidyapeeth

The management of complicated colorectal cancer in older patients in a global perspective after COVID-19: the CO-OLDER WSES project

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CRC. Early diagnosis of CRC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be managed when they are symptomatic in the emergency setting with high morbidity and mortality rates. Our main aim is to provide clinical data about the management of elderly patients presenting complicated colorectal cancer who required emergency surgical management to improve their care. METHODS: The management of complicated COlorectal cancer in OLDER patients (CO-OLDER; ClinicalTrials.gov ID: NCT05788224; evaluated by the local ethical committee CPP EST III-France with the national number 2023-A01094-41) in the emergency setting project provides carrying out an observational multicenter international cohort study aimed to collect data about patients aged ≥75 years to assess modifiable risk factors for negative outcomes and mortality correlated to the emergency surgical management of this group of patients at risk admitted with a complicated (obstructed and perforated) CRC. The CO-OLDER protocol was approved by Institutional Review Board and released. Each CO-OLDER collaborator is asked to enroll ≥25 patients over a study period from 1st January 2018 to 30th October 2023. Data will be analyzed comparing two periods of study: before and after the COVID-19 pandemic. A sample size of 240 prospectively enrolled patients with obstructed colorectal cancer in a 5-month period was calculated. The secured database for entering anonymized data will be available for the period necessary to achieve the highest possible participation. RESULTS: One hundred eighty hospitals asked to be a CO-OLDER collaborator, with 36 potentially involved countries over the world. CONCLUSIONS: The CO-OLDER project aims to improve the management of elderly people presenting with a complicated colorectal cancer in the emergency setting. Our observational global study can provide valuable data on the effectiveness of different management strategies in improving primary assessment, management and outcomes for elderly patients with obstructed or perforated colorectal cancer in the emergency setting, guiding clinical decision-making. This information can help healthcare providers make informed decisions about the best course of action for these patients

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)