[Structural Design and Analysis of Portable Intelligent Wheelchair for Knee Rehabilitation].

Objective: In order to address the issues of inconvenience, high medical costs, and lack of universality associated with traditional knee rehabilitation equipment, a portable intelligent wheelchair for knee rehabilitation was designed in this study. Methods: Based on the analysis of the knee joint's structure and rehabilitation mechanisms, an electric pushrod-driven rehabilitation institution was developed. A multi-functional module was designed with a modular approach, and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer. A three-dimensional model was established using SolidWorks software. In conjunction with Adams and Ansys simulation software, kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components. A prototype was constructed to verify the equipment's actual performance. Results: According to the prototype testing, the actual range of motion for the knee joint swing rod is 15.1°~88.9°, the angular speed of the swing rod ranges from -7.9 to 8.1°/s, the angular acceleration of the swing rod varies from -4.2 to 1.6°/s², the thrust range of the electric pushrod is -82.6 to 153.1 N, and the maximum displacement of the load pedal is approximately 1.7 mm, with the leg support exhibiting a maximum deformation of about 1.5 mm. Conclusion: The intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria, thus validating the rationality and feasibility of the structural design.

In-hospital nursing care intervention increasing the effect of vacuum sealing drainage on wound healing: A meta-analysis.

Vacuum sealing drainage (VSD) could effectively drain superficial wounds and deep tissues, which is beneficial for wound healing. More incentives in nursing care to improve the therapeutic effect of VSD on wound healing were further investigated. Different databases were retrieved for full-text publications about the comparison between intervention nursing care and regular nursing care. Heterogeneity was detected by I2 method, and a random-effect model was applied for data pooling if there existed heterogeneity. Publication bias was analysed by a funnel plot. Eight studies with 762 patients were included for final meta-analysis. In the nursing care intervention group, shorter hospital stay duration (pooled SMD = -2.602, 95% confidence interval: -4.052--1.151), shorter wound healing time (pooled SMD = -1.105, 95% confidence interval: -1.857--0.353), lower pain score (pooled SMD = -2.490, 95% confidence interval: -3.521--1.458), lower drainage tube blocked rate (pooled RR = 0.361, 95% confidence interval: 0.268-0.486), and higher nursing satisfaction (pooled RR = 1.164, 95% confidence interval: 1.095-1.237) was confirmed. More active and incentive nursing care could significantly improve the therapeutic effect of VSD on wound healing, in terms of hospitalisation time, wound healing time, painful symptoms, drainage tube blockage, and nursing satisfaction.

Efficacy and safety of filgotinib in patients with rheumatoid arthritis and inadequate response to disease-modifying antirheumatic drugs (DMARDs): A meta-analysis of randomized controlled trials.

BACKGROUND: Filgotinib has been approved for the treatment of rheumatoid arthritis (RA) in adults who respond inadequately to disease-modifying antirheumatic drugs (DMARDs) in Europe and Japan. Several randomized controlled trials (RCTs) have investigated its efficacy and safety in adult patients with RA. This meta-analysis aimed to study the efficacy and safety of filgotinib in patients with RA withan inadequate response to methotrexateor other DMARDs. METHODS: A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and Cochrane Library from inceptionto December 1, 2021. Outcomes of interest included ACR20/50/70 responses, DAS28-CRP ≤ 3.2, SF-36 PCS Score, FACIT-fatigue, SDAI,CDAI, and HAQ-DI, which were assessed after treatment. The safety outcomes included treatment-emergent adverse events (TEAEs) and serious TEAEs. Odds ratios (ORs) with 95% confidence intervals (CI) were pooled for categorical variables, and the mean difference with 95%CI were pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS: Four RCTs comparing filgotinib (200 and 100 mg once daily) with placebo were identified. Compared with placebo, 200 and 100 mg filgotinib was more effective in achieving ACR20/50/70 responses and other outcomes at weeks 12 and 24 (P < 0.05), with no significant difference in safety outcomes (P > 0.05). Filgotinib 200 mg performed better than filgotinib 100 mg in terms of ACR20/50 responses, DAS28-CRP ≤ 3.2, SDAI, and CDAI at weeks 12 and 24, and caused fewer serious TEAEs than the 100 mg dose. CONCLUSIONS: Filgotinib is effective in the treatment of RA, and the 200 mg dose has a more beneficialprofile thanthe 100 mg dose.

Efficacy of Sinus Tarsal Approach Compared With Conventional L-Shaped Lateral Approach in the Treatment of Calcaneal Fractures: A Meta-Analysis.

Background: This study aims to compare the efficacy of the sinus tarsal approach (STA) with that of the conventional L-shaped lateral approach (CLSLA) in the treatment of calcaneal fractures by meta-analysis. Methods: PubMed, Embase, Web of Science, the Chinese National Knowledge Infrastructure, and China Wanfang database were searched to collect clinical randomized or non-randomized controlled trials of STA and CLSLA in the treatment of calcaneal fractures from January 2010 to May 2020. The data were analyzed by Stata 15.0 software. Results: A total of 12 clinical trials were included, all of which were retrospective studies, including 961 patients. The results showed that when STA was compared with CLSLA, there was no difference in operation time with mean difference (MD) = -5.51 [95% confidence interval (CI): -12.57 to 1.55, P > 0.05], less bleeding during operation with MD = -18.49 (95% CI:-23.79 to -13.18), no difference in Böhler angle after an operation with MD = 0.78 (95% CI: -0.09 to 1.65) and in Gissane angle with MD = -0.07 (95% CI: -1.90 to 1.77), no difference in American Orthopedic Foot and Ankle Society score with MD = 2.16 (95% CI: -1.07 to 5.38), higher-excellent and better rate of Maryland food function with relative ratio = 1.12 (95% CI: 1.04 to 1.20), and lower of incidence of postoperative complications with relative ratio = 0.23 (95% CI: 0.14-0.37). Conclusion: STA was more effective than CLSLA in the treatment of calcaneal fractures. Moreover, STA had advantages in less intraoperative bleeding, higher-excellent and better rate of Maryland foot function, lower incidence of postoperative complications, and higher safety.

Pre-impact Alarm System for Fall Detection Using MEMS Sensors and HMM-based SVM Classifier.

Accidental fall can cause physical injury, fracture and other health complication, especially for elderly people living alone. Aimed to provide timely assistance after the occurrence of falling down, a pre-fall alarm system was proposed. In order to test the reliability of pre-fall alarm system, eighteen subjects who worn this device on the waist were required to participate in a series of experiments. The acceleration and angular velocity time series extracted from human motion processes were used to described human motion features. HMM-based SVM classifier was used to determine the maximum separation boundary between fall and Activities of Daily Living (ADLs). The fall detection results showed 94.91% accuracy, 97.22% Sensitivity and 93.75% Specificity. The proposed device can accurately recognize fall event, achieve additional functions, and have advantages of small size and low power consumption. Based on the findings, this pre-impact fall alarm system with detection algorithm could potentially be useful for monitoring the state of physical function in elderly population.