Assessment of Automated Identification of Phases in Videos of Total Hip Arthroplasty Using Deep Learning Techniques.

Background: As the population ages, the rates of hip diseases and fragility fractures are increasing, making total hip arthroplasty (THA) one of the best methods for treating elderly patients. With the increasing number of THA surgeries and diverse surgical methods, there is a need for standard evaluation protocols. This study aimed to use deep learning algorithms to classify THA videos and evaluate the accuracy of the labelling of these videos. Methods: In our study, we manually annotated 7 phases in THA, including skin incision, broaching, exposure of acetabulum, acetabular reaming, acetabular cup positioning, femoral stem insertion, and skin closure. Within each phase, a second trained annotator marked the beginning and end of instrument usages, such as the skin blade, forceps, Bovie, suction device, suture material, retractor, rasp, femoral stem, acetabular reamer, head trial, and real head. Results: In our study, we utilized YOLOv3 to collect 540 operating images of THA procedures and create a scene annotation model. The results of our study showed relatively high accuracy in the clear classification of surgical techniques such as skin incision and closure, broaching, acetabular reaming, and femoral stem insertion, with a mean average precision (mAP) of 0.75 or higher. Most of the equipment showed good accuracy of mAP 0.7 or higher, except for the suction device, suture material, and retractor. Conclusions: Scene annotation for the instrument and phases in THA using deep learning techniques may provide potentially useful tools for subsequent documentation, assessment of skills, and feedback.

Improving Dust Aerosol Optical Depth (DAOD) Retrieval from the GEOKOMPSAT-2A (GK-2A) Satellite for Daytime and Nighttime Monitoring.

The Advanced Meteorological Image (AMI) onboard GEOKOMPSAT 2A (GK-2A) enables the retrieval of dust aerosol optical depth (DAOD) from geostationary satellites using infrared (IR) channels. IR observations allow the retrieval of DAOD and the dust layer altitude (24 h) over surface properties, particularly over deserts. In this study, dust events in northeast Asia from 2020 to 2021 were investigated using five GK-2A thermal IR bands (8.7, 10.5, 11.4, 12.3, and 13.3 µm). For the dust cloud, the brightness temperature differences (BTDs) of 10.5 and 12.3 µm were consistently negative, while the BTD of 8.7 and 10.5 µm varied based on the dust intensity. This study exploited these optical properties to develop a physical approach for DAOD lookup tables (LUTs) using IR channels to retrieve the DAOD. To this end, the characteristics of thermal radiation transfer were simulated using the forward model; dust aerosols were explained by BTD (10.5, 12.3 µm)-an intrinsic characteristic of dust aerosol. The DAOD and dust properties were gained from a brightness temperature (BT) of 10.5 µm and BTD of 10.5, 12.3 µm. Additionally, the cumulative distribution function (CDF) was employed to strengthen the continuity of 24-h DAOD. The CDF was applied to the algorithm by calculating the conversion value coefficient for the DAOD error correction of the IR, with daytime visible aerosol optical depth as the true value. The results show that the DAOD product can be successfully applied during the daytime and nighttime to continuously monitor the flow of yellow dust from the GK-2A satellite in northeast Asia. In particular, the validation results for IR DAOD were similar to the active satellite product (CALIPSO/CALIOP) results, which exhibited a tendency similar to that for IR DAOD at night.

Probe chip nanofabrication enabled reverse tip sample scanning probe microscopy concept and measurements.

We introduce a new scanning probe microscopy (SPM) concept called reverse tip sample scanning probe microscopy (RTS SPM), where the tip and sample positions are reversed as compared to traditional SPM. The main benefit of RTS SPM over the standard SPM configuration is that it allows for simple and fast tip changes. This overcomes two major limitations of SPM which are slow data acquisition and a strong dependency of the data on the tip condition. A probe chip with thousands of sharp integrated tips is the basis of our concept. We have developed a nanofabrication protocol for Si based probe chips and their functionalization with metal and diamond coatings, evaluated our probe chips for various RTS SPM applications (multi-tip imaging, SPM tomography, and correlative SPM), and showed the high potential of the RTS SPM concept.

Precise individual muscle segmentation in whole thigh CT scans for sarcopenia assessment using U-net transformer.

The study aims to develop a deep learning based automatic segmentation approach using the UNETR(U-net Transformer) architecture to quantify the volume of individual thigh muscles(27 muscles in 5 groups) for Sarcopenia assessment. By automating the segmentation process, this approach improves the efficiency and accuracy of muscle volume calculation, facilitating a comprehensive understanding of muscle composition and its relationship to Sarcopenia. The study utilized a dataset of 72 whole thigh CT scans from hip fracture patients, annotated by two radiologists. The UNETR model was trained to perform precise voxel-level segmentation and various metrics such as dice score, average symmetric surface distance, volume correlation, relative absolute volume difference and Hausdorff distance were employed to evaluate the model's performance. Additionally, the correlation between Sarcopenia and individual thigh muscle volumes was examined. The proposed model demonstrated superior segmentation performance compared to the baseline model, achieving higher dice scores (DC = 0.84) and lower average symmetric surface distances (ASSD = 1.4191 ± 0.91). The volume correlation between Sarcopenia and individual thigh muscles in the male group. Furthermore, the correlation analysis of grouped thigh muscles also showed negative associations with Sarcopenia in the male participants. This thesis presents a deep learning based automatic segmentation approach for quantifying individual thigh muscle volume in sarcopenia assessment. The results highlights the associations between Sarcopenia and specific individual muscles as well as grouped thigh muscle regions, particularly in males. The proposed method improves the efficiency and accuracy of muscle volume calculation, contributing to a comprehensive evaluation of Sarcopenia. This research enhances our understanding of muscle composition and performance, providing valuable insights for effective interventions in Sarcopenia management.

Intrahepatic Cholangiocarcinoma Identified in a Zoo-Housed Sandhill Crane (Grus canadensis): An Anatomopathological and Metagenomic Study.

Tumors in birds can be caused by a variety of factors such as species, age, sex, virus, chemicals, and environment. In particular, tumors are a major cause of death in long-lived birds such as parrots and zoo birds. A male sandhill crane that was bred for 8 years in a zoo was diagnosed with intrahepatic cholangiocarcinoma (ICC). At necropsy, the liver revealed a multinodular mass of variable colors, and severe cirrhosis and hemorrhages were present. Histologically, ICC was characterized by the presence of both types of ICC: small-duct type and large-duct type. Large-duct-type ICC was distinguished by the presence of multifocal biliary neoplasia, characterized by the diffuse papillary proliferation of columnar cells resembling large cholangiocytes. Small-duct-type ICC was characterized by the presence of non-mucin-producing cuboidal cells such as bile duct cells. In this case, no viral cause was identified from the metagenomic analysis and PCR of ICC; however, a contributing role of Cutibacterium sp. and E. coli identified from the metagenomics could not be excluded. This study is the first to describe the anatomopathological characteristics of ICC in the studied sandhill crane and attempts to determine its potential infectious etiology using metagenomics.

Sarcopenia classification model for musculoskeletal patients using smart insole and artificial intelligence gait analysis.

BACKGROUND: The relationship between physical function, musculoskeletal disorders and sarcopenia is intricate. Current physical function tests, such as the gait speed test and the chair stand test, have limitations in eliminating subjective influences. To overcome this, smart devices utilizing inertial measurement unit sensors and artificial intelligence (AI)-based methods are being developed. METHODS: We employed cutting-edge technologies, including the smart insole device and pose estimation based on AI, along with three classification models: random forest (RF), support vector machine and artificial neural network, to classify control and sarcopenia groups. Patient data of 83 individuals were divided into train and test sets, with approximately 67% allocated for training. Classification models were implemented using RStudio, considering individual and combined variables obtained through pose estimation and smart insole measurements. RESULTS: Performance evaluation of the classification models utilized accuracy, precision, recall and F1-score indicators. Using only pose estimation variables, accuracy ranged from 0.92 to 0.96, with F1-scores of 0.94-0.97. Key variables identified by the RF model were 'Hip_dif', 'Ankle_dif' and 'Hipankle_dif'. Combining variables from both methods increased accuracy to 0.80-1.00, with F1-scores of 0.73-1.00. CONCLUSIONS: In our study, a classification model that integrates smart insole and pose estimation technology was assessed. The RF model showed impressive results, particularly in the case of the Hip and Ankle variables. The growth of advanced measurement technologies suggests a promising avenue for identifying and utilizing additional digital biomarkers in the management of various disorders. The convergence of AI technologies with diagnostics and treatment approaches a promising future for enhanced interventions in conditions like sarcopenia.

Application of metagenomics for diagnosis of broilers displaying neurological symptoms.

BACKGROUND: Thirty-two-day-old broiler chickens at a farm located in northwestern South Korea displayed adverse neurological symptoms including limping, lying down, and head shaking. Approximately 2.1% of chickens died or were culled due to severe symptoms. Five carcasses were submitted to the Avian Disease Division of the Animal and Plant Quarantine Agency (APQA) for disease diagnosis. RESULTS: Broilers displayed severe pericarditis and perihepatitis associated with gross lesions. Broilers also displayed microscopic lesions in the cerebrum and in the granular layer of the cerebellum, which were associated with multifocal perivascular cuffing and purulent necrosis in the cerebrum, and severe meningitis with heterophil and lymphocyte infiltration. Staphylococcus spp. were identified in the liver and heart using bacteriological culture. PCR/RT-PCR assays revealed that broilers were negative for avian Clostridium botulinum, Newcastle disease virus, and avian encephalomyelitis virus. Bacterial and viral metagenomic analysis of brain sample further revealed the presence of Pseudomonas spp. and Marek's disease virus, which are known etiological agents of chicken meningoencephalitis. CONCLUSIONS: This study reports a diagnostic analysis of gross and histopathological lesions from 32-day-old broilers displaying unique neurological symptoms that revealed the presence of the several neurological diseases including meningoencephalitis. The causative agents associated with meningoencephalitis of broilers that had not been identified by routine diagnostic methods could be diagnosed by metagenomics, which proves the usefulness of metagenomics as a diagnostic tool for unknown neurological diseases in broilers.

The Development of Novel Reverse Transcription Loop-Mediated Isothermal Amplification Assays for the Detection and Differentiation of Virulent Newcastle Disease Virus.

Newcastle disease (ND) is a highly pathogenic viral infection of poultry with significant economic impacts worldwide. Despite the widespread use of vaccines, ND outbreaks continue to occur even within vaccinated poultry farms. Furthermore, novel Newcastle disease virus (NDV) genotypes are emerging in poultry, increasing the need for the development of rapid, accurate, and simple diagnostic methods. We therefore developed two novel sets of visual reverse transcription loop-mediated isothermal amplification (RT-LAMP) assays based on highly conserved regions of the HN and F genes. The limits of detection of the NDV-Common-LAMP assay, for all the NDV strains, were 103.0 EID50/0.1 mL for Kr005 and 102.0 EID50/0.1 mL for Lasota within 35 min. The sensitivity of the NDV-Patho-LAMP assay, used for the strain differentiation of virulent NDV, was 102.0 EID50/0.1 mL for Kr005. No amplification was detected for the non-NDV templates. Next, we probed 95 clinical strains and 7 reference strains with the RT-LAMP assays to assess the feasibility of their use in diagnostics. We observed no cross-reactivity across the 102 strains. Furthermore, there was 100% congruence between the RT-LAMP assays and full-length sequencing of the target genes, indicating the potential for visual RT-LAMP in the identification and differentiation of NDV. These novel RT-LAMP assays are ideally suited for the field or resource-limited environments to facilitate the faster detection and differentiation of NDV, which can reduce or avoid further spread.

Correlation between Harris hip score and gait analysis through artificial intelligence pose estimation in patients after total hip arthroplasty.

BACKGROUND: Recently, open pose estimation using artificial intelligence (AI) has enabled the analysis of time series of human movements through digital video inputs. Analyzing a person's actual movement as a digitized image would give objectivity in evaluating a person's physical function. In the present study, we investigated the relationship of AI camera-based open pose estimation with Harris Hip Score (HHS) developed for patient-reported outcome (PRO) of hip joint function. METHOD: HHS evaluation and pose estimation using AI camera were performed for a total of 56 patients after total hip arthroplasty in Gyeongsang National University Hospital. Joint angles and gait parameters were analyzed by extracting joint points from time-series data of the patient's movements. A total of 65 parameters were from raw data of the lower extremity. Principal component analysis (PCA) was used to find main parameters. K-means cluster, X-squared test, Random forest, and mean decrease Gini (MDG) graph were also applied. RESULTS: The train model showed 75% prediction accuracy and the test model showed 81.8% reality prediction accuracy in Random forest. "Anklerang_max", "kneeankle_diff", and "anklerang_rl" showed the top 3 Gini importance score in the Mean Decrease Gini (MDG) graph. CONCLUSION: The present study shows that pose estimation data using AI camera is related to HHS by presenting associated gait parameters. In addition, our results suggest that ankle angle associated parameters could be key factors of gait analysis in patients who undergo total hip arthroplasty.

Assessing physical abilities of sarcopenia patients using gait analysis and smart insole for development of digital biomarker.

The aim of this study is to compare variable importance across multiple measurement tools, and to use smart insole and artificial intelligence (AI) gait analysis to create variables that can evaluate the physical abilities of sarcopenia patients. By analyzing and comparing sarcopenia patients with non sarcopenia patients, this study aims to develop predictive and classification models for sarcopenia and discover digital biomarkers. The researchers used smart insole equipment to collect plantar pressure data from 83 patients, and a smart phone to collect video data for pose estimation. A Mann-Whitney U was conducted to compare the sarcopenia group of 23 patients and the control group of 60 patients. Smart insole and pose estimation were used to compare the physical abilities of sarcopenia patients with a control group. Analysis of joint point variables showed significant differences in 12 out of 15 variables, but not in knee mean, ankle range, and hip range. These findings suggest that digital biomarkers can be used to differentiate sarcopenia patients from the normal population with improved accuracy. This study compared musculoskeletal disorder patients to sarcopenia patients using smart insole and pose estimation. Multiple measurement methods are important for accurate sarcopenia diagnosis and digital technology has potential for improving diagnosis and treatment.

Accelerometer-derived physical activity analysis of elderly osteoarthritis patients.

BACKGROUND: Because disability in Osteoarthritis (OA) may change physical activity (PA), which might affect the disease progression, it is important to measure a patient's daily PA to study the relationship between a patient's PA and disease progression. OBJECTIVE: The objective of the present study was to investigate the relationship between PA and patients with OA and people without OA using data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: Demographic study was conducted to obtain data of comorbidities of participants. PA was compared between the group with OA (OA group) and the group without OA (non-OA group). In addition, PAs of OA patients with comorbidities and those without comorbidities were compared. The cut-off of moderate to vigorous physical activity (MVPA) was obtained through a receiver operating characteristic (ROC) curve. RESULTS: In the demographic study, there were significantly more educated participants in the OA group (p < .001). Actigraph data showed a significant decrease in MVPA (p < .001) but a significant increase in light activity (p = .002) in the OA group. In addition, the OA group showed significantly lower light PA but significantly higher MVPA in ≥10 min bout length. OA patients with comorbidities showed higher MVPA than OA patients without comorbidities (p = .044). The cut-off point of MVPA was 7.071 min/day when ROC curve was conducted. CONCLUSIONS: The present study suggests that patients with OA and low activity need a certain level of physical activity and a cut-off point for MVPA is presented which accounts for comorbidities in OA patients.

Genetic Diversity of Fowlpox Virus and Putative Genes Involved in Its Pathogenicity.

To determine the genomic variations of fowlpox virus (FPV)-the largest, very ancient, and still harmful avian virus-the complete genomes of 21 FPVs were analyzed. The genomes showed low genetic diversity relative to their overall size. Our studies revealed that FPVs could phylogenetically be divided into two clades, based on their regional distribution, and comparative analysis showed that 40 putative proteins of FPV were associated with geographic differences in viruses, viral pathogenicity, or the onset of diphtheritic lesions. The strain, classified into a subgroup different from others in the genomic analysis, showed relatively low pathogenicity in chickens, and the onset of diphtheritic lesions was observed to be caused only by the specific strain. Despite genetic differences, some commercial vaccines are protective against virulent strains, and intact reticuloendotheliosis virus inserted into field FPV strains was activated but there was no enhancement of the pathogenicity of FPV. These findings will expand our knowledge of the viral proteome and help us understand the pathogenicity of FPV. IMPORTANCE This study aims at determining molecular candidates using comparative genomics to differentiate between the diphtheritic and cutaneous forms of FPV infection, in addition to their association with the pathogenicity of the virus. Full-genomic analyses of multiple fowlpox strains, including field viruses, isolated between 1960s and 2019, and vaccine strains showed the genetic diversity due to regional differences. Comparative genomic analysis offered the clues related to viral virulence. We believe that our study makes a significant contribution to the literature because we are the first to perform such an elaborate study that compares 21 FPVs to study and highlight their diversity, despite the high level of homology between them. Our results shall help provide insights for tackling FPV that has been taking a toll on the poultry for years now.

Secured and Deterministic Closed-Loop IoT System Architecture for Sensor and Actuator Networks.

Sensors, actuators, and wireless communication technologies have developed significantly. Consequently, closed-loop systems that can be monitored and controlled by devices in IoT environments, such as farms and factories, have emerged. Such systems are realized by means of cloud-level and edge-level implementations. Among them, with a model that generates real-time control decisions at the cloud level, it might be difficult to ensure the determinism of real-time control due to communication overheads. In addition, if the actuator is remotely controlled at the cloud level, it is difficult to secure control safety against external hacking or device malfunction. Herein, we propose a system architecture that can fulfil real-time performance and safety requirements with two commonly used devices, Field Edge Unit (FEU) and Current Sensing Tag (CST), in a closed-loop IoT environment. By using these devices, we designed a special architecture that can be commonly used in various closed-loop sensing and actuating applications. In this study, the proposed architecture is evaluated by applying it to a smart farm application.

Effect of Bacillus mesonae H20-5 Treatment on Rhizospheric Bacterial Community of Tomato Plants under Salinity Stress.

Plant growth-promoting bacteria improve plant growth under abiotic stress conditions. However, their effects on microbial succession in the rhizosphere are poorly understood. In this study, the inoculants of Bacillus mesonae strain H20-5 were administered to tomato plants grown in soils with different salinity levels (EC of 2, 4, and 6 dS/m). The bacterial communities in the bulk and rhizosphere soils were examined 14 days after H20-5 treatment using Illumina MiSeq sequencing of the bacterial 16S rRNA gene. Although the abundance of H20-5 rapidly decreased in the bulk and rhizosphere soils, a shift in the bacterial community was observed following H20-5 treatment. The variation in bacterial communities due to H20-5 treatment was higher in the rhizosphere than in the bulk soils. Additionally, the bacterial species richness and diversity were greater in the H20-5 treated rhizosphere than in the control. The composition and structure of the bacterial communities varied with soil salinity levels, and those in the H20-5 treated rhizosphere soil were clustered. The members of Actinobacteria genera, including Kineosporia, Virgisporangium, Actinoplanes, Gaiella, Blastococcus, and Solirubrobacter, were enriched in the H20-5 treated rhizosphere soils. The microbial co-occurrence network of the bacterial community in the H20-5 treated rhizosphere soils had more modules and keystone taxa compared to the control. These findings revealed that the strain H20-5 induced systemic tolerance in tomato plants and influenced the diversity, composition, structure, and network of bacterial communities. The bacterial community in the H20-5 treated rhizosphere soils also appeared to be relatively stable to soil salinity changes.

Successful Intrathecal Baclofen Therapy for Intractable Paroxysmal Sympathetic Hyperactivity in Patient with Pontine Hemorrhage: A case report.

Paroxysmal sympathetic hyperactivity (PSH) is characterized by increased activity of the sympathetic nervous system. Although several treatments have been proposed for PSH, their efficacies are uncertain. We report a case of a patient with intractable PSH after pontine hemorrhage who was treated with intrathecal baclofen (ITB). A 61-year-old man was diagnosed with pontine hemorrhage expanding to the bilateral midbrain. Beginning 2 weeks after onset, he developed paroxysmal hyperthermia, tachycardia, tachypnea, hypertension, and generalized dystonic movements. Several medications were administered to the patient, including fentanyl patch, dantrolene, gabapentin, and ß blockers. Nevertheless, PSH episodes continued to occur more than twice per day. Seven months after onset, we performed a trial of ITB injection, which led to reduced severity and frequency of PSH. Therefore, the ITB therapy was implanted. Continuous ITB was initiated at a rate of 100 µg/d, which was gradually increased up to 200 µg/d. Oral medications were tapered off. No PSH episode occurred for 4 weeks. Our findings suggest that ITB therapy may be used to manage intractable PSH. Intrathecal baclofen may inhibit postsynaptic activity and suppress sympathetic activity via the stimulation of γ-aminobutyric acid B receptors the brain.

The effects of trunk stability exercise and a combined exercise program on pain, flexibility, and static balance in chronic low back pain patients.

[Purpose] The aim of this study was to examine the effect of trunk stability exercise and combined exercise program on pain, flexibility, and static balance in chronic low back pain patients. [Subjects and Methods] Thirty persons diagnosed with chronic low back pain were divided into a trunk stability exercise group and a combined exercise group and then conducted exercise for six weeks. [Results] VAS and sway lengths decreased significantly in both groups. A comparison of sway lengths after the intervention between the two groups revealed that the trunk stability exercise group had a bigger decrease than the combined exercise group. [Conclusion] The results of this study indicated that trunk stability exercise would have bigger effect than combined exercise on the daily activities of chronic low back pain patients as it strengthens deep abdominal muscles and improves flexibility and balancing ability.

Comparison between the Effects of Horseback Riding Exercise and Trunk Stability Exercise on the Balance of Normal Adults.

[Purpose] The aim of this study was to compare the effects of horseback riding exercise and trunk stability exercise on static and dynamic balance in normal adults. [Subjects and Methods] Twenty-two normal adults residing in communities were randomly divided into a horseback riding exercise group and a trunk stability exercise group, and they conducted exercise for eight weeks. [Results] Sway times of the COG (center of gravity) decreased significantly, and the A-P (anterior-posterior) and M-L (medial-lateral) velocities significantly decreased in both groups. A comparison of sway times of the COG after the intervention between the two groups revealed that the horseback riding exercise group showed larger decreases than the trunk stability exercise group. [Conclusion] In terms of the musculoskeletal factor, horseback riding may result in functional improvement and increased stability, and it may stimulate proprioceptive sense input in neurological terms. It is therefore considered a composite exercise method that may strengthen the two factors simultaneously.