Comparison of Six Sensor Fusion Algorithms with Electrogoniometer Estimation of Wrist Angle in Simulated Work Tasks.

Hand-intensive work is strongly associated with work-related musculoskeletal disorders (WMSDs) of the hand/wrist and other upper body regions across diverse occupations, including office work, manufacturing, services, and healthcare. Addressing the prevalence of WMSDs requires reliable and practical exposure measurements. Traditional methods like electrogoniometry and optical motion capture, while reliable, are expensive and impractical for field use. In contrast, small inertial measurement units (IMUs) may provide a cost-effective, time-efficient, and user-friendly alternative for measuring hand/wrist posture during real work. This study compared six orientation algorithms for estimating wrist angles with an electrogoniometer, the current gold standard in field settings. Six participants performed five simulated hand-intensive work tasks (involving considerable wrist velocity and/or hand force) and one standardised hand movement. Three multiplicative Kalman filter algorithms with different smoothers and constraints showed the highest agreement with the goniometer. These algorithms exhibited median correlation coefficients of 0.75-0.78 for flexion/extension and 0.64 for radial/ulnar deviation across the six subjects and five tasks. They also ranked in the top three for the lowest mean absolute differences from the goniometer at the 10th, 50th, and 90th percentiles of wrist flexion/extension (9.3°, 2.9°, and 7.4°, respectively). Although the results of this study are not fully acceptable for practical field use, especially for some work tasks, they indicate that IMU-based wrist angle estimation may be useful in occupational risk assessments after further improvements.

The Assessment of the Association of Proton Pump Inhibitor Usage with Chronic Kidney Disease Progression through a Process Mining Approach.

Previous studies have suggested an association between Proton Pump Inhibitors (PPIs) and the progression of chronic kidney disease (CKD). This study aims to assess the association between PPI use and CKD progression by analysing estimated glomerular filtration rate (eGFR) trajectories using a process mining approach. We conducted a retrospective cohort study from 1 January 2006 to 31 December 2011, utilising data from the Stockholm Creatinine Measurements (SCREAM). New users of PPIs and H2 blockers (H2Bs) with CKD (eGFR < 60) were identified using a new-user and active-comparator design. Process mining discovery is a technique that discovers patterns and sequences in events over time, making it suitable for studying longitudinal eGFR trajectories. We used this technique to construct eGFR trajectory models for both PPI and H2B users. Our analysis indicated that PPI users exhibited more complex and rapidly declining eGFR trajectories compared to H2B users, with a 75% increased risk (adjusted hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.49 to 2.06) of transitioning from moderate eGFR stage (G3) to more severe stages (G4 or G5). These findings suggest that PPI use is associated with an increased risk of CKD progression, demonstrating the utility of process mining for longitudinal analysis in epidemiology, leading to an improved understanding of disease progression.

Short-term variation of the fetal heart rate as a marker of intraamniotic infection in pregnancies with preterm prelabor rupture of membranes: a historical cohort study.

INTRODUCTION: Intraamniotic infection (IAI) and subsequent early-onset neonatal sepsis (EONS) are among the main complications associated with preterm prelabor rupture of membranes (PPROM). Currently used diagnostic tools have been shown to have poor diagnostic performance for IAI. This study aimed to investigate whether the exposure to IAI before delivery is associated with short-term variation of the fetal heart rate in pregnancies with PPROM. METHODS: Observational cohort study of 678 pregnancies with PPROM, delivering between 24 + 0 and 33 + 6 gestational weeks from 2012 to 2019 in five labor units in Stockholm County, Sweden. Electronic medical records were examined to obtain background and exposure data. For the exposure IAI, we used the later diagnosis of EONS in the offspring as a proxy. EONS is strongly associated to IAI and was considered a better proxy for IAI than the histological diagnosis of acute chorioamnionitis, since acute chorioamnionitis can be observed in the absence of both positive microbiology and biochemical markers for inflammation. Cardiotocography traces were analyzed by a computerized algorithm for short-term variation of the fetal heart rate, which was the main outcome measure. RESULTS: Twenty-seven pregnancies were categorized as having an IAI, based on the proxy diagnosis of EONS after birth. Fetuses exposed to IAI had significantly lower short-term variation values in the last cardiotocography trace before birth than fetuses who were not exposed (5.25 vs 6.62 ms; unadjusted difference: -1.37, p = 0.009). After adjustment for smoking and diabetes, this difference remained significant. IAI with a later positive blood culture in the neonate (n = 12) showed an even larger absolute difference in STV (-1.65; p = 0.034), with a relative decrease of 23.5%. CONCLUSION: In pregnancies with PPROM, fetuses exposed to IAI with EONS as a proxy have lower short-term variation of the fetal heart rate than fetuses who are not exposed. Short-term variation might be useful as adjunct surveillance in pregnancies with PPROM.