Efficacy of tooth brushing via a three-dimensional motion tracking system for dental plaque control in school children: a randomized controlled clinical trial.

BACKGROUND: School children are in a developmental period in which permanent teeth replace primary dentition. It is also a period with a high incidence of gingivitis and caries, which can be improved with adequate tooth brushing. Advances in information technology have led to the development of smart health devices that assist in tooth brushing. We compared the effectiveness of computer-assisted toothbrushing using a toothbrushing instruction (TBI) method called the smart toothbrush and smart mirror (STM) system with that of conventional TBI (verbal instructions) for plaque control in school children. METHODS: This randomized controlled clinical trial analyzed and compared the reduction of the modified Quigley-Hein plaque index between the two methods in 42 school children. The participants were randomly assigned to the STM system group (n = 21) or conventional-TBI group (n = 21). The plaque indices were evaluated at baseline, immediately after TBI (day 0), and 1 week and 1 month after TBI. RESULTS: The STM system and conventional TBI led to an average reduction of 40.50% and 40.57%, respectively, in whole mouth plaque. Reductions in the plaque indices within each tested time period were observed in both groups (P < 0.001), and the mean plaque reduction did not differ between the two groups (P = 0.44). CONCLUSIONS: The present study tested a computer assisted system for TBI, more studies are needed to confirm its usefulness in different objectives. Clinical relevance The computer-assisted STM system may be an alternative of TBI for children. Trial registration ClinicalTrials.gov (NCT04627324) Registered 13/11/2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04627324 .

NPF activates a specific NPF receptor and regulates food intake in Pacific abalone Haliotis discus hannai.

Neuropeptides function through G protein-coupled receptors (GPCRs) with high specificity, implying a significant degree of neuropeptide-GPCR coevolution. However, potential neuropeptide signaling systems in non-chordates are relatively elusive. We determined the specificity of the neuropeptide F (Hdh-NPF) signaling system with a cognate receptor (Hdh-NPFR) in the Pacific abalone, Haliotis discus hannai. Phylogenetic and exon-intron arrangement analyses of bilaterian NPF and the chordate ortholog NPY with their receptor sequences revealed a likely common ancestor, and Hdh-NPFR was similar to the NPYR2 subtype among the NPYR1, NPYR2, and NPYR5 subtypes. Among four Hdh-NPFR-related receptors, Hdh-NPFR specifically responded to Hdh-NPF peptide, supported by the dose-response luciferase reporter curve, intracellular Ca2+ mobilization, and phosphorylation of ERK1/2 and its inhibition with a protein kinase C inhibitor. Peptide fragmentations and shuffling of Hdh-NPF with human NPY could not activate the cellular response of Hdh-NPFR. Three-dimensional in silico modeling suggested that interaction of Hdh-NPF C-terminal amino acids with the extracellular loops of Hdh-NPFR is critical for Hdh-NPFR activation. In vivo injection of Hdh-NPF peptide increased food consumption, and knockdown of Hdh-NPF expression decreased food consumption in Pacific abalone. These findings provide evidence for co-evolution of the NPF/Y ligand-receptor system, enabling further research on mollusk orexigenic neuropeptides.

Assessment of Electrocardiogram Rhythms by GoogLeNet Deep Neural Network Architecture.

The aim of this study is to design GoogLeNet deep neural network architecture by expanding the kernel size of the inception layer and combining the convolution layers to classify the electrocardiogram (ECG) beats into a normal sinus rhythm, premature ventricular contraction, atrial premature contraction, and right/left bundle branch block arrhythmia. Based on testing MIT-BIH arrhythmia benchmark databases, the scope of training/test ECG data was configured by covering at least three and seven R-peak features, and the proposed extended-GoogLeNet architecture can classify five distinct heartbeats; normal sinus rhythm (NSR), premature ventricular contraction (PVC), atrial premature contraction (APC), right bundle branch block (RBBB), and left bundle brunch block(LBBB), with an accuracy of 95.94%, an error rate of 4.06%, a maximum sensitivity of 96.9%, and a maximum positive predictive value of 95.7% for judging a normal or an abnormal beat with considering three ECG segments; an accuracy of 98.31%, a sensitivity of 88.75%, a specificity of 99.4%, and a positive predictive value of 94.4% for classifying APC from NSR, PVC, APC beats, whereas the error rate for misclassifying APC beat was relative low at 6.32%, compared with previous research efforts.

Molecular characterization, expression analysis, and functional properties of multiple 5-hydroxytryptamine receptors in Pacific abalone (Haliotis discus hannai).

Neurotransmitters such as serotonin (5-hydroxytryptamine; 5-HT) in the central nervous system regulate diverse physiological functions, including reproduction, feeding, learning, and memory, in diverse animal phyla. 5-HT and the 5-HT1 subtype receptor play important roles in sexual maturation and in the initiation of gamete release in mollusks. However, little is known about the involvement of other 5-HT receptor subfamilies in the reproduction process. In the present study, we identified the cDNAs encoding eight subtypes of 5-HT receptors from the ganglia tissues of the Pacific abalone Haliotis discus hannai (Mollusca; Gastropoda; Haliotidae), and examined the gonadal expression of the transcripts of 5-HT receptors. A phylogenetic analysis indicated that the molluskan 5-HT receptors are largely classified into four major clades: 5-HT1/5/7, 5-HT2, 5-HT4, and 5-HT6. Among the H. discus hannai (Hdh) 5-HT1-7 transcripts, Hdh5-HT1B, 4A, 4B, and 6 were the major subtypes detected in the mature ovary. Estradiol-17ß injection into the pedal sinus induced the downregulation of 5-HT4B and upregulation of 5-HT6 transcripts in the ovary of mature abalone within 72 h. In HEK293 cells overexpressing Hdh5-HT1B, forskolin-stimulated cAMP response element luciferase (CRE-Luc) reporter activity was inhibited by 5-HT in a dose-dependent manner, whereas serum response element luciferase (SRE-Luc) activity was not affected. In Hdh5-HT4A-expressing HEK293 cells, forskolin-stimulated CRE-Luc and SRE-Luc reporter activities were both marginally increased by treatment with a high dose of 5-HT. Our results provide new insights into the roles of 5-HT through diverse G protein-coupled 5-HT receptors in the reproductive process of mollusks.

Expression profile and reproductive regulation of APGWamide in Pacific abalone (Haliotis discus hannai).

Neuropeptides in the central nervous system regulate reproductive activities in vertebrates. Ala-Pro-Gly-Trp-NH2 (APGWamide), a neuromediator expressed in the neural ganglia of mollusks, controls sexual maturation and reproduction. To clarify the role of APGWamide in sexual behavior regulation and gamete cell maturation in mollusks, we cloned the cDNA of APGWamide precursor (Hdh-APGWamide) and examined the spatiotemporal expression of the transcript in the Pacific abalone Haliotis discus hannai. The 222-amino acid sequence of the precursor deduced from the cDNA sequence showed typical features of gastropod APGWamide precursors. Phylogenetic analysis revealed that Hdh-APGWamide is classified with other gastropod APGWamide precursors, which form a separate branch from those of the bivalves. Hdh-APGWamide mRNA was highly expressed in the neural ganglia in both sexes. In females, the three ganglia (pleuro-pedal ganglion, PPG; branchial ganglion, and cerebral ganglion) showed similar expression in immature and mature animals, whereas in males, the level in the PPG only was higher at maturity (P < 0.05). In vivo injection of APGWamide or 5-hydroxytryptamine (10-3 M) increased the frequency of spawning and the number of released sperm cells by mature males (P < 0.05), while concentrations above 10-7 M enhanced germinal vesicle breakdown in fully developed cultured oocytes (P < 0.05). Thus, the phylogenetic branch of the APGWamide precursor gene in Haliotidae was separate from the other branches under the phylum Mollusca, and this gene exhibited ganglion-specific expression, indicating that it may induce final maturation and spawning in both sexes of Haliotis spp.

Characterization and spatiotemporal expression of gonadotropin-releasing hormone in the Pacific abalone, Haliotis discus hannai.

Gonadotropin-releasing hormone (GnRH) is a key neuropeptide regulating reproduction in humans and other vertebrates. Recently, GnRH-like cDNAs and peptides were reported in marine mollusks, implying that GnRH-mediated reproduction is an ancient neuroendocrine system that arose prior to the divergence of protostomes and deuterostomes. Here, we evaluated the reproductive control system mediated by GnRH in the Pacific abalone Haliotis discus hannai. We cloned a prepro-GnRH cDNA (Hdh-GnRH) from the pleural-pedal ganglion (PPG) in H. discus hannai, and analyzed its spatiotemporal gene expression pattern. The open reading frame of Hdh-GnRH encodes a protein of 101 amino acids, consisting of a signal peptide, a GnRH dodecapeptide, a cleavage site, and a GnRH-associated peptide. This structure and sequence are highly similar to GnRH-like peptides reported for mollusks and other invertebrates. Quantitative polymerase chain reaction demonstrated that Hdh-GnRH mRNA was more strongly expressed in the ganglions (PPG and cerebral ganglion [CG]) than in other tissues (gonads, gills, intestine, hemocytes, muscle, and mantle) in both sexes. In females, the expression levels of Hdh-GnRH mRNA in the PPG and branchial ganglion (BG) were significantly higher at the ripe and partial spent stages than at the early and late active stages. In males, Hdh-GnRH mRNA levels in the BG showed a significant increase in the partial spent stage. Unexpectedly, Hdh-GnRH levels in the CG were not significantly different among the examined stages in both sexes. These results suggest that Hdh-GnRH mRNA expression profiles in the BG and possibly the PPG are tightly correlated with abalone reproductive activities.

Removal of baseline wandering in ECG signal by improved detrending method.

The very first step to process electrocardiogram (ECG) signal is to eliminate baseline wandering interference that is usually caused by electrode-skin impedance mismatch, motion artifacts due to a patient's body moment or respiratory breathing. A new method is thus suggested to remove baseline wandering in ECG by improving the detrending method that was originally proposed for eliminating slow non-stationary trends from heart rate variability (HRV). In our proposed method, a global trend is estimated in terms of baseline wandering by merging the local trend based on an ECG segment that represents a part of the ECG signal. The experimental results show that the improved detrending method can efficiently resolve baseline wandering without distorting any morphological characteristic embedded in the ECG signal in no time delay manner.

Real-time photoacoustic tomograpghy using linear array probe and detection of line structure using Hough transform.

A real-time photoacoustic tomography (PAT) system is developed using a linear array probe and phantom images are acquired with a pattern of line structure. Moreover, it is attempted to detect line structures from the acquired images by Hough transform. This effort leads to the measurement of a process of magenta passing through a tube and acquisition of images at a speed of about 2 frame/sec. Besides, it is confirmed that the Hough transform applied on the acquired PAT images has the detection rate of about 50% for delineating a line structure.

Efficacy of computer-assisted, 3D motion-capture toothbrushing instruction.

OBJECTIVE: The objective of this study was to compare the efficacy of computer-assisted TBI using a smart toothbrush (ST) and smart mirror (SM) in plaque control to that of conventional TBI. MATERIALS AND METHODS: We evaluated the plaque removal efficacy of a ST comprising a computer-assisted, wirelessly linked, three-dimensional (3D) motion-capture, data-logging, and SM system in TBI. We also evaluated the efficacy of TBI with a ST and SM system by analyzing the reductions of the modified Quigley-Hein plaque index in 60 volunteers. These volunteers were separated randomly into two groups: conventional TBI (control group) and computer-assisted TBI (experimental group). The changes in the plaque indexes were recorded immediately, 1 week, 1 month, and 10 months after TBI. RESULTS: The patterns of decreases in the modified Quigley-Hein plaque indexes were similar in the two groups. Reductions of the plaque indexes of both groups in each time period were observed (P < 0.0001), and the effects of TBI did not differ between the two groups (P = 0.3803). All volunteers were sufficiently motivated in using this new system. CONCLUSION: The reported new, computer-assisted TBI system might be an alternative option in controlling dental plaque and maintaining oral hygiene. CLINICAL RELEVANCE: Individuals can be motivated by the new system; meanwhile, comparable effects of controlling dental plaque can be achieved.

Toothbrushing region detection using three-axis accelerometer and magnetic sensor.

Due to the possible occurrence of periodontal disease at an early age, it is important to have proper toothbrushing habits as early as possible. With this aim, the feasibility and concept of a smart toothbrush (ST) capable of tracing toothbrushing motion and orientation information was suggested. In this study, we proposed the advanced ST system and brushing region classification algorithm. In order to trace the brushing region and the orientation of a toothbrush in the mouth, we required the absolute coordinate information of ST. By using tilt-compensated azimuth (heading) algorithm, we found the inclination and orientation information of the toothbrush, and the orientation information while brushing inner tooth surfaces showed specific heading features that could be reliably discriminated from other brushing patterns. In order to evaluate the feasibility of clinical usage of the proposed ST, 16 brushing regions were investigated by 15 individual healthy subjects. The proposed ST system demonstrated 97.1%(±0.91) of the region detection accuracy and 15 brushing regions could be classified. This study also showed that the proposed ST system may be helpful for dental care personnel in patient education and instruction for oral hygiene regarding brushing habits.

Interactive toothbrushing education by a smart toothbrush system via 3D visualization.

The very first step for keeping good dental hygiene is to employ the correct toothbrushing style. Due to the possible occurrence of periodontal disease at an early age, it is critical to begin correct toothbrushing patterns as early as possible. With this aim, we proposed a novel toothbrush monitoring and training system to interactively educate on toothbrushing behavior in terms of the correct brushing motion and grip axis orientation. Our intelligent toothbrush monitoring system first senses a user's brushing pattern by analyzing the waveforms acquired from a built-in accelerometer and magnetic sensor. To discern the inappropriate toothbrushing style, a real-time interactive three dimensional display system, based on an OpenGL 3D surface rendering scheme, is applied to visualize a subject's brushing patterns and subsequently advise on the correct brushing method.

Reusable electrical activity of the heart monitoring patch for mobile/ubiquitous healthcare.

In order to monitor electrical activity of the heart during daily life, we present an electrode of a medical instrument system which is able to measure the body surface potential difference by minimizing the electrode distance. The designed electrode is composed of concentric circles. It was made from the basis of the Laplacian equation, and implemented on PCB coated with gold. So that it does not cause the uncomfortable feeling of contact and possible skin troubles which are typical shortcoming of the conventional ECG measurement. The suggested method utilized three concentric circles on FR-4 substrate, so new amplifier design regarding measuring of small biological signal, is considered which has the characteristics of asymmetric input impedance since the area of concentric circular ring electrodes is not identical. Thereby, electrical activity of the heart was obtained successfully. However, its signal quality is a little bit degraded and the motion artifact still remains as a major problem as is in conventional electrocardiography measurement. Certainly stable measurement setup was needed to reduce the motion artifact originated from variation in static electricity between skin and electrode interfaces.

Application for the wearable heart activity monitoring system: analysis of the autonomic function of HRV.

The wearable patch-style heart activity monitoring system (HAMS) which was used for recording ECG signal in this study is self-developed. This electrode design helps the non-restricted, non-aware and non-invasive ECG measurement. The modified bipolar electrode is convenient in use because it is designed for easy attachment and detachment with ECG measuring module by snap button. Besides, it minimizes EMI by removing the cables. In the same subjects who were exposed under stress and non-stress, the questionnaire was given out, the amount of the stress hormone was measured by blood test and the ECG signal was recorded. Through the analysis of ECG signal which is measured with wearable patch-style HAMS, the parameter highly related with mental stress were extracted from frequency and time domain. These parameters were certified as the meaningful factor after correlation analysis on the results from questionnaire and stress hormone test. Also, it is proved that the availability of wearable patch-style heart monitoring system is efficient as health monitoring system in any places and occasion.

Tooth brushing pattern classification using three-axis accelerometer and magnetic sensor for smart toothbrush.

The concept of intelligent toothbrush, capable of monitoring brushing motion, orientation through the grip axis, during toothbrushing was suggested in our previous study. In this study, we describe a tooth brushing pattern classification algorithm using three-axis accelerometer and three-axis magnetic sensor. We have found that inappropriate tooth brushing pattern showed specific moving patterns. In order to trace the position and orientation of toothbrush in a mouth, we need to know absolute coordinate information of toothbrush. By applying tilt-compensated azimuth (heading) calculation algorithm, which is generally used in small telematics devices, we could find the inclination and orientation information of toothbrush. To assess the feasibility of the proposed algorithm, 8 brushing patterns were preformed by 6 individual healthy subjects. The proposed algorithm showed the detection ratio of 98%. This study showed that the proposed monitoring system was conceived to aid dental care personnel in patient education and instruction in oral hygiene regarding brushing style.

Development of smart toothbrush monitoring system for ubiquitous healthcare.

The design of an intelligent toothbrush, capable of monitoring brushing motion, orientation through the grip axis, during toothbrushing is described. Inappropriate tooth-brushing styles, even in adults, sometimes cause dental problems, cavities, gingivitis, etc. This smart system provides user to monitor his or her brushing pattern using accelerometer and magnetic sensors for evaluation of toothbrushing style. Directional information of toothbrush with respect to the earth's magnetic field and activity data were measured by a miniaturized low-power micro-controller, MSP430 and transmitted to personal computer by 2.4 GHz radio transmitter, nRF2401. A personal computer provides an on-line display of activity and orientation measurements during toothbrushing. The signal trace is then analyzed to extract clinically relevant information. This preliminary study showed that the proposed monitoring system was conceived to aid dental care personnel in patient education and instruction in oral hygiene regarding brushing style.

Image segmentation of human forearms in infrared image.

Due to the possibility of detecting certain physiological conditions from thermal features of the skin surface acquired from infrared thermal imaging, the health conditions of a person can be revealed by analyzing the thermal signatures of his or her forearms regions in an infrared image. The assessment of hand's or arm's temperature distribution for clinical diagnosis or monitoring requires the confinement of region of interest (ROI) on the forearms regions. Hence, the purpose of this study is automatically to segment forearms regions in an infrared thermal image so that the clinicians can able to locate the interested regions and extract the skin temperature distributions with a high degree of reproducibility.

A robust human identification by normalized time-domain features of electrocardiogram.

This study investigates the possibility of using the normalized time-domain features of Electrocardiogram (ECG) for improving the capability of human identification. For this purpose, we measured lead-1 rest ECG (normal heart rate) and physically active one (fast heart rate) from the pre-selected group. The characteristic points on the ECG waveform, P, QRS, T are extracted in terms of its time location and the ECG data is reconstructed in beat-by-beat basis by Fourier synthesis. R-T interval, Q-T interval, and QRS interval on the reconstructed ECG sequence in rest and in physical active mode are computed. The beat-by-beat based discriminatory analysis is performed on the rest and physical active ECG data by applying Malalanobis distance between these intervals.

Thermo-visual evaluation of the Yin-Tang acupuncture point for intracranial hypertension syndrome.

This study describes a thermo-visual method to diagnose intracranial hypertension syndrome that is caused by a high intracranial pressure by observing the relative temperature distribution around the "Yin-Tang" acupuncture point. Based on thermo-visual analysis of 3000 thermal images scanned by infrared thermal imaging system acquired from 1256 admitted patients, we found that a certain specific temperature distribution around the Yin-Tang acupuncture point was related with the degree of severity of intracranial hypertension syndrome. Thus, we claim that the evaluation of the relative temperature distribution around the Yin-Tang acupuncture point can be used to diagnose and control intracranial hypertension syndrome during medical treatments.

A real time QRS detection using delay-coordinate mapping for the microcontroller implementation.

In this article, we propose a new algorithm using the characteristics of reconstructed phase portraits by delay-coordinate mapping utilizing lag rotundity for a real-time detection of QRS complexes in ECG signals. In reconstructing phase portrait the mapping parameters, time delay, and mapping dimension play important roles in shaping of portraits drawn in a new dimensional space. Experimentally, the optimal mapping time delay for detection of QRS complexes turned out to be 20 ms. To explore the meaning of this time delay and the proper mapping dimension, we applied a fill factor, mutual information, and autocorrelation function algorithm that were generally used to analyze the chaotic characteristics of sampled signals. From these results, we could find the fact that the performance of our proposed algorithms relied mainly on the geometrical property such as an area of the reconstructed phase portrait. For the real application, we applied our algorithm for designing a small cardiac event recorder. This system was to record patients' ECG and R-R intervals for 1 h to investigate HRV characteristics of the patients who had vasovagal syncope symptom and for the evaluation, we implemented our algorithm in C language and applied to MIT/BIH arrhythmia database of 48 subjects. Our proposed algorithm achieved a 99.58% detection rate of QRS complexes.

A novel design of thermal anomaly for mammary gland tumor phantom for microwave radiometer.

Microwave radiometry is the spectral measurement technique of resolving electromagnetic radiation of all matters which temperature is above absolute zero. This technique utilizes the electromagnetic noise field generated by a thermal volume similar to a mechanism existing in biological tissues. One particular application of microwave radiometry is for analyzing temperature differentials of inside of human body to detect and diagnose some crucial pathological conditions. For the general evaluation of a microwave radiometer, we propose a new type of phantom containing a mammary gland tumor imitator by considering biological heat diffusion effects propagated by a real tumor. Theoretical researches of human tumor revealed the fact that temperature distribution of tissues around a tumor formed a Gaussian statistics. To comply with the physiological property of the real tumor, we built a mammary gland tumor imitator composed of two parts (pseudotumor and thermal anomaly) and observed its temperature distribution when it was placed inside a phantom. Our results showed that the thermal properties of tumor imitator well agreed with heat-transfer properties of a real tumor and the proportional linear relationship existed between the location of tumor imitator and the intensity of radiometer measurements. From this relationship, we could also estimate several parameters related with our phantom, such as the minimum detectable size and maximum detectable depth of a tumor imitator.