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Acknowledgements | This research was extracted from PhD thesis of Health Education & Health Promotion in Shahid Beheshti University of Medical Sciences. We appreciate all principals and students who helped us during this study. | PMC10276363 | ||
Authors’ contributions | M.GH, S.R, A. P and A.R wrote the main manuscript text and Y.M. prepared Figs. | PMC10276363 | ||
Funding | This work was supported by Shahid Beheshti University of Medical Sciences. | PMC10276363 | ||
Availability of data and materials | The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. | PMC10276363 | ||
Declarations | PMC10276363 | |||
Ethics approval and consent to participate | The researchers observed all the ethical codes including informed consent, confidentiality, plagiarism, double publication, data manipulation, and fake data generation. The study received approval ethical research code from ethics Committee of Shahid Beheshti University of Medical Sciences. And ethical research code fo... | PMC10276363 | ||
Consent for publication | Not applicable. | PMC10276363 | ||
Competing interests | All authors of this article declare they have no conflicts of interest. | PMC10276363 | ||
References | PMC10276363 | |||
Background | There is a tendency of prompted global health systems to reduce the length of hospital stay without compromising patient safety or satisfaction. We evaluated the safety and viability of early discharge in patients undergoing minimally invasive radical prostatectomy (MIRP), as well as patient satisfaction with this stra... | PMC10512494 | ||
Methods | ADVERSE EVENTS, PROSTATE CANCER | This longitudinal prospective study included 72 patients who underwent MIRP for prostate cancer. Three groups were performed according to the day of hospital discharge following surgery: same day (G1), first day after (G2), and second day after (G3). Satisfaction, adverse events, and readmission were analyzed for each ... | PMC10512494 | |
Results | REGRESSION, PROSTATE | 16.7% of patients were not discharged according to randomization (10 randomized to G1). 80% of G1 patients who did not achieve same-day discharge had Gleason scores of 3 + 4 or 4 + 3, which were observed in 35.7% of patients discharged on the same day (P < 0.05). Average prostate weight was significantly lower in patie... | PMC10512494 | |
Conclusions | PROSTATE CANCER | Same-day discharge was both safe and feasible and does not appear to affect satisfaction in a subset of patients with prostate cancer. Surgeons should consider the Gleason score when determining whether same-day discharge is appropriate. | PMC10512494 | |
Keywords | PMC10512494 | |||
Background | COMPLICATION | Additionally to recent advances in surgical techniques, which have substantially decreased mortality and complication rates, there is a tendency of global health systems and hospitals to reduce length of hospital stay without compromising patient safety or satisfaction [While several studies have demonstrated that a hi... | PMC10512494 | |
Methods | absence of fever, pain | REGRESSION, INTRAOPERATIVE COMPLICATIONS | This longitudinal prospective study was conducted between March 2017 and November 2019. The study was performed in accordance with the principles of the Declaration of Helsinki and approved by the Research Ethics Committee of our institution (1325/2017). Informed consent was obtained from all the participants included ... | PMC10512494 |
Results | hematuria, bleeding, prostate, pain | HEMATURIA, BLEEDING, ADVERSE EVENTS, PROSTATE | The study included 72 patients, who randomized into three groups of 24 patients each (Fig.
Patients recruiting design
Epidemiological variables according to discharge groupASA: American Society of Anesthesiologists; PSA: prostate-specific antigenTwelve patients were not discharged according to randomization, 10 of who... | PMC10512494 |
Discussion | cancer, postoperative pain, RP, including reduced blood loss | CANCER, PERIOPERATIVE COMPLICATION, COMPLICATION | MIRP has several advantages over traditional procedures, including reduced blood loss and transfusion rates, decreased postoperative pain, and a shorter duration of hospitalization in more recent cases [Historically, the duration of hospitalization following open RP has decreased with increasing surgical experience ove... | PMC10512494 |
Conclusions | ADVERSE EVENTS | The findings of this study indicate that same-day discharge is both safe and feasible following RARP and does not decrease patient satisfaction rates. For discharge on the day of surgery to be feasible at a large scale, routine surgical changes are required to minimize the risk of adverse events [ | PMC10512494 | |
Acknowledgements | Not applicable. | PMC10512494 | ||
Authors’ contributions | LTB, RJCG | EFF was responsible for conceptualization, project administration, supervision and manuscript final review. RDM, RJCG, MAVM, MTM, RR and DNPBB performed all the methodology. LTB and DNPBB were responsible for data curation, visualization, statistical analysis and original draft writing. All authors approved the final m... | PMC10512494 | |
Funding | This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. | PMC10512494 | ||
Data availability | The datasets used and analysed during the current study are available from the corresponding author on reasonable request. | PMC10512494 | ||
Declarations | PMC10512494 | |||
Competing interests | The authors declare no competing interests. | PMC10512494 | ||
Ethics approval and consent to participate | Cancer | CANCER | This work was approved by Research Ethics Committee of Barretos Cancer Hospital, number 1325/2017, and written informed consent was collected from all participants accordingly. | PMC10512494 |
Consent for publication | Not applicable. | PMC10512494 | ||
References | PMC10512494 | |||
Tim Sziburis | WEST | is with the Institute for Neuroinformatics, Ruhr University Bochum, and the Ruhr West University of Applied Sciences. His research interests include machine learning, control engineering and embedded systems for biomedical data processing. He holds a Dott. Mag. (cum laude) in Computer Science from the University of Tre... | PMC10758379 | |
Markus Nowak | received the M. Sc. degree in mechanical engineering from the Technical University of Munich. In his master’s curriculum, he focused on medical engineering and numerical mechanics. His master thesis was carried in cooperation with the Robotics and Mechatronics Center of the German Aerospace Center (DLR), Oberpfaffenhof... | PMC10758379 | ||
Davide Brunelli | received the M. S. (cum laude) and Ph.D. degrees in electrical engineering from the University of Bologna, Italy, in 2002 and 2007, respectively. He is an Associate Professor with the University of Trento, Italy. He has published more than 260 research papers in international journals or proceedings of international co... | PMC10758379 | ||
Abstract | REGRESSION | This work presents the design, implementation and validation of learning techniques based on the kNN scheme for gesture detection in prosthetic control. To cope with high computational demands in instance-based prediction, methods of dataset reduction are evaluated considering real-time determinism to allow for the rel... | PMC10758379 | |
Graphical abstract | PMC10758379 | |||
Keywords | Open Access funding enabled and organized by Projekt DEAL. | PMC10758379 | ||
Introduction and motivation | amputees | REGRESSION | The development of prosthetics has been continuously improving since the twentieth century. After being solely a cosmetic replacement for amputees, prostheses evolved to body-driven functional devices and, especially beginning in the 1940s, to powered myoelectric systems ([From the existing myographic methods to collec... | PMC10758379 |
Related work | A variety of machine learning strategies has been followed over the years in the context of myocontrol (cf. [The following features and transformations have proven well in the context of pattern-recognition-based myoelectric control (cf. [kNN-based gesture detection in EMG control applications, sorted by year, in studi... | PMC10758379 | ||
Nearest neighbour techniques | amputees | kNN was firstly proposed for the parameter The basic principle of kNN consists of comparing new arriving data (instances) with all instances that were captured as reference data in an initial step and considering a subset of them (number of reference instances The comparison of instances refers to the comparison of dis... | PMC10758379 | |
Training dataset reduction algorithms | An important drawback of instance-based learning schemes is the necessity of comparing new arriving instances whose labels are meant to be predicted to all already stored ones (“training” data). In order to do so, all instances have to be iterated which leads to potentially—depending on the amount of data—high computat... | PMC10758379 | ||
Requirements and concept | The experimental studies and the developments which they are based on are driven by the requirements of Sect. First, a pilot dataset of several (full-intensity) gesture exertions is captured from the authors in order to conduct an offline cross-validation analysis of kNN parameters on gesture classification without rea... | PMC10758379 | ||
Requirements | The requirements listed in Table Requirements for the learning method, providing embedded applicabilityR1 and R2 are considered the minimum standard for myocontrol, while R3 targets the transfer from offline to online scenarios. R4 is motivated by the benefit of home recalibration for prosthetic users [For R5, specific... | PMC10758379 | ||
Sensor hardware | 3-axis gyroscope | CORTEX | A product widely used in research—also in this work—is the Eight EMG electrodes with ST 78589 operational amplifier per electrode.Maximum sampling frequency of 200 Hz.9-axes IMU with 3-axis gyroscope, 3-axis accelerometer and 3-axis magnetometer (InvenSense MPU-9150).Freescale Kinetis ARM Cortex M4 120 Mhz MK22FN1M mic... | PMC10758379 |
Signal processing and nearest-neighbour-based methods | action/gesture | REGRESSION | In general, a kNN-based classification approach will be given priority over kNN regression, as the latter exposed a high extent of instability in preliminary experiments.To keep the computational demands as low as possible for an embedded prosthetic control system, we aimed at utilizing time-domain features due to thei... | PMC10758379 |
Methods | In terms of the methodical realization of the algorithm, several characteristics will be pointed out in the following, regarding both the kNN scheme and data reduction techniques. | PMC10758379 | ||
Methodological considerations for the kNN approach | REGRESSION | The kNN training process is structured as follows (see also Fig. General structure of training phaseThe prediction process comprises the following: applying rest magnitude thresholding (if enabled), executing normalization of sample (if enabled), calculating These steps are also pointed out in Fig. General structure of... | PMC10758379 | |
Nearest neighbour parameter configurations | The number of next neighbouring samples (The examined distance measures are the Minkowski-norm-based metrics Manhattan (kNN inherently involves | PMC10758379 | ||
Proportionality scaling and rest thresholding | As presented in [For the non-rest gestures, an approach of proportionality scaling is utilized [As mentioned, there is the need for a trade-off between the level of proportionality resolution and suppressing unintended activations. Therefore, a divisor Example of proportionality scaling: These relations between measure... | PMC10758379 | ||
Evaluation and results | pronation, supination | This section presents the experimental outcomes to evaluate the developed strategies. These results were obtained from conducting the following experiments: Offline tests with datasets from one subject.Online tests with real-time data from one subject (pilot experiments).Online tests with 12 subjects (basic user study)... | PMC10758379 | |
Offline cross-validation accuracy | The offline experiments described in this section are based on several series of EMG data captured from the authors. They provide a rational measure of the applicability by means of cross-validation accuracy. In the datasets, one training repetition consisted of 400 samples per gesture (2 s capturing with 200 Hz sample... | PMC10758379 | ||
Influence of distance weighting | For the evaluation of cross-validation accuracy when changing the distance weighting factor, the different datasets showed the same qualitative behaviour. The distance from the current to the particular other samples is denoted by Independent of the weighting factor used, it could be observed that high numbers of When ... | PMC10758379 | ||
Influence of distance metric | Minkowski-distance-based | The variation of the distance metric showed almost no effect in the case of the four gestures (rs, pw, fl, ex); see Fig. The observed behaviour in the case of data which included the pointing gesture exposed the following differences (Fig. Distance metric influence on cross-validation accuracy, gestures (rs, pw, pn, fl... | PMC10758379 | |
Summary | All in all, it could be observed that for the cross-validation accuracy in the case of low numbers of With that, the Euclidean distance and a weighting of | PMC10758379 | ||
Real-time pilot experiments | REGRESSION | The pilot study experiments described in this section were only evaluated on one subject. Although the results obtained from these target achievement tests are therefore not representative, they may give insights on how different means and adaptions in the used algorithms can affect the achieved online success rates in... | PMC10758379 | |
Rest class thresholding: rest magnitude threshold | The rest magnitude threshold was introduced to cope with the problem of separating intermediate gestures from the rest class in the proposed proportional control. In order to evaluate the influence on the user success rate, multiple tests were conducted with the gesture sets (rs, pw, fl, ex) and (rs, pw, pn, fl, ex).Fi... | PMC10758379 | ||
Proportionality offset scaling: scale offset divisor | As described, besides the rest magnitude threshold, a proportionality offset was introduced. This offset is divided by the scale offset divisor Influence of scale offset divisor (with rest thresholding, Figure Higher averaged success rates were achievable for all scale offset divisors in kNN than for RR and RR-RFF. The... | PMC10758379 | ||
Evaluation of prototype reduction algorithms | In order to evaluate the performance of the chosen prototype reduction algorithms (see Sect. These were pilot results to test the algorithms’ accuracy and processing times with reduced datasets.The reduction was executed on each cross-validation fold of the dataset individually, followed by the actual validation. As th... | PMC10758379 | ||
Runtime complexity of DSM | To analyze the DSM prototype generation algorithm with regard to its runtime complexity, two phases can be distinguished, namely initialization and actual reduction. The phases will be analyzed on their worst-case runtime.The following conventions are made: The results of this analysis are shown in Table Summarizing Ta... | PMC10758379 | ||
Real-time user studies with multiple subjects | REGRESSION | In order to analyze if requirement R4 can be fulfilled by the proposed algorithms, online user studies with multiple subjects were conducted for the evaluation of suitability in practical scenarios. The setup of the experiment is shown in Fig. kNN parameterized according to the configuration obtained in the pilot exper... | PMC10758379 | |
Basic user study (five classes) | The subjects provided informed consent and statistical information as follows:Age range from 21 to 34 (mean 25, median 24).Three female and 9 male.One left-handed and 11 right-handed.Four already participated in many EMG experiments, 3 in a few and 5 without any EMG experience.In the prediction and test phase, they wer... | PMC10758379 | ||
Extended user study (seven classes) | supination | For the purpose of investigating the suitability of the developed methods when including even more gestures in the training, further experiments were conducted as an extension of the described user study. Four subjects who had no EMG experience before but participated in the basic user study were selected again (subjec... | PMC10758379 | |
User study discussion | pronation, muscle fatigue, supination | REGRESSION, MINOR | Overall, it could be shown in the user studies that both the standard kNN scheme as well as the DSM-reduced technique yielded significantly higher success rates than RR-RFF and RR in most of the scenarios. The behaviour that kNN-based methods performed significantly better at higher exertion levels in the basic user st... | PMC10758379 |
Conclusions and outlook | pronation, supination, gestures or implicit learning | REGRESSION | In this work, a detailed examination of kNN-based learning techniques in the context of electromyographically controlled prostheses was conducted.Summing up, with the proposed and implemented algorithms, all requirements stated in Table First, the influence of several parameters on the block-wise cross-validation was e... | PMC10758379 |
Appendix 1. DSM runtime complexity | PMC10758379 | |||
Funding | Open Access funding enabled and organized by Projekt DEAL. | PMC10758379 | ||
Declarations | PMC10758379 | |||
Ethical approval and informed consent | All procedures performed in the studies that involved human participants were approved by the internal committee for personal data protection of the German Aerospace Center (DLR) and followed the World Medical Association’s Declaration of Helsinki. Each participant was informed about the experimental process beforehand... | PMC10758379 | ||
Conflict of interest | The authors declare no competing interests. | PMC10758379 | ||
References | PMC10758379 | |||
Supplementary Information | sideroblasts, myelodysplastic syndromes | MYELODYSPLASTIC SYNDROMES | Red blood cell transfusion independence (RBC-TI) is an important goal in treating lower-risk myelodysplastic syndromes with ring sideroblasts. In the phase 3 MEDALIST study, RBC-TI of ≥ 8 weeks was achieved by significantly more luspatercept- versus placebo-treated patients in the first 24 weeks of treatment. In this p... | PMC9889415 |
Keywords | Open Access funding enabled and organized by Projekt DEAL. | PMC9889415 | ||
Introduction
| MDS, RBC, anemia, bone marrow disorders, peripheral cytopenias | MYELODYSPLASTIC SYNDROMES, BONE MARROW DISORDER, ANEMIA, ACUTE MYELOID LEUKEMIA | Myelodysplastic syndromes (MDS) are a heterogenous group of clonal bone marrow disorders characterized by inadequate hematopoiesis; peripheral cytopenias, particularly anemia; and an increased risk of progression to acute myeloid leukemia [Real-world, observational studies have shown an inverse relationship between the... | PMC9889415 |
Methods | PMC9889415 | |||
Study design | DISEASE PROGRESSION | The design of the MEDALIST study has been described previously [Patients were randomized 2:1 to receive either luspatercept 1.0 mg/kg subcutaneously or placebo every 3 weeks (Fig. MEDALIST study design. Regardless of meeting the primary endpoint at week 25, patients who had shown clinical benefit (as assessed by the in... | PMC9889415 | |
Assessments | This post hoc analysis of MEDALIST evaluated the cumulative mean number of RBC transfusion units and RBC transfusion visits through 144 weeks of treatment according to baseline RBC transfusion burden level (low vs high). Low and high baseline RBC transfusion burden levels were defined as having < 6 RBC transfusion unit... | PMC9889415 | ||
Results | PMC9889415 | |||
Weeks 25–48 of the extension phase | EVENTS | Of the 68 patients who were initial luspatercept nonresponders (by HI-E) at week 25 and continued treatment, 11 patients (16%) achieved RBC-TI for ≥ 8 weeks during weeks 25–48 of the extension phase. Of these, 3 patients were RBC-TI for ≥ 16 weeks (Online Resource During weeks 25–48, 18 (26%) of the 68 initial luspater... | PMC9889415 | |
Weeks 1–48 and during the entire treatment period | Clinical benefit as assessed with the response indicators RBC-TI for ≥ 8 weeks, ≥ 50% reduction in transfusion burden, and HI-E response is shown in Fig. Response indicators across analysis periods. Evaluated in patients who did not achieve RBC-TI for ≥ 8 weeks by week 25 but continued luspatercept treatment ( | PMC9889415 | ||
Discussion | toxicity, sideroblasts | In the MEDALIST study, luspatercept demonstrated a consistent benefit in reducing RBC transfusion burden within the first 24 weeks of treatment among patients with LR-MDS [The findings of this analysis have value in the real-world clinical setting where luspatercept can lower transfusion burden and continue to offer cl... | PMC9889415 | |
Acknowledgements | The authors received writing and editorial assistance in the preparation of this manuscript from Saba Choudhary, PhD, of Excerpta Medica, funded by Bristol Myers Squibb. The authors are fully responsible for all content and editorial decisions for this manuscript. | PMC9889415 | ||
Author contribution | C.H. | U.G., A.Y., D.T.: conception/design, data interpretation; P.F., U.P., R.B., V.S., M.D-C., D.M., C.H., R.S.K., G. G-M.: data interpretation; S.F.: data acquisition, data interpretation; G.Z., R.Z., X.H.: data analysis; A.M.Z.: data acquisition. | PMC9889415 | |
Funding | Open Access funding enabled and organized by Projekt DEAL. This study was supported by Celgene, a Bristol Myers Squibb Company, in collaboration with Acceleron Pharma Inc., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. | PMC9889415 | ||
Data availability | The BMS policy on data sharing may be found at | PMC9889415 | ||
Declarations | PMC9889415 | |||
Ethics approval | All participating sites received Institutional Review Board or ethics committees approval for the protocol. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 20... | PMC9889415 | ||
Consent to participate | All patients in the MEDALIST study provided written informed consent. | PMC9889415 | ||
Conflict of interest | ONCOLOGY | UG has received research support from BMS and Novartis; speaker honorarium from BMS, Jazz Pharmaceuticals, and Novartis; and consulting fees from BMS. PF has received research support and honoraria from BMS. UP has received research funding from Amgen, BMS, Janssen, Merck, and Novartis; consulting fees from BMS; honora... | PMC9889415 | |
References | PMC9889415 | |||
Background | tibial fracture, death, amputation, amputations, Traffic injuries, pain, infection, fractures, injuries, Infection | SCAR, DISEASE, MUSCULOSKELETAL DISORDERS, INFECTION, INFECTION | Traffic injuries are the leading cause of death among young people worldwide. Tibial fractures are the most common long bone fractures and essential to hospital operating room procedures. Patients remain for many days in health facilities, which imposes a cost to the health system [The National Center for Health Statis... | PMC10707925 |
Methods | bleeding, occlusive arteriopathies, lower limb soft-tissue injury, allergy, tibial fractures, traumatic, neurovascular injury, neurological and psychiatric disorders, purulent, fractures, pain, necrosis, photosensitivity, Trauma, injuries, trauma | SYSTEMIC DISEASE, BLEEDING, DEGENERATION, ADVERSE EVENTS, ALLERGY, COMPLICATION, SECONDARY, NECROSIS, PHOTOSENSITIVITY, JENSEN | This economic evaluation was made from the point of view of the Brazilian public health system. All costs are expressed in reais for the financial year 2022. A comprehensive economic perspective would be desirable. However, due to photonic therapies’ emerging and recent characteristics, we have not yet found many contr... | PMC10707925 |
Treatment direct and indirect cost estimates. | PMC10707925 | |||
Comparison of daily means over the entire follow-up period of progression in itens of the BATES-JENSEN scale. | traumatic, fractures, Martimbianco ALC, RA, injuries, PVD | MAY, ALMEIDA, PVD | * Clinical outcomes of the study: Jana Neto FC, Martimbianco ALC, Mesquita-Ferrari RA, Bussadori SK, Alves GP, Almeida PVD, et al. Effects of multiwavelength photobiomodulation for the treatment of traumatic soft tissue injuries associated with bone fractures: A double-blind, randomized controlled clinical trial. J Bio... | PMC10707925 |
Cost-effectiveness analysis. | The ICER for this outcome was R$752.71 negative every ten days of wound resolution. It is assumed that if the entire sample had been treated with PBM, it would be possible to save R$7,527.10 and reduce the resolution time by ten days compared to the Control group (When analyzing the two outcomes, it was observed that t... | PMC10707925 | ||
Cost-effectiveness matrix–average daily outcome BATES-Jensen scale. | PMC10707925 | |||
Cost-effectiveness matrix–time to resolution outcome. | PMC10707925 | |||
Discussion | tibial fracture, edema, fracture, amputation, traumatic, pain, fractures, injuries | EDEMA, SECONDARY, COMPLICATIONS | The costs of fractures and orthopaedic surgeries are usually divided into direct and indirect costs, that is, those associated with treatment and those related to costs due to loss of productivity [In a systematic review published in 2021 [In this context, the need to implement protocols in health services that can red... | PMC10707925 |
Conclusion | tibial fracture | This study found, in a preliminary way, that pre-surgical PBM in cases of tibial fracture was more effective in the BATES-Jensen Scale and had the same resolution time as the placebo. PBM presented a lower total cost in both outcomes than the control group. It is concluded, therefore, that PBM can be a supportive thera... | PMC10707925 | |
Supporting information | PMC10707925 | |||
Objective | hypertension | HYPERTENSION | This study aims to construct the risk prediction nomogram model of critical condition in patients with hypertension during pregnancy and to verify its evaluation effect. | PMC10413762 |
Methods | hypertension | REGRESSION, HYPERTENSION | A total of 531 patients with hypertension during pregnancy were randomly grouped into 427 model group and 104 validation group. The model group patients included 59 cases of critical group and 368 cases of non-critical group according to the occurrence of critical situation. Multivariate Logistic regression analysis wa... | PMC10413762 |
Results | hypertension, anemia | HYPERTENSION, ANEMIA DURING PREGNANCY, ANEMIA | The proportions of patients aged over 30 years, with an educational background of junior high school or below, a family history of hypertension, anemia during pregnancy, and a lower erythrocyte count were significantly higher in the critical group compared to the non-critical group (P < 0.05). Age > 30 years old, educa... | PMC10413762 |
Conclusion | hypertension | HYPERTENSION | The nomograph model can predict the risk of critical condition in patients with hypertension during pregnancy and screen high-risk population. | PMC10413762 |
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