Una reflexión multimodal sobre los contenidos educativos construidos en imagen y video en el marco de una propuesta educativa para la salud / A Multimodal Reflection on the Educational Contents Constructed in Image and Video within the Framework of an Educational Proposal for Health

Resumen Cuando los procesos de construcción de contenidos digitales se producen con escaza participación de la comunidad, las decisiones sobre el significado pasan por la interpretación de técnicos y profesionales expertos que tienen otra lectura del mundo y en algunos casos se termina en procesos de exclusión desde el mismo significado que se presenta. Debido a la toma de decisiones que surge entre una temática y el modo que se elige, se presenta como reto una participación amplia de las comunidades para crear contenidos formativos en el marco de la Educativos para la Salud (EpS).

Abstract: When the processes of construction of digital contents are produced with little participation of community, decisions about the meaning go through the interpretation of technical and professional experts, who have another reading of the world and, in some cases, end up in processes of exclusion from the same meaning that is presented. Due to the decision making that arises between a theme and the way it is chosen, a broad participation of communities to create formative contents within the framework of Education for Health (EpS) is presented as a challenge.

Construction of a quantitative diagnosis model for predicting the nature of thyroid nodules based on multi-modality ultrasound images / 中华超声影像学杂志

Objective:To construct a quantitatively diagnostic nomogram model by analyzing the clinical information of patients and the features of multi-modality ultrasound images of thyroid lesions, so as to preoperatively predict the malignant probability of suspicious thyroid nodules and provide effective references for clinical decision-making.Methods:A total of 933 patients, 1 121 thyroid nodules of C-TIRADS 3-5 categories, who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from September 1, 2020 to June 10, 2021 were collected. The nodules were randomly divided into training ( n=897) and test groups ( n=224) in 8∶2 ratio. Finally, the diagnostic performance was evaluated by area under the curve (AUC). Results:①After preliminary screening by univariate analysis, multivariate analysis showed that age, echogenicity, orientation, echogenic foci, margin, posterior features, and elastic score were significantly correlated with benign and malignant nodules (all P<0.001), and the difference of halo between benign and malignant nodules was also statistically significant ( P=0.012). ②The AUC of nomogram was up to 0.903(95% CI=0.862-0.944) in the test set, and 0.889(95% CI=0.832-0.946) and 0.960(95% CI=0.925-0.994) in nodules with maximum diameter of ≤10 mm and of >10 mm respectively, which showed high diagnostic performance. Conclusions:The nomogram model could accurately differentiate malignant from benign thyroid nodules preoperatively, with the highest diagnostic performance for the nodules with maximum diameter of >10 mm, and effectively avoid the unnecessary fine-needle biopsy and surgical operation.

Multimodality-based super-resolution reconstruction for routine brain magnetic resonance images / 南方医科大学学报

OBJECTIVE@#To propose a multi-modality-based super-resolution synthesis model for reconstruction of routine brain magnetic resonance images (MRI) with a low resolution and a high thickness into high-resolution images.@*METHODS@#Based on real paired low-high resolution MRI data (2D T1, 2D T2 FLAIR and 3D T1), a structure-constrained image mapping network was used to extract important features from the images with different modalities including the whole T1 and subcortical regions of T2 FLAIR to reconstruct T1 images with higher resolutions. The gray scale intensity and structural similarities between the super-resolution images and high-resolution images were used to enhance the reconstruction performance. We used the anatomical information acquired from segment maps of the super-resolution T1 image and the ground truth by a segmentation tool as a significant constraint for adaptive learning of the intrinsic tissue structure characteristics of the brain to improve the reconstruction performance of the model.@*RESULTS@#Our method showed the performance on the testing dataset than other methods with an average PSNR of 33.11 and SSIM of 0.996. The anatomical structure of the brain including the sulcus, gyrus, and subcortex were all reconstructed clearly using the proposed method, which also greatly enhanced the precision of MSCSR for brain volume measurement.@*CONCLUSION@#The proposed MSCSR model shows excellent performance for reconstructing super-resolution brain MR images based on the information of brain tissue structure and multimodality MR images.

Metáforas da lama: multimodalidade e argumentação em discursos sobre sustentabilidade e rompimento de barragens de rejeitos de minério de ferro / Metaphors of the mud: multimodality and argumentation in discourses about sustainability and the rupture of tailings dams of iron ore

As barragens de rejeito de minério de ferro fazem parte do processo de mineração no Brasil. Trata-se de uma técnica antiga envolvendo diversas tecnologias para torná-la mais segura. A constante vigília e cuidado sobre essas estruturas tornaram-se uma rotina frequente das mineradoras para evitar possíveis rupturas dessas barragens. Após o rompimento da barragem de rejeitos de minério em Brumadinho-MG e Mariana-MG muitos discursos com elementos metafóricos acerca da sustentabilidade e a prática de uso de barragens de rejeitos foram sustentados por uma intencionalidade discursiva voltada para a crítica social. O objetivo deste estudo é identificar e analisar o uso de metáforas conceptuais presentes como elementos multimodais na argumentação textual, numa perspectiva sociocognitiva e interacional da linguagem. Para isso, adota-se uma pesquisa expo-facto. O viés teórico da intencionalidade discursiva na linha de Searle; o caráter de modelos mentais, representações sociais e conhecimento sociocultural tal com prevê Van Dijk, a visão sociosemiótica de Geeraerts para compreender como argumentação por meio do campo imagético das charges é construída e sustentada socialmente e o dialogismo na perspectiva de Meyer a partir da argumentação. Nessa perspectiva sociocognitiva e interacional, o texto é pensado como uma construção linguístico-discursiva na qual a intencionalidade está relacionada com os modelos mentais resultantes de representações construídas a partir da experiencia do sujeito em sociedade e das práticas interacionais. Nesse contexto, o texto contempla uma gama de operações cognitivas interligadas como direciona Marscuschi. Constitui-se um corpus de charges publicadas na mídia brasileira, orientadas para a temática do rompimento de barragens de rejeitos de minério de ferro para a análise do aparecimento de metáforas conceptuais. Conclui-se que as metáforas se constituem recursos multimodais na orientação argumentativa e revelam metáforas do medo e da lama envolvendo um discurso do horror sobre a tragédia das cidades de Brumadinho e Mariana.

Iron ore tailings dams are part of the mining process in Brazil. It is an old technique involving several technologies to make it more secure. Constant vigilance and care about these structures have become a frequent routine for mining companies to avoid possible failures of these dams. After the collapse of the ore tailings dam in Brumadinho (MG) and Mariana (MG) cities, many discourses with metaphorical elements about sustainability and the practice of using tailings dams were supported by a discursive intentionality focused on social criticism. The aim of this study is to identify and analyze the use of conceptual metaphors present as multimodal elements in textual argumentation, in a sociocognitive and interactional perspective of language. For this, it is adopted from expo-facto research. The theoretical bias of discursive intentionality along the lines of Searle; the character of mental models, social representations,and sociocultural knowledge as predicted by Van Dijk, the sociosemiotic vision of Geeraerts (2016) to understand how argumentation through the imagery field of cartoons is constructed and socially supported and dialogism in perspective of Meyer from the argumentation. In this sociocognitive and interactional perspective, the text is thought of as a linguistic-discursive construction in which intentionality is related to mental models resulting from representations built from the subject's experience in society and interactional practices. In this context, the text contemplates a range of interconnected cognitive operations as directed by Marscuschi. A corpus of cartoons published in the Brazilian media is constituted, oriented to the theme of breaking up iron ore tailings dams for the analysis of the appearance of conceptual metaphors. It is concluded that metaphors are multimodal resources in the argumentative orientation and reveal metaphors offear and mud involving a horror speech about the tragedy of the cities of Brumadinho and Mariana.

Imaging study of lymphomatosis cerebri characterized by diffuse lesions of bilateral cerebral white matter / 中华神经科杂志

Objective:To investigate multimodality imaging characteristics and clinical features of lymphomatosis cerebri (LC) and reasons for misdiagnosis,with the goal of potentially facilitating an early and accurate diagnosis for this often-missed disease.Methods:Clinical data and cerebral multimodality imaging findings from 11 patients with LC proven basing on pathology in the Affiliated Hospital of Guizhou Medical University from November 30, 2011 to December 28, 2020 were retrospectively extracted, analyzed, and reviewed in combination with the literatures.Results:The common presenting symptoms with subacute onset included cognitive decline (8/11), gait disturbance (9/11), and behavioral disturbance (5/11). Test of cerebrospinal fluid showed that the number of cells and the level of protein increased (8/10), the sugar content (2/10) and chloride (4/10) decreased. The imaging manifestations of 11 patients with LC were diffuse lesions of bilateral cerebral white matter in the both deep and lobar lesion distribution, involving the cerebral cortex and subcortical white matter in eight cases (8/11), basal ganglia in seven cases (7/11), thalamus in five cases (5/11), cerebellum in six cases and brain stem in six cases (6/11). All 11 patients showed equal or slightly low-density shadows on CT plain scan and slightly longer T 1WI and T 2WI signals on magnetic resonance imaging. Six cases (6/11) had no obvious enhancement in the early stage, and five cases and six follow-up cases showed heterogenous spots, patches, nodules or clusters of distinct enhancement. Diffusion-weighted imaging showed non restricted diffusion in nine (9/11) cases initially diagnosed, and restricted diffusion in two cases (2/11) and nine follow-up cases, which were hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient maps. Five patients (5/5) presented a marked decrease in N-acetyl aspartic acid (NAA)/creatine (Cr) and increase in choline (Cho)/Cr on hydrogen proton magnetic resonance spectrum, including an increase in lipid/Cr in three cases. One case (1/3) showed no abnormal increase in lesion metabolism, and two cases (2/3) showed slightly increased uptake on positron emission tomography/CT. Conclusions:Diffuse bilateral cerebral lesions especially in deep and lobar region, without enhancement or with patchy enhancement, marked decrease in NAA/Cr and increase in Cho/Cr and Lip/Cr are suggestive of LC. Misdiagnosis may be mainly due to insufficient understanding and improper brain biopsy.

Clinical study on diagnosis of myocardial fibrosis by soluble suppression of tumorigenicity 2, galectin-3 combined with magnetic resonance multimodality / 中国医师进修杂志

Objective:To explore the application value of soluble tumor suppressor 2 (SST2), galectin-3 combined with magnetic resonance multimodality in the diagnosis of myocardial fibrosis.Methods:The clinical data of 88 patients with cardiomyopathy from January 2017 to December 2019 in Handan Central Hospital of Hebei Province were retrospectively analyzed as the experimental group, and 100 healthy people in the same period were selected as the control group. According to the results of cardiac magnetic resonance imaging (CMRI)-late gadolinium enhanced (LGE), the patients with cardiomyopathy were divided into LGE positive and LGE negative. The arrhythmia rate was evaluated by ambulatory electrocardiogram. The New York Heart Association (NYHA) cardiac function grade was recorded. The left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were detected by echocardiography. The SST2, galectin-3 and N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of SST2 and Galectin-3 in predicting myocardial fibrosis in patients with cardiomyopathy.Results:CMRI-LGE results of 88 patients with cardiomyopathy showed that LGE was positive in 42 cases and negative in 46 cases. The arrhythmia rate, LVEDD, SST2 and galectin-3 in experimental group were significantly higher than those in control group: 67.05% (59/88) vs. 2.00% (2/100), (46.55 ± 5.99) mm vs. (27.92 ± 2.05) mm, (61.83 ± 10.57) μg/L vs. (24.99 ± 7.69) μg/L and (18.65 ± 3.39) μg/L vs. (7.12 ± 1.33) μg/L, the LVEF was significantly lower than that in control group: (55.11 ± 8.36)% vs. (68.83 ± 9.45)%, and there were statistical differences ( P<0.01). The arrhythmia rate, NYHA cardiac function grade, LVEDD, SST2 and galectin-3 in patients with LGE positive were significantly higher than those in patients with LGE negative: 88.10% (37/42) vs. 47.83% (22/46), (3.10 ± 0.53) grade vs. (2.11 ± 0.61) grade, (48.88 ± 5.95) mm vs. (44.41 ± 5.24) mm, (65.58 ± 11.73) μg/L vs. (58.40 ± 8.10) μg/L and (21.00 ± 2.72) μg/L vs. (16.51 ± 2.39) μg/L, the LVEF was significantly lower than that in patients with LGE negative: (52.15 ± 8.23)% vs. (57.82 ± 7.60)%, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the optimal critical values of serum SST2 and galectin-3 for predicting myocardial fibrosis in patients with cardiomyopathy were 65.07 μg/L and 18.46 μg/L, the area under the curve was 0.714 (95% CI 0.604 to 0.825, P = 0.001) and 0.894 (95% CI 0.828 to 0.960, P = 0.001), the sensitivity was 61.9% and 85.7%, and the specificity was 80.4% and 82.6%. Conclusions:Magnetic resonance multimodality has a good ability in detecting myocardial fibrosis, and serum SST2 and galectin-3 have good predictive value for myocardial fibrosis. SST2 and galectin-3 combined with magnetic resonance multimodality has important clinical significance in the diagnosis of myocardial fibrosis.

A review on the application of UK Biobank in neuroimaging / 生物医学工程学杂志

UK Biobank (UKB) is a forward-looking epidemiological project with over 500, 000 people aged 40 to 69, whose image extension project plans to re-invite 100, 000 participants from UKB to perform multimodal brain magnetic resonance imaging. Large-scale multimodal neuroimaging combined with large amounts of phenotypic and genetic data provides great resources to conduct brain health-related research. This article provides an in-depth overview of UKB in the field of neuroimaging. Firstly, neuroimage collection and imaging-derived phenotypes are summarized. Secondly, typical studies of UKB in neuroimaging areas are introduced, which include cardiovascular risk factors, regulatory factors, brain age prediction, normality, successful and morbid brain aging, environmental and genetic factors, cognitive ability and gender. Lastly, the open challenges and future directions of UKB are discussed. This article has the potential to open up a new research field for the prevention and treatment of neurological diseases.

A review on integration methods for single-cell data / 生物医学工程学杂志

The emergence of single-cell sequencing technology enables people to observe cells with unprecedented precision. However, it is difficult to capture the information on all cells and genes in one single-cell RNA sequencing (scRNA-seq) experiment. Single-cell data of a single modality cannot explain cell state and system changes in detail. The integrative analysis of single-cell data aims to address these two types of problems. Integrating multiple scRNA-seq data can collect complete cell types and provide a powerful boost for the construction of cell atlases. Integrating single-cell multimodal data can be used to study the causal relationship and gene regulation mechanism across modalities. The development and application of data integration methods helps fully explore the richness and relevance of single-cell data and discover meaningful biological changes. Based on this, this article reviews the basic principles, methods and applications of multiple scRNA-seq data integration and single-cell multimodal data integration. Moreover, the advantages and disadvantages of existing methods are discussed. Finally, the future development is prospected.

Application of multi-modal digital MOOCs teaching in the standardized residency training of obstetrics and gynecology / 中华医学教育探索杂志

Objective:To explore the application of multi-modal digital massive open online courses (MOOCs) mode in the standardized residency training of obstetrics and gynecology.Methods:A total of 40 residents who entered the training program of obstetrics and gynecology from September 2018 to February 2020 were selected as the control group, and 40 residents from March 2020 to August 2020 were selected as the study group. The control group adopted the traditional teaching method, and the study group adopted the multi-modal digital MOOCs teaching method. The scores of theoretical examination and skill operation examination after the standardized training, clinical ability examination before and after the standardized training and teaching satisfaction were compared between the two groups. SPSS 22.0 was performed for t test and chi-square test. Results:After the standardized training, the scores of theoretical knowledge [(88.53±6.04) vs. (79.67±5.52)] and skill operation [(85.52±6.33) vs. (71.15±7.86)] in the study group were significantly higher than those in the control group ( P < 0.05). After the standardized training, the scores of all kinds of clinical ability of the two groups were higher than before ( P < 0.05), and the scores of all items in study group were higher ( P < 0.05). The satisfaction of all aspects of teaching in the study group was higher than that in the control group ( P < 0.05). Conclusion:The application of multi-modal digital MOOCs teaching mode in the standardized residency training of obstetrics and gynecology can strengthen the learning and mastering of theoretical knowledge, operational skills and the cultivation of clinical ability, and significantly improve the quality of teaching with high teaching satisfaction.

Interpretation of the 2020 American society of colon and rectal surgeons clinical practice guidelines for the management of rectal cancer / 中华胃肠外科杂志

Located in the pelvic cavity and contiguous to the anal sphincter complex and urogenital organs, the rectum has more intricate anatomical features compared with the colon. Consequently, the treatment of rectal cancer involves more consideration, including pelvic radiation, lateral lymph node dissection, transanal access, postoperative function, sphincter preservation, and nonoperative management. Based on the last set of American society of colon and rectal surgeons (ASCRS) practice parameters for the management of rectal cancer published in 2013, the 2020 guidelines present evidence-based updates for both long-existing and emerging controversies on surgical management of rectal cancer. These updates include the indication for local resection, lymph node dissection for radical proctectomy, minimally invasive surgery, the "watch and wait" strategy for patients with clinical complete response, and prevention of anastomotic leak. Meanwhile, the guidelines recommend a risk-stratified approach for perioperative therapies for non-metastatic disease, and an individualized multimodality treatment based on treatment intent for synchronous metastatic disease.

Supradesnivel del segmento ST como forma de presentación atípica de un tumor cardíaco: rol diagnóstico de la multimodalidad de imagen / ST segment elevation as an atypical presentation of a cardiac tumor: diagnostic role of a multimodal imaging approach / Elevação do segmento ST como apresentação de tumor cardíaco: papel diagnóstico da multimodalidade de imagem

Los tumores cardíacos malignos son neoplasias poco frecuentes que pueden presentarse de diversas formas, lo que dificulta su diagnóstico. La ecocardiografía y la resonancia magnética cardíaca son técnicas fundamentales para el diagnóstico, la caracterización y la evaluación de su extensión tumoral. La identificación de la línea tumoral es esencial al iniciar un tratamiento oncológico dirigido. Si bien el "estándar de oro" para este fin es el estudio anatomopatológico (obtenido por biopsia o resección quirúrgica), en los casos en que esto no es posible, la resonancia magnética cardíaca es la técnica no invasiva que proporciona un mejor abordaje diagnóstico. El tratamiento de elección es la resección quirúrgica y el pronóstico, en general, es malo. Presentamos el caso de una paciente con un tumor cardíaco de presentación clínica atípica, en la que un abordaje imagenológico multimodal aporta información clave y complementaria para el diagnóstico y la caracterización tisular.

Malignant cardiac tumors are rare neoplasms that can present in various forms, making their diagnosis difficult. Echocardiography and cardiac magnetic resonance imaging are fundamental techniques for the diagnosis, characterization, and evaluation of tumor extension. Identification of the tumor line is essential when initiating targeted cancer therapy. Although the "gold standard" for this purpose is the pathological study (obtained by biopsy or surgical resection), in cases where this is not possible, cardiac resonance is the non-invasive technique that provides a better diagnostic approach. The treatment of choice is surgical resection and the prognosis is generally poor. We present the case of a patient with an atypical clinical presentation, in which a multimodal approach provides key and complementary information for tumor diagnosis and tissue characterization.

Os tumores cardíacos malignos são neoplasias raras que podem se apresentar de várias formas, dificultando seu diagnóstico. A ecocardiografia e a ressonância magnética cardíaca são técnicas fundamentais para o diagnóstico, caracterização e avaliação da extensão tumoral. A identificação da linha do tumor é essencial ao iniciar a terapia direcionada do câncer. Embora o "padrão ouro" para esse fim seja o estudo patológico (obtido por biópsia ou ressecção cirúrgica), nos casos em que isso não seja possível, a ressonância cardíaca é a técnica não invasiva que proporciona melhor abordagem diagnóstica. O tratamento de escolha é a ressecção cirúrgica e o pronóstico geralmente é ruim. Apresentamos o caso de uma paciente com apresentação clínica atípica, em que a abordagem multimodal fornece informações essenciais e complementares para o diagnóstico do tumor e caracterização do tecido.

Cuando no todo es lo que parece_: masa extracardíaca en la aurícula izquierda: reporte de un caso en Uruguay / When not everything is what it seems_: extra-cardiac mass in the left atrium: a case report in Uruguay / Quando nem tudo é o que parece_: massa extracardíaca em átrio esquerdo: relato de um caso no Uruguai

La hernia hiatal es una entidad relativamente frecuente y puede ser un hallazgo incidental en un estudio ecocardiográfico. Describimos el caso de una paciente con diagnóstico de masa en la aurícula izquierda (AI) sin clara etiología, a quien se le realiza el diagnóstico de hernia hiatal por resonancia magnética cardíaca (RMC) y luego se demuestra mediante ecocardiografía de contraste el contenido gástrico de la masa tras la ingestión de una bebida carbonatada, lo que permite de forma rápida y sencilla aclarar el diagnóstico.

Hiatal hernia is a relatively common entity, and may be an incidental finding in an echocardiographic study. We describe the case of a patient with a diagnosis of a mass in the left atrium with no clear etiology, in whom the diagnosis of hiatal hernia is made by cardiac magnetic resonance imaging and then demonstrated by contrast echocardiography the gastric content of the mass after the ingestion of a carbonated drink, which allows quickly and easily to clarify the diagnosis.

A hérnia de hiato é uma entidade relativamente comum, e pode ser um achado incidental em um estudo ecocardiográfico. Descrevemos o caso de um paciente com diagnóstico de massa em átrio esquerdo sem etiologia definida, em que o diagnóstico de hérnia de hiato é feito por ressonância magnética cardíaca e posteriormente demonstrado por ecocardiografia contrastada com uma bebida gaseificada, permitindo esclarecer de forma rápida e fácil o diagnóstico.

The vascular armamentarium explored-the ultimate goal achieved

Peripheral arterial disease is one of the commonest causes for a limb being amputated most often, we present this case of medium vessel vasculitis with chronic threatening limb ischemia to make a note of our attempt to save her limb by multiple modalities which included medical management with steroids, immunosuppressants, pulsed cyclophosphamide, interventional radiological procedure of catheter directed thrombolysis with urokinase, surgical procedures like bypass, split skin grafting and minor amputations, implemented novel modalities like hyperbaric oxygen therapy. By exploring the armamentarium available, involving a multidisciplinary team which included vascular surgeon, rheumatologist, intervention radiologist, plastic surgeon, physiotherapist and aptly using the right modality at the right time we were able to ultimately achieve our goal of limb salvage.

Evaluation of pattern and prognostic factors of head injury cases in a tertiary care centre

Background: Head injury is a major public health problem worldwide and requires appropriate attention both regionally and globally. This study was done to find the patterns and to evaluate prognostic factors for final outcome of cranio-cerebral trauma.Methods: A prospective study of 200 cases of head injury was conducted in a tertiary care hospital during one year duration. Apart from patient’s demographic profile detailed history and examination was recorded. Final outcome of all patients was noted at discharge and during follow up, various prognostic factors were studied by taking Glasgow outcome scale (GOS) at 3 months of head injury.Results: This study included 156 (78%) males and 44 (22%) females with average age of 35.95 years. Assault followed by RTI was the main cause of TBI. The factors which correlated with poor prognosis are presence of increasing age, less GCS at admission, alcohol intoxication and multiple lesions on CT scan.Conclusions: Prognostication of patients with head injury will help to provide timely multimodality approach which will ultimately help in improving outcome of these patients.

Design of Multimodality Wheelchair Based on Double Parallelogram Mechanism / 中国康复理论与实践

Objective:To design a multimodality wheelchair in order to meet many use requirements of the lower limbs dyskinesia patients. Methods:For some shortcomings of the existing multimodality wheelchair such as heavy structure and drive redundancy, the design of multimodality wheelchair based on double parallelogram mechanism is studied, and a simple and reliable multimodality wheelchair mechanism is presented. Rotary actuation drives the double parallelogram mechanism and makes parts of the wheelchair move, and three posture transformations are realized. The coupling movement of the back and leg rest realizes the transformation of sitting and supine posture, and the coupling movement of seat and back realizes the change of sitting and standing posture. The mechanical analysis of wheelchairs based on uniform load was carried out, and the rotation moment is calculated. Results:When the driving torque changed from sitting position to supine position, it increased with the increase of rotation angle and reached a peak value. When the driving torque changed from sitting position to standing position, it gradually decreased with the increase of rotation angle. Then the dynamics simulation is carried out in Adams software, the calculated results were basically consistent with the simulation results. Conclusion:The proposed mechanism is helpful to realize the lightweight design of multimodality wheelchair, and meets the design needs of intelligent multimodality wheelchair.

Application of multimodal guidance based on the concept of five senses and six senses on sleep phase of postoperative patients with intestinal tumor / 中国实用护理杂志

Objective@#To explore the effect of multimodal guidance based on the concept of five senses and six senses on the sleep phase of postoperative patients with intestinal tumor.@*Methods@#A total of 110 patients with intestinal tumor after surgery from January 2018 to July 2019 in Qilu Hospital of Shandong University (Qingdao) were randomly divided into two groups, 55 patients in each group. The control group received routine daily care. Instructed, the experimental group conducted multimodal guided training based on the five senses and six senses on the basis of daily care, and continued intervention for 3 weeks. Polysomnography (PSG) was used to compare the sleep phase differences before and after intervention.@*Results@#The ratio of NREM to total sleep time, the ratio of stage 1 sleep time to total sleep time, the ratio of stage 3 sleep time to total sleep time, the ratio of stage 4 sleep time to total sleep time, and the ratio of REM to total sleep time after intervention. The number of NREM micro-wakes (Z value was -5.178--2.157, all P<0.05), the difference was statistically significant. The proportion of NREM in total sleep time, the proportion of sleep time in total sleep time, the number of NREM micro-wakes, and the number of REM micro-wakes decreased compared with the pre-intervention period; the proportion of sleep time in total sleep time in stage 3, sleep in stage 4 The proportion of time to total sleep time and the proportion of REM to total sleep time were increased compared with those before intervention (Z value was -6.029--4.064, all P<0.05), and the difference was statistically significant. In the control group, the proportion of sleep time in total sleep time was increased compared with that before intervention. The number of NREM micro-wake and the number of REM micro-wakes were lower than those before intervention (Z value was -2.948, -5.632, -2.475, all P<0.05). The difference was statistically significant.@*Conclusion@#Multimodal guided training based on the concept of five senses and six senses can effectively improve the sleep structure of patients with intestinal tumors and improve their sleep quality.

Design and implementation of postoperative evaluation pipeline of deep brain stimulation by multimodality imaging / 生物医学工程学杂志

Deep brain stimulation (DBS) surgery is an important treatment for patients with Parkinson's disease in the middle and late stages. The accuracy of the implantation of electrode at the location of the nuclei directly determines the therapeutic effect of the operation. At present, there is no single imaging method that can obtain images with electrodes, nuclei and their positional relationship. In addition, the subthalamic nucleus is small in size and the boundary is not obvious, so it cannot be directly segmented. In this paper, a complete end-to-end DBS effect evaluation pipeline was constructed using magnetic resonance (MR) data of T1, T2 and SWI weighted by DBS surgery. Firstly, the images of preoperative and postoperative patients are registered and normalized to the same coordinate space. Secondly, the patient map is obtained by non-rigid registration of brain map and preoperative data, as well as the preoperative nuclear cluster prediction position. Then, a three-dimensional (3D) image of the positional relationship between the electrode and the nucleus is obtained by using the electrode path in the postoperative image and the result of the nuclear segmentation. The 3D image is helpful for the evaluation of the postoperative effect of DBS and provides effective information for postoperative program control. After analysis, the algorithm can achieve a good registration between the patient's DBS surgical image and the brain map. The error between the algorithm and the expert evaluation of the physical coordinates of the center of the thalamus is (1.590 ± 1.063) mm. The problem of postoperative evaluation of the placement of DBS surgical electrodes is solved.