Reliability of Markerless Motion Capture Systems for Assessing Movement Screenings.

Background: Movement screenings are commonly used to detect unfavorable movement patterns. Markerless motion capture systems have been developed to track 3-dimensional motion. Purpose: To determine the reliability of movement screenings assessed using a markerless motion capture system when comparing the results of multiple systems and multiple collection periods. Study Design: Descriptive laboratory study. Methods: The inter- and intrarater reliability of a commercially available markerless motion capture system were investigated in 21 recreationally active participants aged between 18 and 22 years. A total of 39 kinematic variables arising from 10 fundamental upper and lower body movements typical of a screening procedure in sports performance were considered. The data were statistically analyzed in terms of relative error via the intraclass correlation coefficient (ICC) and absolute error via the residual standard error (RSE). Results: Both inter- and intrarater reliability ICCs were at least moderate across all variables (ICC, >0.50), with most movements and corresponding variables having excellent reliability (ICC, >0.90). Although maximum knee valgus angles were the kinematic variables with the lowest interrater reliability (ICCs, 0.59-0.82) and moderate relative agreement, there was agreement in absolute terms with an RSE of <1.3°. Conclusion: Findings indicated that markerless motion capture provides reliable measurements of joint position during a movement screen, which allows for a more objective evaluation of the direction and subsequent success of interventions. However, practitioners should consider relative and absolute agreements when applying information provided by these systems. Clinical Relevance: Markerless motion capture systems may assist clinicians by reliably assessing movement screenings using different systems over different collection periods.

Intensive care unit telemedicine: review and consensus recommendations.

Intensive care unit telemedicine involves nurses and physicians located at a remote command center providing care to patients in multiple, scattered intensive care units via computer and telecommunication technology. The command center is equipped with a workstation that has multiple monitors displaying real-time patient vital signs, a complete electronic medical record, a clinical decision support tool, a high-resolution radiographic image viewer, and teleconferencing for every patient and intensive care unit room. In addition to communication functions, the video system can be used to view parameters on ventilator screens, infusion pumps, and other bedside equipment, as well as to visually assess patient conditions. The intensivist can conduct virtual rounds, communicate with on-site caregivers, and be alerted to important patient conditions automatically via software-monitored parameters. This article reviews the technology's background, status, significance, clinical literature, financial effect, implementation issues, and future developments. Recommendations from a University HealthSystem Consortium task force are also presented.

Antepartum bleeding of unknown origin in the second half of pregnancy: a review.

UNLABELLED: The objective of this study was to determine the prevalence, adverse pregnancy complications, and optimal management of pregnancies complicated by bleeding in the second half of pregnancy of an unknown origin (ABUO). A MEDLINE search from 1966 through November 2004 using the search terms "antepartum hemorrhage" or "hemorrhage" or "uterine hemorrhage" and "pregnancy complications" and "cardiovascular complications" and "second trimester pregnancy" or "third trimester pregnancy" was undertaken. The inclusion criteria focused on bleeding not resulting from placenta previa or abruption or to any known cause. The MEDLINE search provided 24 abstracts for review with 9 studies meeting the inclusion criteria The prevalence of ABUO was 2%. The likelihood of antepartum hemorrhage and delivery before 37 weeks was significant with an odds ratio (OR) of 3.17 and 95% confidence interval (CI) of 2.76-3.64. The risk of intrauterine fetal demise was significantly increased in women with ABUO (OR, 2.09; 95% CI, 1.43-3.06). The association between ABUO and fetal anomalies was increased with an OR 1.42 (95% CI, 1.07-1.87). Only one study with a small sample size (N = 48) compared the outcomes of women using Doppler studies of the umbilical and uterine arteries and biophysical profiles. No differences were observed in the women undergoing antenatal testing and the women not undergoing antenatal testing. The prevalence of ABUO is 2%. Preterm delivery, stillbirth, and fetal anomalies appear to be increased in these pregnancies. Antenatal testing may be of limited value in their management. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to explain the prevalence of antepartum bleeding of unknown origin (ABUO) in confronting a patient with ABUO, summarize the types and frequency of adverse pregnancy outcomes in ABUO, and recall the limited usefulness of antenatal testing in patients with ABUO.

Clinical gene therapy for nonmalignant disease.

Gene therapy is envisioned as a potentially definitive treatment for a variety of diseases that have a genetic etiology. We reviewed trials of clinical gene therapy for nonmalignant, single-gene, and multifactorial disorders and infectious diseases, and found limited evidence suggesting that gene therapy may benefit patients who have severe, combined, immunodeficiency disorder; cystic fibrosis; coronary artery disease or peripheral arterial disease; or hemophilia. Effective gene therapy requires the targeted transfer of exogenous genetic material into human cells and the subsequent regulated expression of the corresponding gene product. Because no phase 3 randomized controlled trials have been completed that fulfill these criteria, it is difficult to correlate signs of clinical benefit with the administration of gene therapy in any disease. Additional clinical and basic research is needed to determine the future role of gene therapy.

Distributed medical informatics education using internet2.

The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy.