Digital anatomical features of morphological development in C2-C7 neurocentral synchondrosis in children aged 1-6 years: a retrospective study of CT images.

BACKGROUND: With the continuous improvement of diagnosis and treatment technology for cervical spine-related diseases in children at home and abroad, the demand for exploring the developmental anatomy and function of children's cervical spine of different ages is increasing. So the aim of this study was to investigate the changes of anatomical indicators in neurocentral synchondrosis (NCS) of C2-C7 with age and the developmental characteristics of different vertebrae in children aged 1-6 years old. METHOD: A retrospective collection of 160 cases of normal cervical spine CT images of children aged 1-6 years old in provincial tertiary hospitals, according to the age group of 1-year-old into 6 groups. The original data of continuously scanned cervical spine tomography images were imported into Mimics16.0 software, under the two-dimensional image window, selected the measurement tool under the Measurements toolbar to measure and statistically analyzed the anatomical indicators such as cross diameter, sagittal diameter, height, perimeter and area of NCS in the C2-C7 segment of the cervical spine on the coronal plane and cross-section. RESULTS: There was no significant difference in the anatomical indexes of cervical spine NCS in children compared with the left and right sides of the same vertebrae (P > 0.05). The same cervical spine generally had differences between the age groups of 1-4 years old and 5-6 years old (P < 0.05).The transverse diameter and circumference gradually decreased with age; the sagittal diameter and height showed a slight increase trend; there was a maximum area at 2 years of age. In different cervical vertebrae of the same age group, the NCS values of C3, C4, and C5 varied greatly, which showed that the ossification process of cervical cartilage was faster than that at the upper and lower ends. There were obvious differences between C2 and the rest of the cervical vertebral segments' NCS ossification process. C7 was also very different from the rest of the cervical vertebrae segments, presumably more similar to the thoracic spine. CONCLUSIONS: The anatomical indexes of C2-C7 NCS in children have obvious developmental regularities at different ages, and there are also regularities between cervical segments.

Digital anatomical features of morphological development in the atlantoaxial synchondroses in children aged 1 to 6 years old: a retrospective study of CT images.

OBJECTIVE: To investigate the anatomical indexes and anatomical positional indexes of the atlantoaxial synchondroses in normal Chinese Han children aged 1-6 years, and to analyze the changing law of the atlantoaxial cartilage union with the growth and development of age and its influence on the atlantoaxial ossification in children. METHODS: A retrospective collection of CT imaging of 160 cases of normal cervical spine in children aged 1 to 6 years old was conducted. The cases were divided into six age groups, with each group representing a one-year age range. Measure the morphological anatomical indicators and anatomical positional indicators of the atlantoaxial synchondroses. Record and statistically analyze the measurements of each indicator. RESULTS: Measurements were taken on various parameters of the atlantoaxial synchondroses. TD, SD, height, area, and perimeter all gradually decreased among the groups. Distance between bilateral atlantal anterolateral synchondroses increased gradually from Group A to Group F, while the angle formed along the long axis in the cross-section showed a decreasing trend. Distance between the axoid dentolateral synchondroses and between the neurocentral synchondroses increased gradually from Group A to Group F, with the angle value in the cross-section showing a gradual decrease, and distance from the odontoid apex increasing from Group A to Group F. CONCLUSIONS: The atlantoaxial synchondroses gradually decrease in size with age, and ossification levels increase with age, with faster ossification occurring during a 1-2 years-old period. The anterolateral synchondroses, dentolateral synchondroses, and neurocentral synchondroses all gradually ossify towards the lateral direction with increasing age.

Accuracy of digital measurement for quantitative and qualitative indicators of wound healing and repair: a systematic review protocol.

INTRODUCTION: Chronic wound care remains a critical public health challenge in terms of prevalence, quality of life and healthcare costs on a global scale. Currently used methods to assess the size and content of wounds include direct contact techniques based on double-layer film, ruler measurements, digital photography and visual examination. Nowadays, despite these evaluations, close monitoring and tracking of these chronic wounds remain a great challenge. The use of telemonitoring through digital measurement tools may offer a potential means of improving healing management processes. Many studies have evaluated the size and content of the wound through digital devices such as mobile phones and computers. However, the clinical accuracy of these tools remains to be clarified. The objective of this systematic review is to assess and consolidate the current state-of-the-art digital devices for both quantitative (length, width, surface area, perimeter, volume and depth) and qualitative (granulation, fibrin, necrosis and slough) indicators of wound care. METHODS AND ANALYSIS: We will include studies using digital measurement methods from databases such as EBSCO, Cochrane Library, MEDLINE, Web of Science and EMBASE, limited to French and English publications until November 15, 2023. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, selection involves two independent reviewers conducting title and abstract screenings, study selections, data extractions and risk-of-bias assessments using QUADAS-2. Discrepancies will be resolved through discussion or a third reviewer. ETHICS AND DISSEMINATION: Primary data will not be collected in this study; thus, ethical approval will not be required. The study's findings will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023396642.

Combined anatomical reduction plate for quadrilateral acetabular fractures via a posterior approach: an anatomical-morphological study.

OBJECTIVE: To digitally measure the fixation trajectory of anatomical plates used in the combined reduction of quadrilateral acetabular fractures via the posterior approach, and to develop anatomical plates that align with the characteristics of the pelvis in the Chinese population. METHODS: Pelvic computed tomography (CT) data from 102 adult patients were collected at the Affiliated Hospital of Zunyi Medical University. This group included 51 males and 51 females, aged between 20 and 60 years. Using Mimics software (version 21.0), a three-dimensional model of each pelvic data point was reconstructed. The fixation path for the combined reset anatomical steel plate was drawn, where the curves on the fixation path were approximated as arcs. The radius of curvature and length of these curves were measured, and an anatomical steel plate was designed to best fit the pelvic structure. RESULTS: The combined anatomical reduction plate fixation system for quadrilateral acetabular fractures using a posterior approach consisted of two parts: a locking plate and a reduction plate. The posterior wall region (r2), ischial region (r3), quadrilateral region (r4), and bending region (r5), and the total length of the reduction plate were significantly smaller in females (P < 0.05). Similarly, the posterior wall region (R3), distal posterior wall region (R4), and the total length of the locking plate were significantly smaller in females (P < 0.05). Additionally, the anterior superior iliac spine side (r1) and the total length of the T-shaped auxiliary plate were significantly smaller in females (P < 0.05). The bending angle (< A) was also significantly smaller in females (P < 0.05). CONCLUSIONS: The pelvic surface structure is irregular and varies greatly among individuals.Compared to the traditional steel plate, The combined reduction anatomical plate designed in this study demonstrated high precision and improved conformity to the anatomical structure of the pelvis.

Advances in Aeroengine Cooling Hole Measurement: A Comprehensive Review.

Film cooling technology is of great significance to enhance the performance of aero-engines and extend service life. With the increasing requirements for film cooling efficiency, researchers and engineers have carried out a lot of work on the precision and digital measurement of cooling holes. Based on the above, this paper outlines the importance and principles of film cooling technology and reviews the evolution of cooling holes. Also, this paper details the traditional measurement methods of the cooling hole used in current engineering scenarios with their limitations and categorizes digital measurement methods into five main types, including probing measurement technology, optical measurement technology, infrared imaging technology, computer tomography (CT) scanning technology, and composite measurement technology. The five types of methods and integrated automated measurement platforms are also analyzed. Finally, through a generalize and analysis of cooling hole measurement methods, this paper points out technical challenges and future trends, providing a reference and guidance for forward researches.

Digital measuring the ocular morphological parameters of guinea pig eye in vivo with Python.

AIM: To quantitatively measure ocular morphological parameters of guinea pig with Python technology. METHODS: Thirty-six eyeballs of eighteen 3-week-old guinea pigs were measured with keratometer and photographed to obtain the horizontal, coronal, and sagittal planes respectively. The corresponding photo pixels-actual length ratio was acquired by a proportional scale. The edge coordinates were identified artificially by ginput function. Circle and conic curve fitting were applied to fit the contour of the eyeball in the sagittal, coronal and horizontal view. The curvature, curvature radius, eccentricity, tilt angle, corneal diameter, and binocular separation angle were calculated according to the geometric principles. Next, the eyeballs were removed, canny edge detection was applied to identify the contour of eyeball in vitro. The results were compared between in vivo and in vitro. RESULTS: Regarding the corneal curvature and curvature radius on the horizontal and sagittal planes, no significant differences were observed among results in vivo, in vitro, and the keratometer. The horizontal and vertical binocular separation angles were 130.6°±6.39° and 129.8°±9.58° respectively. For the corneal curvature radius and eccentricity in vivo, significant differences were observed between horizontal and vertical planes. CONCLUSION: The Graphical interface window of Python makes up the deficiency of edge detection, which requires too much definition in Matlab. There are significant differences between guinea pig and human beings, such as exotropic eye position, oblique oval eyeball, and obvious discrepancy of binoculus. This study helps evaluate objectively the ocular morphological parameters of small experimental animals in emmetropization research.

Coproduction and Usability of a Smartphone App for Falls Reporting in Parkinson Disease.

OBJECTIVE: The purpose of this study was to coproduce a smart-phone application for digital falls reporting in people with Parkinson disease (PD) and to determine usability using an explanatory mixed-methods approach. METHODS: This study was undertaken in 3 phases. Phase 1 was the development phase, in which people with PD were recruited as co-researchers to the project. The researchers, alongside a project advisory group, coproduced the app over 6 months. Phase 2 was the implementation phase, in which 15 people with PD were invited to test the usability of the app. Phase 3 was the evaluation phase, in which usability was assessed using the systems usability scale by 2 focus groups with 10 people with PD from phase 2. RESULTS: A prototype was successfully developed by researchers and the project advisory group. The usability of the app was determined as good (75.8%) by people with PD when rating using the systems usability scale. Two focus groups (n = 5 per group) identified themes of 1) usability, 2) enhancing and understanding management of falls, and 3) recommendations and future developments. CONCLUSIONS: A successful prototype of the iFall app was developed and deemed easy to use by people with PD. The iFall app has potential use as a self-management tool for people with PD alongside integration into clinical care and research studies. IMPACT: This is the first digital outcome tool to offer reporting of falls and near-miss fall events. The app may benefit people with PD by supporting self-management, aiding clinical decisions in practice, and providing an accurate and reliable outcome measure for future research. LAY SUMMARY: A smartphone application designed in collaboration with people who have PD to record their falls was acceptable and easy to use by people with PD.

Digital measurement of anterolateral knee laxity using strain sensors.

PURPOSE: The ambition of the research group was to develop a sensor-based system that allowed the transfer of results with strain sensors applied to the knee joint. This system was to be validated in comparison to the current static mechanical measurement system. For this purpose, the internal rotation laxity of the knee joint was measured, as it is relevant for anterolateral knee laxity and anterior cruciate ligament (ACL) injury. METHODS: This is a noninvasive measurement method using strain sensors which are applied to the skin in the course of the anterolateral ligament. The subjects were placed in supine position. First the left and then the right leg were clinically examined sequentially and documented by means of an examination form. 11 subjects aged 21 to 45 years, 5 women and 6 men were examined. Internal rotation of the lower leg was performed with a torque of 2 Nm at a knee flexion angle of 30°. RESULTS: Comparison of correlation between length change and internal knee rotation angle showed a strong positive correlation (r = 1, p < 0.01). Whereas females showed a significant higher laxity vs. males (p = 0.003). CONCLUSIONS: The present study showed that the capacitive strain sensors can be used for reproducible measurement of anterolateral knee laxity. In contrast to the previous static systems, a dynamic measurement will be possible by this method in the future.

3D simulation of percutaneous sustentaculum tali screw insertion in calcaneal fractures.

BACKGROUND: In calcaneal fractures, the percutaneous screw fixation (PSF) is currently considered to be the better choice, but it is difficult to accurately place the screw into the sustentaculum tali (ST) during the operation. In this study, the ideal entry point, angle, diameter and length of the screw were calculated by simulating the operation process. METHODS: We retrospectively collected the calcaneus computed tomography (CT) scans of 180 adults, DICOM-formatted CT-scan images of each patient were imported into Mimics software to establish calcaneus model. Virtual screws were placed on the lateral of the posterior talar articular surface (PTAS), the lateral edge of the anterior process of calcaneus (APC), and the calcaneal tuberosity, respectively, the trajectory and size of the screws were calculated. RESULTS: The mean maximum diameter of the PTAS screw was 42.20 ± 3.71 mm. The vertical distance between the midpoint of the APC optimal screw trajectory and the lowest point of the tarsal sinus was 10.67 ± 1.84 mm, and the distance between the midpoint of the APC optimal screw trajectory and the calcaneocuboid joint was 5 mm ~ 19.81 ± 2.08 mm. The mean maximum lengths of APC screws was 44.69 ± 4.81 mm, and the Angle between the screw and the coronal plane of the calcaneus from proximal to distal was 4.72°±2.15° to 20.52°±3.77°. The optimal point of the maximum diameter of the calcaneal tuberosity screw was located at the lateral border of the achilles tendon endpoint. The mean maximum diameters of calcaneal tuberosity screws was 4.46 ± 0.85 mm, the mean maximum lengths of screws was 65.31 ± 4.76 mm. We found gender-dependent differences for the mean maximum diameter and the maximum length of the three screws. CONCLUSIONS: The study provides effective positioning for percutaneous screw fixation of calcaneal fractures. For safer and more efficient screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screw.

Digital Evaluation of the Changes in Eyelid and Ocular Surface Measurements and the Correlation of These Parameters with Visual Field Parameters After Upper Eyelid Blepharoplasty.

Objectives: We aimed to evaluate the change in eyelid and ocular surface parameters that were measured using a digital measurement program, the change in the visual field (VF), and the correlation between ocular surface area (OSA) and VF parameters in patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis. Methods: Patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis between August 2015 and August 2019 were included in the study. The difference between preoperative and postoperative 3rd month values of manually measured margin reflex distance 1 (MRD1), digitally measured eyelid and ocular surface parameters (MRD1, MRD 2 [MRD2], upper eyelid crease height [ECH], pretarsal show height [PTH], eyebrow line-height [EBH] and OSA), and VF parameters were evaluated. The correlation between preoperative and postoperative values of manually and digitally measured MRD1 and also preoperative and postoperative values of OSA and VF parameters were analyzed. Results: Thirty-six eyes from 36 patients were included in this study and the mean age of patients was 57.93±7.64 years. There were statistically significant changes between preoperative and postoperative values in means of the manually measured MRD1 and the digitally measured MRD1, PTH, OSA, and ECH (p<0.001). However, the postoperative changes in the mean MRD2 and EBH were not statistically significant (p=0.664 and p=0.983). There were moderate positive correlations between pre- and post-operative OSA values and pre- and postoperative values of manual and digital MRD1. A statistically significant agreement was observed between the change in OSA and the change in all VF parameters (Bland-Altman analysis test). Conclusion: Digital measurements can be used to evaluate the changes in eyelid and ocular surface parameters in patients who underwent upper eyelid blepharoplasty surgery. OSA provides fast results in accordance with linear measurements and is compatible with the change in the VF.

Digitally measured exposed root surface area for predicting the effectiveness of modified coronally advanced tunnel combined de-epithelialized gingival grafting in the treatment of multiple adjacent gingival recessions.

OBJECTIVES: To assess the predictive value of baseline digitally measured exposure root surface area (ERSA) on the effectiveness of modified coronally advanced tunnel and de-epithelialized gingival grafting (MCAT + DGG) technique for the treatment of multiple adjacent gingival recessions (MAGRs). MATERIALS AND METHODS: A total of 96 gingival recessions (48 RT1 and 48 RT2) from 30 subjects were included. ERSA was measured on the digital model obtained by intraoral scanner. Generalized linear model was used to analyze the possible correlation of ERSA, Cairo recession type (RT), gingival biotype, keratinized gingival width (KTW), tooth type, and cervical step-like morphology on the mean root coverage (MRC) and complete root coverage (CRC) at 1-year after MCAT + DGG. The predictive accuracy of CRC is tested using receiver-operator characteristic curves. RESULTS: At 1-year postoperatively, the MRC for RT1 was 95.14 ± 10.25%, which was significantly higher than 78.42 ± 22.57% for RT2 (p < 0.001). ERSA (OR:1.342, p < 0.001), KTW (OR:1.902, p = 0.028) and lower incisors (OR:15.716, p = 0.008) were independent risk factors for predicting MRC. ERSA and MRC showed significant negative correlation in RT2(r = -0.558, p < 0.001), but not in RT1(r = 0.220, p = 0.882). Meanwhile, ERSA (OR:1.232, p = 0.005) and Cairo RT (OR:3.740, p = 0.040) were independent risk factors for predicting CRC. For RT2, the area under curve was 0.848 and 0.898 for ERSA without or with other correction factors, respectively. CONCLUSIONS: Digitally measured ERSA may provide strong predictive values for RT1 and RT2 defects treated with MCAT + DGG. CLINICAL RELEVANCE: This study demonstrates that digitally measured ERSA is a valid outcome predictor for root coverage surgery, especially applicable for predicting RT2 MAGRs.

Hypoglycemia Detection Using Hand Tremors: Home Study of Patients With Type 1 Diabetes.

BACKGROUND: Diabetes affects millions of people worldwide and is steadily increasing. A serious condition associated with diabetes is low glucose levels (hypoglycemia). Monitoring blood glucose is usually performed by invasive methods or intrusive devices, and these devices are currently not available to all patients with diabetes. Hand tremor is a significant symptom of hypoglycemia, as nerves and muscles are powered by blood sugar. However, to our knowledge, no validated tools or algorithms exist to monitor and detect hypoglycemic events via hand tremors. OBJECTIVE: In this paper, we propose a noninvasive method to detect hypoglycemic events based on hand tremors using accelerometer data. METHODS: We analyzed triaxial accelerometer data from a smart watch recorded from 33 patients with type 1 diabetes for 1 month. Time and frequency domain features were extracted from acceleration signals to explore different machine learning models to classify and differentiate between hypoglycemic and nonhypoglycemic states. RESULTS: The mean duration of the hypoglycemic state was 27.31 (SD 5.15) minutes per day for each patient. On average, patients had 1.06 (SD 0.77) hypoglycemic events per day. The ensemble learning model based on random forest, support vector machines, and k-nearest neighbors had the best performance, with a precision of 81.5% and a recall of 78.6%. The results were validated using continuous glucose monitor readings as ground truth. CONCLUSIONS: Our results indicate that the proposed approach can be a potential tool to detect hypoglycemia and can serve as a proactive, nonintrusive alert mechanism for hypoglycemic events.

Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements.

Background and Objectives: To investigate the digital measurement method for the plate trajectory of dynamic anterior plate-screw system for quadrilateral plate (DAPSQ), and then design a third-generation DAPSQ plate that conforms to the needs of the Chinese population through collating a large sample anatomical data. Materials and Methods: Firstly, the length of the pubic region, quadrilateral region, iliac region, and the total length of the DAPSQ trajectory were measured by a digital measurement approach in 22 complete pelvic specimens. Then, the results were compared with the direct measurement of pelvic specimens to verify the reliability of the digital measurement method. Secondly, 504 cases (834 hemilateral pelvis) of adult pelvic CT images were collected from four medical centers in China. The four DAPSQ trajectory parameters were obtained with the digital measurement method. Finally, the third-generation DAPSQ plate was designed, and its applicability was verified. Results: There was no statistically significant difference in the four trajectory parameters when comparing the direct measurement method with the digital measurement method (p > 0.05). The average lengths of the pubic region, quadrilateral region, iliac region, and the total length in Chinese population were (60.96 ± 5.39) mm, (69.11 ± 5.28) mm, (84.40 ± 6.41) mm, and (214.46 ± 10.15) mm, respectively. Based on the measurement results, six models of the DAPSQ plate including small size (A1,A2), medium size (B1,B2), and the large size (C1,C2) were designed. The verification experiment showed that all these six type plates could meet the requirement of 94.36% cases. Conclusions: A reliable computerized method for measuring irregular pelvic structure was proposed, which not only provided an anatomical basis for the design of the third-generation DAPSQ plate, but also provided a reference for the design of other pelvic fixation devices.

A 3-DOF electromotor-driven external fixator for foot and ankle deformity correction based on X-ray digital measurement.

BACKGROUND: The use of external fixators to treat foot and ankle deformities remains a challenge in orthopedic surgery due to their diversity. We hope to improve the automation and accuracy of the correction process. METHODS: A three-degree-of-freedom (3-DOF) electromotor-driven external fixator for uniplanar foot and ankle deformities was proposed. Computer-assisted correction software was developed to help surgeons use digital technology to measure the required parameters from patients' X-ray radiographs. The correction trajectory and the prescriptions were generated in the software based on the proposed correction strategy. RESULTS: Two clinical cases were simulated to verify the correction ability of the developed external fixator. The results showed that the angular and displacement deformities were well corrected. CONCLUSIONS: The developed external fixator can accurately and automatically correct foot and ankle deformities with the help of computer-assisted correction software, which significantly reduces the burden on surgeons and patients.

Usefulness of digital measurements for functional evaluation of paediatric elbow range of motion.

BACKGROUND: Elbow immobilization due to fractures of the upper limb is frequent in paediatric patients. Proper follow-up is critical to assess elbow functional recovery. Telemedicine can be an option for remote monitoring of these patients. The purpose of this study was to compare personal and virtual evaluation of elbow range of motion after long arm cast withdrawal in paediatric patients. METHODS: An observational cross-sectional study was carried out which included all paediatric patients with elbow immobilization in long arm casts treated at our centre. After cast withdrawal, elbow range of motion was evaluated by telemedicine and in office consultation in all four movements (flexion, extension, pronation and supination). RESULTS: Ninety-three patients met the selection criteria. Median age at time of immobilization was 8 years. Mean elbow immobilization time was 23 days (range 18-56 days). When comparing office and remote measurements, no statistical differences were found for any of the four elbow movements measured in our study. CONCLUSIONS: Remote evaluation of elbow range of motion by telemedicine is technically feasible. We evaluated elbow range of motion in paediatric patients after immobilization and we did not find differences between digital and in office measurements. The results were similar to those obtained through assessment in the office. We believe that this is a useful tool to facilitate remote patient follow-up.

Validity and Reliability of Two Digital Wound Measurement Tools after Surgery in Patients with Hidradenitis Suppurativa.

BACKGROUND: After excision surgery in patients with hidradenitis suppurativa (HS), wounds are usually left open for secondary intention healing. To evaluate wound healing, reliable wound measurement is important. However, digital wound measurement tools for measuring the surface area are validated for small wounds located on flat or mildly convex body surfaces in studies, often powered inadequately. Up until now, a validated digital measurement tool to accurately measure wounds on all body surfaces, including the intertriginous areas, was not available. OBJECTIVES: The aim of this study was to validate two digital wound measurement tools for the measurement of the surface area of larger and concave wounds, using surgical wounds in patients with HS. METHODS: This prospective observational validation study included consecutive patients with HS undergoing excision surgery in the Department of Dermatology of the Erasmus University Medical Center, Rotterdam. Wound measurements using a ruler, the tracing method, the inSight® 3-dimensional (3D) device, and the ImitoWound app were performed by three investigators. The intraclass correlation coefficients (ICCs) for concurrent validity and the intra- and inter-rater reliability were analyzed. The standard error of measurement (SEm) and minimal detectable change were calculated, and Bland-Altman plots were constructed to determine the limits of agreement. RESULTS: Twenty patients with a total of 52 wounds were included. The wounds had a mean surface of 18.7 cm2. The inSight® 3D device showed an ICC of 0.987 for concurrent validity, 0.998 for intra-rater reliability, and 0.997 for inter-rater reliability. The ICCs from the ImitoWound application were 0.974, 0.978, and 0.964 for concurrent validity, intra-rater reliability, and inter-rater reliability, respectively. The SEms for intra- and inter-rater reliability were 0.95 cm2 and 1.11 cm2 for the inSight® 3D device and 3.33 cm2 and 3.51 cm2 for the ImitoWound app, respectively. CONCLUSION: Both the inSight® 3D device and the ImitoWound app demonstrated excellent concurrent validity and reliability for the surface measurements of concave wound, enabling these tools to be used reliably in clinical research and daily practice. Furthermore, it paves the way for broader application, such as telemonitoring of wound care at home.

An Algorithm to Classify Real-World Ambulatory Status From a Wearable Device Using Multimodal and Demographically Diverse Data: Validation Study.

BACKGROUND: Measuring the amount of physical activity and its patterns using wearable sensor technology in real-world settings can provide critical insights into health status. OBJECTIVE: This study's aim was to develop and evaluate the analytical validity and transdemographic generalizability of an algorithm that classifies binary ambulatory status (yes or no) on the accelerometer signal from wrist-worn biometric monitoring technology. METHODS: Biometric monitoring technology algorithm validation traditionally relies on large numbers of self-reported labels or on periods of high-resolution monitoring with reference devices. We used both methods on data collected from 2 distinct studies for algorithm training and testing, one with precise ground-truth labels from a reference device (n=75) and the second with participant-reported ground-truth labels from a more diverse, larger sample (n=1691); in total, we collected data from 16.7 million 10-second epochs. We trained a neural network on a combined data set and measured performance in multiple held-out testing data sets, overall and in demographically stratified subgroups. RESULTS: The algorithm was accurate at classifying ambulatory status in 10-second epochs (area under the curve 0.938; 95% CI 0.921-0.958) and on daily aggregate metrics (daily mean absolute percentage error 18%; 95% CI 15%-20%) without significant performance differences across subgroups. CONCLUSIONS: Our algorithm can accurately classify ambulatory status with a wrist-worn device in real-world settings with generalizability across demographic subgroups. The validated algorithm can effectively quantify users' walking activity and help researchers gain insights on users' health status.

Periodontal soft tissue increase induced by periodontally accelerated osteogenic orthodontics surgery.

OBJECTIVES: To quantitatively assess periodontal soft tissue changes, including gingival thickness and keratinized gingiva width after periodontally accelerated osteogenic orthodontics (PAOO) surgery by digital measurements.  METHODS: This study enrolled 15 maxillaries with 89 anterior teeth and 16 mandibles with 94 anterior teeth from Chinese adult patients with skeletal Angle Class III malocclusion for whom PAOO surgery was proposed during orthodontic treatment. Intraoral scanning and cone beam computed tomography (CBCT) examinations were performed before PAOO surgery and 6 months after the surgery. Keratinized gingiva width was measured on the digital model acquired by intraoral scanning. The gingival thickness was measured using a digital three-dimensional (3D) model based on the combination of digital intraoral scanning and CBCT data. RESULTS: The mean gingival thickness before surgery was 0.91 ± 0.32 mm and 1.21 ± 0.38 mm at 6-month after PAOO. Patients showed periodontal soft tissue increase with a mean gingival tissue gain of 0.30 ± 0.33 mm. At 1 mm, 2 and 3 mm apical to cemento-enamel junction (CEJ) levels, the gingival thickness increase of the mandible was higher than that of the maxilla (0.38 ± 0.30 mm vs. 0.24 ± 0.31 mm, 0.43 ± 0.35 mm vs. 0.26 ± 0.41 mm, 0.36 ± 0.27 vs. 0.25 ± 0.32 mm, respectively, all P < 0.05). Moreover, the sites of gingival thickness ≤ 1 mm before surgery showed more tissue gain than the sites > 1 mm (0.36 ± 0.32 mm vs. 0.18 ± 0.31 mm, P < 0.001). The mean keratinized gingiva width at T0 was 3.88 ± 1.22 mm, and increased 1.05 ± 1.24 mm 6 months after PAOO surgery. Moreover, a digital 3D model for gingival thickness measurement based on the combination of digital intraoral scanning and CBCT displayed high reliability and accuracy with an intra-class correlation coefficient (ICC) of 0.897. CONCLUSION: PAOO could improve an insufficient quantity of periodontal soft and hard tissues in patients with skeletal Angle Class III malocclusion, including the gingival thickness and keratinized gingiva width. A digital 3D model based on the combination of digital intraoral scanning and CBCT data could provide a new digital measurement of gingival thickness with high accuracy and reliability.

Treatment of multiple gingival recessions with concentrated growth factor membrane and coronally advanced tunnel technique via digital measurements: A randomized controlled clinical trial.

Background/purpose: Research into biomaterial alternatives to connective tissue grafts (CTG) is a research hotspot. The purpose of this clinical trial was to compare the effectiveness of root coverage through tunnel technique with concentrated growth factor (CGF) vs CTG in treating multiple gingival recessions using digital measurements. Materials and methods: Seventy Cairo Class I multiple gingival recessions (in 28 patients) were treated with either CGF or CTG combined with coronally advanced tunnel technique. Digital models were obtained at baseline, 2 weeks, 6 weeks, and 6 months post-op to compare the gain in gingival height, area, volume, and thickness. Tooth sensitivity, post-operative pain, and healing index were also recorded. Results: Complete root coverage at 6 months post-op were 47.06% in the CGF group and 77.78% in the CTG groups. Mean root coverages were 80.55% and 96.18%, respectively. No statistical difference was demonstrated between the two groups in terms of gingival area gain at 2 weeks post-op, but the CTG group had greater increases in gingival height, area, volume, and thickness in the period after 2 weeks post-op. Pain scores were statistically significantly lower in the CGF group. At 6 months post-op, sensitivity scores decreased more significantly in the CTG group. Conclusion: Digital measurements revealed post-operative gingival shrinkage was more pronounced in the CGF group than in the CTG group when combined with coronally advanced tunnel technique. Despite the ease-of-use and minimal post-operative discomfort, it is difficult to achieve similar root coverage outcomes to CTG when using CGF alone in treating multiple gingival recessions.

Interproximal contact loss at implant sites: a retrospective clinical study with a 10-year follow-up.

AIM: To assess the frequency and quantity of interproximal contact loss (ICL) between implant restorations and adjacent teeth after at least 10 years of follow-up (FU). METHODS: Thirty-nine patients (median age 57.3 years) with 80 implants were re-examined at least 10 years after insertion of final restorations (single crowns or fixed dental prostheses (FDPs)). Baseline (insertion of the restorations) and FU examinations encompassed the following: Stone casts were scanned and superimposed for metric assessment of tooth movements, radiographs, and clinical measurements. Outcome measures at implant sites were as follows: the extent of tooth movement and the frequency of interproximal contact loss [ICL], peri-implant marginal bone levels [MBLs], and clinical measurements (plaque control record [PCR], Bleeding on Probing [BOP], and probing depth [PD]). Data were analyzed statistically with generalized regression modeling with robust standard errors to account for within-patient clustering at 5%. RESULTS: Interproximal contact loss for at least one contact point after 10 years was observed in 50% of all implants (with open interproximal spaces up to 1.64 mm). Mesial contact points were significantly more prone to ICL than distal ones (relative risk [RR] = 1.79; 95% confidence interval [CI] = 1.07-2.99; p = .03). The type of restoration had a significant effect on ICL, with FDPs of 2 implants being significantly more prone to mesial ICL than single crowns (RR = 1.52; 95% CI = 1.02-2.25; p = .04). ICL was also associated with a significant increase in PD (+0.46 mm (95% CI = 0.04-0.88 mm; p = .03)) compared to implant sites without ICL. BOP, MBLs, and PCR were not significantly influenced by ICL. CONCLUSION: Interproximal contact loss was a common finding in 50% of the implant sites and was significantly associated with an increase in PD.