Fully automated deep learning for knee alignment assessment in lower extremity radiographs: a cross-sectional diagnostic study

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

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Preoperative prevalence of deep vein thrombosis in patients scheduled to have surgery for degenerative musculoskeletal disorders

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04405-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Keigo Sato ◽

Hideki Date ◽

Takehiro Michikawa ◽

Mitsuhiro Morita ◽

Kazue Hayakawa ◽

...

Keyword(s):

Lower Extremity ◽

Musculoskeletal Disorders ◽

Pulmonary Thromboembolism ◽

Elective Surgery ◽

Knee Surgery ◽

Care Providers ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

D Dimer

Abstract Background Although the incidence of symptomatic pulmonary thromboembolism after elective surgery for degenerative musculoskeletal disorders is comparatively low, it is extremely detrimental to both patients and health-care providers. Therefore, its prevention is mandatory. We aimed to perform a cross-sectional analysis of deep venous thrombosis (DVT) before elective surgery for degenerative musculoskeletal disorders, including total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal surgery, and identify the factors associated with the incidence of preoperative DVT. Methods The clinical data of patients aged ≥ 30 years who underwent TKA or THA, and spine surgery for lumbar or cervical degenerative disorders at our institution were retrospectively collected. D-dimer levels were measured preoperatively in all the patients scheduled for surgery. For the patients with D-dimer levels ≥ 1 µg/mL or who were determined by their physicians to be at high risk of DVT, the lower extremity vein was preoperatively examined for DVT on ultrasonography. Results Overall, we retrospectively evaluated 1236 consecutive patients, including 701 men and 535 women. Of the patients, 431 and 805 had D-dimer levels ≥ 1 and < 1 µg/mL, respectively. Of 683 patients who underwent lower extremity ultrasonography, 92 had proximal (n = 7) and distal types (n = 85) of DVT. The preoperative prevalence of DVT was 7.4 %. No patient had the incidence of postoperative symptomatic venous thromboembolism. A multivariate analysis revealed that age ≥ 80 years (odds ratio [OR], 95 % confidence interval [CI]: 2.8, 1.1–7.3), knee surgery (2.1, 1.1–4.0), American Society of Anesthesiologists (ASA) grade 2 (2.8, 1.2–6.8), ASA grades 3 or 4 (3.1, 1.0–9.4), and malignancy (1.9, 1.1–3.2) were significantly associated with DVT incidence. Conclusions This is the first study to conduct a cross-sectional analysis of preoperative DVT data of patients scheduled for elective surgery for degenerative musculoskeletal disorders. Although whether screening for preoperative DVT is needed to prevent postoperative symptomatic pulmonary thromboembolism remains to be clarified, our data suggested that DVT should be noted before surgery in the patients with advanced age, knee surgery, high ASA physical status, and malignancy.

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Work Ability and Employment in Rheumatoid Arthritis: A Cross-Sectional Study on the Role of Muscle Strength and Lower Extremity Function

International Journal of Rheumatology ◽

10.1155/2018/3756207 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Carolin Berner ◽

Sandra Haider ◽

Igor Grabovac ◽

Thomas Lamprecht ◽

Karl Heinrich Fenzl ◽

...

Keyword(s):

Muscle Strength ◽

Lower Extremity ◽

Work Ability ◽

Employment Status ◽

Knee Extensor ◽

Lower Extremity Function ◽

Cross Sectional ◽

Hand Grip ◽

Extremity Function ◽

Knee Extensor Strength

Objective. The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients. Methods. One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors. Results. Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables. Conclusions. The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.

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Deep learning-based estimation of Flory–Huggins parameter of A–B block copolymers from cross-sectional images of phase-separated structures

Scientific Reports ◽

10.1038/s41598-021-91761-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Katsumi Hagita ◽

Takeshi Aoyagi ◽

Yuto Abe ◽

Shinya Genda ◽

Takashi Honda

Keyword(s):

Deep Learning ◽

Diblock Copolymers ◽

Three Dimensional ◽

Image Data ◽

Real Space ◽

Cross Sectional ◽

Regression Problem ◽

Self Consistent Field ◽

Experimental Image ◽

Chain Lengths

AbstractIn this study, deep learning (DL)-based estimation of the Flory–Huggins χ parameter of A-B diblock copolymers from two-dimensional cross-sectional images of three-dimensional (3D) phase-separated structures were investigated. 3D structures with random networks of phase-separated domains were generated from real-space self-consistent field simulations in the 25–40 χN range for chain lengths (N) of 20 and 40. To confirm that the prepared data can be discriminated using DL, image classification was performed using the VGG-16 network. We comprehensively investigated the performances of the learned networks in the regression problem. The generalization ability was evaluated from independent images with the unlearned χN. We found that, except for large χN values, the standard deviation values were approximately 0.1 and 0.5 for A-component fractions of 0.2 and 0.35, respectively. The images for larger χN values were more difficult to distinguish. In addition, the learning performances for the 4-class problem were comparable to those for the 8-class problem, except when the χN values were large. This information is useful for the analysis of real experimental image data, where the variation of samples is limited.

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Association of Dermal Hypoechogenicity and Cellulitis History in Patients with Lower Extremity Lymphedema: A Cross-Sectional Observational Study

Lymphatic Research and Biology ◽

10.1089/lrb.2021.0004 ◽

2021 ◽

Author(s):

Misako Dai ◽

Takeo Minematsu ◽

Yoshihiro Ogawa ◽

Atsuo Kawamoto ◽

Gojiro Nakagami ◽

...

Keyword(s):

Observational Study ◽

Lower Extremity ◽

Cross Sectional

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Abstract 18615: Impact of Peripheral Atherectomy Utilization on the Outcomes of Lower Extremity Arterial Intervention - A Cross-sectional US Experience

Circulation ◽

10.1161/circ.132.suppl_3.18615 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shilpkumar Arora ◽

Sopan Lahewala ◽

Nilay Patel ◽

Kanishk Agnihotri ◽

Sidakpal Panaich ◽

...

Keyword(s):

Multivariate Analysis ◽

Lower Extremity ◽

Arterial Intervention ◽

Limb Ischemia ◽

Outcome Data ◽

Drug Eluting Stent ◽

P Value ◽

Diagnostic Code ◽

Cross Sectional ◽

Arterial Revascularization

Background: Contemporary outcome data regarding effects of atherectomy in lower extremity arterial revascularization is lacking. Methods: We queried HCUP’s Nationwide Inpatient Sample (NIS) for 2012 using the appropriate primary ICD 9-CM diagnostic code for peripheral vascular disease and procedural codes 39.90 (bare metal stent - BMS), 00.55 (drug eluting stent - DES), 17.56 (peripheral artherectomy) and 39.50 for angioplasty. Only procedures performed in patients >= 18 years were included. Hierarchical mixed effects logistic regression models were generated to evaluate multivariate predictors of outcomes. Results: In total 13,206 (weighted: 66,030) lower extremity arterial revascularization were analyzed (65.5% white, 56.2% Male & 97.4% angioplasty). Atherectomy utilization (23.2%) was associated with significant reduction in amputation (11.5% vs 13.4%), any complications (13.2% vs 16.3%) and in hospital morality (0.8% vs 1.4%) compared to no atherectomy group (p < 0.001). Multivariate analysis showed similar results with decrease amputation (OR, 95% CI; p - value) (0.83, 0.71 - 0.97, p = 0.02) and in hospital mortality/any complication (0.79, 0.69 - 0.90, p = 0.001) with atherectomy (similar results were observed with propensity score matching). “Atherectomy only” was utilized only in 2.3%. post-hoc analysis also shows better outcomes when atherectomy was used with either angioplasty or stenting (figure a & b). subgroup multivariate analysis shows significant reduction in amputation when atherectomy was utilized in chronic limb ischemia (0.74, 0.59 - 0.93, p = 0.01) and with angioplasty (0.72, 0.60 - 0.87, p = 0.001) and trend towards advantage while used along with stents but not reaching statistical significant. Conclusion: Lower extremity atherectomy utilization was associated with significant reduction in amputation and overall complication. We observed better outcomes when atherectomy was used in conjunction with angioplasty.

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A Study of Transcutaneous Oxygen Saturation by Pulse Oximetry in Symptomatic Ischaemic Lower Limb – A Cross Sectional Analytical Study in a Tertiary Care Hospital in Tirupathi

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/550 ◽

2021 ◽

Vol 8 (32) ◽

pp. 3018-3022

Author(s):

Sadhu Nagamuneiah ◽

Gandikota Venkata Prakash ◽

Sabitha P ◽

Jandla Bhulaxmi ◽

Dintyala Venkata S.S.Dintyala Venkata S.S. Mythri ◽

...

Keyword(s):

Lower Extremity ◽

Pulse Oximetry ◽

Analytical Study ◽

Lower Extremities ◽

Care Hospital ◽

Colour Doppler ◽

Duplex Scan ◽

Cross Sectional ◽

Transcutaneous Oxygen ◽

Arterial Insufficiency

BACKGROUND Chronic arterial insufficiency (CAI) results in stenotic-occlusive disease of vascularized arterial disorders of tissues and organs. CAI of the lower extremities represents a significant medical and socio-economic problem due to a high incidence of morbidity, invalidity and mortality. METHODS A cross sectional analytical study was conducted in a group of 100 patients, admitted at the Vascular Department of the Sri Venkateshwara Ramnaraian Ruia Government General Hospital, Tirupati during the period from September 2018 to August 2019, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO2 was determined by pulse oximetry. CAI of the lower extremity was determined on the basis of clinical findings and colour Doppler duplex scan echo sonography results. Using the conventional method (single-gate) and colour Doppler duplex scan (multi-gate), the presence and localization of stenosis, the segmental predominance (with multisegmental forms) and the degree of progression of stenotic-occlusive lesions were verified. RESULTS Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia Mean SpO2: Fontaine I – 95.50 %, Fontaine II – 92.90; in stage critical ischemia SpO2: Fontaine III – 65.00 % and Fontaine IV – 49.87 %. In 29 patients with gangrenous foot and fingers SpO2 was immeasurable and progressive decrease in SpO2 of arterial capillaries (p<0.01 between stages). CONCLUSIONS Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI. KEYWORDS Chronic Arterial Insufficiency, SPO2, Pulse Oximetry, Ischemia

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Are surface and deep learning approaches associated with study patterns and choices among medical students? A cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2018.0200060818 ◽

2018 ◽

Vol 136 (5) ◽

pp. 414-420 ◽

Cited By ~ 1

Author(s):

Álvaro Henrique de Almeida Delgado ◽

João Paulo Rodrigues Almeida ◽

Larissa Souza Borowski Mendes ◽

Isabella Noceli de Oliveira ◽

Oscarina da Silva Ezequiel ◽

...

Keyword(s):

Deep Learning ◽

Medical Students ◽

Cross Sectional Study ◽

Learning Approaches ◽

Sectional Study ◽

Cross Sectional

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Incidental Detection of Adrenal Myelolipoma: A Case Report and Review of Literature

Case Reports in Urology ◽

10.1155/2013/789481 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 7

Author(s):

Junaid Nabi ◽

Danish Rafiq ◽

Fatema N. Authoy ◽

Ghulam Nabi Sofi

Keyword(s):

Computed Tomography ◽

Imaging Techniques ◽

Diagnostic Study ◽

Hormone Production ◽

Adrenal Myelolipoma ◽

Cross Sectional ◽

Cect Scan ◽

The Right ◽

Enhanced Computed Tomography ◽

Upper Abdomen

Introduction. Adrenal myelolipoma is a rare tumor that is benign in nature, usually asymptomatic, unilateral, and nonsecreting. It is composed of variable mixture of mature adipose tissue and hematopoietic elements and develops within the adrenal gland. With the widespread use of cross-sectional imaging modalities such as ultrasonography and computed tomography, the incidental detection of these tumors is increasing in frequency.Case Presentation. We report a case of adrenal myelolipoma in a 63-year-old Kashmiri male, who presented with pain in the right upper abdomen. Physical examination was unremarkable. Ultrasound abdomen showed the presence of a hyperechoic mass in the right suprarenal region with undefined margins. Contrast-enhanced computed tomography (CECT) scan of abdomen revealed a well-defined, round lesion in the right suprarenal region with heterogeneous attenuation suggesting the possibility of myelolipoma. The patient was subjected to right adrenalectomy and his postoperative course was uneventful. The histopathological evaluation of the mass confirmed the initial diagnosis of adrenal myelolipoma.Conclusion. Although mostly discovered as an “incidentaloma”, the diagnosis of adrenal myelolipoma warrants thorough diagnostic study. Imaging techniques such as ultrasonography and CT scans as well as biochemical studies are useful for indicating the best treatment taking into account the size of the mass and possible hormone production. Surgical resection is advocated through extraperitoneal approach as it minimizes postoperative complications and leads to quicker recovery.

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