scholarly journals Investigating the Benefits of Using 3D Camera Technology to Improve Wound Measurements in a Tissue Viability Service: Outcomes of a Pilot Implementation Study

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
King BM ◽  
◽  
Doyle K ◽  
Kelley J ◽  
Taylor C ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Outcome Measurement ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Case Depth ◽  
Continuous Assessment ◽  
Tissue Viability ◽  
Important Indicator ◽  
Manual Measurement ◽  
Depth Measurement

Sub-optimal experience and outcomes for people with stalled wounds is common. Clinicians have limited methods for reliably and accurately measure wounds. Depth measurement is an important indicator of healing, and digital methods of imaging the wound may offer increased accuracy and enable clinical decision-making. This study aimed to implement a Panasonic FZ-M1 toughpad with WoundCareLite software version 1.5.0.0, to enable three-dimensional measurements in Tissue Viability (TV) service. Length, width, and depth measurement were compared with usual manual measurement using a paper ruler alongside a 2D photographic image. Statistical analysis included the comparison of wound dimension measures and a presentation of visual healing trajectories over 4 weeks using run-charts. 30 patients were recruited over five weeks (13 female and 17 male), representing 4% of the usual caseload. Manual measurement and 3D software automatic method demonstrated that the width and depth 3D auto measures were more accurate than manual measures but depth measures were often wrong thus making volumetric measures inaccurate. Consistent wound size measurement was feasible, and healing trajectories provide a useful means of continuous assessment. Technology guided measurement has potential benefits over manual measurement as a means of more accurately monitoring healing. In this case, depth measurement could not be accurately assessed in practice and further software innovation is indicated to enable outcome measurement in tissue viability services.

scholarly journals Telomere Architecture Correlates with Aggressiveness in Multiple Myeloma

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1969
Author(s):  
Aline Rangel-Pozzo ◽  
Pak Yu ◽  
Sadhana LaL ◽  
Yasmin Asbaghi ◽  
Luiza Sisdelli ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Disease Progression ◽  
Genomic Instability ◽  
Clinical Decision Making ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Response To Treatment ◽  
Average Intensity ◽  
Patient Response ◽  
Smoldering Multiple Myeloma

The prognosis of multiple myeloma (MM), an incurable B-cell malignancy, has significantly improved through the introduction of novel therapeutic modalities. Myeloma prognosis is essentially determined by cytogenetics, both at diagnosis and at disease progression. However, for a large cohort of patients, cytogenetic analysis is not always available. In addition, myeloma patients with favorable cytogenetics can display an aggressive clinical course. Therefore, it is necessary to develop additional prognostic and predictive markers for this disease to allow for patient risk stratification and personalized clinical decision-making. Genomic instability is a prominent characteristic in MM, and we have previously shown that the three-dimensional (3D) nuclear organization of telomeres is a marker of both genomic instability and genetic heterogeneity in myeloma. In this study, we compared in a longitudinal prospective study blindly the 3D telomeric profiles from bone marrow samples of 214 initially treatment-naïve patients with either monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or MM, with a minimum follow-up of 5 years. Here, we report distinctive 3D telomeric profiles correlating with disease aggressiveness and patient response to treatment in MM patients, and also distinctive 3D telomeric profiles for disease progression in smoldering multiple myeloma patients. In particular, lower average intensity (telomere length, below 13,500 arbitrary units) and increased number of telomere aggregates are associated with shorter survival and could be used as a prognostic factor to identify high-risk SMM and MM patients.

Right ventricle and pulmonary arterial pressure

2016 ◽  
Author(s):  
Annemien E. van den Bosch ◽  
Luigi P. Badano ◽  
Julia Grapsa
Keyword(s):  
Clinical Decision Making ◽  
Complex Geometry ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Prognostic Information ◽  
Recent Developments ◽  
And Function

Right ventricular (RV) performance plays an important role in the morbidity and mortality of patients with left ventricular dysfunction, congenital heart disease, and pulmonary hypertension. Assessment of RV size, function, and haemodynamics has been challenging because of its complex geometry. Conventional two-dimensional echocardiography is the modality of choice for assessment of RV function in clinical practice. Recent developments in echocardiography have provided several new techniques for assessment of RV dimensions and function, include tissue Doppler imaging, speckle-tracking imaging, and volumetric three-dimensional imaging. However, specific training, expensive dedicated equipment, and extensive clinical validation are still required. Doppler methods interrogating tricuspid inflow and pulmonary artery flow velocities, which are influenced by changes in pre- and afterload conditions, may not provide robust prognostic information for clinical decision-making. This chapter addresses the role of the various echocardiographic modalities used to assess the RV and pulmonary circulation. Special emphasis has been placed on technical considerations, limitations, and pitfalls of image acquisition and analysis.

The Elderly Psychiatric Patient with Positive Syphilis Serology: The Problem of Neurosyphilis

1998 ◽  
Vol 28 (3) ◽  
pp. 333-339 ◽  
Author(s):  
Ishwer L. Bharwani ◽  
Charles O. Hershey
Keyword(s):  
Elderly Patients ◽  
Clinical Decision Making ◽  
Relevant Literature ◽  
Clinical Decision ◽  
The Elderly ◽  
Illustrative Case ◽  
Positive Serology ◽  
Important Indicator ◽  
Syphilis Serology ◽  
Latent Syphilis

Objective: Older patients have a high prevalence of neurological and psychiatric disorders. They also have a baseline prevalence of late latent syphilis or positive syphilis serology. Thus the clinical question arises as to whether a neuropsychiatric disorder in a geriatric patient is neurosyphilis or if the positive serology is incidental. Method: An illustrative case example is used to illustrate this dilemma. The relevant literature is reviewed. Results: The cerebrospinal fluid (CSF) protein is an important indicator of inflammatory activity in the central nervous system and is used as a clinical guide in the diagnosis. Elderly patients have higher values of normal CSF protein than younger patients. Conclusions: Given the importance of CSF protein in the diagnosis of neurosyphilis, physicians must include this knowledge, that elderly patients have higher CSF protein values, in their clinical decision making in the differentiation between neurosyphilis and late latent syphilis in the elderly patient.

scholarly journals Cronic Kidney Disease, Life Quality Assessment Of Patients

2016 ◽  
Vol 12 (6) ◽  
pp. 103
Author(s):  
Marsida Duli ◽  
Qamil Dika ◽  
Matilda Bushati
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Healthy Population ◽  
Important Indicator

Assessing quality of life in patients with varying degrees of chronic kidney disease is an important issue because of its impact on clinical decision-making as increasing the efficiency of resources in the health system. Through this survey provided an attempt to assess the quality of life of patients with chronic kidney disease undergoing dialysis. Commitment to maximize their functioning and well-being constitutes the essence of the purpose of health care. In recent decades elaborate SF 36 is cut by a gauge derive so simple and basic that helps to evaluate the function of the target of researchers, a certain age group, a disease or a treatment group. Short questionnaire forms SF36 instrument gauge is used to determine the level of quality of life in patients with chronic renal failure under the different stages of treatment with dialysis. The study involved 206 people, 112 from patients to Tirana and Shkodra and 94 healthy persons, who collaborated consensually for completing the questionnaires. Based on the results, the quality of life of dialysis patients is significantly worse than that of the healthy population and patients with other injuries less severe of renal function. Survey indicates that a more holistic approach to be used in the treatment of patients with chronic kidney disease including clinical decision making and patient perception. Precisely for this it is recommended to enter the practice of clinical interest that a set of questionnaires that provide information on patients' perception of health as an important indicator that facilitates the physician-patient collaboration in order to better treatment of the disease and increase the quality the life of the patient.

scholarly journals SGPNet: A Three-Dimensional Multitask Residual Framework for Segmentation and IDH Genotype Prediction of Gliomas

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yao Wang ◽  
Yan Wang ◽  
Chunjie Guo ◽  
Shuangquan Zhang ◽  
Lili Yang
Keyword(s):  
Brain Tumor ◽  
Clinical Decision Making ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Error Rates ◽  
The Cancer Genome Atlas ◽  
Classification Error ◽  
Tumor Segmentation ◽  
Brain Tumor Segmentation ◽  
The Status

Glioma is the main type of malignant brain tumor in adults, and the status of isocitrate dehydrogenase (IDH) mutation highly affects the diagnosis, treatment, and prognosis of gliomas. Radiographic medical imaging provides a noninvasive platform for sampling both inter and intralesion heterogeneity of gliomas, and previous research has shown that the IDH genotype can be predicted from the fusion of multimodality radiology images. The features of medical images and IDH genotype are vital for medical treatment; however, it still lacks a multitask framework for the segmentation of the lesion areas of gliomas and the prediction of IDH genotype. In this paper, we propose a novel three-dimensional (3D) multitask deep learning model for segmentation and genotype prediction (SGPNet). The residual units are also introduced into the SGPNet that allows the output blocks to extract hierarchical features for different tasks and facilitate the information propagation. Our model reduces 26.6% classification error rates comparing with previous models on the datasets of Multimodal Brain Tumor Segmentation Challenge (BRATS) 2020 and The Cancer Genome Atlas (TCGA) gliomas’ databases. Furthermore, we first practically investigate the influence of lesion areas on the performance of IDH genotype prediction by setting different groups of learning targets. The experimental results indicate that the information of lesion areas is more important for the IDH genotype prediction. Our framework is effective and generalizable, which can serve as a highly automated tool to be applied in clinical decision making.

scholarly journals Effectiveness of Global Optimisation and Direct Kinematics in Predicting Surgical Outcome in Children with Cerebral Palsy

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1306
Author(s):  
Claude Fiifi Hayford ◽  
Emma Pratt ◽  
John P. Cashman ◽  
Owain G. Evans ◽  
Claudia Mazzà
Keyword(s):  
Cerebral Palsy ◽  
Clinical Decision Making ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Contact Forces ◽  
Gait Quality ◽  
Children With Cerebral Palsy ◽  
Profile Score ◽  
Joint Contact ◽  
Direct Kinematics

Multibody optimisation approaches have not seen much use in routine clinical applications despite evidence of improvements in modelling through a reduction in soft tissue artifacts compared to the standard gait analysis technique of direct kinematics. To inform clinical use, this study investigated the consistency with which both approaches predicted post-surgical outcomes, using changes in Gait Profile Score (GPS) when compared to a clinical assessment of outcome that did not include the 3D gait data. Retrospective three-dimensional motion capture data were utilised from 34 typically developing children and 26 children with cerebral palsy who underwent femoral derotation osteotomies as part of Single Event Multi-Level Surgeries. Results indicated that while, as expected, the GPS estimated from the two methods were numerically different, they were strongly correlated (Spearman’s ρ = 0.93), and no significant differences were observed between their estimations of change in GPS after surgery. The two scores equivalently classified a worsening or improvement in the gait quality in 93% of the cases. When compared with the clinical classification of responders versus non-responders to the intervention, an equivalent performance was found for the two approaches, with 27/41 and 28/41 cases in agreement with the clinical judgement for multibody optimisation and direct kinematics, respectively. With this equivalent performance to the direct kinematics approach and the benefit of being less sensitive to skin artefact and allowing additional analysis such as estimation of musculotendon lengths and joint contact forces, multibody optimisation has the potential to improve the clinical decision-making process in children with cerebral palsy.

Three-dimensional surface imaging for clinical decision making in pectus excavatum

2021 ◽  
Author(s):  
Jean H.T. Daemen ◽  
Nadine A. Coorens ◽  
Karel W.E. Hulsewé ◽  
Thomas J.J. Maal ◽  
Jos G. Maessen ◽  
...  
Keyword(s):  
Decision Making ◽  
Pectus Excavatum ◽  
Clinical Decision Making ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Surface Imaging ◽  
Dimensional Surface

scholarly journals Numerical Investigation of the Flow Field in Realistic Nasal Septal Perforation Geometry

2014 ◽  
Vol 5 (2) ◽  
pp. ar.2014.5.0090 ◽  
Author(s):  
Mohammad Faramarzi ◽  
Mohammad Hossein Baradaranfar ◽  
Omid Abouali ◽  
Saeid Atighechi ◽  
Goodarz Ahmadi ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Assessment Tool ◽  
Anterior Part ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Clinical Decision ◽  
Airflow Rate ◽  
Septal Perforation ◽  
Pressure Drops ◽  
Wide Range

The computational fluid dynamics (CFD) are used to evaluate the physiological function of the nose. We evaluated the aerodynamics of the nasal cavity in a patient with septal perforation (SP), pre- and postvirtual repair. Three-dimensional nasal models were reconstructed, and then a wide range of the pressure drops and flow rates were analyzed. The airflow velocity is higher in the central region and is lower around the boundary of the SP. The air velocity in the SP increases as the pressure drop increases. Furthermore, at the anterior part of the SP, the shear stress is higher in the upper part. In addition, the repair of SP does not affect the total nasal airflow rate and the velocity contour patterns. The potential usage of the CFD technique as a predictive technique to explore the details and a preoperative assessment tool to help in clinical decision making in nasal surgery is emphasized.

scholarly journals Standard set of patient-reported outcomes for personality disorder

2021 ◽  
Author(s):  
Valentina Prevolnik Rupel ◽  
Beth Jagger ◽  
Luz Sousa Fialho ◽  
Lisa-Marie Chadderton ◽  
Timea Gintner ◽  
...  
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Outcome Measures ◽  
Working Group ◽  
Clinical Decision Making ◽  
Outcome Measurement ◽  
Clinical Decision ◽  
Case Mix ◽  
Patient Reported ◽  
Standard Set

Abstract Purpose The purpose of the article is to present standard set of outcomes for people with personality disorder (PD), in order to facilitate patient outcome measurement worldwide. Methods The International Consortium for Health Outcomes Measurement (ICHOM) gathered a multidisciplinary international working group, consisting of 16 experts, including clinicians, nurses, psychologists, methodologists and patient representatives, to develop a standard set of outcome measures for people with PD. The Delphi method was used to reach consensus on the scope of the set, outcome domains, outcome measures, case-mix variables and time points for measuring outcomes in service users. For each phase, a project team prepared materials based on systematic literature reviews and consultations with experts. Results The working group decided to include PD, as defined by International Classification of Diseases 11th revision (ICD-11). Eleven core outcomes and three optional outcomes across four health domains (mental health, behaviour, functioning and recovery) were defined as those relevant for people with PD. Validated measures for the selected outcomes were selected, some covering more than one outcome. Case-mix variables were aligned to other ICHOM mental health standard sets and consisted of demographic factors and those related to the treatment that people received. The group recommended that most outcomes are measured at baseline and annually. Conclusion The international minimum standard set of outcomes has the potential to improve clinical decision making through systematic measurement and comparability. This will be key in improving the standard of health care for people with PD across the world.

scholarly journals Circulating Tumor Cell Analysis: Technical and Statistical Considerations for Application to the Clinic

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Alison L. Allan ◽  
Michael Keeney
Keyword(s):  
Metastatic Disease ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Circulating Tumor Cell ◽  
Cell Analysis ◽  
Important Indicator ◽  
Robust Detection ◽  
Technological Advances ◽  
Clinical Detection

Solid cancers are a leading cause of death worldwide, primarily due to the failure of effective clinical detection and treatment of metastatic disease in distant sites. There is growing evidence that the presence of circulating tumor cells (CTCs) in the blood of cancer patients may be an important indicator of the potential for metastatic disease and poor prognosis. Technological advances have now facilitated the enumeration and characterization of CTCs using methods such as PCR, flow cytometry, image-based immunologic approaches, immunomagnetic techniques, and microchip technology. However, the rare nature of these cells requires that very sensitive and robust detection/enumeration methods be developed and validated in order to implement CTC analysis for widespread use in the clinic. This review will focus on the important technical and statistical considerations that must be taken into account when designing and implementing CTC assays, as well as the subsequent interpretation of these results for the purposes of clinical decision making.

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