Mean Difference In Measurements Research Articles

Differences in quality of life and fitness level among men and women in the adulthood: a cross-sectional analysis

BackgroundThis study aimed to examine the associations between physical fitness components and health-related quality of life (HRQoL) among adults stratified by sex and age. In addition, we aimed to examine whether these associations change based on socioeconomic, clinical, and biochemical characteristics.MethodsA total of 297 participants aged 47.41 (standard deviation: 9.08) years from the “Validity of a Model of Accelerated Vascular Aging as a Cardiovascular Risk Index in Healthy Adults: the EVasCu cross-sectional study” were included in this analysis. HRQoL, physical fitness, socioeconomic status (SES), waist circumference, and blood pressure were measured. Additionally, blood samples were extracted to determine cholesterol, triglyceride, and glycated hemoglobin A1c (HbA1c) levels. Analyses of covariance (ANCOVAs) were estimated to test mean differences in physical and mental health-related health measures (HRQoL) between fitness categories (fixed factors) by sex and age categories.ResultsThe physical HRQoL was related to the levels of fitness parameters among women, independent of age, while for men, it was related to better levels of general fitness and cardiorespiratory fitness among men aged < 50 and men aged ≥ 50, respectively. In contrast, mental HRQoL was related to cardiorespiratory fitness only among women aged < 50 years; speed/agility and flexibility among men aged < 50 years; and general fitness, strength, and flexibility among men aged ≥ 50 years. These data did not change when SES, clinical variables, or biochemical determinations were included in the analyses, neither for the physical nor for the mental HRQoL.ConclusionGender and age are important factors to be considered when analysing health indicators and influences in the population. In addition, SES, clinical characteristics, and biochemical parameters do not seem to influence the relationship between HRQoL and fitness.

Reliability of interview-based ADL ability measures in older adults obtained by occupational therapists, physical therapists, and nursing staff

Purpose: To examine the reliability of ADL interview (ADL-I) ability measures when administered by different health professionals (HPs). Materials and methods: Older adults with stable ADL ability were invited to participate in three ADL-I interviews, administered by occupational therapists (OTs), physical therapists (PTs), and nursing staff (NS), respectively. Methods based on classic and modern test theory were applied. Results: Overall, n = 36 older adults and n = 11 HPs participated. Intraclass Correlation Coefficients were acceptable for research purposes (> 0.7), but not for clinical use. Mean differences in ADL ability measures were significant when comparing measures based on interviews by OTs to measures based on interviews by PTs and NS. Further, in 25 to 47% of the individuals, ADL-I ability measures differed significantly across HPs. Limits of Agreement revealed that measures based on interviews by OTs were systematically lower compared to measures based on interviews by PTs and NS. Four ADL-I items displayed Differential Item Functioning based on HP. Conclusion: When using the ADL-I, it is recommended to only involve one profession, to increase the reliability of measures. Results highlight the importance of evaluating reliability of measures based on instruments administered across HPs before implementation in rehabilitation practice and research.

Anti-Xa Monitoring of Apixaban (ZyQuis) in Venous Thrombo-Embolism and Atrial Fibrillation.

Apixaban is a direct oral Xa inhibitor and is indicated for the treatment of venous thrombo-embolism (VTE) and prevention of stroke in atrial fibrillation (AF). Recently, a generic (ZyQuis, Zydus Lifesciences Limited, India) has received Food and Drug Administration approval. While bioequivalence has been demonstrated with Eliquis (Bristol-Myers Squibb/Pfizer, UK), it is necessary to monitor its effectiveness prior to acceptance in medical practice. This prospective study independently evaluated Apixaban (ZyQuis) at two accredited laboratories. Participants were converted from Warfarin or Rivaroxaban to Apixaban 5 mg bd for a duration of one month. Peak anti-Xa levels were measured 3-4 h post the morning dose. The samples were processed on the Atellica COAG 360 (Siemens Healthineers, Marburg, Germany) analyzers with a chromogenic anti-Xa assay (Innovance, reference interval 69-321 ng/mL). There were 26 participants; 5 men, 21 women; mean ± standard deviation age of 46 ± 12 years. Indications for anticoagulation included: VTE (88.5%) and AF (11.5%). 69.2% of the participants had at least one comorbidity. 96.2% of the anti-Xa levels were within the laboratory's 95% reference interval. Mean anti-Xa activity was 191 ± 69 ng/mL and 186 ± 68 ng/mL measured at respective laboratories. Mean differences in anti-Xa measurements represented by Bland-Altman statistics were small (bias of -2.6%, 95% confidence interval -1.11 to -4.09) and a strong correlation was observed on Deming regression analysis (0.995). Apixaban (ZyQuis) was effective for the management of VTE and AF as evidenced by anti-Xa activity.

Cross-sectional and longitudinal analyses of variations of anthropometric measures of obesity with age in the Jackson Heart Study

ObjectiveTo explore how anthropometric measures of obesity vary with age among African American (AA) adults.Participants and setting3634 AA adults participated in the Jackson Heart Study (Jackson, Mississippi, USA) from 2004...

Enamel matrix derivative for alveolar ridge preservation: A randomized controlled trial.

The aims of this clinical trial were to evaluate the radiographic dimensional changes in alveolar ridge and patient-reported outcomes following tooth extraction and alveolar ridge preservation (ARP) using either deproteinized bovine bone mineral (DBBM) with EMD or DBBM alone. Participants requiring at least one posterior tooth extraction and ARP were randomly allocated into two treatment groups: ARP using either DBBM with EMD or DBBM alone. Cone-beam computed tomography (CBCT) images were recorded immediately prior to extraction and at 6 months. Changes in alveolar ridge height (ARH) and alveolar ridge width (ARW) at 1, 3, and 5 mm were recorded. A total of 18 participants with 25 preserved sites were evaluated. ARH and ARW changed significantly from baseline to 6 months for both treatment groups but the difference between the groups was not statistically significant over the 6-month follow-up period (ARH: DBBM/EMD 1.26 ± 1.53 mm vs. DBBM 2.26 ± 1.60 mm; ARW-1 DBBM/EMD 1.98 ± 1.80 mm vs. DBBM 2.34 ± 1.89 mm). A significant difference, favoring DBBM with EMD group, was observed in percentage of sites that had less than 1 mm loss in ARH (54.5% sites in DBBM/EMD group vs. 14.3% sites in DBBM alone group). The participants' perception of bruising, bleeding, and pain in the first two postoperative days was significantly in favor of DBBM alone group. There were no significant differences in radiographic mean measurements of ARH and ARW following ARB with DBBM and EMD or DBBM alone.

Effect of humeral rotation on the reliability of radiographic measurements for proximal humerus fractures

BackgroundThere are concerns as to the reliability of proximal humerus radiographic measurements, particularly regarding the rotational position of the humerus when obtaining radiographs. MethodsTwenty-four patients with proximal humerus fractures fixed surgically with locked plates received postoperative anteroposterior radiographs with the humerus in neutral rotation and in 30° of internal and external rotation. Radiographic measurements for head shaft angle, humeral offset and humeral head height were performed in each humeral rotation position. Intra-class correlation coefficient was used to assess inter-rater and intra-rater reliability. Mean differences (md) in measurements between humeral positions was evaluated using one-way ANOVA. ResultsHead shaft angle demonstrated good-to-excellent reliability; the highest estimates for inter-rater reliability (ICC: 0.85; 95% CI: 0.76, 0.94) and intra-rater reliability (ICC: 0.96; 95% CI: 0.93, 0.98) were achieved in neutral rotation. There were significant differences in measurement values between each rotational position, with mean head shaft angle of 133.1° in external rotation, and increasingly valgus measurements in neutral (md: 7.6°; 95% CI: 5.0, 10.3°; p < 0.001) and internal rotation (md: 26.4°; 95% CI: 21.8, 30.9°; p < 0.001). Humeral head height and humeral offset showed good-to-excellent reliability in neutral and external rotation, but poor inter-rater reliability in internal rotation. Humeral head height was significantly greater using internal compared to external rotation (md: 4.5 mm; 95% CI: 1.7, 7.3 mm; p = 0.002). Humeral offset was significantly greater in external compared to internal rotation (md: 4.6 mm; 95% CI: 2.6, 6.6 mm; p < 0.001). ConclusionsViews of the humerus in neutral rotation and 30° of external rotation displayed superior reliability. Differences in radiographic measurement values, depending on humeral rotation views, can make for problematic correlations with patient outcome measures. Studies assessing radiographic outcomes following proximal humerus fractures should ensure standardized humeral rotation for obtaining anteroposterior shoulder radiographs, with neutral rotation and external rotation views likely yielding the most reliable results. Level of EvidenceLevel IV

Impact of arm position on vertebral bone marrow proton density fat fraction in chemical-shift-encoded magnetic resonance imaging: a preliminary study.

Arm positions employed during magnetic resonance imaging (MRI) can affect magnetic field distribution, which may result in variability in proton density fat fraction (PDFF) measurements. This study evaluated the effect of arm position on lumbar PDFF measured using chemical-shift-encoded MRI (CSE-MRI). Fifteen healthy volunteers from a single-center underwent lumbar CSE-MRI at two different arm positions (side and elevated) using a single 3T scanner. Scans were performed twice in each position. PDFFs of the L1-L5 vertebrae were independently measured by two readers, and reader measurements were compared by calculating intraclass correlation coefficients (ICC). We compared PDFF measurements from two arm positions and from two consecutive scans using the Wilcoxon test and Bland-Altman analysis. Measurements from the two readers were in high agreement [ICC =0.999; 95% confidence interval (CI), 0.998-0.999]. No significant difference was observed between PDFFs from the first and second scans of all vertebrae for each reader (all P>0.05); however, PDFF for the elevated arm position was significantly higher than that for the side arm position (37.9-44.8% vs. 37.0-43.8%; all P<0.05), except at the L2 level by reader 2. The mean differences in PDFF measurements from the first and second scans [0.1%; 95% limits of agreement (LoA), -1.8% to 1.9%] and from the side arm and elevated arm positions (0.8%; 95% LoA, -1.6% to 3.2%) were small. In conclusion, these preliminary data suggest that different arm positions during CSE-MRI can slightly affect lumbar PDFF; however, the mean absolute differences were very small.

Alveolar bone measurements in magnetic resonance imaging compared with cone beam computed tomography: a pilot, ex-vivo study

Objectives To compare alveolar bone height and width measurements from zero-echo-time MRI (ZTE-MRI) and cone beam CT (CBCT), in human specimens. Material and methods Twenty posterior edentulous sites in human cadaver specimens were imaged with CBCT and ZTE-MRI. Bone height and width at 1, 3, 5, 7 and 9 mm from the top of the alveolar ridge was measured by two trained observers in cross-sections of a site where an implant was to be planned. Twenty percent of the sample was measured in duplicate to assess method error and intra-observer reproducibility (ICC). The differences between CBCT and ZTE-MRI measurements were compared (t-test). Results Inter- and intra-observer reproducibility was >0.90. The method error (average between observers) for bone height was 0.45 mm and 0.39 mm, and for bone width (average) was 0.52 mm and 0.80 mm (CBCT and ZTE-MRI, respectively). The majority of the bone measurement differences were statistically insignificant, except bone width measurements at 5 mm (p ≤ .05 for both observers). Mean measurement differences were not larger than the method error. Conclusion ZTE-MRI is not significantly different from CBCT when comparing measurements of alveolar bone height and width.

AGREEMENT BETWEEN DIFFERENT TYPES OF BLOOD PRESSURE MONITORING: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS

Objective: An accurate blood pressure measurement (BPM) is important for diagnosing and managing hypertension. Several monitoring techniques of BPM, including office BPM (OBPM), ambulatory BPM (ABPM), and home BPM (HBPM) have been widely utilized; however, the corresponding agreement and conversion between these modalities remained elusive. With emerging evidence suggesting the utility of out-of-office blood pressure (BP) for hypertension management, an investigation into the relationship between BPMs is crucial. Therefore, we performed a systematic review and network meta-analysis from published studies and compared the reported BP values between different BPM modalities. Design and method: We searched MEDLINE and Scopus for observational studies and andomised controlled trials reporting more than one type of BPM by Apr 6, 2021. Studies with participants that were over 18 years old and received at least two different BPM within a week were included. The risk of bias of included studies was assessed by the quality of the study and BPM techniques. We calculated the mean differences (MD) between modalities and pooled the measurements using random-effects network meta-analysis. Furthermore, the agreement between BPMs within different BP levels was investigated using network meta-regression. Results: We identified 10970 studies and included 486/482 studies (467654/466167 individuals) for SBP/DBP measurements. With reference to OBPM, the MDs of SBP of casual OBPM, HBPM, 24 hours ABPM, daytime ABPM, and night time ABPM, were 2.8, -5.5, -10.0, -6.4, -19.5mmHg, respectively. For DBP the MDs were 1.3, -3.0, -6.3, -3.19, and -13.76mmHg. Network meta-regression (see figure) showed that the MDs between OBPM and casual OBPM were rather fixed; however, those between OBPM/HBPM or OBPM/ABPM followed a negatively associated linear relationship across BP levels. The diagnostic thresholds of different BPMs corresponding to OBPM 140/90mmHg and 130/80mmHg were generally in agreement with current guidelines. Conclusions: Our study demonstrated the agreement between common BPM modalities by synthesizing the body of evidence from a comprehensive search. Furthermore, the regression model showed that the MDs of measurements between modalities may vary depending on the mean BP. Our systematic review supports the diagnostic thresholds for different BPM recommended by current guidelines.

Feasibility and accuracy of printed models of complex cardiac defects in small infants from cardiac CT

3D printed models are increasingly used to enhance understanding of complex anatomy in congenital heart disease. To assess feasibility and accuracy of 3D printed models obtained from cardiac CT scan in small pediatric population with complex congenital heart diseases. Patients with conotruncal heart anomalies aged less than 2 years old who had a cardiac CT scan in course of their follow-up were included. Cardiac CT scan datasets were used to generate 3D models. To assess model's accuracy, 4 diameters were compared for each patient between the CT images and the printed models, including the largest diameters (Dmax) of ventricular septal defects (VSD) and aortic annulus (AA) and their minimal diameters (Dmin). Images of 14 patients were obtained. Mean age was 5.5 months (1-24 months), mean weight was 6.7 kg (3.4-14.5 kg). 3D models were obtained in all patients. Mean measurement difference between CT image and 3D model was 0.13 mm for Dmin and 0.12 mm for Dmax for VSD diameters, and was 0.16 mm for Dmin and -0.13 mm for Dmax for AA diameter indicating a non-clinically significant difference ( Fig. 1 ). 3D printed models are feasible from cardiac CT scan in small pediatric population with complex congenital heart diseases. This technique is highly accurate and reliably reflects the same structure dimensions when compared to CT source images.

Fully automated guideline-compliant diameter measurements of the thoracic aorta on ECG-gated CT angiography using deep learning.

Manually performed diameter measurements on ECG-gated CT-angiography (CTA) represent the gold standard for diagnosis of thoracic aortic dilatation. However, they are time-consuming and show high inter-reader variability. Therefore, we aimed to evaluate the accuracy of measurements of a deep learning-(DL)-algorithm in comparison to those of radiologists and evaluated measurement times (MT). We retrospectively analyzed 405 ECG-gated CTA exams of 371 consecutive patients with suspected aortic dilatation between May 2010 and June 2019. The DL-algorithm prototype detected aortic landmarks (deep reinforcement learning) and segmented the lumen of the thoracic aorta (multi-layer convolutional neural network). It performed measurements according to AHA-guidelines and created visual outputs. Manual measurements were performed by radiologists using centerline technique. Human performance variability (HPV), MT and DL-performance were analyzed in a research setting using a linear mixed model based on 21 randomly selected, repeatedly measured cases. DL-algorithm results were then evaluated in a clinical setting using matched differences. If the differences were within 5 mm for all locations, the cases was regarded as coherent; if there was a discrepancy >5 mm at least at one location (incl. missing values), the case was completely reviewed. HPV ranged up to ±3.4 mm in repeated measurements under research conditions. In the clinical setting, 2,778/3,192 (87.0%) of DL-algorithm's measurements were coherent. Mean differences of paired measurements between DL-algorithm and radiologists at aortic sinus and ascending aorta were -0.45±5.52 and -0.02±3.36 mm. Detailed analysis revealed that measurements at the aortic root were over-/underestimated due to a tilted measurement plane. In total, calculated time saved by DL-algorithm was 3:10 minutes/case. The DL-algorithm provided coherent results to radiologists at almost 90% of measurement locations, while the majority of discrepent cases were located at the aortic root. In summary, the DL-algorithm assisted radiologists in performing AHA-compliant measurements by saving 50% of time per case.

User Perceptions and Experiences of a Handheld 12-Lead Electrocardiographic Device in a Clinical Setting: Usability Evaluation.

BackgroundCardiac arrhythmias are a leading cause of death. The mainstay method for diagnosing arrhythmias (eg, atrial fibrillation) and cardiac conduction disorders (eg, prolonged corrected QT interval [QTc]) is by using 12-lead electrocardiography (ECG). Handheld 12-lead ECG devices are emerging in the market. In tandem with emerging technology options, evaluations of device usability should go beyond validation of the device in a controlled laboratory setting and assess user perceptions and experiences, which are crucial for successful implementation in clinical practice.ObjectiveThis study aimed to evaluate clinician and patient perceptions and experiences, regarding the usability of a handheld 12-lead ECG device compared to a conventional 12-lead ECG machine, and generalizability of this user-centered approach.MethodsInternational Organization for Standardization Guidelines on Usability and the Technology Acceptance Model were integrated to form the framework for this study, which was conducted in outpatient clinics and cardiology wards at Westmead Hospital, New South Wales, Australia. Each patient underwent 2 ECGs (1 by each device) in 2 postures (supine and standing) acquired in random sequence. The times taken by clinicians to acquire the first ECG (efficiency) using the devices were analyzed using linear regression. Electrocardiographic parameters (QT interval, QTc interval, heart rate, PR interval, QRS interval) and participant satisfaction surveys were collected. Device reliability was assessed by evaluating the mean difference of QTc measurements within ±15 ms, intraclass correlation coefficient, and level of agreement of the devices in detecting atrial fibrillation and prolonged QTc. Clinicians’ perceptions and feedback were assessed with semistructured interviews based on the Technology Acceptance Model.ResultsA total of 100 patients (age: mean 57.9 years, SD 15.2; sex: male: n=64, female n=36) and 11 clinicians (experience acquiring ECGs daily or weekly 10/11, 91%) participated, and 783 ECGs were acquired. Mean differences in QTc measurements of both handheld and conventional devices were within ±15 ms with high intraclass correlation coefficients (range 0.90-0.96), and the devices had a good level of agreement in diagnosing atrial fibrillation and prolonged QTc (κ=0.68-0.93). Regardless of device, QTc measurements when patients were standing were longer duration than QTc measurements when patients were supine. Clinicians’ ECG acquisition times improved with usage (P<.001). Clinicians reported that device characteristics (small size, light weight, portability, and wireless ECG transmission) were highly desired features. Most clinicians agreed that the handheld device could be used for clinician-led mass screening with enhancement in efficiency by increasing user training. Regardless of device, patients reported that they felt comfortable when they were connected to the ECG devices.ConclusionsReliability and usability of the handheld 12-lead ECG device were comparable to those of a conventional ECG machine. The user-centered evaluation approach helped us identify remediable action to improve the efficiency in using the device and identified highly desirable device features that could potentially help mass screening and remote assessment of patients. The approach could be applied to evaluate and better understand the acceptability and usability of new medical devices.

Cardiac Output Measurement in Neonates and Children Using Noninvasive Electrical Bioimpedance Compared With Standard Methods: A Systematic Review and Meta-Analysis.

To systematically review and meta-analyze the validity of electrical bioimpedance-based noninvasive cardiac output monitoring in pediatrics compared with standard methods such as thermodilution and echocardiography. Systematic searches were conducted in MEDLINE and EMBASE (2000-2019). Method-comparison studies of transthoracic electrical velocimetry or whole body electrical bioimpedance versus standard cardiac output monitoring methods in children (0-18 yr old) were included. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Mean differences of cardiac output, stroke volume, or cardiac index measurements were pooled using a random-effects model (R Core Team, R Foundation for Statistical Computing, Vienna, Austria, 2019). Bland-Altman statistics assessing agreement between devices and author conclusions about inferiority/noninferiority were extracted. Twenty-nine of 649 identified studies were included in the qualitative analysis, and 25 studies in the meta-analyses. No significant difference was found between means of cardiac output, stroke volume, and cardiac index measurements, except in exclusively neonatal/infant studies reporting stroke volume (mean difference, 1.00 mL; 95% CI, 0.23-1.77). Median percentage error in child/adolescent studies approached acceptability (percentage error less than or equal to 30%) for cardiac output in L/min (31%; range, 13-158%) and stroke volume in mL (26%; range, 14-27%), but not in neonatal/infant studies (45%; range, 29-53% and 45%; range, 28-70%, respectively). Twenty of 29 studies concluded that transthoracic electrical velocimetry/whole body electrical bioimpedance was noninferior. Transthoracic electrical velocimetry was considered inferior in six of nine studies with heterogeneous congenital heart disease populations. The meta-analyses demonstrated no significant difference between means of compared devices (except in neonatal stroke volume studies). The wide range of percentage error reported may be due to heterogeneity of study designs, devices, and populations included. Transthoracic electrical velocimetry/whole body electrical bioimpedance may be acceptable for use in child/adolescent populations, but validity in neonates and congenital heart disease patients remains uncertain. Larger studies in specific clinical contexts with standardized methodologies are required.

Feasibility and accuracy of printed models of complex cardiac defects in small infants from cardiac computed tomography

Three-dimensional (3-D) printed models are increasingly used to enhance understanding of complex anatomy in congenital heart disease. To assess feasibility and accuracy of 3-D printed models obtained from cardiac CT scans in young children with complex congenital heart diseases. We included children with conotruncal heart anomalies who were younger than 2years and had a cardiac CT scan in the course of their follow-up. We used cardiac CT scan datasets to generate 3-D models. To assess the models' accuracy, we compared four diameters for each child between the CT images and the printed models, including the largest diameters (Dmax) of ventricular septal defects and aortic annulus and their minimal diameters (Dmin). We obtained images from 14 children with a mean age of 5.5months (range 1-24months) and a mean weight of 6.7kg (range 3.4-14.5kg). We generated 3-D models for all children. Mean measurement difference between CT images and 3-D models was 0.13mm for Dmin and 0.12mm for Dmax for ventricular septal defect diameters, and it was 0.16mm for Dmin and -0.13mm for Dmax for aortic annulus diameter, indicating a non-clinically significant difference. Three-dimensional printed models could be feasibly generated from cardiac CT scans in a small pediatric population with complex congenital heart diseases. This technique is highly accurate and reliably reflects the same structural dimensions when compared to CT source images.

Validation Study of Kids Hearing Game: A Self-Administered Pediatric Audiology Application.

Conduct a comparison study between conventional audiometry and a tablet-based hearing screening application, Kids Hearing Game (KHG). If KHG measures hearing at levels comparable with conventional audiometry, it could be used to screen hearing in children. Prospective equivalence study where measurements of pure tone hearing via KHG are compared with measurements of pure tone hearing via conventional audiometry in patients aged 6-11 years over a 4-month period. Eighteen patients completed the study. Results from 36 ears were included in the data for analysis. Decibel measurements from each frequency measured with KHG for each ear were compared with conventional audiometry. Mean measurements were calculated for each ear and frequency as well as mean differences in measurements at each ear and frequency. Tests of equivalence were used to assess mean within-subject differences in decibel measurements using a 10-dB zone of indifference. Mean decibel measurements using KHG for the right ear at 500, 1000, 2000, 4000, and 8000 Hz and the left ear at 1000, 2000, 4000, and 8000 Hz were found equivalent to conventional audiometry (p < 0.050). The mean decibel measurement using KHG for the left ear at 500 Hz was found not equivalent (p = 0.101). However, when left and right ear data were analyzed together, KHG was found to be equivalent to conventional audiometry across all frequencies. Eight patients having hearing loss greater than 25 dB on conventional audiometry were also identified by KHG to have hearing loss. KHG is comparable to conventional audiometry and may be used as a screening tool for children.

Feasibility and accuracy of printed models of complex cardiac defects in small infants from cardiac CT

3D printed models are increasingly used to enhance understanding of complex anatomy in congenital heart disease. We aimed to assess feasibility and accuracy of 3D printed models obtained from cardiac CT scan in small pediatric population with complex congenital heart diseases. Patients with conotruncal heart anomalies aged less than 2 years old who had a cardiac CT scan in course of their follow-up were included. Cardiac CT scan datasets were used to generate 3D models. To assess model's accuracy, 4 diameters were compared for each patient between the CT images and the printed models, including the largest diameters (Dmax) of ventricular septal defects (VSD) and aortic annulus (AA) and their minimal diameters (Dmin). Images of 14 patients were obtained. Mean age was 5.5 months (1–24 months), mean weight was 6.7 kg (3.4–14.5 kg). 3D models were successfully obtained in all patients. Correlations between measurements obtained from printed models and CT images were excellent ( r = 0.90 to 0.98). Mean measurement difference between CT image and 3D model was 0.13 mm for Dmin and 0.12 mm for Dmax for VSD diameters, and was 0.16 mm for Dmin and −0.13 mm for Dmax for AA diameter indicating a non-clinically significant difference ( Fig. 1 ). 3D printed models are feasible from cardiac CT scan in small pediatric population with complex congenital heart diseases. This technic is highly accurate and reliably reflects the same structure dimensions when compared to CT source images.

Power Consumption Profiling of a Lightweight Development Board: Sensing with the INA219 and Teensy 4.0 Microcontroller

At the heart of most technological advancements is a network of processors executing code and consuming energy. Understanding those systems’ energy consumption profiles provides optimisation possibilities and thus contributes to strategies for reducing energy consumption in general. This paper assesses the power consumption characteristics of a highly competitive low cost, small form factor development board (the Raspberry Pi4 model B), powered with the minimal load associated with its bare-metal configuration and the related impact on baseline power consumption. We also consider the load associated with an out-of-box operating system, running at several underclocking frequency scaling levels and the associated impact on baseline power consumption. Our experimental set-up consists of integrating an INA219 high-side current sense amplifier for the capturing of power, current, and voltage measurements; and a Teensy 4.0 microcontroller for sampling. Overall, our results indicate statistically significant differences in overall power consumption distribution characteristics across all models. Our results also indicate the presence of three distinct power phase envelopes and statistically significant differences in mean and median power measurements between the different underclocking frequency test cases and the bare-metal cases. Our results also indicate that power consumption is an increasing monotonic function across test scenarios. Finally, our results have also shown that isolating power consumption composite distributions increases model predictability from 67% to 97%.

Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials.

ObjectivesWork related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID‐19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta‐analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers.MethodsDatabases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow‐up. Meta‐analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non‐intervention controls. Network meta‐analysis was conducted to determine the best relaxation method.ResultsFifteen trials representing 688 healthcare workers were identified. Random‐effects meta‐analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow‐up vs baseline compared to non‐intervention controls (SMD −0.53; 95% CI [−0.74 to −0.33]; p < .00001). On network meta‐analysis, only yoga alone (SMD −0.71; 95% CI [−1.01 to −0.41]) and massage therapy alone (SMD −0.43; 95% CI [−0.72 to −0.14]) were more effective than control, with yoga identified as the best method (p‐score = .89).ConclusionPhysical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.

The Vectra M3 3-dimensional digital stereophotogrammetry system: A reliable technique for detecting chin asymmetry.

PurposeThe aim of this study was to evaluate the reliability of the Vectra M3 (3D Imaging System; Canfield Scientific, Parsippany, NJ, USA) in detecting chin asymmetry, and to assess whether the automatic markerless tracking function is reliable compared to manually plotting landmarks.Materials and MethodsTwenty subjects (18 females and 2 males) with a mean age of 42.5±10.5 years were included. Three-dimensional image acquisition was carried out on all subjects with simulated chin deviation in 4 stages (1-4 mm). The images were analyzed by 2 independent observers through manually plotting landmarks and by Vectra software auto-tracking mode. Repeated-measures analysis of variance and the Tukey post-hoc test were performed to evaluate the differences in mean measurements between the 2 operators and the software for measuring chin deviation in 4 stages. The intraclass correlation coefficient (ICC) was calculated to estimate the intra- and inter-examiner reliability.ResultsNo significant difference was found between the accuracy of manually plotting landmarks between observers 1 and 2 and the auto-tracking mode (P=0.783 and P=0.999, respectively). The mean difference in detecting the degree of deviation according to the stage was <0.5 mm for all landmarks.ConclusionThe auto-tracking mode could be considered as reliable as manually plotted landmarks in detecting small chin deviations with the Vectra® M3. The effect on the soft tissue when constructing a known dental movement yielded a small overestimation of the soft tissue movement compared to the dental movement (mean value<0.5 mm), which can be considered clinically non-significant.

Narrow Ridge Expansion for Implant Placement Using Ultrasonic Bone Surgery and Platelet Rich Fibrin With and Without Silk Fibroin.

ABSTRACT Object: To evaluate the effect of combined split-crest technique using ultrasonic bone surgery with platelet rich fibrin alone and in combination with silk fibroin for dental implant placement in narrow ridge. Subject and Methods: A total of 24 implants inserted in 18 patients with narrow ridge. Patients were assigned into one of the following 2 groups based on the graft material used. For group I, the peri implant gap was filled with silk fibroin mixed with PRF while for group 2 was filled with PRF only. All patients undergone a ridge splitting technique using piezoelectrical device and immediate implant placment. Assessments included measurements of the ridge width, implant stability and bone density. Results: The differences in implant stability measurements were non- significant in both groups at baseline however, at 6 months was statistically significant (P=0.001) in favor of silk fibroin group. Additionally, the differences in mean crest width measurements between both studied groups, were statistically non- significant at base line and immediately after surgery while silk fibroin group exhibited a statistically significant (P=0.010) increase in mean crest width measurements at 6 months. Moreover, silk fibroin group also showed higher and statistically significant (P=0.001) mean bone density measurements, at 6 months compared to PRF group. Conclusions: Compared to PRF alone, adding silk fibroin might provide a better reconstruction of ridge width, implant stability and bone density in the narrow ridge augmented with crest splitting and immediate implants.