BACKGROUND: In recent years, there has been an increasing effort to take advantage of the potential use of low magnetic induction devices with less than 1 T, referred to as Low-Field MRI (LF MRI). LF MRI systems were used, especially in the early days of magnetic resonance technology. Over time, magnetic induction values of 1.5 and 3 T have become the standard for clinical devices, mainly because LF MRI systems were suffering from significantly lower quality of the images, e.g., signal-noise ratio. In recent years, due to advances in image processing with artificial intelligence, there has been an increasing effort to take advantage of the potential use of LF MRI with induction of less than 1 T. This overview article focuses on the analysis of the evidence concerning the diagnostic efficacy of modern LF MRI systems and the clinical comparison of LF MRI with 1.5 T systems in imaging the nervous system, musculoskeletal system, and organs of the chest, abdomen, and pelvis. METHODOLOGY: A systematic literature review of MEDLINE, PubMed, Scopus, Web of Science, and CENTRAL databases for the period 2018-2023 was performed according to the recommended PRISMA protocol. Data were analysed to identify studies comparing the accuracy, reliability and diagnostic performance of LF MRI technology compared to available 1.5 T MRI. RESULTS: A total of 1275 publications were retrieved from the selected databases. Only two articles meeting all predefined inclusion criteria were selected for detailed assessment. CONCLUSIONS: A limited number of robust studies on the accuracy and diagnostic performance of LF MRI compared with 1.5 T MRI was available. The current evidence is not sufficient to draw any definitive insights. More scientific research is needed to make informed conclusions regarding the effectiveness of LF MRI technology.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
As female soccer's popularity and participation rise, injury rates are expected to increase due to the sport's complexity, highlighting the importance of regular health and neuromuscular function screenings for injury prevention. The aim of the study was to determine how neuromuscular warm-up affects the contractility of the lower limb muscles and its significance in the prevention of injuries in female soccer players. The research sample consisted of 36 female soccer players, who were divided into an experimental (EG) and a control (CG) group with an average age 17.45 ± 2.63 years (EG) and 16.24 ± 1.09 years (CG). The contractility of the lower limb muscles was monitored using Tensiomyography (TMG). We evaluated bilaterally five muscles of the lower limbs for each soccer player: m. biceps femoris, m. gastrocnemius medialis, m. gluteus maximus, m. vastus lateralis, and m. vastus medialis. The experimental factor in the research, implemented during the warm-up phase of the training session, was neuromuscular warm-up over 12 weeks of EG. To assess the effect of the intervention program on changes in the muscle contractility of the soccer players, we employed the non-parametric Wilcoxon signed-rank test for dependent samples and the Mann-Whitney U test for independent samples. Results indicates that the speed of muscle contraction (Tc) and muscle stiffness (Dm) vary among different muscles and even between dominant and non-dominant limbs of soccer players. The impact of neuromuscular warm-up on contraction time and maximal displacement was negligible, except for a moderate effect in m. gluteus maximus of the non-dominant limb. Although the impact of neuromuscular warm-up on lower limb muscle contractility was not significant, more regular monitoring and inclusion of neuromuscular warm-up at a higher weekly frequency may have beneficial effects.
High-frequency waveform recordings of biological signals enable more detailed data analysis and deeper physiological exploration. However, the waveform data—like invasive arterial blood pressure (ABP)—are particularly susceptible to frequent contamination with artifacts that can devalue the subsequent calculations like pressure reactivity index (PRx). This study aimed to verify the ability of the short-time Fourier transform (STFT) based algorithm to detect artifacts in the ABP waveform. Four types of modeled artifacts (rectangular, fast impulse, sawtooth and baseline drift) with different durations and amplitudes were inserted into undisturbed ABP waveforms. Short-time Fourier transform with a 5-second time window is computed on artifact-polluted ABP signals to detect changes in the frequency domain caused by these artifacts. An algorithm with three decision-making rules based on the dominant frequency component, standardized power spectrum, and the value of the second harmonic of the dominant frequency was used. Only segments that passed all three rules were labeled as artifact-free. Results indicated high sensitivity (93.35% and 94.83%) in detecting rectangular and sawtooth artifacts, with specificity exceeding 99% for both. Baseline drift artifact was detected with a low sensitivity of 5.02%, and fast impulse was not detected. This study proposes the application of a short-time Fourier transform-based algorithm to enhance the detection of clinically significant artifacts in arterial blood pressure signals, particularly relevant for PRx and other secondary calculations.
Breast augmentation is one of the most frequently performed cosmetic procedures worldwide, but it carries certain risks including breast implant rupture. Timely and accurate diagnostics of ruptures are crucial, as undiagnosed ruptures can lead to serious health complications. Imaging methods, such as magnetic resonance imaging (MRI), are recommended for the diagnosis of breast implants due to their high accuracy. However, current diagnostics rely heavily on the subjective interpretation and experience of the physician. This study investigates the potential of neural networks (NN) to address this limitation and improve the accuracy of rupture detection in silicone breast implants. We applied a deep learning-based neural network system trained on MRI images of breast implants to detect ruptures. The dataset included annotated MRI scans of symptomatic and asymptomatic patients with confirmed implant integrity or rupture. Several models were trained using ResNet-18, ResNet-50, and Xception networks, with various hyperparameter settings and augmentation techniques applied to enhance model performance and generalizability. The performance of the NN model was evaluated using confusion matrices and standard metrics such as true positive rate (TPR) and true negative rate (TNR). A semi-automated algorithm for the detection of intracapsular ruptures of breast implants on MRI was successfully developed. The algorithm correctly detected ruptures in 95.4% of cases and accurately identified cases without rupture in 86.7% of instances. Our findings highlight the potential of neural networks as a supportive tool in diagnosing breast implant ruptures. By semi-automating rupture detection, NNs can reduce diagnostic errors, expedite image evaluation, and optimize resource use in medical practice. The study underscores the importance of combining artificial intelligence with expert evaluation to enhance patient care and reduce costs in medical diagnostics.
BACKGROUND: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma. METHODS: In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL). RESULTS: Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly. CONCLUSION: Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.
- MeSH
- bronchiální astma * farmakoterapie MeSH
- COVID-19 * MeSH
- hormony kůry nadledvin MeSH
- kvalita života MeSH
- lidé MeSH
- usilovný výdechový objem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Although smartwatches are not considered medical devices, experimental validation of their accuracy in detecting hypoxemia is necessary due to their potential use in monitoring conditions manifested by a prolonged decrease in peripheral blood oxygen saturation (SpO2), such as chronic obstructive pulmonary disease, sleep apnea syndrome, and COVID-19, or at high altitudes, e.g., during sport climbing, where the use of finger-sensor-based pulse oximeters may be limited. The aim of this study was to experimentally compare the accuracy of SpO2 measurement of popular smartwatches with a clinically used pulse oximeter according to the requirements of ISO 80601-2-61. Each of the 18 young and healthy participants underwent the experimental assessment three times in randomized order-wearing Apple Watch 8, Samsung Galaxy Watch 5, or Withings ScanWatch-resulting in 54 individual experimental assessments and complete datasets. The accuracy of the SpO2 measurements was compared to that of the Radical-7 (Masimo Corporation, Irvine, CA, USA) during short-term hypoxemia induced by consecutive inhalation of three prepared gas mixtures with reduced oxygen concentrations (14%, 12%, and 10%). All three smartwatch models met the maximum acceptable root-mean-square deviation (≤4%) from the reference measurement at both normal oxygen levels and induced desaturation with SpO2 less than 90%. Apple Watch 8 reached the highest reliability due to its lowest mean bias and root-mean-square deviation, highest Pearson correlation coefficient, and accuracy in detecting hypoxemia. Our findings support the use of smartwatches to reliably detect hypoxemia in situations where the use of standard finger pulse oximeters may be limited.
- MeSH
- chronická obstrukční plicní nemoc * MeSH
- hypoxie diagnóza MeSH
- kyslík MeSH
- lidé MeSH
- oxymetrie * metody MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Data o zdravotní péči ve správě státem řízených organizací jsou pro společnost cenným nehmotným aktivem. Jejich využití by mělo být pro jejich správce a stát prioritou. Zcela paternalistický přístup správců a státu je nežádoucí, jakkoliv má za cíl ochranu práva na soukromí osob registrovaných v databázích. V souladu s evropskou politikou a celosvětovým trendem by však tato opatření neměla převážit společenský benefit, který z analýzy těchto údajů vyplývá, existují-li technické možnosti práva osob na soukromí dostatečně chránit. Česká společnost vede k tématu intenzivní diskusi, která se však podle autorů jen nedostatečně opírá o fakta a postrádá jasně artikulovaná stanoviska odborné veřejnosti. Cílem tohoto článku je tyto mezery zacelit. Techniky anonymizace údajů představují řešení, jak chránit práva jednotlivců na soukromí a zároveň zachovat vědeckou hodnotu údajů. Riziko ztotožnění jednotlivců v anonymizovaných souborech údajů je škálovatelné a lze ho minimalizovat v závislosti na typu a obsahu údajů a jejich použití konkrétním žadatelem. Nalezení optimální formy a rozsahu deidentifikovaných údajů vyžaduje kompetence a znalosti jak na straně žadatele, tak na straně správce. Je v zájmu žadatele, správce i chráněných osob v databázích, aby obě strany projevily ochotu a měly schopnost a odborné znalosti komunikovat v průběhu žádosti a jejího zpracování.
Healthcare data held by state-run organisations is a valuable intangible asset for society. Its use should be a priority for its administrators and the state. A completely paternalistic approach by administrators and the state is undesirable, however much it aims to protect the privacy rights of persons registered in databases. In line with European policies and the global trend, these measures should not outweigh the social benefit that arises from the analysis of these data if the technical possibilities exist to sufficiently protect the privacy rights of individuals. Czech society is having an intense discussion on the topic, but according to the authors, it is insufficiently based on facts and lacks clearly articulated opinions of the expert public. The aim of this article is to fill these gaps. Data anonymization techniques provide a solution to protect individuals' privacy rights while preserving the scientific value of the data. The risk of identifying individuals in anonymised data sets is scalable and can be minimised depending on the type and content of the data and its use by the specific applicant. Finding the optimal form and scope of deidentified data requires competence and knowledge on the part of both the applicant and the administrator. It is in the interest of the applicant, the administrator, as well as the protected persons in the databases that both parties show willingness and have the ability and expertise to communicate during the application and its processing.
The pressure reactivity index (PRx) is a parameter for the assessment of cerebrovascular autoregulation, but its calculation is affected by artifacts in the source biosignals-intracranial pressure (ICP) and arterial blood pressure. We sought to describe the most common short-duration artifacts and their effect on the PRx. A retrospective analysis of 935 h of multimodal monitoring data was conducted, and five types of artifacts, characterized by their shape, duration, and amplitude, were identified: rectangular, fast impulse, isoline drift, saw tooth, and constant ICP value. Subsequently, all types of artifacts were mathematically modeled and inserted into undisturbed segments of biosignals. Fast impulse, the most common artifact, did not alter the PRx index significantly when inserted into one or both signals. Artifacts present in one signal exceeded the threshold PRx in less than 5% of samples, except for isoline drift. Compared to that, the shortest rectangular artifact inserted into both signals changed PRx to a value above the set threshold in 55.4% of cases. Our analysis shows that the effect of individual artifacts on the PRx index is variable, depending on their occurrence in one or both signals, duration, and shape. This different effect suggests that potentially not all artifacts need to be removed.
BACKGROUND: The role of high-frequency oscillatory ventilation (HFOV) has long been debated. Numerous studies documented its benefits, whereas several more recent studies did not prove superiority of HFOV over protective conventional mechanical ventilation (CV). One of the accepted explanations is that CV and HFOV act differently, including gas exchange. METHODS: To investigate a different level of coupling or decoupling between oxygenation and carbon dioxide elimination during CV and HFOV, we conducted a prospective crossover animal study in 11 healthy pigs. In each animal, we found a normocapnic tidal volume (VT) after the lung recruitment maneuver. Then, VT was repeatedly changed over a wide range while keeping constant the levels of PEEP during CV and mean airway pressure during HFOV. Arterial partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2) were recorded. The same procedure was repeated for CV and HFOV in random order. RESULTS: Changes in PaCO2 intentionally induced by adjustment of VT affected oxygenation more significantly during HFOV than during CV. Increasing VT above its normocapnic value during HFOV caused a significant improvement in oxygenation, whereas improvement in oxygenation during CV hyperventilation was limited. Any decrease in VT during HFOV caused a rapid worsening of oxygenation compared to CV. CONCLUSION: A change in PaCO2 induced by the manipulation of tidal volume inevitably brings with it a change in oxygenation, while this effect on oxygenation is significantly greater in HFOV compared to CV.
- MeSH
- dechový objem MeSH
- plíce MeSH
- prasata MeSH
- prospektivní studie MeSH
- výměna plynů v plicích * MeSH
- vysokofrekvenční ventilace * MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Amyotrophic lateral sclerosis is a disease with rapid progression. The use of mechanical ventilation helps to manage symptoms and delays death. Use in a home environment could reduce costs and increase quality of life. The aim of this study is a cost-utility analysis of home mechanical ventilation in adult patients with amyotrophic lateral sclerosis from the perspective of healthcare payers in the Czech Republic. The study evaluates home mechanical ventilation (HMV) and mechanical ventilation (MV) in a healthcare facility. A Markov model was compiled for evaluation in a timeframe of 10 years. Model parameters were obtained from the literature and opinions of experts from companies dealing with home care and home mechanical ventilation. The cost-utility analysis was carried out at the end of the study and results are presented in incremental cost-utility ratio (ICUR) using quality-adjusted life-years. Uncertainty was assessed by one-way sensitivity analysis and scenario analysis. The cumulative costs of HMV are CZK 1,877,076 and the cumulative costs of the MV are CZK 7,386,629. The cumulative utilities of HMV are 12.57 quality-adjusted life year (QALY) and the cumulative utilities of MV are 11.32 QALY. The ICUR value is CZK-4,403,259. The results of this study suggest that HMV is cost effective.
- Publikační typ
- časopisecké články MeSH
