Background: Low-resolution magnetic resonance imaging (MRI) has high imaging speed, but the image details cannot meet the needs of clinical diagnosis. More and more researchers are interested in neural network-based reconstruction methods. How to effectively process the super-resolution reconstruction of the low-resolution images has become highly valuable in clinical applications. Methods: We introduced Super-Resolution Convolution Neural Network (SRCNN) into the reconstruction of magnetic resonance images. The SRCNN consists of three layers, the image feature extraction layer, the nonlinear mapping layer, and the reconstruction layer. For the feature extraction layer, a multi-scale feature extraction (MFE) method was used to extract the features in different scales by involving three different levels of views, which is superior to the original feature extraction in views with fixed size. Compared with the original feature extraction only in fixed size views, we used three different levels of views to extract the features of different scales. This MFE could also be combined with residual learning to improve the performance of MRI super-resolution reconstruction. The proposed network is an end-to-end architecture. Therefore, no manual intervention or multi-stage calculation is required in practical applications. The structure of the network is extremely simple by omitting the fully connected layers and the pooling layers from traditional Convolution Neural Network. Results and Conclusions: After comparative experiments,the effectiveness of the MFE SRCNN-based network in super-resolution reconstruction of MR images has been greatly improved. The performance is significantly improved in terms of evaluation indexes peak signal-to-noise ratio and structural similarity index measure, and the detail recovery of images is also improved.

Background and Purpose: To characterize the global physician community's opinions on the use of digital tools for COVID-19 public health surveillance and self-surveillance. Materials and Methods: Cross-sectional, random, stratified survey done on Sermo, a physician networking platform, between September 9 and 15, 2020. We aimed to sample 1000 physicians divided among the USA, EU, and rest of the world. The survey questioned physicians on the risk-benefit ratio of digital tools, as well as matters of data privacy and trust. Statistical Analysis Used: Descriptive statistics examined physicians' characteristics and opinions by age group, gender, frontline status, and geographic region. ANOVA, t-test, and Chi-square tests with P < 0.05 were viewed as qualitatively different. As this was an exploratory study, we did not adjust for small cell sizes or multiplicity. We used JMP Pro 15 (SAS), as well as Protobi. Results: The survey was completed by 1004 physicians with a mean (standard deviation) age of 49.14 (12) years. Enthusiasm was highest for self-monitoring smartwatches (66%) and contact tracing apps (66%) and slightly lower (48–56%) for other tools. Trust was highest for health providers (68%) and lowest for technology companies (30%). Most respondents (69.8%) felt that loosening privacy standards to fight the pandemic would lead to misuse of privacy in the future. Conclusion: The survey provides foundational insights into how physicians think of surveillance.

Background: Telerehabilitation has been recommended as a potential solution to bridge service delivery gap, especially in geographically remote areas with shortage of healthcare personnel and lack of access to physical therapy. This study was aimed to develop and test the feasibility of a smartphone video-based exercise program (VBEP) for patients with knee osteoarthritis (OA). Methods: This two-phase study involved the development and feasibility testing stages. A three-round modified Delphi approach was employed in the development phase involving a panel of four experts and a patient with knee OA. Based on consensus, five types of exercises comprising seated knee flexion and extension, quadriceps isometric setting, quadriceps strengthening exercise, hamstring clenches, and wall squats were developed into a video-program for knee OA. 15 consenting patients with knee OA participated in the feasibility testing of the program after 2 weeks of utilization. Feasibility of the VBEP was assessed using system usability scale and user experience questionnaire, respectively. The quadruple visual analog scale was used to assess the pain intensity. Results: The mean age and pain intensity of the participants were 67.3 ± 6.4 years and 61.1 ± 10.6, respectively. User perceived usability of the VBEP was 77.1 ± 13.1 (out of 100) with a high usability rating of 86.7%. Pragmatic quality score, hedonic quality rating, attractiveness, and perspicuity were 2.2 (out of 3.0), 1.6 (out of 3.0), 2.4 (out of 3.0), and 3.0 (out of 3.0), respectively. Efficiency, dependability, stimulation, and novelty scores were 2.3 (out of 3.0), 1.8 (out of 3.0), 2.3 (out of 3.0), and 1.0 (out of 3.0), respectively. Conclusions: The VBEP for knee OA has high usability and quality rating, as well as good user experience, and it may be a feasible alternative platform for rehabilitation of patients with knee OA.

The treatment of bone defects, especially large-area bone defects caused by trauma, congenital malformations, senile diseases, and other factors, is often the key and difficult point of orthopedic diseases, which often brings a lot of troubles in the daily work of orthopedic physicians. Bone tissue engineering attempts to repair bone defects using three-dimensional (3D) bioprinted living tissue, and induces osteoblasts to differentiate and proliferate by placing biological scaffolds, thus finally forming bone tissue commensurate with the original tissue functional structure, reducing the difficulty of surgery. Compared with the traditional bone grafting surgery, it causes less trauma to patients. It is an emerging technology with crossover and cutting edge, and has huge application space and good application prospect in biomedical field. In this article, the clinical application of 3D bioprinting technology in various orthopedic fields in recent 5 years is briefly discussed.

Background: Some small sample size studies have yielded slightly inconsistent results for comparing the efficacy and toxicity of trifluridine/tipiracil (TAS-102) with or without bevacizumab. This meta-analysis aims to further investigate the additive effect and safety profile of bevacizumab when combined with TAS-102 in patients receiving a salvage-line treatment for metastatic colorectal cancer (mCRC). Methods: A systematic literature search was conducted using PubMed, Web of Science, Cochrane Library, and some oncological conferences by the end of February 2021. No restrictions were placed on the searches. Two reviewers independently performed the retrieval and selection according to the “Patient, Intervention, Comparison, Outcome, Study design” principle. The outcome endpoints included overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and adverse events (AEs). Results: Six controlled trials which recruited 435 refractory mCRC patients were ultimately taken in. Our results suggested that the regimen of TAS-102 plus bevacizumab had a significant advantage in OS, PFS, and DCR over TAS-102 alone (hazard ratio (HR) = 0.43, 95% confidence interval (CI): 0.27–0.67, P < 0.001; HR = 0.48, 95% CI: 0.39–0.59, P < 0.001; OR = 3.19, 95% CI: 1.56–6.50, P = 0.001; respectively). In general, the incidence of AEs was slightly but not obviously higher in the combination therapy group than the monotherapy group (OR = 1.08; 95% CI: 0.89–1.30; P = 0.458). However, the most frequent grade 3 or worse AE was neutropenia (OR = 2.32; 95% CI: 1.53–3.52; P < 0.001) which was higher in the TAS-102 plus bevacizumab group. Meanwhile, the morbidity of anemia (OR = 0.43; 95% CI: 0.22–0.83; P = 0.013) was significantly higher in TAS-102 monotherapy group. Conclusion: TAS-102 plus bevacizumab has promising activity with a manageable safety profile in a salvage-line treatment for mCRC who are refractory or intolerant to standard chemotherapy.

Bioprinting is expected to be a revolutionary technology for application in medicine, bringing hope to countless patients. For a long time, many patients have been experiencing a lack of suitable organs for transplantation, which eventually lead to loss of lives. Bioprinting technology can integrate cells, proteins, cytokines, and other supporting materials, such as biomaterials and hydrogels, to produce biomedical devices with biological functions. However, no bioprinting medical devices have been approved by the National Medical Products Administration, with specific registration and regulatory requirements for bioprinting medical devices still needing to be explored. To standardize the Bioprinting Medical Devices Special Requirements for Quality Management System, Chinese experts in relevant fields were organized to formulate this expert consensus.

Recent clinical research emphasizes utilizing virtual reality (VR) technology in cognitive impairment rehabilitation. The high immersion and polymorphism make a practical option in cases where the current head-mounted devices (HMD). VR has been used in Alzheimer's disease (AD) patients. The function of HMD is better than traditional therapies in clinical diagnosis; however, its application in treatment for AD patients remains unclear. The Web of Science databases were searched from January 2016 to August 2021. In addition, research or review articles were filtered according to the preferred reporting items for systematic reviews and meta-analyses guidelines. We bring into a total of 11 studies published in recent 5 years which show high degree of clinical feasibility. One study showed combined cognitive-behavioral therapy and VR in designing a reminiscence therapy for dementia patients; five other studies were focused on spatial navigation and posture positioning for AD patients and one of them showed effective clinical feasibility; other two studies were aimed at helping AD patients who lacked of attention and failed to propose unique advantage due to the samples data were not large enough for clinical validation. Last three studies were using a comprehensive task model in overall cognitive level and obtain considerable training in specific AD patients. HMD VR has become a reliable tool for cognitive rehabilitation in AD patients' prophylactic treatment: Patients with AD in nursing homes and families showed greater interest in VR-based attention and spatial way finding tasks, and their performance was better for a period of time after the end of the task. Combining the VR tasks with clinical cognitive theory and traditional task models will exert more benefits. More clinical case will further determine the potential of VR in AD patients to develop a practical new path for cognitive rehabilitation in the near future.

Ever since the concept of artificial intelligence (AI) has been suggested, it has undergone years of research and development. Under the current condition of rapid development of information and data technology, AI has shown significant effective value and application capability in multiple fields, especially in medical treatment. AI has become essential for routine medical treatment. This review summarizes the current clinical application of AI in orthopedics, in reference to the basic principle of AI, AI supported in clinical diagnosis, AI supported in clinical decision-making, AI supported clinical surgery, and the combination of AI and telemedicine. At the same time, this review also specifies the advantages, disadvantages, and capability of AI in the current clinical application, to provide some understanding for further research of AI.

The digitalization of medicine promises great advances for global health. Combined with three-dimensional (3D) printing technology, noncontact optical scanner, and computer-aided design, we can make personalized 3D printing scoliosis orthosis for patients across the country – with better diagnostics, personalized treatments, and early disease prevention. We hope optimize the production process of scoliosis orthotics, improve the production efficiency of orthotics, and promote the clinical transformation of 3D-printed scoliosis orthosis. To standardize the design, manufacture, materials, and clinical applications of 3D printing technology in the scoliosis orthosis, Chinese experts in relevant fields were organized to formulate this expert consensus.

Digitalizing clinical trials provide an opportunity to address challenges faced in the Phase I trial settings, where near real-time data capture and data interpretation are prerequisites for iterative decision-making to rapidly adapt trial designs based on emerging insights. Although digital technologies have driven significant improvements in many businesses and organizations, the adoption of digital technologies in clinical trials has been slow. In recognition of this lag, the UpSMART consortium, a 5-year funded program (2020–2024), has been established in Europe between the UK, Spain, and Italy to embrace digital technologies and drive benefits to patients. The consortium, led by the Cancer Research UK Manchester Institute Cancer Biomarker Centre, aims to 'digitalize' Experimental Cancer Medicine Centres in the UK and Early Drug Development Units in Spain and Italy by open-sourcing and sharing digital healthcare products between participating centers across the consortium. The goal is to optimize data capture and interpretation thus accelerating Phase I clinical research to ultimately benefit patients by allowing faster access to tomorrow's medicines.

The severity of mercury intoxication depends on the chemical form, dose, and route of exposure. Mercury intoxication has a wide variety of clinical manifestations that may involve the neurological, gastrointestinal, and dermatological systems. After diagnosis is made, prompt treatment is necessary to avoid systemic complications. Here, we report an unusual case of accidental ingestion of mercury and presenting as acute pain abdomen. She was managed conservatively and discharged in hemodynamically stable condition.

In recent years, the application of three-dimensional printing (3DP) in the field of medicine has been expanding and has become the focus of clinical research and application. The 3D reconstruction and 1:1 model can be used to analyze and evaluate the prosthesis installation before operation and improve the accuracy and clinical effect of total hip replacement. In particular, the preoperative evaluation of total hip arthroplasty (THA) in patients with spinal-pelvic sagittal plane deformity is significant. Lumbar degeneration is one of the most common spinal-pelvic sagittal plane malformations, it is difficult to determine acetabular anteversion in THA for these patients, and it is easy to cause postoperative complications. At present, 3DP has been used to determine the anteversion of THA in patients with lumbar degenerative disease, and this article reviews the research and application of 3DP in anteversion evaluation of THA for lumbar degenerative disease, as well as its clinical advantages and challenges.

Computer technology has undergone decades of advancement since its emergence and has been extensively used in various fields of life. Under the existing environment of rapid development of information and data technology, computer technology has also shown significant application value and application potential in medical treatment. The combination of computer technology and medicine has formed a new field described as digital medicine. This article reviews the progress in the application of digital medicine in pediatric orthopedics from the aspects of three-dimensional (3D) model reconstruction, virtual reality technology, 3D printing, artificial intelligence, robots, and biomechanical analysis by finite element method. At the same time, this paper also preliminarily discusses the advantages and disadvantages of digital medicine in the current clinical application and possible future developments.

Background and Purpose: The emergence of digitalized technology has greatly promoted the progress of craniomaxillofacial and head and neck surgery. This present study aimed to explore and describe the advantages of digital design combined with personalized three-dimensional (3D) printing technology in the treatment of deep oromaxillofacial-cervical tumors. Patients and Methods: Nine patients with deep tumor of oral and maxillofacial and neck region admitted to Xinjiang Medical University Affiliated First Hospital from June 2017 to March 2021 were all treated by the digitalized surgery. Preoperatively, radiological examination including computed tomography (CT) angiography, plain and enhanced CT scan, and magnetic resonance imaging were performed in all patients. The software packaged of MIMICS, 3-matic and MAYA was cooperatively used to offer 3D modeling and create 3D texturing for morphological and functional reconstruction. The application effect was assessed by analyzing the relevant data and every patient followed up regularly after the operation. Results: The reconstructed images were acquired through computer-aided three-dimension reconstruction, as well as the navigated devices were established through 3D printing. There were totally nine patients including 4 males and 5 females with a mean age of 48.5 years old, whose tumor size ranged from 1.5 cm × 2.2 cm to 3.5 cm × 4.2 cm. The analysis of data also showed that five cases were characterized by oromaxillofacial osseous defect, 2 primary lesions were adjacent to bone and 2 were noncontacted with bone; the location of 7 cases were closely next to blood vessels of oral-maxillofacial-cervical region, while 2 were contactless. Conclusions: Although the tumors occurred in the deeply maxillofacial area are difficult to resect due to several complex anatomical and functional subunits in this area, digital design combined with 3D technology is a promising tool to provide precise diagnosis with an accurately targeted treatment for maxillofacial deep tumor. The preoperative design and the combined navigation technology can further improve the accuracy and safety for curing deep maxillofacial and neck tumors.

Background and Purpose: Lots of clinical observations have found that there is a close relationship between the pathological changes of lateral pterygoid muscle (LPM) and temporomandibular disc displacement. On medical images, unfortunately, these occult dysfunctions of LPM could scarcely be detected by naked eyes. As the presence of intrinsic properties of the human body, textural feature is capable to effectively discover the subtle functional changes of involved tissues. This study aimed to evaluate the lateral pterygoid myospasm in patients with temporomandibular joint disorders (TMD) applying magnetic resonance imaging (MRI) texture analysis. Patients and Methods: From December 2019 to October 2020, totally nine patients suffered from unilateral spasm of LPM (which is a subtype of TMD) were evaluated by MRI, who were consecutively recruited from Xinjiang Medical University Affiliated First Hospital. Gray-level co-occurrence matrix method was used to analyze the textural features of MRI T2-weighted images with the maximum area of LPM scanned at axial (closed-mouth) plane. Independent samples t-test was performed to compare the relevant parameters of bilateral LPMs (healthy- and affected-side of one individual self-controlled trial). Results: There were no statistically significant values between the two sides of angular second moment, inversed differential moment, and entropy (P > 0.05). The contrast of the healthy-side (267.983 ± 45.952) was significantly higher than that of the affected-side (210.003 ± 29.613) (P < 0.05); and the autocorrelation of the healthy-side (4.536 ± 0.819) was significantly lower than that of the affected-side (6.563 ± 1.653) (P < 0.05). Conclusion: The texture contrast and autocorrelation have certain clinical meanings of diagnosis since they could identify the altered status of LPM, and could be considered as the efficient imaging biomarkers to assess LPM changes in patients with TMD.

Background: Clear aligners (CAs) can distalize mandibular molars. The present study aimed to study the efficiency and influencing the factors of CAs for mandibular molar distalization and to provide guidance for clinical design. Materials and Methods: The present study evaluated 32 adult orthodontic patients who needed mandibular molar distalization and were treated with CAs between September 2018 and September 2020 at the school of medicine. The cone-beam computed tomography images of T₀ (before orthodontic treatment) and T₁ (after mandibular molars were fully distalized) were collected, and the actual movements of mandibular molars were measured and compared with the expected movements. The efficiency of mandibular molar distalization during treatment was comprehensively evaluated, and the relevant factors were analyzed. Results: For mandibular first molar distalization, the average efficiency of the crown was 67.19% 9swn. 13%, and that of the root was 37.87% 7stn. 72%. There was a significant difference between the achieved movement amount and the expected amount (P < 0.05). For mandibular second molars, the average efficiency of the crown was 58.47% 7swn. 07%, and that of the root was 57.03% 3stn. 48%. There was a statistically significant difference between the achieved movement amount and the expected amount (P < 0.05). There was a significant negative correlation between the expected movement and the efficiency of the crown. Conclusions: CAs can achieve mandibular molar distalization, and the movement pattern of molars is mainly a tipping movement. To accomplish bodily movement, overcorrection should be fully considered. In addition, it is suggested that close attention should be given to observing root movement during molar distalization.

The coronavirus disease-2019 (COVID-19) pandemic has affected almost every person across the world and it is high time that we reach to each and every one of them with reliable information at the earliest to minimize the risk of acquisition as well as transmission of the infection. In these testing times, there is an immense need to utilize the communication technology in the various activities of the disease mitigation, treatment and advocacy, communication and social mobilization. It is important to acknowledge that this is the first pandemic in which technology and social media are simultaneously being utilized to ensure people safety. In conclusion, in the battle against the COVID-19 pandemic, information technology and social media have emerged as one of the important tools for the health sector to create not only awareness about the disease, but also it has aided in the prevention and control of the novel viral infection.

In view of the shortage of equipment resources and the inability for on-site disassembly and assembly training in the current teaching of positron emission tomography/computed tomography (PET/CT), a simulation training system for PET/CT based on Unity 3D engine and C# language is designed by 3ds Max and Cinema 4D. The system realizes the simulation interaction of the equipment, thus providing a simulation environment for the operation training of equipment disassembly and maintenance. Through practical application, more users have a great interest in learning, and the comprehensive quality of operation and maintenance ability has been significantly improved, which shows that the system effectively improves teaching quality and reduces teaching costs. Taken together, we can see that it is worth rolling out.

Background: Digital physiotherapy in line with global health coverage has become a salient field of physiotherapy practice where routine and innovative forms of information and communications technology are employed with the aim of facilitating effective delivery and access to physiotherapeutic services and resources. This study evaluated and determined the socio-demographic correlates of awareness, acceptability, and willingness-to-pay (WTP) for digital physiotherapy among patients. Materials and Methods: A total of 92 consenting patients who were 18 years and older responded in this cross-sectional study. An adapted tool on awareness, acceptability, and WTP for telemedicine services was adapted for use in this study. Data were analyzed using descriptive statistics of mean, standard deviation, and percentages; inferential statistics of Chi-square was used for test of association. Alpha level was set at P < 0.05. Results: The mean age of the respondents was 52.40 ± 15.62 years. There was a high rate of unawareness (91.3%), moderate-to-high acceptability (87.0%) and high WTP (88.0%) for digital physiotherapy, respectively. There was no significant association between the socio-demographic factors and each of acceptability and WTP for digital physiotherapy (P > 0.05). Conclusion: In spite of low awareness of digital physiotherapy, Nigerian patients attending physiotherapy clinics are willing to accept and pay for its use irrespective of socio-demographic variations.

Considering the extensive use of mobile devices by medical teachers, undergraduate students, postgraduate residents, and patients, it becomes an indispensable need to deploy mobile technologies in various areas of the health professions education, medical training, and patient care. The purpose of the current review is to explore the scope and utility of mobile technology in ensuring the effective delivery of medical education and clinical teaching. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 15 articles were selected based on their suitability with the current review objectives and analyzed. The use of mobile technologies creates a gamut of educational experiences and learning opportunities for medical students and thereby enhances the efficiency and effectiveness of the learning process. The adoption of mobile technology in medical training is more of a student-centered approach and ensures active engagement of the students with an ultimate goal to become a competent health-care professional. In conclusion, in the best interest of the medical students, it is high time to employ mobile-based applications and technologies in the period of medical training as it is expected to play an important role in the accomplishment of learning outcomes and patient care.

On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time.