Journal of Mechanics in Medicine and Biology

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired $t$-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent $t$-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired $t$-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ($P=0.56$; 0.11). Meanwhile, the independent $t$-test revealed a significant difference between the affected and unaffected sides ($P<0.02$). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

Spinal cord injury (SCI) is a severe neurological disease. Although surgery within 8h after SCI can substantially reduce paraplegia, most patients still suffer from hypomusculariasis after neuron recovery, which results in insufficient lower limb muscles to support bodyweight. Currently, there is no effective method to prevent muscle atrophy. Previous studies have shown that low-frequency electromagnetics (LFE) can stimulate the differentiation, proliferation and fusion of muscle satellite cells, however, the optimal electromagnetic strength and effects on the immune system have not been established. Here, we investigated the influence of LFE at different electromagnetic strengths on muscle cell recovery and assessed the impact of chronic LFE on the immune system of SCI rats. The rat immune system was rapidly activated after SCI. High-energy LFE provoked intensive immune responses, while low-energy LFE did not affect immune responses. Simultaneously, LFE effectively prevented myotube reduction and atrophy in SCI rats. The mRNA and protein levels of Pax7 and MyoD were increased after LFE at both high and low electromagnetic strengths, with the latter leading to more robust increases. Indeed, LFE remarkably induced muscle cell fusion. Together, our results demonstrated that LFE activates muscle satellite cells via stimulating myogenic factors. Chronic low-energy LFE is a safe therapy with no adverse impact on the immune system of SCI rats. LFE with 1.5 mT energy should be considered as an optimal therapeutic strategy.

This study processed the recent in vivo survey results for over a thousand patients and optimized their neck and head CT angiography triggered timing (CTA-TT) via the inverse problem algorithm, which ensured the maximal ratio of both left and right arterial to upper sinuses (LRA/US). These results are instrumental in examining the ischemic stroke syndromes along the neck and head. These 1001 patients were randomly categorized into test surveyed (802 patients) and verification group (199 patients), then a six factors semi-empirical formula was constructed by the STATISTICA program. The six factors were assigned a patient’s biological data and preset of the CTA facility; namely Age, mean arterial pressure (MAP), heart rate (HR), contrast media dose (CMD), Pre (injected pressure of CMD), and body surface area (BSA). Each factor was normalized into dimensionless values and incorporated into the dataset matrix $V[802\times 22]$ to analyze the coefficient matrix $M[22\times 1]$. The derived semi-empirical formula closely correlated with experimental data, according to the loss function $\mathrm{\Phi }=4.4084$, correlation coefficient $r^2=0.9468$, and variance of 0.8965. The formula verification for 199 more patients (verification group) yielded a correlation coefficient $r^2=0.8965$. Thus, it can be used for the CTA-TT estimation of patients without their preliminary tests, avoiding unnecessary irradiation. The estimated LRA/US was $2.19\pm 0.30$ for the verification group in this study. A simplified three-factor formula, featuring only age, MAP, and BSA, was also proposed.

The lumbar disc has complex structure and material properties, and if it develops disease, it cannot heal itself. Therefore, prevention of lumbar disc herniation is very important. In this paper, the model of lumbar disc is built, and the nonlinear dynamic response of the system is researched. A modified Van der Pol model is imported to describe the stress–strain curves of the lumbar disc. The system’s dynamic model is set up, and harmonic balance method is applied to revise the natural frequency of the system. The product of numerical simulation reveals that the lumbar disc has complex dynamic characteristics, including balance point, limit cycle bifurcation and stochastic Hopf bifurcation. By changing the parameters, we can avoid large-scale periodic movement of the lumbar disc which causes lumbar disc herniation. These results contribute to the prevention of lumbar disc herniation.

This study aimed to investigate the effectiveness of a 3D-modeling-based customized off-loading cushion to prevent pressure ulcers in people with spinal cord injury (SCI) using wheelchairs. The study included five people with SCI who use the traditionally manufactured customized off-loading cushions. As part of the test, each subject sat on three types of pressure-relief cushions, and the pressure between the seating surface and cushion was measured for 60min. The average measured pressure values were compared, and the change in pressure with time was analyzed to verify the clinical effect. The results showed that the CAD/CAM-based customized off-loading cushion exhibited a better decrease in pressure and pressure distribution effect on the ischial tuberosity and coccyx than the adjustable air cushion but did not differ much from the traditionally manufactured customized off-loading cushion. The clinical and economic effectiveness of the customized off-loading cushion based on the computer-aided design and manufacturing (CAD/CAM) technology was analyzed and tested on people with SCI. An occupational therapist evaluating the client followed by designing the customized off-loading strategy has no difference in terms of clinical effect compared to the traditional manufacturing method. However, time, effort, and cost should be considered when choosing an intervention strategy.

Heart rate measurement through Ballistocardiogram (BCG) signal is an efficient method for long-term cardiac activity monitoring in real-time, especially for patients with cardiovascular and cerebrovascular disease. In this study, we propose a one-dimensional (1D) U-net++ to identify the position of J-peak in BCG signals automatically. The proposed 1D U-net++ is based on a 1D convolution neural network through dense skip connection backward transfer data features. The low-level and high-level data features of the BCG signals are combined with the last layer features of 1D U-net++ to shorten the semantic gap when the encoder and decoder feature skip connection. The BCG signals of eight healthy subjects were collected for experimental verification, and the accuracy and precision of J-peak detection reached 99.4% and 99.3%, respectively. The experimental results demonstrate that our proposed method can effectively identify J-peak in BCG signal.

Subdividing the human brain into several functionally distinct and spatially contiguous areas is important to understand the amazingly complex human cerebral cortex. However, adult aging is related to differences in the structure, function, and connectivity of brain areas, so that the single population subdivision does not apply to multiple age groups. Moreover, different modalities could provide affirmative and complementary information for the human brain subdivision. To obtain a more reasonable subdivision of the cerebral cortex, we make use of multimodal information to subdivide the human cerebral cortex across lifespan. Specifically, we first construct a population average functional connectivity matrix for each modality of each age group. Second, we separately calculate the population average similarity matrix for the cortical thickness and myelin modality of each age group. Finally, we fuse these population average matrixes to obtain the multimodal similarity matrix and feed it into the spectral clustering algorithm to generate the brain parcellation for each age group.

This study aimed to systematically evaluate the effectiveness of Baduanjin in the treatment of lumbar disc herniation (LDH). We searched PubMed, the Cochrane Library, EMBASE, Web of Science (WOS), CNKI, and Wanfang Databases from their inception until August 1, 2021, to collect the randomized controlled trials (RCTs) of Baduanjin in the treatment of LDH. After literature screening, data extraction, and quality evaluation by two independent researchers, the RevMan 5.4 software was used for meta-analysis. A total of 13 studies, involving 853 patients were finally included. The results showed that compared with the control group, the Baduanjin group showed remarkably improved treatment efficiency ($\mathrm{\text{RR}}=1.14$, 95% CI (1.05, 1.23), $P=0.001$), JOA score ($\mathrm{\text{MD}}=2.62$, 95% CI (0.56, 4.68), $P=0.01$), and VAS score ($\mathrm{\text{MD}}=-0.87$, 95% CI ($-1.14$, $-0.60$), $P<0.00001$). The Baduanjin group exhibited higher VAS scores than the control group in different intervention times (within 1 month, 1–2 months, and more than two months) ($P<0.05$). Moreover, the JOA score of the Baduanjin was better than that of the control group in the presence of intervention for more than two months ($\mathrm{\text{MD}}=4.17$, 95% CI (1.05, 7.30), $P=0.009$). In the comparison of exercise therapy, Baduanjin has more advantages than traditional rehabilitation training, as manifested by the improved VAS score ($\mathrm{\text{MD}}=-0.60$, 95% CI ($-0.83$, $-0.36$), $P<0.00001$) and JOA score ($\mathrm{\text{MD}}=2.63$, 95% CI (1.63, 3.09), $P<0.00001$). Conclusion: Baduanjin can significantly improve the rehabilitation evaluation scores of LDH patients and the treatment efficiency, and its curative effect was more obvious in a long time.

The purpose of this study was to investigate the effects of functional games using neurofeedback on cognitive function and changes in brain waves of people with developmental disabilities. Toward this goal, the MiND RACER program developed by Minders Co., Ltd. in 2018 was used for 5 people with developmental disabilities enrolled in the continuing education course at D University in Gyeongsangbuk-do, Korea. It was carried out once a week from October 13 to December 15, 2020; pre- and post-tests were conducted one week before the program execution and one week after the program execution. Electroencephalography measurements were performed 3 times as pre, intermediate, and posttest. As a result, the functional game using neurofeedback showed a remarkable change in the cognitive function of the person with developmental disabilities and significant changes in $\alpha$ waves.

This study proposed to detect changes in brain microstructure in patients with Parkinson’s disease (PD) using diffusion kurtosis imaging (DKI) to quantitatively diagnose early-stage PD. Conventional magnetic resonance imaging and DKI scanning were performed in 24 patients with PD and in 12 age- and sex-matched healthy participants. Hoehn and Yahr (H–Y) stage and Unified Parkinson’s Disease Rating Scale-III (UPDRS-III) scores were obtained from both groups. The mean kurtosis (MK), axial kurtosis, and radial kurtosis of the bilateral substantia nigra on DKI were measured and compared between the two groups. The correlations between MK, H–Y stage, and UPDRS-III scores were determined. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of MK for PD in the substantia nigra. The MK value in the PD group was 0.971. The area under the ROC curve of the substantia nigra was 0.905; the sensitivity and specificity were 0.917 and 0.875, respectively, and the cutoff value was 1.046. The MK of the substantia nigra in the PD group had no significant correlation with the H–Y stages but was negatively correlated with the UPDRS-III scores ($r=-0.506$; $p=0.012$). Our research identified DKI as a novel tool for the qualitative diagnosis of PD. The optimal MK value for PD diagnosis could be determined with ROC analysis.

Neural activation of the motor cortex has been consistently reported to be evoked in the emotion processing of facial expressions, but it is poorly understood whether and how the motor system influences the activity of limbic areas during participants’ perceived emotional expressions. In this study, we proposed that motor activations evoked by emotional processing influence the activations in limbic areas such as amygdala during the perception of facial expressions. To examine this issue, a masked priming paradigm was adopted in our fMRI experiment, which could modulate the activation within the motor cortex when healthy participants perceived sad or happy facial expressions. We found that the first presented stimulus (masked prime) in each trial reduced the activations in the premotor cortex and inferior frontal gyrus when the movement of facial muscles implied by the arrows on the prime stimulus was consistent with that implied by the target face expressions (compatible condition), but increased the activations in these two areas when the movements implied by the arrows and the target face expressions were inconsistent (incompatible condition). The superior temporal gyrus, middle cingulate gyrus and amygdala also showed similar response tendency to that in motor cortex. Moreover, psychophysiological interaction (PPI) analysis showed that both right middle cingulate gyrus and bilateral superior temporal gyrus were closely linked to the premotor cortex with inferior frontal gyrus during the incompatible trials compared with the compatible trials. Together with this result and the significant activation correlations between the motor cortex and the limbic areas, this work revealed the modulation effect of motor cortex on brain regions related to emotion perception, suggesting that motor representation of facial movements can affect emotion experience. Our results provide new evidence for the functional role of motor system in the perception of facial emotions, and could contribute to the understanding of the deficit in social interaction for patients with autism or schizophrenia.

For patients with stroke at home, strategies have been formulated for emotional nursing, sports rehabilitation nursing, and interventions for poor lifestyle habits such as smoking, drinking, and picky eating. Data were obtained through tracking investigation, effect evaluation indexes were developed according to Hamilton depression scale (HAMD), activities of daily living (ADL) and other rating scale; C4.5 decision tree algorithm was used to analyze the effect of nursing intervention strategy, then we derived the corresponding knowledge rules. We come to conclusions: ① Effective emotional care and bad living habits interventions are contributed to reduce the risk of stroke. ② Smoking, drinking, picky eating, exercising and other factors are associated, so we should combine and intervene them as to better perfect the risk of stroke to provide decision-making reference for home nursing and rehabilitation intervention of stroke patients.

The presence of normal upper limb arm swing movement is considered an important gait movement that affects the selective coordinated locomotor control of the shoulder, elbow, and wrist joint movements. However, in patients with neurological disorders, flexor synergy is characterized by decreased selective neuromuscular control and reciprocal disinhibition of the wrist flexor muscles associated with spasticity or shortness. This research aimed to demonstrate the reliability, validity, and feasibility of the progressive exoskeletal robotic shoulder joint kinematics system. The robotic shoulder joint kinematics system comprises a gait function-retraining robot designed to provide arm swing. The changes in the shoulder joint angle between ImageJ motion analysis software and robotic shoulder joint kinematics system were compared in this research to investigate the reliability and validity of the latter. The linear regression analysis revealed good correlation between the measured angles and the shoulder angle data ($R^2=0.943$). Furthermore, the test–retest reliability test demonstrated excellent reliability ($R^2=0.978$). The robotic shoulder joint kinematics system generated successful arm swing during the locomotion and range of motion training of the shoulder.

The minimum detectable difference (MDD) at various beats/min (BPM) of CT angiography (CTA) was evaluated using an oblique V-shape line gauge and poly methyl methacrylate (PMMA) phantom in this study. The customized phantom with the size of $30\times 30\times 30$cm³ was made from a 1cm-thick PMMA. The reciprocating mechanism in the phantom was run by a step motor with an eccentric gear connected to a crank rod to provide a stable harmonic motion, simulating the cardiac beats. The MDD has a unique feature in defining the quality characteristic of CT-scanned images and provides more information than simple line pair/cm in the previous studies. The derived MDD was quantified according to various BPM, and the CTA factor combination was preset following either the conventional recommendation or the optimal one. In doing so, the performance was substantiated by the Taguchi-based signal-to-noise ratio and integrated by another index, namely, figure of merit (FOM). The MDD and corresponding $\eta$ (dB) changed from $1.70\pm 0.01$mm to $2.66\pm 0.01$mm and from 16.7dB to 14.2dB, respectively, for conventional settings; while those obtained for the optimal preset changed from $1.71\pm 0.03$mm to $2.58\pm 0.02$mm and from 12.2 dB to 16.4 dB, respectively of CTA at 0–90 BPM. The integrated FOM values for conventional or optimal cases were 1240 and 1337, respectively. The MDD proved to be a useful technique in justifying the CTA-scanned images. For compliance with previous studies, MDD results can be converted to the line pair/cm results, but it is more informative than the quantized number of line pairs.

Arrhythmia classification with electrocardiogram (ECG) is of great importance for the identification of arrhythmia diseases. However, since the variance of ECG signal in wave appears frequently, it is still a very challenging task to obtain a very good classification result. In this paper, an arrhythmia classification with ECG based on deep residual networks is proposed, of which two improved residual blocks are used to combine soft and hard subsampling. With such blocks, the network can well hold spatial information and improve the classification performance with a simple model structure. Experiments on the MIT-BIH arrhythmia database show that the proposed method obtained an average classification accuracy of 99.59% and an average classification specificity 99.63%, which are 0.26% and 0.57% higher than that of the most state-of-art method based on deep learning.

Up to now, there is still the absence of research about depression recognition using resting-state functional magnetic resonance imaging (rest_fMRI) and deep learning. Previous studies have shown that regional homogeneity (ReHo) of rest_fMRI (rest_ReHo_fMRI) is a characterization of the functional synchronization of adjacent voxels in brain regions, and the mental and behavioral abnormalities in depression are due to an imbalance of ReHo synchronization in some brain functional areas. Accordingly, this paper presents a method for depression recognition using rest_ReHo_fMRI. First, the rest_ReHo_fMRI is extracted from the preprocessed rest-fMRI by calculation. Then, deep convolutional networks (such as VGG16) pretrained on ImageNet are used to automatically complete extracting the classification features from rest_ReHo_fMRI. Finally, the Kernel Extreme Learning Machine (KELM) was used to classify the depression. The results of the test set show that the proposed method achieves 89.07% in sensitivity and 89.74% in specificity. This study suggests that features of rest_ReHo_fMRI can be used as biomarkers to distinguish depression from normal people.

Objective: To analyze the anatomical morphological and hemodynamic characteristics of left ventricular outflow tract stenosis (LVOTS) by echocardiography and MRI. Methods: The Echocardiography data of 112 patients with LVOTS were retrospectively analyzed by measuring the basal interventricular septal thickness (IVST-b), the left ventricle posterior wall thickness (LVPWT), and the peak pressure gradient of LVOTS, as well as by observing the characteristics of spectral pattern and the presence of systolic anterior motion of mitral valve leaflets. A Siemens 3.0T MRI scanner was used to scan the contrast-enhanced left ventricular (LV) volume of all cases. The obtained end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) of LV were compared with the Echocardiography results. Results: The 112 patients were divided into four groups: hypertrophic obstructive cardiomyopathy (Group I, 42 cases), hypertensive left ventricular hypertrophy (Group II, 40 cases), basal septal hypertrophy in the elderly (Group III, 21 cases), and the subaortic membrane (Group IV, 9 cases). The continuous wave (CW) Doppler characteristic of Groups I, II, and III was broadsword-shaped jet, and that of Group IV was equilateral triangle-like spectrum. The IVST-b, IVST-b/LVPWT ratio and peak pressure gradient of LVOTS of Group I was significantly higher than those in Groups II and III ($P<0.001$). The LVPWT of the first three groups was slightly correlated with the LVOTS peak pressure gradient ($r=0.404$, respectively, $P<0.001$). There were no statistically significant differences between Echocardiography and MRI results regarding the LV EDV, ESV, SV, and EF ($P>0.05$), and no statistically significant differences were found between Echocardiography and MRI results regarding the myocardial thicknesses of septal, anterior, lateral, and inferior walls ($P>0.05$). The Pearson’s correlation analysis demonstrated correlations between MRI and Echocardiography results for LV EDV, ESV, SV, and EF ($P=0.002$, 0.002, 0.009, and $<0.001$, respectively). The MRI enhancement was shown as delayed enhancement in 52 cases, localized enhancement in 8 cases, diffuse enhancement in 6 cases, and transmural enhancement in 3 cases, with abnormal enhancement lesions distributed in the area of ventricular septum free wall junctions and ventricular septum. Conclusion: Using MRI to evaluate LV function of hypertrophic cardiomyopathy is reliable and accurate. MRI enhancement can be used for the quantitative measurement of myocardial fibrosis. Echocardiography can distinguish the stenosis types of LVOTS. The IVST-b and existence of SAM may be important anatomical characteristics determining the degree of dynamic stenosis, and MRI combined with Echocardiography can provide important detailed information.

Traditional manual puncture surgery has low positioning accuracy and poor stability. Moreover, the computed tomography method can cause strong radiation damage. Therefore, this study intends to establish a robotic system in puncture surgery, which is based on optical registration to improve safety, accuracy, and efficiency. As the accuracy of surgical space calibration influences the accuracy of the surgical system, this study proposes an improved automatic calibration algorithm for linear rotation. The algorithm can reduce error caused by manual calibration and system noise. Recalibration is not required provided that the pose of the digital reference frame is unchanged, thereby improving accuracy and efficiency. The proposed algorithm is experimentally verified to prove its effectiveness. Results show that the average errors of position and posture are 0.25mm and 0.2^∘, respectively. The accuracy of calibration fully meets the needs of surgery.

Static electric field (SEF) from ultra-high-voltage direct-current (UHVDC) transmission lines has the potential to produce neurobiological effects. To explore these effects and elucidate their potential mechanisms, protein expression levels and morphological structure in the hippocampi of mice were investigated after SEF exposure. Mice from the Institute of Cancer Research were exposed to an environmental SEF induced by UHVDC transmission lines with the strength of 9.20–21.85kV/m for 35 days. Mouse body weight was measured weekly during the exposure. After the exposure, hippocampal Ca${}^{2+}$/calmodulin-dependent protein kinase II (CaMKII) and calcineurin (CaN) expression levels were assayed by Western blot. Hippocampal pathologic morphology and ultrastructure were observed using light microscopy and transmission electron microscopy, respectively. No significant differences in body weight, CaMKII and CaN expression levels, and hippocampal pathologic morphology were observed between mice in the exposed and the control groups. However, cytoplasmic vacuolization of the hippocampal neurons was observed in the exposed group. Thus, hippocampal neuron ultrastructure damage may be a mechanism of SEF-exposure-induced memory decline in mice.

Objective: The detection of QRS complexes is an important part of computer-aided analysis of electrocardiogram (ECG). However, most of the existing detection algorithms are mainly for single-lead ECG signals, which requires high quality of signal. If the signal quality decreases suddenly due to some interference, then the current algorithm is easy to cause misjudgment or missed detection. To improve the detection ability of QRS complexes under sudden interference, we study the QRS complexes information on multiple leads in-depth, and propose a two-lead joint detection algorithm of QRS complexes. Methods: Firstly, the suspected QRS complexes are screened on the main lead. For the suspected QRS complexes with low confidence and the complexes that may be missed, further accurate detection and joint judgment shall be carried out at the corresponding position of the auxiliary lead. At the same time, the adaptive threshold adjustment algorithm and backtracking mechanism are used to modify the detection results. Results: The proposed detection algorithm is validated using 48 ECG records of the MIT-BIH arrhythmia database, and achieves average detection accuracy of 99.71%, sensitivity of 99.88% and positive predictivity of 99.81%. Conclusion: The proposed algorithm has high accuracy, which can effectively deal with the sudden interference of ECG signal. Meanwhile, the algorithm requires small amount of computation, and can be embedded into hardware for real-time detection.

The hydrogen emission characteristics of a hydrogen storage alloy operating system employing the Zr${}_{0.9}$Ti${}_{0.1}$Cr${}_{0.6}$Fe${}_{1.4}$ alloy were analyzed under different temperatures and loading conditions for application in a rehabilitation system for motion assistance for the aged and disabled. After activating 8.56g of a Zr${}_{0.9}$Ti${}_{0.1}$Cr${}_{0.6}$Fe${}_{1.4}$ alloy under a 5.5MPa hydrogen atmosphere, operation tests were conducted in the temperature range of 25–80^∘C under the loading conditions of 5–45kg. The lightest load of 5kg was lifted by 150mm when the system was heated from the initial test temperature of 25–80^∘C and a 40kg load was lifted by 12.5mm at 80^∘C, while a 45kg load could not be lifted under any of the temperature conditions. The hydrogen storage alloy operating system developed in this study is expected to be useful in motion assistance for the socially underprivileged, as a rehabilitation tool for the hand, wrist, and elbow, as supplementary equipment, and in rehabilitation systems for daily life.

For severe patients with new coronavirus pneumonia, the use and stability of the ventilator are important. In this paper, we proposed a new type of shock-absorbing structure that can be used to improve the stability of the ventilator’s gas pipeline, thereby reducing the risk of the gas pipeline falling due to external interference. The film shape memory alloy (SMA) compared with bulk SMA is more suitable for gas pipeline shock absorption due to its large volume ratio and extremely high energy density. In order to optimize the performance of actuator and enhance the utilization rate of SMA, the nonlinear characteristics of Ti-Ni thin film actuator are researched and the effect of SMA film position on the system are investigated. The van der Pol term is introduced to fit the hysteresis loop of shape memory materials. Thus, the nonlinear dynamic response of SMA thin film actuator under stochastic excitation is studied. The numerical and experiment results show that the position of SMA can change the system’s stability, the proposed structure can reduce the system’s vibration to the maximum extent. The results indicate that the new proposed polymer/SMA composite film micro-actuator exhibits high energy dissipation ability, and the utilization rate of smart material is enhanced. Therefore, the new damping structure proposed in this paper is of great significance to the damping of gas pipelines.

Subject: This study assessed the absorbed dose for patients who underwent Tc-99m Methylene Diphosphonates (MDP) bone scan examination based on a series of personal dosimeter measurements and a derived semi-empirical formula. Material and methods: 210 volunteers among the patients, who were administrated 925 MBq Tc-99m MDP for the bone scan examination in the Department of Nuclear Medicine in the Dalin Tuzchi Hospital, Taiwan, underwent personal dosimeter measurements at 30, 120, and 180min after the injection. A personal dosimeter was held at a 30cm distance from the patient’s stomach. The acquired data were analyzed to derive the residence time of Tc-99m radionuclide in the patient’s body. Five biological parameters (gender, age, BMI, eGFR, and creatinine) of these 210 patients were collected and processed by the STATISTICA program, yielding a nonlinear 16-term first-order semi-empirical formula for the radionuclide residence time prediction. The respective four- and three-factor calculations, excluding creatinine and eGFR, provided poor correlation. Results and Conclusion: According to the phantom concept, treating a patient’s body as a homogenous spherical ball, a simplified formula was used to assess the absorbed dose rate and magnitude. Therefore, the derived residence time, dose rate, and absorbed dose were $146.1\pm 36.3$min, $8.3\pm 1.0\mu$Sv/min, and $1211.7\pm 354.2\mu$Sv, respectively. These results were lower than those obtained in previous studies, which can be attributed to accelerated radionuclide excretion of patients who drank 2000 cc of water after the procedure, yielding shorter residence times.

Patients with adhesive capsulitis (AC) demonstrate limited shoulder movement, often accompanied by pain. Common treatment methods include pain medication, and continuous passive movement (CPM). However, it is sometimes difficult to improve the reduction of pain and movement using a CPM intervention because the patient’s interest is diminished. In this study, we developed an innovative deep learning-based smartphone application (Funrehab exercise game (FEG)) to provide accurate kinematics movement and motivation as well as high-intensity and repetitive movements using deep learning. We compared the effects of CPM and FEG on brain activity and shoulder range of motion in patients with AC. Sixteen patients (males, $n=5$; females, $n=11$; mean age, $50.3\pm 3.3$ years) with acute AC were randomized into either CPM group or FEG group 4 days/week for 2 weeks. The outcome measures were shoulder abduction kinematics movement and electroencephalography (EEG) brain activity (bilateral prefrontal, bilateral sensorimotor cortex, and somatosensory association cortex) during the intervention. The analysis of variance (ANOVA) test was performed at $P<0.05$, and the analysis demonstrated that FEG showed superior effects on shoulder abduction kinematics and brain $\alpha$ and $\beta$-wave activations compared to CPM. Our results provide a novel and promising clinical evidence that FEG can more effectively improve neurophysiological EEG data and shoulder abduction movements than CPM in patients with AC.