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.