Are EU member states ready for the European Health Data Space? Lessons learnt on the secondary use of health data from the TEHDAS Joint Action.

The proposal for a regulation on the European Health Data Space (EHDS) contains provisions that would significantly change health data management systems in European member states (MS). This article presents results of a country mapping exercise conducted during the Joint Action 'Towards the European Health Data Space' (TEHDAS) in 2022. It presents the state-of-play of health data management systems in 12 MS and their preparedness to comply with the EHDS provisions.

Mapping the regulatory landscape for artificial intelligence in health within the European Union.

Regulatory frameworks for artificial intelligence (AI) are needed to mitigate risks while ensuring the ethical, secure, and effective implementation of AI technology in healthcare and population health. In this article, we present a synthesis of 141 binding policies applicable to AI in healthcare and population health in the EU and 10 European countries. The EU AI Act sets the overall regulatory framework for AI, while other legislations set social, health, and human rights standards, address the safety of technologies and the implementation of innovation, and ensure the protection and safe use of data.

Altered patterns of displacement within the Achilles tendon following surgical repair.

Purpose: Ultrasound speckle tracking was used to compare tendon deformation patterns between uninjured and surgically repaired Achilles tendons at 14-27-month follow-up. The hypothesis was that the non-homogenous displacement pattern previously described in uninjured tendons, where displacement within deep layers of the tendons exceeds that of superficial layers, is altered following tendon rupture and subsequent surgical repair.

Methods: In the first part of this study, an in-house-developed block-matching speckle tracking algorithm was evaluated for assessment of displacement on porcine flexor digitorum tendons.

Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls - a case-control ultrasound study.

Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography.

A speckle tracking application of ultrasound to evaluate activity of multilayered cervical muscles.

Objective: To evaluate the capacity of the ultrasound-based method of speckle tracking analysis to detect changes in multilayered dorsal neck muscle activity induced by performing a lifting task.

Subjects: Twenty-one healthy individuals.

Design: Participants performed a loaded lifting task in 3 different postural orientations of the neck (neutral, flexed and forward head posture).

Longitudinal changes in ventral and dorsal neck muscle layers during loading against gravity in healthy volunteers using speckle tracking.

Objective: This study aimed to describe and compare the longitudinal mechanical activity, deformation, and deformation rate of the different layers of dorsal and ventral neck muscles in healthy volunteers during head lifts against gravity.

Methods: The cross-sectional study included 19 healthy volunteers (mean age, 28 years; SD, 7 years). Ultrasound with speckle-tracking analysis was used to investigate longitudinal mechanical activation, deformation, and deformation rate of dorsal and ventral neck muscles in real time during a head lift.

Does posture of the cervical spine influence dorsal neck muscle activity when lifting?

Previous studies have shown that postural orientations of the neck, such as flexed or forward head postures, are associated with heightened activity of the dorsal neck muscles. While these studies describe the impact of variations in neck posture alone, there is scant literature regarding the effect of neck posture on muscle activity when combined with upper limb activities such as lifting. The purpose of this study was to evaluate the effect of three different neck postures on the activity of the different layers of the dorsal neck muscles during a lifting task.

Is there a difference in the pattern of muscle activity when performing neck exercises with a guild board versus a pulley?

Objective: Guild boards and pulleys are apparatus commonly used to train cervical muscle function for their purported benefit in facilitating activity of the deeper muscle layers, although this effect has not been substantiated. The objective of this study was to compare the activity of the different layers of cervical muscles when performing exercise with these 2 types of apparatus.

Subjects: A total of 19 healthy persons (mean age 28 years, (standard deviation 7 years).

Cervical muscle activity during loaded arm lifts in patients 10 years postsurgery for cervical disc disease.

Objective: The purpose of this study was to compare the mechanical activity of the neck muscles during loaded arm lifting tasks in individuals with long-standing disability after anterior cervical decompression and fusion (ACDF) with that of healthy controls.

Methods: Ten individuals (mean age, 60 years; SD, 7.1) who underwent ACDF (10-13 years previously) for cervical disc disease and 10 healthy age- and sex-matched controls participated in the study.

Dynamic ultrasound imaging--a multivariate approach for the analysis and comparison of time-dependent musculoskeletal movements.

Background: Muscle functions are generally assumed to affect a wide variety of conditions and activities, including pain, ischemic and neurological disorders, exercise and injury. It is therefore very desirable to obtain more information on musculoskeletal contributions to and activity during clinical processes such as the treatment of muscle injuries, post-surgery evaluations, and the monitoring of progressive degeneration in neuromuscular disorders.The spatial image resolution achievable with ultrasound systems has improved tremendously in the last few years and it is nowadays possible to study skeletal muscles in real-time during activity.

Ultrasound imaging with speckle tracking of cervical muscle deformation and deformation rate: isometric contraction of patients after anterior cervical decompression and fusion for cervical disc disease and controls.

There is currently a lack of information regarding neck muscle activity during specific exercises. The purpose of the present study was to investigate deformation and deformation rate in different layers of dorsal and ventral neck muscles during isometric neck muscle contraction in individuals after anterior cervical decompression and fusion and in healthy controls. This study included 10 individuals (mean age 60 years; SD 7.

Non-uniform displacement within the Achilles tendon during passive ankle joint motion.

Purpose: An initial step in the understanding of Achilles tendon dynamics is to investigate the effects of passive motion, thereby minimising muscle activation and reducing internal joint forces. Internal tendon dynamics during passive ankle joint motion have direct implications for clinical rehabilitation protocols after Achilles tendon surgery. The aim of this study was to test the hypothesis that tendon tissue displacement is different in different layers of the Achilles tendon during controlled passive ankle joint movements.

A tissue velocity ultrasound imaging investigation of the dorsal neck muscles during resisted isometric extension.

Persons with neck pain exhibit altered patterns of muscle patterning, but limited investigations have been carried out on these alterations or muscle patterning in healthy volunteers. This study investigated the tissue motion of the dorsal neck muscles at the C4 segmental level in 15 healthy subjects during manually resisted head extension. Doppler-based tissue velocity ultrasound imaging (TVI) was used to detect regional tissue deformation, providing indirect evidence of inter-muscular movement patterning.

Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health in with chronic pain patients.

Purpose: To investigate the interactions between self-efficacy - including subcomponents - and symptoms (pain, depression and anxiety), catastrophising, disability, quality of life and health in a population of patients with chronic pain.

Method: The study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 patients with chronic whiplash-associated disorders and 236 patients with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological- and health-related variables.

Modelling human musculoskeletal functional movements using ultrasound imaging.

Background: A widespread and fundamental assumption in the health sciences is that muscle functions are related to a wide variety of conditions, for example pain, ischemic and neurological disorder, exercise and injury. It is therefore highly desirable to study musculoskeletal contributions in clinical applications such as the treatment of muscle injuries, post-surgery evaluations, monitoring of progressive degeneration in neuromuscular disorders, and so on.The spatial image resolution in ultrasound systems has improved tremendously in the last few years and nowadays provides detailed information about tissue characteristics.

Tissue motion pattern of ventral neck muscles investigated by tissue velocity ultrasonography imaging.

We designed this experimental study to investigate tissue motions and thus infer the recruitment pattern of the ventral neck muscles [sternocleidomastoid (SCM), longus capitis (Lca), and longus colli (Lco)] at the C4-C5 level in healthy volunteers during isometric manual resistance of the head in flexion in a seated position. This exercise is used in the physiotherapeutic treatment of neck pain and is assumed to activate the deep ventral muscles, but the assumption has not been clearly evaluated. Neck flexors of 16 healthy volunteers (mean age 24 years, SD 3.

The complex interplay between pain intensity, depression, anxiety and catastrophising with respect to quality of life and disability.

Purpose: To identify subgroups of patients with chronic pain based on the occurrence of depression, anxiety and catastrophising and the duration of pain and pain intensity. In addition to this, the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability and perceived quality of life are investigated.

Methods: This study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 with chronic whiplash associated disorders and 236 with fibromyalgia.

Wave intensity wall analysis: a novel noninvasive method to measure wave intensity.

Wave intensity analysis is a concept providing information about the interaction of the heart and the vascular system. Originally, the technique was invasive. Since then new noninvasive methods have been developed.

Multivariate relationships between pain intensity and other aspects of health in rheumatoid arthritis--cross sectional and five year longitudinal analyses (the Swedish TIRA project).

Objectives: This study analyses the relationships between pain intensity and other aspects of health commonly used to assess disease activity and disability in early rheumatoid arthritis and examines whether such relationships were different between women and men.

Subjects And Methods: This study included the 189 patients (69% women) with early RA (symptoms <12 months at diagnosis) still remaining in the Swedish TIRA cohort 5 years after inclusion. Disease activity and disability was assessed 3, 6, 12, 18, 24, 36, 48, and 60 months (M0-M60) after inclusion by erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), number of swollen and tender joints, physicians global assessment of disease activity (PGA), grip force average over 10 seconds (Grippit), Grip Ability Test (GAT), Signals of Functional Impairment (SOFI) in hand, lower limb and upper limb, Health Assessment Questionnaire (HAQ), and pain intensity measured with a visual analogue scale (VAS).

A pilot study using Tissue Velocity Ultrasound Imaging (TVI) to assess muscle activity pattern in patients with chronic trapezius myalgia.

Background: Different research techniques indicate alterations in muscle tissue and in neuromuscular control of aching muscles in patients with chronic localized pain. Ultrasound can be used for analysis of muscle tissue dynamics in clinical practice.

Aim: This study introduces a new muscle tissue sensitive ultrasound technique in order to provide a new methodology for providing a description of local muscle changes.

Catastrophizing, depression, and pain: correlation with and influence on quality of life and health - a study of chronic whiplash-associated disorders.

Objective: The aims of this study were: (i) to classify subgroups according to the degree of pain intensity, depression, and catastrophizing, and investigate distribution in a group of patients with chronic whiplash-associated disorders; and (ii) to investigate how these subgroups were distributed and inter-related multivariately with respect to consequences such as health and quality of life outcome measures.

Design: Descriptive cross-sectional study.

Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

Predictive factors for long-term outcome of anterior cervical decompression and fusion: a multivariate data analysis.

We conducted a prospective randomized study to investigate predictive factors for short- and long-term outcome of anterior cervical decompression and fusion (ACDF) as measured by current pain intensity on the Visual Analogue Scale (VAS) and by disability using the Neck Disability Index (NDI). Current understanding about how preoperative and short-term outcome data predict long-term outcome is sparse, and there are few studies involving analysis of short-term follow-up using multivariate approaches with quantification of the relative importance of each variable studied. A total of 95 patients were randomly allocated for ACDF with the cervical intervertebral fusion cage or the Cloward procedure.

Generalized pain is associated with more negative consequences than local or regional pain: a study of chronic whiplash-associated disorders.

Objective: The main aims of this study were: (i) to determine, for chronic whiplash-associated disorders, whether widespread pain has more severe consequences for other symptoms and different aspects of perceived health than does local/regional pain; (ii) to investigate whether pain, depression, and symptoms not directly related to pain are intercorrelated and to what extent these symptoms correlate with catastrophizing according to the Coping Strategy Questionnaire.

Design: Descriptive cross-sectional study.

Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital.

Biochemical alterations in the trapezius muscle of patients with chronic whiplash associated disorders (WAD)--a microdialysis study.

The mechanisms behind the development of chronic trapezius myalgia in patients with whiplash associated disorders (WAD) appear to involve both peripheral and central components, but the specific contribution of alterations in muscle is not clear. Female patients with WAD and involvement of trapezius (N=22) and female controls (N=20; CON) were studied during an experiment compromised of rest (baseline), 20min repetitive low-force exercise and 120min recovery. Their interstitial concentrations of serotonin (5-HT), glutamate, lactate, pyruvate, potassium, interleukin-6 (IL-6), and blood flow were determined in the trapezius muscle using a microdialysis technique.

Increased levels of interstitial potassium but normal levels of muscle IL-6 and LDH in patients with trapezius myalgia.

The mechanisms behind the development of work-related trapezius pain are suggested to involve both peripheral and central components, but the specific contribution of alterations in muscle nociceptive and other substances is not clear. Female patients with chronic trapezius myalgia (N=19; TM) and female controls (N=20; CON) were studied at rest, during 20 min repetitive low-force exercise and recovery, and had their interstitial concentrations of potassium (K(+)), lactate dehydrogenase (LDH), interleukin-6 (IL-6) and collagen turnover determined in the trapezius muscle by the microdialysis technique. K(+) levels were at all time points higher in TM than in CON (P<0.