Deep learning approach to estimate foot pressure distribution in walking with application for a cost-effective insole system

Background Foot pressure distribution can be used as a quantitative parameter for evaluating anatomical deformity of the foot and for diagnosing and treating pathological gait, falling, and pressure sores in diabetes. The objective of this study was to propose a deep learning model that could predict pressure distribution of the whole foot based on information obtained from a small number of pressure sensors in an insole. Methods Twenty young and twenty older adults walked a straight pathway at a preferred speed with a Pedar-X system in anti-skid socks. A long short-term memory (LSTM) model was used to predict foot pressure distribution. Pressure values of nine major sensors and the remaining 90 sensors in a Pedar-X system were used as input and output for the model, respectively. The performance of the proposed LSTM structure was compared with that of a traditionally used adaptive neuro-fuzzy interference system (ANFIS). A low-cost insole system consisting of a small number of pressure sensors was fabricated. A gait experiment was additionally performed with five young and five older adults, excluding subjects who were used to construct models. The Pedar-X system placed parallelly on top of the insole prototype developed in this study was in anti-skid socks. Sensor values from a low-cost insole prototype were used as input of the LSTM model. The accuracy of the model was evaluated by applying a leave-one-out cross-validation. Results Correlation coefficient and relative root mean square error (RMSE) of the LSTM model were 0.98 (0.92 ~ 0.99) and 7.9 ± 2.3%, respectively, higher than those of the ANFIS model. Additionally, the usefulness of the proposed LSTM model for fabricating a low-cost insole prototype with a small number of sensors was confirmed, showing a correlation coefficient of 0.63 to 0.97 and a relative RMSE of 12.7 ± 7.4%. Conclusions This model can be used as an algorithm to develop a low-cost portable smart insole system to monitor age-related physiological and anatomical alterations in foot. This model has the potential to evaluate clinical rehabilitation status of patients with pathological gait, falling, and various foot pathologies when more data of patients with various diseases are accumulated for training.

Prevalence of asymptomatic hyperuricemia and its association with prediabetes, dyslipidemia and subclinical inflammation markers among young healthy adults in Qatar

Aim The aim of this study is to investigate the prevalence of asymptomatic hyperuricemia in Qatar and to examine its association with changes in markers of dyslipidemia, prediabetes and subclinical inflammation. Methods A cross-sectional study of young adult participants aged 18 - 40 years old devoid of comorbidities collected between 2012 and 2017. Exposure was defined as uric acid level, and outcomes were defined as levels of different blood markers. De-identified data were collected from Qatar Biobank. T-tests, correlation tests and multiple linear regression were all used to investigate the effects of hyperuricemia on blood markers. Statistical analyses were conducted using STATA 16. Results The prevalence of asymptomatic hyperuricemia is 21.2% among young adults in Qatar. Differences between hyperuricemic and normouricemic groups were observed using multiple linear regression analysis and found to be statistically and clinically significant after adjusting for age, gender, BMI, smoking and exercise. Significant associations were found between uric acid level and HDL-c p = 0.019 (correlation coefficient -0.07 (95% CI [-0.14, -0.01]); c-peptide p = 0.018 (correlation coefficient 0.38 (95% CI [0.06, 0.69]) and monocyte to HDL ratio (MHR) p = 0.026 (correlation coefficient 0.47 (95% CI [0.06, 0.89]). Conclusions Asymptomatic hyperuricemia is prevalent among young adults and associated with markers of prediabetes, dyslipidemia, and subclinical inflammation.

Cross-Cultural Adaptation and Validation of the Chinese Version of the Brace Questionnaire

Objective: To adapt the questionnaire cross-culturally and to analyze the adaptation and validation of the Chinese version of the Brace Questionnaire (C-BrQ).Methods: The adaptation was based on the International Quality of Life Assessment Project guidelines. A total of 79 patients with AIS were included to examine the psychometric properties of the C-BrQ. The reliability was assessed using internal consistency (the Cronbach's alpha coefficient) and test–retest reliability (intraclass correlation coefficient ICC2.1, 95% CI). Floor and ceiling effects were calculated. Lin's concordance correlation coefficient (CCC, 95% CI) was used to compare the agreement between the Scoliosis Research Society-22 patient questionnaire (SRS-22) and C-BrQ.Results: There were strong correlations between each item and its corresponding domain significantly. The correlations between the C-BrQ domains and their related questions vary from moderate to strong (r = 0.311–0.933, P < 0.05). The Cronbach's was 0.891, showing good internal consistency of each domain of the BrQ, and the ICC in test–retest was 0.860 (0.8776, 0.912), which means an excellent test–retest reliability. The Lin's CCC between SRS-22 and C-BrQ was 0.773 (0.669, 0.848), showing great agreement. However, no significant floor and ceiling effects in C-BrQ was observed except the ceiling effect in school activity and bodily pain.Conclusion: BrQ was translated and cross-culturally adapted for use in China with good internal consistency and excellent test–retest reliability.

The Reliability of a New Device for Measuring the Maximum Bite Force

Objective. To test the inter- and intraexaminer reliability of a recently developed instrument for measuring the maximum bite force (MBF). Material and Methods. Sixty patients who were clinically confirmed as having Oral Submucous Fibrosis (OSMF) and 60 healthy controls were included in this study. For each subject, age, gender, weight, height, and body mass index (BMI) were recorded. The maximum bite force was recorded in alternate order with a bite force sensor (D1) and an occlusal force meter (D2). Bite force was measured in the first molar region. Pearson’s correlation coefficient and kappa statistic were applied to assess the reliability between D1 and D2 in the assessment of maximum bite force. The independent t -test was performed to find the statistical significance between the two study groups. The paired t -test was applied to find out the difference between the right and left disease in groups of two devices separately. The one-way analysis of covariance (ANOVA) was performed to find the significant difference between grades of OSMF. Results. The results of the kappa values were 0.8531 ± 0.0724 and 0.7336 ± 0.0737 for interdevice reliability in OSMF patients in right and left sides. Similar findings were obtained in right and left sides of healthy individuals ( 0.7549 ± 0.0816 and 0.9440 ± 0.0806 ) and in the total sample ( 0.8132 ± 0.0544 and 0.8303 ± 0.0538 ). Pearson’s correlation coefficient between two devices revealed a high and significant positive correlation between D1 and D2 separately and in the whole sample. Conclusion. The observations of the present study suggest that the bite force sensor can be used as a reliable device for measuring bite force.

VALIDITY AND RELIABILITY TESTS FOR ADMINISTRATION OF KIDNEY DISEASE QUALITY OF LIFE-SHORT FORM IN INDONESIAN VERSION

Objective: This study aims to adapt the KDQOL-SF questionnaire into Indonesian and to evaluate the reliability and validity of the questionnaire in healthy subjects in Indonesia. Material & Methods: Previously translated (into Indonesian) KDQOL-SF questionnaire was given to 33 healthy subjects at Cipto Mangunkusumo General Hospital. Respondents were over 18 years old and were able to speak Indonesian orally and in written form. Reliability was measured using Alpha Cronbach’s intraclass correlation coefficient and internal consistency reliability. Validity was evaluated using Pearson’s correlation test. Results: Out of 33 respondents, the majority of subjects were male (81%) with mean age 47.4 ± 13.7 years old. The highest score was in social support aspects with mean score 99.48 ± 2.95, while the lowest score was vitality aspect with mean score 63.28 ± 11.61. Alpha Cronbach’s score was between 0.580-0.999 and Pearson’s correlation coefficient between 0.405-0.976 with P < 0.05. Conclusion: KDQOL-SF questionnaire, which was translated into Indonesian, was valid and reliable to be used in evaluating patients’ quality of before kidney transplantation in Indonesia

The Impact of Business Attitude on Entrepreneurial Behavior in Postgraduate Students: A Cross-sectional Study During the COVID-19 Pandemic

Background: Entrepreneurship and business behavior are of great significance in developing countries, such as Iran, due to the unemployment crisis. Today's economic status and population composition have propelled everyone to find effective solutions in the economic arena. Therefore, appropriate educational models for students and programs to encourage students to turn to entrepreneurship and create new businesses are vital. Objectives: The present study aimed to determine the impact of business attitude on entrepreneurial behavior in postgraduate students. Methods: This cross-sectional study was conducted on the postgraduate students of Qazvin University of Medical Sciences in 2021. Data were collected using the standard questionnaires of Aution et al. and Leon Dice Zamptakis and Vasilis Mustakis. Data analysis was performed in the R software version 4.0.4 using Spearman’s or Pearson’s correlation-coefficient and multivariate analysis of variance (MANOVA). Results: The mean age of the participants was 28.17 ± 6.297 years. Pearson’s correlation-coefficient indicated a significant, inverse correlation between age and attitudes toward competitiveness and entrepreneurial culture (r = -0.210; P = 0.002 and r = -0.177; P = 0.01, respectively). In addition, the results of multiple linear regression analysis showed that the attitude to business had a significant, inverse effect on entrepreneurial behavior (r = -0.259; P < 0.001). Conclusions: According to the results, students' unpreparedness for self-employment activities highlights the need for changing the attitude of postgraduate students in this regard by explaining the prevalence of the COVID-19. Due to the outbreak of the disease, numerous startups and personal businesses were shut down. Therefore, students are mostly reluctant to become involved in entrepreneurial activities despite their business attitude.

ImReLnc: Identifying Immune-Related LncRNA Characteristics in Human Cancers Based on Heuristic Correlation Optimization

Long non-coding RNAs (lncRNAs) play critical roles in cancer through gene expression and immune regulation. Identifying immune-related lncRNA (irlncRNA) characteristics would contribute to dissecting the mechanism of cancer pathogenesis. Some computational methods have been proposed to identify irlncRNA characteristics in human cancers, but most of them are aimed at identifying irlncRNA characteristics in specific cancer. Here, we proposed a new method, ImReLnc, to recognize irlncRNA characteristics for 33 human cancers and predict the pathogenicity levels of these irlncRNAs across cancer types. We first calculated the heuristic correlation coefficient between lncRNAs and mRNAs for immune-related enrichment analysis. Especially, we analyzed the relationship between lncRNAs and 17 immune-related pathways in 33 cancers to recognize the irlncRNA characteristics of each cancer. Then, we calculated the Pscore of the irlncRNA characteristics to evaluate their pathogenicity levels. The results showed that highly pathogenic irlncRNAs appeared in a higher proportion of known disease databases and had a significant prognostic effect on cancer. In addition, it was found that the expression of irlncRNAs in immune cells was higher than that of non-irlncRNAs, and the proportion of irlncRNAs related to the levels of immune infiltration was much higher than that of non-irlncRNAs. Overall, ImReLnc accurately identified the irlncRNA characteristics in multiple cancers based on the heuristic correlation coefficient. More importantly, ImReLnc effectively evaluated the pathogenicity levels of irlncRNAs across cancer types. ImReLnc is freely available at https://github.com/meihonggao/ImReLnc.

Vitamin D levels in Greek patients with systemic lupus erythematosus

Objectives Vitamin D deficiency has been observed in autoimmune rheumatic diseases, such as rheumatoid arthritis. The aim was to study vitamin D in patients with systemic lupus erythematosus (SLE) and its relationship with disease activity. Methods In a cohort of 45 patients with SLE, 41 females and 4 males, aged 47.07 ± 2.17 years (mean ± SEM), and range = 21–79 years, 25(OH)D3 levels were determined by electrochemiluminescence. C3 and C4 levels were also analyzed. SLE disease activity was estimated by SLEDAI-2K. Observations were also performed in a control group matched for age and sex. Results In this cohort of SLE patients, 25(OH)D3 levels were 40.36 ± 2.41 nmol/L (mean ± SEM) as opposed to 60.98 ± 4.28 nmol/L in the control group ( p < 0.001, Student’s t test). Vitamin D levels were related to C3 ( p < 0.001, linear regression analysis), correlation coefficient 0.106, r2 = 0.011, and C4 ( p < 0.001); correlation coefficient 0.316 and r2 = 0.100; and inversely related to disease activity ( p < 0.001), correlation coefficient −0.572 and r2 = 0.327. 25(OH)D3 levels were 17.73 ± 1.20 nmol/L and 12.24 ± 0.93 nmol/L, in the groups without and with renal involvement, respectively ( p = 0.001, Student’s t test). Conclusions Vitamin D levels are low in SLE patients and are inversely related to disease activity. Routine screening for vitamin D levels should be performed in SLE patients.