Designing core-shell heterostructure arrays based on snowflake NiCoFe-LTH shelled over W2N-WC nanowires as an advanced bi-functional electrocatalyst for boosting alkaline water/seawater electrolysis.

The pursuit of efficient and sustainable hydrogen production through water splitting has led to intensive research in the field of electrocatalysis. However, the impediment posed by sluggish reaction kinetics has served as a significant barrier. This challenge has inspired the development of electrocatalysts characterized by high activity, abundance in earth's resources, and long-term stability. In addressing this obstacle, it is imperative to meticulously fine-tune the structure, morphology, and electronic state of electrocatalysts. By systematically manipulating these key parameters, the full potential of electrocatalysts can unleash, enhancing their catalytic activity and overall performance. Hence in this study, a novel heterostructure is designed, showcasing core-shell architectures achieved by covering W2N-WC nanowire arrays with tri-metallic Nickel-Cobalt-Iron layered triple hydroxide nanosheets on carbon felt support (NiCoFe-LTH/W2N-WC/CF). By integrating the different virtue such as binder free electrode design, synergistic effect between different components, core-shell structural advantages, high exposed active sites, high electrical conductivity and heterostructure design, NiCoFe-LTH/W2N-WC/CF demonstrates striking catalytic performances under alkaline conditions. The substantiation of all the mentioned advantages has been validated through electrochemical data in this study. According to these results NiCoFe-LTH/W2N-WC/CF achieves a current density of 10 mA cm-2 needs overpotential values of 101 mV for HER and 206 mV for OER, respectively. Moreover, as a bi-functional electrocatalyst for overall water splitting, a two-electrode device needs a voltage of 1.543 V and 1.569 V to reach a current density of 10 mA cm-2 for alkaline water and alkaline seawater electrolysis, respectively. Briefly, this research with attempting to combination of different factors try to present a promising stride towards advancing bi-functional catalytic activity with tailored architectures for practical green hydrogen production via electrochemical water splitting process.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Background and Aims: Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Methods: Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. Results: The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). Conclusion: The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.

Investigating the atomic behavior of carbon nanotubes as nanopumps.

In this study, we utilized molecular dynamics (MD) simulations to investigate the nano pumping process of Carbon Nanotube (CNT) in an aqueous environment. In this research, an attempt has been made to investigate and analyze the pumping process of fullerene C20 and water molecules through a carbon nanotube that is externally stimulated by two oscillators. It should be noted that this nano pump is completely immersed in an aqueous environment and the inside and outside of the carbon nanotube is filled with water molecules. To simulate the aqueous environment with NaCl impurities and carbon structures, we employed the Universal Force Field and Tersoff interatomic potentials, respectively. The stability of the simulated structures was demonstrated through an equilibrium process, which was a result of the appropriate settings in our MD simulations. To describe the CNT nano pumping process, we analyzed the velocity and translational/rotational components of C20 kinetic energy over time steps. By decreasing the water impurity concentration from 0.50 to 0.075 mol/l, the nano pumping time varied from 10.98 to 10.11 ps, respectively. Additionally, optimization of the atomic wave producing in the nano pumping process led to a further decrease in pumping time to 10.01 ps. Finally, a 2.86% variation in calculated results was observed by changing the water MD simulation model from SPC to TIP4P.

Effect of Dynamic Neuromuscular Stabilization and Vojta Therapy on Respiratory Complications in Neuromuscular Diseases: A Literature Review.

Objective: The purpose of this study was to review the literature on the effect of dynamic neuromuscular stabilization (DNS)/Vojta on respiratory complications of neuromuscular diseases. Methods: The search strategy was conducted, based on the population, intervention, comparison, and outcome method, in the PubMed, Embase, ISI Web of Knowledge, ProQuest, and Scopus databases from inception to August 2021. The quality assessment of included papers was performed through the Physiotherapy Evidence Database scale. A narrative analysis was performed since a meta-analysis could not be conducted. Results: A total of 7 papers were chosen for the final assessment. All studies, except 1, evaluated individuals with neurological disease. Three studies evaluated Vojta therapy effects, and 4 studies evaluated DNS effects on respiratory parameters. Although the studies had limitations in their methodology according to the Physiotherapy Evidence Database scale, 4 were identified as level 1 evidence. None of the studies reported any adverse effects of Vojta therapy or DNS on respiratory parameters. However, not enough clinical trials were found to examine the effect of DNS on respiratory disease. Conclusion: Although the studies were weak in internal and external validity, this review suggests that Vojta therapy and DNS may influence respiratory parameters, such as blood gases, diaphragm movements, and functional respiratory parameters, in patients with neuromuscular diseases.

Nutritional and sensory properties of low-fat milk dessert enriched with quinoa (Chenopodium quinoa Willd) Titicaca protein isolate.

The purpose of this work was to investigate the potential production of Titicaca quinoa protein isolated (TQPI) to improve the quality of low-fat desserts. In this study, low-fat desserts incorporating TQPI (0, 1%, 3%, and 5%) were produced. The results indicated that as TQPI increased, protein content, acidity, b*, hardness, and water-holding capacity (WHC) increased. Dessert containing 5% TQPI exhibited the highest values of hardness (63.23 ± 1.46 g), adhesiveness (0.88 ± 0.19), gumminess (67.30 ± 1.41 g), chewiness (11.41 ± 0.46 mJ), protein content (18.09%), b*(20.75), WHC (50.65%), and acidity (25.9 °D) on the 21st day of the storage time. TQPI (1%) gave a better effect on taste, texture, and total acceptability in comparison with other fortified desserts. Electron microscopy shows that the fortified dessert containing 5% TQPI had a stronger network than the others. It can be concluded that desserts containing 1% TQPI presented a very good response as a potential new dairy product based on sensory properties.

Evaluation of the Effects of PAKDAM, an Invented Device to Get Nitrous Oxide and Oxygen, in the Consumers: A Report of Pilot Study.

Background: Since last decade, a device called PAKDAM (means clean inspiration) was invented in Iran which has been used in some cafe to prepare N2O and O2 as a new instrument instead of using water pipe. This study aimed to evaluate the respiratory and health effects of Pakdam and investigate its short and midterm side effects in users. Materials and Methods: In a case-control pilot study between September 2021 and March 2022, 152 individuals were divided into two groups: 76 consumers (case) and 76 non- consumers (control). Both groups were divided into two groups of 36 smokers and 36 non-smokers. Participants signed the participation form and filled out the demographic data questionnaire, and then their vital signs, O2 saturation, expiratory CO, and spirometry tests were recorded. Results: The subjects who used the device had a mean blood pressure of 123.71±16.11 mmHg, oxygen saturation of 97.2±1.9, exhaled carbon monoxide of 9.8±5.5, and an FVC / FEV1 ratio of 88.5±7.9. These figures in control group were (137.79±18.15) - (94.1±4.2) - (14.3 ± 9.3) and (83.9 ± 10.4), respectively. In addition to the effects on the respiratory system, consumers had lower heart rates and lower systolic and diastolic blood pressures. Conclusion: The blood oxygen level and FEV1/FVC ratio were higher in subjects using Pakdam and the amount of exhaled carbon monoxide and blood pressure were lower. This condition was more common in smokers and less in non-smokers. It is possible to see the favorable effects of using Pakdam device on people especially in smokers.

Distinction of non-specific low back pain patients with proprioceptive disorders from healthy individuals by linear discriminant analysis.

The central nervous system (CNS) dynamically employs a sophisticated weighting strategy of sensory input, including vision, vestibular and proprioception signals, towards attaining optimal postural control during different conditions. Non-specific low back pain (NSLBP) patients frequently demonstrate postural control deficiencies which are generally attributed to challenges in proprioceptive reweighting, where they often rely on an ankle strategy regardless of postural conditions. Such impairment could lead to potential loss of balance, increased risk of falling, and Low back pain recurrence. In this study, linear and non-linear indicators were extracted from center-of-pressure (COP) and trunk sagittal angle data based on 4 conditions of vibration positioning (vibration on the back, ankle, none or both), 2 surface conditions (foam or rigid), and 2 different groups (healthy and non-specific low back pain patients). Linear discriminant analysis (LDA) was performed on linear and non-linear indicators to identify the best sensory condition towards accurate distinction of non-specific low back pain patients from healthy controls. Two indicators: Phase Plane Portrait ML and Entropy ML with foam surface condition and both ankle and back vibration on, were able to completely differentiate the non-specific low back pain groups. The proposed methodology can help clinicians quantitatively assess the sensory status of non-specific low back pain patients at the initial phase of diagnosis and throughout treatment. Although the results demonstrated the potential effectiveness of our approach in Low back pain patient distinction, a larger and more diverse population is required for comprehensive validation.

Role of Inspiratory Muscle Training on Pulmonary Rehabilitation in Patients with COVID-19: A Pilot Study.

Background: Inspiratory muscle training has been introduced as one of the effective methods in pulmonary rehabilitation, and attention to this technique in patients with COVID-19 is still being studied. Materials and Methods: In the present study 52 patients who have undergone the period of the COVID-19 disease were randomly divided into two groups. In the control group, in addition to the routine treatment prescribed by a specialist physician, rehabilitation was performed by performing diaphragmatic breathing exercises, pursed-lips breathing, chest expansion, and simple stretching exercises. In the intervention group in addition to the rehabilitation program provided to the control group, patients used an inspiratory muscle training device. This pulmonary rehabilitation program was performed twice a day and 30 repetitions each time with a two-minute rest after every 10 exercises. After 4 weeks, patients in both groups were referred to the hospital for reassessment of the distance of the 6-minute walk test, SF-12 questionnaire results, dyspnea, and S-index. To compare quantitative variables between the two groups we utilized a student t-test. Type one error was put at P≤0.05. Results: The comparison of 6MWT values shows that the mean of this index in the intervention group is significantly higher than the control group (p = 0.002). Also, the S-index of the two groups showed a significant difference (p=0.024). Results show a significant increase in the SF-12 quality of life questionnaire in patients using IMT (p=0.001). Conclusion: IMT improves pulmonary functions, 6MWT, and SF-12 Questionnaire in recovered COVID-19 patients.

Effect of Fluvoxamine on Interleukin-6 Levels in COVID-19 Patients Hospitalized in ICU: A Randomized Clinical Trial.

Background: Reviewing the laboratory studies, we observe some drugs with other specified applications, which cause serious inhibitory immune responses in the body. Selective Serotonin Reuptake Inhibitors (SSRIs) are among these drugs. Therefore, the current research aimed to evaluate the effectiveness of one of the SSRI drugs called fluvoxamine on the cytokine levels in COVID-19 patients. Materials and Methods: The current research included 80 patients with COVID-19 hospitalized in ICU in Massih Daneshvari Hospital. They were entered into the research by an accessible method of sampling and then divided into two groups randomly. One of the groups underwent the treatment with fluvoxamine as the experimental group and the other group did not receive fluvoxamine as the control group. Interleukin-6 (IL-6) and CRP levels were measured before the onset of fluvoxamine consumption and when discharging from the hospital in all members of the sample group. Results: The current study showed that IL-6 levels increased, while CRP levels decreased in the experimental group significantly (P-value≤ 0.01). After consuming fluvoxamine, IL-6 and CRP levels were higher and lower in the females compared to the males, respectively. Conclusion: Considering the effectiveness of fluvoxamine on IL-6 and CRP in COVID-19 patients, it may ultimately come true to use this drug to improve both psychological and physical conditions simultaneously and leave the COVID-19 pandemic behind with less pathology.

Construct validity and internal consistency of the modified Persian version of the STarT Back Screening Tool.

BACKGROUND AND AIM: Considering the importance of non-specific low back pain (NSLBP) and its increasing spread, the need for instruments for the accurate diagnosis of back pain is evident in order to offer more effective treatment. One such instrument is the STarT Back Screening Tool (STarT) which is examined by numerous studies, while some of its psychometric dimensions still require attention. Therefore, the objective of this study was to assess the internal consistency and construct validity of this questionnaire to propose a modified version. METHOD: In this cross-sectional study, the data of 295 patients with NSLBP were analyzed. Cronbach's alpha was used to assess internal consistency, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess construct validity. The Χ2/df, GFI, CFI, and RMSEA indices were also utilized as the goodness-of-fit criteria. Data analysis was performed in SPSS, AMOS, and EQS programs. RESULTS: Goodness-of-fit indicators were calculated for the original Persian version of the questionnaire, showing an improper fit (RMSEA = 0.162). According to the measures of sampling adequacy (MSA) of the questions, Questions 1 and 8 were deleted, resulting in an improved index (RMSEA = 0.062). All the regression coefficients in the CFA model were significant (p < 0.001for all 7 parameters). CONCLUSION: Based on the results, the modified Persian version of the STarT is simpler and more practical than the previous version, serving as a valid and reliable tool for assessing patients with low back pain. With respect to the goodness-of-fit indices, we recommend that more studies with larger samples be conducted on different populations.

Linear and Non-linear Dynamic Methods Toward Investigating Proprioception Impairment in Non-specific Low Back Pain Patients.

Central nervous system (CNS) uses vision, vestibular, and somatosensory information to maintain body stability. Research has shown that there is more lumbar proprioception error among low back pain (LBP) individuals as compared to healthy people. In this study, two groups of 20 healthy people and 20 non-specific low back pain (NSLBP) participants took part in this investigation. This investigation focused on somatosensory sensors and in order to alter proprioception, a vibrator (frequency of 70 Hz, amplitude of 0.5 mm) was placed on the soleus muscle area of each leg and two vibrators were placed bilaterally across the lower back muscles. Individuals, whose vision was occluded, were placed on two surfaces (foam and rigid) on force plate, and trunk angles were recorded simultaneously. Tests were performed in eight separate trials; the independent variables were vibration (four levels) and surface (two levels) for within subjects and two groups (healthy and LBP) for between subjects (4 × 2 × 2). MANOVA and multi-factor ANOVA tests were done. Linear parameters for center of pressure (COP) [deviation of amplitude, deviation of velocity, phase plane portrait (PPP), and overall mean velocity] and non-linear parameters for COP and trunk angle [recurrence quantification analysis (RQA) and Lyapunov exponents] were chosen as dependent variables. Results indicated that NSLBP individuals relied more on ankle proprioception for postural stability. Similarly, RQA parameters for the COP on both sides and for the trunk sagittal angle indicated more repeated patterns of movement among the LBP cohort. Analysis of short and long Lyapunov exponents showed that people with LBP caused no use of all joints in their bodies (non-flexible), are less stable than healthy subjects.

Using a Motion Sensor to Categorize Nonspecific Low Back Pain Patients: A Machine Learning Approach.

Nonspecific low back pain (NSLBP) constitutes a critical health challenge that impacts millions of people worldwide with devastating health and socioeconomic consequences. In today's clinical settings, practitioners continue to follow conventional guidelines to categorize NSLBP patients based on subjective approaches, such as the STarT Back Screening Tool (SBST). This study aimed to develop a sensor-based machine learning model to classify NSLBP patients into different subgroups according to quantitative kinematic data, i.e., trunk motion and balance-related measures, in conjunction with STarT output. Specifically, inertial measurement units (IMU) were attached to the trunks of ninety-four patients while they performed repetitive trunk flexion/extension movements on a balance board at self-selected pace. Machine learning algorithms (support vector machine (SVM) and multi-layer perceptron (MLP)) were implemented for model development, and SBST results were used as ground truth. The results demonstrated that kinematic data could successfully be used to categorize patients into two main groups: high vs. low-medium risk. Accuracy levels of ~75% and 60% were achieved for SVM and MLP, respectively. Additionally, among a range of variables detailed herein, time-scaled IMU signals yielded the highest accuracy levels (i.e., ~75%). Our findings support the improvement and use of wearable systems in developing diagnostic and prognostic tools for various healthcare applications. This can facilitate development of an improved, cost-effective quantitative NSLBP assessment tool in clinical and home settings towards effective personalized rehabilitation.

A Practical Sensor-Based Methodology for the Quantitative Assessment and Classification of Chronic Non Specific Low Back Patients (NSLBP) in Clinical Settings.

The successful clinical application of patient-specific personalized medicine for the management of low back patients remains elusive. This study aimed to classify chronic nonspecific low back pain (NSLBP) patients using our previously developed and validated wearable inertial sensor (SHARIF-HMIS) for the assessment of trunk kinematic parameters. One hundred NSLBP patients consented to perform repetitive flexural movements in five different planes of motion (PLM): 0° in the sagittal plane, as well as 15° and 30° lateral rotation to the right and left, respectively. They were divided into three subgroups based on the STarT Back Screening Tool. The sensor was placed on the trunk of each patient. An ANOVA mixed model was conducted on the maximum and average angular velocity, linear acceleration and maximum jerk, respectively. The effect of the three-way interaction of Subgroup by direction by PLM on the mean trunk acceleration was significant. Subgrouping by STarT had no main effect on the kinematic indices in the sagittal plane, although significant effects were observed in the asymmetric directions. A significant difference was also identified during pre-rotation in the transverse plane, where the velocity and acceleration decreased while the jerk increased with increasing asymmetry. The acceleration during trunk flexion was significantly higher than that during extension, in contrast to the velocity, which was higher in extension. A Linear Discriminant Analysis, utilized for classification purposes, demonstrated that 51% of the total performance classifying the three STarT subgroups (65% for high risk) occurred at a position of 15° of rotation to the right during extension. Greater discrimination (67%) was obtained in the classification of the high risk vs. low-medium risk. This study provided a smart "sensor-based" practical methodology for quantitatively assessing and classifying NSLBP patients in clinical settings. The outcomes may also be utilized by leveraging cost-effective inertial sensors, already available in today's smartphones, as objective tools for various health applications towards personalized precision medicine.

Postural Balance Evaluation in Patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: The risk of falling in patients with chronic obstructive pulmonary disease (COPD) is higher than healthy people, imposing a great financial burden on patients due to clinical diagnosis and treatment. This study aimed to compare static balance between two groups of healthy people and COPD patients, based on cognitive tasks and vision tests, using linear and non-linear analyses. MATERIALS AND METHODS: A total of 15 patients with COPD and 14 age- and gender-matched healthy individuals were recruited in this study. Variations in the center of pressure were recorded in both medial-lateral (ML) and anterior-posterior (AP) directions by implementing visual feedback and cognitive tasks, with the subject standing on a force plate. Data related to the center of pressure were analyzed in the AP and ML directions by linear methods (i.e., standard deviation of displacement, standard deviation of maximum velocity, average velocity, and phase plane). Also, the nonlinear method (Lyapunov exponents) was used in both directions. RESULTS: The cognitive tasks improved the center of pressure variables in both groups. In association with the vision tests, only lack of vision had a significant effect on the patients. The results of the linear analysis in the ML direction were significantly higher in the COPD group as compared to the healthy group; however, the results were not significant in the AP direction. Also, the non-linear analysis showed significant differences between the groups. CONCLUSION: Use of both linear and non-linear analyses is necessary for evaluating the balance of patients with breathing difficulties. Balance disorders in COPD patients were mostly in the ML direction; therefore, postural deformities might be one of the reasons for balance problems in the AP direction.

The Optimal Cut-off Score of the Nijmegen Questionnaire for Diagnosing Hyperventilation Syndrome Using a Bayesian Model in the Absence of a Gold Standard.

BACKGROUND: The Nijmegen questionnaire is one of the most common tools for diagnosing hyperventilation syndrome (HVS). However, there is no precise cut-off score for differentiating patients with HVS from those without HVS. This study was conducted to evaluate the accuracy of Nijmegen questionnaire for detecting patients with HVS and to provide the best cut-off score for differentiating patients with HVS from normal individuals using a Bayesian model in the absence of a gold standard. MATERIALS AND METHODS: A total of 490 students from a rehabilitation center in Tehran, Iran, were asked to participate in this case study of HVS from January to August 2018. RESULTS: A total of 215 students (40% male and 60% female) completed the Nijmegen questionnaire. The area under the receiver operating characteristic curve (AUC) was 0.93 (male: 0.95; female: 94) for all of the cut-off scores. The optimal cut-off score of ≥20 could predict HVS with sensitivity of 0.91 (male: 0.99; female: 91) and specificity of 0.92 (male: 96; female: 89). CONCLUSION: Accurate differentiation of HVS patients from individuals without HVS can be accomplished by estimating the cut-off score of Nijmegen questionnaire based on a non-parametric Bayesian model.

Human wild-type superoxide dismutase 1 gene delivery to rat bone marrow stromal cells: its importance and potential future trends.

OBJECTIVES: Human superoxide dismutase 1 (SOD1) is the cytosolic form of this enzyme it detoxifies superoxide anions and attenuates their toxicities and concomitant detrimental effects on the cells. It is believed that the amount of these enzymes present in the oxidative stress-induced diseases is crucial for preventing disease progression. Transfection of rat bone marrow stromal cells (BMSCs) by a constructed vector carrying the human wild-type SOD1 gene, a non-viral gene transfer method, was the main aim of this study. MATERIALS AND METHODS: For this purpose, the rat BMSCs were transfected with the vector using Turbofect reagent and then stabilized. Western-blot and real-time PCR were also used for evaluation of SOD1 expression. RESULTS: Data analysis from RT-PCR and Western-blot techniques revealed that the stable transfected cells could secrete human wild-type SOD1 in the supernatant. Also, the total activity of SOD1 was about 0.5±0.09 U/ml and 0.005±0.002 U/ml in the supernatants of the transfected and not-transfected of rat BMSCs, respectively. CONCLUSION: This study showed that expansion of the stable transfected rat BMSCs by a constructed vector carrying the human wild-type SOD1 gene is capable of secreting the active SOD1 enzyme under ex-vivo conditions. The recommendation of this study is that the same experiment would be applicable for expression of the other form of this enzyme, SOD3, as well. More valuable information could probably be provided about the variety of the diseases caused by superoxide anions toxicities by intervention and application of the non-viral method for expressions of SOD1 and SOD3 enzymes.

A Poincare map based analysis of stroke patients' walking after a rehabilitation by a robot.

Since the past decade, rehabilitation robots have become common technologies for recovering gait ability after a stroke. Nevertheless, it is believed that these robots can be further enhanced. Hence, several researches are making progress in optimizing gait rehabilitation robots. However, most of these researches have only assessed the robots and their controllers in improving spatiotemporal and kinetic features of walking. There are not many researchers have focused on the robots' controllers' effects on the central nervous or neuromuscular systems. On the other hand, recently computational methods have been utilized to investigate the rehabilitations of neural disorders, through developing neuromechanical models. However, these methods have neither studied the robot-assisted gait rehabilitation, nor have they theoretically proved why rehabilitation exercises enhance patients' walking ability. Therefore, this paper merged a theoretical approach into a computational method to investigate the effects of gait rehabilitation robots on post-stroke neuromuscular system. To this end, a neuromechanical model of gait has been developed and thereby, the Poincare maps of intact and stroke people have been obtained. Comparison of these maps revealed why a stroke reduces the stability of walking. Then, the effect of an impedance controller, which is used in a rehabilitative robot, is scrutinized in stabilizing a walking motion. Obtaining the Poincare map of this close-loop system, proved that this controller improves motion stability. Finally, the effect of this controller is investigated by simulations and experiments. The experimental tests are performed by Arman rehabilitative robot. Clinical Reference Number: IR.TMU.REC.1394.254.

A novel approach to spinal 3-D kinematic assessment using inertial sensors: Towards effective quantitative evaluation of low back pain in clinical settings.

This paper presents a novel approach for evaluating LBP in various settings. The proposed system uses cost-effective inertial sensors, in conjunction with pattern recognition techniques, for identifying sensitive classifiers towards discriminate identification of LB patients. 24 healthy individuals and 28 low back pain patients performed trunk motion tasks in five different directions for validation. Four combinations of these motions were selected based on literature, and the corresponding kinematic data was collected. Upon filtering (4th order, low pass Butterworth filter) and normalizing the data, Principal Component Analysis was used for feature extraction, while Support Vector Machine classifier was applied for data classification. The results reveal that non-linear Kernel classification can be adequately employed for low back pain identification. Our preliminary results demonstrate that using a single inertial sensor placed on the thorax, in conjunction with a relatively simple test protocol, can identify low back pain with an accuracy of 96%, a sensitivity of %100, and specificity of 92%. While our approach shows promising results, further validation in a larger population is required towards using the methodology as a practical quantitative assessment tool for the detection of low back pain in clinical/rehabilitation settings.

Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain.

OBJECTIVE: To translate the STarT Back Screening Tool (SBT) into Persian and to investigate the psychometric properties of the new version in a group of patients with Non-Specific Low Back Pain (NSLBP). BACKGROUND: The STarT is a validated questionnaire used for subgrouping LBP patients at three levels of low-, medium-, and high-risk, based on the risk of chronicity. It has previously been translated and validated in different languages. METHODS: The translation and validation of the original questionnaire were carried out in accordance with the standard guidelines. To approve the construct validity, 295 patients with NSLBP completed a questionnaire package. The package comprised of the STarT, Roland-Morris Disability questionnaire (RMDQ), Tampa Scale for Kinesiophobia (TSK), Coping Strategies Questionnaire (CSQ), and Hospital Anxiety and Depression Scale (HADS). To evaluate test-retest reliability, 35 randomly selected NSLBP patients completed the STarT questionnaire within min. 24-hour interval. RESULTS: Factor analysis confirmed two subscales of the STarT. The Cronbach α was .83 and .81 for the STarT and the subscale, respectively. This questionnaire showed excellent test-retest reliability (ICC = .85) (p < 0.01). The correlations between the STarT and RMDQ, CSQ, TSK, and the two subscales of HADS were estimated to be .81, .70, .71, .74, and .71, respectively. The Area under the Curve was also calculated for 6 items and the range was between .734 and .860. CONCLUSIONS: The Persian version of the STarT is reliable and valid, and consistent with the original questionnaire. Therefore, clinicians to subgroup Persian-speaking NSLBP patients can use it.

Translation and validation study of the Persian version of the Western Ontario Rotator Cuff Index.

The translation, cultural adaptation and validation of the Persian version of the Western Ontario Rotator Cuff Index (WORC) were carried out in accordance with published guidelines. One hundred fifty consecutive patients with rotator cuff disorders completed the Persian WORC, the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure, the Short Form Health Survey (SF-36) and visual analog scale (VAS) to test convergent validity. Forty-five randomly selected patients completed the WORC 48 h later for the second time. High internal validity and discriminatory power of the WORC scales were found. Cronbach's alpha coefficient for the Persian WORC ranged from 0.85 to 0.92. The Persian WORC showed excellent test-retest reliability, with intraclass correlation coefficient ranging from 0.88 to 0.94 (P < 0.01). The Pearson's correlation coefficient between the Persian WORC total score and the DASH, the VAS and the SF-36 subscales was -0.76, -0.62 and 0.43 to 0.69, respectively (P < 0.001), indicating a good convergent validity. The results show that the Persian WORC is a reliable and valid instrument to measure health-related quality of life in Persian-speaking patients with rotator cuff disorders in Iran.