Convolutional Neural Network for Individual Identification Using Phase Space Reconstruction of Electrocardiogram.

Electrocardiogram (ECG) biometric provides an authentication to identify an individual on the basis of specific cardiac potential measured from a living body. Convolutional neural networks (CNN) outperform traditional ECG biometrics because convolutions can produce discernible features from ECG through machine learning. Phase space reconstruction (PSR), using a time delay technique, is one of the transformations from ECG to a feature map, without the need of exact R-peak alignment. However, the effects of time delay and grid partition on identification performance have not been investigated. In this study, we developed a PSR-based CNN for ECG biometric authentication and examined the aforementioned effects. Based on a population of 115 subjects selected from the PTB Diagnostic ECG Database, a higher identification accuracy was achieved when the time delay was set from 20 to 28 ms, since it produced a well phase-space expansion of P, QRS, and T waves. A higher accuracy was also achieved when a high-density grid partition was used, since it produced a fine-detail phase-space trajectory. The use of a scaled-down network for PSR over a low-density grid with 32 × 32 partitions achieved a comparable accuracy with using a large-scale network for PSR over 256 × 256 partitions, but it had the benefit of reductions in network size and training time by 10 and 5 folds, respectively.

Deep Neural Network for the Detections of Fall and Physical Activities Using Foot Pressures and Inertial Sensing.

Fall detection and physical activity (PA) classification are important health maintenance issues for the elderly and people with mobility dysfunctions. The literature review showed that most studies concerning fall detection and PA classification addressed these issues individually, and many were based on inertial sensing from the trunk and upper extremities. While shoes are common footwear in daily off-bed activities, most of the aforementioned studies did not focus much on shoe-based measurements. In this paper, we propose a novel footwear approach to detect falls and classify various types of PAs based on a convolutional neural network and recurrent neural network hybrid. The footwear-based detections using deep-learning technology were demonstrated to be efficient based on the data collected from 32 participants, each performing simulated falls and various types of PAs: fall detection with inertial measures had a higher F1-score than detection using foot pressures; the detections of dynamic PAs (jump, jog, walks) had higher F1-scores while using inertial measures, whereas the detections of static PAs (sit, stand) had higher F1-scores while using foot pressures; the combination of foot pressures and inertial measures was most efficient in detecting fall, static, and dynamic PAs.

Incidence and risk of major adverse cardiovascular events in middle-aged patients with chronic kidney disease: a population-based cohort study.

PURPOSE: For early prevention, information regarding the incidence of major adverse cardiovascular events (MACEs) in middle-aged patients with chronic kidney disease (CKD) may be more beneficial than that regarding MACE prevalence. But, literature comparing the incidence and risk of MACEs in middle-aged patients with CKD with the controls using a population-based cohort study is scant. Our aim was to estimate the incidence and risk of MACEs, such as congestive heart failure (CHF) and ischemic heart disease (IHD), in middle-aged patients with advanced (stages 3-5) CKD. METHODS: From the National Health Insurance Research Database, 261 patients aged 35-65 years who had received advanced CKD diagnoses in 2000 and 1305 age-, sex-, and comorbidity-matched controls were recruited. Patients with CHF alone (MACE 1), IHD alone (MACE 2), or CHF and IHD (MACE 3) diagnoses between January 1, 2001, and December 31, 2008, were identified in the CKD and control groups. RESULTS: Patients (mean age ± standard deviation, 50.0 ± 8.3 years; female, 56%) exhibited a higher incidence of MACE 1, MACE 2, and MACE 3 (11.9 vs. 1.4/1000, 30.7 vs. 13.4/1000, and 13.4 vs. 1.7/1000 person-years, respectively, all p < 0.001) and were at a higher risk of experiencing MACEs than the controls (adjusted hazard ratios: MACE 1, MACE 2, and MACE 3: 8.57, 2.26, and 3.80, respectively, all p < 0.001). CONCLUSIONS: CKD is an independent risk factor for CHF and IHD among patients aged 35-65 years. Early intervention for preventing CHF and IHD in middle-aged patients with CKD is crucial.

Kinesio taping reduces elbow pain during resisted wrist extension in patients with chronic lateral epicondylitis: a randomized, double-blinded, cross-over study.

BACKGROUND: Lateral epicondylitis is frequently seen in racquet sport players and the treatments are usually symptomatic rather than curative. Taping therapy is cheap and easy to apply in the sport field. In this study we valued the effectiveness of Kinesio taping (KT) on immediate pain control for patients with chronic lateral epicondylitis. METHODS: We conducted a randomized, double-blinded, cross-over study with 15 patients with chronic lateral epicondylitis. All participants received two taping sessions in a random order with a 3-day interval in between: one with KT and the other with sham taping (ST). Pain perceived during resisted wrist extension and at rest using numeric rating scale (NRS), the pain-free grip strength, and the pressure pain threshold, were measured before and 15 min after the tape was applied. RESULTS: A significant reduction of 2.1 ± 1.6 (Z = - 3.081, P = 0.002) and 0.7 ± 0.8 (Z = - 2.428, P = 0.015) was found on a NRS with KT and ST, respectively, indicating that both taping sessions produced immediate pain relief for resisted wrist extension. Both taping sessions significantly improved the pain-free grip strength with increases of 3.31 ± 5.05 (Z = - 2.615, P = 0.009) and 2.43 ± 3.31 (Z = - 2.783, P = 0.005) kg found with KT and ST, respectively. Compared with ST, KT exhibited superiority in controlling pain experienced during resisted wrist extension (Z = - 2.168, P = 0.030). CONCLUSIONS: Taping produced unneglectable placebo effects on pain relief and painf-free grip strength for patients with lateral epicondylitis, and KT seemed to have additional effects on controlling pain that was elicited by resisted wrist extension. TRIAL REGISTRATION: ISRCTN13618356 (retrospectively registered on 13/02/2017).

Non-elastic taping, but not elastic taping, provides benefits for patients with knee osteoarthritis: systemic review and meta-analysis.

OBJECTIVE: To determine whether therapeutic taping, which includes elastic (Kinesio tape) and non-elastic (Leukotape) taping, is superior to control taping in improving pain and functions for patients with knee arthritis. To understand whether both elastic and non-elastic taping are beneficial. METHODS: We searched the PubMed and Scopus databases from their earliest record to 31 May 2017 for randomized controlled and cross-over studies that used taping to treat knee osteoarthritis. We extracted the mean differences and SD between baseline and posttreatment for selected outcomes measured in the experimental and control groups for subsequent meta-analyses. RESULTS: In total, 11 studies were included in the review. Of which, five Leukotaping and five Kinesio taping studies involving 379 participants were used in the meta-analysis. PEDro scores of the Leukotaping and Kinesio taping studies were 4.2 and 7.8, respectively. Overall, therapeutic taping exhibited significantly greater pain reduction than control taping with a significant weighted mean difference of 12.8 mm on a 0- to 100-mm visual analogue scale. Compared to control taping, Leukotaping produced a significant weighted mean difference of 11.6 mm regarding pain with a large effect size of 0.89 and I2 = 0%, while Kinesio taping produced a non-significant weighted mean difference of 12.1 mm and I2 = 93%. Leukotaping also exhibited a large and significant standard mean difference of 0.82, while Kinesio taping exhibited a non-significant standard mean difference of 1.34 regarding climbing stairs and stepping. CONCLUSION: Therapeutic taping seemed to be superior to control taping in pain control for knee osteoarthritis. Non-elastic taping, but not elastic taping, provides benefits in pain reduction and functional performance.

Association Between Manual Loading and Newly Developed Carpal Tunnel Syndrome in Subjects With Physical Disabilities: A Follow-Up Study.

OBJECTIVE: To identify the association between body composition and newly developed carpal tunnel syndrome (CTS) and to search for the best probabilistic cutoff value of associated factors to predict subjects with physical disabilities developing new CTS. DESIGN: Longitudinal. SETTING: University-affiliated medical center. PARTICIPANTS: Subjects with physical disabilities (N=47; mean age ± SD, 42.1±7.7y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Median and ulnar sensory nerve conduction velocity (SNCV) were measured at the initial and follow-up tests (interval >2y). Total and regional body composition were measured with dual-energy x-ray absorptiometry at the initial test. Leg lean tissue percentage was calculated to delineate each participant's manual loading degree during locomotion. Leg lean tissue percentage is the lean tissue mass of both legs divided by body weight. RESULTS: Based on median SNCV changes, we divided all participants into 3 groups: subjects with bilateral CTS (median SNCV value <45m/s plus a normative ulnar SNCV value >37.8m/s) in the initial test (n=10), subjects with newly developed CTS in the follow-up test (n=8), and subjects without additional CTS in the follow-up test (n=27). Eight of 35 subjects not having bilateral CTS initially developed new CTS (8.8% per year; mean follow-up period, 2.6y). Leg lean tissue percentage was associated with the probability of newly developed CTS (adjusted odds ratio, .64; P<.05). Subjects with a leg lean tissue percentage >12% were less likely to have developed new CTS at the follow-up test (sensitivity, .75; specificity, .85; area under the curve, .88; P<.005). CONCLUSIONS: Leg lean tissue percentage may be useful for early identification of developing new CTS in subjects with physical disabilities. Therefore, a preventive program for those subjects at risk can start early.

The probability of spontaneous regression of lumbar herniated disc: a systematic review.

OBJECTIVE: To determine the probability of spontaneous disc regression among each type of lumbar herniated disc, using a systematic review. DATA SOURCES: Medline, Cochrane Library, CINAHL, and Web of Science were searched using key words for relevant original articles published before March 2014. Articles were limited to those published in English and human studies. REVIEW METHODS: Articles had to: (1) include patients with lumbar disc herniation treated conservatively; (2) have at least two imaging evaluations of the lumbar spine; and (3) exclude patients with prior lumbar surgery, spinal infections, tumors, spondylolisthesis, or spinal stenosis. Two reviewers independently extracted study details and findings. Thirty-one studies met the inclusion criteria. Furthermore, if the classification of herniation matched the recommended classification of the combined Task Forces, the data were used for combined analysis of the probability of disc regression of each type. Nine studies were applicable for probability calculation. RESULTS: The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging. The rate of complete resolution of disc herniation was 43% for sequestrated discs and 15% for extruded discs. CONCLUSIONS: Spontaneous regression of herniated disc tissue can occur, and can completely resolve after conservative treatment. Patients with disc extrusion and sequestration had a significantly higher possibility of having spontaneous regression than did those with bulging or protruding discs. Disc sequestration had a significantly higher rate of complete regression than did disc extrusion.

Pathogen colonization in patients with acute cerebral stroke.

PURPOSE: To identify the pathogens that frequently cause infection and to explore their clinical features in acute stroke patients. METHODS: From June 1, 1999 to December 31, 2008, we reviewed medical records of 263 patients with acute stroke and 351 controls. Within 30 days from admission, 109 and 107 patients had one or more bacterial cultures, respectively. The cumulative bacteria-free probability of all patients and the incidence of each isolated pathogen were assessed. We searched for the factors associated with isolation of different Gram-negative bacilli (GNB). RESULTS: Patients with recent stroke were prone to healthcare-associated colonization within 2 weeks from admission. One-fourth of stroke patients had positive bacterial culture. Stroke patients had a high incidence of Staphylococcus aureus and various GNB in their sputum. When urinary tract infections (UTIs) began 9 days or more after admission, the contributory pathogens were most often glucose-nonfermenting bacilli. However, if UTIs occurred within 9 days after admission, the pathogens were likely to be Enterobacteriaceae bacilli. CONCLUSIONS: Stroke patients had high incidence of pathogenic bacteria in their sputum which might be prone to pneumonia. The time after admission of the onset of UTI is useful information for predicting contributory pathogens and planning for appropriate treatment.

Prevalence and correlates of self-induced vomiting as weight-control strategy among adolescents in Taiwan.

AIMS: This study was designed to assess the prevalence and correlates of self-induced vomiting to control body weight among adolescents in Taiwan. BACKGROUND: Over the past decades, the rate of obesity among children in Taiwan has nearly tripled. Educational authorities have devoted considerable effort to prevent the increase in childhood obesity. DESIGN: An observational exploratory design to investigate the problem of using unhealthy weight-reduction strategy. METHODS: This study consists of a cross-sectional study aimed at collecting national representative data. We chose 120 representative schools using a three-stage stratified systematic sampling design with probability proportionate to the size of the population in Taiwan. Participants consisted of 8673 girls and 7043 boys, aged 10-18 old. RESULTS: Of the participants, 13% reported using self-induced vomiting, the prevalence being highest in participants aged 10-12 (15·9%) and lowest in participants aged 16-18 (7·5%). Several factors were significantly and positively associated with the use of self-induced vomiting as a weight-loss strategy, specifically subjects who (1) watched television, used computer, surfed the Internet or played video games for greater than or equal to two hours/day, (2) consumed fried food every day and (3) ate night-time snacks every day (odds ratio = 1·55, 2·10 and 1·51, respectively; p < 0·05). Eating breakfast every day and sleeping for more than eight hours a day were both protective factors against the use of self-induced vomiting to control body weight (odds ratio = 0·43 and 0·86, respectively; p < 0·05). CONCLUSIONS: Self-induced vomiting was prevalent among adolescents who had tried to lose weight; sedentary lifestyle, shorter sleep length and unhealthy eating habits may contribute significantly to this behaviour among these adolescents. RELEVANCE TO CLINICAL PRACTICE: School nurses who are helping adolescents lose weight should also pay attention to the possibility they are using self-induced vomiting as a weight-control strategy.