Human Joint Angle Estimation Using Deep Learning-Based Three-Dimensional Human Pose Estimation for Application in a Real Environment.

Human pose estimation (HPE) is a technique used in computer vision and artificial intelligence to detect and track human body parts and poses using images or videos. Widely used in augmented reality, animation, fitness applications, and surveillance, HPE methods that employ monocular cameras are highly versatile and applicable to standard videos and CCTV footage. These methods have evolved from two-dimensional (2D) to three-dimensional (3D) pose estimation. However, in real-world environments, current 3D HPE methods trained on laboratory-based motion capture data encounter challenges, such as limited training data, depth ambiguity, left/right switching, and issues with occlusions. In this study, four 3D HPE methods were compared based on their strengths and weaknesses using real-world videos. Joint position correction techniques were proposed to eliminate and correct anomalies such as left/right inversion and false detections of joint positions in daily life motions. Joint angle trajectories were obtained for intuitive and informative human activity recognition using an optimization method based on a 3D humanoid simulator, with the joint position corrected by the proposed technique as the input. The efficacy of the proposed method was verified by applying it to three types of freehand gymnastic exercises and comparing the joint angle trajectories during motion.

Postural stability for taekwondo athletes with repetitive ankle sprains during a single-leg stance.

[Purpose] The purpose of this study is to investigate postural stability in such group of taekwondo athletes by measuring the center-of-pressure variables in both the injured limb and uninjured limb during a single-leg stance with eyes closed. [Subjects and Methods] The study includes eleven taekwondo athletes with repetitive ankle sprains (RASs) and eleven healthy taekwondo athletes (the controls) at the college level participating in taekwondo training sessions. For the controls, the "injured" limb was taken to be the left limb. [Results] The postural stability measured in both the anteroposterior and mediolateral directions using center-of-pressure variables was lower in the uninjured limb of the RAS group than in the control group during a single-leg stance with eyes closed. However, for the injured limb, there were no significant differences between the two groups. Furthermore, compared to the RAS group, the control group had higher stability in the injured limb than in the uninjured limb. [Conclusion] Individuals with RASs should ensure improvements in their proprioceptive and neuromuscular functions, as well as muscle strength, through an adequate period of rehabilitation to reduce the risk of re-injury.

Evaluation of the turning characteristics according to the severity of Parkinson disease during the timed up and go test.

BACKGROUND: Patients with Parkinson disease (PD) experience problems such as falls and freezing of gait during walking and turning in daily activities. However, few studies have examined the relationship between simultaneous turning tasks and the severity of PD. AIM: To investigate turning characteristics in patients with PD using three-dimensional (3D) analysis during the timed up and go (TUG) test. METHODS: Thirty individuals performed the TUG test under 3D motion analysis: 10 patients with Hoehn and Yahr (H&Y) stages 2.5 and 3.0 PD (group I), 10 patients with H&Y stage 2.0 PD (group II), and 10 healthy older adult controls. Spatiotemporal and kinematic variables were analyzed during the TUG test with a Vicon 3-D motion analysis system. RESULTS: The walking speed, step length, step length asymmetry index, range of motion of the hip, knee, and shoulder joints, and foot clearance height significantly differed between patients with PD and the controls. The step length and foot clearance height were significantly different between groups I and II. DISCUSSION: The step length and foot clearance are different between the severity levels of PD, and the TUG test may be useful for identifying turning characteristics in patients with PD. CONCLUSIONS: Patients with PD exhibited significant differences in all variables of interest compared to the controls. The step length and foot clearance height as well as the TUG test during the turning phase may be helpful for measuring turning in patients with different severity levels of PD.

Effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive taekwondo athletes.

[Purpose] The purpose of this study was to investigate the effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive Taekwondo athletes during single-leg drop landing. [Subjects and Methods] Fourteen competitive taekwondo athletes with chronic ankle instability and 14 healthy adults participated, and they performed three single-leg drop landings from a 40-cm height before and after induced fatigue. Ankle angular position, peak vertical ground reaction force, loading rate, eccentric work, and contribution were calculated and analyzed. [Results] Athletes had lower ankle eversion and abduction angle than the controls did at maximum knee flexion both pre- and post-fatigue. Furthermore, athletes had lower eccentric work of the hip than the controls did post-fatigue, and they had lower eccentric work of the knee than controls at both pre- and post-fatigue. The eccentric work of the knee increased while, peak vertical ground reaction force decreased in both, athletes as well as controls post-fatigue. [Conclusion] Taekwondo athletes with chronic ankle instability who participate in a high-intensity training program are continuously exposed to potential injuries of their ankle or knee joints. Therefore, competitive taekwondo athletes with chronic ankle instability should limit their participation in regular training until they complete the rehabilitation process.

Corrigendum: Transcriptional inhibition of STAT1 functions in the nucleus alleviates Th1 and Th17 cell-mediated inflammatory diseases.

[This corrects the article DOI: 10.3389/fimmu.2022.1054472.].

Turning reveals the characteristics of gait freezing better than walking forward and backward in Parkinson's disease.

BACKGROUNDS: People with Parkinson's disease (PD) experiences walking disturbances and freezing of gait (FoG) is one of the most distressing symptoms. RESEARCH QUESTION: This study aimed to comprehensively analyze the walking characteristics of patients with PD, including forward and backward walking and turning, in order to define the characteristics of FoG. METHODS: A total of 68 patients with PD and 14 control subjects were enrolled in this study. Forward and backward walking and 360-degree turning were recorded at preferred speed in "off" state using three-dimensional motion analysis system. RESULTS: PD patients showed a narrower step length, slower walking speed, and higher asymmetry index (AI) of step length during forward and backward walking. During turning, the PD patients had more turning steps, longer turning time, and shorter step length than the control subjects. No difference was observed in the characteristics of forward walking according to the FoG status, but the freezer group showed a narrower step length and decreased range of motion in the ankle joints during backward walking. Freezer group showed longer step time and higher AI of step length at turning. The severity of FoG was correlated with step length and walking speed during forward and backward walking, total step count, total step time, and walking speed during turning. SIGNIFICANCE: The characteristics and impacts of FoG in PD were most prominent during turning, followed by backward and forward walking. Further comprehensive analyses of walking including turning might contribute to the understanding of the pathophysiology of walking disturbances in PD.

Transcriptional inhibition of STAT1 functions in the nucleus alleviates Th1 and Th17 cell-mediated inflammatory diseases.

T helper 1 cells (Th1 cells) and T helper 17 cells (Th17 cells) play pivotal roles in the pathogenesis of various autoimmune diseases, including psoriasis and inflammatory bowel disease (IBD). Signal transducer and activator of transcription 1 (STAT1) regulates the Th1 and Th17 cell lineage commitment at an early stage and maintains their immunological functions in vitro and in vivo. The previous strategies to block STAT1 functions to treat autoimmune diseases inhibit Th1 cell activity but simultaneously cause hyper-activation of Th17 cells. Herein, to modulate the functions of pathogenic Th1 and Th17 cells without genetic modification in normal physiological conditions, we generated the nucleus-deliverable form of the transcription modulation domain of STAT1 (ndSTAT1-TMD), which can be transduced into the nucleus of the target cells in a dose- and time-dependent manner without affecting the cell viability and T cell activation signaling events. ndSTAT1-TMD significantly blocked the differentiation of naïve CD4+ T cells into Th1 or Th17 cells via competitive inhibition of endogenous STAT1-mediated transcription, which did not influence Th2 and Treg cell differentiation. When the gene expression profile of Th1 or Th17 cells after ndSTAT1-TMD treatment was analyzed by mRNA sequencing, the expression of the genes involved in the differentiation capacity and the immunological functions of Th1 or Th17 cells were substantially reduced. The therapeutic potential of ndSTAT1-TMD was tested in the animal model of psoriasis and colitis, whose pathogenesis is mainly contributed by Th1 or/and Th17 cells. The symptoms and progression of psoriasis and colitis were significantly alleviated by ndSTAT1-TMD treatment, comparable to anti-IL-17A antibody treatment. In conclusion, our study demonstrates that ndSTAT1-TMD can be a new therapeutic reagent for Th1/17 cell-mediated autoimmune diseases by modulating the functions of pathogenic Th1 and Th17 cells together.

Highly Stereoselective Asymmetric Total Synthesis of (-)-Jimenezin via Sequential Intramolecular Amide Enolate Alkylation.

A highly stereoselective asymmetric total synthesis of (-)-jimenezin (1), a potent anticancer acetogenin, was efficiently completed with the key feature being a sequential intramolecular amide enolate alkylation (IAEA). Our investigation to probe the origin of the complete stereoselectivity in the second IAEA step to form the conformationally flexible tetrahydrofuran with perfect stereocontrol identified the presence of the oxygen atom in the adjacent tetrahydropyran ring to be crucial.

High Rate of False Negative Diagnosis of Silent Patent Ductus Arteriosus on the Chest CT with 3 mm Slice-Thickness, Suggesting the Need for Analysis with Thinner Slice Thickness.

The purpose of this study was to evaluate the diagnostic accuracy of patent with ductus arteriosus (PDA) based on the availability of pretest information on routine chest CT with 3 mm slice-thickness. We retrospectively evaluated CT of 64 patients with PDA. The enrolled patients were categorized as group 1 (presence of pretest information) and 2 (absence of pretest information, silent PDA). CTs were read by eleven board-certified radiologists, and subsequently by two blind readers. We investigated whether a PDA was mentioned on the initial CT reading. Correct diagnosis of PDA was made in all patients with group 1 (n = 42). In contrast, only 13.7% were correctly diagnosed in group 2. All cases of missed PDA in group 2 were also missed by two blind readers. It is important to realize that the diagnostic accuracy of silent PDA is poor on the chest CT with 3 mm slice-thickness. Thus, use of axial CT images with the thinnest slice-thickness and multi-planar reformatted images (i.e., sagittal and coronal images) may be one way to reduce the number of missed PDA.

The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson's disease using inertial sensor.

This study aimed to evaluate the effect of levodopa on the phase coordination index (PCI) and gait asymmetry (GA) of patients with Parkinson's disease (PD) and to investigate correlations between the severity of motor symptoms and gait parameters measured using an inertial sensor. Twenty-six patients with mild-to-moderate-stage PD who were taking levodopa participated in this study. The Unified Parkinson's Disease Rating Scale part III (UPDRS III) was used to assess the severity of motor impairment. The Postural Instability and Gait Difficulty (PIGD) subscore was calculated from UPDRS III. Patients were assessed while walking a 20-m corridor in both "OFF" and "ON" levodopa medication states, and gait analysis was performed using inertial sensors. We investigated the changes in gait parameters after taking levodopa and the correlations between UPDRS III, PIGD, and gait parameters. There was a significant improvement in PCI after taking levodopa. No significant effect of levodopa on GA was found. In "OFF" state, PCI and GA were not correlated with UPDRS III and PIGD. However, in "ON" state, PCI was the only gait parameter correlating with UPDRS III, and it was also highly correlated with PIGD compared to other gait parameters. Significant improvement in bilateral-phase coordination was identified in patients with PD after taking levodopa, without significant change in gait symmetricity. Considering the high correlation with UDPRS III and PIGD in "ON" states, PCI may be a useful and quantitative parameter to measure the severity of motor symptoms in PD patients who are on medication.

Effect of knee extensor fatigue level and sex on bilateral jump-landing.

OBJECTIVE: The purpose of this study was to determine the effect of fatigue level and sex on the range of motions of the lower extremities and impulses during the jump-landing phase after performing bilateral fatiguing tasks. METHODS: In total, 41 healthy young adults volunteered for this study. Participants' jump-landing trajectories were monitored using nine cameras, and ground reaction forces were measured using a force plate. Participants performed five maximal bilateral countermovement jumps as prefatiguing tasks. The fatiguing tasks consisted of maximal effort contractions of the knee extensor at 60°/s on a dynamometer until task failure, defined as the inability to reach 50% of the peak knee extension torque for three consecutive times. The post-task maximal bilateral jumps were immediately captured after the participants failed the fatiguing task. Participants were asked to perform this cycle again, performing the fatiguing contraction task until failure to reach 30% of the peak knee extension torque. RESULTS AND CONCLUSION: It was found that the knee joint was more extended in the post-30% fatiguing task, which was due to the reduction of the flexion angle of the hip and knee joints in response to fatigue level. The impulses for both sexes were reduced at the severe fatigue level. Fatigability altered jump-landing kinematics, jump heights and impulses in response to fatigue level. The post-30% fatiguing task elicited more fatigue than the post-50% fatiguing task.

Clinical Significance of Inflammatory Biomarkers in Acute Pediatric Diarrhea.

PURPOSE: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. METHODS: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. RESULTS: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and 22.8 µg/mL, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. CONCLUSION: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

Depression and posture in patients with Parkinson's disease.

BACKGROUND: Depression is an important non-motor symptom of Parkinson's disease (PD) that significantly impacts the daily activities of affected patients. Furthermore, the stooped posture that characterizes patients with PD has also been associated with depression. The purpose of this study was to investigate the relationship between the presence of depressive symptoms and body posture in patients with PD. METHODS: Forty-six patients with mild-to-moderate PD were recruited. The patients were divided into depression and no depression groups based on Beck Depression Inventory scores. All patients underwent kinematic analysis conducted in the upright standing posture with a motion capture system. RESULTS: There were no differences in clinical characteristics between the depression (n = 22) and no depression groups (n = 24). In the standing position, patients with depression showed anterior tilting of the head from the pelvis and an increased distance between head and pelvis. The severity of depression was correlated with the degree of flexion at the lower trunk level and the degree of anterior tilting of the head, neck, and trunk from the pelvis and base of support. CONCLUSIONS: Patients with PD and depression showed increased flexion at pelvis level, which caused the trunk to tilt anteriorly. In addition, the severity of depression was correlated with the degree of anterior tilting of the head and trunk. These findings suggest that stooped posture, especially from the pelvis level, could be a marker of depression in patients with PD.

Impacts of freezing of gait on forward and backward gait in Parkinson's disease.

Freezing of gait (FOG) is a major risk factor for falls and fall-related injuries in patients with Parkinson's disease (PD). The characteristics of gait in PD patients with FOG have been studied but remain controversial. To investigate gait characteristics of FOG in PD, this study analyzed the forward and backward walking of patients with PD. Twenty-six patients with PD were recruited [age: 71.0 ±â€¯6.2 years, Hoehn and Yahr stage: 2-3 (median 2.5)]. Based on responses to the New Freezing of Gait Questionnaire, we classified patients into either the "freezer" or "non-freezer" group. Spatiotemporal and kinematic analyses of forward and backward walking were completed using a three-dimensional motion analysis system over an 8 m walkway in the defined "off" state. There was no difference in demographic and clinical characteristics between the freezers (n = 10) and non-freezers (n = 16). Analysis of forward walking revealed no between-group differences, except for faster walking speed among the non-freezers. During backward walking, the freezers exhibited slower walking speed, shorter stride length, and increased asymmetry of step length. Kinematic analysis of backward walking revealed smaller range of motion in hip and ankle joints and lower step height in freezers. Further investigations of backward walking might expand our understanding of the pathophysiology of FOG in patients with PD.

Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus 71-induced hand, foot and mouth disease.

OBJECTIVES: The enterovirus EV71 is a major pathogen of hand, foot, and mouth disease (HFMD) in children. Aseptic meningitis is the most common neurologic complication of EV71-induced HFMD. Lumbar puncture is a crucial procedure in the diagnosis of aseptic meningitis. It is often performed based on physicians' clinical suspicion. A diagnostic method that can aid in deciding whether this procedure should be performed is necessary. Cytokines are speculated to be associated with neurologic complications. In this study, we aimed to find an indicator of the presence of aseptic meningitis in children with EV71-induced HFMD. METHODS: This cross-sectional study included children with EV71-induced HFMD. The children underwent lumbar puncture due to suspected aseptic meningitis. They were categorized into an aseptic meningitis complicated group (n = 54) and uncomplicated group (n = 47) based on the results of cerebrospinal fluid examination. Healthy children were included as controls (n = 51). The sample serum levels of tumor necrosis factor-α, interferon-γ, interleukin (IL)-1ß, IL-2, IL-6, IL-8, IL-10, and IL-13 were detected using multiplexed fluorescent bead-based immunoassays. RESULTS: The levels of all cytokines were significantly higher in children with EV71-induced HFMD complicated with aseptic meningitis than in children with uncomplicated EV71-induced HFMD and controls (p < 0.001). Binary logistic regression analysis demonstrated that IL-6 had the strongest association with aseptic meningitis of all cytokines examined. According to receiver operating characteristic analysis, the optimal cutoff value for IL-6 was 66 pg/mL with maximum sensitivity and specificity. CONCLUSIONS: The results of this study suggest the association between higher production of cytokine and aseptic meningitis among children with EV71-induced HFMD. IL-6 was also suggested as an indicator of aseptic meningitis. Rapid measurement of IL-6 could be useful in deciding whether physicians should perform lumbar puncture on children.

Risk factors for latent tuberculosis infection in children in South Korea.

OBJECTIVES: In South Korea, latent tuberculosis infection (LTBI) screening is a critical strategy associated with efforts to reduce the incidence of tuberculosis (TB). Currently, only children with a known history of TB contact are considered as pediatric high-risk groups for LTBI, and consequently, LTBI screening is only provided to these children. However, to reduce the incidence of TB, the high-risk groups that undergo LTBI screening should be expanded. This study aimed to assess the risk factors for LTBI among children living in South Korea with no known history of TB contact for the identification of additional high-risk groups. We investigated the risk factors for LTBI among US visa applicant children, who undergo LTBI screening regardless of their TB contact history. METHODS: We obtained data on demographic characteristics, medical history, Bacillus Calmette-Guerin (BCG) vaccination history, and results of LTBI screening for children aged 2-14 years. A tuberculin skin test was used for the diagnosis of LTBI, and an induration of 10 mm or greater was used to define a positive test. Adjusted odds ratios and 95% confidence intervals were calculated to determine the association between clinical and demographic variables and LTBI. RESULTS: Of the 1,664 study participants, 91 (5.5%) had LTBI. The binary logistic regression analysis showed that children born in high TB burden foreign countries had the highest odds of LTBI when considering all the risk factors investigated. Increasing age, absence of BCG vaccination, and a previous diagnosis of asthma were also significant risk factors for LTBI. CONCLUSION: These results indicate that children born in high TB burden foreign countries should be considered a high-risk group for LTBI in South Korea; the inclusion of these children in LTBI screening should be considered.

The effect of knee flexor and extensor fatigue on shock absorption during cutting movements after a jump landing.

BACKGROUND: Sporting situations include instances of continuous and/or integrated movements. However, the effect of fatigue on the performance of these movements remains unclear. PURPOSE: To investigate the effect of knee flexor and extensor fatigue on the shock absorption strategy of the lower limb during cutting movements performed after jump landings. METHODS: Twenty-four healthy participants performed cutting movements following jump landings from two heights - 30cm and 40cm - and under three levels of lower limb fatigue: pre-fatigue (100% peak knee extension torque), and post-fatigue 50% (post-50%) and 30% (post-30%) peak knee extension torque. Fatigue was induced by repeated isokinetic flexion/extension of the knee (60°/s). RESULTS: Compared to the pre-fatigue condition, power and work at the knee joint decreased under both post-50% and post-30% conditions (P<0.001), while the work performed by the ankle (P<0.001) increased significantly. An increase in height from 30cm to 40cm was associated with an increase in the range of motion of the ankle (P<0.001) and knee (P=0.022), peak vertical ground reaction force (P<0.001), rate of loading (P<0.001), knee stiffness (P=0.026) and peak power of the knee (P<0.001), as well as the work performed by the knee (P<0.001) and hip (P<0.001) joints. CONCLUSIONS: Under substantial muscle fatigue the proportion of shock absorption contributed by the knee for cutting movements performed after jump landings from a height of 40cm decreased; there was an adaptive increase in the contribution by the ankle.