Automated design of robust discriminant analysis classifier for foot pressure lesions using kinematic data

In the recent years, the use of motion tracking systems for acquisition of functional biomechanical gait data, has received increasing interest due to the richness and accuracy of the measured kinematic information. However, costs frequently restrict the number of subjects employed, and this makes the dimensionality of the collected data far higher than the available samples. This paper applies discriminant analysis algorithms to the classification of patients with different types of foot lesions, in order to establish an association between foot motion and lesion formation. With primary attention to small sample size situations, we compare different types of Bayesian classifiers and evaluate their performance with various dimensionality reduction techniques for feature extraction, as well as search methods for selection of raw kinematic variables. Finally, we propose a novel integrated method which fine-tunes the classifier parameters and selects the most relevant kinematic variables simultaneously. Performance comparisons are using robust resampling techniques such as Bootstrap$632+$and k-fold cross-validation. Results from experimentations with lesion subjects suffering from pathological plantar hyperkeratosis, show that the proposed method can lead to$sim 96$correct classification rates with less than 10% of the original features

The Association Between Health Literacy and Diet Adherence Among Primary Care Patients with Hypertension

This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between adequate health literacy and adherence to a low-salt diet (OR = 1.06, 95% CI: 0.36-3.10) after adjusting for confounders. This study addresses the conflicting findings for health literacy in two related areas: chronic illness self-care, and nutrition/diet skills. Additional research is warranted among black Americans given their increased risk of hypertension, low rates of diet adherence and previous findings of positive associations between health literacy and nutrition skills

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

Background: The Root paradigm of foot function continues to underpin the majority of clinical foot biomechanics practice and foot orthotic therapy. There are great number of assumptions in this popular paradigm, most of which have not been thoroughly tested. One component supposes that patterns of plantar pressure and associated hyperkeratosis lesions should be associated with distinct rearfoot, mid foot, first metatarsal and hallux kinematic patterns. Our aim was to investigate the extent to which this was true. Methods: Twenty-seven subjects with planter pathological hyperkeratosis were recruited into one of two groups. Group 1 displayed pathological plantar hyperkeratosis only under metatarsal heads 2, 3 and 4 (n = 14). Group 2 displayed pathological plantar hyperkeratosis only under the 1st and 5th metatarsal heads (n = 13). Foot kinematics were measured using reflective markers on the leg, heel, midfoot, first metatarsal and hallux. Results: The kinematic data failed to identify distinct differences between these two groups of subjects, however there were several subtle (generally <3°) differences in kinematic data between these groups. Group 1 displayed a less everted heel, a less abducted heel and a more plantarflexed heel compared to group 2, which is contrary to the Root paradigm. Conclusions: There was some evidence of small differences between planter pathological hyperkeratosis groups. Nevertheless, there was too much similarity between the kinematic data displayed in each group to classify them as distinct foot types as the current clinical paradigm proposes

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

Background: The Root paradigm of foot function continues to underpin the majority of clinical foot biomechanics practice and foot orthotic therapy. There are great number of assumptions in this popular paradigm, most of which have not been thoroughly tested. One component supposes that patterns of plantar pressure and associated hyperkeratosis lesions should be associated with distinct rearfoot, mid foot, first metatarsal and hallux kinematic patterns. Our aim was to investigate the extent to which this was true.Methods: Twenty-seven subjects with planter pathological hyperkeratosis were recruited into one of two groups.Group 1 displayed pathological plantar hyperkeratosis only under metatarsal heads 2, 3 and 4 (n = 14). Group 2displayed pathological plantar hyperkeratosis only under the 1st and 5th metatarsal heads (n = 13). Foot kinematicswere measured using reflective markers on the leg, heel, midfoot, first metatarsal and hallux.Results: The kinematic data failed to identify distinct differences between these two groups of subjects, howeverthere were several subtle (generally <3°) differences in kinematic data between these groups. Group 1 displayed aless everted heel, a less abducted heel and a more plantarflexed heel compared to group 2, which is contrary tothe Root paradigm.Conclusions: There was some evidence of small differences between planter pathological hyperkeratosis groups.Nevertheless, there was too much similarity between the kinematic data displayed in each group to classify themas distinct foot types as the current clinical paradigm proposes

Interaction between the NS4B amphipathic helix, AH2, and charged lipid headgroups alters membrane morphology and AH2 oligomeric state — Implications for the Hepatitis C virus life cycle

AbstractThe non-structural protein 4B (NS4B) from Hepatitis C virus (HCV) plays a pivotal role in the remodelling of the host cell's membranes, required for the formation of the viral replication complex where genome synthesis occurs. NS4B is an integral membrane protein that possesses a number of domains vital for viral replication. Structural and biophysical studies have revealed that one of these, the second amphipathic N-terminal helix (AH2), plays a key role in these remodelling events. However, there is still limited understanding of the mechanism through which AH2 promotes these changes. Here we report on solid-state NMR and molecular dynamics studies that demonstrate that AH2 promotes the clustering of negatively charged lipids within the bilayer, a process that reduces the strain within the bilayer facilitating the remodelling of the lipid bilayer. Furthermore, the presence of negatively charged lipids within the bilayer appears to promote the disassociation of AH2 oligomers, highlighting a potential role for lipid recruitment in regulating NS protein interactions

Randomized Trial to Compare the Immunogenicity and Safety of a CRM or TT Conjugated Quadrivalent Meningococcal Vaccine in Teenagers who Received a CRM or TT Conjugated Serogroup C Vaccine at Preschool Age

Protection after meningococcal C (MenC) conjugate (MCC) vaccination in early childhood is short-lived. Boosting with a quadrivalent vaccine in teenage years, a high-risk period for MenC disease, should protect against additional serogroups but might compromise MenC response. The carrier protein in the primary MCC vaccine determines the response to MCC booster in toddlers, but the relationship between primary vaccine and booster given later is unclear. This study compared responses to a CRM-conjugated or tetanus toxoid (TT)-conjugated MenACWY vaccine in teenagers primed with different MCC vaccines at preschool age

The association between client type and condom use with steady and unsteady partners among persons seeking HIV testing and counseling services in Kenya

Background: Approximately 70% of global HIV infections are located in sub-Saharan Africa, and the prevalence of HIV infection in Kenya remains high. Objectives: This study examined the association between client type (general population, commercial sex worker [CSW], or truck driver) and consistent condom use with steady and unsteady partners. Methods: Self-reported data included in the Kenyan Ministry of Health 2010-2011 National HIV Testing and Counseling Registry were used (n=11,567). Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using logistic regression. Results: After adjustment, CSWs and truck drivers had decreased odds of consistent condom use with steady partners compared to the general population (OR=0.52; 95% CI: 0.41-0.67 and OR=0.29; 95% CI: 0.13-0.63; respectively). CSWs had 1.95 times the odds of consistent condom use (95% CI: 1.58-2.42) and truck drivers had 0.64 times the odds of consistent condom use with unsteady partners (95% CI: 0.45-0.91) compared to the general population. Conclusion: Although CSWs consistently use condoms with their unsteady partners, truck drivers do not consistently use condoms with any partners. Future HIV prevention efforts should target CSWs and truck drivers to increase consistent condom use with all partners. Such efforts may decrease the prevalence of HIV in Kenya