Construction and verification of an intelligent measurement model for diabetic foot ulcer / 中南大学学报(医学版)

OBJECTIVES@#The measurement of diabetic foot ulcers is important for the success in diabetic foot ulcer management. At present, it lacks the accurate and convenient measurement tools in clinical. In recent years, artificial intelligence technology has demonstrated the potential application value in the field of image segmentation and recognition. This study aims to construct an intelligent measurement model of diabetic foot ulcers based on the deep learning method, and to conduct preliminary verification.@*METHODS@#The data of 1 042 diabetic foot ulcers clinical samples were collected. The ulcers and color areas were manually labeled, of which 782 were used as the training data set and 260 as the test data set. The Mask RCNN ulcer tissue color semantic segmentation and RetinaNet scale digital scale target detection were used to build a model. The training data set was input into the model and iterated. The test data set was used to verify the intelligent measurement model.@*RESULTS@#This study established an intelligent measurement model of diabetic foot ulcers based on deep learning. The mean average precision@.5 intersection over union (mAP@.5IOU) of the color region segmentation in the training set and the test set were 87.9% and 63.9%, respectively; the mAP@.5IOU of the ruler scale digital detection in the training set and the test set were 96.5% and 83.4%, respectively. Compared with the manual measurement result of the test sample, the average error of the intelligent measurement result was about 3 mm.@*CONCLUSIONS@#The intelligent measurement model has good accuracy and robustness in measuring the diabetic foot ulcers. Future research can further optimize the model with larger-scale data samples.

Knowledge, attitude, and practice survey regarding coronavirus disease 2019 among residents in Hunan Province / 中南大学学报(医学版)

OBJECTIVES@#To evaluate residents' knowledge, attitude and behavior towards coronavirus disease 2019 (COVID-19) in Hunan Province, and to explore the factors influencing behaviors.@*METHODS@#A self-designed questionnaire was used to conduct an online survey for 4 139 Hunan residents. The contents included general population information, residents' knowledge, attitude and practice to COVID-19.@*RESULTS@#Mean scores of knowledge, attitude, and behavior were 29.82±3.16, 6.71±1.12, and 14.93±1.45, respectively. Residents had the highest score of major symptoms of COVID-19 (3.96±0.39), but the lowest was the main transmission routes (3.47±0.89). A total of 22.68% of the residents were very or relatively afraid of the outbreak, but 95.22% of the residents had confidence in defeating COVID-19. In behavior dimension, "handling of suspicious symptoms" had the lowest score (3.58±0.75). The behavior implementation rate of "keep the surfaces of household items clean" (80.50%), "doing more exercise, reasonable diet, working and resting regularly" (84.59%), and "avoid hand contacting with eyes, mouth or nose" (89.51%) were relatively low. Pearson correlation coefficient showed that the knowledge, attitude, and practices score were correlated with each other (knowledge vs behavior: =0.366; knowledge vs attitude: =0.041; attitude vs behavior: =0.100; all <0.05). Multiple linear regression analysis showed that the knowledge, attitude and behavior on COVID-19 were mostly influenced by education background (all <0.05), and the independent factors affecting behavior included knowledge and attitude, gender, permanent residence, education background (all <0.05).@*CONCLUSIONS@#Residents in Hunan Province have a good knowledge, attitude, and behavior to COVID-19. Nevertheless there are still weak links to be improved in all dimensions. It is necessary to strengthen knowledge and behavior of family protection, and care for residents' psychological health, especially persons with low education degree, male and rural residents.

Clinical analysis for patients with diabetic foot among multiple centers in China / 中南大学学报(医学版)

To explore the clinical characteristics, risk factors and factors affecting the severity of the disease in patients with diabetic foot at the current stage through a multi-center cross-sectional survey.
 Methods: Clinical data of 326 patients with diabetic foot (205 males and 121 females) from 13 general hospitals nationwide were collected from October to November 2017 using a unified clinical data collection table. The clinical characteristics were analyzed, and the influential factors for severe diabetic foot were analyzed by logistic regression analysis.
 Results: Among 326 patients with diabetic foot, 68.4% of the patients were more than 60 years old, and 60.1% of the patients received primary or junior high school education; 96.3% of the patients developed Type 2 diabetes; 80.1% of patients had glycated hemoglobin (HbA1c)≥7%; 60.1% of patients suffered dyslipidemia. Improper wearing of footwear (38.5%) is the main cause of diabetic foot. Diabetic neuropathy (76.7%), diabetic retinopathy (62.3%) and lower limb vascular disease (57.4%) were the most common complications. Logistic regression analysis showed that diabetic nephropathy, diabetic lower extremity vascular disease, and HbA1c levels were independent risk factors for severe diabetic foot, and receiving foot care education can be regarded as a protective factor.
 Conclusion: The diabetic foot occurs mostly in male patients, and Type 2 diabetes with older age, lower education level, poor glycemic control and dyslipidemia are the risk factors. Diabetic nephropathy, diabetic lower extremity vascular disease, HbA1c, and receiving foot care education are independent influential factors for the severity of diabetic foot.