COVID-19 vaccination status in people with spinal cord injury: Results from a cross-sectional study in Thailand.

OBJECTIVE: To assess COVID-19 vaccination status among individuals with spinal cord injury (SCI). DESIGN: A cross-sectional study. SETTING: Twelve hospitals from all regions of Thailand. PARTICIPANTS: One hundred and eighty people with SCI were randomly selected from the Thai SCI registry database. INTERVENTION: Not applicable. OUTCOME MEASURES: The primary outcome, which was the COVID-19 vaccination status, and the secondary outcomes, which were the number of vaccination doses, satisfaction and dissatisfaction aspects, and barriers to vaccination, were recorded using a specifically developed questionnaire over the telephone during February to March 2022. Data were analyzed using descriptive analyses, bivariate, and multivariable analyses. RESULTS: Of the 96 people with SCI who were able to respond, the prevalence of receiving at least one dose was 77% but the prevalence of receiving a booster dose was 20%. Being non-traumatic SCI correlated negatively with having received any vaccination doses when compared to traumatic SCI. Most of the participants were satisfied with the government provision of COVID-19 vaccines. The major barriers to vaccination were problems related to a negative attitude toward the vaccination, followed by transportation difficulties and wheelchair-inaccessible vaccination sites. CONCLUSIONS: Seventy-seven percent of people with SCI participating in this study received at least one dose of the COVID-19 vaccine, whereas only 20% of them received a booster dose of the COVID-19 vaccination. To increase the prevalence of vaccination, healthcare providers should deliver the fact regarding COVID-19 vaccination to reduce negative attitudes, as well as remove physical barriers to vaccination places for people with SCI.

AI-Assisted Assessment of Wound Tissue with Automatic Color and Measurement Calibration on Images Taken with a Smartphone.

Wound assessment is essential for evaluating wound healing. One cornerstone of wound care practice is the use of clinical guidelines that mandate regular documentation, including wound size and wound tissue composition, to determine the rate of wound healing. The traditional method requires wound care professionals to manually measure the wound area and tissue composition, which is time-consuming, costly, and difficult to reproduce. In this work, we propose an approach for automatic wound assessment that incorporates automatic color and measurement calibration and artificial intelligence algorithms. Our approach enables the comparison of images taken at different times, even if they were taken under different lighting conditions, distances, lenses, and camera sensors. We designed a calibration chart and developed automatic algorithms for color and measurement calibration. The wound area and wound composition on the images were annotated by three physicians with more than ten years of experience. Deep learning models were then developed to mimic what the physicians did on the images. We examined two network variants, U-Net with EfficientNet and U-Net with MobileNetV2, on wound images with a size of 1024 × 1024 pixels. Our best-performing algorithm achieved a mean intersection over union (IoU) of 0.6964, 0.3957, 0.6421, and 0.1552 for segmenting a wound area, epithelialization area, granulation tissue, and necrotic tissue, respectively. Our approach was able to accurately segment the wound area and granulation tissue but was inconsistent with respect to the epithelialization area and necrotic tissue. The calibration chart, which helps calibrate colors and scales, improved the performance of the algorithm. The approach could provide a thorough assessment of the wound, which could help clinicians tailor treatment to the patient's condition.

Comparison between the plantar pressure effects of toe separators and insoles in patients with hallux valgus at a one-month follow-up.

BACKGROUND: Various designs of foot orthoses for hallux valgus have been developed to reduce foot pain. The plantar pressure assessment can determine the better intervention. This study aimed to compare the effectiveness of plantar pressure distribution in patients with hallux valgus during walking with toe separator and insole. METHOD: Patients with hallux valgus were randomized into one of two interventions: prefabricated toe separator or customized insole. The plantar pressure distribution of the participants was measured during walking with the devices after use for one month with an in-shoe measurement system. RESULTS: Twenty-three participants were analyzed. After 1-month, significant peak pressures and pressure-time integral reductions were observed during walking in the middle forefoot (64.28 kPa and 28.97 kPa s, respectively) and lateral forefoot regions (54.03 kPa and 22.30 kPa s, respectively) after insole use compared with a toe separator. CONCLUSIONS: After one month of use, the customized insole was more effective in plantar pressure reduction than the toe separator for a hallux deformity.

The insole materials influence the plantar pressure distributions in diabetic foot with neuropathy during different walking activities.

BACKGROUND: Abnormal peak plantar pressure in neuropathic diabetic foot during walking activities is well managed through the use of appropriate design and material selection for the fabrication of custom made insoles (CMI). The redistribution of plantar pressure is possible by selecting an appropriate material for the fabrication of CMI. The walking activities may alter the plantar pressure distribution; which may differ while using CMI with different materials. OBJECTIVE: The objective of the study was to evaluate the effectiveness of CMI's materials on plantar pressure distribution during different walking activities, in diabetic feet with neuropathy. METHODS: The study was conducted on sixteen diabetic neuropathic subjects. The subjects were provided with two types of CMI; CMI-A (Plastazote® and microcellular rubber) and CMI-B (Multifoam, Plastazote® and microcellular rubber). Maximum peak plantar pressure and plantar pressure distribution were determined by Pedar-X® sensor insole during level walking, ramp walking and stair walking. RESULTS: The CMI-B lessened the maximum peak plantar pressure from the forefoot throughout the walking activities compared to CMI-A. The contact area was observed as lower using CMI-A compared to CMI-B, while performing walking activities. CONCLUSION: CMI-B, with multifoam as an additional top layer, provided more effective peak plantar pressure reduction at forefoot and it had better plantar pressure distribution compared to CMI-A during level walking and ramp ascending in diabetic foot with neuropathy.