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Jeong Bae Ko,1,* Kwang Bok Kim,1,* Young Sub Shin,1 Hun Han,1 Sang Kuy Han,2 Duk Young Jung,3 Jae Soo Hong1 1Digital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South Korea; 2Robotics R&D Department, Korea Institute of Industrial Technology, Ansan, Gyeonggi-do, South Korea; 3Seongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South Korea*These authors contributed equally to this workCorrespondence: Jae Soo HongDigital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South KoreaTel +82 41-589-8412Fax +82 41-589-8413Email jshong94@kitech.re.krDuk Young JungSeongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South KoreaTel +82 41-589-8412Email dyjung@eulji.ac.krPurpose: Sarcopenia is a symptom in which muscle mass decreases due to decreasing in the number of muscle fibers and muscle cross-sectional area as aging. This study aimed to develop a machine learning classification model for predicting sarcopenia through a inertial measurement unit (IMU)-based physical performance measurement data of female elderly.Patients and Methods: Seventy-eight female subjects from an elderly population (aged: 78.8± 5.7 years) volunteered to participate in this study. To evaluate the physical performance of the elderly, the experiment conducted timed-up-and-go test (TUG) and 6-minute walk test (6mWT) with worn a single IMU. Based on literature review, 132 features were extracted from collected data. Feature selection was performed through the Kruskal–Wallis test, and features datasets were constructed according to feature selection. Three major machine learning-based classification algorithms classified the sarcopenia group in each dataset, and the performance of classification models was compared.Results: As a result of comparing the classification model performance for sarcopenia prediction, the k-nearest neighborhood algorithm (kNN) classification model using 40 major features of TUG and 6mWT showed the best performance at 88%.Conclusion: This study can be used as a basic research for the development of self-monitoring technology for sarcopenia.Keywords: sarcopenia, physical activity, machine learning, inertial measurement unit

Dohyung Lim,1 ChoongYeon Kim,2 HoHyun Jung,1 Dukyoung Jung,3 Keyoung Jin Chun21Department of Mechanical Engineering, Sejong University, Seoul, Republic of Korea; 2Advanced Biomedical Engineering Lab, Korea Institute of Industrial Technology, Cheonan, Republic of Korea; 3R&D Team, Senior Products Industrial Center, Busan, Republic of KoreaAbstract: The risk of falling increases significantly in the elderly because of deterioration of the neural musculature regulatory mechanisms. Several studies have investigated methods of preventing falling using real-time systems to evaluate balance; however, it is difficult to monitor the results of such characterizations in real time. Herein, we describe the use of Microsoft’s Kinect depth sensor system to evaluate balance in real time. Six healthy male adults (25.5±1.8 years, 173.9±6.4 cm, 71.4±6.5 kg, and 23.6±2.4 kg/m2), with normal balance abilities and with no musculoskeletal disorders, were selected to participate in the experiment. Movements of the participants were induced by controlling the base plane of the balance training equipment in various directions. The dynamic motion of the subjects was measured using two Kinect depth sensor systems and a three-dimensional motion capture system with eight infrared cameras. The two systems yielded similar results for changes in the center of body mass (P>0.05) with a large Pearson’s correlation coefficient of γ>0.60. The results for the two systems showed similarity in the mean lower-limb joint angle with flexion–extension movements, and these values were highly correlated (hip joint: within approximately 4.6°; knee joint: within approximately 8.4°) (0.400.05). Large differences with a low correlation were, however, observed for the lower-limb joint angle in relation to abduction–adduction and internal–external rotation motion (γ

Objective: To determine the mechanisms by which blockade of adenosine A(2B) receptors (A(2B)Rs) reduces insulin resistance.Research Design and Methods: We investigated the effects of deleting or blocking the A(2B)R on insulin sensitivity using glucose tolerance tests (GTTs) and hyperinsulinemic-euglycemic clamps in mouse models of type 2 diabetes. The effects of diabetes on A(2B)R transcription and signaling were measured in human and mouse macrophages and mouse endothelial cells. In addition, tag single nucleotide polymorphisms (SNPs) in ~42 kb encompassing the A(2B)R gene, ADORA2B, were evaluated for associations with markers of diabetes and inflammation.Results: Treatment of mice with the nonselective adenosine receptor agonist 5'-N-ethylcarboxamidoadensoine (NECA) increased fasting blood glucose and slowed glucose disposal during GTTs. These responses were inhibited by A(2B)R deletion or blockade and minimally affected by deletion of A(1)Rs or A(2A)Rs. During hyperinsulinemic-euglycemic clamp of diabetic KKA(Y) mice, A(2B)R antagonism increased glucose infusion rate, reduced hepatic glucose production, and increased glucose uptake into skeletal muscle and brown adipose tissue. Diabetes caused a four- to sixfold increase in A(2B)R mRNA in endothelial cells and macrophages and resulted in enhanced interleukin (IL)-6 production in response to NECA due to activation of protein kinases A and C. Five consecutive tag SNPs in ADORA2B were highly correlated with IL-6 and C-reactive protein (CRP). Diabetes had a highly significant independent effect on variation in inflammatory markers. The strength of associations between several ADORA2B SNPs and inflammatory markers was increased when accounting for diabetes status.Conclusions: Diabetes affects the production of adenosine and the expression of A(2B)Rs that stimulate IL-6 and CRP production, insulin resistance, and the association between ADORA2B SNPs and inflammatory markers. We hypothesize that increased A(2B)R signaling in diabetes increases insulin resistance in part by elevating proinflammatory mediators. Selective A(2B)R blockers may be useful to treat insulin resistance. [ABSTRACT FROM AUTHOR]

Objective: Liver-specific inactivation of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) by a dominant-negative transgene (l-SACC1 mice) impaired insulin clearance, caused insulin resistance, and increased hepatic lipogenesis. To discern whether this phenotype reflects a physiological function of CEACAM1 rather than the effect of the dominant-negative transgene, we characterized the metabolic phenotype of mice with null mutation of the Ceacam1 gene (Cc1(-/-)).Research Design and Methods: Mice were originally generated on a mixed C57BL/6x129sv genetic background and then backcrossed 12 times onto the C57BL/6 background. More than 70 male mice of each of the Cc1(-/-) and wild-type Cc1(+/+) groups were subjected to metabolic analyses, including insulin tolerance, hyperinsulinemic-euglycemic clamp studies, insulin secretion in response to glucose, and determination of fasting serum insulin, C-peptide, triglyceride, and free fatty acid levels.Results: Like l-SACC1, Cc1(-/-) mice exhibited impairment of insulin clearance and hyperinsulinemia, which caused insulin resistance beginning at 2 months of age, when the mutation was maintained on a mixed C57BL/6x129sv background, but not until 5-6 months of age on a homogeneous inbred C57BL/6 genetic background. Hyperinsulinemic-euglycemic clamp studies revealed that the inbred Cc1(-/-) mice developed insulin resistance primarily in liver. Despite substantial expression of CEACAM1 in pancreatic beta-cells, insulin secretion in response to glucose in vivo and in isolated islets was normal in Cc1(-/-) mice (inbred and outbred strains).Conclusions: Intact insulin secretion in response to glucose and impairment of insulin clearance in l-SACC1 and Cc1(-/-) mice suggest that the principal role of CEACAM1 in insulin action is to mediate insulin clearance in liver. [ABSTRACT FROM AUTHOR]

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program. [ABSTRACT FROM AUTHOR]