Abstract: Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.
Abstract: Objectives: The main objective of this study was to examine the association between the elevated level of C-reactive protein (CRP) and incidence of hypertension before and after adjustments for age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL, and to determine whether the association differs by race. Method: Cross sectional data for participants from aged 17 years to 74 years, included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. The CRP level was classified into three categories (> 3 mg/L, between 1 mg/L and 3 mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 indicator. Hypertension is defined as either systolic blood pressure (SBP) of 140 mmHg or more and diastolic blood pressure (DBP) of 90 mmHg or more, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as 139 ≥ SBP > 120 or 89 ≥ DBP >80. Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexicans had the highest risk of incident hypertension (OR = 2.39; 95% CI, 2.21-2.58). This risk was statistically insignificant after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08), or categorized by race [American Mexican: OR= 1.58; 95% CI, 0.58-4.26, Other Hispanic: OR = 0.87; 95% CI, 0.19-4.42, Non-Hispanic white: OR = 0.90; 95% CI, 0.50-1.59, Non-Hispanic Black: OR = 0.44; 95% CI, 0.22-0.87. The same results were found for pre-hypertension, and the Non-Hispanic black segment showed the highest significant risk for Pre-Hypertension (OR = 1.60; 95% CI, 1.26-2.03). When CRP concentrations were between 1.0 and 3.0 mg/L in unadjusted models, prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. Contrary, hypertension was not independently associated with elevated CRP, and the results were the same after being grouped by race or adjustments for the possible confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables.
Abstract: Availability of different genetic tests after completion
of Human Genome Project increases the physicians’ responsibility to
keep themselves update on the potential implementation of these
genetic tests in their daily practice. However, due to numbers of
barriers, still many of physicians are not either aware of these tests or
are not willing to offer or refer their patients for genetic tests. This
study was conducted an anonymous, cross-sectional, mailed-based
survey to develop a primary data of Malaysian physicians’ level of
knowledge and perception of gene profiling. Questionnaire had 29
questions. Total scores on selected questions were used to assess the
level of knowledge. The highest possible score was 11. Descriptive
statistics, one way ANOVA and chi-squared test was used for
statistical analysis. Sixty three completed questionnaires were
returned by 27 general practitioners (GPs) and 36 medical specialists.
Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4).
About 40% of the participants rated themselves as having poor level
of knowledge in genetics in general whilst 60% believed that they
have fair level of knowledge; however, almost half (46%) of the
respondents felt that they were not knowledgeable about available
genetic tests. A majority (94%) of the responders were not aware of
any lab or company which is offering gene profiling services in
Malaysia. Only 4% of participants were aware of using gene profiling
for detection of dosage of some drugs. Respondents perceived greater
utility of gene profiling for breast cancer (38%) compared to the
colorectal familial cancer (3%). The score of knowledge ranged from
2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score
of knowledge of GPs and specialists were observed, with score of
4.19 and 4.58 respectively. There was no significant association
between any demographic factors and level of knowledge. However,
those who graduated between years 2001 to 2005 had higher level of
knowledge. Overall, 83% of participants showed relatively high level
of perception on value of gene profiling to detect patient’s risk of
disease. However, low perception was observed for both statements
of using gene profiling for general population in order to alter their
lifestyle (25%) as well as having the full sequence of a patient
genome for the purpose of determining a patient’s best match for
treatment (18%). The lack of clinical guidelines, limited provider
knowledge and awareness, lack of time and resources to educate
patients, lack of evidence-based clinical information and cost of tests
were the most barriers of ordering gene profiling mentioned by
physicians. In conclusion Malaysian physicians who participate in
this study had mediocre level of knowledge and awareness in gene
profiling. The low exposure to the genetic questions and problems
might be a key predictor of lack of awareness and knowledge on
available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling
into practice for eligible patients.
Abstract: Sonogram images of normal and lymphocyte thyroid tissues have considerable overlap which makes it difficult to interpret and distinguish. Classification from sonogram images of thyroid gland is tackled in semiautomatic way. While making manual diagnosis from images, some relevant information need not to be recognized by human visual system. Quantitative image analysis could be helpful to manual diagnostic process so far done by physician. Two classes are considered: normal tissue and chronic lymphocyte thyroid (Hashimoto's Thyroid). Data structure is analyzed using K-nearest-neighbors classification. This paper is mentioned that unlike the wavelet sub bands' energy, histograms and Haralick features are not appropriate to distinguish between normal tissue and Hashimoto's thyroid.