Movement Function Assessment Based on Human Pose Estimation from Multi-View

Human pose estimation is a basic and critical task in the field of computer vision that involves determining the position(or spatial coordinates)of the joints of the human body in a given image or video.It is widely used in motion analysis,medical evaluation,and behavior monitoring.In this paper,the authors propose a method for multi-view human pose estimation.Two image sensors were placed orthogonally with respect to each other to capture the pose of the subject as they moved,and this yielded accurate and comprehensive results of three-dimensional(3D)motion reconstruction that helped capture their multi-directional poses.Following this,we propose a method based on 3D pose estimation to assess the similarity of the features of motion of patients with motor dysfunction by comparing differences between their range of motion and that of normal subjects.We converted these differences into Fugl–Meyer assessment(FMA)scores in order to quantify them.Finally,we implemented the proposed method in the Unity framework,and built a Virtual Reality platform that provides users with human–computer interaction to make the task more enjoyable for them and ensure their active participation in the assessment process.The goal is to provide a suitable means of assessing movement disorders without requiring the immediate supervision of a physician.

Functional Assessment of Typical Wetlands in Shangri-La

The development and protection of Shangri-La wetlands in southwestern Yunnan Province is of great significance for the protection of regional biodiversity, ecotourism and regional development. To specify the functions of Shangri-La wetlands, with the help of Analytic Hierarchy Process (AHP), 7 typical wetlands in Shangri-La (Bita Lake Wetland, Napa Lake Wetland, Shudu Lake Wetland, Dazhongdian Wetland, Xiaozhongdian Wetland, Dahei Lake Wetland, Jinsha River Wetland) were selected for the quantitative analysis of 20 indexes in 3 comprehensive assessment layers (service functions, protective functions and production functions). The results showed that Shangri-La wetlands followed the below sequence in function: Bita Lake Wetland (0.811 4), Shudu Lake Wetland (0.739 3), Napa Lake Wetland (0.695 3), Dahei Lake Wetland (0.659 5), Jinsha River Wetland (0.614 3), Dazhongdian Wetland (0.520 4) and Xiaozhongdian Wetland (0.505 2). As single indexes of those wetlands were compared, it was found that values of certain indexes varied greatly, and value differences among 5 of 20 indexes even reached more than 100%, among which that of water supply capacity and tourism recreational value (164.60%) remained the highest, then water supplementation capacity (121.17%) and habitat stability (109.05%), and others varied between 5.58%-91.10%. The assessment results were similar to actual conditions, thus such a method was proved scientific and practical.

Agroecosystem functional assessment and its difficulties

Agroecosystem functional assessment indicators provide a necessary bridge between decision makers and scientists. The development of acceptable indicators, however, remains a difficult task because the current knowledge and understanding of ecosystems is not sufficient to allow an objective assessment of all ecosystem functions. These difficulties were summarized from three perspectives. First, there are difficulties in individual function assessment. Of the four functions associated with agroecosystems energy flow, materials cycling, information flow and value flow data on material cycling and information flow remain difficult to obtain and the indicators relatively immature. Secondly, there are difficulties of integration. During the assessment process, the integration of the agroecosystem functions remains the biggest obstacle. Until now, there has been no practical or effective methodology established to resolve the problem. At present, the makeshift approach has been to weight the various indicators and then add them together. Thirdly, there is the problem of obscure concepts and concept confusion. When assessments of agroecosystems are conducted, concepts such as structure, function, benefit, and resource utilization are used extensively. To date, no logical relationship(either real or implied) has been developed between any of these concepts. Are they causes and results such that the relationship between them is linear, or are they independent from one another such that the relationship is parallel? Thus far, the essence of this question is yet to be explored.

An Exploratory Investigation of Difficulties in Applying Functional Behavior Assessment and Implementing Behavioral Intervention Plans in ADHD Programs in Saudi Arabia

Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA procedures and,in turn,BIPs because of lack of time,insufficient training,and multiplicity of beliefs.Thus,it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans.This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions.This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs.Using the descriptive-analytical approach,a questionnaire targeting difficulties and barriers was admi-nistered to 209 public school teachers from specialized ADHD programs in Saudi Arabia.The results revealed that the difficulty level of applying FBA in ADHD programs was high.The level of barriers in implementing BIPs was moderate.Finally,the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA.The results suggest the importance offinding better practices,restructuring the provision of ADHD programs,training teachers,improving assessment tool availability,and ensuring cooperation between school administrators and teachers.

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Prostate cancer （PCa） is the most common visceral malignancy in men with androgen deprivation therapy （ADT） the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data （up to 2 years） for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality.

Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.

Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma

AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages ⅡΙ, ⅢA and ⅢB (P = 0.002vs StageⅠ). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.

Preclinical animal studies in ischemic stroke:Challenges and some solutions

Despite the impressive efficacies demonstrated in preclinical research,hundreds of potentially neuroprotective drugs have failed to provide effective neuroprotec-tion for ischemic stroke in human clinical trials.Lack of a powerful animal model for human ischemic stroke could be a major reason for the failure to develop successful neuroprotective drugs for ischemic stroke.This review recapitulates the available cerebral ischemia animal models,provides an anatomical comparison of the circle of Willis of each species,and describes the functional assessment tests used in these ischemic stroke models.The distinct differences between human ischemic stroke and experimental stroke in available animal models is explored.Innovative animal models more closely resembling human strokes,better techniques in functional out-come assessment and better experimental designs generating clearer and stronger evidence may help realise the development of truly neuroprotective drugs that will benefit human ischemic stroke patients.This may involve use of newer molecules or revisiting earlier studies with new experimental designs.Translation of any resultant successes may then be tested in human clinical trials with greater confidence and optimism.

Evaluation of biodegradable electric conductive tube-guides and mesenchymal stem cells

AIM: To study the therapeutic effect of three tubeguides with electrical conductivity associated to mesenchymal stem cells(MSCs) on neuro-muscular regeneration after neurotmesis.METHODS: Rats with 10-mm gap nerve injury were tested using polyvinyl alcohol(PVA), PVA-carbon nanotubes(CNTs) and MSCs, and PVA-polypyrrole(PPy). The regenerated nerves and tibialis anterior muscles were processed for stereological studies after 20 wk. The functional recovery was assessed serially for gait biomechanical analysis, by extensor postural thrust, sciatic functional index and static sciatic functionalindex(SSI), and by withdrawal reflex latency(WRL). In vitro studies included cytocompatibility, flow cytometry, reverse transcriptase polymerase chain reaction and karyotype analysis of the MSCs. Histopathology of lung, liver, kidneys, and regional lymph nodes ensured the biomaterials biocompatibility. RESULTS: SSI remained negative throughout and independently from treatment. Differences between treted groups in the severity of changes in WRL existed, showing a faster regeneration for PVA-CNTs-MSCs(P < 0.05). At toe-off, less acute ankle joint angles were seen for PVA-CNTs-MSCs group(P = 0.051) suggesting improved ankle muscles function during the push off phase of the gait cycle. In PVA-PPy and PVA-CNTs groups, there was a 25% and 42% increase of average fiber area and a 13% and 21% increase of the "minimal Feret's diameter" respectively. Stereological analysis disclosed a significantly(P < 0.05) increased myelin thickness(M), ratio myelin thickness/axon diameter(M/d) and ratio axon diameter/fiber diameter(d/D; g-ratio) in PVA-CNT-MSCs group(P < 0.05). CONCLUSION: Results revealed that treatment with MSCs and PVA-CNTs tube-guides induced better nerve fiber regeneration. Functional and kinematics analysis revealed positive synergistic effects brought by MSCs and PVA-CNTs. The PVA-CNTs and PVA-PPy are promising scaffolds with electric conductive properties, bio- and cytocompatible that might prevent the secondary neurogenic muscular atrophy by improving the reestablishment of the neuro-muscular junction.

Health-related quality of life in patients that have undergone liver resection:A systematic review and meta-analysis

BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.

Changes in motor function in the unaffected hand of stroke patients should not be ignored

Motor function changes in the unaffected hand of stroke patients with hemiplegia. These changes are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency and Lind-mark hand function score showed that the motor function of unaffected hands in stroke patients was poorer than that of a healthy control hand. After 2 weeks of rehabilitation treatment, motor function of the unaffected hand of stroke patients was obviously improved. Therefore, attention should also be paid to motor function in the unaffected hand of stroke patients with hemiplegia during rehabilitation.

Effectiveness and safety of human umbilical cord-mesenchymal stem cells for treating type 2 diabetes mellitus

BACKGROUND Progressive pancreaticβ-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus(T2DM).Cellular therapies offer novel opportunities for the treatment of T2DM to improve the function of isletβ-cells.AIM To evaluate the effectiveness and safety of human umbilical cord-mesenchymal stem cell(hUC-MSC)infusion in T2DM treatment.METHODS Sixteen patients were enrolled and received 1×10^(6) cells/kg per week for 3 wk as intravenous hUC-MSC infusion.The effectiveness was evaluated by assessing fasting blood glucose,C-peptide,normal glycosylated hemoglobin A1c(HbA1c),insulin resistance index(homeostatic model assessment for insulin resistance),and isletβ-cell function(homeostasis model assessment ofβ-cell function).The dosage of hypoglycemic agents and safety were evaluated by monitoring the occurrence of any adverse events(AEs).RESULTS During the entire intervention period,the fasting plasma glucose level was significantly reduced[baseline:9.3400(8.3575,11.7725),day 14±3:6.5200(5.2200,8.6900);P<0.01].The HbA1c level was significantly reduced on day 84±3[baseline:7.8000(7.5250,8.6750),day 84±3:7.150(6.600,7.925);P<0.01].The patients’isletβ-cell function was significantly improved on day 28±3 of intervention[baseline:29.90(16.43,37.40),day 28±3:40.97(19.27,56.36);P<0.01].The dosage of hypoglycemic agents was reduced in all patients,of whom 6(50%)had a decrement of more than 50%and 1(6.25%)discontinued the hypoglycemic agents.Four patients had transient fever,which occurred within 24 h after the second or third infusion.One patient(2.08%)had asymptomatic nocturnal hypoglycemia after infusion on day 28±3.No liver damage or other side effects were reported.CONCLUSION The results of this study suggest that hUC-MSC infusion can improve glycemia,restore isletβ-cell function,and reduce the dosage of hypoglycemic agents without serious AEs.Thus,hUC-MSC infusion may be a novel option for the treatment of T2DM.

The circulation physiology of agroecosystems

This paper represents an effort to enlarge the understanding of the biophysical foundation of agroecosystemsby using an analogy with the circulation of the blood in the human body. The circulation function in the human body canbe represented as arterial pressure. The factors affecting arterial pressure in the human body have direct counterpartsin the cultivation-husbandry system. The relationship between circulation pressure and the factors affecting that pressurein the cultivation-husbandry system are similar to the relationship between the arterial pressure and factors affectingarterial pressure in the human body. Furthermore, circulation resistance in the cultivation-husbandry system can beshown to be analogous to the calculation of peripheral resistance in the human body by Poiseuille’s formula.

Assessment of slow pathway function after successful radiofrequency modification in patients with typical AV nodal reentry tachycardia by the use of the maximal AH interval

Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compared two methods (maximal AH interval during decremental atrial stimlation vs occurrence of AV nodal echos or dual AV nodal physiology (DAVNP): ≥50 msec increment in AH interval with a 10 msec decrement in A1A2) for the assessment of SP function immediately and 40 minutes after successful RF modification of SP. In 31 consecutive patients (age: 51±16 years, 18 women, 13 men) with typical AVNRT, SP modification was performed using a combined anatomic and electrogram guided approach. Immediately after successful SP modification, AV nodal function was assessed. This was repeated 40 minutes later. RF modification of SP was successful in all 31 patients. There was no recurrance during a 5±3 month follow up period. There was no significant difference between the electrophysiological parameters immediately and University of Frankfurt, Germany (Li YG, Bogun F, Grnefeld G, Hohnloser SH and Goethe JW)40 min after successful SP modification. There was evidence of SP function in 14 patients (6 with DAVNP+AV nodal echoes, 8 with either DAVNP or AV nodal echos) immehiately after SP modification. These patients could be differentiated from the patients without remaining SP function by maximal AH interval (298±102 msec vs 198±72 msec, P=0.004). 40 minutes after the suucessful SP modification, 11 patients displayed SP function (4 patients with DAVNP+AV nodal echos, 7 patients with either DAVNP or AV nodal echos). These patients could also be differentiated from the remaining patients with the use of the maximal AH interval (294±89 msec vs 189±50 msec, P<0.001).[BHDFG3,WK9ZQ,WK6,WK10*2,WK5W]Befroe SP modificationImmediately after RF40 min after RF[BHDZG1*2,WK9ZQ,WK6,WK10*2,WK5W]AVNERP (msec)258±44310±116316±114AVBCL (msec)330±55384±113376±110VABCL (msec)306±67306± 66311±54Max AH (msec)337±96247±100233±86 Conclusion SP function assessed immediately and 40 minutes after a successful SP modification remains stable. SP function can be assessed reliable by maximal AH interval during decremental atrial stimulation.

Assessment of the Endothelial Function with Changed Volume of Brachial Artery by Menstrual Cycle

The endothelial function has been proven to be an important factor in the pathogenesis of atheroscle-rosis, hypertension and heart failure. The flow-mediated vasodilation (FMD) of the peripheral artery is an endothelium-dependent function. Brachial-artery ultrasound scanning is the popular method for evaluat-ing FMD.

Molecular and functional analysis of monoclonal antibodies in support of biologics development

Monoclonal antibody （mAb）-based therapeutics are playing an increasingly important role in the treatment or pre- vention of many important diseases such as cancers, autoimmune disorders, and infectious diseases. Multi- domain mAbs are far more complex than small molecule drugs with intrinsic heterogeneities. The critical quality attributes of a given mAb, including structure, post-trans- lational modifications, and functions at biomolecular and cellular levels, need to be defined and profiled in details during the developmental phases of a biologics. These critical quality attributes, outlined in this review, serve an important database for defining the drug properties during commercial production phase as well as post licensure life cycle managemenL Specially, the molecular characteriza- tion, functional assessment, and effector function analysis of mAbs, are reviewed with respect to the critical parame- ters and the methods used for obtaining them. The three groups of analytical methods are three essential and inte. gral facets making up the whole analytical package for a mAIPbased drug. Such a package is critically important for the licensure and the post-licensurs life cycle management of a therapeutic or prophylactic biologics. In addition, the basic principles on the evaluation of biosimilar mAbs were discussed briefly based on the recommendations by the World Health Organization.

Quality of life outcomes including neuropathy-associated scale from a phase II,multicenter,randomized trial of eribulin plus gemcitabine versus paclitaxel plus gemcitabine as first-line chemotherapy for HER2-negative metastatic breast cancer:Korean Cancer Study Group Trial(KCSG BR13-11)

Background: A phase II clinical trial of the comparison between eribulin plus gemcitabine (EG) and paclitaxel plus gemcitabine (PG) as first-line chemotherapy for patients with metastatic breast cancer (MBC) found that the EG regimen was less neurotoxic, but was similar in efficacy to the PG regimen. In the present study, we analyzed functional assessment of cancer therapy-taxane (FACT-Taxane) questionnaires from patients in this clinical trial to determine their quality of life (QoL). Methods: QoL was assessed using the Korean version of the FACT-Taxane questionnaires. After baseline assessment, QoL was assessed every 2 cycles for 12 cycles and every 3 cycles thereafter. The linear mixed model was used to evaluate the difference in QoL between the EG and PG arms. Results: Of the 118 enrolled patients, 117 responded to the FACT-Taxane questionnaires at baseline, 1 in the PG arm did not. Baseline QoL scores were not different between the EG and PG arms. During treatment, taxane subscale scores were significantly higher in the PG arm than in the EG arm after 2-13 cycles of chemotherapy (all P < 0.05), except for the 11th cycle. Neuropathy-specific analysis showed that patients in the PG arm had earlier and more severe neuropathic symptoms than those in the EG arm (P < 0.001). Conclusions: In our QoL analysis, the EG regimen delayed and decreased neuropathy as compared with the PG regimen. Therefore, eribulin would be a reasonable substitute for paclitaxel as first-line chemotherapy for MBC.