197 research outputs found

    A study of service quality assessment in property management of private housing estates in Hong Kong

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    Thesis (B.Sc)--University of Hong Kong, 2007.Includes bibliographical references (p. 128-132).published_or_final_versio

    Systematic Review of the Addition of Hip Strengthening Exercises for Adults with Patellofemoral Pain Syndrome

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    Patellofemoral Pain Syndrome (PFPS) is a common musculoskeletal disorder typically occurring in physically active people aged 40 years and younger, causing pain, functional deficits and lower limb weakness. Traditional treatment has been aimed at strengthening the knee, however recent research suggests the muscles around the hip also play an important role in the development and continuity of Patellofemoral Pain Syndrome. Purpose: To investigate the effectiveness of the addition of hip strengthening exercises to standard physiotherapy treatment (knee strengthening and stretching exercises) on reducing pain, and enhancing strength and function when compared to standard physiotherapy treatment alone in adults with Patellofemoral Pain Syndrome. Method: A systematic search of Cochrane, CINAHL, Embase, MEDLINE®, PEDro and SportDiscus was conducted. Studies of participants aged 18 to 44, diagnosed with Patellofemoral Pain Syndrome by a healthcare practitioner, or reporting peripatellar or retropatellar pain with common functional tasks, were included. A critical appraisal, using the Critical Appraisal Skills Program for Randomised Controlled Trials (CASP) was used to assess methodological quality. Results: Five randomised controlled trials of varying methodological quality met the inclusion criteria. The participants in these studies were aged between 18 to 40 years of age. The duration of the intervention ranged from four to six weeks consisting of 12 to 30 supervised exercise sessions. Studies used varying outcome measures for each of the three outcomes. Overall, the studies demonstrated that the addition of hip strengthening exercises to standard physiotherapy care consistently improved pain and function, but the impact on strength was variable. Conclusion: Previously, only a small number of studies have looked at the addition of hip exercises to standard physiotherapy care for treatment of Patellofemoral Pain Syndrome. While there is a growing body of evidence for the efficacy of hip strengthening exercises for Patellofemoral Pain Syndrome, this is constrained by bias towards female participants, lack of true controls in most studies, and low methodological quality of studies overall. Hip exercises added to standard physiotherapy care shows potential as a treatment method for improving outcomes of pain and function in adults with Patellofemoral Pain Syndrome

    RECOMMENDATIONS FOR MINIMUM TRIAL NUMBERS DURING WALKING GAIT

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    In a rehabilitation context, athletes may not be able to complete large numbers of trials during testing due to joint edema and pain. The purpose of this research was to determine the minimum number of trials needed to achieve a negligibly fluctuating temporal variance profile during walking gait. The time-series kinematics of the hip, knee and ankle were recorded from 10 participants, completing 11 trials each. The time-series variance of each kinematic variables were calculated for ten trials and used as a reference. Using a two-sample SPM1D {t} (α=0.05), all variance combinations (9, 8, 7, ... 3 of 11 trials) from the same participants were compared to the reference. Results showed a minimum of 7 trials were needed to achieve ’stable‘ kinematic variance during walking gait. This study provides evidence for selecting an appropriate number of walking trials in gait analysis, especially in early-stage rehabilitation for patients with joint pain or edema

    Surface design for immobilization of an antimicrobial peptide mimic for efficient anti‐biofouling

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    Microbial surface attachment negatively impacts a wide range of devices from water purification membranes to biomedical implants. Mimics of antimicrobial peptides (AMPs) constituted from poly(N‐substituted glycine) "peptoids" are of great interest as they resist proteolysis and can inhibit a wide spectrum of microbes. We investigate how terminal modification of a peptoid AMP‐mimic and its surface immobilization affect antimicrobial activity. We also demonstrate a convenient surface modification scheme for enabling alkyne‐azide "click" coupling on amino‐functionalized surfaces. Our results verified that the N‐ and C‐terminal peptoid structures are not required for antimicrobial activity. Moreover, our peptoid immobilization density and choice of PEG tether resulted in a "volumetric" spatial separation between AMPs that, compared to past studies, enabled the highest AMP surface activity relative to bacterial attachment. Our analysis suggests the importance of spatial flexibility for membrane activity and that AMP separation may be a controlling parameter for optimizing surface anti‐biofouling

    Weight Loss Surgery Utilization in Patients Aged 14–25 With Severe Obesity Among Several Healthcare Institutions in the United States

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    Introduction: Obesity is associated with early co-morbidities and higher mortality. Even though weight loss surgery (WLS) in adolescents with severe obesity reliably achieves safe and lasting improvement in BMI and superior resolution of comorbid diseases, its utilization among young patients in the clinical practice stands unclear.Objective: To show the prevalence of weight loss surgery utilization rates in adolescents and young adults among several healthcare institutions in the United States.Method: WLS in 14–25 years old between 2000 and 2017 was obtained from Washington University, Morehouse Medical, University of Texas, Wake Forest Baptist Medical Center, Beth Israel Deaconess Medical Center, Boston Children's Hospital, Boston Medical Center, and Partners Healthcare using the Shared Health Research Information Network (SHRINE) and Research Patient Data Registry (RPDR) web-based query tools. ICD-9 codes were used for bariatric surgery.Results: Among 2500635 individuals, 18008 (0.7%) had severe obesity. At Partners, 1879 patients had severe obesity, of which 404 (21.5%) underwent WLS, whereas at Washington University, 44 (2.5%) of 1788 the underwent WLS. 13 (2.3%) of the 575 at BIDMC, 43 (1.5%) of the 2969 at BMC, and 37 (0.4%) of 8908 at BCH underwent WLS (p < 0.0001 for all).Discussion: Even though WLS has shown to be the most effective treatment to create sustainable changes in metabolic derangements for moderate to severe obesity and its comorbidities, it has been underutilized. Further studies need to be conducted to ensure WLS is utilized for those patients who would achieve the most benefit

    Automated Machine Learning (AutoML)-Derived Preconception Predictive Risk Model to Guide Early Intervention for Gestational Diabetes Mellitus

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    The increasing prevalence of gestational diabetes mellitus (GDM) is contributing to the rising global burden of type 2 diabetes (T2D) and intergenerational cycle of chronic metabolic disorders. Primary lifestyle interventions to manage GDM, including second trimester dietary and exercise guidance, have met with limited success due to late implementation, poor adherence and generic guidelines. In this study, we aimed to build a preconception-based GDM predictor to enable early intervention. We also assessed the associations of top predictors with GDM and adverse birth outcomes. Our evolutionary algorithm-based automated machine learning (AutoML) model was implemented with data from 222 Asian multi-ethnic women in a preconception cohort study, Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO). A stacked ensemble model with a gradient boosting classifier and linear support vector machine classifier (stochastic gradient descent training) was derived using genetic programming, achieving an excellent AUC of 0.93 based on four features (glycated hemoglobin A(1c) (HbA(1c)), mean arterial blood pressure, fasting insulin, triglycerides/HDL ratio). The results of multivariate logistic regression model showed that each 1 mmol/mol increase in preconception HbA(1c) was positively associated with increased risks of GDM (p = 0.001, odds ratio (95% CI) 1.34 (1.13-1.60)) and preterm birth (p = 0.011, odds ratio 1.63 (1.12-2.38)). Optimal control of preconception HbA(1c) may aid in preventing GDM and reducing the incidence of preterm birth. Our trained predictor has been deployed as a web application that can be easily employed in GDM intervention programs, prior to conception.Peer reviewe

    Overcoming Insulin Insufficiency by Forced Follistatin Expression in β -cells of db/db Mice

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    Diabetes poses a substantial burden to society as it can lead to serious complications and premature death. The number of cases continues to increase worldwide. Two major causes of diabetes are insulin resistance and insulin insufficiency. Currently, there are few antidiabetic drugs available that can preserve or protect β-cell function to overcome insulin insufficiency in diabetes. We describe a therapeutic strategy to preserve β-cell function by overexpression of follistatin (FST) using an AAV vector (AAV8-Ins-FST) in diabetic mouse model. Overexpression of FST in the pancreas of db/db mouse increased β-cell islet mass, decreased fasting glucose level, alleviated diabetic symptoms, and essentially doubled lifespan of the treated mice. The observed islet enlargement was attributed to β-cell proliferation as a result of bioneutralization of myostatin and activin by FST. Overall, our study indicates overexpression of FST in the diabetic pancreas preserves β-cell function by promoting β-cell proliferation, opening up a new therapeutic avenue for the treatment of diabetes
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