Search results for: trabecular bone score

Authors: Latha V. Prabhu, B.V. Murlimanju, P.J. Jiji, Mangala M. Pai

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Background: The capitate is the largest among the carpal bones. There exists no literature about the vascular foramina of the capitate bone. The objective of the present study was to investigate the morphology and number of the nutrient foramina in the cadaveric dried capitate bones of the Indian population. Methods: The present study included 59 capitate bones (25 right sided and 34 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular and articular surfaces. The foramina were observed at the medial, lateral, palmar and dorsal surfaces of the capitate bones. The foramina were ranged from 6 to 23 in each capitate bone. In the medial surface, the foramina ranged from 1 to 6, lateral surface from 0 to 7, the foramina ranged between 0 and 5 in the palmar surface. However most of the foramina were located at the dorsal surface which ranged from 3 to 11. Conclusion: We believe that the present study has provided additional data about the nutrient foramina of the capitate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The knowledge about the foramina is also important to the radiologists to prevent the misinterpretation of the findings in the x ray and computed tomogram scan films. The foramina may mimick like erosions and ossicles. The morphological knowledge of the vasculature, their foramina of entry and number is required to understand the concepts in the avascular necrosis of the capitate.

Keywords: avascular necrosis, capitate, morphology, nutrient foramen

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Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic, biopsy, diabetic foot

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Authors: Swathi Sampath, V. Kalaichelvi

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The assessment of the risk posed by a borrower to a lender is one of the common problems that financial institutions have to deal with. Consumers vying for a mortgage are generally compared to each other by the use of a number called the Credit Score, which is generated by applying a mathematical algorithm to information in the applicant’s credit report. The higher the credit score, the lower the risk posed by the candidate, and the better he is to be taken on by the lender. The objective of the present work is to use fuzzy logic and linguistic rules to create a model that generates Credit Scores.

Keywords: credit scoring, fuzzy logic, mortgage, risk assessment

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Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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Authors: Y. S. Darmanto, P. H. Riyadi, S. Susanti

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Recently, approximately 9.1 million people of 237.56 million of Indonesian population suffer diabetes. Such condition was caused by high rice consumption of most Indonesian people. It has been known that rice contains low amylose, high calorie, and possesses hyperglycemic properties. Through this study, we tried to solve that problem by creating a super food in order to provide an alternative healthy and balanced diet. We formulated Taro and Seaweed flour based analog rice that fortified by various fishes bone collagens. Corms of Taro contain easily digestible starch and seaweed is rich in fiber, vitamin, and mineral. That mixture was fortified with collagen-containing unique amino acids such as glysine, lysine, alanine, arginine, proline, and hydroxyprolin. Subsequently, super analog rice was characterized about its nutritional composition such are proximate analyses, water, dietary fiber and amylose content. Furthermore, its morphological structure was analyzed by using scanning electron microscopy while the level of consumer preferences was performed by hedonic test. Results demonstrated that fortification by using various fishes bone collagen into analog rice were significantly different in nutritional composition, morphological structure as well as its preferences. Thus, this study was expected as new avenue in functional food discovery especially in the treatment and prevention of diabetic diseases.

Keywords: analogue rice, taro, seaweed, collagen

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Authors: Pitsanu Poonpetpun

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This research aimed to study opinions of Suan Sunandha Rajabhat University administrative personnel towards performance of the university council committee by addressing (1) personal characteristics of the committees; (2) duties designated by the university council; and (3) relationship between university council and university administrative personnel. The population of this study including the president, vice presidents, faculty deans, deputy deans, office heads, director of office of president, directors, deputy directors, division directors, made a total of 118 respondents. Frequency, percentage, mean, and standard deviation were utilized in analyzing the data. The finding on opinions of the administrative personnel towards personal characteristics of the university council committees was averagely at a high level. The characteristic items were rated and revealed that the item gaining the highest mean score was the item stating that the university council committees obtained overall appropriate qualification. The items stating that the president of the teachers’ council acting as the university council committee had impartiality and good governance reported the lowest mean score. The opinions of the administrative personnel towards duty performance of the university council committees was averagely in a high level, in which the item gaining the highest mean score was the item stating that formulating rules and regulations or assigning governmental offices to do so was practiced with governance or fairness to all stakeholders, and the item stating that the president of the teachers’ council acting as the university council committee had impartiality good governance reported the lowest mean score. Moreover, the study found that the rating of opinions of the administrative personnel towards relationship between university council and university administrative personnel was averagely high. Relationship items were rated and revealed that the highest mean score was rated for the fact that the university president was empowered by the university council to manage the university with no violation of the policies. The fact that there was the integrity of policy between the university council and the university administrative personnel was rated the lowest score.

Keywords: performance, university council, education, university administrative personnel

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Authors: Basheer Ahmad Al-Alwan

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This study aimed to assess the extent of administrative creativity and identify its barriers from the perspective of employees working in youth centers in Jordan. The sample comprised 156 individuals employed in youth centers within the Hashemite Kingdom of Jordan. Data collection involved the utilization of two measures: the administrative creativity scale and the obstacles to administrative work scale. Correlation and stepwise multiple regression analyses were conducted. The findings revealed a high level of administrative creativity, as indicated by a mean score of 3.82 and a standard deviation of 0.51. Furthermore, statistically significant gender-based differences in administrative creativity were observed, favoring males, with a mean score of 3.32 for males compared to 2.91 for females. The results also demonstrated statistically significant differences in the level of administrative creativity based on experience, with the highest mean score observed for individuals with 5 to less than 10 years of experience. Regarding the obstacles to administrative creativity, the findings revealed an average level, with a mean score of 2.86 and a standard deviation of 0.791. Based on these results, the study recommends the promotion of a culture of creativity among employees and the provision of a broader scope of authority to foster an environment conducive to administrative creativity. Additionally, it suggests offering training courses encompassing the annual plan for these centers and minimizing obstacles that hinder the creative process among employees in Jordanian youth centers.

Keywords: administrative creativity, obstacles, workers in youth centers, Jordan

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Authors: Shiyin He, Zheng Huang

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In this paper, deep learning methods are applied in bio-medical field to detect and count different types of cells in an automatic way instead of manual work in medical practice, specifically in bone marrow examination. The process is mainly composed of two steps, detection and recognition. Mask-Region-Convolutional Neural Networks (Mask-RCNN) was used for detection and image segmentation to extract cells and then Convolutional Neural Networks (CNN), as well as Deep Residual Network (ResNet) was used to classify. Result of cell detection network shows high efficiency to meet application requirements. For the cell recognition network, two networks are compared and the final system is fully applicable.

Keywords: cell detection, cell recognition, deep learning, Mask-RCNN, ResNet

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Authors: Einat Peles, Anat Sason, Ariel Claman, Gabriel Barkay, Miriam Adelson

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Individuals with opioid addiction are characterized as suffering from stress responses disturbance, including the hypothalamic-pituitary-adrenal (HPA) axis, and autonomic nervous system function. HPA axis is known to be stabilized during methadone maintenance treatment (MMT). Mindfulness (present-oriented, nonjudgmental awareness of cognitions, emotions, perceptions, and habitual behavioral reactions in daily life) counteracts stress. To our knowledge, the relation between perceived stress and mindfulness trait among MMT patients has never been studied. To measure indices of mindfulness and their relation to perceived stress among MMT patients, a cross-sectional random sample of current MMT patients was performed using questionnaires for perceived stress (PSS) and mindfulness trait (FFMQ- yields a total score and individual scores for five internally consistent mindfulness factors: Observing, Describing, Acting with awareness and consciousness, Non-judging the inner experience, Non-reactivity to the inner experience). Two additional groups were studied to serve as reference groups; Medical students that are known to suffer from stress, and Axis II psychiatric diagnosis patients that are known to characterized with poor mindfulness trait. Results: Groups included 41 MMT patients, 27 Axis II patients and 36 medical students. High perceived stressed (PSS≥18) defined among 61% of the MMT patients and 50% of the medical students. Highest mindfulness score observed among non-stressed MMT patients (153.5±17.2) followed by the groups of stressed MMT and non-stressed student (128.9±17.0 and 130.5±13.3 respectively), with the lowest score among stressed students (116.3±17.9) (multivariate analyses, corrected model p (F=14.3) < 0.0005, p (group) < 0.0005, p (stress) < 0.0005, p (interaction) =0.2). Linear inverse correlations were found between perceived stress score and mindfulness score among MMT patients (R=-0.65, p < 0.0005) and students (R=-0.51, p=0.002). Axis II patients had the lowest mindfulness score (103.4±25.3). Conclusion: High prevalence of high perceived stressed which characterized with poor mindfulness trait observed in both MMT patients and medical students, two different population groups. The effectiveness of mindfulness treatment in reducing stress and improve mindfulness trait should be evaluated to improve rehabilitation of MMT patients, and students success.

Keywords: mindfulness, stress, methadone maintenance treatment, medical students

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Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

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Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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Authors: Jia-Yu Wu, Chih-Han Chang, Shu-Fen Chuang, Rong-Yang Lai

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Objective: This study was to examine the stress distribution of tooth with different class V restorations under different loading situations and geometry by 3D finite element (FE) analysis. `Methods: A series of FE models of mandibular premolars containing class V cavities were constructed using micro-CT. The class V cavities were assigned as the combinations of different cavity depths x occlusal -gingival heights: 1x2, 1x4, 2x2, and 2x4 mm. Three alveolar bone loss conditions were examined: 0, 1, and 2 mm. 200 N force was exerted on the buccal cusp tip under various directions (vertical, V; obliquely 30° angled, O; oblique and parallel the individual occlusal cavity wall, P). A 3-D FE analysis was performed and the von-Mises stress was used to summarize the data of stress distribution and maximum stress. Results: The maximal stress did not vary in different alveolar bone heights. For each geometry, the maximal stress was found at bilateral corners of the cavity. The peak stress of restorations was significantly higher under load P compared to those under loads V and O while the latter two were similar. 2x2mm cavity exhibited significantly increased (2.88 fold) stress under load P compared to that under load V, followed by 1x2mm (2.11 fold), 2x4mm (1.98 fold) and 1x4mm (1.1fold). Conclusion: Load direction causes the greatest impact on the results of stress, while the effect of alveolar bone loss is minor. Load direction parallel to the cavity wall may enhance the stress concentration especially in deep and narrow class cavities.

Keywords: class v restoration, finite element analysis, loading situation, stress

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Authors: Ayda Khosravanihaghighi, Pramod Koshy, Bill Walsh, Vedran Lovric, Charles Christopher Sorrell

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There is an increasing demand for orthopedic implants owing to the increasing numbers of the aging population. Titanium alloy (Ti6Al4V) is a common material used for orthopedic implants owing to its advantageous properties in terms of good corrosion resistance, minimal elastic modulus mismatch with bone, bio-inertness, and high mechanical strength. However, it is important to improve the bioactivity and osseointegration of the titanium alloy and this can be achieved by coating the implant surface with suitable ceramic materials. In the present work, pure and doped-ceria (CeO₂) coatings were deposited by spin coating on the titanium alloy surface in order to enhance the biological interactions between the surface of the implant and the surrounding tissue. In order to examine the bone-binding ability of an implant, simulated body fluid (SBF) tests were conducted in order to assess the capability of apatite layer formation on the surface and thus predict in vivo bone bioactivity. Characterization was done using scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses to determine the extent of apatite formation. Preliminary tests showed that the CeO₂ coatings were biocompatible and that the extent of apatite formation and its characteristics can be enhanced by doping with suitable metal ions.

Keywords: apatite layer, biocompatibility, ceria, orthopaedic implant, SBF, spin coater, Ti-implant

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Authors: Jisoo Kim, Min Su Lee, Sunmook Lee

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Durability assessment of nanocomposite-based bone fixation device was performed by flexural fatigue tests, for which the changes in the life cycles of nanocomposite samples synthesized by blending bioabsorbable polymer (PLGA) and ceramic nanoparticles (β-TCP) with different ratios were monitored. The nanocomposite samples were kept in a constant temperature/humidity chamber at 37°C/50%RH for varied incubation periods for the degradation of nanocomposite samples under the temperature/humidity stress. It was found that the life cycles were increasing as the incubation time in the chamber were increasing in the initial stage irrespective of sample compositions, which was due to the annealing effect of the polymer. However, the life cycle was getting shorter as the incubation time increased afterward, which was due to the overall degradation of nanocomposites. It was found that the life cycle of the nanocomposite sample with high ceramic content was shorter than the one with low ceramic content, which was attributed to the increased brittleness of the composite with high ceramic content. The changes in chemical properties were also monitored by FT-IR, which indicated that the degradation of the biodegradable polymer could be confirmed by the increased intensities of carboxyl groups and hydroxyl groups since the hydrolysis of ester bonds connecting two successive monomers yielded carboxyl end groups and hydroxyl groups.

Keywords: bioabsorbable polymer, bone fixation device, ceramic nanoparticles, durability assessment, fatigue test

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Authors: Moncayo Donoso Miguelangel, Guevara Morales Johana, Kalenia Flores Kalenia, Barrera Avellaneda Luis Alejandro, Garzon Alvarado Diego Alexander

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In mammals, long bones are formed by ossification of a cartilage mold during early embryonic development, forming structures called secondary ossification centers (SOCs), a primary ossification center (POC) and growth plates. This last structure is responsible for long bone growth. During the femur growth, the morphology of the growth plate and the SOCs may vary during different developmental stages. So far there are no detailed morphological studies of the development process from embryonic to adult stages. In this work, we carried out a morphological characterization of femur development from embryonic period to adulthood in mice. 15, 17 and 19 days old embryos and 1, 7, 14, 35, 46 and 52 days old mice were used. Samples were analyzed by a computational approach, using 3D images obtained by micro-CT imaging. Results obtained in this study showed that femur, its growth plates and SOCs undergo morphological changes during different stages of development, including changes in shape, position and thickness. These variations may be related with a response to mechanical loads imposed for muscle development surrounding the femur and a high activity during early stages necessary to support the high growth rates during first weeks and years of development. This study is important to improve our knowledge about the ossification patterns on every stage of bone development and characterize the morphological changes of important structures in bone growth like SOCs and growth plates.

Keywords: development, femur, growth plate, mice

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Authors: Itsuo Yokoyama, Rikako Kikuti, Naoko Watabe, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Chronic kidney disease presents significant changes in mineral and bone metabolism, referred to as CKD-MBD. These changes lead to decreased bone mass, heightened bone fragility, fractures, and increased vascular and valvular calcification, ultimately impacting cardiovascular outcomes. Key contributors to these complications in dialysis patients include calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and the vitamin D hormonal system. Methods: In our outpatient dialysis clinic, we monitor the long-term effects of vascular calcifications by calculating the volume of calcified areas in the abdominal aorta based on CT scan data. The results revealed a progressive nature of vascular calcification. To extend our study, we measured the volume of calcification in bones (vertebrae and femur) corresponding to Hounsfield units of 200 and 300. The study aims to investigate changes in osteoporosis during a 5-year follow-up period and its relationship with extraosseous calcification. Results and Considerations: While extraosseous calcification demonstrated a generally progressive nature, often resistant to medical treatment, the degree of osteoporotic change varied among patients. The majority exhibited continuous osteoporotic changes, while some showed improvement or minimal changes in bone calcification. Variations in the distribution and magnitude of osteoporotic changes were observed between groups based on the timing of hemodialysis initiation during the study. The former group tended to display more osteoporotic changes, possibly attributed to differences in medication between the groups. Other contributing factors may include the patient's age, duration of dialysis, or causes of renal disease. In conclusion, we emphasize the importance of carefully monitoring calcium and phosphate levels and maintaining adequate dialysis therapy to prevent osteoporosis in dialysis patients.

Keywords: CKD-MBD, dialysis, calcification, kidney

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Authors: Muhammad Saleem

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Background: Inattentive food choices and engagement in excessive physical activities by male athletes can potentially lead to adverse health consequences. Objective: The aim was to ascertain the occurrence of risk factors associated with the Male Athlete Triad among young elite athletes in Pakistan. Methodology: In 2018, a cross-sectional study based on questionnaires was conducted at the Pakistan Sports Board. The study aimed to explore the risk factors related to the Male Athlete Triad in young elite athletes who were part of national training camps in major metropolitan areas. The study included proficient male elite athletes aged 18 to 25 years, capable of understanding the English questionnaire. The athletes completed a survey encompassing aspects like demographic information, educational background, Body Mass Index (BMI), sports involvement, and hours of participation. Additionally, they filled out the Eating Attitude Test-26 (EAT-26) and questionnaires assessing risks of amenorrhea and low bone mineral density. The prevalence of risk factors for each of the three components was individually evaluated. The collected data underwent analysis using SPSS-20, with descriptive statistics being applied. Results: The study comprised a sample of 90 elite athletes (mean age: 23.57 ± 2.37 years, mean BMI: 21.97 ± 1.90) engaged in various sports. The EAT-26 results indicated that 50% of athletes were at risk of developing an eating disorder. Moreover, 83.3% exhibited disordered eating behaviors that necessitated referral. Risks for amenorrhea were observed in 15% of the participants, and regarding low bone mineral density, notable risks were absent except for the consumption of caffeinated beverages, which was noted in 51.7% of participants. Conclusion: The study identified a significant prevalence of disordered eating risk among male elite athletes in Pakistan. However, the risks associated with amenorrhea and low bone mineral density were not a major concern in this particular group.

Keywords: Pakistan, osteoporosis, female athlete triad, bone mineral density, athlete, amenorrhea, eating disorders

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Authors: Khader A. Almhdawi, Saddam F. Kanaan

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Background: Allied health (AH) students, including rehabilitation sciences students, are subjected to significant levels of physical and mental stressors, which could affect their education. This study aimed to study physical and mental of Health-related Quality of Life (HR-QoL) levels along with their predictors among students of nine AH majors. Methods: Students filled validated anonymous surveys covering demographics and life style, Nordic Musculoskeletal Questionnaire, 12-item Short-Form Health Survey (SF-12), and Depression Anxiety Stress Scale (DASS- 42). SF-12 Mental (MCS) and Physical (PCS) summary scores were compared between academic majors and gender. Multiple linear regression models were conducted to examine potential predictors of PCS and MCS scores. Results: 838 students (77.4% females) participated in this study. Participants’ PCS mean score was 45.64±7.93 and found statistically different between the nine academic majors (P < 0.001). Additionally, participants’’ MCS mean score was 39.45±10.86 and significantly greater in males (P < 0.001). Significant PCS scores predictors included hip and upper back musculoskeletal pain, anxiety score, diet self-evaluation, and GPA. Finally, MCS scores were statistically associated with neck musculoskeletal pain, stress score, depression score, number of weekly clinical training hours, gender, university year, GPA, sleep quality self-evaluation, and diet self-evaluation. Conclusion: Clinical educators of AH need to account for students’ low levels of HR-QoL and their academic-related, health-related, and lifestyle-related associated factors. More studies are recommended to investigate the progression of HR-QoL throughout university years and to create effective interventions to improve HR-QoL among healthcare students.

Keywords: medical education, quality of life, stress, anxiety, depression

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Authors: Tuba Tekin, Nurcan Baglam, Emine Dincer

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This study aimed to examine the effects of nutrition education received by university students on sustainable healthy eating behaviors and adherence to the Mediterranean diet. The 2nd, 3rd, and 4th-grade university students studying at the Faculty of Health Sciences, Nutrition and Dietetics, Midwifery, Nursing, Physical Therapy, and Rehabilitation departments of universities in Turkey were included in the study. Students' adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale, and their sustainable and healthy eating behaviors were evaluated using the Sustainable and Healthy Eating Behaviors Scale. In addition, the body weight and height of the students were measured by the researchers, and the Body Mass Index (BMI) value was calculated. A total of 181 students, 85 of whom were studying in the Department of Nutrition and Dietetics and 96 of whom were educated in other departments, were included in the study. 75.7% of the students in the sample are female, while 24.3% are male. The average body weight of the students was 61.17±10.87 kg, and the average BMI was 22.04±3.40 kg/m2. While the mean score of the Mediterranean Diet Adherence Scale was 6.72±1.84, in the evaluation of adherence to the Mediterranean diet, it was determined that 25.4% of the students had poor adherence and 66.9% needed improvement. When the adherence scores of students who received and did not receive nutrition education were compared, it was discovered that the students who received nutrition education had a higher score (p<0.05). Students who received nutrition education had a higher total score on the Sustainable and Healthy Eating Behaviors scale (p<0.05). A moderately positive correlation was found between the Sustainable and Healthy Eating Behaviors scale total score and the Mediterranean Diet Adherence scores (p<0.05). As a result of the linear regression analysis, it was revealed that a 1-unit increase in the Mediterranean diet adherence score would result in a 1.3-point increase in the total score of the Sustainable and Healthy Eating Behaviors scale. Sustainable and healthy diets are important for improving and developing health and the prevention of diseases. The Mediterranean diet is defined as a sustainable diet model. The findings revealed the relationship between the Mediterranean diet and sustainable nutrition and showed that nutrition education increased knowledge and awareness about sustainable nutrition and increased adherence to the Mediterranean diet. For this reason, courses or seminars on sustainable nutrition can be organized during educational periods.

Keywords: healthy eating, Mediterranean diet, nutrition education, sustainable nutrition

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Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

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Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented work is to recognize the impact of mini-plate application approach on the stress and displacement within the stabilization devices and surrounding bones. The mini-plate osteosynthesis technique is widely used by craniofacial surgeons as an improved replacement of wire connection approach. Many different types of metal plates and screws are used to the physical connection of fractured bones. Below investigation is based on a clinical observation of patient hospitalized with mini-plate stabilization system. Analysis was conducted on a solid mandible geometry, which was modeled basis on the computed tomography scan of the hospitalized patient. In order to achieve most realistic connected system behavior, the cortical and cancellous bone layers were assumed. The temporomandibular joint was simplified to the elastic element to allow physiological movement of loaded bone. The muscles of mastication system were reduced to three pairs, modeled as shell structures. Finite element grid was created by the ANSYS software, where hexahedral and tetrahedral variants of SOLID185 element were used. A set of nonlinear contact conditions were applied on connecting devices and bone common surfaces. Properties of particular contact pair depend on screw - mini-plate connection type and possible gaps between fractured bone around osteosynthesis region. Some of the investigated cases contain prestress introduced to the mini-plate during the application, what responds the initial bending of the connecting device to fit the retromolar fossa region. Assumed bone fracture occurs within the mandible angle zone. Due to the significant deformation of the connecting plate in some of the assembly cases the elastic-plastic model of titanium alloy was assumed. The bone tissues were covered by the orthotropic material. As a loading were used the gauge force of magnitude of 100N applied in three different locations. Conducted analysis shows significant impact of mini-plate application methodology on the stress distribution within the miniplate. Prestress effect introduces additional loading, which leads to locally exceed the titanium alloy yield limit. Stress in surrounding bone increases rapidly around the screws application region, exceeding assumed bone yield limit, what indicate the local bone destruction. Approach with the doubled mini-plate shows increased stress within the connector due to the too rigid connection, where the main path of loading leads through the mini-plates instead of plates and connected bones. Clinical observations confirm more frequent plate destruction of stiffer connections. Some of them could be an effect of decreased low cyclic fatigue capability caused by the overloading. The executed analysis prove that the mini-plate system provides sufficient support to mandible fracture treatment, however, many applicable solutions shifts the entire system to the allowable material limits. The results show that connector application with the initial loading needs to be carefully established due to the small material capability tolerances. Comparison to the clinical observations allows optimizing entire connection to prevent future incidents.

Keywords: mandible fracture, mini-plate connection, numerical analysis, osteosynthesis

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Authors: Rabab Makki

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Bone mineral density and bone metabolism are affected by various factors such as genetic, endocrine, mechanical and nutritional. Our understanding of nutritional influences on bone health is limited because most studies have focused on calcium. This study investigated the dietary factors which are likely t contribute to Osteoporosis in Saudi post-menopausal women, and correlated it with BMD. This is a case controlled study involved 36 postmenopausal Saudi females selected from the Orthopedics and osteoporosis outpatient clinics, and 25 postmenopausal Saudi females as controls from the primary clinic of Military Hospital in Riyadh. The women were diagnosed as osteoporotic based on the BMD measurement at any site (left femur neck, right femur neck, left total hip or right total hip or spine). Both the controls and the Osteoporotics were over 50 years of age and BMI between 31-34 kg/m2 had 2nd degree obesity, and were not free from other problems such as diabetes, hypertension, etc. Subjects (osteoporotics and controls) were interviewed to called data on demographic characterstics, medical history, dietary intake anthropometry (height and weight) bone mineral density. Blood samples were collected from subjects (Osteoporotics and controls). Analysis of serum calcium, vitamin D, phosphate were done at the main laboratory at Military Hospital Riyadh, by the laboratory technician while BMD was determined at the department of Nuclear Medicine by an expert technician and results were interpreted by radiologist.Data on frequency of consumption of animal food (meat, eggs, poultry and fish) and diary foods (milk, yogurt, cheese) of osteoporotic was less than control. In spite of the low intake there was no association with BMD.In general, the vegetables and fruits were consumed less by the osteoporotics than control. The only fruit which had shown a significant positive correlation is banana with right and left hip BMD total probably due to high potassium and minerals content which likely to prevent bone resorption. Mataziz vegetables combination of wheat showed a significant positive correlation with the same site (total right and left hip). Both osteoporotics abd controls were consuming table sugar. (But the sweet intake showed a significant negative correlation with left neck femur BMD, suggesting sucrose increase urinary calcium loss. Both osteoporotic and controls were consuming Arabic coffee. A negative significant correlation between intake of Arabic coffee and BMD of right neck femur of osteoporosis patient was observed. It could be suggested that increased intake of fruits and vegetables, might promote bone density while high intake of coffee and sugars might affect bone density, no significant correlation was observed between BMD at any site and diary product. We can say the major risk factors are inadequate nutrition. Further studies are needed among Saudi population to confirm these results.

Keywords: osteoporosi, Saudia Arabia, Riyadh Armed Forces, postmenopausal women

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Authors: Christelle Navarro, Sébastien Viaud, Carole Gard, Bruno Jahier

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Background: Idiopathic or familial nasal hyperkeratosis (NHK) may be considered a cosmetic issue in its uncomplicated form. Nevertheless, prevention of secondary lesions such as fissures or infections could be advised by proper management. The objective of this open-field study is to evaluate the benefits of a moisturizing balm in privately owned dogs with NHK, using an original validation grid for both investigator and owner assessments. Methods: Dogs with idiopathic or familial NHK received a vegetable-based ointment (Sensiderm® Balm, MP Labo, France) BID for 60 days. A global dermatological score (GDS) was defined using the sum of 4 criteria (“dryness,” “lichenification”, “crusts,” and “affected area”) on a 0 (no) to 3 (severe or > 2/3 extension) scale. Evaluation of this GDS (0-12) on D0, D30, and D60, by owners and investigators was the main outcome. The score’s percentage decrease versus D0, the evolution of each individual score, the correlation between observers, and the evaluation of clinical improvement and animal discomfort on VAS (0-10) during follow-up were analysed. Results: The global dermatological score significantly decreased over time (p<0.0001) for all observers. The decrease reached 44.9% and 54.3% at D30 and 54.5% and 62.3% at D60, for investigators and owners, respectively. “Dryness”, “Lichenification,” and “Affected area scores” decreased significantly and steadily over time compared to Day 0 for both investigators and owners (p < 0.001 and p = 0.001 for investigator assessment of dryness). All but one score (lichenification) were correlated at all times between observers (only at D60 for crusts). Whoever the observer, clinical improvement was always above 7. At D30 and until D60, “animal discomfort” was more than halved. Owner satisfaction was high as soon as D30 (8.1/10). No adverse effects were reported. Conclusion and clinical importance: The positive results confirm the benefits and safety of a moisturizing balm when used in dogs with uncomplicated NHK.

Keywords: hyperkeratosis, nose, dog, moisturizer

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Authors: Patarawan Sangnawakij, Sa-Aat Niwitpong

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In this paper, we proposed two new confidence intervals for the difference of coefficients of variation, CIw and CIs, in two independent gamma distributions. These proposed confidence intervals using the close form method of variance estimation which was presented by Donner and Zou (2010) based on concept of Wald and Score confidence interval, respectively. Monte Carlo simulation study is used to evaluate the performance, coverage probability and expected length, of these confidence intervals. The results indicate that values of coverage probabilities of the new confidence interval based on Wald and Score are satisfied the nominal coverage and close to nominal level 0.95 in various situations, particularly, the former proposed confidence interval is better when sample sizes are small. Moreover, the expected lengths of the proposed confidence intervals are nearly difference when sample sizes are moderate to large. Therefore, in this study, the confidence interval for the difference of coefficients of variation which based on Wald is preferable than the other one confidence interval.

Keywords: confidence interval, score’s interval, wald’s interval, coefficient of variation, gamma distribution, simulation study

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Authors: Phornchanok Motantasut, Torkamol Hunsawong, Lugkana Mato, Wanida Donpunha

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Identifying abnormal foot posture is important for prescribing appropriate management in patients with lower limb disorders and chronic non-specific low back pain. The normalized navicular height truncated (NNHt) and the foot posture index-6 (FPI-6) have been recommended as the common, simple, valid, and reliable static measures for clinical application. The NNHt is a single plane measure while the FPI-6 is a triple plane measure. At present, there is inadequate information about the correlation between the NNHt and the FPI-6 for categorizing foot posture that leads to a difficulty of choosing the appropriate assessment. Therefore, the present study aimed to determine the correlation between the NNHt and the FPI-6 measures in adult participants with asymptomatic feet. Methods: A cross-sectional descriptive study was conducted in 47 asymptomatic individuals (23 males and 24 females) aged 28.89 ± 7.67 years with body mass index 21.73 ± 1.76 kg/m². The right foot was measured twice by the experienced rater using the NNHt and the FPI-6. A sequence of the measures was randomly arranged for each participant with a 10-minute rest between the tests. The Pearson’s correlation coefficient (r) was used to determine the relationship between the measures. Results: The mean NNHt score was 0.23 ± 0.04 (ranged from 0.15 to 0.36) and the mean FPI-6 score was 4.42 ± 4.36 (ranged from -6 to +11). The Pearson’s correlation coefficient among the NNHt score and the FPI-6 score was -0.872 (p < 0.01). Conclusion: The present finding demonstrates the strong correlation between the NNHt and FPI-6 in adult feet and implies that both measures could be substituted for each other in identifying foot posture.

Keywords: foot posture index, foot type, measurement of foot posture, navicular height

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Authors: A. Bentley, A. Prost, N. Daruwalla, D. Osrin

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Background: This study aims to investigate the relationship between experiences of violence against women in the family, and levels of self-esteem in women residing in informal settlement (slum) areas of Mumbai, India. The authors hypothesise that violence against women in Indian households extends beyond that of intimate partner violence (IPV), to include other members of the family and that experiences of violence are associated with lower levels of self-esteem. Methods: Experiences of violence were assessed through a cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points, and the main perpetrator of each. Self-esteem was assessed using the Rosenberg self-esteem questionnaire. A global score for self-esteem was calculated and the relationship between violence in the past year and Rosenberg self-esteem score was assessed using multivariable linear regression models, adjusted for years of education completed, and clustering using robust standard errors. Results: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 6 years of education and had been married 9.5 years. 88% were Muslim and 46% lived in joint families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 24% physical, 12% sexual). Of the women who experienced violence after marriage, 70% cited a perpetrator other than the husband for at least one of the acts. 5% had low self-esteem (Rosenberg score < 15). For women who experienced emotional violence in the past year, the Rosenberg score was 2.6 points lower (p < 0.001). It was 1.2 points lower (p = 0.03) for women who experienced economic violence. For physical or sexual violence in the past year, no statistically significant relationship with Rosenberg score was seen. However, for a one-unit increase in the number of different acts of each type of violence experienced in the past year, a decrease in Rosenberg score was seen (-0.62 for emotional, -0.76 for economic, -0.53 for physical and -0.47 for sexual; p < 0.05 for all). Discussion: The high prevalence of violence experiences across the lifetime was likely due to the detailed assessment of violence and the inclusion of perpetrators within the family other than the husband. Experiences of emotional or economic violence in the past year were associated with lower Rosenberg scores and therefore lower self-esteem, but no relationship was seen between experiences of physical or sexual violence and Rosenberg score overall. For all types of violence in the past year, a greater number of different acts were associated with a decrease in Rosenberg score. Emotional violence showed the strongest relationship with self-esteem, but for all types of violence the more complex the pattern of perpetration with different methods used, the lower the levels of self-esteem. Due to the cross-sectional nature of the study causal directionality cannot be attributed. Further work to investigate the relationship between severity of violence and self-esteem and whether self-esteem mediates relationships between violence and poorer mental health would be beneficial.

Keywords: family violence, India, informal settlements, Rosenberg self-esteem scale, self-esteem, violence against women

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

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Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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Authors: D. Adel, F. Giacomini, R. Gildenhaar, G. Berger, C. Gomes, U. Linow, M. Hardt, B. Peleskae, J. Günster, A. Houshmand, M. Stiller, A. Rack, K. Ghaffar, A. Gamal, M. El Mofty, C. Knabe

Abstract:

The goal of this study was to develop 3D scaffolds from a silica containing calcium alkali orthophosphate utilizing two different fabrication processes, first a replica technique namely the Schwartzwalder Somers method (SSM), and second 3D printing, i.e. Rapid prototyping (RP). First, the mechanical and physical properties of the scaffolds (porosity, compressive strength, and solubility) was assessed and second their potential to facilitate homogenous colonization with osteogenic cells and extracellular bone matrix formation throughout the porous scaffold architecture. To this end murine and rat calavarie osteoblastic cells were dynamically seeded on both scaffold types under perfusion with concentrations of 3 million cells. The amount of cells and extracellular matrix as well as osteogenic marker expression was evaluated using hard tissue histology, immunohistochemistry, and histomorphometric analysis. Total porosities of both scaffolds were 86.9 % and 50% for SSM and RP respectively, Compressive strength values were 0.46 ± 0.2 MPa for SSM and 6.6± 0.8 MPa for RP. Regarding the cellular behavior, RP scaffolds displayed a higher cell and matrix percentage of 24.45%. Immunoscoring yielded strong osteocalcin expression of cells and matrix in RP scaffolds and a moderate expression in SSM scaffolds. 3D printed RP scaffolds displayed superior mechanical and biological properties compared to SSM. 3D printed scaffolds represent excellent candidates for bone tissue engineering.

Keywords: calcium alkali orthophosphate, extracellular matrix mineralization, osteoblast differentiation, rapid prototyping, scaffold

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Authors: Yizhi Zhang, Xiaozan Wang, Mingming Guo, Pengpeng Li

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Introduction: The purpose of this study is to examine the effectiveness of after-school football training in improving the physical fitness of primary school students, so as to provide corresponding suggestions for carrying out after-school football training in primary schools. Methods: A total of 72 students from the experimental primary school of Mouping district, Yantai city, Shandong province, participated in this experiment. The experiment was conducted for two semesters. During the experiment period, the experimental group conducted one-hour football training after school from Monday to Thursday afternoon every week, and two hours of football training on Saturday morning every week. The control group conducted sports teaching and extracurricular activities as usual without other intervention. Before and after the experiment, both the experimental group and the control group underwent physical fitness tests according to the physical fitness test standards of Chinese students, including lung capacity, 50-meter run, one-minute skipping rope, sitting forward flexor, and one-minute sit-ups. The test results were all converted to the 100-point system according to the scoring standards. Results: (1) Before the experiment, there was no significant difference between the experimental group and the control group in various physical fitness indicators (p > 0.05). (2) After the experiment, the lung capacity score (T = 3.108, p < 0.05), the 50-meter run score (T = 6.593, p < 0.05), the skipping score (T = 9.227, p < 0.05), the sitting forward flexor score (T = 3.742, p < 0.05), and the sit-up score (T = 5.210, p < 0.05) of the experimental group were significantly higher than that of the control group. Conclusion: This study shows that the physical fitness of primary school students can be improved by football training in their spare time. It is suggested to carry out after-school football training activities in primary schools so as to effectively improve the physical fitness of pupils.

Keywords: after-school football training, physical fitness, primary school students, school sports

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Authors: Mahboobe Daneshvar

Abstract:

Introduction: Clinical studies on the effect of systemic conditions on periodontal diseases have shown that some systemic deficiencies may provide grounds for the onset of periodontal diseases. One of these systemic problems is osteoporosis, which may be a risk factor for the onset and exacerbation of periodontitis. This study tends to evaluate periodontal indices in osteoporotic menopausal women and compare them with healthy controls. Materials and Methods: In this case-control study, participants included 45-75-year-old menopausal women referred to rheumatology wards of the Khatamolanbia Clinic and Shahid Sadoughi Hospital in Yazd; Their bone density was determined by DEXA-scan and by imaging the femoral-lumbar bone. Thirty patients with osteoporosis and 30 subjects with normal BMD were selected. Then, informed consent was obtained for participation in the study. During the clinical examinations, tooth loss (TL), plaque index (PI), gingival recession, pocket probing depth (PPD), clinical attachment loss (CAL), and tooth mobility (TM) were measured to evaluate the periodontal status. These clinical examinations were performed to determine the periodontal status by catheter, mirror and probe. Results: During the evaluation, there was no significant difference in PPD, PI, TM, gingival recession, and CAL between case and control groups (P-value>0.05); that is, osteoporosis has no effect on the above factors. These periodontal factors are almost the same in both healthy and patient groups. In the case of missing teeth, the following results were obtained: the mean of missing teeth was 22.173% of the total teeth in the case group and 18.583% of the total teeth in the control group. In the study of the missing teeth in the case and control groups, there was a significant relationship between case and control groups (P-value = 0.025). Conclusion: In fact, since periodontal disease is multifactorial and microbial plaque is the main cause, osteoporosis is considered a predisposing factor in exacerbation or persistence of periodontal disease. In patients with osteoporosis, usually pathological fractures, hormonal changes, and aging lead to reduced physical activity and affect oral health, which leads to the manifestation of periodontal disease. But this disease increases tooth loss by changing the shape and structure of bone trabeculae and weakening them. Osteoporosis does not seem to be a deterministic factor in the incidence of periodontal disease, since it affects bone quality rather than bone quantity.

Keywords: plaque index, Osteoporosis, tooth mobility, periodontal packet

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Authors: Sunghoon Park, Hank Kim, Jinwon An, Sungzoon Cho

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Internet of Things allows one to collect data from facilities which are then used to monitor them and even predict malfunctions in advance. Conventional quality control methods focus on setting a normal range on a sensor value defined between a lower control limit and an upper control limit, and declaring as an anomaly anything falling outside it. However, interactions among sensor values are ignored, thus leading to suboptimal performance. We propose a multivariate approach which takes into account many sensor values at the same time. In particular Gaussian Mixture Model is used which is trained to maximize likelihood value using Expectation-Maximization algorithm. The number of Gaussian component distributions is determined by Bayesian Information Criterion. The negative Log likelihood value is used as an anomaly score. The actual usage scenario goes like a following. For each instance of sensor values from a facility, an anomaly score is computed. If it is larger than a threshold, an alarm will go off and a human expert intervenes and checks the system. A real world data from Building energy system was used to test the model.

Keywords: facility anomaly detection, gaussian mixture model, anomaly score, expectation maximization algorithm

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