Search results for: STEMM subjects

Authors: Nehal Adel Khalil, Amel Foad Ketat, Fairouz Elsayed Mohamed Ali, Nahla Abdelmoneim Hamid, Hazem Farag Manaa

Abstract:

Background: Chronic myeloid leukemia (CML) represents 15% of adult leukemias. Imatinib Mesylate (IM) is the gold standard treatment for new cases of CML. Treatment with IM results in improvement of the majority of cases. However, about 25% of cases may develop resistance. Sensitive and specific early predictors of IM resistance in CML patients have not been established to date. Aim: To investigate the value of miR-451 in CML as an early predictor for IM resistance in Egyptian CML patients. Methods: The study employed Real time Polymerase Reaction (qPCR) technique to investigate the leucocytic expression of miR-451 in fifteen newly diagnosed CML patients (group I), fifteen IM responder CML patients (group II), fifteen IM resistant CML patients (group III) and fifteen healthy subjects of matched age and sex as a control group (group IV). The response to IM was defined as < 10% BCR-ABL transcript level after 3 months of therapy. The following parameters were assessed in subjects of all the studied groups: 1- Complete blood count (CBC). 2- Measurement of plasma level of miRNA 451 using real-time Polymerase Chain Reaction (qPCR). 3- Detection of BCR-ABL gene mutation in CML using qPCR. Results: The present study revealed that miR-451 was significantly down-regulated in leucocytes of newly diagnosed CML patients as compared to healthy subjects. IM responder CML patients showed an up-regulation of miR- 451 compared with IM resistant CML patients. Conclusion: According to the data from the present study, it can be concluded that leucocytic miR- 451 expression is a useful additional follow-up marker for the response to IM and a promising prognostic biomarker for CML.

Keywords: chronic myeloid leukemia, imatinib resistance, microRNA 451, Polymerase Chain Reaction

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Authors: Anupam Deka, Indira Bardoloi

Abstract:

Gender discrimination has been considered as a major obstacle in granting equal opportunity for women in higher education as education plays a pivotal role in a country’s socioeconomic development. To examine the empowerment of women in the higher education field of Assam, a case study has been carried out. In the first stage, an overview of enrollment of students in different courses has been made by considering the whole state. In the second stage, a study has been conducted regarding the enrollment of students in various degree and postgraduate courses for the period 2000-2007 at Gauhati University (one of the four universities of Assam), and the relevant data has been collected. It has been found that though the enrollment of students in the degree levels has been constantly increasing, but the enrollment of girls are not proportionately increasing, especially in commerce and law. On the other hand, in the postgraduate level, these proportions are higher in almost all subjects (except some subjects like M. COM., L.L.M, M. C. A., Mathematics, etc.), indicating that compared to boys, a higher number of girls are being admitted in postgraduate courses.

Keywords: field study, enrollment of girls in degree and postgratudate levels, regression lines, chi square test, diagrams, statistical tables

Procedia PDF Downloads 232

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

Abstract:

Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

Procedia PDF Downloads 88

Authors: Zbigniew Wochynski, Justyna Skrzynska, Robert Jedrys, Zdzislaw Kobos

Abstract:

The aim of the study is to determine the types of motor skills and their impact on achieving results while undergoing Aviation Synthetic Efficiency Test (ASET). The study involved 59 cadets, 21 years-old on average, who are studying on first year for a pilot. The average weight of the respondents is 73.8 kg. The subjects were divided into two groups by weight: up to 73.8 kg -group A (n-30) and above 73,8kg -group B (n-29). All subjects underwent the following tests: running at 40m, 100m, 1000m, 2000m, pull-ups, ASET. In both groups, the cadets were divided into two motor skills types taking into advance 40 m running, pull-ups, 2000 meters running and then subjected to do ASET. There has been shown statistically significant increase in group B in body height, weight and BMI with p <0.0003, p <0.0001, p <0.0001 compared to group A. The results indicate that the dominant motor type in all subjects is the endurance-strength model, which reached the speed V = 1,42m/s in overcoming ASET. This is confirmed by the correlation between 2000m and pull-ups r = 0.37 (p <0.05). In group A, the results indicate that the dominant type of motor is a high-speed-endurance model (26.6%), which reached speed V = 1,42m/s in overcoming ASET. In Group B, there was type of motor speed-strength (20.6%), which reached speed of V = 1.45m/s in overcoming ASET. This confirms the correlation between ASET and pull-ups r = 0.56 (p <0.005). Examined cadets who were having one dominant characteristic achieved worse results is ASET. The best results from all examined cadets in overcoming ASET had the type of motor endurance-strength, in group A endurance-speed model and in group B type of speed-strength

Keywords: ASET, Aviation Synthetic Efficiency Test, motor skills, physical tests, pilot-cadets

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Authors: Jukka Surakka, Risto Tuominen, Jukka Piippo

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The aim of this work was to study the development of sick leaves and presenteeism during a work ability program. Productivity losses were determined for 70 employees from four organizations and for 42 controls. Numbers of sick leave days (SLD) were collected from employers’ records for three months before the program started and each subsequent three months for one year after the initiation. Presenteeism was determined for four weeks before and after one year of the program implementation. In the first three months of implementation SLD reduced among project members by 55% and increased by 27% among controls (p<0.001). However, during the last two measurement periods, the project subjects had more SLD than they had before the program started (p<0.001), and also more than the controls (p<0.001). Overall, during the one year implementation the program subjects had on average 23% increase in SLD, whereas the controls had 35% decrease in their SLD (p<0.001). Program participants experienced per month 3.6 hours more presenteeism after the one-year implementation and among the controls presenteeism increased by 2.5 hours. Work ability program produced short-term productivity benefits, but with longer program duration the benefits disappeared.

Keywords: work ability, absenteeism, presenteeism, productivity, sick leave

Procedia PDF Downloads 261

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

Procedia PDF Downloads 447

Authors: Noah R. Fram

Abstract:

Although it has been confirmed by multiple studies, the inverted-U relationship between stimulus complexity and preference (liking) remains contentious. Research aimed at substantiating the model are largely reliant upon anecdotal self-assessments of subjects and basic measures of complexity, leaving potential confounds unresolved. This study attempts to address the topic by assessing listening time as a behavioral correlate of liking (with the assumption that engagement prolongs listening time) and by looking for latent factors underlying several measures of rhythmic complexity. Participants listened to groups of rhythms, stopping each one when they started to lose interest and were asked to rate each rhythm in each group in terms of interest, complexity, and preference. Subjects were not informed that the time spent listening to each rhythm was the primary measure of interest. The hypothesis that listening time does demonstrate the same inverted-U relationship with complexity as verbal reports of liking was confirmed using a variety of metrics for rhythmic complexity, including meter-dependent measures of syncopation and meter-independent measures of entropy.

Keywords: complexity, entropy, rhythm, syncopation

Procedia PDF Downloads 143

Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

Procedia PDF Downloads 147

Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

Abstract:

This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

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Authors: Jianxin Zhu, Na Liu

Abstract:

Entry strategies play a vital role in the development of new enterprises in the catering industry. Different entry strategies will have different effects on the development of new enterprise. Based on the research of scholars at home and abroad, and combining the characteristics of the catering industry, the entry strategies are divided into low-price entry strategies and high-quality entry strategies. Facing the entry of new enterprise, the strategies of incumbent enterprises are divided into response strategies and non-response strategies. This paper uses evolutionary game theory to study the strategic interaction mechanism between incumbent companies and new enterprises. When different initial values and parameter values are set, which strategy will the two-game subjects choose, respectively? Using matlab2016 for numerical simulation, the results show that the choice of strategies for new enterprise and incumbent enterprise is influenced by more than one factor, and the system has different evolution trends under different circumstances. When the parameters were set, the choice of two subjects' strategies mainly depends on the net profit between the strategies.

Keywords: catering industry, entry strategy, evolutionary game, strategic interaction mechanism

Procedia PDF Downloads 99

Authors: Yunita Kurniawati

Abstract:

The aim of the research is to understand the influence of self concept on the tendency for body dysmorphic disorder among beauty salon and fitness centre customers in Malang. Subjects in this study amounted to 200 of beauty salon and fitness centre customers in Malang. Subjects completed a self-concept scale and the tendency of body dysmorphic scale. This study was analyzed using simple linear regression. The result shows that there are 14% influence of self concept on the tendency of body dysmorphic disorder among customers of beauty salon and fitness centre in Malang.

Keywords: self concept, tendency of body dysmorphic disorder, beauty salon and fitness centre customers, Malang

Procedia PDF Downloads 394

Authors: Onyebueke Godwin, Okwarafor Friday

Abstract:

Introduction: Persons with HIV/AIDS disease are predisposed to mental health disorders such as depression and suicide. HIV/AIDS, being a chronic medical illness with antecedent stigmatization ostracization, leads to low mood, low self-esteem, and a tendency to kill oneself due to the burden of the disease in terms of cost and disability. The aim of one study was to examine the prevalence of depression and risk of suicide among HIV/AIDS patients compared to negative persons. Instruments: The Major Depressive Episode and Suicidality modules of the MINI-Neuropsychiatric inventory were used to screen the attendees. Report: The prevalence of depression and risk of suicide were 27.8% and 7.8%, respectively, for the HIV positive subjects, but 1208% and 2.2%, respectively, for negative subjects. Conclusion and Significance: Persons with HIV/AIDS usually present with mental health symptoms, but the attending physicians usually pay attention to physical symptoms. The symptoms of the disease or the side effects of the medication may mask the mental health disease. Recommendation: There is need to screen HIV/AIDS patents for mental health disorders during clinic visits.

Keywords: depression, HIV/AIDS, suicidality

Procedia PDF Downloads 29

Authors: Bahareh Yazdanparast Chaharmahali

Abstract:

The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

Procedia PDF Downloads 219

Authors: I. Wardana Ketut, I. Suparwa Nyoman

Abstract:

This study investigated the form and characteristic of speech sound produced by three Balinese subjects who have recovered from aphasia as well as intervened their language impairment on side of linguistic and neuronal aspects of views. The failure of judging the speech sound was caused by impairment of motor cortex that indicated there were lesions in left hemispheric language zone. Sound articulation phenomena were in the forms of phonemes deletion, replacement or assimilation in individual words and meaning building for anomic aphasia. Therefore, the Balinese sound patterns were stimulated by showing pictures to the subjects and recorded to recognize what individual consonants or vowels they unclearly produced and to find out how the sound disorder occurred. The physiology of sound production by subject’s speech organs could not only show the accuracy of articulation but also any level of severity the lesion they suffered from. The subjects’ speech sounds were investigated, classified and analyzed to know how poor the lingual units were and observed to clarify weaknesses of sound characters occurred either for place or manner of articulation. Many fricative and stopped consonants were replaced by glottal or palatal sounds because the cranial nerve, such as facial, trigeminal, and hypoglossal underwent impairment after the stroke. The phonological intervention was applied through a technique called phonemic articulation drill and the examination was conducted to know any change has been obtained. The finding informed that some weak articulation turned into clearer sound and simple meaning of language has been conveyed. The hierarchy of functional parts of brain played important role of language formulation and processing. From this finding, it can be clearly emphasized that this study supports the role of right hemisphere in recovery from aphasia is associated with functional brain reorganization.

Keywords: aphasia, intervention, phonology, stroke

Procedia PDF Downloads 176

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

Procedia PDF Downloads 240

Authors: Johnson C. Y. Pang, Bo Pengb, Kara K. L. Reevesc, Allan C. L. Fud

Abstract:

Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding are potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26±5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms and quality of life (QOL), were analyzed by repeated-measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: reliability, jumping, 3D motion analysis, anterior crucial ligament reconstruction

Procedia PDF Downloads 89

Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke

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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.

Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency

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Authors: O. Hakim, K. Hart, P. McCabe, J. Berry, L. E. Rhodes, N. Spyrou, A. Alfuraih, S. Lanham-New

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It is known that skin pigmentation reduces the penetration of ultraviolet radiation (UVR) and thus photosynthesis of 25(OH)D. However, the ethnic differences in 25(OH)D production remain to be fully elucidated. This study aimed to investigate the differences in vitamin D production between Asian and Caucasian postmenopausal women, in response to a defined, controlled UVB exposure. Seventeen women; nine white Caucasian (skin phototype II and III), eight South Asian women (skin phototype IV and V) participated in the study, acting as their controls. Three blood samples were taken for measurement of 25(OH)D during the run-in period (nine days, no sunbed exposure) after which all subjects underwent an identical UVR exposure protocol irrespective of skin colour (nine days, three sunbed sessions: 6, 8 and 8 minutes respectively with approximately 80% of body surface exposed). Skin tone was measured four times during the study. Both groups showed a gradual increase in 25(OH)D with final levels significantly higher than baseline (p<0.01). 25(OH)D concentration mean from a baseline of 43.58±19.65 to 57.80±17.11 nmol/l among Caucasian and from 27.03±23.92 to 44.73±17.74 nmol/l among Asian women. The baseline status of vitamin D was classified as deficient among the Asian women and insufficient among the Caucasian women. The percentage increase in vitamin D3 among Caucasians was 39.86% (21.02) and 207.78% (286.02) in Asian subjects respectively. This greater response to UVR exposure reflects the lower baseline levels of the Asian subjects. The mixed linear model analysis identified a significant effect of duration of UVR exposure on the production of 25(OH)D. However, the model shows no significant effect of ethnicity and skin tone on the production of 25(OH)D. These novel findings indicate that people of Asian ethnicity have the full capability to produce a similar amount of vitamin D compared to the Caucasian group; initial vitamin D concentration influences the amount of UVB needed to reach equal serum concentrations.

Keywords: ethnicity, Caucasian, South Asian, vitamin D, ultraviolet radiation, UVR

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Authors: Zeynep Altinkaya, Ugur Dal, Figen Dag, Dilan D. Koyuncu, Merve Turkegun

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Obesity is defined as abnormal fat-tissue accumulation as a result of imbalance between energy intake and expenditure. Since 50-70% daily energy expenditure of sedantary individuals is consumed as resting energy expenditure (REE), it takes an important place in the evaluation of new methods for obesity treatment. Also, it is known that walking is a prevalent activity in the prevention of obesity. The primary purpose of this study is to evaluate and compare the resting and walking energy expenditures of individuals with different body mass index (BMI). In this research, 4 groups are formed as underweight (BMI < 18,5 kg/m2), normal (BMI=18,5-24,9 kg/m2), overweight (BMI=25-29,9 kg/m2), and obese (BMI ≥ 30) according to BMI of individuals. 64 healthy young adults (8 man and 8 woman per group, age 18-30 years) with no known gait disabilities were recruited in this study. The body compositions of all participants were measured via bioelectric empedance analysis method. The energy expenditure of individuals was measured with indirect calorimeter method as inspired and expired gas samples are collected breath-by-breath through a special facemask. The preferred walking speed (PWS) of each subject was determined by using infrared sensors placed in 2nd and 12th meters of 14 m walkway. The REE was measured for 15 min while subjects were lying, and walking energy expenditure was measured during subjects walk in their PWS on treadmill. The gross REE was significantly higher in obese subjects compared to underweight and normal subjects (p < 0,0001). When REE was normalized to body weight, it was higher in underweight and normal groups than overweight and obese groups (p < 0,0001). However, when REE was normalized to fat-free mass, it did not differ significantly between groups. The gross walking energy expenditure in PWS was higher in obese and overweight groups than underweight and normal groups (p < 0,0001). The regression coefficient between gross walking energy expenditure and body weight was significiant among normal and obese groups (p < 0.05). It accounted for 70,5% of gross walking energy expenditure in normal group, and 57,9% of gross walking energy expenditure in obese group. It is known that obese individuals have more metabolically inactive fat-tissue compared to other groups. While excess fat-tissue increases total body weight, it does not contribute much to REE. Therefore, REE results normalized to body weight could lead to misleading results. In order to eliminate fat-mass effect on REE of obese individuals, REE normalized to fat-free mass should be used to acquire more accurate results. On the other hand, the fat-mass increasement raises energy requirement while walking to retain the body balance. Thus, gross walking energy expenditure should be taken into consideration for the evaluating energy expenditure of walking.

Keywords: body composition, obesity, resting energy expenditure, walking energy expenditure

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Authors: Zylfi Shehu, Rozeta Shatku

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The aim of this study is the identification of the goods and the consequences it brings up the mountain climbing to the youth, how mountain climbing influences in physical activity and the health of young people. Taken to study 37 young people aged 18-30 years, 25 males and 12 females. The selection was made at random and voluntary. Subjects were not professionals but amateurs climbing in the mountain. They were informed and instructed for the test to be carried out. The ascent was made in January 2016 in the Mount of Gjallica in Kukës, Albania, the height of the mountain is 2489 m above sea level. Backpack for each subject weighing 32 kg. Time of ascent, attitude and descent was 6 days. In 22 males, 2 of them did not afford the ascent on the first day and went back. Of the 12 women, 5 of them withdrew on the first day. During the descent on day six, 20 males 7 of them had minor injuries, three with serious injuries. While a total of 7 women, 4 of them had minor injuries and one with serious injuries. Most of the men and women who deal with physical activity throughout life faced the light and were not injured, and the rest that were not dealt with physical activity were more injured. Lack of experience and knowledge was one of the causes of injuries. The subjects had anxiety all the time, uncertainty and fear of avalanches of snow and difficult terrain.

Keywords: climbing, physical activity, young people

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Authors: Tahira Hyder, Saima Quraeshi, Zohaib Akram

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Salvadora Persica (SP) is known to have anti-inflammatory, antioxidant, anti-coagulant and anti-bacterial properties that may provide therapeutic benefits in the treatment of chronic periodontitis (CP). The current clinical trial was designed to investigate the clinical and anti-microbial effects of SP gel as an adjunct to scaling and root planning (SRP) in subjects with generalized CP. Sixty-six subjects with CP were randomized allocated into two groups: SRP + SP gel (test group) and SRP only (control group). Clinical parameters (periodontal pocket depth, gingival recession, clinical attachment level, bleeding score and plaque score) were recorded at baseline before SRP and at 6 weeks. At baseline and 6 weeks subgingival plaque samples were collected and periodontopathogen Porphyromonas Gingivalis (Pg) quantified using Real-time Polymerase Chain Reaction (RT-PCR). Both therapies reduced the mean periodontal pocket depth (PPD), plaque score (PS) and bleeding score (BOP) and improved the mean clinical attachment level (CAL) between baseline and 6 weeks. In subjects receiving adjunctive SP gel a statistically significant improvement was observed in BOP at follow-up compared to control group (15.01±3.47% and 22.81±6.81% respectively, p=0.001), while there was no statistically significant difference in periodontal pocket depth, gingival recession, clinical attachment level and plaque score between both groups. The test group displayed significantly greater Pg reduction compared to the control group after 6 weeks. The current study establishes that local delivery of SP gel into periodontal pocket in CP stimulated a significant reduction in bacteria Pg level and an improvement in gingival health, as evident from a reduced bleeding score, when used as an adjunct to SRP.

Keywords: miswak, scaling and root planing, porphyromonas gingivalis, chronic periodontitis

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Authors: Myla Zenaida Cabrillas-Torio, Von Anthony G. Torio

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Homework is defined as an additional task that a student does outside of the school. This added activity is in recognition of the necessity to spend additional time for subjects such as Mathematics. The dilemma comes in the form of the advantages and disadvantages that can be derived from homework. Studies have revealed varying effects to students on academic and non-academic areas. Teachers are at the forefront of the decision towards the giving or not of homework. Pre-service teachers at the elementary level represent the future leaders of the educational system and should be acquainted and involved at the onset of the dilemma. The main objective of this study is to determine the perspective of pre-service elementary teachers towards homework. The anatomy of their belief can be key towards addressing the issue via teacher training. Salient results revealed that the subjects favor the giving homework on the following grounds: it helps add knowledge and confidence. Those who do not favor homework find it as an additional burden. Difficulties in complying with homework are usually associated with lack of references and performance of other household chores. Students usually spend late nights to comply with homework and are unable to perform at the best of their potentials.

Keywords: attitude, homework, pre-service teachers, mathematics education, Philippines

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Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde

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Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.

Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity

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Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

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Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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Authors: Mohamed Gomaa Mohamed

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Type of study: Observational cross section study. Background and purpose: Forward head posture (FHP) is a common sagittal faulty posture with anterior head translation relative to vertical posture line. FHP related to temporomandibular joint dysfunctions, neck pain and headache. Sports persons usually overuse one side of the body in training and playing leading to postural imbalance, yet the effect of playing football or bodybuilding on measurements of FHP has never been studied. Participants: Thirty six subjects divided into 3 groups of 12 football players, 12 body builders and 12 students. Method: FHP severity was assessed by measuring the craniovertebral (CVA) and gaze angles, using the photogrammetric method. Photos were taken from right side of subjects while assuming standing position. Analysis of variance was used to assess angles difference between the three groups. Results: No significant differences were found in CVA and gaze angles between the three groups (P > 0.05). Conclusion: Playing football or body building doesn't impose significant FHP.

Keywords: craniovertebral angle, gaze angle, football, body building

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Authors: Issam M Hajjaji, Adel Tajoury, Salah R Benhamid

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The MENA region has the highest prevalence of diabetes in the world. Various risk scores were developed, not all appropriate locally. The objective of this study is to apply the FINDRISC Score to adult Libyan males to determine its significance, sensitivity, specificity and Positive Predictive Values as an initial screening tool for type 2 diabetes, and suggest a cut-off point. Methods: 600 subjects answered the questionnaire at their place of work, and their waist, weight, height & BP were measured. Thereafter, after excluding those with known diabetes, an Oral Glucose Tolerance Test was done. Results: 414 subjects aged 19-78 completed the questionnaire and tests. 35 (8.4%) had impaired glucose tolerance (IGT) and 13 (3.1%) had diabetes (DM). The AUC-ROC for IGT was 0.614 (95% CI: 0.527-0.701), for DM 0.810 (95% CI: 0.709-0.911) and for both 0.689 (95% CI: 0.609-0.769). The Positive Predictive Value for a cut-off score of 5 were 15.5%, 11.7% & 5.7% for both conditions combined, prediabetes & diabetes respectively. The equivalent values for a cut-off score of 8 were 16.1%, 9.0% & 7.7%. The Negative Predictive Values were uniformly above 90%. Conclusions & Recommendations: The FINDRISC Score had a low predictive value for dysglycaemia in this sample and performed at a level of significance for IGT that is similar to other MENA countries, but did better for DM. A larger sample that included women is suggested, with a view of adjusting the Score to suit the local population.

Keywords: diabetes, FINDRISK, Libya, prediabetes

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Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda

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The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).

Keywords: health-related QOL, HRQOL, SF-36, motorist, spinal cord injury, Japan

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Authors: Kin On Kwok, Vivian Wei, Benjamin Cowling, Steven Riley, Jonathan Read

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Background: The role of social contact behavior measured in different contact constructs in the transmission of respiratory pathogens with acute respiratory illness (ARI) remains unclear. We, therefore, aim to depict the individual pattern of ARI in the community and investigate the association between different contact dimensions and ARI in Hong Kong. Methods: Between June 2013 and September 2013, 620 subjects participated in the last two waves of recruitment of the population based longitudinal phone social contact survey. Some of the subjects in this study are from the same household. They are also provided with the symptom diaries to self-report any acute respiratory illness related symptoms between the two days of phone recruitment. Data from 491 individuals who were not infected on the day of phone recruitment and returned the symptom diaries after the last phone recruitment were used for analysis. Results: After adjusting different follow-up periods among individuals, the overall incidence rate of ARI was 1.77 per 100 person-weeks. Over 75% ARI episodes involve running nose, cough, sore throat, which are followed by headache (55%), malagia (35%) and fever (18%). Using a generalized estimating equation framework accounting for the cluster effect of subjects living in the same household, we showed that both daily number of locations visited with contacts and the number of contacts, explained the ARI incidence rate better than only one single contact construct. Conclusion: Our result suggests that it is the intertwining property of contact quantity (number of contacts) and contact intensity (ratio of subject-to-contact) that governs the infection risk by a collective set of respiratory pathogens. Our results provide empirical evidence that multiple contact constructs should be incorporated in the mathematical transmission models to feature a more realistic dynamics of respiratory disease.

Keywords: acute respiratory illness, longitudinal study, social contact, symptom diaries

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Authors: Mohammad Alkhatatbeh, Nehad Ayoub, Nizar Mhaidat, Nesreen Saadeh, Lisa Lincz

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CD36 is involved in the development of atherosclerosis by enhancing macrophage endocytosis of oxidized-low density lipoproteins and foam cell formation. Soluble CD36 (sCD36) was found to be elevated in type 2 diabetic patients and was supposed to act as a marker of insulin resistance and atherosclerosis. In young subjects, sCD36 was associated with cardiovascular risk factors including obesity and hypertriglyceridemia. This study was conducted to further investigate the relationship between plasma sCD36 and cardiovascular risk factors among middle-aged patients with metabolic syndrome (MetS) and healthy controls. SCD36 concentrations were determined by enzyme-linked immunosorbent assays (ELISA) for 41 patients with MetS and 36 healthy controls. Data for other variables were obtained from patients' medical records. SCD36 concentrations were relatively low compared to most other studies and were not significantly different between the MetS group and controls (P-value=0.17). SCD36 was also not correlated with age, body mass index, glucose, lipid profile, serum electrolytes and blood counts. SCD36 was not significantly different between subjects with obesity, hyperglycemia, dyslipidemia, hypertension or cardiovascular disease and those without these abnormalities (P-value > 0.05). The inconsistency between results reported in this study and other studies may be unique to the study population or be a result of the lack of a reliable standardized method for determining absolute sCD36 concentrations. However, further investigations are required to assess CD36 tissue expression in the study population and to assess the accuracy of various commercially available sCD36 ELISA kits. Thus, the availability of a standardized simple sCD36 ELISA that could be performed in any basic laboratory would be more favorable to the specialized flow cytometry methods that detect CD36+ microparticles if it was to be used as a biomarker.

Keywords: metabolic syndrome, CD36, cardiovascular risk, obesity, type 2 diabetes mellitus

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Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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