Lower Mean Values Research Articles

Abstract PO3-20-08: Case Studies on Detecting Ductal Carcinoma in Situ Using Contrast-Enhanced Spectral Mammography and Predictive Indicators for Underestimation

Abstract Purpose: To introduce clinical cases of ductal carcinoma in situ (DCIS) underestimation focusing on additional benefits of contrast-enhanced spectral mammography (CESM). Background: DCIS, a noninvasive breast cancer, is often underestimated during diagnosis. Predicting which cases will upgrade to invasive cancer is crucial. CESM offers superior diagnostic performance compared to mammography and mammography with targeted ultrasound (US). Its low-energy images improve microcalcification conspicuity, enable accurate tumor extent measurement, and provide information on enhancements associated with nonmass microcalcifications. Enhanced areas on CESM can be easily compared with mammographic microcalcifications, for they are obtained during the same session. Indicators heralding DCIS underestimation 1. Detectability: underestimated DCIS is more likely to be detected on CESM and mammogram than pure DICS, whereas detection rates do not statistically differ on US and MRI. 2. Lesion type: underestimated DCIS mostly presents as enhancing mass or nonmass lesions on CESM and calcifications on low-energy conventional mammography. 3. Disease extent: on CESM, pure DCIS show smaller tumor extent than the underestimated ones. 4. CESM gray value (CGV) of the lesion on recombined image: the pure DCIS types show lower mean, standard deviation, maximum, and difference values, whereas the underestimated types demonstrate lower minimum values, and vice versa. Case 1: Screen detected pure DCIS without postsurgical upgrade in an asymptomatic 44-year-old woman. US-guided core biopsy yielded DCIS, intermediate nuclear grade with necrosis. Postsurgical pathology confirmed a 1.5 cm pure ductal carcinoma in situ, intermediate nuclear grade with necrosis. (A) US shows a 1.3 cm irregular hypoechoic mass in the right breast. (B) Routine mammography demonstrates no definite abnormality in the right breast. (C) CESM shows a 1.2 cm irregular enhancing mass in the upper central portion of right breast and CGV was 2034 AU. (D) Contrast-enhanced MR images show a 2.1 cm irregular enhancing mass in 12 o’clock direction of the right breast. Case 2: Screen detected DCIS with postsurgical upgrade to microinvasive ductal carcinoma in a 64-year-old woman with nonspecific discomfort in her right breast. US-guided core biopsy yielded DCIS, high nuclear grade with necrosis. Postsurgical pathology confirmed a 2.8 cm sized microinvasive ductal carcinoma, high nuclear grade, histologic grade 3 with necrosis. (A) US demonstrates a 1.9 cm irregular hypoechoic mass with calcifications in 9 o’clock direction 2.1 cm from the nipple in the right breast. (B) Right magnification view shows a 2.5 cm-extent segmentally distributed fine pleomorphic calcifications in the right breast. (C) CESM shows a 3 cm irregular enhancing mass with calcifications in the right breast, and CGV was 2045 AU. (D) Contrast-enhanced MR images shows a 2.3 cm irregular enhancing mass in the right breast. Case 3: Screen detected DCIS with postsurgical upgrade to invasive ductal carcinoma with DCIS in a 47-year-old woman who had a family history of breast cancer. US-guided core biopsy yielded DCIS, intermediate nuclear grade with necrosis. Postsurgical pathology confirmed a 0.2 cm invasive ductal carcinoma with 2.4 cm DCIS. (A) US demonstrates a 2.3 cm irregular hypoechoic mass in the left breast. (B) Routine mammography shows asymmetry in the upper portion of the left breast. (C) CESM shows a 3 cm enhancing mass in the left breast, and CGV of the lesion on MLO-recombined image was 2072 AU. (D) Contrast-enhanced MR image shows a 6 cm irregular enhancing mass in the upper portion of the left breast. Conclusion: CESM provides added advantages over mammography and breast US in detecting underestimated DCIS, and it is comparable to breast MRI. Key indicators to consider include detectability, enhancing lesion, larger tumor extent, higher mean CGV on CESM. Citation Format: Minji Song, Hee Jung Shin. Case Studies on Detecting Ductal Carcinoma in Situ Using Contrast-Enhanced Spectral Mammography and Predictive Indicators for Underestimation [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-20-08.

Tree Radial Growth Responses to Climate and Reservoir Impoundment in Valleys in Southwestern China

Southwestern China is a critical biodiversity hotspot area, and many large hydroelectric projects have been established in the valleys in the region. Tree growth in the valleys will be affected by both regional climate and reservoir impoundment. However, it remains unknown whether the radial growth of trees in the valleys has a common response pattern to the regional climate, and it is also unclear whether the response of radial growth to reservoir impoundment can be detected. In this study, we developed tree-ring width chronologies of Pinus yunnanensis Franch. collected at 11 sites with vertical and horizontal gradients to three hydroelectric reservoirs in three riverine valleys in southwestern China. We analyzed the radial growth responses to the regional climate from 1986 to 2017 by correlation with instrumental meteorological data. Tree growth responses to reservoir impoundment were investigated through spatial and temporal comparisons using the change in the Euclidean distance and difference test. We also distinguished their responses at tree-ring sites without influenced by reservoir impoundment including two sites in the valleys and seven sites at high elevations. The results showed that the climate conditions in May and the dry season before the growth season significantly limit the radial growth in the valleys, which is different to that at high-elevation areas in southwestern China. Growth variations in the valleys are related to elevations and the trees in similar slopes positions exhibit similar responses. For trees in the low slope positions, both variance and mean values of radial growth are affected by reservoir impoundment. Trees at relatively low sites (i.e., sites M2, R2, L2), rather than the trees close to the reservoirs (i.e., sites M1, R1, L1), respond more sensitively to reservoir impoundment.

Effect of Dance on Body Type: A Study on Adult Bengalee Female in North 24 Parganas, West Bengal

Due to the economic development in Indian society, most people are experiencing a sedentary lifestyle and least physical exercise, which is responsible for the increase in various health issues. Exercise plays a great role in maintaining our health, and dancing is an enjoyable exercise which involves various body movements to stay fit and maintain the body shape. The present study attempted to find out the differences in body types between female dancers and non-dancers used as a control group. Out of total 140 female participants aged 18–40 years, 70 were dancers and the remaining 70 were age-matched controls. Heath and Carter’s method of somatotyping was used to estimate the somatotypes of dancers and controls. Dancers and controls differed significantly ( t-test, p <.05) in terms of their body types and shapes, with dancers having greater mean values of mesomorphy, while lower mean values of endomorphy and WHR compared to the control group. This study suggests, based on somatotype, that dancers were more muscular and less fatty than the control group. Also, dancers were found to have a lower waist circumference than the hip circumference, resulting in a pear-shaped body. In light of this, the study indicates that dancing is a useful art form and a health-beneficial substitute for other forms of exercise.

Evaluation of compressive strength, microhardness and solubility of zinc-oxide eugenol cement reinforced with E-glass fibers

BackgroundZinc-oxide eugenol (ZOE) cements are among the most used temporary materials in dentistry. Although ZOE has advantages over other temporary fillers, its mechanical strength is weaker, so researchers are working to improve it. E-glass fibers have emerged as promising reinforcing fibers in recent years due to their strong mechanical behavior, adequate bonding, and acceptable aesthetics.ObjectivesTo evaluate and compare the compressive strength, surface microhardness, and solubility of the ZOE and those reinforced with 10 wt.% E-glass fibers.MethodsA total of 60 ZEO specimens were prepared; 30 specimens were reinforced with 10 wt.% E-glass fibers, considered modified ZOE. The characterization of the E-glass fibers was performed by XRF, SEM, and PSD. The compressive strength, surface microhardness, and solubility were evaluated. Independent sample t-tests were used to statistically assess the data and compare mean values (P ≤ 0.05).ResultsThe results revealed that the modified ZOE showed a significantly higher mean value of compressive strength and surface microhardness while having a significantly lower mean value of solubility compared to unmodified ZOE (P ≤ 0.05).ConclusionThe modified ZOE with 10 wt.% E-glass fibers had the opportunity to be used as permanent filling materials.

Gendered Perspectives on Sustainable Entrepreneurship: A Study of Finnish SMEs

The objective of this research is to understand how gender is related to opportunities of sustainable entrepreneurship. The data was gathered from Finnish SMEs, and it has responses from 202 SME owner-managers. Of the SME owner-managers, 28 % were women and 72 % male. Most of the SMEs were small sized and employed under 50 employees. First, we developed a taxonomy of green entrepreneurship by building an instrument with 10 items (7-point Likert scale) based on the definitions of green SMEs. For building the taxonomy, we performed an exploratory factor analysis, which produced three factors. The first factor was named as “green entrepreneurs”. This factor measures the behaviour related to seeking business opportunities from green transition and reducing the negative impact of SME’s operations. The second factor was named as “green missionaries”. This factor measures behaviour related to active promotion of green transition and the SME’s vision to improve the state of the environment. The third factor was named as “no concern for environmental issues”. SMEs with high values in this factor represent SMEs who think that environmental issues do not concern their business or industry. Based on these factors, scales were created with acceptable reliability (Cronbach’s alphas over 0,70). Secondly, we performed t-tests to test mean differences between men and women in these scales. Results show that women have higher mean values in the scale “green entrepreneurs” (4,9 vs. 4,3), and lower mean values in the scale “no concern for environmental issues” (2,8 vs. 3,2). No mean differences between men and women were found in the scale “green missionaries”. The results indicate that women approach the opportunities offered by sustainable entrepreneurship differently than men. They are more proactive in seeking new business opportunities and are more inclined than men to promote sustainability principles in their own business operations. This research sheds light on how women and men engage differently in green business initiatives, providing valuable insights for fostering gender-inclusive sustainability strategies.

Oculometric responses to high emotional impact advertising stimuli: a comparison with autonomic and self-report measures

Covid-19 affected people’s social lives and advertising (ADV) behavior. This study used implicit (oculometric and autonomic) and explicit (self-report) measures to understand the consumer’s emotional and attentional involvement with ADV. Twenty participants watched Covid-19- related and neutral ADVs (No-Covid-19 stimuli) in two different exposure orders. Oculometric, autonomic, and self-report data were collected. Participants were randomly divided into two groups that watched Covid stimuli followed by No-Covid stimuli (Order 1) or the opposite (Order 2). Oculometric data showed a decrease in Time to First Fixation, Fixation Count, and Fixation Duration sum for the Covid compared to the No-Covid condition, suggesting the Covid stimuli were more salient. Lower cardiovascular mean values for Covid condition in Order 1 were interpreted as a parasympathetic inhibitory mechanism linked to a potential freezing effect. Self-report data confirmed eye-tracking and autonomic evidence. Given the emotional impact of Covid stimuli, using Covid-themed ADV can be a helpful marketing strategy.

Assessment of Isokinetic Trunk Muscle Strength and Fatigue Rate in Individuals after Bariatric Surgery.

Background and Objectives: Lean body mass loss after bariatric surgery (BS) is remarkable, despite an effective long-term mass reduction and significant declines in comorbidities. A person's functional capacity is adversely affected when their skeletal muscle strength declines by up to 30%. This study aimed to assess the isokinetic trunk muscle strength and fatigue rate in individuals after BS. Materials and Methods: This study included fifty-eight patients, both male and female, ranging in age from 19 to 45. Twenty-seven individuals had BS and twenty-seven healthy people served as the control group. The primary outcomes were the measurement of the concentric and eccentric isokinetic muscle strength of the trunk flexor and extensor muscles. An isokinetic dynamometer (Biodex Rehabilitation and Testing System 3) was used for the assessment of the isokinetic muscle strength. Noraxon EMG was used to determine a secondary outcome, which was the median frequency slop (MF/time) and root mean square slop (RMS/time) of the lumbar erector spinea muscle at 50% of the Maximum Voluntary Isometric Contraction (MVIC). Outcome measures were assessed for both groups. Results: Compared to the control group, the bariatric group showed a lower mean value of both concentric and eccentric isokinetic muscle strength for the flexor and extensor trunk muscles (p < 0.05). In terms of the EMG fatigue rate, the RMS slope increased significantly more than that of the control group, while the MF slope decreased (p > 0.05). Conclusions: The current study found that, in comparison to the healthy subjects, the BS group showed reduced levels of fatigue and isokinetic strength in the trunk muscles. Based on these results, it is recommended that individuals who underwent BS take part in tailored rehabilitation programs to avoid potential musculoskeletal issues in the future.

Active Ankle–Foot Orthosis Design and Computer Simulation with Multi-Objective Parameter Optimization

There are many current active orthosis designs to assist with disabilities related to foot-drop, with most of them intervening during the whole gait cycle. We propose that, for the treatment of foot-drop, it is possible to design an ankle–foot device that will assist a walking user only during the dorsiflexion stages of the gait, avoiding interference with other stages, by using a single actuator with a simple transmission and a suspension block. This design can be improved by the use of multi-objective optimization to obtain a static set of parameters that are applicable to varying initial conditions. We present a computer simulation study of an active ankle–foot orthosis design, based on the interaction of a cam and lever with a suspension block, with the objective of assisting only with dorsiflexion during the gait cycle, leaving the rest of the movements unimpeded while reducing the complexity and weight of the device. This design is validated using a full simulation environment that includes the movements of the lower leg and foot, as they interact with our device and a ground element. As part of the design and validation, we found sets of mechanical and control parameters that provoke adequate output behavior of the orthosis to help the wearer perform a moderate-speed, normal gait. To optimize the design, we proposed three objectives to warrant ankle angle accuracy, minimal oscillations, and low energy consumption. A set of solutions was obtained with multi-objective optimization algorithms NSGA-II and RVEA to tune the parameters of the active orthosis. The solutions set from RVEA resulted in lower mean and standard deviation values for the oscillations and energy objectives in comparison to the solutions from NSGA-II, while for the MSE objective, NSGA-II obtained lower mean and standard deviation; for the energy consumption objective, the mean score using RVEA is 17% less than with NSGA-II. The orthosis is shown to be robust to differences in initial ankle angles. We observed that it is possible to obtain a broad set of solutions with a good performance during the gait cycle in controlled spaces and that in this application, the RVEA algorithm results in a better option for optimization to balance the objectives.

Utility of single fibre electromyography (SFEMG)and motor unit number estimation technique (MUNE) in the diagnosis and differentiation of polyneuropathies of different aetiology

Objectives: To determine whether single fibre electromyography and motor unit number index can distinguish between axonal and myelin lesions in polyneuropathies. Method: This case-control study was conducted at the Department of Medical Physiology, School of Medicine, University of Duhok, Iraq, and the Neurophysiology Department, Hawler Teaching Hospital, Erbil, Iraq, from January 2021 to March 2022. Group A had patients diagnosed with polyneuropathy regardless of the aetiology, while group B had age-matched healthy controls. Both groups were subjected to single fibre electromyography and motor unit number index as well as conventional nerve conduction study and concentric needle electromyography. Data was analysed using SPSS 26. Results: Of the 140 subjects, 60(43%) were patients in group A; 40(67%) males and 20(33%) females with mean age 55.3±7.2 years. There were 80(57%) controls in group B; 43(54%) females and 37(46%) males with mean age 53.81±7.15. Group A had significantly higher single fibre electromyography jitter, and mean consecutive difference (MCD) values than group B (p&lt;0.05). Group A patients with axonal polyneuropathy had a higher mean jitter (MCD) value (36.476.7ms) than those with demyelinating polyneuropathy (23.262.31 ms) (P &lt;0.05). Patients in group A had a motor unit number index value with a significantly lower mean value (p&lt;0.05) when compared to the controls. Axonal polyneuropathy patients had a lower MUNIX value (99.612.8) than demyelinating polyneuropathy patients (149.845.7) (P&lt; 0.05). Conclusions: Single fibre electromyography and motor unit number index could help differentiate between the pathophysiology of axonal and demyelinating polyneuropathy. Key Words: Single fibre electromyography, Motor unit number index, Polyneuropathy classification, Nerve conduction studies.

Effects of restraint stress and surface treatments on the stability of titanium dental implant osseointegration in dogs: An in vivo comparative study

ObjectivesThis study was aimed at assessing the effects of restraint stress and sandblasting; sandblasting with acid etching; Er˗Cr: YSGG laser treatment; and propolis coating of implant surfaces on the implant stability quotient (ISQ) of grade 4 titanium dental implant osseointegration in model dogs. MethodsA total of forty-eight CPTi dental implants were divided into four groups according to surface treatment: group A: sandblasting with acid etching; group B: sandblasting with Al2O3; group C: Er˗Cr: YSGG laser; and group D: propolis coating. Sixteen male dogs of local breed,1˗1.5 years of age, weighing 22 ± 3 kg, were divided into two main groups (n˗8 dogs each): a non-stressed group (group I) and stressed group (group II). Each of these groups is further divided into four implant groups per surface treatment, A, B, C, and D (two dogs per implant group), each dog has three implants. The ISQ was tested at 0 (baseline), 14, and 90 days with a noninvasive EasyCheck® device. Serum cortisol in the stressed and non-stressed groups was analyzed at 0, 15, 30, 45, 60, 75, and 90 days with a canine cortisol ELISA kit. The data were statistically analyzed with one-way analysis of variance and Tukey's post hoc test at a 0.05 level of significance. ResultsFor implant stability quotient (ISQ), sandblasting in the non-stressed (group I) had the highest mean value (88.0) at 90˗days, whereas sandblasting with acid etching at 14˗days had the lowest mean value (82.6). Sandblasting in the stressed (group II) had the highest mean value (88.3) at 90˗days, whereas the laser surface treatment had the lowest mean value (72.00) at 14˗days. Serum cortisol (ng/μl) at 90 days (143.10 and 195.33 for non-stressed and stressed groups respectively), was significantly higher than other time intervals (P < 0.05). ConclusionsThe ISQ was dependent on surface treatment, and was higher with sandblasting than the other treatments in the stressed and non-stressed groups at 90 days. For all surface-treated implants, the stressed group had significantly higher serum cortisol levels than the non-stressed group.

Analysis of Difficulty Index, Discrimination Index and Distractor Efficiency in Multiple Choice Questions

Background: The item analysis of multiple-choice questions (MCQs) is an essential tool that can provide input on validity and reliability of items. It helps to identify items, which can be revised or discarded, thus building a quality MCQ bank. Aim: The aim of the study to evaluate the quality of MCQs by analyzing DIF, DI and DE and to find out the association of MCQs having good difficulty and discrimination indices with DE. Method: The study was conducted in the Department of Maternity and Child Health Nursing at the College of Nursing during the academic year 2023, second semester. Students of level six who took the final exam of one-course second-semester academic year 2023, A total of 152 third-year Bachelor of Nursing. The item analysis explored the difficulty index (DIF I) and discrimination index (DI) with distractor effectiveness (DE). Data was kept confidential and the descriptive and inferential statistics will be computed using SPSS 22.0. Results: A total of 50 MCQs, the majority, that is, 74 (82%) MCQs had a good/acceptable level of difficulty with a mean DIF I of 94.94 ± 6.36 (mean ± SD); this indicates that, on average, the MCQs were relatively easy for the students, as the difficulty index is close to 100. The discrimination index, which assesses the ability of the MCQs to differentiate between high and low-performing students, had a mean of 0.11 and a standard deviation of 0.47. This relatively low mean value suggests that the MCQs had limited discriminatory power, meaning they did not effectively distinguish between students with different levels of performance. 150 (75%) were categorized as functional distractors (FDs). These FDs effectively served their purpose by distracting students from selecting the correct answer, challenging their knowledge and understanding. On the other hand, 50 distractors (25%) were classified as non-functional distractors (NFDs). Conclusion: The categorization of the MCQs based on distractor efficiency highlights the importance of having well-constructed and effective distractors. The presence of functional distractors challenges students' decision-making, while non-functional distractors need to be revised or replaced to improve the overall quality of the MCQs. This finding indicates a potential area for improvement in the construction and selection of MCQs to enhance their ability to differentiate student abilities

Evaluation of Bony Femoral Morphological Parameters in Anterior Cruciate Ligament Injury Using Magnetic Resonance Imaging: A Retrospective Unmatched Case-Control Study.

Background Over time, there has been a noticeable increase in anterior cruciate ligament (ACL) injuries. The current imperative is to anticipate predisposing factors and proactively prevent ACL injuries. The occurrence of ACL injuries has been linked to diverse factors associated with the morphology of the distal femur. Objectives Through this study, we aim to compare the anatomic variables of distal femur morphology such as notch width (NW), bicondylar width (BW), notch entrance width (NEW), and notch width index (NWI) between patients with ACL injuries and non-injured patients using MRI. We also aim to make a comparison of these factors between male and female genders to assess the gender variability. Material and methods A retrospective case-control study was conducted amongst patients who underwent MRI Knee scan for clinical suspicion of internal derangement during the study period. We selected the first 125 individuals who were found to have ACL injury in the MRI scans and selected another 125 individuals who had an intact ACL in the scans, to serve as controls in the study. Demographic information was retrieved from the hospital's electronic records, and the assessment of NW, NWI, BW, and NEW was conducted through a review of MRI sequences. They were then compared between the cases and control groups, as well as between male and female genders. Results The ACL-injured group exhibited statistically significant reductions in NW and NWI. While 17.39 mm was the mean NW among cases, 17.86 was the mean value among controls. Similarly, the mean NWI was 0.25 among patients with ACL injuries and 0.27 among controls. Gender-based comparisons also revealed statistically significant differences in NW and NWI measurements, where females were reported to have comparatively lower measurements. The mean NW for males and females in the injured group were 18.26 mm and 15.40 mm, respectively, while it was 18.71 mm and 16.90 mm, respectively, in the control group. In the case of NEW, males in the injured group had a slightly higher value (21.33 mm) than the controls (20.65). Females on the other hand exhibited a lower mean value of NEW in ACL-injured group (18.51 mm) in comparison to the non-injured (18.79 mm). BW did not seem to show a significant difference between the two groups. Conclusions In the studied population, ACL injuries demonstrated a higher occurrence in individuals with a narrow femoral intercondylar NWI. If any of these characteristics are identified in an MRI, it may be helpful to identify individuals who are at a higher risk of developing ACL injuries and may thereby help in planning preventative strategies.

Effect of Low Level Laser Therapy Vs Ultrasound Therapy in The Management of Temporomandibular Joint Pain Syndrome

The temporomandibular joint is a synovial joint made up of articulating surface of the temporal bone and the head of the mandible.Patients suffering from temporomandibular joint pain syndrome will frequently have pain in the region, limitation in opening, asymmetrical jawmovements, and restricted jaw movements. The etiology is associated with several factors, including malocclusion, trauma, emotional stress,and para-functional habits, which cause excruciating pain and inflammation of the surrounding muscle, posterior fibers, and synovial fluid. Thisstudy evaluated and compared the effectiveness of low-level laser therapy (LLLT) and ultrasound therapy (UST) in managing temporomandibularjoint pain syndrome. This experimental study of pre and post-comparative types involves 30 subjects with temporomandibular joint painsyndrome who were selected from the outpatient department. This study included 30 subjects divided into two groups of each 15 by simplerandom sampling method.15 sessions each alternate day of low-level laser therapy (GROUP A) and ultrasound therapy (GROUP B) wereadministered to the affected side. Both groups received stretching exercises as a common intervention. Group A received low-level lasertherapy along with stretching exercises for 7 sessions /week/10 min. Group B received ultrasound therapy and stretching exercises for 7sessions /one weeks/10 min. On comparing the mean values of Group A &amp; Group B on the Visual Analogue Scale Score in terms of painintensity, it shows a significant decrease in the post-test mean values in both groups, but (Group A - Low-level Laser Therapy) shows 2.33,which has the lower mean value is more effective than (Group B - Ultrasound Therapy) 3.53 at P ≤ 0.001. Hence the null Hypothesis isrejected. On comparing the pre-test and Post-test between Group A &amp; Group B on VAS Score, Group A shows a highly significant difference inmean values at P ≤ 0. 001. Thus, we conclude that low-level laser therapy is more effective than ultrasound therapy in the management oftemporomandibular joint pain syndrome.

Long-term outcomes in sacral agenesis.

Sacral agenesis (SA) includes a range of clinical presentations of varying severity, with implications for function and quality of life (QoL). Diagnosis is often made perinatally, and prognostic discussions become an important aspect of parental counselling. This study engaged SA sufferers and their caregivers to obtain objective, long-term patient reported outcome data. Patients with radiologically confirmed SA from a single tertiary spinal unit underwent retrospective medical record review. Patients were then contacted by telephone to complete QoL questionnaires including EQ-ED-5L for adults and EQ-ED-Y for < 16-year-olds. Additional information including Renshaw grade, employment, living situation and bladder function was also collected. Twenty-six patients with SA were identified. Mean age is 23.35years (range 0.92-63.53), 13M:17F. Renshaw grade ranged from 1 to 4. Sixty-eight percent had associated kyphoscoliotic deformities. The majority (70%) had either impaired or absent bladder control, and 80% need walking aids to mobilise. Twenty patients completed the questionnaire (10 adults and 10 < 16-year-olds). Mean EQ-ED-5L index for adults was +0.474 (range -0.1 to +0.089, 1 = best), with a lower mean value of +0.287 (range -0.54 to +1) for the < 16-year cohort. Those undergoing spinal fusion procedures had significantly lower scores (-0.08 v +0.44, p = 0.022). This study provides an objective record of the QoL of individuals with SA, illustrating a wide variety of outcomes, with differences between younger and older individuals which may reflect the results of a long-term adaptive process. The implications for individuals should be carefully tailored to the specific deformity and the likely underlying neurological deficits.

Aromatase deficiency in transplanted bone marrow cells improves vertebral trabecular bone quantity, connectivity, and mineralization and decreases cortical porosity in murine bone marrow transplant recipients.

Estradiol is an important regulator of bone accumulation and maintenance. Circulating estrogens are primarily produced by the gonads. Aromatase, the enzyme responsible for the conversion of androgens to estrogen, is expressed by bone marrow cells (BMCs) of both hematopoietic and nonhematopoietic origin. While the significance of gonad-derived estradiol to bone health has been investigated, there is limited understanding regarding the relative contribution of BMC derived estrogens to bone metabolism. To elucidate the role of BMC derived estrogens in male bone, irradiated wild-type C57BL/6J mice received bone marrow cells transplanted from either WT (WT(WT)) or aromatase-deficient (WT(ArKO)) mice. MicroCT was acquired on lumbar vertebra to assess bone quantity and quality. WT(ArKO) animals had greater trabecular bone volume (BV/TV p = 0.002), with a higher trabecular number (p = 0.008), connectivity density (p = 0.017), and bone mineral content (p = 0.004). In cortical bone, WT(ArKO) animals exhibited smaller cortical pores and lower cortical porosity (p = 0.02). Static histomorphometry revealed fewer osteoclasts per bone surface (Oc.S/BS%), osteoclasts on the erosion surface (ES(Oc+)/BS, p = 0.04) and low number of osteoclasts per bone perimeter (N.Oc/B.Pm, p = 0.01) in WT(ArKO). Osteoblast-associated parameters in WT(ArKO) were lower but not statistically different from WT(WT). Dynamic histomorphometry suggested similar bone formation indices' patterns with lower mean values in mineral apposition rate, label separation, and BFR/BS in WT(ArKO) animals. Ex vivo bone cell differentiation assays demonstrated relative decreased osteoblast differentiation and ability to form mineralized nodules. This study demonstrates a role of local 17β-estradiol production by BMCs for regulating the quantity and quality of bone in male mice. Underlying in vivo cellular and molecular mechanisms require further study.

An in vitro study using confocal laser scanning microscopy to evaluate the marginal misfits of different implant-supported frameworks.

This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). The greatest |X| misfit was observed in the OP group with both screws tightened (290µm) and one screw tightened (388 and 340µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35µm, both screws tightened; and 275µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

Circulating miR-206, miR-181b, and miR-21 as promising biomarkers in hypothyroidism and their relationship to related hyperlipidemia and hepatic steatosis.

Background: Thyroid hormones (THs) signaling has profound effects on many physiological processes. The regulation of THs signaling in various tissues involves the action of microRNAs (miRNAs) on thyroid deiodinases and receptors. THs regulate the expression of certain miRNAs and their target messenger RNAs (mRNAs) in various tissues and cells. The modulation of miRNA levels by THs affects their functions in processes such as liver lipid metabolism, skin physiology, and muscle and heart performance. Aim: This research aimed to investigate miR-181b, miR-206, and miR-21 in the serum of patients with subclinical and overt hypothyroidism to determine their possible role in the diagnosis of the disease and their relationship to clinical disorders related to hypothyroidism. Methods: This study included ninety participants, divided evenly into three groups as follows: patients with overt hypothyroidism diagnosed clinically, radiologically, and by investigation, subclinical hypothyroid patients, and healthy volunteers. The patients had a thorough medical history and underwent a clinical examination. Laboratory tests included plasma cholesterol, LDL, HDL, TGs, liver and renal function tests, CBC, fasting insulin, HOMA-IR, HbA1c, TSH, and free T4. The serum levels of miR-21, miR-206, and miR-181b were measured using qRT-PCR. Results: miR-206 and miR-181b levels were higher in the subclinical group, followed by the hypothyroid and control groups. For miR-21, there was a significantly lower mean value in both the hypothyroid and subclinical groups than in the control group, with no difference between the two groups. Both miR-206 and miR-181b showed a significant negative association with albumin and free T4 levels and a significant direct association with GGT, ALT, AST, creatinine, uric acid, TGs, TC, LDL, TSH, thyroid volume, and CAP score. The same correlation pattern was observed for miR-181b, except that it was not significantly correlated with the TGs. For miR-21 levels, there was a significant positive correlation with albumin, free T4 level, and kPa score and a negative correlation with GGT, ALT, AST, creatinine, uric acid, HOMA-IR, HbA1c, TC, LDL, TSH, and CAP score. Cases with F1 kPa score and S2 CAP scores had significantly higher averages for miR-206 and miR-181b, with a p-value of 0.05. Moreover, miR-21 levels were significantly lower in the S2 CAP score group. Conclusion: These miRNAs (miR-206, miR-181b, and miR-21) may be used as diagnostic biomarkers for hypothyroidism. They may be used as therapeutic targets to control dyslipidemia and hepatic steatosis during hypothyroid disease.

Trajectories and tipping points of piñon-juniper woodlands after fire and thinning.

Piñon-juniper (PJ) woodlands are a dominant community type across the Intermountain West, comprising over a million acres and experiencing critical effects from increasing wildfire. Large PJ mortality and regeneration failure after catastrophic wildfire have elevated concerns about the long-term viability of PJ woodlands. Thinning is increasingly used to safeguard forests from fire and in an attempt to increase climate resilience. We have only a limited understanding of how fire and thinning will affect the structure and function of PJ ecosystems. Here, we examined vegetation structure, microclimate conditions, and PJ regeneration dynamics following ~20 years post-fire and thinning treatments. We found that burned areas had undergone a state shift that did not show signs of returning to their previous state. This shift was characterized by (1) distinct plant community composition dominated by grasses; (2) a lack of PJ recruitment; (3) a decrease in the sizes of interspaces in between plants; (4) lower abundance of late successional biological soil crusts; (5) lower mean and minimum daily soil moisture values; (6) lower minimum daily vapor pressure deficit; and (7) higher photosynthetically active radiation. Thinning created distinct plant communities and served as an intermediate between intact and burned communities. More intensive thinning decreased PJ recruitment and late successional biocrust cover. Our results indicate that fire has the potential to create drier and more stressful microsite conditions, and that, in the absence of active management following fire, there may be shifts to persistent ecological states dominated by grasses. Additionally, more intensive thinning had a larger impact on community structure and recruitment than less intensive thinning, suggesting that careful consideration of goals could help avoid unintended consequences. While our results indicate the vulnerability of PJ ecosystems to fire, they also highlight management actions that could be adapted to create conditions that promote PJ re-establishment.

Measurement of Calprotectin and PTH in the Amniotic Fluid of Early Second Trimester Pregnancies and Their Impact on Fetuses with Growth Disorders: Are Their Levels Related to Oxidative Stress?

Background: During the early stages of human fetal development, the fetal skeleton system is chiefly made up of cartilage, which is gradually replaced by bone. Fetal bone development is mainly regulated by the parathyroid hormone parathormone (PTH) and PTH-related protein, with specific calprotectin playing a substantial role in cell adhesion and chemotaxis while exhibiting antimicrobial activity during the inflammatory osteogenesis process. The aim of our study was to measure the levels of PTH and calprotectin in early second trimester amniotic fluid and to carry out a comparison between the levels observed among normal full-term pregnancies (control group) and those of the groups of embryos exhibiting impaired or enhanced growth. Methods: For the present prospective study, we collected amniotic fluid samples from pregnancies that underwent amniocentesis at 15 to 22 weeks of gestational age during the period 2021–2023. Subsequently, we followed up on all pregnancies closely until delivery. Having recorded fetal birthweights, we then divided the neonates into three groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: In total, 64 pregnancies, including 14 SGA, 10 LGA, and 40 AGA fetuses, were included in our study. Both substances were detected in early second trimester amniotic fluid in both groups. Concentrations of calprotectin differed significantly among the three groups (p = 0.033). AGA fetuses had a lower mean value of 4.195 (2.415–6.425) IU/mL, whereas LGA fetuses had a higher mean value of 6.055 (4.887–13.950) IU/mL, while SGA fetuses had a mean value of 5.475 (3.400–9.177) IU/mL. Further analysis revealed that only LGA fetuses had significantly higher calprotectin concentrations compared to AGA fetuses (p = 0.018). PTH concentration was similar between the groups, with LGA fetuses having a mean value of 13.18 (9.51–15.52) IU/mL, while SGA fetuses had a mean value of 14.18 (9.02–16.00) IU/mL, and AGA fetuses had similar concentrations of 13.35 (9.05–15.81) IU/mL. The differences in PTH concentration among the three groups were not statistically significant (p = 0.513). Conclusions: Calprotectin values in the amniotic fluid in the early second trimester were higher in LGA fetuses compared to those in the SGA and AGA categories. LGA fetuses can possibly be in a state of low-grade chronic inflammation due to excessive fat deposition, causing oxidative stress in LGA fetuses and, eventually, the release of calprotectin. Moreover, PTH concentrations in the amniotic fluid of early second trimester pregnancies were not found to be statistically correlated with fetal growth abnormalities in either LGA or SGA fetuses. However, the early time of collection and the small number of patients in our study should be taken into account.

Effect of Bypass Fat and Bypass Protein Supplementation During Transition Period on Reproductive Performance of Assam Hill Goat

The present study was undertaken to evaluate the response of Assam Hill Goat (AHG) in terms of their productive and reproductive performances upon bypass fat and bypass protein supplementation during the transition period. Twenty-four AHG in transition period (21day prepartum to 21day post-partum) were divided into two equal groups (n=12) viz. T-0 and T-1; where Group T-1 was supplemented with 10 g of bypass fat and 5 g of bypass protein along with their normal diet for a period of 42 days. Group T-0 acted as control and was provided with a normal diet without any supplementation. Blood samples were collected on day -21, -14, -7, 0 (day of kidding), +7, +14 and +21 of the transition period for haemato-biochemical studies. Birth weight, milk yield and time taken for expulsion of foetus and foetal membrane and incidences of peri-partum diseases were recorded. The results indicated that, the supplementation had no significant effect on haematological parameters (TLC, Neutrophil count and Hb), serum Ca, P, glucose, globulin and GGT activity. Serum non-esterified fatty acids (NEFA) levels were significantly (p&lt;0.05) lower in supplemented groups on the day of kidding (0.75±0.09 mmol/L) and day 21 of postpartum (0.38±0.04 mmol/L). Significantly (p&lt;0.05) higher mean values of total protein on day -14, -7, 0, 7, 14 and 21 (6.96±0.21, 6.99±0.25, 7.02±0.26, 7.24±0.28, 7.03±0.12 and 6.95±0.15 g/dL) and serum albumin values on day -14, 7 and 21 (4.46±0.23, 4.69±0.23 and 4.44±0.27 g/dL) were recorded in T-1 group. Significantly (p&lt;0.05) lower mean values of BUN were recorded in T-1 group on day 0, 7 and 21 (30.25±1.74, 35.62±1.58 and 42.08±1.45 mg/dL). The supplemented (T–1) group recorded significantly higher milk yield (303.5±21.16, 306.25±19.67 and 310.75±23.93 ml) on day 14, 21 and 28 after kidding and there was a significant (p&lt;0.05) reduction in time taken for the expulsion of foetus (89.75±11.84 mins) and foetal membranes (90.50±5.86 mins). The supplementation of bypass fat (10g/day) and bypass protein (5 g/day) during the transition period reduce the effect of negative energy balance and facilitate quicker recovery from negative energy balance along with improvement in milk yield and reduce time taken for expulsion of foetus and foetal membrane.