Moderate Negative Linear Correlation Research Articles

Pulmonary function in Thai patients with systemic sclerosis;a single center 6-year retrospective study.

Pulmonary involvement is a major cause of internal organ complication and the leading cause of death in patients with systemic sclerosis (SSc). This study aimed to demonstrate the characteristics of pulmonary function (PF) in Thai patients with SSc and the association between PF and body mass index (BMI) and anti-topoisomerase (anti-Scl70). All patients diagnosed with SSc in our tertiary care teaching hospital database between 2016 and 2021 were reviewed and analyzed. Of 211 SSc patients, 128 patients who underwent the PF test were enrolled; 102 (79.7%) were female. The mean age was 54 years. The median BMI for all patients was 21.7 kg/m 2. Regarding anti-Scl70, 10.9% of patients were positive, 7.8% were negative, and the status was unreported for 81.3%. The mean (SD) forced expiratory volume in one second (FEV1) forced vital capacity (FVC) ratio was 0.8 (0.1). The mean (SD) % predicted values of FEV1, FVC, and diffusing capacity of the lungs for carbon monoxide (DLCO) were 76.3 (16.3), 69.1 (15.8), and 75.5 (22.8), respectively. A restrictive spirometry pattern (RSP) was found in 78.8% of the patients. DLCO had a moderate positive linear correlation with FVC (r=0.50, p <0.001) and a moderate negative linear correlation with BMI (r=-0.36, p <0.001). However, there was no correlation between FVC and BMI. There was no statistical difference in demographic data or the presence of anti-Scl70 among patients with or without RSP. RSP is common among Thai patients with SSc. However, the power of using demographic data and the presence of anti-Scl70 to determine the probability of pulmonary involvement remains limited.

Pulmonary function in Thai patients with systemic sclerosis; a single center 6-year retrospective study

Background Interstitial lung fibrosis is a major cause of internal organ involvement and the leading cause of death in patients with systemic sclerosis (SSc). This study aimed to demonstrate the characteristics of pulmonary function (PF) in Thai patients with SSc and the association between PF and body mass index (BMI) and anti-topoisomerase (anti-Scl70). Methods All patients diagnosed with SSc in our tertiary care teaching hospital database between 2016 and 2021 were reviewed. Clinical characteristics and PF were recorded and analyzed. Results Of 211 SSc patients, 128 patients who underwent the PF test were enrolled; 102 (79.7%) were female. The mean (SD) age was 54.0 (12.5) years. The mean (SD) forced expiratory volume in one second (FEV1) forced vital capacity (FVC) ratio was 0.8 (0.1). The mean (SD) % predicted values of FEV1, FVC, and diffusing capacity of the lungs for carbon monoxide (DLCO) were 76.3 (16.3), 69.1 (15.8), and 75.5 (22.8), respectively. A restrictive spirometry pattern (RSP), defined as FVC &lt; 80% predicted, was found in 78.8% of the patients. DLCO had a moderate positive linear correlation with FVC (r=0.50, p &lt;0.001) and a moderate negative linear correlation with BMI (r=-0.36, p &lt;0.001). However, there was no correlation between FVC and BMI. There was no statistical difference in demographic data or the presence of anti-Scl70 among patients with or without RSP. Conclusions RSP is common among Thai patients with SSc. Spirometry is a cost-effective screening tool for detecting SSc-related pulmonary involvement in resource-limited settings. However, the power of using demographic data and the presence of anti-Scl70 to determine the probability of pulmonary complications remains limited.

Novel inflammatory mediator profile observed during pediatric heart surgery with cardiopulmonary bypass and continuous ultrafiltration

BackgroundCardiopulmonary bypass (CPB) is associated with systemic inflammation, featuring increased levels of circulating pro-inflammatory cytokines. Intra-operative ultrafiltration extracts fluid and inflammatory factors potentially dampening inflammation-related organ dysfunction and enhancing post-operative recovery. This study aimed to define the impact of continuous subzero-balance ultrafiltration (SBUF) on circulating levels of major inflammatory mediators.MethodsTwenty pediatric patients undergoing cardiac surgery, CPB and SBUF were prospectively enrolled. Blood samples were collected prior to CPB initiation (Pre-CPB Plasma) and immediately before weaning off CPB (End-CPB Plasma). Ultrafiltrate effluent samples were also collected at the End-CPB time-point (End-CPB Effluent). The concentrations of thirty-nine inflammatory factors were assessed and sieving coefficients were calculated.ResultsA profound increase in inflammatory cytokines and activated complement products were noted in plasma following CBP. Twenty-two inflammatory mediators were detected in the ultrafiltrate effluent. Novel mediators removed by ultrafiltration included cytokines IL1-Ra, IL-2, IL-12, IL-17A, IL-33, TRAIL, GM-CSF, ET-1, and the chemokines CCL2, CCL3, CCL4, CXCL1, CXCL2 and CXCL10. Mediator extraction by SBUF was significantly associated with molecular mass < 66 kDa (Chi2 statistic = 18.8, Chi2 with Yates’ correction = 16.0, p < 0.0001). There was a moderate negative linear correlation between molecular mass and sieving coefficient (Spearman R = − 0.45 and p = 0.02). Notably, the anti-inflammatory cytokine IL-10 was not efficiently extracted by SBUF.ConclusionsCPB is associated with a burden of circulating inflammatory mediators, and SBUF selectively extracts twenty of these pro-inflammatory factors while preserving the key anti-inflammatory regulator IL-10. Ultrafiltration could potentially function as an immunomodulatory therapy during pediatric cardiac surgery.Trial registration ClinicalTrials.gov, NCT05154864. Registered retrospectively on December 13, 2021. https://clinicaltrials.gov/ct2/show/record/NCT05154864.

Vertebral bone quality score provides preoperative bone density assessment for patients undergoing lumbar spine surgery: a retrospective study.

The novel MRI-based vertebral bone quality (VBQ) score has been described as an opportunistic screening tool for osteoporosis, but the stability and practical value of this score deserve further investigation. The purpose of this study was to assess whether preoperative VBQ scores could assist in identifying reduced bone mineral density (BMD) or osteoporosis and evaluating the consistency between MRI systems with different field strengths. The VBQ scores of the patients who underwent surgery for lumbar disc herniation and the single-level VBQ scores of each L1-4 vertebral body were measured and calculated with preoperative lumbar MRI noncontrast T1-weighted phases. The VBQ scores were evaluated for correlation analysis using dual-energy x-ray absorptiometry (DEXA) T-scores. The receiver operating characteristic (ROC) curve was used to evaluate the ability of the VBQ scores to identify patients with reduced BMD and with osteoporosis. Differences in CSF measurements at different levels of L1-4 were compared. Twenty-four patients who had been examined using another MRI machine were used as controls to test the interdevice agreement of the VBQ scores. The study included 100 patients with mean VBQ scores of 2.81 ± 0.28 (normal BMD), 3.06 ± 0.36 (osteopenia), and 3.43 ± 0.37 (osteoporosis). VBQ scores differed significantly between BMD subgroups (p < 0.001). The Pearson correlation coefficient showed a moderate negative linear correlation between novel VBQ scores and the lowest DEXA T-scores (r = -0.524). ROC analysis showed good discrimination of VBQ scores in patients with reduced BMD (area under the curve [AUC] 0.793) and with osteoporosis (AUC 0.810). The diagnostic thresholds of reduced BMD and osteoporosis according to the maximum Youden index were 3.06 (sensitivity 0.636, specificity 0.870, positive predictive value [PPV] 0.942, negative predictive value [NPV] 0.417) and 3.05 (sensitivity 0.875, specificity 0.618, PPV 0.519, NPV 0.913), respectively. CSF measurements at the L2, L3, and L4 levels were essentially identical and did not significantly affect the final VBQ scores (p > 0.05), whereas CSF measurements at the L1 level were found to be heterogeneous (p < 0.001). No significant differences were found in VBQ scores between the same brand of MRI machines at different field strengths (1.5 and 3.0 T, p = 0.107). The new VBQ score provides an additional screening opportunity for preoperative BMD assessment. A VBQ score < 3.05 essentially excludes osteoporosis, whereas a VBQ score ≥ 3.05 (especially ≥ 3.06) suggests the need for further examination. The VBQ score is comparable between different MRI systems.

Determination of Acrylamide and 5-hydroxymethyl-2-furfural (HMF) Levels and Related Parameters in Turkish Pekmez (A Traditional Fruit Product)

Background: Pekmez is an important fruit-based food of Turkish culinary culture. The aim of this study is to determine the levels of acrylamide (AA), 5-hydroxymethyl-2-furfural (HMF) and other selected parameters in grape, mulberry and carob Pekmez. Methods: AA and HMF were analyzed by Liquid Chromatography and High Performance Liquid Chromatography, respectively. Also, glucose, fructose, pH, protein, total phenolic, and color (L*a*b*) were analyzed. The analyses were done by IBM SPSS Statistics 26 software. Results: The average AA, HMF, glucose, fructose, total reducing sugar, pH, protein, total phenolic, and colour (L*a*b*) values of Pekmez were 302 µg/kg, 25.7 mg/kg, 13.2%, 14.0%, 27.2%, 5.27, 1.16%, 4.64 mg GAE/g, and 4.83*5.60*1.52, respectively. AA indicates a moderate positive linear correlation with HMF, protein, total phenolic; whereas AA indicates a moderate negative linear correlation with glucose, fructose, total reducing sugar, pH, and L*a*b. Conclusion: It is presumed that heat treatment is a determinant in AA and HMF formulation.

Performance and runoff coefficient of permeable concretes subjected to heavy rainfall simulations

The use of permeable concrete pavements can mitigate flooding in densely populated areas by serving as a functional and sustainable mechanism for surface water absorption and drainage. However, it is found that the performance of the pavement is often limited to low and moderate flows and that the absorption capacity of the concrete matrix decreases as the flow rate increases. Therefore, the present study was developed aiming to evaluate the potential to reduce runoff in permeable concrete pavements subjected to simulations of successive events of heavy rainfall. For this purpose, 2 binary combinations of coarse aggregates were used, varying the cement consumption and the water/cement (w/c) ratio. The samples were submitted to simulations of heavy and sequential rainfall, with evaluation of the volume of water absorbed and the runoff. The mechanical and hydraulical properties of the permeable pavements were evaluated, as well as the characteristics of the area and volume of the internal and superficial pores. Among the results, specific weight stands out as the parameter that showed the highest linear correlation with the mechanical and hydraulic behavior of the specimens. It was also found that the runoff coefficient had a moderate negative linear correlation with the average pore size of the surface of the pavement. Finally, the permeable concrete pavements investigated were found to have the potential to reduce surface runoff in densely populated areas that are prone to frequent flooding, thus playing a critical role in mitigating the problems associated with stormwater runoff.

Ergonomic parameters of the pathologist’s workplace as important factors in the prevention of occupational musculoskeletal diseases

More than 80% of pathologists suffer from various manifestations of disorders of the musculoskeletal system. The daily duties of pathologists include several hours of work at a microscope and a computer. Microscopes are often not optimized for ergonomics and do not allow the doctor to take the correct sitting position, most often working with a microscope requires leaning forward. To study the ergonomic properties of the workplace of a pathologist and develop specific practical recommendations for long-term work at a microscope. The study included microscopes with an adjustable and non-adjustable angle of inclination of the tube and height-adjustable chairs. We identify following ergonomic parameters: pathologist height; angle of inclination of the back of the chair; angle of inclination of the microscope tube; angle of inclination of the neck; chair height. The study included 21 participants. Statistical processing and analysis were made using single-factor and multifactorial correlation analysis. A strong positive linear correlation was identified (r=0.80; p<0.05) between the height of test person and angle of inclination of the microscope tube. A strong positive linear correlation was established (r=0.91; p<0.05) between the test person height and the angle of inclination of the neck for microscopes with non-adjustable 31°-angle of inclination of the tube. For microscopes with non-adjustable 45°-angle of inclination of the tube a strong polynomial correlation of the second degree (r=0.85; p<0.05) was found. A moderate negative linear correlation was found between the height of the pathologist and his tilt angle neck with both adjustable and non-adjustable tube angle of the microscope. In this study for the first-time exact correlation dependencies between key ergonomic parameters of pathologist's workplace were evaluated. This study showed that only microscopes with an adjustable angle of inclination of the tube allow to achieve an optimal body position.

Розробка неінвазивної моделі для підвищення точності діагностики стадії фіброзу печінки при неалкогольній жировій хворобі печінки

Актуальність. Відмінність між м’яким (F1–2) і розвинутим фіброзом (F3–4), як і відсутність фіброзу у хворих на неалкогольну жирову хворобу печінки (НАЖХП), є важливим питанням для з’ясування прогнозу. Сироваткові маркери були запропоновані як альтернатива біопсії. Мета: розробити нову модель для визначення стадії фіброзу на основі більш ефективної комбінації серологічних маркерів та порівняння її з встановленими алгоритмами. Матеріали та методи. У дослідження включені 60 пацієнтів із НАЖХП, які проходили обстеження і лікування у відділенні захворювань печінки та підшлункової залози ДУ «Інститут гастроентерології НАМН України». Серед досліджених 26 (42,3 %) чоловіків та 34 (56,7 %) жінки, середній вік яких (37,1 ± 12,4) та (44,3 ± 7,3) року відповідно. Всім пацієнтам була проведена черезшкірна пункційна трепан-біопсія печінки з подальшим морфологічним дослідженням пунктату; виконано визначення вмісту гіалуронової кислоти, α2-макроглобуліну, аполіпопротеїну А1, фібронектину, гаптоглобіну в сироватці крові та був проведений розрахунок неінвазивних маркерів фіброзу печінки: AAR, APRI, FIB-4. Результати. Проведений ROC-аналіз показав, що найбільші показники площі під AUROC-кривою були для індексу FIB-4 для F2 — 0,72, F3 — 0,8, F4 — 0,82 при р &lt; 0,05. Результати індексу APRI були вірогідно високими для помірного та вираженого фіброзу (F2 — 0,74, F3 — 0,82, р &lt; 0,05). А показники AAR були вірогідними лише для цирозу печінки (площа під AUROC-кривою 0,89, р &lt; 0,05). Установлено сильний прямий зв’язок між стадією фіброзу та рівнем гіалуронової кислоти, α2-макроглобуліну і фібронектину (r = 0,72, 0,93 та 0,71 відповідно при р &lt; 0,05) та обернений зв’язок помірної сили між показниками аполіпопротеїну А1, гаптоглобіну (r = –0,61 і –0,35 при р &lt; 0,05). Визначено прямий зв’язок помірної сили між ступенем активності запального процесу і показниками гіалуронової кислоти, α2-макроглобуліну і фібронектину (r = 0,54, 0,67 та 0,55 при р &lt; 0,05) і обернений помірний зв’язок — аполіпопротеїну А1 та гаптоглобіну (r = –0,56 і –0,33 при р &lt; 0,05). Висновки. Установлено, що найбільшу діагностичну цінність із неінвазивних маркерів фіброзу мають показники α2-макроглобуліну, аполіпопротеїну А1, гіалуронової кислоти та фібронектину, для яких площа під AUROC-кривою для мінімального фіброзу не була нижчою ніж 0,75, а для помірного, вираженого фіброзу та цирозу становила більше 0,9.

Relationship between somatotype components and muscle fiber type

Background and Study Aim. It is stated that genetic factors, lifestyle and demographic components affect the morphological properties of the muscle; moreover, there is a relationship between adiposity indicators and skeletal muscle. The aim of this study is to examine the relationship between the somatotype components and obesity markers and the percentage of the fast twitch fibril type of skeletal muscle.&#x0D; Material and Methods. Nine male students of sports sciences voluntarily participated in the study (age = 22 ± 3.24 years). By applying the isokinetic fatigue test protocol, which is a non-invasive method, the percentage of fast twitch fibril of the vastus lateralis muscle was estimated. Body fat ratio and somatotype body types of the participants were determined as indicators of obesity.&#x0D; Results. There was a high positive linear correlation between the obesity indicators (endomorphy and body fat ratio) and the percentage of fast twitch fibril (r=0.738; r=0.809, p&lt;0.01 respectively). The variance between the endomorphy and body fat ratio expressing fatness and the fast twitch fibril percentage were found to be acceptable (54-65% explained variance). A moderate negative linear correlation was found between the ectomorphy and percentage of fast-twitch fibril (r= -0.674, p&lt;0.05). Finally, a moderate positive but statistically insignificant linear correlation was found between the mesomorphy and the percentage of fast twitch fibril (r=0.623, p&gt;0.05).&#x0D; Conclusion. The findings show that the total fatness level of the body and the percentage of fast twitch fibril are not independent parameters and have a positive effect on each other.

Predictive factors of severity and persistence of oropharyngeal dysphagia in sub-acute stroke.

This study aims to understand the factors contributing to the severity of oropharyngeal dysphagia and its persistence in the sub-acute phase of stroke. We retrospectively collected the data of all the patients suffering from a stroke in the last year. The severity of stroke was reported according to the NIHSS score. All the patients were evaluated with the Dysphagia Risk Score and with a FEES. We classified the Dysphagia Risk Score and FEES results using the PAS score and ASHA-NOMS levels. The data were analysed statistically with ANOVA test, Student's t test and Pearson's correlation coefficient. A series of 54 patients were evaluated. The ANOVA test did not find any difference in the mean score of Dysphagia Risk Score, PAS and ASHA-NOMS when compared with the brain area of stroke. An NIHSS at hospital admission (stroke unit) of more than 12 was predictive of ASHA-NOMS score 1-4 after 60days (p < 0.05). A PAS score between 6 and 8 at first FEES evaluation was predictive of poor (1-4) ASHA-NOMS score after 60days (p < 0.01). A moderate positive linear correlation was found between NIHSS score and both PAS (r 0.65) and Dysphagia Risk Score (r 0.50); a moderate negative linear correlation was recorded between NIHSS and ASHA-NOMS (r - 0.66) scores. In the sub-acute phase of stroke, the predictive factors of persistent dysphagia are not linked to the damaged neuroanatomical region and others factors such as NIHSS value and high PAS score seem more useful.

Effect of Patella Alta on the Native Anatomometricity of the Medial Patellofemoral Complex: A Cadaveric Study

Objectives:Patella alta has been identified as an important risk factor for lateral patellar instability and medial patellofemoral complex (MPFC) reconstruction failure. To our knowledge, no prior study has analyzed the anisometry of the MPFC in the setting of patella alta as this may play a role in the postoperative outcomes and could affect surgical technique.Methods:Eight (n=8) fresh frozen cadaveric knees were used in this study. No IRB approval was needed at our institution due to the use of cadaveric specimen. The MPFC was identified and dissected along with the patellar tendon, and quadriceps tendon. A custom-made jig was utilized to evaluate MPFC lengths from 0-90° of flexion. Length was measured at four possible reconstruction locations (midpoint patella [MP], MPFC osseous center [FC], superior medial pole of the patella [SM], and quadriceps tendon [Q]) along the extensor mechanism using a 3D robotic arm. These measurements were repeated at 0, 20, 40, 60 and 90° degrees of flexion. Degrees of increasing severity of patella alta at Caton-Deschamps index (CDI) ratios of 1.0, 1.2, 1.4, and 1.6, were then investigated.Results:CDI and attachment sites significantly affect changes in MPFC length from 0-90° of flexion (p < 0.0005). Proximal attachment points had more robust length changes than distal ones and increases in CDI enhanced these differences. Point Q at CDI 1 was similar to SM at 1.2 (p = 0.234), SM and FC at 1.4 (p = 0.89 and p = 0.073) and FC at 1.6 (p = 0.928). SM at CDI of 1 was similar to FC at 1.2 and 1.4 (p = 0.414 and p = 0.503) and MP at 1.6 (p = 0.473), while FC at CDI 1 was similar to the FC at 1.2 (p = 0.157) and MP at 1.4 and 1.6 (p = 0.068 and p = 0.519). Finally, the MP was similar at CDI 1.2 (p = 0.888) and 1.4 (p = 0.385) compared to at CDI of 1. At the quadriceps points, MPFC length and flexion degrees showed a moderate negative linear correlation at a CDI of 1 (r = -0.484, p = 0.002) and 1.6 (r = -0.692, p < 0.0005) (Fig 1). At the MP location at a CDI ratio of 1.6, significant differences were seen at 0° vs 90° (p = 0.027), 0° vs 60° (p = 0.044), 0° vs 40° (p = 0.016), and 0° vs 20° (p = 0.044), suggesting differing length change properties between the Q and MP attachment sites.Conclusions:Anisometry varies with location of the patellar attachment and with patellar height within the MPFC. The superior aspect of the MPFC demonstrated the most isometric behavior, increasing linearly with increasing flexion. The inferior aspect of the MPFC retains a relatively constant length at 20 to 90° of flexion. Increasing CDI amplified these results. These findings demonstrate that proximal based grafts loosen significantly before engaging in the trochlea and this effect is exaggerated in the setting of patella alta. Furthermore, this data suggests that soft tissue surgical reconstructions may be modified to correct for patella alta in place of performing distalization, which carries significant morbidity.

Effect of Patella Alta on the Native Anatomometricity of the Medial Patellofemoral Complex: A Cadaveric Study

Background: Patella alta has been identified as an important risk factor for lateral patellar instability and medial patellofemoral complex (MPFC) reconstruction failure. Purpose: To evaluate the length changes of the MPFC at multiple possible reconstruction locations along the extensor mechanism in varying degrees of patella alta throughout knee motion. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric knees were used in this study. The MPFC was identified and dissected with the patellar tendon and quadriceps tendon. A custom-made jig was utilized to evaluate lengths from 0° to 90° of flexion with physiological quadriceps loading. Length was measured with a 3-dimensional robotic arm at 4 possible reconstruction locations along the extensor mechanism: the midpoint patella (MP), the MPFC osseous center (FC), the superior medial pole of the patella (SM) at the level of the quadriceps insertion, and 1 cm proximal to the SM point along the quadriceps tendon (QT). These measurements were repeated at 0°, 20°, 40°, 60° and 90° of flexion. Degrees of increasing severity of patella alta at Caton-Deschamps index (CDI) ratios of 1.0, 1.2, 1.4, and 1.6 were then investigated. Results: Patella alta and MPFC attachment site location significantly affected changes in MPFC length from 0° to 90° of flexion (P< .0005). Length changes at attachment MP showed no difference when CDI 1.0 was compared with all patella alta values (CDI 1.2, 1.4, 1.6; P > .05). Similarly, FC showed no difference in length change from 0° to 90° until CDI 1.6, in contrast to proximal attachments (SM, QT), which demonstrated significant changes at CDI 1.4 and 1.6. When length changes were analyzed at each degree of flexion (0°, 20°, 40°, 60°, 90°), Spearman correlation analysis showed a moderate negative linear correlation for QT at CDI 1.0 (r= −0.484; P = .002) and 1.6 (r = −0.692; P < .0005), demonstrating constant loosening at the QT point at normal and elevated patellar height. In contrast, no differences in length were observed for MP at CDI 1.0 throughout flexion, and at CDI 1.6, there was a difference only at 0° (P < .05). Points FC and MP at CDI 1.6 had similar length change properties to points SM and QT at CDI 1.0 (P > .05), suggesting that distal attachments in the setting of patella alta may provide similar length changes to proximal attachmentswith normal height. Conclusion: Anisometry of the MPFC varies not only with attachment location on the extensor mechanism but also with patellar height. Increased patellar height leads to more significant changes in anisometry in the proximal MPFC attachment point as compared with the distal component. In the setting of patella alta, including a CD ratio of 1.6, the osseous attachments of the MPFC remain nearly isometric wheras the proximal half length changes increase significantly. Clinical Significance: The results of this study support the idea that the MPFC should be considered as 2 separate entities (proximal medial quadriceps tendon femoral ligament and distal medial patellofemoral ligament) owing to their unique length change properties.

Clinical assessment of the palatal alveolar bone thickness and its correlation with the buccolingual angulation of maxillary incisors for immediate implant placement.

Clinicians needed to be aware of the thinness of the palatal bone plate when identifying severe protrusion of maxillary incisors, as this could result in perforation of the palatal bone plate during surgical procedures associated with immediate maxillary implant placement. This study evaluated the thickness of the palatal bone plate, the buccolingual angulation of maxillary incisors, and the correlation between these two parameters in relation to immediate implant placement. Cone-beam computed tomography images of 37 Asian patients (20-60 years old) with no evidence of dental treatment in the maxillary incisor area were collected and classified into groups based on sex and incisor locations. Sagittal slices were used to measure the palatal bone plate thickness at the cervical, middle, and apical levels, and the buccolingual angulation of each tooth was also measured. The intraclass correlation, Shapiro-Wilk test, descriptive analysis, Student's t-test, and Pearson correlation were used for statistical and correlation analyses, with P < .05 applied as the criterion for statistical significance. At the apical level of all inspected teeth and the middle level of lateral incisors, the palatal bone was significantly thicker in males than in females. The inclination of the maxillary lateral incisor showed a moderate negative linear correlation with the palatal bone thickness at the apical level (R = -0.517 and R = -0.579 for males and females, respectively). In an Asian population, an increased buccolingual angulation of the maxillary lateral incisors was correlated with a thinner palatal bone plate at the apical level.

Capacidades ecoeficientes e as interferências no desempenho social: um estudo das unidades federativas do brasil

O propósito deste estudo é contribuir com as discussões socioambientais no âmbito da gestão governamental, adentrando na relação entre ecoeficiência e desempenho social. O estudo consistiu em um perfil descritivo, com uma abordagem quantitativa cujo processo ocorreu em dois momentos: para estabelecer os scores de ecoeficiência, foi empregada a técnica não paramétrica FDH com o modelo orientado para insumos e na sequência foi utilizada a correlação linear de Pearson, buscando encontrar possível associação entre os constructos investigados. Os resultados evidenciam algumas regiões benchmarking de ecoeficiência, além de apresentar correlação linear negativa moderada, sugerindo que a desigualdade social tende a diminuir à medida que o score de ecoeficiência aumenta. Espera-se que tais resultados norteiem, quanto ao apelo prático, às políticas públicas no que tange à eficiência econômica e ambiental. Não obstante, são designadas contribuições para a comunidade científica quanto ao preenchimento da lacuna de literatura na área em questão.

Simulation and Evaluation of a Bone Sawing Procedure for Orthognathic Surgery Based on an Experimental Force Model

Bone sawing is widely used in orthognathic surgery to correct maxillary deformities. Successful execution of bone sawing requires a high level of dexterity and experience. A virtual reality (VR) surgical simulator can provide a safe, cost-effective, and repeatable training method. In this study, we developed a VR training simulator with haptic functions to simulate bone-sawing force, which was generated by the experimental force model. Ten human skulls were obtained in this study for the determination of surgical bone-sawing force. Using a 5-DOF machining center and a micro-reciprocating saw, bone specimens with different bone density were sawed at different feed rates (20, 40, and 60 mm/min) and spindle speeds (9800, 11,200 and 12,600 cycles per minute). The sawing forces were recorded with a piezoelectric dynamometer and a signal acquisition system. Linear correlation analysis of all experimental data indicates that there were significant positive linear correlations between bone-sawing force and bone density and tool feed rate and a moderate negative linear correlation with tool spindle rate. By performing multiple regression analysis, the prediction models for the bone-sawing procedure were determined. By employing Omega.6 as a haptic device, a medical simulator for the Lefort I osteotomy was developed based on an experimental force model. Comparison of the force-time curve acquired through experiments and the curve computed from the simulator indicate that the obtained forces based on the experimental force model and the acquired data had the same trend for the bone-sawing procedure of orthognathic surgery.

The burden and quality of life of caregivers of sickle cell anemia patients taking hydroxyurea versus those not taking hydroxyurea.

Objective To assess the burden and quality of life of caregivers of patients with sickle cell anemia taking hydroxyurea versus those of patients not taking hydroxyurea. Methods A cross-sectional study was performed of caregivers of outpatients with sickle cell anemia in two public hospitals in Campo Grande, MS, from January through June 2010. The World Health Organization Quality of Life-BREF Scale and the Caregiver Burden Scale were used. Results Of the 37 caregivers in this study, 81.1% were women, 73.0% were mothers, 59.5% were married, 54.1%were mulattos, 48.6% were housewives, 54.1% had family incomes of up to one minimum wage and 75.7% had onlycompleted elementary education. The mean duration of care provided (time after diagnosis) was 16.08 ± 9.88 yearsand 89.2% reported that they provided 24-hour care. Regarding health, 27.0% of study participants reported having physical and 13.5% emotional problems. There were no significant relationships between these variables either with the different domains or the total score of the WHOQOL-BREF comparing caregivers of patients taking hydroxyurea versusthose of patients not taking hydroxyurea. There was a moderate negative linear correlation between the WHOQOL-BREF and the Caregiver Burden Scale scores (linear correlation test of Pearson: p-value = 0.003, r = -0.477). The burden of caregivers of patients who did not take hydroxyurea was significantly higher than those of patients who took the medication in terms of general tension, disappointment, environment and total score (student t-test: p-value < 0.05). ConclusionIn the perception of the caregiver, looking after sickle cell anemia patients represents a moderate negative burden.

A disease survey of Fusarium wilt and Alternaria blight on sweet potato in South Africa

A disease survey was conducted on sweet potato in the major production areas of South Africa in 2006–2008 to determine the importance of wilt disease (WD) and Alternaria blight (AB) caused by Alternaria bataticola. The disease prevalence, incidence and severity were assessed for both WD and AB in 58 sweet potato fields in seven provinces, and included both commercial and resource-poor growers. The prevalence of WD in commercial fields was significantly higher than in resource-poor fields; while disease incidence and severity were very low in both commercial and resource-poor fields. Soil pH showed a moderate negative linear correlation to WD severity. WD is at present considered a minor disease of sweet potato in South Africa, although local outbreaks can be damaging. AB had very low disease prevalence, incidence and severity levels in both commercial and resource-poor fields countrywide. However, one of the fields had moderately high disease incidence and severity levels, showing that the disease can be destructive if not controlled. AB should be considered a potentially destructive disease of sweet potato in South Africa. Fusarium oxysporum was consistently isolated from WD plants, with F. oxysporum f. sp. batatas identified, but other formae speciales were also associated with the disease.

Peritumoral edema in osteoid osteoma on magnetic resonance imaging.

To determine whether there is a relationship between the peritumoral edema caused by osteoid osteoma seen on magnetic resonance (MR) imaging and the patient's age, duration of symptoms, or location of the lesion. All histologically proven osteoid osteomas seen in our institutions during a 5-year period in patients with known age, gender, duration of symptoms, and available radiological and MR imaging examinations were included in this study. The extent of the edema in the bone marrow and extraosseous soft tissue around the nidus of osteoid osteoma on T2-weighted MR imaging were graded from 1 (nonexistent) to 4 (extensive) by two masked observers. The relationships between the patient's age, duration of symptoms, and location of lesions were evaluated by Pearson's correlation coefficient and analysis of variance. Twenty-seven cases met the inclusion criteria. The observer agreement on grading was good. Patients of 15 years of age or younger had significantly higher grades than patients older than 15 years. There was a moderate negative linear correlation between the patient's age and peritumoral edema. No significant relationship was identified between edema and the duration of symptoms or the location of lesions. Osteoid osteomas in younger patients tend to be associated with more extensive peritumoral edema.

Correcting umbilical artery flow velocity waveforms for fetal heart rate is unnecessary

We prospectively examined 55 normal pregnant women between 32 and 41 (x = 37) weeks' gestation. Five measurements of the umbilical artery peak-systolic/end-diastolic frequency ratio were obtained from each patient during one examination. Comparison of the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratios between pregnancies 37 weeks' gestation revealed no difference. Subsequently a total of 256 measurements were analyzed as one group. Plotting the individual peak-systolic/end-diastolic frequency ratios against the corresponding fetal heart rates revealed a moderate negative linear correlation: y = 4.15 0.012x, r = -0.36 and p < 0.04. When only heart rates between 120 to 160 beats/min were plotted against peak-systolic/end-diastolic frequency ratios, a weaker correlation was found (r = 0.33, P = 0.15). The difference (mean ± SD) between the obtained and the corrected peak-systolic/end-diastolic frequency ratios was 4.4% ± 3.2%. The 95th percentile of the obtained peak-systolic/end-diastolic frequency ratio was 3.35 and the corrected ratio was 3.27. Averaging of the five measurements obtained from each patient for all 55 patients decreased the 95th percentile value to 3.09 whereas the same procedure for the corrected peak-systolic/end-diastolic frequency ratios decreased it to 3.07. We conclude that although there is a statistically significant negative linear correlation between the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratio, this relationship is not clinically significant. (AM J OBSTET GVNECOL 1989;160:704-7.)

Correcting umbilical artery flow velocity waveforms for fetal heart rate is unnecessary

We prospectively examined 55 normal pregnant women between 32 and 41 (means = 37) weeks' gestation. Five measurements of the umbilical artery peak-systolic/end-diastolic frequency ratio were obtained from each patient during one examination. Comparison of the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratios between pregnancies less than 37 and greater than 37 weeks' gestation revealed no difference. Subsequently a total of 256 measurements were analyzed as one group. Plotting the individual peak-systolic/end-diastolic frequency ratios against the corresponding fetal heart rates revealed a moderate negative linear correlation: y = 4.15-0.012x, r = -0.36 and p less than 0.04. When only heart rates between 120 to 160 beats/min were plotted against peak-systolic/end-diastolic frequency ratios, a weaker correlation was found (r = -0.33, p = 0.15). The difference (mean +/- SD) between the obtained and the corrected peak-systolic/end-diastolic frequency ratios was 4.4% +/- 3.2%. The 95th percentile of the obtained peak-systolic/end-diastolic frequency ratio was 3.35 and the corrected ratio was 3.27. Averaging of the five measurements obtained from each patient for all 55 patients decreased the 95th percentile value to 3.09 whereas the same procedure for the corrected peak-systolic/end-diastolic frequency ratios decreased it to 3.07. We conclude that although there is a statistically significant negative linear correlation between the fetal heart rate and the umbilical artery peak-systolic/end-diastolic frequency ratio, this relationship is not clinically significant.