WorldWideScience

Sample records for bone health designing

  1. Green tea polyphenols and Tai Chi for bone health: Designing a placebo-controlled randomized trial

    Directory of Open Access Journals (Sweden)

    Chyu Ming-Chien

    2009-09-01

    Full Text Available Abstract Background Osteoporosis is a major health problem in postmenopausal women. Evidence suggests the importance of oxidative stress in bone metabolism and bone loss. Tea consumption may be beneficial to osteoporosis due to its antioxidant capability. However, lack of objective data characterizing tea consumption has hindered the precise evaluation of the association between tea ingestion and bone mineral density in previous questionnaire-based epidemiological studies. On the other hand, although published studies suggest that Tai Chi (TC exercise can benefit bone health and may reduce oxidative stress, all studies were conducted using a relatively healthy older population, instead of a high-risk one such as osteopenic postmenopausal women. Therefore, this study was designed to test an intervention including green tea polyphenol (GTP and TC exercise for feasibility, and to quantitatively assess their individual and interactive effects on postmenopausal women with osteopenia. Methods/Design One hundred and forty postmenopausal women with osteopenia (defined as bone mineral density T-score at the spine and/or hip between 1 to 2.5 SD below the reference database were randomly assigned to 4 treatment arms: (1 placebo group receiving 500 mg medicinal starch daily, (2 GTP group receiving 500 mg of GTP per day, (3 placebo+TC group receiving both placebo treatment and TC training (60-minute group exercise, 3 times per week, and (4 GTP+TC group receiving both GTP and TC training for 24 weeks. The outcome measures were bone formation biomarker (serum bone alkaline phosphatase, bone resorption biomarker (serum tartrate resistant acid phosphatase, and oxidative DNA damage biomarker (urinary 8-hydroxy-2'-deoxyguanosine. All outcome measures were determined at baseline, 4, 12, and 24 weeks. Urinary and serum GTP concentrations were also determined at baseline, 4, 12, and 24 weeks for bioavailability. Liver function was monitored monthly for safety. A

  2. Exercise for Your Bone Health

    Science.gov (United States)

    ... FAQs Breadcrumb Home Exercise for Your Bone Health Exercise for Your Bone Health Vital at every age ... A Complete Osteoporosis Program For Your Information Why Exercise? Like muscle, bone is living tissue that responds ...

  3. Sodium and bone health

    DEFF Research Database (Denmark)

    Teucher, B.; Dainty, J. R.; Spinks, C. A.

    2008-01-01

    High salt intake is a well-recognized risk factor for osteoporosis because it induces calciuria, but the effects of salt on calcium metabolism and the potential impact on bone health in postmenopausal women have not been fully characterized. This study investigated adaptive mechanisms in response.......9 Versus 11.2 g) diets, reflecting lower and upper intakes in post men opausal women consuming a Western-style diet, were provided. Stable isotope labeling techniques were used to measure calcium absorption and excretion, compartmental modeling was undertaken to estimate bone calcium balance......, and biomarkers of bone formation and resorption were measured in blood and urine. Moderately high salt intake (11.2 g/d) elicited a significant increase in urinary calcium excretion (p = 0.0008) and significantly affected bone calcium balance with the high calcium diet 0.024). Efficiency of calcium absorption...

  4. Children's Bone Health and Calcium

    Science.gov (United States)

    ... Twitter Pinterest Email Print Children's Bone Health and Calcium: Condition Information What is bone health and how ... straight, walk, run, and lead an active life. Calcium is one of the key dietary building blocks ...

  5. Vitamin D, Calcium, and Bone Health

    Science.gov (United States)

    ... Bone Health Featured Resource Find an Endocrinologist Search Vitamin D, Calcium, and Bone Health Download PDFs English ... also helps keep your bones strong. Why are vitamin D and calcium important to bone health? Vitamin ...

  6. Oral Health and Bone Disease

    Science.gov (United States)

    ... that the loss of alveolar bone mineral density leaves bone more susceptible to periodontal bacteria, increasing the ... bone density will have a favorable impact on dental health. Bisphosphonates, a group of medications available for the treatment of osteoporosis, have been linked to the development ...

  7. Smoking and Bone Health

    Science.gov (United States)

    ... consequences because building healthy bones in youth helps prevent osteoporosis and fractures later in life. However, it is never too late to adopt new habits for healthy bones. Smoking and Osteoporosis Cigarette smoking was first identified as ...

  8. Vitamin K and bone health.

    Science.gov (United States)

    Hamidi, Maryam S; Gajic-Veljanoski, Olga; Cheung, Angela M

    2013-01-01

    Vitamin K has been purported to play an important role in bone health. It is required for the gamma-carboxylation of osteocalcin (the most abundant noncollagenous protein in bone), making osteocalcin functional. There are 2 main forms (vitamin K1 and vitamin K2), and they come from different sources and have different biological activities. Epidemiologic studies suggest a diet high in vitamin K is associated with a lower risk of hip fractures in aging men and women. However, randomized controlled trials of vitamin K1 or K2 supplementation in white populations did not increase bone mineral density at major skeletal sites. Supplementation with vitamin K1 and K2 may reduce the risk of fractures, but the trials that examined fractures as an outcome have methodological limitations. Large well-designed trials are needed to compare the efficacies of vitamin K1 and K2 on fractures. We conclude that currently there is not enough evidence to recommend the routine use of vitamin K supplements for the prevention of osteoporosis and fractures in postmenopausal women. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  9. Children's bone health

    NARCIS (Netherlands)

    I.M. van der Sluis (Inge)

    2002-01-01

    textabstractThe thesis can be divided in two main parts. In the first part (Chapter 2 to 5) bone mineral density, bone metabolism and body composition in healthy children and young adults have been evaluated, while in the second part (Chapter 6 to 10) these issues were studied in children

  10. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...

  11. Ethnic Differences in Bone Health

    Directory of Open Access Journals (Sweden)

    Ayse eZengin

    2015-03-01

    Full Text Available There are differences in bone health between ethnic groups in both men and in women. Variations in body size and composition are likely to contribute to reported differences. Most studies report ethnic differences in areal bone mineral density (aBMD which do not consistently parallel ethnic patterns in fracture rates. This suggests that other parameters beside aBMD should be considered when determining fracture risk between and within populations, including other aspects of bone strength: bone structure and microarchitecture as well muscle strength (mass, force generation, anatomy and fat mass. We review what is known about differences in bone-densitometry derived outcomes between ethnic groups and the extent to which they account for the differences in fracture risk. Studies are included that were published primarily between 1994 – 2014. A ‘one size fits all approach’ should not be used to understand better ethnic differences in fracture risk.

  12. Bone health in anorexia nervosa

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Purpose of review Anorexia nervosa is associated with low bone mineral density (BMD), concerning for an increased risk of fractures, and decreased bone accrual in adolescents, concerning for suboptimal peak bone mass. This review discusses causes of impaired bone health in anorexia nervosa and potential therapeutic strategies. Recent findings Low BMD in anorexia nervosa is consequent to decreased lean mass, hypogonadism, low insulin-like growth factor-1 (IGF-1), relative hypercortisolemia and alterations in hormones impacted by energy availability. Weight gain causes some improvement in bone accrual, but not to the extent observed in controls, and vitamin D supplementation does not increase BMD. Oral estrogen is not effective in increasing BMD, likely from IGF-1 suppressive effects. In contrast, transdermal estrogen replacement is effective in increasing bone accrual in adolescents with anorexia nervosa, although not to the extent seen in controls. Recombinant human IGF-1 increases bone formation in adolescents, and with oral estrogen increases BMD in adults with anorexia nervosa. Bisphosphonates increase BMD in adults, but not in adolescents, and should be used cautiously given their long half-life. Summary Further investigation is necessary to explore therapies for low BMD in anorexia nervosa. Weight gain is to be encouraged. Transdermal estrogen in adolescents, and bisphosphonates in adults, have a potential therapeutic role. PMID:21897220

  13. [Diet, nutrition and bone health].

    Science.gov (United States)

    Miggiano, G A D; Gagliardi, L

    2005-01-01

    drugs may interfere with calcium and other nutrients and produce an unfavourable effect on bone health.

  14. Dairy products, yogurts, and bone health.

    Science.gov (United States)

    Rizzoli, René

    2014-05-01

    Fracture risk is determined by bone mass, geometry, and microstructure, which result from peak bone mass (the amount attained at the end of pubertal growth) and from the amount of bone lost subsequently. Nutritional intakes are an important environmental factor that influence both bone mass accumulation during childhood and adolescence and bone loss that occurs in later life. Bone growth is influenced by dietary intake, particularly of calcium and protein. Adequate dietary calcium and protein are essential to achieve optimal peak bone mass during skeletal growth and to prevent bone loss in the elderly. Dairy products are rich in nutrients that are essential for good bone health, including calcium, protein, vitamin D, potassium, phosphorus, and other micronutrients and macronutrients. Studies supporting the beneficial effects of milk or dairy products on bone health show a significant inverse association between dairy food intake and bone turnover markers and a positive association with bone mineral content. Fortified dairy products induce more favorable changes in biochemical indexes of bone metabolism than does calcium supplementation alone. The associations between the consumption of dairy products and the risk of hip fracture are less well established, although yogurt intake shows a weakly positive protective trend for hip fracture. By consuming 3 servings of dairy products per day, the recommended daily intakes of nutrients essential for good bone health may be readily achieved. Dairy products could therefore improve bone health and reduce the risk of fractures in later life.

  15. Bone Health and Pelvic Radiotherapy.

    Science.gov (United States)

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  16. Vitamin D and bone health

    International Nuclear Information System (INIS)

    Holick, M.F.

    1996-01-01

    Vitamin D plays an essential role in maintaining a healthy mineralized skeleton for most land vertebrates including humans. Sunlight causes the photoproduction of vitamin D3 in the skin. Once formed, vitamin D3 is metabolized sequentially in the liver and kidney to 1,25-dihydroxyvitamin D. The major biological function of 1,25-dihydroxyvitamin D is to keep the serum calcium and phosphorus concentrations within the normal range to maintain essential cellular functions and to promote mineralization of the skeleton. Most foods do not contain any vitamin D. Foods fortified with vitamin D have a variable amount present and cannot be depended on as a sole source of vitamin D nutrition. Exposure to sunlight provides most humans with their vitamin D requirement. Aging, sunscreen use and the change in the zenith angle of the sun can dramatically affect the cutaneous production of vitamin D3. Vitamin D insufficiency and vitamin D deficiency is now being recognized as a major cause of metabolic bone disease in the elderly. Vitamin D deficiency not only causes osteomalacia but can exacerbate osteoporosis. It is generally accepted that an increase in calcium intake to 1000-1500 mg/d along with an adequate source of vitamin D of at least 400 IU/d is important for maintaining good bone health

  17. Growth hormone and bone health.

    Science.gov (United States)

    Bex, Marie; Bouillon, Roger

    2003-01-01

    Growth hormone (GH) and insulin-like growth factor-I have major effects on growth plate chondrocytes and all bone cells. Untreated childhood-onset GH deficiency (GHD) markedly impairs linear growth as well as three-dimensional bone size. Adult peak bone mass is therefore about 50% that of adults with normal height. This is mainly an effect on bone volume, whereas true bone mineral density (BMD; g/cm(3)) is virtually normal, as demonstrated in a large cohort of untreated Russian adults with childhood-onset GHD. The prevalence of fractures in these untreated childhood-onset GHD adults was, however, markedly and significantly increased in comparison with normal Russian adults. This clearly indicates that bone mass and bone size matter more than true bone density. Adequate treatment with GH can largely correct bone size and in several studies also bone mass, but it usually requires more than 5 years of continuous treatment. Adult-onset GHD decreases bone turnover and results in a mild deficit, generally between -0.5 and -1.0 z-score, in bone mineral content and BMD of the lumbar spine, radius and femoral neck. Cross-sectional surveys and the KIMS data suggest an increased incidence of fractures. GH replacement therapy increases bone turnover. The three controlled studies with follow-up periods of 18 and 24 months demonstrated a modest increase in BMD of the lumbar spine and femoral neck in male adults with adult-onset GHD, whereas no significant changes in BMD were observed in women. GHD, whether childhood- or adult-onset, impairs bone mass and strength. Appropriate substitution therapy can largely correct these deficiencies if given over a prolonged period. GH therapy for other bone disorders not associated with primary GHD needs further study but may well be beneficial because of its positive effects on the bone remodelling cycle. Copyright 2003 S. Karger AG, Basel

  18. Nail Properties and Bone Health: A Review

    Directory of Open Access Journals (Sweden)

    Pouya Saeedi

    2018-04-01

    Full Text Available Physicochemical properties of nail may offer valuable insight into the health of bone. Currently, dual-energy X-ray absorptiometry (DXA is the gold standard technique for evaluating bone health through bone mineral density (BMD. However, only 70% of fractures are explained by low BMD according to DXA. Therefore, the World Health Organisation recommended the need for the development of alternative methods of assessing bone health. Keratin and collagen type I are major proteins in nail and bone, respectively. Both of these proteins undergo post-translational modifications, with a possible correlation between the degree of post-translational modifications in keratin and collagen. Raman spectroscopy is a technique used to detect changes in protein composition and structure. As changes in protein function and structure may be associated with the development of osteoporosis, Raman spectroscopy may be a valuable adjunct to assess bone health and fracture risk. This review critically evaluates various methods and techniques to identify the link between nail properties and bone health. The strengths and limitations of various studies and the potential use of nail protein and minerals to evaluate bone health have been also presented.

  19. Optimizing Bone Health in Duchenne Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Jason L. Buckner

    2015-01-01

    Full Text Available Duchenne muscular dystrophy (DMD is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA, as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA.

  20. Nutrition, bone health, and the young dancer

    NARCIS (Netherlands)

    Brown, D.D.; Solomon, R.; Solomon, J.; Micheli, L.

    2017-01-01

    Optimized bone health is a dynamic process that utilizes hormonal, nutritional, and biomechanical balance. For those who dance recreationally and in particular as young professionals, healthy bones become especially important given the demands of dance training. An imbalance in one of the areas

  1. Pregnancy, Breastfeeding, and Bone Health

    Science.gov (United States)

    ... Bone Mass in Women Osteoporosis and African American Women Osteoporosis and Asian American Women Osteoporosis and Asian American Women (繁體中文) Osteoporosis and Hispanic Women Osteoporosis ...

  2. Bone health in Down syndrome.

    Science.gov (United States)

    García-Hoyos, Marta; Riancho, José Antonio; Valero, Carmen

    2017-07-21

    Patients with Down syndrome have a number of risk factors that theoretically could predispose them to osteoporosis, such as early aging, development disorders, reduced physical activity, limited sun exposure, frequent comorbidities and use of drug therapies which could affect bone metabolism. In addition, the bone mass of these people may be affected by their anthropometric and body composition peculiarities. In general terms, studies in adults with Down syndrome reported that these people have lower areal bone mineral density (g/cm 2 ) than the general population. However, most of them have not taken the smaller bone size of people with Down syndrome into account. In fact, when body mineral density is adjusted by bone size and we obtain volumetric body mineral density (g/cm 3 ), the difference between both populations disappears. On the other hand, although people with Down syndrome have risk factor of hypovitaminosis D, the results of studies regarding 25(OH)D in this population are not clear. Likewise, the studies about biochemical bone markers or the prevalence of fractures are not conclusive. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Irradiation of the red bone marrow and the health implications ...

    African Journals Online (AJOL)

    The physiology and function of the bone is looked at as to the role in housing bone marrow. The bone marrow and particularly the red bone marrow is discussed. Sources of radiation are discussed and the health implications highlighted for caution and for study or evaluation. Key Words: Bone marrow, Irradiation, Radiation, ...

  4. Bone Health in Adrenal Disorders

    Directory of Open Access Journals (Sweden)

    Beom-Jun Kim

    2018-03-01

    Full Text Available Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Thus, the present review discusses the possibility of adrenal disorders, especially focusing on pheochromocytoma and primary aldosteronism, as secondary causes of osteoporosis.

  5. Aging, human immunodeficiency virus, and bone health

    Directory of Open Access Journals (Sweden)

    Kim C Mansky

    2010-09-01

    Full Text Available Kim C ManskyDivision of Orthodontics, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USAAbstract: Highly active antiretroviral therapy (HAART has had a profound impact on improving the long-term prognosis for individuals infected with human immunodeficiency virus (HIV. HAART has been available for close to two decades, and now a significant number of patients with access to HAART are over the age of 50 years. Many clinical studies have indicated that HIV infection, as well as components of HAART, can increase the risk in these individuals to a variety of noninfectious complications, including a risk to bone health. There is a significant need for detailed mechanistic analysis of the aging, HIV-infected population regarding the risk of HIV infection and therapy in order to maintain bone health. Insights from basic mechanistic studies will help to shed light on the role of HIV infection and the components of HAART that impact bone health, and will help in identifying preventative countermeasures, particularly for individuals 50 years of age and older.Keywords: osteopenia, osteomalacia, osteoporosis, bisphosphonates, tenofovir, osteoimmunology

  6. Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Twilt, Marinka; Pradsgaard, Dan; Spannow, Anne Helene

    2017-01-01

    BACKGROUND: BoneXpert is an automated method to calculate bone maturation and bone health index (BHI) in children with juvenile idiopathic arthritis (JIA). Cartilage thickness can also be seen as an indicator for bone health and arthritis damage. The objective of this study was to evaluate...... the relation between cartilage thickness, bone maturation and bone health in patients with JIA. METHODS: Patients with JIA diagnosed according ILAR criteria included in a previous ultrasonography (US) study were eligible if hand radiographs were taken at the same time as the US examination. Of the 95 patients...... 67 met the inclusion criteria. RESULTS: Decreased cartilage thickness was seen in 27% of the examined joints. Decreased BHI was seen in half of the JIA patient, and delayed bone maturation was seen in 33% of patients. A combination of decreased BHI and bone age was seen in 1 out of 5 JIA patients...

  7. Bone Marrow Transplantation: MedlinePlus Health Topic

    Science.gov (United States)

    ... marrow transplant - discharge (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Bone Marrow Transplantation ... transplant - slideshow Graft-versus-host disease Related Health Topics Bone Marrow Diseases Stem Cells National Institutes of ...

  8. Bionic Design, Materials and Performance of Bone Tissue Scaffolds

    Directory of Open Access Journals (Sweden)

    Tong Wu

    2017-10-01

    Full Text Available Design, materials, and performance are important factors in the research of bone tissue scaffolds. This work briefly describes the bone scaffolds and their anatomic structure, as well as their biological and mechanical characteristics. Furthermore, we reviewed the characteristics of metal materials, inorganic materials, organic polymer materials, and composite materials. The importance of the bionic design in preoperative diagnosis models and customized bone scaffolds was also discussed, addressing both the bionic structure design (macro and micro structure and the bionic performance design (mechanical performance and biological performance. Materials and performance are the two main problems in the development of customized bone scaffolds. Bionic design is an effective way to solve these problems, which could improve the clinical application of bone scaffolds, by creating a balance between mechanical performance and biological performance.

  9. Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis.

    Science.gov (United States)

    Twilt, Marinka; Pradsgaard, Dan; Spannow, Anne Helene; Horlyck, Arne; Heuck, Carsten; Herlin, Troels

    2017-08-10

    BoneXpert is an automated method to calculate bone maturation and bone health index (BHI) in children with juvenile idiopathic arthritis (JIA). Cartilage thickness can also be seen as an indicator for bone health and arthritis damage. The objective of this study was to evaluate the relation between cartilage thickness, bone maturation and bone health in patients with JIA. Patients with JIA diagnosed according ILAR criteria included in a previous ultrasonography (US) study were eligible if hand radiographs were taken at the same time as the US examination. Of the 95 patients 67 met the inclusion criteria. Decreased cartilage thickness was seen in 27% of the examined joints. Decreased BHI was seen in half of the JIA patient, and delayed bone maturation was seen in 33% of patients. A combination of decreased BHI and bone age was seen in 1 out of 5 JIA patients. Decreased cartilage thickness in the knee, wrist and MCP joint was negatively correlated with delayed bone maturation but not with bone health index. Delayed bone maturation and decreased BHI were not related to a thinner cartilage, but a thicker cartilage. No relation with JADAS 10 was found. The rheumatologist should remain aware of delayed bone maturation and BHI in JIA patients with cartilage changes, even in the biologic era.

  10. Progesterone and Bone: Actions Promoting Bone Health in Women

    Directory of Open Access Journals (Sweden)

    Vanadin Seifert-Klauss

    2010-01-01

    Full Text Available Estradiol (E2 and progesterone (P4 collaborate within bone remodelling on resorption (E2 and formation (P4. We integrate evidence that P4 may prevent and, with antiresorptives, treat women's osteoporosis. P4 stimulates osteoblast differentiation in vitro. Menarche (E2 and onset of ovulation (P4 both contribute to peak BMD. Meta-analysis of 5 studies confirms that regularly cycling premenopausal women lose bone mineral density (BMD related to subclinical ovulatory disturbances (SODs. Cyclic progestin prevents bone loss in healthy premenopausal women with amenorrhea or SOD. BMD loss is more rapid in perimenopause than postmenopause—decreased bone formation due to P4 deficiency contributes. In 4 placebo-controlled RCTs, BMD loss is not prevented by P4 in postmenopausal women with increased bone turnover. However, 5 studies of E2-MPA co-therapy show greater BMD increases versus E2 alone. P4 fracture data are lacking. P4 prevents bone loss in pre- and possibly perimenopausal women; progesterone co-therapy with antiresorptives may increase bone formation and BMD.

  11. Fat, Sugar, and Bone Health: A Complex Relationship

    Directory of Open Access Journals (Sweden)

    Li Tian

    2017-05-01

    Full Text Available With people aging, osteoporosis is expected to increase notably. Nutritional status is a relatively easily-modified risk factor, associated with many chronic diseases, and is involved in obesity, diabetes, and coronary heart disease (CHD, along with osteoporosis. Nutrients, such as fats, sugars, and proteins, play a primary function in bone metabolism and maintaining bone health. In Western nations, diets are generally high in saturated fats, however, currently, the nutritional patterns dominating in China continue to be high in carbohydrates from starch, cereals, and sugars. Moreover, high fat or high sugar (fructose, glucose, or sucrose impart a significant impact on bone structural integrity. Due to diet being modifiable, demonstrating the effects of nutrition on bone health can provide an approach for osteoporosis prevention. Most researchers have reported that a high-fat diet consumption is associated with bone mineral density (BMD and, as bone strength diminishes, adverse microstructure changes occur in the cancellous bone compartment, which is involved with lipid metabolism modulation disorder and the alteration of the bone marrow environment, along with an increased inflammatory environment. Some studies, however, demonstrated that a high-fat diet contributes to achieving peak bone mass, along with microstructure, at a younger age. Contrary to these results, others have shown that a high-fructose diet consumption leads to stronger bones with a superior microarchitecture than those with the intake of a high-glucose diet and, at the same time, research indicated that a high-fat diet usually deteriorates cancellous bone parameters, and that the incorporation of fructose into a high-fat diet did not aggravate bone mass loss. High-fat/high-sucrose diets have shown both beneficial and detrimental influences on bone metabolism. Combined, these studies showed that nutrition exerts different effects on bone health. Thus, a better understanding of

  12. Fat, Sugar, and Bone Health: A Complex Relationship.

    Science.gov (United States)

    Tian, Li; Yu, Xijie

    2017-05-17

    With people aging, osteoporosis is expected to increase notably. Nutritional status is a relatively easily-modified risk factor, associated with many chronic diseases, and is involved in obesity, diabetes, and coronary heart disease (CHD), along with osteoporosis. Nutrients, such as fats, sugars, and proteins, play a primary function in bone metabolism and maintaining bone health. In Western nations, diets are generally high in saturated fats, however, currently, the nutritional patterns dominating in China continue to be high in carbohydrates from starch, cereals, and sugars. Moreover, high fat or high sugar (fructose, glucose, or sucrose) impart a significant impact on bone structural integrity. Due to diet being modifiable, demonstrating the effects of nutrition on bone health can provide an approach for osteoporosis prevention. Most researchers have reported that a high-fat diet consumption is associated with bone mineral density (BMD) and, as bone strength diminishes, adverse microstructure changes occur in the cancellous bone compartment, which is involved with lipid metabolism modulation disorder and the alteration of the bone marrow environment, along with an increased inflammatory environment. Some studies, however, demonstrated that a high-fat diet contributes to achieving peak bone mass, along with microstructure, at a younger age. Contrary to these results, others have shown that a high-fructose diet consumption leads to stronger bones with a superior microarchitecture than those with the intake of a high-glucose diet and, at the same time, research indicated that a high-fat diet usually deteriorates cancellous bone parameters, and that the incorporation of fructose into a high-fat diet did not aggravate bone mass loss. High-fat/high-sucrose diets have shown both beneficial and detrimental influences on bone metabolism. Combined, these studies showed that nutrition exerts different effects on bone health. Thus, a better understanding of the regulation

  13. Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

    Science.gov (United States)

    Lovald, Scott T; Khraishi, Tariq; Wagner, Jon; Baack, Bret

    2009-03-01

    Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

  14. Maintaining bone health in prostate cancer throughout the disease continuum.

    Science.gov (United States)

    Saad, Fred; Eastham, James

    2010-06-01

    Prostate cancer (PC) is the most prevalent malignancy in men, with 604,506 new cases diagnosed yearly worldwide. Maintaining bone health is important during all stages of PC, including patients who experience bone loss from androgen-deprivation therapy and patients who develop bone metastases. Patients with bone metastases often experience severe bone pain and are at increased risk for potentially debilitating skeletal-related events. Bisphosphonates are a well-established treatment option for patients with bone metastases from solid tumors and bone lesions from multiple myeloma. Zoledronic acid (ZOL) is the only bisphosphonate (BP) that has been extensively studied in patients with castration-recurrent PC and is indicated for treating patients with bone metastases from PC in conjunction with standard antineoplastic therapy. This review will examine the breadth of evidence supporting a role for ZOL and emerging therapies in managing patients with PC throughout the disease continuum. 2010 Elsevier Inc. All rights reserved.

  15. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    OpenAIRE

    Young-Shin Lee

    2017-01-01

    Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women com...

  16. A Review on the Relationship between Aspirin and Bone Health

    Directory of Open Access Journals (Sweden)

    Kok-Yong Chin

    2017-01-01

    Full Text Available Aspirin is a cyclooxygenase inhibitor commonly used in primary prevention of cardiovascular diseases and cancers. Its users are elderly population susceptible to osteoporosis. It also inhibits the synthesis of prostaglandin E2 essential in bone remodeling. This prompts the question whether it can influence bone health among users. This review aimed to summarize the current literature on the use of aspirin on bone health. A literature search on experimental and clinical evidence on the effects of aspirin on bone health was performed using major scientific databases. In vitro studies showed that aspirin could enhance the survival of bone marrow mesenchymal stem cells, the progenitors of osteoblasts, and stimulate the differentiation of preosteoblasts. Aspirin also inhibited the nuclear factor kappa-B (NFκB pathway and decreased the expression of receptor activator of NFκB ligand, thus suppressing the formation of osteoclast. Aspirin could prevent bone loss in animal models of osteoporosis. Despite a positive effect on bone mineral density, the limited human epidemiological studies revealed that aspirin could not reduce fracture risk. A study even suggested that the use of aspirin increased fracture risk. As a conclusion, aspirin may increase bone mineral density but its effect on fracture prevention is inconclusive. More data are needed to determine the effects of aspirin and bone health in human.

  17. Vitamins and bone health: beyond calcium and vitamin D.

    Science.gov (United States)

    Ahmadieh, Hala; Arabi, Asma

    2011-10-01

    Osteoporosis is a major health disorder associated with an increased risk of fracture. Nutrition is among the modifiable factors that influence the risk of osteoporosis and fracture. Calcium and vitamin D play important roles in improving bone mineral density and reducing the risk of fracture. Other vitamins appear to play a role in bone health as well. In this review, the findings of studies that related the intake and/or the status of vitamins other than vitamin D to bone health in animals and humans are summarized. Studies of vitamin A showed inconsistent results. Excessive, as well as insufficient, levels of retinol intake may be associated with compromised bone health. Deficiencies in vitamin B, along with the consequent elevated homocysteine level, are associated with bone loss, decreased bone strength, and increased risk of fracture. Deficiencies in vitamins C, E, and K are also associated with compromised bone health; this effect may be modified by smoking, estrogen use or hormonal therapy after menopause, calcium intake, and vitamin D. These findings highlight the importance of adequate nutrition in preserving bone mass and reducing the risk of osteoporosis and fractures. © 2011 International Life Sciences Institute.

  18. Bone health in endurance athletes: runners, cyclists, and swimmers.

    Science.gov (United States)

    Scofield, Kirk L; Hecht, Suzanne

    2012-01-01

    Weight-bearing exercise has been recognized widely to be beneficial for long-term bone health. However inherent differences in bone-loading characteristics and energy expenditure during participation in endurance sports place many endurance athletes at a relative disadvantage with regard to bone health compared with other athletes. Adolescents and adults who participate in endurance sports, such as running, and non-weight-bearing sports, such as biking and swimming, often have lower bone mineral density (BMD) than athletes participating in ball and power sports, and sometimes their BMD is lower than their inactive peers. Low BMD increases the risk of stress and fragility fractures, both while an athlete is actively competing and later in life. This article reviews the variable effects of distance running, cycling, swimming, and triathlons on bone health; the evaluation of stress and fragility fractures; and the diagnosis, management, and prevention of low BMD in endurance athletes.

  19. Protecting Bone Health in Pediatric Rheumatic Diseases: Pharmacological Considerations.

    Science.gov (United States)

    Zhang, Yujuan; Milojevic, Diana

    2017-06-01

    Bone health in children with rheumatic conditions may be compromised due to several factors related to the inflammatory disease state, delayed puberty, altered life style, including decreased physical activities, sun avoidance, suboptimal calcium and vitamin D intake, and medical treatments, mainly glucocorticoids and possibly some disease-modifying anti-rheumatic drugs. Low bone density or even fragility fractures could be asymptomatic; therefore, children with diseases of high inflammatory load, such as systemic onset juvenile idiopathic arthritis, juvenile dermatomyositis, systemic lupus erythematosus, and those requiring chronic glucocorticoids may benefit from routine screening of bone health. Most commonly used assessment tools are laboratory testing including serum 25-OH-vitamin D measurement and bone mineral density measurement by a variety of methods, dual-energy X-ray absorptiometry as the most widely used. Early disease control, use of steroid-sparing medications such as disease-modifying anti-rheumatic drugs and biologics, supplemental vitamin D and calcium, and promotion of weight-bearing physical activities can help optimize bone health. Additional treatment options for osteoporosis such as bisphosphonates are still controversial in children with chronic rheumatic diseases, especially those with decreased bone density without fragility fractures. This article reviews common risk factors leading to compromised bone health in children with chronic rheumatic diseases and discusses the general approach to prevention and treatment of bone fragility.

  20. Bone biopsy needles. Mechanical properties, needle design and specimen quality

    International Nuclear Information System (INIS)

    Keulers, Annika; Penzkofer, T.; Cunha-Cruz, V.C.; Bruners, P.; Helmholtz Inst. fuer biomedizinische Technik, Aachen; Braunschweig, T.; Schmitz-Rode, T.; Mahnken, A.; Helmholtz Inst. fuer biomedizinische Technik, Aachen

    2011-01-01

    To quantitatively analyze differences in mechanical properties, needle design including signs of wear, subjective handling and specimen quality of bone biopsy needles. Materials and Methods: In this study 19 different bone biopsy systems (total 38; 2 /type) were examined. With each biopsy needle five consecutive samples were obtained from vertebral bodies of swine. During puncture a force-torques sensor measured the mechanical properties and subjective handling was assessed. Before and after each biopsy the needles were investigated using a profile projector and signs of wear were recorded. Afterwards, a pathologist semi-quantitatively examined the specimen regarding sample quality. The overall evaluation considered mechanical properties, needle wear, subjective handling and sample quality. Differences were assessed for statistical significance using ANOVA and t-test. Results: Needle diameter (p = 0.003) as well as needle design (p = 0.008) affect the mechanical properties significantly. Franseen design is significantly superior to other needle designs. Besides, length reduction recorded by the profile projector, as a quality criterion showed notable distinctions in between the needle designs. Conclusion: Bone biopsy needles vary significantly in performance. Needle design has an important influence on mechanical properties, handling and specimen quality. Detailed knowledge of those parameters would improve selecting the appropriate bone biopsy needle. (orig.)

  1. [Nutrition and bone health. Soybean and soy foods, and bone health].

    Science.gov (United States)

    Kubota, Megumi; Shimizu, Hirotoshi

    2009-10-01

    Soybean and various types of soy products, such as natto, tofu, miso, and soy sauce, have long been consumed in Japan. Soybean, a rich source of plant proteins, contains a relatively high amount of calcium as well as being an important source of isoflavones, a group of substances whose chemical structure is similar to that of estrogen. Natto, fermented soybeans, contains vitamin K, which is involved in the activation of osteocalcin. For bone health and osteoporosis prevention in Japanese, it is thus beneficial to consume adequate amounts of soybean and soy products on a daily basis.

  2. Is fatty acid composition of human bone marrow significant to bone health?

    Science.gov (United States)

    Pino, Ana María; Rodríguez, J Pablo

    2017-12-16

    The bone marrow adipose tissue (BMAT) is a conserved component of the marrow microenvironment, providing storage and release of energy and stabilizing the marrow extent. Also, it is recognized both the amount and quality of BMAT are relevant to preserve the functional relationships between BMAT, bone, and blood cell production. In this article we ponder the information supporting the tenet that the quality of BMAT is relevant to bone health. In the human adult the distribution of BMAT is heterogeneous over the entire skeleton, and both BMAT accumulation and bone loss come about with aging in healthy populations. But some pathological conditions which increase BMAT formation lead to bone impairment and fragility. Analysis in vivo of the relative content of saturated and unsaturated fatty acids (FA) in BMAT indicates site-related bone marrow fat composition and an association between increased unsaturation index (UI) and bone health. With aging some impairment ensues in the regulation of bone marrow cells and systemic signals leading to local chronic inflammation. Most of the bone loss diseases which evolve altered BMAT composition have as common factors aging and/or chronic inflammation. Both saturated and unsaturated FAs originate lipid species which are active mediators in the inflammation process. Increased free saturated FAs may lead to lipotoxicity of bone marrow cells. The pro-inflammatory, anti-inflammatory or resolving actions of compounds derived from long chain poly unsaturated FAs (PUFA) on bone cells is varied, and depending on the metabolism of the parent n:3 or n:6 PUFAs series. Taking together the evidence substantiate that marrow adipocyte function is fundamental for an efficient link between systemic and marrow fatty acids to accomplish specific energy or regulatory needs of skeletal and marrow cells. Further, they reveal marrow requirements of PUFAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Bone Health in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Vit Zikan

    2011-01-01

    Full Text Available Multiple sclerosis (MS is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorption with depressed bone formation and a marked disruption of mechanosensory network of tightly connected osteocytes due to increase of osteocyte apoptosis. Patients with higher level of disability have also higher risk of falls that combined with a bone loss increases the frequency of bone fractures. There are currently no recommendations how to best prevent and treat osteoporosis in patients with MS. However, devastating effect of immobilization on the skeleton in patients with MS underscores the importance of adequate mechanical stimuli for maintaining the bone structure and its mechanical competence. The physical as well as pharmacological interventions which can counteract the bone remodeling imbalance, particularly osteocyte apoptosis, will be promising for prevention and treatment of osteoporosis in patients with MS.

  4. Dietary nutraceuticals as backbone for bone health.

    Science.gov (United States)

    Pandey, Manoj K; Gupta, Subash C; Karelia, Deepkamal; Gilhooley, Patrick J; Shakibaei, Mehdi; Aggarwal, Bharat B

    2018-03-27

    Bone loss or osteoporosis, is a slow-progressing disease that results from dysregulation of pro-inflammatory cytokines. The FDA has approved number of drugs for bone loss prevention, nonetheless all are expensive and have multiple side effects. The nutraceuticals identified from dietary agents such as butein, cardamonin, coronarin D curcumin, diosgenin, embelin, gambogic acid, genistein, plumbagin, quercetin, reseveratrol, zerumbone and more, can modulate cell signaling pathways and reverse/slow down osteoporosis. Most of these nutraceuticals are inexpensive; show no side effect while still possessing anti-inflammatory properties. This review provides various mechanisms of osteoporosis and how nutraceuticals can potentially prevent the bone loss. Published by Elsevier Inc.

  5. Bone health in children and adolescents with perinatal HIV infection

    Science.gov (United States)

    Puthanakit, Thanyawee; Siberry, George K

    2013-01-01

    The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood. PMID:23782476

  6. Experimental design of natural and accellerated bone and wood ageing

    DEFF Research Database (Denmark)

    Facorellis, Y.; Pournou, A.; Richter, Jane

    2015-01-01

    This paper presents the experimental design for natural and accelerated ageing of bone and wood samples found in museum conditions that was conceived as part of the INVENVORG (Thales Research Funding Program – NRSF) investigating the effects of the environmental factors on natural organic materials....

  7. Nutritional factors affecting poultry bone health.

    Science.gov (United States)

    Fleming, Robert H

    2008-05-01

    Outlined are two main current research concerns relating to skeletal disorders in poultry: (a) osteoporosis in egg-laying hens; (b) leg problems caused by rapid bone growth in broiler chickens. Surveys indicate that 30% of caged laying hens suffer at least one lifetime fracture (a severe welfare issue). Modern hybrids produce one egg per d for 50 weeks. For this period 'normal' bone turnover ceases; only medullary bone (MB) is formed, a woven bone type of limited structural value. MB is resorbed for eggshell formation alongside structural bone, leading to increased fracture risk. Avian osteoporosis is reduced by activity and genetic selection but nutrition is also important. Fluoride and vitamin K are beneficial but the timing of nutritional intervention is important. Ca, inorganic P and vitamin D must be adequate and the form of Ca is critical. Limestone fed as particulates benefits skeletal and eggshell quality. In hens fed particulate limestone compared with flour-fed hens the tibiotarsus breaking strength and radiographic density are increased at 56 weeks of age (Pbroiler (meat) chickens selection for rapid growth from approximately 50 g to 3 kg in 42 d has inadvertently produced skeletal disorders such as tibial dyschondroplasia, rickets and associated valgus-varus deformities leading to lameness. The beneficial skeletal effects during growth of increased dietary n-3 PUFA:n-6 PUFA (utilising salmon oil) have been demonstrated. Experiments simulating daylight UVB levels have produced beneficial skeletal effects in Ca- and vitamin D-deficient chicks.

  8. Design, Materials, and Mechanobiology of Biodegradable Scaffolds for Bone Tissue Engineering

    Science.gov (United States)

    Velasco, Marco A.; Narváez-Tovar, Carlos A.; Garzón-Alvarado, Diego A.

    2015-01-01

    A review about design, manufacture, and mechanobiology of biodegradable scaffolds for bone tissue engineering is given. First, fundamental aspects about bone tissue engineering and considerations related to scaffold design are established. Second, issues related to scaffold biomaterials and manufacturing processes are discussed. Finally, mechanobiology of bone tissue and computational models developed for simulating how bone healing occurs inside a scaffold are described. PMID:25883972

  9. Bone health in HIV-infected children and adolescents.

    Science.gov (United States)

    Eckard, Allison R; Mora, Stefano

    2016-05-01

    Chronic HIV infection and exposure to antiretroviral therapy compromises bone health in children and adolescents, potentially impacting their long-term quality of life. Thus, the purpose of this article is to review the most recent literature on this topic in HIV-infected children and adolescents. Recent studies continue to demonstrate bone abnormalities in HIV-infected children and adolescents, whether HIV is acquired perinatally or during adolescence. Researchers have employed new modalities, both high tech and those that can be utilized in resource-limited settings, to better assess bone health. New data suggest that this population may also be experiencing an increase incidence of fractures, and they may not acquire the same peak bone mass as their HIV-uninfected counterparts. Reassuringly, however, in-utero tenofovir exposure does not appear to have a significant impact on bone health in HIV-exposed, uninfected infants. HIV-infected children and adolescents are exposed to HIV and antiretroviral therapy for many decades starting early in life and during the most critical time for skeletal growth and bone mass accrual. Recent findings underscore the need for further research on bone in this population. Longitudinal studies are especially needed to evaluate long-term risk of osteoporosis and fracture.

  10. [THE IMPORTANCE OF "MILK BONES" TO "WISDOM BONES" - COW MILK AND BONE HEALTH - LESSONS FROM MILK ALLERGY PATIENTS].

    Science.gov (United States)

    Nachshon, Liat; Katz, Yitzhak

    2016-03-01

    The necessity of milk consumption in the western diet is a subject of intense controversy. One of the main benefits of milk is that it is the main source of dietary calcium. Calcium is a major bone mineral, mandatory for bone health. Its supply is derived exclusively from external dietary sources. During the growth period, an increased calcium supply is needed for the process of bone mass accumulation. An optimal bone mass achieved by the end of the growth period may be protective later in life against the bone mass loss that commonly occurs. This in turn, can be preventative against the occurrence of osteoporosis and the development of spontaneous bone fractures. Over the past several decades, an increased incidence of osteoporosis has been documented in western countries, leading to high rates of morbidity and mortality in the middle-aged and geriatric population. Many studies have investigated the dietary calcium requirements for different ages, to achieve and maintain proper bone health. Based on their results, guidelines concerning calcium intake in every stage of life have been published by national and international organizations. In the western diet, it is difficult to achieve the recommended calcium intake without milk consumption. Moreover, calcium bioavailability for intestinal absorption is high. Several studies have recently raised doubts concerning the amounts of calcium intake in the western diet and its effectiveness in preventing osteoporosis. The main disadvantage of these studies is their being based on the patient's past memory recall of milk consumption. Patients with IgE-mediated cow's milk protein allergy are a unique population. Their lifetime negligible milk consumption is undisputed. A recent study investigated for the first time, the bone density of young adults with milk allergy at the end of their growth period. Their severe reduction in bone mineral density and dietary calcium intake defines them as a high risk group for the

  11. Vitamin D, Breast Cancer, and Bone Health

    Science.gov (United States)

    2011-05-01

    vitamin D and bone from David Feldman, MD and from David Karpf, MD. I am thankful for Department of Defense, Breast Cancer Research Program for...Clin Nutr. Jul 2008;88(1):133-139. 3. Crew KD, Shane E, Cremers S, McMahon DJ, Irani D, Hershman DL. High prevalence of vitamin D deficiency despite

  12. Cycling and bone health: a systematic review

    Directory of Open Access Journals (Sweden)

    Olmedillas Hugo

    2012-12-01

    Full Text Available Abstract Background Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass. Methods A scientific literature search on studies discussing bone mass and bone metabolism in cyclists was performed to collect all relevant published material up to April 2012. Descriptive, cross-sectional, longitudinal and interventional studies were all reviewed. Inclusion criteria were met by 31 studies. Results Heterogeneous studies in terms of gender, age, data source, group of comparison, cycling level or modality practiced among others factors showed minor but important differences in results. Despite some controversial results, it has been observed that adult road cyclists participating in regular training have low bone mineral density in key regions (for example, lumbar spine. Conversely, other types of cycling (such as mountain biking, or combination with other sports could reduce this unsafe effect. These results cannot yet be explained by differences in dietary patterns or endocrine factors. Conclusions From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level.

  13. [The Effects of Exercising in Childhood on Bone Health.

    Science.gov (United States)

    Imai, Kazuhiro; Iwamoto, Jun; Torii, Suguru; Masujima, Atsushi

    In contemporary Japan, there is a polarizing trend in children who exercise more than 1,800 minutes a week and those who exercise less than 60 minutes a week. Quite a lot of girls in particular hate exercise,and therefore they don't get enough of it. Osteoporosis is a preventable disease from childhood. It is crucial for girls to exercise and to provide appropriate stimulation to bones before menarche, which increases bone mineral content. Exercise and sports in childhood are characterized as the ways to the lifelong prevention strategies against osteoporosis and fractures. It is hoped that all children practice appropriate exercise program based on scientific evidence to promote bone health. In this review article, the effects of exercising in childhood on bone health, and the points to be noted regarding childhood sports are described.

  14. The emerging role of bone marrow adipose tissue in bone health and dysfunction.

    Science.gov (United States)

    Ambrosi, Thomas H; Schulz, Tim J

    2017-12-01

    Replacement of red hematopoietic bone marrow with yellow adipocyte-rich marrow is a conserved physiological process among mammals. The extent of this conversion is influenced by a wide array of pathological and non-pathological conditions. Of particular interest is the observation that some marrow adipocyte-inducing factors seem to oppose each other, for instance obesity and caloric restriction. Intriguingly, several important molecular characteristics of bone marrow adipose tissue (BMAT) are distinct from the classical depots of white and brown fat tissue. This depot of fat has recently emerged as an active part of the bone marrow niche that exerts paracrine and endocrine functions thereby controlling osteogenesis and hematopoiesis. While some functions of BMAT may be beneficial for metabolic adaptation and bone homeostasis, respectively, most findings assign bone fat a detrimental role during regenerative processes, such as hematopoiesis and osteogenesis. Thus, an improved understanding of the biological mechanisms leading to formation of BMAT, its molecular characteristics, and its physiological role in the bone marrow niche is warranted. Here we review the current understanding of BMAT biology and its potential implications for health and the development of pathological conditions.

  15. Bone health, vitamin D and lupus.

    Science.gov (United States)

    Sangüesa Gómez, Clara; Flores Robles, Bryan Josué; Andréu, José Luis

    2015-01-01

    The prevalence of vitamin D deficiency and insufficiency among patients with systemic lupus erythematosus is high. This is likely due to photoprotection measures in addition to intrinsic factors of the disease. Low levels of vitamin D increase the risk of low bone mineral density and fracture. Vitamin D deficiency could also have undesirable effects on patients' immune response, enhancing mechanisms of loss of tolerance and autoimmunity. Vitamin D levels should be periodically monitored and patients should be treated with the objective of reaching vitamin D levels higher than 30-40 ng/ml. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  16. Regulation of placental calcium transport and offspring bone health

    Directory of Open Access Journals (Sweden)

    Laura eGoodfellow

    2011-02-01

    Full Text Available Osteoporosis causes considerable morbidity and mortality in later life, and the risk of the disease is strongly determined by peak bone mass, which is achieved in early adulthood. Poor intrauterine and early childhood growth are associated with reduced peak bone mass, and increased risk of osteoporotic fracture in older age. In this review we describe the regulatory aspects of intrauterine bone development, and then summarise the evidence relating early growth to later fracture risk. Physiological systems include vitamin D, PTH; leptin; GH/ IGF-1; finally the potential role of epigenetic processes in the underlying mechanisms will be explored. Thus factors such as maternal lifestyle, diet, body build, physical activity and vitamin D status in pregnancy all appear to influence offspring bone mineral accrual. These data demonstrate a likely interaction between environmental factors and gene expression, a phenomenon ubiquitous in the natural world (developmental plasticity, as the potential key process. Intervention studies are now required to test the hypotheses generated by these epidemiological and physiological findings, to inform potential novel public health interventions aimed at improving childhood bone health and reducing the burden of osteoporotic fracture in future generations.

  17. Participatory Design & Health Information Technology

    DEFF Research Database (Denmark)

    Health Information Technology (HIT) continues to increase in importance as a component of healthcare provision, but designing HIT is complex. The creation of cooperative learning processes for future HIT users is not a simple task. The importance of engaging end users such as health professionals......, in collaboration with a wide range of people, a broad repertoire of methods and techniques to apply PD within multiple domains has been established. This book, Participatory Design & Health Information Technology, presents the contributions of researchers from 5 countries, who share their experience and insights......, patients and relatives in the design process is widely acknowledged, and Participatory Design (PD) is the primary discipline for directly involving people in the technological design process. Exploring the application of PD in HIT is crucial to all those involved in engaging end users in HIT design and...

  18. Midlife women, bone health, vegetables, herbs and fruit study. The Scarborough Fair study protocol

    Directory of Open Access Journals (Sweden)

    Gunn Caroline A

    2013-01-01

    Full Text Available Abstract Background Bone loss is accelerated in middle aged women but increased fruit/vegetable intake positively affects bone health by provision of micronutrients essential for bone formation, buffer precursors which reduce acid load and phytochemicals affecting inflammation and oxidative stress. Animal studies demonstrated bone resorption inhibiting properties of specific vegetables, fruit and herbs a decade ago. Objective: To increase fruit/vegetable intake in post menopausal women to 9 servings/day using a food specific approach to significantly reduce dietary acid load and include specific vegetables, fruit and herbs with bone resorbing inhibiting properties to assess effect on bone turnover, metabolic and inflammatory markers. Methods/Design The Scarborough Fair Study is a randomised active comparator controlled multi centre trial. It aimed to increase fruit and vegetable intake in 100 post menopausal women from ≤ 5 servings/day to ≥ 9 servings/day for 3 months. The women in the dietary intervention were randomly assigned to one of the two arms of the study. Both groups consumed ≥ 9 servings/day of fruit/vegetables and selected herbs but the diet of each group emphasised different fruit/vegetables/herbs with one group (B selecting from a range of vegetables, fruit and culinary herbs with bone resorbing inhibiting properties. 50 women formed a negative control group (Group C usual diet. Primary outcome variables were plasma bone markers assessed at baseline, 6 weeks and 12 weeks. Secondary outcome variables were plasma inflammation and metabolic markers and urinary electrolytes (calcium, magnesium, potassium and sodium assessed at baseline and 12 weeks. Dietary intake and urine pH change also were outcome variables. The dietary change was calculated with 3 day diet diaries and a 24 hour recall. Intervention participants kept a twice weekly record of fruit, vegetable and herb intake and urine pH. Discussion This study will provide

  19. Calcium and bone health in children: a review.

    Science.gov (United States)

    Stallings, V A

    1997-01-01

    The recent national survey shows that dietary calcium intake is variable in children and adolescents, with about half consuming less than the intake recommended by the Recommended Dietary Allowances or the National Institutes of Health Consensus Panel on Optimal Calcium Intake. Osteoporosis is a major disease in adults, resulting in 1.5 million fractures and over $10 billion in medical expenditures annually. Osteoporosis is of growing interest in the research, public health, and health consumer-lay communities and to the many primary care and specialty physicians and other health care professionals who work directly with patients with osteoporosis. Treatment of osteoporosis to prevent fracture is improving with newly introduced medications and approaches, but it is not as effective as needed. Effective prevention strategies are critical to decreasing the morbidity and mortality of the disease. Peak bone mass, obtained during childhood and adolescent growth, is one of the major determinants for the risk of developing osteoporosis and fracture. Genetic potential, gender, ethnic origins, nutritional factors such as calcium and vitamin D intake, growth patterns, and physical activity influence the accretion of bone mineral during childhood and determine the peak bone mass. Randomized, placebo-controlled intervention trials conducted in healthy children who are consuming amounts of dietary calcium in accordance with the US recommendations show that bone mass can be increased by calcium supplementation. Retrospective studies in adults suggest that childhood calcium intake is associated with risk of later osteoporosis and fracture. In addition, common childhood clinical conditions, such as low calcium intake related to lactose intolerance or the use of glucocorticoid medications for chronic illness, are risk factors for the development of osteoporosis in childhood, not just in adulthood. An approach for physicians and other pediatric care providers for screening children

  20. How B cells influence bone biology in health and disease.

    Science.gov (United States)

    Horowitz, Mark C; Fretz, Jackie A; Lorenzo, Joseph A

    2010-09-01

    It is now well established that important regulatory interactions occur between the cells in the hematopoietic, immune and skeletal systems (osteoimmunology). B lymphocytes (B cells) are responsible for the generation and production of antibodies or immunoglobulins in the body. Together with T cells these lymphocytes comprise the adaptive immune system, which allows an individual to develop specific responses to an infection and retain memory of that infection, allowing for a faster and more robust response if that same infection occurs again. In addition to this immune function, B cells have a close and multifaceted relationship with bone cells. B cells differentiate from hematopoietic stem cells (HSCs) in supportive niches found on endosteal bone surfaces. Cells in the osteoblast lineage support HSC and B cell differentiation in these niches. B cell differentiation is regulated, at least in part, by a series of transcription factors that function in a temporal manner. While these transcription factors are required for B cell differentiation, their loss causes profound changes in the bone phenotype. This is due, in part, to the close relationship between macrophage/osteoclast and B cell differentiation. Cross talk between B cells and bone cells is reciprocal with defects in the RANKL-RANK, OPG signaling axis resulting in altered bone phenotypes. While the role of B cells during normal bone remodeling appears minimal, activated B cells play an important role in many inflammatory diseases with associated bony changes. This review examines the relationship between B cells and bone cells and how that relationship affects the skeleton and hematopoiesis during health and disease. Copyright 2010 Elsevier Inc. All rights reserved.

  1. Bike racing, recreational riding, impact sport and bone health

    Directory of Open Access Journals (Sweden)

    Carmont Michael R

    2012-12-01

    Full Text Available Abstract Cycling has been shown to confer considerable benefits in terms of health, leading to reductions in death rates principally due to cardiovascular improvements and adaptation. Given the disparity between the benefits of cycling on cardiovascular fitness and previous research finding that cycling may not be beneficial for bone health, Hugo Olmedillas and colleagues performed a systematic review of the literature. They concluded that road cycling does not appear to confer any significant osteogenic benefit. They postulate that the cause of this is that, particularly at a competitive level, riders spend long periods of time in a weight-supported position on the bike. Training programs may be supplemented with impact loading to preserve bone health; however, the small increased risk of soft tissue injury must also be considered. See related commentary http://www.biomedcentral.com/1741-7015/10/168

  2. Poor bone health in underprivileged Indian girls: an effect of low bone mass accrual during puberty.

    Science.gov (United States)

    Khadilkar, Anuradha V; Sanwalka, Neha J; Kadam, Nidhi S; Chiplonkar, Shashi A; Khadilkar, Vaman V; Mughal, M Zulf

    2012-05-01

    A socio-economic gradient exists for most reasons of morbidity and mortality including delayed puberty in lower (LSES) as compared to higher (HSES) socio-economic stratum and puberty is an important factor affecting bone status in children and adolescents. Thus, a cross-sectional study was conducted on 195 age-matched pairs of girls (8-17years) from LSES and HSES in Pune City, India to assess the hypothesis that socio-economic factors working through late puberty would have a negative association with bone status of adolescents. Height, weight and Tanner stage were assessed. Total body bone mineral content (TBBMC), total body bone area (TBBA), total body bone mineral density (TBBMD), lean body mass (LBM) and total body fat mass (TBFM) were measured using GE Lunar DPX Pro Pencil Beam DXA (Wisconsin, USA) scanner. Mean TBBMC (1172±434g), TBBA (1351±356cm(2)), TBBMD (0.846±0.104g/cm(2)), LBM (21,622±5306g) and TBFM (7746±5194g) in LSES girls were significantly lower than that of HSES girls [TBBMC (1483±525g), TBBA (1533±380cm(2)), TBBMD (0.942±0.119g/cm(2)), LBM (24,308±5829g) and TBFM (12,196±7404g)] (pbone parameters. The differences in TBBMC, TBBA, LBM and TBFM between the 2 socio-economic strata at Tanner stage I were not significant (p>0.1) whereas there were significant differences in these parameters from Tanner stages II to V (pbone health in adolescent girls from the lower socio-economic stratum. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Design of complex bone internal structure using topology optimization with perimeter control.

    Science.gov (United States)

    Park, Jaejong; Sutradhar, Alok; Shah, Jami J; Paulino, Glaucio H

    2018-03-01

    Large facial bone loss usually requires patient-specific bone implants to restore the structural integrity and functionality that also affects the appearance of each patient. Titanium alloys (e.g., Ti-6Al-4V) are typically used in the interfacial porous coatings between the implant and the surrounding bone to promote stability. There exists a property mismatch between the two that in general leads to complications such as stress-shielding. This biomechanical discrepancy is a hurdle in the design of bone replacements. To alleviate the mismatch, the internal structure of the bone replacements should match that of the bone. Topology optimization has proven to be a good technique for designing bone replacements. However, the complex internal structure of the bone is difficult to mimic using conventional topology optimization methods without additional restrictions. In this work, the complex bone internal structure is recovered using a perimeter control based topology optimization approach. By restricting the solution space by means of the perimeter, the intricate design complexity of bones can be achieved. Three different bone regions with well-known physiological loadings are selected to illustrate the method. Additionally, we found that the target perimeter value and the pattern of the initial distribution play a vital role in obtaining the natural curvatures in the bone internal structures as well as avoiding excessive island patterns. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Bone health history in breast cancer patients on aromatase inhibitors.

    Directory of Open Access Journals (Sweden)

    Marilyn L Kwan

    Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

  5. Adolescent girls, the menstrual cycle, and bone health.

    Science.gov (United States)

    Adams Hillard, Paula J; Nelson, Lawrence M

    2003-05-01

    In adolescent girls, amenorrhea is sometimes viewed as a variant of normal; in fact, however, during the first gynecologic year, the 95th percentile for cycle length is 90 days. Although early menstrual cycles are frequently anovulatory and may be somewhat irregular, girls with menses coming less frequently than every 90 days may have significant pathology associated with hypoestrogenism. Hypoestrogenism is a known risk factor for the development of osteoporosis. Causes of oligomenorrhea and amenorrhea include the relatively common conditions of hyperandrogenism, eating disorders, and exercise-induced amenorrhea, as well as uncommon conditions such as pituitary tumor, gonadal dysgenesis, and premature ovarian failure. Even functional hypothalamic oligomenorrhea has been linked to reduced bone density. Attention to menstrual irregularity and the earlier diagnosis of conditions causing it may lead to interventions that will benefit life-long bone health.

  6. Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Young-Joo Park, PhD, RN

    2017-03-01

    Conclusion: Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on self-management ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.

  7. Design of a multi-axis implantable MEMS sensor for intraosseous bone stress monitoring

    International Nuclear Information System (INIS)

    Alfaro, Fernando; Weiss, Lee; Campbell, Phil; Fedder, Gary K; Miller, Mark

    2009-01-01

    The capability to assess the biomechanical properties of living bone is important for basic research as well as the clinical management of skeletal trauma and disease. Even though radiodensitometric imaging is commonly used to infer bone quality, bone strength does not necessarily correlate well with these non-invasive measurements. This paper reports on the design, fabrication and initial testing of an implantable ultra-miniature multi-axis sensor for directly measuring bone stresses at a micro-scale. The device, which is fabricated with CMOS-MEMS processes, is intended to be permanently implanted within open fractures, or embedded in bone grafts, or placed on implants at the interfaces between bone and prosthetics. The stress sensor comprises an array of piezoresistive pixels to detect a stress tensor at the interfacial area between the MEMS chip and bone, with a resolution to 100 Pa, in 1 s averaging. The sensor system design and manufacture is also compatible with the integration of wireless RF telemetry, for power and data retrieval, all within a 3 mm × 3 mm × 0.3 mm footprint. The piezoresistive elements are integrated within a textured surface to enhance sensor integration with bone. Finite element analysis led to a sensor design for normal and shear stress detection. A wired sensor was fabricated in the Jazz 0.35 µm BiCMOS process and then embedded in mock bone material to characterize its response to tensile and bending loads up to 250 kPa

  8. Effect of a program of short bouts of exercise on bone health in adolescents involved in different sports: the PRO-BONE study protocol.

    Science.gov (United States)

    Vlachopoulos, Dimitris; Barker, Alan R; Williams, Craig A; Knapp, Karen M; Metcalf, Brad S; Gracia-Marco, Luis

    2015-04-11

    Osteoporosis is a skeletal disease associated with high morbidity, mortality and increased economic costs. Early prevention during adolescence appears to be one of the most beneficial practices. Exercise is an effective approach for developing bone mass during puberty, but some sports may have a positive or negative impact on bone mass accrual. Plyometric jump training has been suggested as a type of exercise that can augment bone, but its effects on adolescent bone mass have not been rigorously assessed. The aims of the PRO-BONE study are to: 1) longitudinally assess bone health and its metabolism in adolescents engaged in osteogenic (football), non-osteogenic (cycling and swimming) sports and in a control group, and 2) examine the effect of a 9 month plyometric jump training programme on bone related outcomes in the sport groups. This study will recruit 105 males aged 12-14 years who have participated in sport specific training for at least 3 hours per week during the last 3 years in the following sports groups: football (n = 30), cycling (n = 30) and swimming (n = 30). An age-matched control group (n = 15) that does not engage in these sports more than 3 hours per week will also be recruited. Participants will be measured on 5 occasions: 1) at baseline; 2) after 12 months of sport specific training where each sport group will be randomly allocated into two sub-groups: intervention group (sport + plyometric jump training) and sport group (sport only); 3) exactly after the 9 months of intervention; 4) 6 months following the intervention; 5) 12 months following the intervention. Body composition (dual energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance), bone stiffness index (ultrasounds), physical activity (accelerometers), diet (24 h recall questionnaire), pubertal maturation (Tanner stage), physical fitness (cardiorespiratory and muscular), bone turnover markers and vitamin D will be measured at each visit. The PRO-BONE

  9. Design of bone-integrating organic-inorganic composite suitable for bone repair.

    Science.gov (United States)

    Miyazaki, Toshiki

    2013-01-01

    Several ceramics exhibit specific biological affinity, i.e. direct bone integration, when implanted in bony defects. They are called bioactive ceramics and utilized as important bone substitutes. However, there is limitation on clinical application, because of their inappropriate mechanical properties such as high Young's modulus and low fracture toughness. Novel bioactive materials exhibiting high machinability and flexibility have been desired in medical fields. Mixing bioactive ceramic powders and organic polymers have developed various organic-inorganic composites. Their mechanical property and bioactivity are mainly governed by the ceramics content. It is known that bioactive ceramics integrate with the bone through bone-like hydroxyapatite layer formed on their surfaces by chemical reaction with body fluid. This is triggered by a catalytic effect of various functional groups. On the basis of these facts, novel bioactive organic-inorganic nanocomposites have been developed. In these composites, inorganic components effective for triggering the hydroxyapatite nucleation are dispersed in polymer matrix at molecular level. Concept of the organic-inorganic composite is also applicable for providing polymethyl methacrylate (PMMA) bone cement with the bioactivity.

  10. Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study

    Directory of Open Access Journals (Sweden)

    Emma T. Callegari

    2015-11-01

    Full Text Available Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study. Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.

  11. Design and properties of 3D scaffolds for bone tissue engineering.

    Science.gov (United States)

    Gómez, S; Vlad, M D; López, J; Fernández, E

    2016-09-15

    In this study, the Voronoi tessellation method has been used to design novel bone like three dimension (3D) porous scaffolds. The Voronoi method has been processed with computer design software to obtain 3D virtual isotropic porous interconnected models, exactly matching the main histomorphometric indices of trabecular bone (trabecular thickness, trabecular separation, trabecular number, bone volume to total volume ratio, bone surface to bone volume ratio, etc.). These bone like models have been further computed for mechanical (elastic modulus) and fluid mass transport (permeability) properties. The results show that the final properties of the scaffolds can be controlled during their microstructure and histomorphometric initial design stage. It is also shown that final properties can be tuned during the design stage to exactly match those of trabecular natural bone. Moreover, identical total porosity models can be designed with quite different specific bone surface area and thus, this specific microstructural feature can be used to favour cell adhesion, migration and, ultimately, new bone apposition (i.e. osteoconduction). Once the virtual models are fully characterized and optimized, these can be easily 3D printed by additive manufacturing and/or stereolitography technologies. The significance of this article goes far beyond the specific objectives on which it is focussed. In fact, it shows, in a guided way, the entire novel process that can be followed to design graded porous implants, whatever its external shape and geometry, but internally tuned to the exact histomorphometric indices needed to match natural human tissues microstructures and, consequently, their mechanical and fluid properties, among others. The significance is even more relevant nowadays thanks to the available new computing and design software that is easily linked to the 3D printing new technologies. It is this transversality, at the frontier of different disciplines, the main characteristic

  12. Computational model-informed design and bioprinting of cell-patterned constructs for bone tissue engineering.

    Science.gov (United States)

    Carlier, Aurélie; Skvortsov, Gözde Akdeniz; Hafezi, Forough; Ferraris, Eleonora; Patterson, Jennifer; Koç, Bahattin; Van Oosterwyck, Hans

    2016-05-17

    Three-dimensional (3D) bioprinting is a rapidly advancing tissue engineering technology that holds great promise for the regeneration of several tissues, including bone. However, to generate a successful 3D bone tissue engineering construct, additional complexities should be taken into account such as nutrient and oxygen delivery, which is often insufficient after implantation in large bone defects. We propose that a well-designed tissue engineering construct, that is, an implant with a specific spatial pattern of cells in a matrix, will improve the healing outcome. By using a computational model of bone regeneration we show that particular cell patterns in tissue engineering constructs are able to enhance bone regeneration compared to uniform ones. We successfully bioprinted one of the most promising cell-gradient patterns by using cell-laden hydrogels with varying cell densities and observed a high cell viability for three days following the bioprinting process. In summary, we present a novel strategy for the biofabrication of bone tissue engineering constructs by designing cell-gradient patterns based on a computational model of bone regeneration, and successfully bioprinting the chosen design. This integrated approach may increase the success rate of implanted tissue engineering constructs for critical size bone defects and also can find a wider application in the biofabrication of other types of tissue engineering constructs.

  13. A study of the bone healing kinetics of plateau versus screw root design titanium dental implants.

    LENUS (Irish Health Repository)

    Leonard, Gary

    2009-03-01

    This study was designed to compare the bone healing process around plateau root from (PRF) and screw root from (SRF) titanium dental implants over the immediate 12 week healing period post implant placement.

  14. Bone-composition imaging using coherent-scatter computed tomography: Assessing bone health beyond bone mineral density

    International Nuclear Information System (INIS)

    Batchelar, Deidre L.; Davidson, Melanie T.M.; Dabrowski, Waldemar; Cunningham, Ian A.

    2006-01-01

    Quantitative analysis of bone composition is necessary for the accurate diagnosis and monitoring of metabolic bone diseases. Accurate assessment of the bone mineralization state is the first requirement for a comprehensive analysis. In diagnostic imaging, x-ray coherent scatter depends upon the molecular structure of tissues. Coherent-scatter computed tomography (CSCT) exploits this feature to identify tissue types in composite biological specimens. We have used CSCT to map the distributions of tissues relevant to bone disease (fat, soft tissue, collagen, and mineral) within bone-tissue phantoms and an excised cadaveric bone sample. Using a purpose-built scanner, we have measured hydroxyapatite (bone mineral) concentrations based on coherent-scatter patterns from a series of samples with varying hydroxyapatite content. The measured scatter intensity is proportional to mineral density in true g/cm 3 . Repeated measurements of the hydroxyapatite concentration in each sample were within, at most, 2% of each other, revealing an excellent precision in determining hydroxyapatite concentration. All measurements were also found to be accurate to within 3% of the known values. Phantoms simulating normal, over-, and under-mineralized bone were created by mixing known masses of pure collagen and hydroxyapatite. An analysis of the composite scatter patterns gave the density of each material. For each composite, the densities were within 2% of the known values. Collagen and hydroxyapatite concentrations were also examined in a bone-mimicking phantom, incorporating other bone constituents (fat, soft tissue). Tomographic maps of the coherent-scatter properties of each specimen were reconstructed, from which material-specific images were generated. Each tissue was clearly distinguished and the collagen-mineral ratio determined from this phantom was also within 2% of the known value. Existing bone analysis techniques cannot determine the collagen-mineral ratio in intact specimens

  15. Validation of scaffold design optimization in bone tissue engineering: finite element modeling versus designed experiments.

    Science.gov (United States)

    Uth, Nicholas; Mueller, Jens; Smucker, Byran; Yousefi, Azizeh-Mitra

    2017-02-21

    This study reports the development of biological/synthetic scaffolds for bone tissue engineering (TE) via 3D bioplotting. These scaffolds were composed of poly(L-lactic-co-glycolic acid) (PLGA), type I collagen, and nano-hydroxyapatite (nHA) in an attempt to mimic the extracellular matrix of bone. The solvent used for processing the scaffolds was 1,1,1,3,3,3-hexafluoro-2-propanol. The produced scaffolds were characterized by scanning electron microscopy, microcomputed tomography, thermogravimetric analysis, and unconfined compression test. This study also sought to validate the use of finite-element optimization in COMSOL Multiphysics for scaffold design. Scaffold topology was simplified to three factors: nHA content, strand diameter, and strand spacing. These factors affect the ability of the scaffold to bear mechanical loads and how porous the structure can be. Twenty four scaffolds were constructed according to an I-optimal, split-plot designed experiment (DE) in order to generate experimental models of the factor-response relationships. Within the design region, the DE and COMSOL models agreed in their recommended optimal nHA (30%) and strand diameter (460 μm). However, the two methods disagreed by more than 30% in strand spacing (908 μm for DE; 601 μm for COMSOL). Seven scaffolds were 3D-bioplotted to validate the predictions of DE and COMSOL models (4.5-9.9 MPa measured moduli). The predictions for these scaffolds showed relative agreement for scaffold porosity (mean absolute percentage error of 4% for DE and 13% for COMSOL), but were substantially poorer for scaffold modulus (51% for DE; 21% for COMSOL), partly due to some simplifying assumptions made by the models. Expanding the design region in future experiments (e.g., higher nHA content and strand diameter), developing an efficient solvent evaporation method, and exerting a greater control over layer overlap could allow developing PLGA-nHA-collagen scaffolds to meet the mechanical requirements for

  16. Design and fabrication of biomimetic multiphased scaffolds for ligament-to-bone fixation.

    Science.gov (United States)

    He, Jiankang; Zhang, Wenyou; Liu, Yaxiong; Li, Xiang; Li, Dichen; Jin, Zhongmin

    2015-05-01

    Conventional ligament grafts with single material composition cannot effectively integrate with the host bones due to mismatched properties and eventually affect their long-term function in vivo. Here we presented a multi-material strategy to design and fabricate composite scaffolds including ligament, interface and bone multiphased regions. The interface region consists of triphasic layers with varying material composition and porous structure to mimic native ligament-to-bone interface while the bone region contains polycaprolactone (PCL) anchor and microchanneled ceramic scaffolds to potentially provide combined mechanical and biological implant-bone fixation. Finite element analysis (FEA) demonstrated that the multiphased scaffolds with interference value smaller than 0.5 mm could avoid the fracture of ceramic scaffold during the implantation process, which was validated by in-vitro implanting the multiphased scaffolds into porcine joint bones. Pull-out experiment showed that the initial fixation between the multiphased scaffolds with 0.47 mm interference and the host bones could withstand the maximum force of 360.31±97.51 N, which can be improved by reinforcing the ceramic scaffolds with biopolymers. It is envisioned that the multiphased scaffold could potentially induce the regeneration of a new bone as well as interfacial tissue with the gradual degradation of the scaffold and subsequently realize long-term biological fixation of the implant with the host bone. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Mixed reality temporal bone surgical dissector: mechanical design.

    Science.gov (United States)

    Hochman, Jordan Brent; Sepehri, Nariman; Rampersad, Vivek; Kraut, Jay; Khazraee, Milad; Pisa, Justyn; Unger, Bertram

    2014-08-08

    The Development of a Novel Mixed Reality (MR) Simulation. An evolving training environment emphasizes the importance of simulation. Current haptic temporal bone simulators have difficulty representing realistic contact forces and while 3D printed models convincingly represent vibrational properties of bone, they cannot reproduce soft tissue. This paper introduces a mixed reality model, where the effective elements of both simulations are combined; haptic rendering of soft tissue directly interacts with a printed bone model. This paper addresses one aspect in a series of challenges, specifically the mechanical merger of a haptic device with an otic drill. This further necessitates gravity cancelation of the work assembly gripper mechanism. In this system, the haptic end-effector is replaced by a high-speed drill and the virtual contact forces need to be repositioned to the drill tip from the mid wand. Previous publications detail generation of both the requisite printed and haptic simulations. Custom software was developed to reposition the haptic interaction point to the drill tip. A custom fitting, to hold the otic drill, was developed and its weight was offset using the haptic device. The robustness of the system to disturbances and its stable performance during drilling were tested. The experiments were performed on a mixed reality model consisting of two drillable rapid-prototyped layers separated by a free-space. Within the free-space, a linear virtual force model is applied to simulate drill contact with soft tissue. Testing illustrated the effectiveness of gravity cancellation. Additionally, the system exhibited excellent performance given random inputs and during the drill's passage between real and virtual components of the model. No issues with registration at model boundaries were encountered. These tests provide a proof of concept for the initial stages in the development of a novel mixed-reality temporal bone simulator.

  18. Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

    Science.gov (United States)

    Spinato, Sergio; Galindo-Moreno, Pablo; Bernardello, Fabio; Zaffe, Davide

    This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

  19. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    Directory of Open Access Journals (Sweden)

    Young-Shin Lee

    2017-01-01

    Full Text Available Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care providers’ advice were analyzed according to three age (pre-, peri-, and post-menopausal groups, BMD levels, and health insurance coverage. Overall, health insurance coverage and having a primary health care provider of Korean American women were 59.0% and 32.0%, respectively; 61.9% had lower than normal BMD levels, which were significantly increased by advanced age. Individual awareness of risks of osteoporosis and screening behaviors were significantly higher in peri-menopausal than in pre- and post-menopausal groups, but no differences were found in health care providers’ information. The awareness and care providers’ information by BMD level or health insurance did not differ. The findings show a discrepancy between individual perceptions and behaviors and health care providers’ recommendations regard to bone health. Health behaviors should be guided by professional health care providers. The women in the post-menopausal stage need to be educated about the high risk of osteoporosis and its management.

  20. Designing digital health information in a health literacy context

    NARCIS (Netherlands)

    Meppelink, C.S.

    2016-01-01

    Digital health information is widely available, but not everyone fully benefits due to limited health literacy. Until now, little was known about how health literacy influences information processing and how design features of digital health information can be used to create optimal health messages

  1. Late health effects of chronic radiation exposure of bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Yarmoshenko, Ilia V.; Malinovsky, Georgy P.; Konshina, Lidia G.; Zhukovsky, Michael V. [Institute of Industrial Ecology UB RAS, 620219, 20, Sophy Kovalevskoy St., Ekaterinburg (Russian Federation); Tuzankina, Irina A. [Institute of Immunology and Physiology UB RAS, 620049, 106, Pervomayskaya St., Ekaterinburg (Russian Federation)

    2014-07-01

    Accidental explosion of waste storage tank at former soviet plutonium production plant 'Mayak' in 1957 resulted in emission of considerable amount of radioactive substances to the atmosphere. Atmospheric transfer and fallout caused contamination of the environment by Sr-90 and short-lived radionuclides (East-Ural Radioactive Trace, EURT). Due to consumption of contaminated food and milk some internal organs were affected to relatively high radiation exposure. Archive data of causes of deaths of rural population of EURT northern part for period 1957-2000 were used to create the Register on causes of deaths. Register records related to the settlements where initial surface contamination by Sr-90 was above and below 3.7 kBq/m2 were included to exposed (4 844 records) and unexposed (6 158 records) group respectively. Basing on the Register the analysis of cancer and non-cancer health effects of radiation exposure was conducted. By estimating proportionate mortality ratios statistically significant excess mortality due to the groups of causes of death as follow was observed in exposed population: stomach, liver and cervix cancers; group consisted only of stomach cancer; non-cancer deceases of infectious etiology. Non-significant but remarkably high risk was observed for the following groups of causes of death: bone cancer; leukemia; liver cancer; cervix cancer. Insignificant, virtually zero risk was found for: non-gastrointestinal solid cancers; colon and lung cancers; non-infectious non-cancer deceases. At the same time, considerable radiation doses were absorbed in bone (mean bone surface dose about 0.1 Gy) and colon (mean dose about 0.07 Gy). Doses absorbed in other organs and tissues were negligible and amounted less than 0.01 Gy for most tissues. It can be seen that some disagreement between observed effects and absorbed doses is revealed. Most remarkable is the high excess risks of stomach, liver and cervix cancers as well as non-cancer deceases of

  2. Bone health measured using quantitative ultrasonography in adult males with muscular dystrophy

    OpenAIRE

    Morse, C.I.; Smith, J.; Denny, A.; Tweedale, J.; Searle, N.D.; Winwood, K.; Onambele-Pearson, G.L.

    2016-01-01

    Objectives: To compare muscle and bone health markers in adult males (aged 20-59 yrs) with and without muscular dystrophy (MD). Methods: Participants included 11 Fascioscapulohumeral (FSH), 11 Becker?s (Be), 9 limb girdle (LG), 11 Duchenne (DMD), and 14 non-dystrophic controls (CTRL). Physical activity was assessed using Bone (BPAQ) and disability specific (PASIPD) questionnaires. Bone QUS provided T- and Z scores from the Distal Radius (DR) and Mid-shaft tibia (MST). Tibialis anterior cross ...

  3. Vitamin D and adverse pregnancy outcomes: beyond bone health and growth.

    Science.gov (United States)

    Brannon, Patsy M

    2012-05-01

    Concerns exist about adequacy of vitamin D in pregnant women relative to both maternal and fetal adverse health outcomes. Further contributing to these concerns is the prevalence of inadequate and deficient vitamin D status in pregnant women, which ranges from 5 to 84% globally. Although maternal vitamin D metabolism changes during pregnancy, the mechanisms underlying these changes and the role of vitamin D during development are not well understood. Observational evidence links low maternal vitamin D status with an increased risk of non-bone health outcome in the mother (pre-eclampsia, gestational diabetes, obstructed labour and infectious disease), the fetus (gestational duration) and the older offspring (developmental programming of type 1 diabetes, inflammatory and atopic disorders and schizophrenia); but the totality of the evidence is contradictory (except for maternal infectious disease and offspring inflammatory and atopic disorders), lacking causality and, thus, inconclusive. In addition, recent evidence links not only low but also high maternal vitamin D status with increased risk of small-for-gestational age and schizophrenia in the offspring. Rigorous and well-designed randomised clinical trials need to determine whether vitamin D has a causal role in non-bone health outcomes in pregnancy.

  4. The Personal Health Technology Design Space

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Frost, Mads

    2016-01-01

    . To enable designers to make informed and well-articulated design decision, the authors propose a design space for personal health technologies. This space consists of 10 dimensions related to the design of data sampling strategies, visualization and feedback approaches, treatment models, and regulatory......Interest is increasing in personal health technologies that utilize mobile platforms for improved health and well-being. However, although a wide variety of these systems exist, each is designed quite differently and materializes many different and more or less explicit design assumptions...

  5. Miniscrew design and bone response: defining a correlation.

    Science.gov (United States)

    Bhalla, Karan; Kalha, Anmol S

    2013-01-01

    This prospective clinical trial aims at correlating miniscrew implant (MSI) micro/macro architecture, the method of placement, and biologic markers in peri-MSI crevicular fluid (PMICF) as indicators of bone response. A comparative evaluation of surface morphology of the MSIs before placement and after retrieval defines a correlation between the architecture of the MSIs and the bone- implant contact ratio. Two types of MSIs (hybrid and cylindric) were placed in ten patients using a split-mouth technique with the aid of a restricted random number table. Each of the MSIs was placed in the intraradicular area between the second premolar and first molar in the attached gingiva, 4 mm from the cementoenamel junction. The MSIs were immediately loaded, and PMICF was collected on days 0, 7, 14, 21, 28, and 42 and evaluated using a standard laboratory protocol. Surface morphology before placement and after retrieval of the MSI was observed using scanning electron microscopy (SEM) at a magnification of ×11, ×40, and ×1,000. Alkaline phosphatase (ALP) and aspartate aminotransferase (AST) levels observed were lower in the hybrid MSI in comparison to the cylindric MSI. For both MSIs, ALP and AST levels showed a trend of significant increase at days 0, 7, and 14 and then a significant decrease on days 21, 28, and 42. Observations from SEM showed an oxide layer over the entire surface of the bone-expanding hybrid MSI; this layer was observed only at the tip of the cylindric MSI. Levels of both the diagnostic tissue destruction biologic markers ALP and AST are significantly higher in cylindric MSIs compared with hybrid MSIs, indicating a correlation to the type and method of placement of the MSI. The inflammatory markers show a definitive trend, with an elevation until day 14 and a decline after that, indicating an active inflammatory process until day 14 that could be correlated to tissue trauma. Observations from the SEM show a greater oxide layer formation in the hybrid MSI

  6. Design and characterization of calcium phosphate ceramic scaffolds for bone tissue engineering.

    Science.gov (United States)

    Denry, Isabelle; Kuhn, Liisa T

    2016-01-01

    Our goal is to review design strategies for the fabrication of calcium phosphate ceramic scaffolds (CPS), in light of their transient role in bone tissue engineering and associated requirements for effective bone regeneration. We examine the various design options available to meet mechanical and biological requirements of CPS and later focus on the importance of proper characterization of CPS in terms of architecture, mechanical properties and time-sensitive properties such as biodegradability. Finally, relationships between in vitro versus in vivo testing are addressed, with an attempt to highlight reliable performance predictors. A combinatory design strategy should be used with CPS, taking into consideration 3D architecture, adequate surface chemistry and topography, all of which are needed to promote bone formation. CPS represent the media of choice for delivery of osteogenic factors and anti-infectives. Non-osteoblast mediated mineral deposition can confound in vitro osteogenesis testing of CPS and therefore the expression of a variety of proteins or genes including collagen type I, bone sialoprotein and osteocalcin should be confirmed in addition to increased mineral content. CPS are a superior scaffold material for bone regeneration because they actively promote osteogenesis. Biodegradability of CPS via calcium and phosphate release represents a unique asset. Structural control of CPS at the macro, micro and nanoscale and their combination with cells and polymeric materials is likely to lead to significant developments in bone tissue engineering. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  7. [Milk, Daily products and Bone health.Milk or dairy products and bone:Epidemiology.

    Science.gov (United States)

    Tamaki, Junko

    2018-01-01

    An assessment of the association between the intake of milk or dairy products and bone density or the risk of fractures on the basis of epidemiological studies revealed the following findings:(1)a sufficient prepubertal intake of milk or dairy products could contribute to the increased bone growth and maximized peal bone mass because the intake of calcium in the corresponding stage in Japan is inadequate;(2)adequate milk intake could contribute to the maintenance of peal bone mass among menstruating adult females and the decrease of bone loss in postmenopausal females. Adequate milk intake could contribute to the decrease of aging-induced bone loss in elderly males, though there is no sufficient scientific evidence;and(3)a meta-analysis indicated no correlation between the increased milk intake and decreased risks of hip fractures in the elderly. As the intake of milk or dairy products in the Japanese elderly is rather less than that reported by the meta-analysis, the minimal intake of milk or dairy products is anticipated to elevate the risk of fractures in middle-aged or elderly males and females although the scientific evidence is inadequate.

  8. Men's health-seeking behaviours regarding bone health after a fragility fracture: a secondary analysis of qualitative data.

    Science.gov (United States)

    Sale, J E M; Ashe, M C; Beaton, D; Bogoch, E; Frankel, L

    2016-10-01

    In our qualitative study, men with fragility fractures described their spouses as playing an integral role in their health behaviours. Men also described taking risks, preferring not to dwell on the meaning of the fracture and/or their bone health. Communication strategies specific to men about bone health should be developed. We examined men's experiences and behaviours regarding bone health after a fragility fracture. We conducted a secondary analysis of five qualitative studies. In each primary study, male and female participants were interviewed for 1-2 h and asked to describe recommendations they had received for bone health and what they were doing about those recommendations. Maintaining the phenomenological approach of the primary studies, the transcripts of all male participants were re-analyzed to highlight experiences and behaviours particular to men. Twenty-two men (50-88 years old) were identified. Sixteen lived with a wife, male partner, or family member and the remaining participants lived alone. Participants had sustained hip fractures (n = 7), wrist fractures (n = 5), vertebral fractures (n = 2) and fractures at other locations (n = 8). Fourteen were taking antiresorptive medication at the time of the interview. In general, men with a wife/female partner described these women as playing an integral role in their health behaviours, such as removing tripping hazards and organizing their medication regimen. While participants described giving up activities due to their bone health, they also described taking risks such as drinking too much alcohol and climbing ladders or deliberately refusing to adhere to bone health recommendations. Finally, men did not dwell on the meaning of the fracture and/or their bone health. Behaviours consistent with those shown in other studies on men were described by our sample. We recommend that future research address these findings in more detail so that communication strategies specific to men about

  9. Oral Contraceptives and Bone Health in Female Runners

    National Research Council Canada - National Science Library

    Kelsey, Jennifer

    2000-01-01

    .... This study is a two-year randomized trial of the effects of oral contraceptives on bone mass and stress fracture incidence among 150 female competitive distance runners in the age range 18-25 years...

  10. Oral Contraceptives and Bone Health in Female Runners

    National Research Council Canada - National Science Library

    Kelsey, Jennifer

    1999-01-01

    .... This study is a two-year randomized trial of the effects of oral contraceptives on bone mass and stress fracture incidence among 150 female competitive cross country runners in the age range 18-25 years...

  11. Oral Contraceptives and Bone Health in Female Runners

    National Research Council Canada - National Science Library

    Kelsey, Jennifer L

    2007-01-01

    .... Previous cross-sectional research has shown that women with exercise-induced menstrual irregularities have a significantly higher frequency of stress fractures and low bone mass than normally menstruating controls...

  12. For Strong Bones...For Lifelong Health...Milk Matters!

    Science.gov (United States)

    ... climbing stairs, and playing team sports like basketball, soccer, and volleyball help make bones stronger. Older teenagers ... dishes. Source: American Dietetic Association’s Complete Food and Nutrition Guide, 1996. 13 If you enjoy milk, chances ...

  13. Designing Mobile Health Technology for Bipolar Disorder

    DEFF Research Database (Denmark)

    Bardram, JE; Frost, Mads; Szántó, Károly

    2013-01-01

    usefulness of the system was high. Based on this study, the paper discusses three HCI questions related to the design of personal health technologies; how to design for disease awareness and self-treatment, how to ensure adherence to personal health technologies, and the roles of different types...

  14. Selenium in bone health: roles in antioxidant protection and cell proliferation.

    Science.gov (United States)

    Zeng, Huawei; Cao, Jay J; Combs, Gerald F

    2013-01-10

    Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Such findings may relate to roles of Se in antioxidant protection, enhanced immune surveillance and modulation of cell proliferation. Elucidation of the mechanisms by which Se supports these cellular processes can lead to a better understanding of the role of this nutrient in normal bone metabolism. This article reviews the current knowledge concerning the molecular functions of Se relevant to bone health.

  15. Optimization of Bone Health in Children before and after Renal Transplantation: Current Perspectives and Future Directions

    Science.gov (United States)

    Sgambat, Kristen; Moudgil, Asha

    2014-01-01

    The accrual of healthy bone during the critical period of childhood and adolescence sets the stage for lifelong skeletal health. However, in children with chronic kidney disease (CKD), disturbances in mineral metabolism and endocrine homeostasis begin early on, leading to alterations in bone turnover, mineralization, and volume, and impairing growth. Risk factors for CKD–mineral and bone disorder (CKD–MBD) include nutritional vitamin D deficiency, secondary hyperparathyroidism, increased fibroblast growth factor 23 (FGF-23), altered growth hormone and insulin-like growth factor-1 axis, delayed puberty, malnutrition, and metabolic acidosis. After kidney transplantation, nutritional vitamin D deficiency, persistent hyperparathyroidism, tertiary FGF-23 excess, hypophosphatemia, hypomagnesemia, immunosuppressive therapy, and alteration of sex hormones continue to impair bone health and growth. As function of the renal allograft declines over time, CKD–MBD associated changes are reactivated, further impairing bone health. Strategies to optimize bone health post-transplant include healthy diet, weight-bearing exercise, correction of vitamin D deficiency and acidosis, electrolyte abnormalities, steroid avoidance, and consideration of recombinant human growth hormone therapy. Other drug therapies have been used in adult transplant recipients, but there is insufficient evidence for use in the pediatric population at the present time. Future therapies to be explored include anti-FGF-23 antibodies, FGF-23 receptor blockers, and treatments targeting the colonic microbiota by reduction of generation of bacterial toxins and adsorption of toxic end products that affect bone mineralization. PMID:24605319

  16. Health by Design: Interweaving Health Promotion into Environments and Settings

    Science.gov (United States)

    Springer, Andrew E.; Evans, Alexandra E.; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

    2017-01-01

    The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet

  17. Greater access to fast-food outlets is associated with poorer bone health in young children.

    Science.gov (United States)

    Vogel, C; Parsons, C; Godfrey, K; Robinson, S; Harvey, N C; Inskip, H; Cooper, C; Baird, J

    2016-03-01

    A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years. Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. One thousand one hundred and seven children participating in the Southampton Women's Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant's neighbourhood were used to derive three measures of the food environment: the counts of fast-food outlets, healthy speciality stores and supermarkets. Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (β = -0.23 (z-score): 95% CI -0.38, -0.08) and lower BMC after adjustment for bone area and confounding variables (β = -0.17 (z-score): 95% CI -0.32, -0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (β = 0.16(z-score): 95% CI 0.00, 0.32 and β = 0.13(z-score): 95% CI -0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years. The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in

  18. Awareness, concern, and communication between physicians and patients on bone health in cancer.

    Science.gov (United States)

    Tripathy, Debu; Durie, Brian G M; Mautner, Beatrice; Ferenz, Krag S; Moul, Judd W

    2014-06-01

    This study aims to explore physician-patient communications about bone metastases and cancer treatment-induced bone loss (CTIBL). The study utilizes online survey of patients with breast cancer, prostate cancer, and multiple myeloma, and the physicians who treat them. Even though 69 and 48 % of patients with nonmetastatic breast and prostate cancer aware of treatment-induced bone loss, only 39 and 23 %, respectively, were concerned about bone loss. Yet, 62 and 71 % of oncologists treating breast and prostate cancer felt that their patients were concerned. Among patients with metastatic breast and prostate cancer, two thirds had not discussed treatment for bone metastases with their doctor; when discussed, 88 and 91 % of discussions were initiated by the doctor, usually prior to initiating treatment. Most myeloma patients (77 %) had discussed treatment options with their physicians; 99 % of hematologists reported discussing treatment of bone disease with patients. Physicians are primary sources of information to patients regarding bone health. There is a gap between what physicians assume their patients know about bone health and the patients' perceptions, presenting a need for systematic awareness and education.

  19. Gamified Design for Health Workshop.

    Science.gov (United States)

    Giunti, Guido

    2016-01-01

    Increasing lifespans for chronic disease sufferers means a population of young patients who require lifestyle intervention from an early age. For multiple sclerosis (MS) patients, social problems begin with the decline of cognitive skills and their quality of life is affected. In this workshop, organizers will propose participants to work on different gamification design approachs to solve MS patients' engagement problem. Participants will obtain skills that can be extrapolated to other conditions that require patients change to adopt a different behavior. At the end, participants will present their proposed gamification design and discuss and comment each solution, assessing potential unintended outcomes and advantages.

  20. Design and Fabrication of 3D printed Scaffolds with a Mechanical Strength Comparable to Cortical Bone to Repair Large Bone Defects

    OpenAIRE

    Roohani-Esfahani, Seyed-Iman; Newman, Peter; Zreiqat, Hala

    2016-01-01

    A challenge in regenerating large bone defects under load is to create scaffolds with large and interconnected pores while providing a compressive strength comparable to cortical bone (100?150?MPa). Here we design a novel hexagonal architecture for a glass-ceramic scaffold to fabricate an anisotropic, highly porous three dimensional scaffolds with a compressive strength of 110?MPa. Scaffolds with hexagonal design demonstrated a high fatigue resistance (1,000,000 cycles at 1?10?MPa compressive...

  1. [Researches on biomechanics of micro-implant-bone interface and optimum design of micro implant's neck].

    Science.gov (United States)

    Deng, Feng; Zhang, Lei; Zhang, Yi; Song, Jin-lin; Fan, Yuboa

    2007-07-01

    To compare and analyze the stress distribution at the micro-implant-bone interface based on the different micro-implant-bone conditioned under orthodontic load, and to optimize the design of micro implant's neck. An adult skull with all tooth was scanned by spiral CT, and the data were imported into computer for three-dimensional reconstruction with software Mimics 9.0. The three dimensional finite element models of three micro-implant-bone interfaces(initial stability, full osseointegration and fibrous integration) were analyzed by finite element analysis software ABAQUS6.5. The primary stress distributions of different micro-implant-bone conditions were evaluated when 2N force was loaded. Then the diameter less than 1.5 mm of the micro implant's neck was added with 0.2 mm, to compare the stress distribution of the modified micro-implant-bone interface with traditional type. The stress mostly concentrated on the neck of micro implant and the full osseointegration interface in all models showed the lowest strain level. Compared with the traditional type, the increasing diameter neck of the micro implant obviously decreased the stress level in all the three conditions. The micro-implant-bone interface and the diameter of micro implant's neck both are the important influence factors to the stress distribution of micro implant.

  2. Dietary acid load in early life and bone health in childhood: the Generation R Study.

    Science.gov (United States)

    Garcia, Audry H; Franco, Oscar H; Voortman, Trudy; de Jonge, Ester A L; Gordillo, Noelia G; Jaddoe, Vincent W V; Rivadeneira, Fernando; van den Hooven, Edith H

    2015-12-01

    Dietary contribution to acid-base balance in early life may influence subsequent bone mineralization. Previous studies reported inconsistent results regarding the associations between dietary acid load and bone mass. We examined the associations of dietary acid load in early life with bone health in childhood. In a prospective, multiethnic, population-based cohort study of 2850 children, we estimated dietary acid load as dietary potential renal acid load (dPRAL), based on dietary intakes of calcium, magnesium, phosphorus, potassium, and protein, and as a protein intake to potassium intake ratio (Pro:K) at 1 y of age and in a subgroup at 2 y of age : Bone mineral density, bone mineral content (BMC), area-adjusted BMC, and bone area were assessed by dual-energy X-ray absorptiometry at the median age of 6 y. Data were analyzed by using multivariable linear regression models. After adjusting for relevant maternal and child factors, dietary acid load estimated as either dPRAL or Pro:K ratio was not consistently associated with childhood bone health. Associations did not differ by sex, ethnicity, weight status, or vitamin D supplementation. Only in those children with high protein intake in our population (i.e., >42 g/d), a 1-unit increase in dPRAL (mEq/d) was inversely associated with BMC (difference: -0.32 g; 95% CI: -0.64, -0.01 g). Dietary acid load in early life was not consistently associated with bone health in childhood. Further research is needed to explore the extent to which dietary acid load in later childhood may affect current and future bone health. © 2015 American Society for Nutrition.

  3. Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year.

    Science.gov (United States)

    Shin, Young-Kyu; Han, Chong-Hyun; Heo, Seong-Joo; Kim, Sunjai; Chun, Heoung-Jae

    2006-01-01

    To evaluate the influence of macro- and microstructure of the implant surface at the marginal bone level after functional loading. Sixty-eight patients were randomly assigned to 1 of 3 groups. The first group received 35 implants with a machined neck (Ankylos); the second group, 34 implants with a rough-surfaced neck (Stage 1); and the third, 38 implants with a rough-surfaced neck with microthreads (Oneplant). Clinical and radiographic examinations were conducted at baseline (implant loading) and 3, 6, and 12 months postloading. Two-way repeated analysis of variance (ANOVA) was used to test the significance of marginal bone change of each tested group at baseline, 3, 6, and 12 month follow-ups and 1-way ANOVA was also used to compare the bone loss of each time interval within the same implant group (P implant neck not only reduce crestal bone loss but also help with early biomechanical adaptation against loading in comparison to the machined neck design. A rough surface with microthreads at the implant neck was the most effective design to maintain the marginal bone level against functional loading.

  4. Influence of controlled immediate loading and implant design on peri-implant bone formation.

    Science.gov (United States)

    Vandamme, Katleen; Naert, Ignace; Geris, Liesbet; Vander Sloten, Jozef; Puers, Robert; Duyck, Joke

    2007-02-01

    Tissue formation at the implant interface is known to be sensitive to mechanical stimuli. The aim of the study was to compare the bone formation around immediately loaded versus unloaded implants in two different implant macro-designs. A repeated sampling bone chamber with a central implant was installed in the tibia of 10 rabbits. Highly controlled loading experiments were designed for a cylindrical (CL) and screw-shaped (SL) implant, while the unloaded screw-shaped (SU) implant served as a control. An F-statistic model with alpha=5% determined statistical significance. A significantly higher bone area fraction was observed for SL compared with SU (pimplant contact occurred was the highest for SL and significantly different from SU (pimplant contact was observed, a loading (SL versus SU: p=0.0049) as well as an implant geometry effect (SL versus CL: p=0.01) was found, in favour of the SL condition. Well-controlled immediate implant loading accelerates tissue mineralization at the interface. Adequate bone stimulation via mechanical coupling may account for the larger bone response around the screw-type implant compared with the cylindrical implant.

  5. [Bone metabolism and cardiovascular function update. Estrogen and its therapeutic potential for bone and vascular health].

    Science.gov (United States)

    Ohta, Hiroaki

    2014-07-01

    Despite its long-standing role as a "guardian angel" for the female body, estrogen has recently been dethroned from its status as an "elixir" and its use has been restricted due to its oncogenic potential as well as its coagulation system-associated risk. However, it is recognized that estrogen not only works against bone resorption but also improves vascular function. In this regard, it is suggested that estrogen may have a role in improving deteriorated bone quality through its antioxidant action, while this same effect with the SERMs, which may be accounted for by the presence of estrogen, remains yet to be established. Not only evidence needs to be accumulated to support the vascular effects of the SERMs, but their pleiotropic, rather than extra-skeletal, effects, as likely mediated by the estrogen receptors distributed throughout the body, remain to be elucidated.

  6. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

    Science.gov (United States)

    Wang, Xiaojian; Xu, Shanqing; Zhou, Shiwei; Xu, Wei; Leary, Martin; Choong, Peter; Qian, M; Brandt, Milan; Xie, Yi Min

    2016-03-01

    One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Calcium and vitamin D for bone health in adults

    Science.gov (United States)

    The calcium intake requirement is challenging to determine, and the IOM recommendations are based largely on calcium balance studies. The IOM recommends a calcium intake of 1000-1200 mg per day for older adults to support the preservation of bone mass. Food sources of calcium are preferred because h...

  8. On some properties of bone functional adaptation phenomenon useful in mechanical design.

    Science.gov (United States)

    Nowak, Michał

    2010-01-01

    The paper discusses some unique properties of trabecular bone functional adaptation phenomenon, useful in mechanical design. On the basis of the biological process observations and the principle of constant strain energy density on the surface of the structure, the generic structural optimisation system has been developed. Such approach allows fulfilling mechanical theorem for the stiffest design, comprising the optimisations of size, shape and topology, using the concepts known from biomechanical studies. Also the biomimetic solution of multiple load problems is presented.

  9. Bone health measured using quantitative ultrasonography in adult males with muscular dystrophy.

    Science.gov (United States)

    Morse, C I; Smith, J; Denny, A; Tweedale, J; Searle, N D; Winwood, K; Onambele-Pearson, G L

    2016-12-14

    To compare muscle and bone health markers in adult males (aged 20-59 yrs) with and without muscular dystrophy (MD). Participants included 11 Fascioscapulohumeral (FSH), 11 Becker's (Be), 9 limb girdle (LG), 11 Duchenne (DMD), and 14 non-dystrophic controls (CTRL). Physical activity was assessed using Bone (BPAQ) and disability specific (PASIPD) questionnaires. Bone QUS provided T- and Z scores from the Distal Radius (DR) and Mid-shaft tibia (MST). Tibialis anterior cross sectional area (TA ACSA ) was measured using B-mode ultrasound. Grip strength was measured in all but DMD. Physical activity was lower in DMD, FSH and BeMD than CTRL (PPASIPD correlated with grip strength (r=0.65, P<0.01) and TA ACSA (r=0.46, P<0.01). Muscle size, strength, and bone health was lower in adult males with MD compared to adult males without MD, the extent of this is partially determined by physical activity.

  10. Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis.

    Science.gov (United States)

    Lewiecki, E Michael; Rochelle, Rachelle; Bouchonville, Matthew F; Chafey, David H; Olenginski, Thomas P; Arora, Sanjeev

    2017-12-01

    Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention ( P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

  11. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Versijpt, J.; Dierckx, R.A.; Bondt, P. de [Division of Nuclear Medicine, University Hospital Gent (Belgium); Dierckx, I. [Department of Radiology, St. Elisabeth Hospital Antwerpen (Belgium); Lambrecht, L. [Outpatient Internal Medicine Clinic, Gent (Belgium); Sadeleer, C. de [Division of Nuclear Medicine, University Hospital Gent (Belgium)]|[Department of Nuclear Medicine, O.L.V. Hospital Geraardsbergen (Belgium)

    1999-08-01

    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  12. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

    International Nuclear Information System (INIS)

    Versijpt, J.; Dierckx, R.A.; Bondt, P. de; Dierckx, I.; Lambrecht, L.; Sadeleer, C. de

    1999-01-01

    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  13. FES-Rowing versus Zoledronic Acid to Improve BoneHealth in SCI

    Science.gov (United States)

    2016-12-01

    Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public...no established treatment to prevent bone loss or to induce new bone formation following SCI. The goal of this clinical trial -- FES-Rowing versus...infusion at the VA Boston Healthcare-Jamaica Plain Campus. The nurse practitioner that administered the infusion made follow-up phone calls within 24

  14. Application of quality by design for 3D printed bone prostheses and scaffolds.

    Science.gov (United States)

    Martinez-Marquez, Daniel; Mirnajafizadeh, Ali; Carty, Christopher P; Stewart, Rodney A

    2018-01-01

    3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review

  15. Application of quality by design for 3D printed bone prostheses and scaffolds

    Science.gov (United States)

    Martinez-Marquez, Daniel; Mirnajafizadeh, Ali; Carty, Christopher P.

    2018-01-01

    3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review

  16. Dietary intakes of expeditioners during prolonged sunlight deprivation in polar enviroments do not support bone health.

    Science.gov (United States)

    Iuliano, Sandra; Ayton, Jeff

    2015-01-01

    Background Early Antarctic expeditions were plagued by nutrient deficiencies, due to lack of fresh food and reliance on preserved foods. Modern Antarctic expeditioners also require provisions to be shipped in, but improved knowledge and storage options ensure foods are nutritionally sound. Despite this, nutritional imbalances are observed. Objectives To determine the adequacy of dietary intake of Antarctic expeditioners, with reference to bone health. Design Dietary intake was determined on 225 adults (mean age 42±11 years, 16% female) during 12-month deployments at Australian Antarctic stations from 2004 to 2010, using weighed 3-day food records. Nutrient intake was analysed using FoodWorks. Foods were divided into the 5 food groups according to the Australian Guide to Healthy Eating. Results Men consumed below the recommended levels [recommended daily intake (RDI)/adequate intakes (AI)] of calcium (79±42% of RDI, p<0.001), magnesium (83±34% of RDI, p<0.001), potassium (86±29% of AI, p<0.001) and fibre (75±30% of AI, p<0.001), and above the upper limit (UL) for sodium (125±48% of UL p<0.001), whereas women consumed below the recommended levels of calcium (68±21% of RDI, p<0.001) and iron (73±37% of RDI, p<0.001). Vitamin D intake is not substantial (<150 IU/d). Men consumed more alcohol than women (18±24 g/d vs. 10±13 g/d, p<0.05), nearer the guideline of ≤20 g/d. Men and women consumed approximately 1 serving of dairy food per day, and 3 of 5 recommended vegetable servings. Discretionary foods were consumed in excess of recommended. Conclusions Improving consumption of calcium-rich (dairy) foods better supports bone health during sunlight deprivation. Increasing vegetable intake to recommended levels will increase fibre, potassium and magnesium intakes. The challenge is the logistics of providing these foods throughout the year.

  17. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review123

    Science.gov (United States)

    Movassagh, Elham Z

    2017-01-01

    Nutrition is an important modifiable factor that affects bone health. Diet is a complex mixture of nutrients and foods that correlate or interact with each other. Dietary pattern approaches take into account contributions from various aspects of diet. Findings from dietary pattern studies could complement those from single-nutrient and food studies on bone health. In this study we aimed to conduct a scoping review of the literature that assessed the impact of dietary patterns (derived with the use of both a priori and data-driven approaches) on bone outcomes, including bone mineral status, bone biomarkers, osteoporosis, and fracture risk. We retrieved 49 human studies up to June 2016 from the PubMed, Embase, and CINAHL databases. Most of these studies used a data-driven method, especially factor analysis, to derive dietary patterns. Several studies examined adherence to a variety of the a priori dietary indexes, including the Mediterranean diet score, the Healthy Eating Index (HEI), and the Alternative Healthy Eating Index (AHEI). The bone mineral density (BMD) diet score was developed to measure adherence to a dietary pattern beneficial to bone mineral density. Findings revealed a beneficial impact of higher adherence to a “healthy” dietary pattern derived using a data-driven method, the Mediterranean diet, HEI, AHEI, Dietary Diversity Score, Diet Quality Index–International, BMD Diet Score, Healthy Diet Indicator, and Korean Diet Score, on bone. In contrast, the “Western” dietary pattern and those featuring some aspects of an unhealthy diet were associated inversely with bone health. In both a priori and data-driven dietary pattern studies, a dietary pattern that emphasized the intake of fruit, vegetables, whole grains, poultry and fish, nuts and legumes, and low-fat dairy products and de-emphasized the intake of soft drinks, fried foods, meat and processed products, sweets and desserts, and refined grains showed a beneficial impact on bone health

  18. Computer-aided design evaluation of harvestable mandibular bone volume: a clinical and tomographic human study.

    Science.gov (United States)

    Verdugo, Fernando; Simonian, Krikor; Raffaelli, Luca; D'Addona, Antonio

    2014-06-01

    To evaluate and compare the volume of bone graft material that can be safely harvested from the mandibular symphysis and rami using a computer-aided design (CAD) software program. Preoperative computerized tomography scans from 40 patients undergoing bone augmentation procedures were analyzed. Symphysis and rami cross sections were mapped using a CAD software program (AutoCAD(®), Autodesk, Inc., San Rafael, CA, USA) to evaluate the bone volume that can be safely harvested. CAD calculations were contrasted to intrasurgical measurements in a subgroup of 20 individuals. CAD calculations yielded a safe harvestable osseous volume of 1.44 cm(3) ± 0.49 for the symphysis and 0.82 cm(3) ± 0.21 for each ramus (p < .0001, confidence interval [CI] 95%: 0.47-0.78). These measurements were significantly lower (p < .0001) than the bone volumes harvested intrasurgically for both symphysis and ramus, respectively (2.40 cm(3) ± 0.50 vs. 2.65 cm(3) ± 0.45). CAD calculations of harvestable symphysis and ramus bone translated into an average of 2.40 cm(3) ± 0.50 (range: 1.80-3.10 cm(3)) and 2.65 cm(3) ± 0.45 (range: 1.90-3.50) of particulate bone graft intrasurgically, respectively. Ramus cortical was significantly thicker than the symphysis cortical, 2.9 ± 0.4 mm versus 2.19 mm ± 0.4 mm (p < .0001, CI 95%: 0.45-1.03). The symphysis and rami are good harvesting sources to obtain dense corticocancellous bone. The significant volumetric CAD differences between the symphysis and ramus seem to balance out intrasurgically and may be due to the greater cortical bone volume at the ramus area. It is plausible to harvest an average of 7.70 cm(3) from the symphysis and rami alone. The use of a CAD software program can enhance surgical treatment planning prior to bone transplantation. © 2012 Wiley Periodicals, Inc.

  19. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

    Science.gov (United States)

    Houdek, Devon

    2017-01-01

    It is well recognized that bone loss accelerates in hypogonadal states, with female menopause being the classic example of sex hormones affecting the regulation of bone metabolism. Underrepresented is our knowledge of the clinical and metabolic consequences of overt male hypogonadism, as well as the more subtle age-related decline in testosterone on bone quality. While menopause and estrogen deficiency are well-known risk factors for osteoporosis in women, the effects of age-related testosterone decline in men on bone health are less well known. Much of our knowledge comes from observational studies and retrospective analysis on small groups of men with variable causes of primary or secondary hypogonadism and mild to overt testosterone deficiencies. This review aims to present the current knowledge of the consequences of adult male hypogonadism on bone metabolism. The direct and indirect effects of testosterone on bone cells will be explored as well as the important differences in male osteoporosis and assessment as compared to that in females. The clinical consequence of both primary and secondary hypogonadism, as well as testosterone decline in older males, on bone density and fracture risk in men will be summarized. Finally, the therapeutic options and their efficacy in male osteoporosis and hypogonadism will be discussed. PMID:28408926

  20. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

    Directory of Open Access Journals (Sweden)

    Gary Golds

    2017-01-01

    Full Text Available It is well recognized that bone loss accelerates in hypogonadal states, with female menopause being the classic example of sex hormones affecting the regulation of bone metabolism. Underrepresented is our knowledge of the clinical and metabolic consequences of overt male hypogonadism, as well as the more subtle age-related decline in testosterone on bone quality. While menopause and estrogen deficiency are well-known risk factors for osteoporosis in women, the effects of age-related testosterone decline in men on bone health are less well known. Much of our knowledge comes from observational studies and retrospective analysis on small groups of men with variable causes of primary or secondary hypogonadism and mild to overt testosterone deficiencies. This review aims to present the current knowledge of the consequences of adult male hypogonadism on bone metabolism. The direct and indirect effects of testosterone on bone cells will be explored as well as the important differences in male osteoporosis and assessment as compared to that in females. The clinical consequence of both primary and secondary hypogonadism, as well as testosterone decline in older males, on bone density and fracture risk in men will be summarized. Finally, the therapeutic options and their efficacy in male osteoporosis and hypogonadism will be discussed.

  1. Natural Products from Chinese Medicines with Potential Benefits to Bone Health

    Directory of Open Access Journals (Sweden)

    Chun-Tao Che

    2016-02-01

    Full Text Available Osteoporosis is a progressive, systemic bone disorder characterized by loss of bone mass and microstructure, leading to reduced bone strength and increased risk of fracture. It is often associated with reduced quality of life and other medical complications. The disease is common in the aging population, particularly among postmenopausal women and patients who receive long-term steroidal therapy. Given the rapid growth of the aging population, increasing life expectancy, the prevalence of bone loss, and financial burden to the healthcare system and individuals, demand for new therapeutic agents and nutritional supplements for the management and promotion of bone health is pressing. With the advent of global interest in complementary and alternative medicine and natural products, Chinese medicine serves as a viable source to offer benefits for the improvement and maintenance of bone health. This review summarizes the scientific information obtained from recent literatures on the chemical ingredients of Chinese medicinal plants that have been reported to possess osteoprotective and related properties in cell-based and/or animal models. Some of these natural products (or their derivatives may become promising leads for development into dietary supplements or therapeutic drugs.

  2. Bone Health in a Nonjaundiced Population of Children with Biliary Atresia

    Directory of Open Access Journals (Sweden)

    Rachel A. Kramer

    2009-01-01

    Full Text Available Objectives. To assess bone health in a cohort of nonjaundiced children with biliary atresia (BA and the effect of growth and development on bone outcomes. Methods. Children ages one to eighteen years receiving care from Children's Hospital of Philadelphia were recruited. Each child was seen once and assessed for growth, pubertal development, concurrent medications, bilirubin, ALT, albumin, vitamin D status, bone mineral density (BMD, and bone mineral content (BMC of the lumbar spine and whole body. Results. BMD declined significantly with age, and upon further analysis with a well-phenotyped control cohort, it was found that BMC was significantly decreased for both lumbar spine and whole body, even after adjustment for confounding variables. An age interaction was identified, with older subjects having a significantly greater impairment in BMC. Conclusions. These preliminary results demonstrate that children with BA, including those without jaundice, are likely to have compromised bone health even when accounting for height and puberty, which are common confounding factors in chronic disease. Further investigation is needed to identify the determinants of poor bone mineral status and to develop strategies to prevent osteoporosis later in life.

  3. Health and Welfare IT Product Design

    DEFF Research Database (Denmark)

    Merritt, Timothy; Grønbæk, Kaj

    2012-01-01

    In this paper we describe the outcomes from a university design class focused on the design of systems intended to solve problems faced by health care professionals, patients and systems that support welfare or extended independence for older people. The students worked in groups for 10 weeks...... finding a suitable problem to solve, iterating and refining their designs, evaluating prototypes with users, and finally presenting their work as a potential product with a detailed plan for how the product would be sold in the market. The primary contribution of this paper is to share innovative design...

  4. Design of wearable health monitoring device

    Science.gov (United States)

    Devara, Kresna; Ramadhanty, Savira; Abuzairi, Tomy

    2018-02-01

    Wearable smart health monitoring devices have attracted considerable attention in both research community and industry. Some of the causes are the increasing healthcare costs, along with the growing technology. To address this demand, in this paper, design and evaluation of wearable health monitoring device integrated with smartphone were presented. This device was designed for patients in need of constant health monitoring. The performance of the proposed design has been tested by conducting measurement once in 2 minutes for 10 minutes to obtain heart rate and body temperature data. The comparation between data measured by the proposed device and that measured by the reference device yields only an average error of 1.45% for heart rate and 1.04% for body temperature.

  5. Smart Sensing System for the Prognostic Monitoring of Bone Health

    KAUST Repository

    Afsarimanesh, Nasrin; Zia, Asif; Mukhopadhyay, Subhas; Kruger, Marlena; Yu, Pak-Lam; Kosel, Jü rgen; Kovacs, Zoltan

    2016-01-01

    The objective of this paper is to report a novel non-invasive, real-time, and label-free smart assay technique for the prognostic detection of bone loss by electrochemical impedance spectroscopy (EIS). The proposed system incorporated an antibody-antigen-based sensor functionalization to induce selectivity for the C-terminal telopeptide type one collagen (CTx-I) molecules—a bone loss biomarker. Streptavidin agarose was immobilized on the sensing area of a silicon substrate-based planar sensor, patterned with gold interdigital electrodes, to capture the antibody-antigen complex. Calibration experiments were conducted with various known CTx-I concentrations in a buffer solution to obtain a reference curve that was used to quantify the concentration of an analyte in the unknown serum samples. Multivariate chemometric analyses were done to determine the performance viability of the developed system. The analyses suggested that a frequency of 710 Hz is the most discriminating regarding the system sensitivity. A detection limit of 0.147 ng/mL was achieved for the proposed sensor and the corresponding reference curve was linear in the range of 0.147 ng/mL to 2.669 ng/mL. Two sheep blood samples were tested by the developed technique and the results were validated using enzyme-linked immunosorbent assay (ELISA). The results from the proposed technique match those from the ELISA.

  6. Smart Sensing System for the Prognostic Monitoring of Bone Health

    KAUST Repository

    Afsarimanesh, Nasrin

    2016-06-24

    The objective of this paper is to report a novel non-invasive, real-time, and label-free smart assay technique for the prognostic detection of bone loss by electrochemical impedance spectroscopy (EIS). The proposed system incorporated an antibody-antigen-based sensor functionalization to induce selectivity for the C-terminal telopeptide type one collagen (CTx-I) molecules—a bone loss biomarker. Streptavidin agarose was immobilized on the sensing area of a silicon substrate-based planar sensor, patterned with gold interdigital electrodes, to capture the antibody-antigen complex. Calibration experiments were conducted with various known CTx-I concentrations in a buffer solution to obtain a reference curve that was used to quantify the concentration of an analyte in the unknown serum samples. Multivariate chemometric analyses were done to determine the performance viability of the developed system. The analyses suggested that a frequency of 710 Hz is the most discriminating regarding the system sensitivity. A detection limit of 0.147 ng/mL was achieved for the proposed sensor and the corresponding reference curve was linear in the range of 0.147 ng/mL to 2.669 ng/mL. Two sheep blood samples were tested by the developed technique and the results were validated using enzyme-linked immunosorbent assay (ELISA). The results from the proposed technique match those from the ELISA.

  7. Optimization of scaffold design for bone tissue engineering: A computational and experimental study.

    Science.gov (United States)

    Dias, Marta R; Guedes, José M; Flanagan, Colleen L; Hollister, Scott J; Fernandes, Paulo R

    2014-04-01

    In bone tissue engineering, the scaffold has not only to allow the diffusion of cells, nutrients and oxygen but also provide adequate mechanical support. One way to ensure the scaffold has the right properties is to use computational tools to design such a scaffold coupled with additive manufacturing to build the scaffolds to the resulting optimized design specifications. In this study a topology optimization algorithm is proposed as a technique to design scaffolds that meet specific requirements for mass transport and mechanical load bearing. Several micro-structures obtained computationally are presented. Designed scaffolds were then built using selective laser sintering and the actual features of the fabricated scaffolds were measured and compared to the designed values. It was possible to obtain scaffolds with an internal geometry that reasonably matched the computational design (within 14% of porosity target, 40% for strut size and 55% for throat size in the building direction and 15% for strut size and 17% for throat size perpendicular to the building direction). These results support the use of these kind of computational algorithms to design optimized scaffolds with specific target properties and confirm the value of these techniques for bone tissue engineering. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

  8. Privacy by design in personal health monitoring.

    Science.gov (United States)

    Nordgren, Anders

    2015-06-01

    The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted.

  9. The role of lean body mass and physical activity in bone health in children.

    Science.gov (United States)

    Baptista, Fátima; Barrigas, Carlos; Vieira, Filomena; Santa-Clara, Helena; Homens, Pedro Mil; Fragoso, Isabel; Teixeira, Pedro J; Sardinha, Luís B

    2012-01-01

    In the context of physical education curricula, markers of physical fitness (e.g., aerobic capacity, muscular strength, flexibility, and body mass index or body fat) are usually evaluated in reference to health standards. Despite their possible mediating role in the relationship between weight-bearing or muscle forces and features of bone tissue, these attributes of fitness may not be the most relevant to predict skeletal health. It is therefore important to analyze the relative contribution of these factors to the variability in bone tissue of different parts of the skeleton, and to analyze it by gender, as sensitivity to mechanical loading can diverge for boys and girls. We compared the effects of habitual physical activity (PA) and lean mass, as surrogates of weight-bearing and muscle forces, and of physical fitness (aerobic and muscle capacity of lower and upper limbs) on bone mineral content (BMC) and size of total body, lumbar spine, femoral neck, and 1/3 radius in 53 girls and 64 boys from 7.9 to 9.7 years of age. After controlling for bone age, body mass, body height, and calcium intake, lean mass was the most important predictor of bone size and/or mineral in both genders (p  608 counts/min/day (~105 min/day of moderate and vigorous intensity) showed 13-20% more BMC than those with less physical activity, and girls with a lean mass >19 kg showed 12-19% more BMC than those with less lean mass. These findings suggest that lean mass was the most important predictor of bone size and/or mineralization in both genders, while habitual weight-bearing PA appears to positively impact on bone mineral in prepubertal boys and that both lean mass and PA need to be considered in physical education curricula and other health-enhancing programs.

  10. The association between bone health indicated by calcaneal quantitative ultrasound and metabolic syndrome in Malaysian men.

    Science.gov (United States)

    Chin, Kok-Yong; Ima-Nirwana, Soelaiman; Mohamed, Isa Naina; Ahmad, Fairus; Mohd Ramli, Elvy Suhana; Aminuddin, Amilia; Wan Ngah, Wan Zurinah

    2015-01-01

    Previous studies on the relationship between bone health and metabolic syndrome (MS) have revealed heterogeneous results. There are limited studies employing bone quantitative ultrasonometry in evaluating this relationship. This study aimed to determine the relationship between MS and bone health in a group of Malaysian middle-aged and elderly men using bone quantitative ultrasonometry. This cross-sectional study recruited 309 free living Chinese and Malay men aged 40 years and above residing in Klang Valley, Malaysia. Their demographic and anthropometric data were collected. Their calcaneal speed of sound (SOS) was measured using a CM-200 bone ultrasonometer. Their blood was collected for the evaluation of lipid profile, total testosterone and sex hormone-binding globulin. The joint interim MS definition was used for the classification of subjects. Multiple linear regression analysis was used to assess the association between SOS and indicators of MS and the presence of MS, with suitable adjustment for confounders. There was no significant difference in SOS value between MS and non-MS subjects (p > 0.05). The SOS values among subjects with different MS scores did not differ significantly (p > 0.05). There were no significant associations between SOS values and indicators of MS or the presence of MS (p > 0.05). The relationship between bone health and MS is not significant in Malaysian middle-aged and elderly men. A longitudinal study should be conducted to evaluate the association between bone loss and MS to confirm this finding.

  11. Health and Welfare IT Product Design

    DEFF Research Database (Denmark)

    Merritt, Timothy; Grønbæk, Kaj

    2012-01-01

    finding a suitable problem to solve, iterating and refining their designs, evaluating prototypes with users, and finally presenting their work as a potential product with a detailed plan for how the product would be sold in the market. The primary contribution of this paper is to share innovative design......In this paper we describe the outcomes from a university design class focused on the design of systems intended to solve problems faced by health care professionals, patients and systems that support welfare or extended independence for older people. The students worked in groups for 10 weeks...... ideas with the design community and to reflect on lessons learned by the students who, for the first time, were designing robust prototypes that solve real world problems....

  12. Office design and health: a systematic review.

    Science.gov (United States)

    Richardson, Ann; Potter, John; Paterson, Margaret; Harding, Thomas; Tyler-Merrick, Gaye; Kirk, Ray; Reid, Kate; McChesney, Jane

    2017-12-15

    To carry out a systematic review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. The research question was "Does workplace design (specifically individual offices compared with shared workspaces) affect the health of workers?" A literature search limited to articles published between 2000 and 2017 was undertaken. A systematic review was carried out, and the findings of the reviewed studies grouped into themes according to the primary outcomes measured in the studies. The literature search identified 15 relevant studies addressing health effects of shared or open-plan offices compared with individual offices. Our systematic review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees' health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. Our findings are also consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.

  13. Assessment of Bone Health in Patients With Type 1 Gaucher Disease Using Impact Microindentation.

    Science.gov (United States)

    Herrera, Sabina; Pérez-López, Jordi; Moltó-Abad, Marc; Güerri-Fernández, Roberto; Cabezudo, Elena; Novelli, Silvana; Esteve, Jordi; Hernández, Albert; Roig, Inmaculada; Solanich, Xavier; Prieto-Alhambra, Daniel; Nogués, Xavier; Díez-Pérez, Adolfo

    2017-07-01

    Gaucher disease (GD), one of the most common lysosomal disorders (a global population incidence of 1:50,000), is characterized by beta-glucocerebrosidase deficiency. Some studies have demonstrated bone infiltration in up to 80% of patients, even if asymptomatic. Bone disorder remains the main cause of morbidity in these patients, along with osteoporosis, avascular necrosis, and bone infarcts. Enzyme replacement therapy (ERT) has been shown to improve these symptoms. This cross-sectional study included patients with type 1 Gaucher disease (GD1) selected from the Catalan Study Group on GD. Clinical data were collected and a general laboratory workup was performed. Bone mineral density (BMD) was measured at the lumbar spine and hip using dual-energy X-ray absorptiometry (DXA). Patients with bone infarcts or any other focal lesion in the area of indentation visible on imaging were excluded. Bone Material Strength index (BMSi) was measured by bone impact microindentation using an Osteoprobe instrument. Analysis of covariance (ANCOVA) models were fitted to adjust for age, sex, weight, and height. Sixteen patients with GD1 and 29 age- and sex-matched controls were included. GD1 was associated with significantly lower BMSi (adjusted beta -9.30; 95% CI, -15.18 to -3.42; p = 0.004) and reduced lumbar BMD (adjusted beta -0.14; 95% CI, -0.22 to -0.06; p = 0.002) and total hip BMD (adjusted beta -0.09; 95% CI, -0.15 to -0.03; p = 0.006), compared to GD1-free controls. Chitotriosidase levels were negatively correlated with BMSi (linear R 2  = 51.6%, p = 0.004). Bone tissue mechanical characteristics were deteriorated in patients with GD1. BMSi was correlated with chitotriosidase, the marker of GD activity. Bone disorder requires special consideration in this group of patients, and microindentation could be an appropriate tool for assessing and managing their bone health. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone

  14. Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study1234

    Science.gov (United States)

    Orchard, Tonya S; Larson, Joseph C; Alghothani, Nora; Bout-Tabaku, Sharon; Cauley, Jane A; Chen, Zhao; LaCroix, Andrea Z; Wactawski-Wende, Jean; Jackson, Rebecca D

    2014-01-01

    Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P 422.5 compared with magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611. PMID:24500155

  15. Facts about Broken Bones

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Broken Bones KidsHealth / For Kids / Broken Bones What's in this ... sticking through the skin . What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  16. Broken Bones (For Parents)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Broken Bones KidsHealth / For Parents / Broken Bones What's in this ... bone fragments in place. When Will a Broken Bone Heal? Fractures heal at different rates, depending upon ...

  17. Designing and Conducting Health Systems Research Projects ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · Resources · Publications. Designing and Conducting Health Systems Research Projects Volume 1: Proposal Development and Fieldwork ... IDRC and the United Kingdom's Global AMR Innovation Fund—managed by the ... New website will help record vital life events to improve access to services for all.

  18. Designing for health in school buildings

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette; Jensen, Bjarne Bruun; Larsen, Kristian

    2015-01-01

    Aim: To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Methods: Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings...

  19. Rodent bone densitometer on the International Space Station: Instrument design and performance

    Science.gov (United States)

    Vellinger, John C.; Barton, Kenneth; Faget, Paul; Todd, Paul; Boland, Eugene

    2016-07-01

    The study of bone loss dynamics, mechanisms and countermeasures has been a publicly stated purpose of biomedical research aboard the International Space Station. Rodent research has always played a major role in terrestrial laboratories studying bone loss. The "gold standard" for assessing bone loss in human patients has been dual-energy x-ray absorptiometry (DEXA). DEXA is also widely applied to the study of bone loss in laboratory animals, so this technology has been added to the ISS inventory of analytical tools in the form of the ISS Bone Densitometer (BD) designed, constructed, tested and integrated by Techshot, Inc. (Greenville, Indiana, USA). The BD is a re-packaged COTS device known as PIXImus (GE-Lunar, USA), which was installed on ISS in November 2014 after launching on SpaceX-4. To facilitate operations in microgravity and to meet spaceflight facility and safety requirements the commercial x-ray source, control electronics and imaging system were modified and packaged by Techshot into a drawer that fits into a single EXPRESS Locker replacement. A space-rated "Exam Box" is also supplied for containment of the anesthetized subject during transfer into the BD and during exposure. The commercial software package controls four paired-energy exposures, 80 and 35 kV, and applies DEXA algorithms to the fluorescence images and displays bone mineral density (BMD), bone mineral content, lean mass, fat mass, total mass and per cent fat. The BD is therefore also a means for measuring mass and body composition making it a versatile tool for many types of rodent studies on orbit. The BD has been operated multiple times on orbit, and its performance has not differed significantly from its performance on the ground. It has been shown to measure body mass with a precision of +/- 0.1 g and on-orbit accuracy of -0.3 g. It is expected to detect BMD losses of approximately 2%. The image data are stored in a manner that allows post-test data analysis especially including the

  20. Design and optimization of a tissue-engineered bone graft substitute

    Science.gov (United States)

    Shimko, Daniel Andrew

    2004-12-01

    formulation, and scaffold material from all preceding studies were combined and a tissue-engineered bone graft was fabricated. The graft was exposed to long-term in vitro culture, and then mechanically evaluated to determine its clinical potential. The studies contained herein constitute the first steps in the conception and development of a viable tissue-engineered bone graft substitute and establish a solid scientific foundation for future in vivo experimentation utilizing this design.

  1. Effects of early vitamin D deficiency rickets on bone and dental health, growth and immunity.

    Science.gov (United States)

    Zerofsky, Melissa; Ryder, Mark; Bhatia, Suruchi; Stephensen, Charles B; King, Janet; Fung, Ellen B

    2016-10-01

    Vitamin D deficiency is associated with adverse health outcomes, including impaired bone growth, gingival inflammation and increased risk for autoimmune disease, but the relationship between vitamin D deficiency rickets in childhood and long-term health has not been studied. In this study, we assessed the effect of early vitamin D deficiency on growth, bone density, dental health and immune function in later childhood to determine if children previously diagnosed with rickets were at greater risk of adverse health outcomes compared with healthy children. We measured serum 25-hydroxyvitamin D, calcium, parathyroid hormone, bone mineral density, anthropometric measures, dietary habits, dental health, general health history, and markers of inflammation in 14 previously diagnosed rickets case children at Children's Hospital Oakland Research Center. We compared the findings in the rickets cases with 11 healthy children selected from the population of CHO staff families. Fourteen mothers of the rickets cases, five siblings of the rickets cases, and seven mothers of healthy children also participated. Children diagnosed with vitamin D deficiency rickets had a greater risk of fracture, greater prevalence of asthma, and more dental enamel defects compared with healthy children. Given the widespread actions of vitamin D, it is likely that early-life vitamin D deficiency may increase the risk of disease later in childhood. Further assessment of the long-term health effects of early deficiency is necessary to make appropriate dietary recommendations for infants at risk of deficiency. © 2015 John Wiley & Sons Ltd.

  2. Design and Fabrication of 3D printed Scaffolds with a Mechanical Strength Comparable to Cortical Bone to Repair Large Bone Defects

    Science.gov (United States)

    Roohani-Esfahani, Seyed-Iman; Newman, Peter; Zreiqat, Hala

    2016-01-01

    A challenge in regenerating large bone defects under load is to create scaffolds with large and interconnected pores while providing a compressive strength comparable to cortical bone (100-150 MPa). Here we design a novel hexagonal architecture for a glass-ceramic scaffold to fabricate an anisotropic, highly porous three dimensional scaffolds with a compressive strength of 110 MPa. Scaffolds with hexagonal design demonstrated a high fatigue resistance (1,000,000 cycles at 1-10 MPa compressive cyclic load), failure reliability and flexural strength (30 MPa) compared with those for conventional architecture. The obtained strength is 150 times greater than values reported for polymeric and composite scaffolds and 5 times greater than reported values for ceramic and glass scaffolds at similar porosity. These scaffolds open avenues for treatment of load bearing bone defects in orthopaedic, dental and maxillofacial applications.

  3. Micronutrients, Essential Fatty Acids and Bone Health in Phenylketonuria.

    Science.gov (United States)

    Demirdas, Serwet; van Spronsen, Francjan J; Hollak, Carla E M; van der Lee, J Hanneke; Bisschop, Peter H; Vaz, Fred M; Ter Horst, Nienke M; Rubio-Gozalbo, M Estela; Bosch, Annet M

    2017-01-01

    In phenylketonuria (PKU), a natural protein-restricted dietary treatment prevents severe cognitive impairment. Nutrient deficiencies may occur due to strict diet. This study is aimed at evaluating the dietary intake and blood concentrations of micronutrients and essential fatty acids (FA), bone mineral density (BMD) and fracture history in patients on long-term dietary treatment. Sixty early diagnosed Dutch patients (aged 1-39 years) were included in a multi-center cross-sectional study. Their dietary intake, blood concentrations of micronutrients, FA, fracture history and BMD were assessed. Selenium dietary intake and serum concentrations were low in 14 and 46% of patients, respectively. The serum 25-OH vitamin D2 + D3 concentration was low in 14% of patients while 20% of patients had a low vitamin D intake. Zinc serum concentrations were below normal in 14% of patients, despite adequate intake. Folic acid serum concentrations and intake were elevated. Despite safe total protein and fat intake, arginine plasma concentrations and erythrocyte eicosapentaenoic acid were below reference values in 19 and 6% of patients, respectively. Low BMD (Z-score <-2) was slightly more prevalent in patients, but the lifetime fracture prevalence was comparable to the general population. Dutch patients with PKU on long-term dietary treatment have a near normal nutrient status. Supplementation of micronutrients of which deficiency may be deleterious (e.g., vitamin D and selenium) should be considered. BMD warrants further investigation. © 2017 S. Karger AG, Basel.

  4. Marginal bone levels at single tooth implants with a conical fixture design. The influence of surface macro- and microstructure.

    Science.gov (United States)

    Norton, M R

    1998-04-01

    The concept of a conical implant design to accommodate single tooth replacement, has previously been shown to result in excessive bone loss, around the machined titanium conical collar, usually down to the 1st thread. This unusually aggressive loss of bone was shown to occur within a short period of time, post loading, with greater than 3 mm of bone loss occurring within the 1st 6 months to 1 year. The influence of implant design, surface texture and microleakage have all been highlighted as a potential cause. A modification of the surface structure, both at the macroscopic and microscopic level, as well as an altered fixture-abutment interface design has resulted in the maintenance of marginal bone around a single tooth titanium implant with a similar conical design. The radiographic follow-up of 33 implants loaded for up to 4 years, has revealed, by comparison, a most favourable maintenance of marginal bone around the conical collar, with a mean marginal bone loss of 0.32 mm mesially and 0.34 mm distally for the whole group. The cumulative mean marginal bone loss mesially and distally is 0.42 mm and 0.40 mm from 1 to 2 years, 0.54 mm and 0.43 mm from 2 to 3 years, 0.51 mm and 0.24 mm from 3 to 4 years, and 0.62 mm and 0.60 mm for implants past their 4 year recall.

  5. Investigating the role of natural phyto-oestrogens on bone health in postmenopausal women

    NARCIS (Netherlands)

    Valtueña, S.; Cashman, K.; Robins, S.P.; Cassidy, A.; Kardinaal, A.; Branca, F.

    2003-01-01

    Research on the bone effects of natural phyto-oestrogens after menopause is at a relatively early stage. Published studies are few, difficult to compare and often inconclusive, due in part to design weaknesses. Currently, many questions remain to be answered including to what extent a safe daily

  6. Permanence of diced cartilage, bone dust and diced cartilage/bone dust mixture in experimental design in twelve weeks.

    Science.gov (United States)

    Islamoglu, Kemal; Dikici, Mustafa Bahadir; Ozgentas, Halil Ege

    2006-09-01

    Bone dust and diced cartilage are used for contour restoration because their minimal donor site morbidity. The purpose of this study is to investigate permanence of bone dust, diced cartilage and bone dust/diced cartilage mixture in rabbits over 12 weeks. New Zealand white rabbits were used for this study. There were three groups in the study: Group I: 1 mL bone dust. Group II: 1 mL diced cartilage. Group III: 0.5 mL bone dust + 0.5 mL diced cartilage mixture. They were placed into subcutaneous tissue of rabbits and removed 12 weeks later. The mean volumes of groups were 0.23 +/- 0.08 mL in group I, 0.60 +/- 0.12 mL in group II and 0.36 +/- 0.10 mL in group III. The differences between groups were found statistically significant. In conclusion, diced cartilage was found more reliable than bone dust aspect of preserving its volume for a long period in this study.

  7. Health and Safety at Work: Analysis from the Brazilian Documentary Film Flesh and Bone.

    Science.gov (United States)

    Mendes, Luciano; Dos Santos, Heliani Berlato; Ichikawa, Elisa Yoshie

    2017-12-01

    The objective of this article is to make some analysis on the process of work and accidents occurring in slaughterhouses, evidenced in the Brazilian documentary film called Flesh and Bone . As such, it was necessary to discuss an alternative theoretical concept in relation to theories about health and safety at work. This alternative discussion focuses on the concepts of biopower and biopolitics. The use of audiovisual elements in research is not new, and there is already a branch of studies with methodological and epistemological variations. The Brazilian documentary Flesh and Bone was the basis for the research. The analysis of this documentary will be carried out from two complementary perspectives: "textual analysis" and "discourse analysis." Flesh and Bone presents problems related to health and safety at work in slaughterhouses because of the constant exposure of workers to knives, saws, and other sharp instruments in the workplace. The results show that in favor of higher production levels, increased overseas market sales, and stricter quality controls, some manufacturers resort to various practices that often result in serious injuries, disposal, and health damages to workers. Flesh and Bone , by itself, makes this explicit in the form of denunciation based on the situation of these workers. What it does not make clear is that, in the context of biopolitics, the actions aimed at solving these problems or even reducing the negative impacts for this group of workers, are not efficient enough to change such practices.

  8. High Dietary Protein Intake and Protein-Related Acid Load on Bone Health.

    Science.gov (United States)

    Cao, Jay J

    2017-12-01

    Consumption of high-protein diets is increasingly popular due to the benefits of protein on preserving lean mass and controlling appetite and satiety. The paper is to review recent clinical research assessing dietary protein on calcium metabolism and bone health. Epidemiological studies show that long-term, high-protein intake is positively associated with bone mineral density and reduced risk of bone fracture incidence. Short-term interventional studies demonstrate that a high-protein diet does not negatively affect calcium homeostasis. Existing evidence supports that the negative effects of the acid load of protein on urinary calcium excretion are offset by the beneficial skeletal effects of high-protein intake. Future research should focus on the role and the degree of contribution of other dietary and physiological factors, such as intake of fruits and vegetables, in reducing the acid load and further enhancing the anabolic effects of protein on the musculoskeletal system.

  9. BONE MINERAL DENSITY IN MIDLIFE WOMEN: THE STUDY OF WOMEN’S HEALTH IN QATAR

    Science.gov (United States)

    Gerber, Linda M.; Bener, Abdulbari; Al-Ali, Hala M.; Hammoudeh, Mohammed; Liu, Lyn Q.; Verjee, Mohamud

    2015-01-01

    Objectives The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index, menopause status, and nationality, on BMD of the spine and femur. Study design A cross-sectional study was conducted among women aged 40–60 recruited from nine primary care health centers in Qatar. BMD (g/m2) was assessed at the lumbar spine and the femur. Results The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values Nationality was not associated with mean BMD of the spine or the femur. Conclusions No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for femur in the age group 55–60, where values were lower among non-Qataris (p=0.04). Multivariate analysis showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed. PMID:25032729

  10. Bone health in patients with epilepsy: A community-based pilot nested case–control study

    Directory of Open Access Journals (Sweden)

    Shweta Singla

    2017-01-01

    Full Text Available Background: Antiepileptic drugs (AEDs adversely affect bone health and there are reports describing association of alternations of bone and mineral metabolism in epileptic patients. Objectives: This study was undertaken to evaluate the bone profile (bone mineral parameters and bone mineral density [BMD] of patients with epilepsy and compare them to their age-, gender-, and socioeconomic status-matched healthy controls in a community. Materials and Methods: This was a nested case–control study conducted in fifty individuals, which included 25 cases (age above 18 years and on AEDs for at least 3 years for which 25 controls were selected from the same community. Bone mineral parameters (serum calcium, proteins, phosphorous, alkaline phosphate, parathyroid hormone, and Vitamin D and BMD were measured. Results: There was significant hypocalcemia (P = 0.003, hypoproteinemia (P = 0.014, hyperparathyroidism (P = 0.048, and increased levels of serum alkaline phosphatase (P = 0.019 in cases as compared to controls. The difference was insignificant in the serum levels of Vitamin D and phosphorous among both the groups. Vitamin D was significantly low in female patients as compared to males (P = 0.043. There was no significant difference in BMD at the lumbar spine and femur neck among both the groups. Mean duration of epilepsy was longest in patients with osteoporosis (23.6 years, and increasing duration of epilepsy was associated with reduction in age- and sex-corrected total BMD mean Z-score anteroposterior spine. There was negative correlation between cumulative drug load and T-score of patients with epilepsy. Conclusion: Patients on long-term AED treatment have altered bone profile as evident from biochemical parameters and reduced BMD. There is a need for more extensive research and that too on a larger sample size.

  11. Dietary intakes of expeditioners during prolonged sunlight deprivation in polar enviroments do not support bone health

    Directory of Open Access Journals (Sweden)

    Sandra Iuliano

    2015-08-01

    Full Text Available Background: Early Antarctic expeditions were plagued by nutrient deficiencies, due to lack of fresh food and reliance on preserved foods. Modern Antarctic expeditioners also require provisions to be shipped in, but improved knowledge and storage options ensure foods are nutritionally sound. Despite this, nutritional imbalances are observed. Objectives: To determine the adequacy of dietary intake of Antarctic expeditioners, with reference to bone health. Design: Dietary intake was determined on 225 adults (mean age 42±11 years, 16% female during 12-month deployments at Australian Antarctic stations from 2004 to 2010, using weighed 3-day food records. Nutrient intake was analysed using FoodWorks. Foods were divided into the 5 food groups according to the Australian Guide to Healthy Eating. Results: Men consumed below the recommended levels [recommended daily intake (RDI/adequate intakes (AI] of calcium (79±42% of RDI, p<0.001, magnesium (83±34% of RDI, p<0.001, potassium (86±29% of AI, p<0.001 and fibre (75±30% of AI, p<0.001, and above the upper limit (UL for sodium (125±48% of UL p<0.001, whereas women consumed below the recommended levels of calcium (68±21% of RDI, p<0.001 and iron (73±37% of RDI, p<0.001. Vitamin D intake is not substantial (<150 IU/d. Men consumed more alcohol than women (18±24 g/d vs. 10±13 g/d, p<0.05, nearer the guideline of ≤20 g/d. Men and women consumed approximately 1 serving of dairy food per day, and 3 of 5 recommended vegetable servings. Discretionary foods were consumed in excess of recommended. Conclusions: Improving consumption of calcium-rich (dairy foods better supports bone health during sunlight deprivation. Increasing vegetable intake to recommended levels will increase fibre, potassium and magnesium intakes. The challenge is the logistics of providing these foods throughout the year.

  12. [Architecture and design of mental health institutions].

    Science.gov (United States)

    Richter, Dirk; Hoffmann, Holger

    2014-04-01

    The physical environment of mental health institutions is regarded as a therapeutic agent within the treatment. There is only little scientific evidence on the consequences of architecture and design on psychiatric patients available. A systematic review was conducted on studies from adult mental health institutions. 25 studies were included into the review. Pre-post-studies and control group conditions were predominant study designs. Randomized controlled trials were not available. Interventions reached from art installations up to entire ward renovations. Outcome indicators were rather heterogeneous, including psychopathology, behavioural observations and aggression incidents. Overwhelmingly, the studies revealed positive results of interventions into the physical environment. We found positive outcomes independent from the intervention in detail. This result should be interpreted in the light of the generally low study quality and further methodological problems. © Georg Thieme Verlag KG Stuttgart · New York.

  13. The Tarsal Bone Test: A Basic Test of Health Sciences Students' Knowledge of Lower Limb Anatomy

    Directory of Open Access Journals (Sweden)

    José Manuel Castillo-López

    2014-01-01

    Full Text Available Objectives. The aim of the present study was to design an easy-to-use tool, the tarsal bone test (TBT, to provide a snapshot of podiatry students’ basic anatomical knowledge of the bones of the lower limb. Methods. The study included 254 podiatry students from three different universities, 145 of them were first-year students and 109 were in their fourth and final years. The TBT was administered without prior notice to the participants and was to be completed in 5 minutes. Results. The results show that 97.2% of the subjects (n=247 correctly labelled all tarsal bones, while the other 2.8% (n=7 incorrectly labelled at least one bone, that was either the cuboid (7 times or the navicular (6 times. Although only one fourth-year student inaccurately identified one bone, no significant differences in the distribution of the correct and incorrect responses were found between first and fourth-year students. Conclusions. The TBT seems to be a straightforward and easy-to-apply instrument, and provides an objective view of the level of knowledge acquired at different stages of podiatry studies.

  14. Calcium from salmon and cod bone is well absorbed in young healthy men: a double-blinded randomised crossover design

    Directory of Open Access Journals (Sweden)

    Graff Ingvild E

    2010-07-01

    Full Text Available Abstract Background Calcium (Ca - fortified foods are likely to play an important role in helping the consumer achieve an adequate Ca intake, especially for persons with a low intake of dairy products. Fish bones have a high Ca content, and huge quantities of this raw material are available as a by-product from the fish industry. Previously, emphasis has been on producing high quality products from fish by-products by use of bacterial proteases. However, documentation of the nutritional value of the enzymatically rinsed Ca-rich bone fraction remains unexplored. The objective of the present study was to assess the bioavailability of calcium in bones of Atlantic salmon (oily fish and Atlantic cod (lean fish in a double-blinded randomised crossover design. Methods Ca absorption was measured in 10 healthy young men using 47Ca whole body counting after ingestion of a test meal extrinsically labelled with the 47Ca isotope. The three test meals contained 800 mg of Ca from three different calcium sources: cod bones, salmon bones and control (CaCO3. Results Mean Ca absorption (± SEE from the three different Ca sources were 21.9 ± 1.7%, 22.5 ± 1.7% and 27.4 ± 1.8% for cod bones, salmon bones, and control (CaCO3, respectively. Conclusion We conclude that bones from Atlantic salmon and Atlantic cod are suitable as natural Ca sources in e.g. functional foods or as supplements.

  15. Calcium from salmon and cod bone is well absorbed in young healthy men: a double-blinded randomised crossover design.

    Science.gov (United States)

    Malde, Marian K; Bügel, Susanne; Kristensen, Mette; Malde, Ketil; Graff, Ingvild E; Pedersen, Jan I

    2010-07-20

    Calcium (Ca) - fortified foods are likely to play an important role in helping the consumer achieve an adequate Ca intake, especially for persons with a low intake of dairy products. Fish bones have a high Ca content, and huge quantities of this raw material are available as a by-product from the fish industry. Previously, emphasis has been on producing high quality products from fish by-products by use of bacterial proteases. However, documentation of the nutritional value of the enzymatically rinsed Ca-rich bone fraction remains unexplored. The objective of the present study was to assess the bioavailability of calcium in bones of Atlantic salmon (oily fish) and Atlantic cod (lean fish) in a double-blinded randomised crossover design. Ca absorption was measured in 10 healthy young men using 47Ca whole body counting after ingestion of a test meal extrinsically labelled with the 47Ca isotope. The three test meals contained 800 mg of Ca from three different calcium sources: cod bones, salmon bones and control (CaCO3). Mean Ca absorption (+/- SEE) from the three different Ca sources were 21.9 +/- 1.7%, 22.5 +/- 1.7% and 27.4 +/- 1.8% for cod bones, salmon bones, and control (CaCO3), respectively. We conclude that bones from Atlantic salmon and Atlantic cod are suitable as natural Ca sources in e.g. functional foods or as supplements.

  16. Bone health in children with long–term idiopathic subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Di Mase Raffaella

    2012-10-01

    Full Text Available Abstract Background Subclinical hypothyroidism (SH is a relatively common condition characterized by a mild persistent thyroid failure. The management of children with SH is still a controversial issue and the decision to treat with L-thyroxine represents a clinical dilemma. Thyroid hormone and TSH play an important role in skeletal growth and bone mineral homeostasis. Aim To evaluate whether untreated idiopathic SH may affect bone health in childhood and to compare two different diagnostic tools such as dual-energy X-ray densitometry (DXA and quantitative ultrasound (QUS. Patients and Methods Twenty-five children and adolescents (11 males aged 9.8 ± 3.5 years (range 4.2-18.7 with untreated idiopathic SH were enrolled in the study. SH was diagnosed on the basis of normal FT4 levels with TSH concentrations between 4.2 and 10 mU/l. Children have been followed for 3.3 ± 0.3 years from the time of SH diagnosis. Twenty-five healthy children, age- and sex-matched, were enrolled as controls. Patients and controls underwent DXA to evaluate lumbar spine bone mineral density (BMD and QUS at proximal phalanges of the non-dominant hand to assess bone quality, measured as amplitude-dependent speed of sound (Ad-SoS and bone transmission time (BTT. Results Mean BMD Z-score was −0.4 ± 1.36 in patients and −0.2 ± 1.2 in controls. Mean Ad-SoS Z-score was 0.01 ± 1.0 in patients and 0.1 ± 1.2 in controls and mean BTT Z-score was −0.03 ± 0.8 and 0.04 ± 1.1 respectively. All values were within the normal range, both in patients and in controls. There were no statistically significant differences between the two groups. Conclusion Bone health, evaluated by lumbar spine DXA and phalangeal QUS, is not impaired in our children, despite long-term duration of idiopathic SH. Data about bone status provided by QUS are comparable to those provided by DXA. Therefore, QUS may represent a good, cheaper and safe screening test for bone evaluation in children with SH.

  17. Development of a novel method for surgical implant design optimization through noninvasive assessment of local bone properties.

    Science.gov (United States)

    Schiuma, D; Brianza, S; Tami, A E

    2011-03-01

    A method was developed to improve the design of locking implants by finding the optimal paths for the anchoring elements, based on a high resolution pQCT assessment of local bone mineral density (BMD) distribution and bone micro-architecture (BMA). The method consists of three steps: (1) partial fixation of the implant to the bone and creation of a reference system, (2) implant removal and pQCT scan of the bone, and (3) determination of BMD and BMA of all implant-anchoring locations along the actual and alternative directions. Using a PHILOS plate, the method uncertainty was tested on an artificial humerus bone model. A cadaveric humerus was used to quantify how the uncertainty of the method affects the assessment of bone parameters. BMD and BMA were determined along four possible alternative screw paths as possible criteria for implant optimization. The method is biased by a 0.87 ± 0.12 mm systematic uncertainty and by a 0.44 ± 0.09 mm random uncertainty in locating the virtual screw position. This study shows that this method can be used to find alternative directions for the anchoring elements, which may possess better bone properties. This modification will thus produce an optimized implant design. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  18. Designing Work, Family & Health Organizational Change Initiatives.

    Science.gov (United States)

    Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

    2014-01-01

    For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

  19. Environmental, health, and safety by design

    International Nuclear Information System (INIS)

    Soklow, R.G.

    1999-01-01

    Solar Turbines Incorporated created a self-directed work team, the Safety and Environmental Awareness (SEA) Team that initiated a company wide effort to raise employee awareness to promote integrating responsible environmental, health, and safety practices into product design, manufacturing, and services. Environmental, health, and safety issues influence how all businesses operate around the world. Companies choose to operate in an environmentally responsible manner because it not only benefits employees and the communities where they live, it also benefits the business when superior performance results in a competitive advantage. Solar surveyed gas turbines users to identify their top environmental and safety concerns and issues. The authors asked about various environmental and safety aspects of their equipment. Results from the survey has helped engineering and design focus efforts so that future products and product improvements assist customers in meeting their regulatory obligations and social responsibilities. Air pollution has historically been one of the most important environmental issues facing customers, because pollutant emissions greatly influence equipment choices and operation flexibility. There are other environmental, health and safety issues: sustainable fire suppression choices, start systems, hazardous materials use and ability to recycle materials, package accessibility, noise and product take back issues

  20. TU-AB-204-03: Advances in CBCT for Orhtopaedics and Bone Health Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zbijewski, W. [Johns Hopkins University (United States)

    2015-06-15

    , significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and

  1. TU-AB-204-03: Advances in CBCT for Orhtopaedics and Bone Health Imaging

    International Nuclear Information System (INIS)

    Zbijewski, W.

    2015-01-01

    , significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and

  2. Impact of air pollution on vitamin D deficiency and bone health in adolescents.

    Science.gov (United States)

    Feizabad, Elham; Hossein-Nezhad, Arash; Maghbooli, Zhila; Ramezani, Majid; Hashemian, Roxana; Moattari, Syamak

    2017-12-01

    The association between air pollution and bone health was evaluated in adolescents in the city of Tehran. This study is essentially ecological. Vitamin D deficiency among adolescents has been reported at higher rates in polluted areas than in non-polluted areas. Additionally, residence in polluted areas is associated with lower levels of bone alkaline phosphatase. The aim of this study was to evaluate the association between ambient air pollution and bone turnover in adolescents and to compare the prevalence of vitamin D deficiency between polluted and non-polluted areas of Tehran. This cross-sectional population-based study was conducted on 325 middle- and high-school students (both girls and boys) in Tehran in the winter. During the study period, detailed daily data on air pollution were obtained from archived data collected by Tehran Air Quality Control Company (AQCC). Serum levels of calcium, phosphorus, parathyroid hormone (PTH), bone-specific alkaline phosphatase, 25(OH) vitamin D, osteocalcin, cross-linked C-telopeptide (CTX), total protein, albumin, and creatinine were obtained from the study group. Vitamin D deficiency was more prevalent in polluted areas than in non-polluted areas. After adjustment for age and sex, residence in the polluted area showed a statistically significant positive association with vitamin D deficiency and a statistically significant negative association with bone turnover. Interestingly, high calcium intake (>5000 mg/week) protects against the effects of air pollution on bone turnover. Air pollution is a chief factor determining the amount of solar UVB that reaches the earth's surface. Thus, atmospheric pollution may play a significant independent role in the development of vitamin D deficiency.

  3. Design and testing of small scale fish meat bone separator useful for fish processing.

    Science.gov (United States)

    Ali Muhammed, M; Manjunatha, N; Murthy, K Venkatesh; Bhaskar, N

    2015-06-01

    The present study relates to the food processing machinery and, more specifically machine for producing boneless comminuted meat from raw fish fillet. This machine is of belt and drum type meat bone separator designed for small scale fish processing in a continuous mode. The basic principal involved in this machine is compression force. The electric geared motor consists of 1HP and the conveyor belt has a linear velocity of 19 to 22 m min(-1), which was sufficient to debone the fish effectively. During the meat bone separation trials an efficiency up to 75 % on dressed fish weight basis was observed and with a capacity to separate 70 kg h(-1) of meat from fish at the machine speed of 25 rpm. During the trials, it was demonstrated that there was no significant change in the proximate composition of comminuted fish meat when compared to unprocessed fish meat. This design has a greater emphasis on hygiene, provision for cleaning-in-place (CIP) and gives cost effective need and reliability for small scale industries to produce fish meat in turn used for their value added products.

  4. Novel biocompatible polymeric blends for bone regeneration: Material and matrix design and development

    Science.gov (United States)

    Deng, Meng

    The first part of the work presented in this dissertation is focused on the design and development of novel miscible and biocompatible polyphosphazene-polyester blends as candidate materials for scaffold-based bone tissue engineering applications. Biodegradable polyesters such as poly(lactide-co-glycolide) (PLAGA) are among the most widely used polymeric materials for bone tissue engineering. However, acidic degradation products resulting from the bulk degradation mechanism often lead to catastrophic failure of the structure integrity, and adversely affect biocompatibility both in vitro and in vivo. One promising approach to circumvent these limitations is to blend PLAGA with other macromolecules that can buffer the acidic degradation products with a controlled degradation rate. Biodegradable polyphosphazenes (PPHOS), a new class of biomedical materials, have proved to be superior candidate materials to achieve this objective due to their unique buffering degradation products. A highly practical blending approach was adopted to develop novel biocompatible, miscible blends of these two polymers. In order to achieve this miscibility, a series of amino acid ester, alkoxy, aryloxy, and dipeptide substituted PPHOS were synthesized to promote hydrogen bonding interactions with PLAGA. Five mixed-substituent PPHOS compositions were designed and blended with PLAGA at different weight ratios producing candidate blends via a mutual solvent method. Preliminary characterization identified two specific side groups namely glycylglycine dipeptide and phenylphenoxy that resulted in improved blend miscibility and enhanced in vitro osteocompatibility. These findings led to the synthesis of a mixed-substituent polyphosphazene poly[(glycine ethyl glycinato)1(phenylphenoxy)1phosphazene] (PNGEGPhPh) for blending with PLAGA. Two dipeptide-based blends having weight ratios of PNGEGPhPh to PLAGA namely 25:75 (Matrix1) and 50:50 (Matrix2) were fabricated. Both of the blends were

  5. A computational and cellular solids approach to the stiffness-based design of bone scaffolds.

    Science.gov (United States)

    Norato, J A; Wagoner Johnson, A J

    2011-09-01

    We derive a cellular solids approach to the design of bone scaffolds for stiffness and pore size. Specifically, we focus on scaffolds made of stacked, alternating, orthogonal layers of hydroxyapatite rods, such as those obtained via micro-robotic deposition, and aim to determine the rod diameter, spacing and overlap required to obtain specified elastic moduli and pore size. To validate and calibrate the cellular solids model, we employ a finite element model and determine the effective scaffold moduli via numerical homogenization. In order to perform an efficient, automated execution of the numerical studies, we employ a geometry projection method so that analyses corresponding to different scaffold dimensions can be performed on a fixed, non-conforming mesh. Based on the developed model, we provide design charts to aid in the selection of rod diameter, spacing and overlap to be used in the robotic deposition to attain desired elastic moduli and pore size.

  6. Increasing Dietary Phosphorus Intake from Food Additives: Potential for Negative Impact on Bone Health123

    OpenAIRE

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2014-01-01

    It is important to consider whether habitual high phosphorus intake adversely affects bone health, because phosphorus intake has been increasing, whereas calcium intake has been decreasing in dietary patterns. A higher total habitual dietary phosphorus intake has been associated with higher serum parathyroid hormone (PTH) and lower serum calcium concentrations in healthy individuals. Higher serum PTH concentrations have been shown in those who consume foods with phosphorus additives. These fi...

  7. Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

    Science.gov (United States)

    Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

    2018-01-01

    The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, pBMC and BMD for LL (R2adj = 0.68, pBMC (R2adj = 0.47, pBMC (R2adj = 0.36, pBMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

  8. Design of polymer-biopolymer-hydroxyapatite biomaterials for bone tissue engineering: Through molecular control of interfaces

    Science.gov (United States)

    Verma, Devendra

    In this dissertation, novel biomaterials are designed for bone biomaterials and bone tissue engineering applications. Novel biomaterials of hydroxyapatite with synthetic and natural polymers have been fabricated using a combination of processing routes. Initially, we investigated hydroxyapatite-polycaprolactone-polyacrylic acid composites and observed that minimal interfacial interactions between polymer and mineral led to inadequate improvement in the mechanical properties. Bioactivity experiments on these composites showed that the presence of functional groups, such as carboxylate groups, influence bioactivity of the composites. We have developed and investigated composites of hydroxyapatite with chitosan and polygalacturonic acid (PgA). Chitosan and PgA are biocompatible, biodegradable, and also electrostatically complementary to each other. This strategy led to significant improvement in mechanical properties of new composites. The nanostructure analysis using atomic force microscopy revealed a multilevel organization in these composites. Enhancement in mechanical response was attributed to stronger interfaces due to strong electrostatic interaction between oppositely charged chitosan and PgA. Further analysis using the Rietveld method showed that biopolymers have marked impact on hydroxyapatite crystal growth and also on its crystal structure. Significant changes were observed in the lattice parameters of hydroxyapatite synthesized by following biomineralization method (organics mediated mineralization). For scaffold preparation, chitosan and PgA were mixed first, and then, nano-hydroxyapatite was added. Oppositely charged polyelectrolytes, such as chitosan and PgA, spontaneously form complex upon mixing. The poly-electrolyte complex exists as nano-sized particles. Chitosan/PgA scaffolds with and without hydroxyapatite were prepared by the freeze drying method. By controlling the rate of cooling and concentration, we have produced both fibrous and sheet

  9. Effect of microthreads on coronal bone healing of narrow-diameter implants with reverse-tapered design in beagle dogs.

    Science.gov (United States)

    Chang, Yun-Young; Kim, Su-Hwan; Park, Keun-Oh; Yun, Jeong-Ho

    2017-12-01

    The objective of this study was to investigate the effect of microthreads on the coronal bone healing of narrow-diameter implants with reverse-tapered design. A total of 52 implants were classified into two groups according to presence or absence of coronal microthreads, the reverse-tapered narrow-diameter implant (RTN) group, and the reverse-tapered narrow-diameter implant with microthreads (RTNM) group. The implants were installed in split-mouth design in the edentulous mandible of six dogs. Three animals were sacrificed at 4 weeks and three at 8 weeks. Resonance frequency analysis, bone measurement using microcomputed tomography (micro-CT), removal torque test, and histometric analysis were performed. No significant differences in implant stability quotient value were observed between the groups at baseline, 4 weeks, or 8 weeks. Bone measurement using micro-CT showed that bone-implant contact volume (BICV) and bone-implant contact volume ratio (BICVR) in the coronal part of RTNM were statistically higher than those in RTN at 4 and 8 weeks. Histometric analysis showed statistically higher bone-implant contact length (BICL) in the coronal part of RTNM than in RTN at 4 weeks; however, bone-implant contact ratio (BICR) was not significantly different between the groups. At 8 weeks, the BICL and BICR did not differ significantly between the groups. Removal torque test showed no significant differences between the groups at 4 and 8 weeks. The microthreads might facilitate more coronal bone-implant contact due to increased surface areas at an early healing phase; however, they did not significantly affect coronal bone healing at 8 weeks. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Effects of the implant design on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis of original computer-aided design models.

    Science.gov (United States)

    Yamanishi, Yasufumi; Yamaguchi, Satoshi; Imazato, Satoshi; Nakano, Tamaki; Yatani, Hirofumi

    2014-09-01

    Occlusal overloading causes peri-implant bone resorption. Previous studies examined stress distribution in alveolar bone around commercial implants using three-dimensional (3D) finite element analysis. However, the commercial implants contained some different designs. The purpose of this study is to reveal the effect of the target design on peri-implant bone stress and abutment micromovement. Six 3D implant models were created for different implant-abutment joints: 1) internal joint model (IM); 2) external joint model (EM); 3) straight abutment (SA) shape; 4) tapered abutment (TA) shapes; 5) platform switching (PS) in the IM; and 6) modified TA neck design (reverse conical neck [RN]). A static load of 100 N was applied to the basal ridge surface of the abutment at a 45-degree oblique angle to the long axis of the implant. Both stress distribution in peri-implant bone and abutment micromovement in the SA and TA models were analyzed. Compressive stress concentrated on labial cortical bone and tensile stress on the palatal side in the EM and on the labial side in the IM. There was no difference in maximum principal stress distribution for SA and TA models. Tensile stress concentration was not apparent on labial cortical bone in the PS model (versus IM). Maximum principal stress concentrated more on peri-implant bone in the RN than in the TA model. The TA model exhibited less abutment micromovement than the SA model. This study reveals the effects of the design of specific components on peri-implant bone stress and abutment displacement after implant-supported single restoration in the anterior maxilla.

  11. Design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite as a potential bone graft substitute material

    Science.gov (United States)

    Florschutz, Anthony Vatroslav

    Utilization of bone grafts for the treatment of skeletal pathology is a common practice in orthopaedic, craniomaxillofacial, dental, and plastic surgery. Autogenous bone graft is the established archetype but has disadvantages including donor site morbidity, limited supply, and prolonging operative time. In order to avoid these and other issues, bone graft substitute materials are becoming increasingly prevalent among surgeons for reconstructing skeletal defects and arthrodesis applications. Bone graft substitutes are biomaterials, biologics, and guided tissue/bone regenerative devices that can be used alone or in combinations as supplements or alternatives to autogenous bone graft. There is a growing interest and trend to specialize graft substitutes for specific indications and although there is good rationale for this indication-specific approach, the development and utility of a more universal bone graft substitute may provide a better answer for patients and surgeons. The aim of the present research focuses on the design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite composites for potential use as a bone graft substitutes. After initial establishment of rational material design, gelatinhydroxyapatite scaffolds were fabricated with different gelatin:hydroxyapatite ratios and crosslinking concentrations. The synthesized scaffolds were subsequently evaluated on the basis of their swelling behavior, porosity, density, percent composition, mechanical properties, and morphology and further assessed with respect to cell-biomaterial interaction and biomineralization in vitro. Although none of the materials achieved mechanical properties suitable for structural graft applications, a reproducible material design and synthesis was achieved with properties recognized to facilitate bone formation. Select scaffold formulations as well as a subset of scaffolds loaded with recombinant human bone morphogenetic protein-2 were

  12. Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study.

    Science.gov (United States)

    Callegari, Emma T; Reavley, Nicola; Garland, Suzanne M; Gorelik, Alexandra; Wark, John D

    2015-11-17

    Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public healthVitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared to healthy controls. Early adulthood is a critical

  13. Evaluation of a “Just-in-Time” Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial

    Science.gov (United States)

    Roblin, Douglas W; Zelman, David; Plummer, Sally; Robinson, Brandi E; Lou, Yiyue; Edmonds, Stephanie W; Wolinsky, Fredric D; Saag, Kenneth G; Cram, Peter

    2017-01-01

    Context Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes. Objective To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care. Design Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662). After DXA, consenting adults age 50 years or older were randomly assigned to 3 groups: nurse consultation, PAADRN intervention (mailed letter with individualized fracture risk and an educational brochure), or usual care (control). Nurse consultation included reviewing DXA results, counseling on bone health, and ordering needed follow-up tests or physician referrals. Main Outcome Measures Change from baseline to 52 weeks in participant-reported osteoporosis-related pharmacotherapy, lifestyle, activation and self-efficacy, and osteoporosis care satisfaction. Results Nurse consultation participants (n = 104) reported 52-week improvements in strengthening and weight-bearing exercise (p = 0.09), calcium intake (p Just-in-time” nurse consultation yielded a few improvements over 52 weeks in osteoporosis-related outcomes; however, most changes were not different from those obtained through the lower-cost PAADRN intervention or usual care. PMID:28746019

  14. Monitoring Bone Health after Spaceflight: Data Mining to Support an Epidemiological Analysis of Age-related Bone Loss in Astronauts

    Science.gov (United States)

    Baker, K. S,; Amin, S.; Sibonga, Jean D.

    2009-01-01

    Through the epidemiological analysis of bone data, HRP is seeking evidence as to whether the prolonged exposure to microgravity of low earth orbit predisposes crewmembers to an earlier onset of osteoporosis. While this collaborative Epidemiological Project may be currently limited by the number of ISS persons providing relevant spaceflight medical data, a positive note is that it compares medical data of astronauts to data of an age-matched (not elderly) population that is followed longitudinally with similar technologies. The inclusion of data from non-ISS and non-NASA crewmembers is also being pursued. The ultimate goal of this study is to provide critical information for NASA to understand the impact of low physical or minimal weight-bearing activity on the aging process as well as to direct its development of countermeasures and rehabilitation programs to influence skeletal recovery. However, in order to optimize these results NASA needs to better define the requirements for long term monitoring and encourage both active and retired astronauts to contribute to a legacy of data that will define human health risks in space.

  15. Mobile health units. Design and implementation considerations.

    Science.gov (United States)

    Murphy, D C; Klinghoffer, I; Fernandez-Wilson, J B; Rosenberg, L

    2000-11-01

    The decision to provide health care services with a mobile van is one which educational and service facilities are increasingly pursuing. The benefits include: The potential to increase the availability of services to underserved populations where access to care is perceived to be one reason for underuse of available services. The opportunity to increase and broaden the educational experiences of students in a training program. The opportunity to develop a sense of social responsibility in the health care provider. The process of deciding to pursue a van purchase is complicated, and administrators may best be served by obtaining experienced consultants to help them fully comprehend the issues involved. After the decision to purchase a mobile unit is made, it is necessary to focus on van requirements and design to meet federal, state, and city codes concerning motor vehicles and health requirements. Some modifications of one's standard practices are needed because of these codes. Being aware of them in advance will allow a smooth project completion. This article provides information about some of the steps required to implement a mobile unit. The approximate time from initial concept to van delivery was 1 year, with one fully dedicated project coordinator working to assure the project's success in such a short time frame. Seeing the gratified personnel and students who serve the children on the "Smiling Faces, Going Places" Mobile Dental Van of the NYUCD (see Figure 2), and knowing the children would otherwise not have received such services, allows the health care professionals involved to feel the development of this van is an exciting mechanism for delivery of health care to individuals who would otherwise go without.

  16. Suppressor of cytokine signaling 2 (Socs2 deletion protects bone health of mice with DSS-induced inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Ross Dobie

    2018-01-01

    Full Text Available Individuals with inflammatory bowel disease (IBD often present with poor bone health. The development of targeted therapies for this bone loss requires a fuller understanding of the underlying cellular mechanisms. Although bone loss in IBD is multifactorial, the altered sensitivity and secretion of growth hormone (GH and insulin-like growth factor-1 (IGF-1 in IBD is understood to be a critical contributing mechanism. The expression of suppressor of cytokine signaling 2 (SOCS2, a well-established negative regulator of GH signaling, is stimulated by proinflammatory cytokines. Therefore, it is likely that SOCS2 expression represents a critical mediator through which proinflammatory cytokines inhibit GH/IGF-1 signaling and decrease bone quality in IBD. Using the dextran sodium sulfate (DSS model of colitis, we reveal that endogenously elevated GH function in the Socs2−/− mouse protects the skeleton from osteopenia. Micro-computed tomography assessment of DSS-treated wild-type (WT mice revealed a worsened trabecular architecture compared to control mice. Specifically, DSS-treated WT mice had significantly decreased bone volume, trabecular thickness and trabecular number, and a resulting increase in trabecular separation. In comparison, the trabecular bone of Socs2-deficient mice was partially protected from the adverse effects of DSS. The reduction in a number of parameters, including bone volume, was less, and no changes were observed in trabecular thickness or separation. This protected phenotype was unlikely to be a consequence of improved mucosal health in the DSS-treated Socs2−/− mice but rather a result of unregulated GH signaling directly on bone. These studies indicate that the absence of SOCS2 is protective against bone loss typical of IBD. This study also provides an improved understanding of the relative effects of GH/IGF-1 signaling on bone health in experimental colitis, information that is essential before these drugs are

  17. Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study

    Science.gov (United States)

    Prentice, Ann; Kuh, Diana L; Adams, Judith E; Ambrosini, Gina L

    2016-01-01

    ABSTRACT Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis‐based dietary patterns and bone health. We investigated whether a protein‐calcium‐potassium–rich (PrCaK‐rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size‐adjusted bone mineral content (SA‐BMC) and volumetric bone mineral density (vBMD). A food‐based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z‐scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z‐scores were modeled to summarize changes in Z‐scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z‐score and other confounders. A consistent PrCaK‐rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z‐scores at age 36 years and age 60 to 64 years were –0.32 ± 0.97 and 2.2 ± 1.5 (women) and –0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z‐scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02‐SD unit/year higher trajectory in dietary pattern Z‐score over time was associated with higher SA‐BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary

  18. Designing of PLA scaffolds for bone tissue replacement fabricated by ordinary commercial 3D printer.

    Science.gov (United States)

    Gregor, Aleš; Filová, Eva; Novák, Martin; Kronek, Jakub; Chlup, Hynek; Buzgo, Matěj; Blahnová, Veronika; Lukášová, Věra; Bartoš, Martin; Nečas, Alois; Hošek, Jan

    2017-01-01

    The primary objective of Tissue engineering is a regeneration or replacement of tissues or organs damaged by disease, injury, or congenital anomalies. At present, Tissue engineering repairs damaged tissues and organs with artificial supporting structures called scaffolds. These are used for attachment and subsequent growth of appropriate cells. During the cell growth gradual biodegradation of the scaffold occurs and the final product is a new tissue with the desired shape and properties. In recent years, research workplaces are focused on developing scaffold by bio-fabrication techniques to achieve fast, precise and cheap automatic manufacturing of these structures. Most promising techniques seem to be Rapid prototyping due to its high level of precision and controlling. However, this technique is still to solve various issues before it is easily used for scaffold fabrication. In this article we tested printing of clinically applicable scaffolds with use of commercially available devices and materials. Research presented in this article is in general focused on "scaffolding" on a field of bone tissue replacement. Commercially available 3D printer and Polylactic acid were used to create originally designed and possibly suitable scaffold structures for bone tissue engineering. We tested printing of scaffolds with different geometrical structures. Based on the osteosarcoma cells proliferation experiment and mechanical testing of designed scaffold samples, it will be stated that it is likely not necessary to keep the recommended porosity of the scaffold for bone tissue replacement at about 90%, and it will also be clarified why this fact eliminates mechanical properties issue. Moreover, it is demonstrated that the size of an individual pore could be double the size of the recommended range between 0.2-0.35 mm without affecting the cell proliferation. Rapid prototyping technique based on Fused deposition modelling was used for the fabrication of designed scaffold

  19. The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness.

    Science.gov (United States)

    Garrido-Miguel, Miriam; Torres-Costoso, Ana; Martínez-Andrés, María; Notario-Pacheco, Blanca; Díez-Fernández, Ana; Álvarez-Bueno, Celia; García-Prieto, Jorge Cañete; Martínez-Vizcaíno, Vicente

    2017-11-13

    To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 eating disorders and bone health in young adults. Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults. Level V, cross-sectional descriptive study.

  20. DXA study on bone health status among hospital based middle aged population

    International Nuclear Information System (INIS)

    Jehan, A.H.

    2004-01-01

    III 70-100 years. Group I consisted of 43 female and 11 male patients. Of the 43 female 9 (21%) showed osteopenia while 5 (12 %) showed osteoporotic change and 29 patients had normal scan. Of the 11 male patients only 1 had osteopenia and one osteoporosis and both had history of renal failure while 9 patients showed normal scan. In-group ii there was 203 female and 27 male patients. Among the 203 female 61 (30%) showed osteopenia while 83 (41%) showed osteoporotic change while 59 had normal scan. Among the 27 male 4 (15 %) had osteopenia and 5 ( 18 %) osteoporosis and 18 showed normal scan. Group III consisted of 19 female and 8 male patients. Out of 19 female 6 (32%) had osteopenia while 9 (47%) were diagnosed with osteoporosis while 4 were normal. Of the 8 male patients 2 had osteopenia and 4 were diagnosed with osteoporosis while 2 were normal. Conclusion: Bone pain present as a manifestation among the middle aged and the elderly population in Bangladesh. Various investigations like X-ray, BMD, serum calcium, uric acid levels, complete blood picture etc. are done to find out the cause. It was observed from this study that in group II female patients showed predominance of bone loss and early bony change mostly appeared in the lumber spine while established cases of osteoporosis were mostly seen in the proximal part of the femur. It may be concluded that bone mineral loss was evident in individuals (group II) who are under the process of reduction of gonadal hormones. Therefore early diagnosis of bone health status in this group of patients may assist the physicians as well as the affected individuals for early therapeutic intervention and better management to ensure a fracture risk free life. As a result improvement in the lifestyle and national health status of the senior citizens can be expected. (authors)

  1. Alveolar Bone Resorption Evaluation Around Single-piece Designed Bicortical Implants, Using Immediate Loading Protocol, Based on Orthopantomographs

    Directory of Open Access Journals (Sweden)

    Száva Dániel-Tamás

    2017-12-01

    Full Text Available Background: Inserting dental implants in severely atrophied jawbones is a great challenge for the dental practitioner. There are an increasing number of patients who choose dental implantanchored prosthetic restorations despite compromised bone quality and quantity. There have been numerous attempts in adapting implant design for the atrophic crestal bone. One-piece, needle-type basal implant design is a typical design for these cases. These implants are inserted in the remaining compact bone located in the basal aspect of the jawbones. If high primary stability is achieved, these implants are used for immediate loading protocol. From many points of view, this technique is based on contradictory principles compared to classic implant surgery and loading protocols. The aim of this study was to investigate the long-term success of basal one-piece short-diameter dental implants used for immediate loading protocol.

  2. Increasing dietary phosphorus intake from food additives: potential for negative impact on bone health.

    Science.gov (United States)

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2014-01-01

    It is important to consider whether habitual high phosphorus intake adversely affects bone health, because phosphorus intake has been increasing, whereas calcium intake has been decreasing in dietary patterns. A higher total habitual dietary phosphorus intake has been associated with higher serum parathyroid hormone (PTH) and lower serum calcium concentrations in healthy individuals. Higher serum PTH concentrations have been shown in those who consume foods with phosphorus additives. These findings suggest that long-term dietary phosphorus loads and long-term hyperphosphatemia may have important negative effects on bone health. In contrast, PTH concentrations did not increase as a result of high dietary phosphorus intake when phosphorus was provided with adequate amounts of calcium. Intake of foods with a ratio of calcium to phosphorus close to that found in dairy products led to positive effects on bone health. Several randomized controlled trials have shown positive relations between dairy intake and bone mineral density. In our loading test with a low-calcium, high-phosphorus lunch provided to healthy young men, serum PTH concentrations showed peaks at 1 and 6 h, and serum fibroblast growth factor 23 (FGF23) concentrations increased significantly at 8 h after the meal. In contrast, the high-calcium, high-phosphorus meal suppressed the second PTH and FGF23 elevations until 8 h after the meal. This implies that adequate dietary calcium intake is needed to overcome the interfering effects of high phosphorus intake on PTH and FGF23 secretion. FGF23 acts on the parathyroid gland to decrease PTH mRNA and PTH secretion in rats with normal kidney function. However, increased serum FGF23 is an early alteration of mineral metabolism in chronic kidney disease, causing secondary hyperthyroidism, and implying resistance of the parathyroid gland to the action of FGF23 in chronic kidney disease. These findings suggest that long-term high-phosphorus diets may impair bone health

  3. Increasing Dietary Phosphorus Intake from Food Additives: Potential for Negative Impact on Bone Health123

    Science.gov (United States)

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2014-01-01

    It is important to consider whether habitual high phosphorus intake adversely affects bone health, because phosphorus intake has been increasing, whereas calcium intake has been decreasing in dietary patterns. A higher total habitual dietary phosphorus intake has been associated with higher serum parathyroid hormone (PTH) and lower serum calcium concentrations in healthy individuals. Higher serum PTH concentrations have been shown in those who consume foods with phosphorus additives. These findings suggest that long-term dietary phosphorus loads and long-term hyperphosphatemia may have important negative effects on bone health. In contrast, PTH concentrations did not increase as a result of high dietary phosphorus intake when phosphorus was provided with adequate amounts of calcium. Intake of foods with a ratio of calcium to phosphorus close to that found in dairy products led to positive effects on bone health. Several randomized controlled trials have shown positive relations between dairy intake and bone mineral density. In our loading test with a low-calcium, high-phosphorus lunch provided to healthy young men, serum PTH concentrations showed peaks at 1 and 6 h, and serum fibroblast growth factor 23 (FGF23) concentrations increased significantly at 8 h after the meal. In contrast, the high-calcium, high-phosphorus meal suppressed the second PTH and FGF23 elevations until 8 h after the meal. This implies that adequate dietary calcium intake is needed to overcome the interfering effects of high phosphorus intake on PTH and FGF23 secretion. FGF23 acts on the parathyroid gland to decrease PTH mRNA and PTH secretion in rats with normal kidney function. However, increased serum FGF23 is an early alteration of mineral metabolism in chronic kidney disease, causing secondary hyperthyroidism, and implying resistance of the parathyroid gland to the action of FGF23 in chronic kidney disease. These findings suggest that long-term high-phosphorus diets may impair bone health

  4. Changes in fitness are associated with changes in body composition and bone health in children after cancer.

    Science.gov (United States)

    Dubnov-Raz, Gal; Azar, Meital; Reuveny, Ronen; Katz, Uriel; Weintraub, Michael; Constantini, Naama W

    2015-10-01

    This study examined the effects of physical activity on the fitness, body composition and mental health of children after cancer or bone marrow transplantation. We focused on 22 children aged from seven to 14 years who had received chemotherapy and/or bone marrow transplantation in our medical centre. Ten children took part in a six-month exercise programme, and 12 children who did not exercise formed the control group. At baseline and at the end of the trial, we measured aerobic fitness, body composition, bone density and assessed the child's mood and quality of life. We pooled all participants together post hoc to compare changes in fitness with the various study outcomes. We found no differences between groups in changes in fitness, body composition or mental health indices. Significant correlations were found between changes in aerobic fitness and changes in lean body mass (r = 0.74, p = 0.002), bone mineral content (r = 0.57, p = 0.026) and femoral neck bone mineral density (r = 0.59, p = 0.027) in all participants. Group-based exercise training did not improve aerobic fitness in children after cancer or bone marrow transplantation. However, changes in fitness throughout the study period were associated with changes in body composition and bone health in all participants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Periprosthetic bone densitometry of the hip: Influence of design and hydroxyapatite coating on regional bone remodeling; 5 year follow-up

    International Nuclear Information System (INIS)

    Rosenthall

    2002-01-01

    Aim: To determine bone mineral density changes surrounding two differently designed titanium alloy porous-coated femoral hip prostheses (S-ROM and Multilock) as a function of time. Materials and Methods: The periprosthetic bone regions were defined by the seven Gruen zones. Measurements were obtained by DXA utilizing a dedicated software program (LUNAR ORTH). Inclusion criteria required that the patients were asymptomatic with Harris hip scores >95, showed no radiographic evidence of loosening and that they had primary implants. The protocol specified that bone measurements be obtained within one week after implantation as a baseline reference and at 6 months, 12 months and yearly thereafter. 111 consecutive S-ROM and 65 consecutive Multilock patients were enrolled in this ongoing prospective study. Of the 65 patients with Multilock implants, 25 had a 50 micron thick coating of hydroxyapatite-tricalcium phosphate (HA) sprayed over the porous surface and 40 were without coating. Results: At 6 months the mean BMD of all zones showed a significant decrease relative to the baseline measurement, varying from 6% to 17%. Gruen zones 2 to 6 exhibited variable degrees of recovery by 60 months. The maximum mineral losses were registered proximally in zone 1 (greater trochanter) and zone 7 (calcar and lesser trochanter), which are recognized sites of prosthetic stress shielding. The detailed results at 60 months are presented. In Gruen zone 1 the mineral loss in the S-ROM implant is significantly less the than either Multilock type. Also, mineral loss with Multilock-HA is about 55% less than the Multilock-uncoated. In Gruen zone 7 there is no difference between S-ROM and Multilock-uncoated, but Multilock-HA lost 44% less density than Multilock-uncoated. Conclusion: Regional bone remodeling appears to be related to prosthesis design. HA coating substantially and significantly reduces mineral loss in the proximal porous area; the mechanism is speculative

  6. Evaluation of Strain Distribution in Bone around Implant in Treatment Design of Overdentures Using Computer and Modeling of Finite Elements

    Directory of Open Access Journals (Sweden)

    Masoumeh Khoshhal

    2016-03-01

    Full Text Available Introduction: Introduction: Few studies have investigated the distribution of stress around implants. In this study the distribution of stress in bones around implants was investigated in five overdenture (OD treatment designs including OD-1, OD-2, OD-3, OD-4 and OD-5. Materials and methods: The Catia modeling software was used in order to simulate the tooth/implant model and bone. First, the borders of cancellous and cortical bone in each section of the CT images were attained by Photoshop software. Then, modeling softwares SolidWorks and NUMBER were applied to make the final three-dimensional model of jaw. Finally, the amount of stress on the surface of bone/implant was studied by means of stress analysis software (Ansys v11.0. Results: Protrusive movements of implants B and D in OD-1 showed the highest amount of strain, 2435 εµ. Also, high amounts of strain, 1668 and 1557 εµwere observed in OD-1 and OD-2 designs in lateral movements respectively. Conclusion: The bottom line is that no forces to the extent of destruction based on the Ferost model were found for these designs. The highest amount of strain occurred in OD-1 design, which is held in mild overload window. Moreover, the amounts of strain in the rest of designs investigated were in adaptive window.

  7. Evaluation of Strain Distribution in Bone around Implant in Treatment Design of Overdentures Using Computer and Modeling of Finite Elements

    Directory of Open Access Journals (Sweden)

    Masoumeh Khoshhal

    2015-12-01

    Full Text Available Introduction: Introduction: Few studies have investigated the distribution of stress around implants. In this study the distribution of stress in bones around implants was investigated in five overdenture (OD treatment designs including OD-1, OD-2, OD-3, OD-4 and OD-5. Materials and methods: The Catia modeling software was used in order to simulate the tooth/implant model and bone. First, the borders of cancellous and cortical bone in each section of the CT images were attained by Photoshop software. Then, modeling softwares SolidWorks and NUMBER were applied to make the final three-dimensional model of jaw. Finally, the amount of stress on the surface of bone/implant was studied by means of stress analysis software (Ansys v11.0. Results: Protrusive movements of implants B and D in OD-1 showed the highest amount of strain, 2435 εµ. Also, high amounts of strain, 1668 and 1557 εµwere observed in OD-1 and OD-2 designs in lateral movements respectively. Conclusion: The bottom line is that no forces to the extent of destruction based on the Ferost model were found for these designs. The highest amount of strain occurred in OD-1 design, which is held in mild overload window. Moreover, the amounts of strain in the rest of designs investigated were in adaptive window.

  8. Does the Laser-Microtextured Short Implant Collar Design Reduce Marginal Bone Loss in Comparison with a Machined Collar?

    Directory of Open Access Journals (Sweden)

    B. Alper Gultekin

    2016-01-01

    Full Text Available Purpose. To compare marginal bone loss between subgingivally placed short-collar implants with machined collars and those with machined and laser-microtextured collars. Materials and Methods. The investigators used a retrospective study design and included patients who needed missing posterior teeth replaced with implants. Short-collar implants with identical geometries were divided into two groups: an M group, machined collar; and an L group, machined and laser-microtextured collar. Implants were evaluated according to marginal bone loss, implant success, and probing depth (PD at 3 years of follow-up. Results. Sixty-two patients received 103 implants (56 in the M group and 47 in the L group. The cumulative survival rate was 100%. All implants showed clinically acceptable marginal bone loss, although bone resorption was lower in the L group (0.49 mm than in the M group (1.38 mm at 3 years (p<0.01. A significantly shallower PD was found for the implants in the L group during follow-up (p<0.01. Conclusions. Our results suggest predictable outcomes with regard to bone loss for both groups; however, bone resorption was less in the L group than in the M group before and after loading. The laser-microtextured collar implant may provide a shallower PD than the machined collar implant.

  9. Maintaining bone health in patients with multiple myeloma: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

    Science.gov (United States)

    Miceli, Teresa S; Colson, Kathleen; Faiman, Beth M; Miller, Kena; Tariman, Joseph D

    2011-08-01

    About 90% of individuals with multiple myeloma will develop osteolytic bone lesions from increased osteoclastic and decreased osteoblastic activity. Severe morbidities from pathologic fractures and other skeletal events can lead to poor circulation, blood clots, muscle wasting, compromised performance status, and overall poor survival. Supportive care targeting bone disease is an essential adjunct to antimyeloma therapy. In addition, the maintenance of bone health in patients with multiple myeloma can significantly improve quality of life. Oncology nurses and other healthcare providers play a central role in the management of bone disease and maintenance throughout the course of treatment. Safe administration of bisphosphonates, promotion of exercise, maintenance of adequate nutrition, vitamin and mineral supplementation, scheduled radiographic examinations, and monitoring of bone complications are among the important functions that oncology nurses and healthcare providers perform in clinical practice.

  10. An Insilico Design of Nanoclay Based Nanocomposites and Scaffolds in Bone Tissue Engineering

    Science.gov (United States)

    Sharma, Anurag

    A multiscale in silico approach to design polymer nanocomposites and scaffolds for bone tissue engineering applications is described in this study. This study focuses on the role of biomaterials design and selection, structural integrity and mechanical properties evolution during degradation and tissue regeneration in the successful design of polymer nanocomposite scaffolds. Polymer nanocomposite scaffolds are synthesized using aminoacid modified montmorillonite nanoclay with biomineralized hydroxyapatite and polycaprolactone (PCL/in situ HAPclay). Representative molecular models of polymer nanocomposite system are systematically developed using molecular dynamics (MD) technique and successfully validated using material characterization techniques. The constant force steered molecular dynamics (fSMD) simulation results indicate a two-phase nanomechanical behavior of the polymer nanocomposite. The MD and fSMD simulations results provide quantitative contributions of molecular interactions between different constituents of representative models and their effect on nanomechanical responses of nanoclay based polymer nanocomposite system. A finite element (FE) model of PCL/in situ HAPclay scaffold is built using micro-computed tomography images and bridging the nanomechanical properties obtained from fSMD simulations into the FE model. A new reduction factor, K is introduced into modeling results to consider the effect of wall porosity of the polymer scaffold. The effect of accelerated degradation under alkaline conditions and human osteoblast cells culture on the evolution of mechanical properties of scaffolds are studied and the damage mechanics based analytical models are developed. Finally, the novel multiscale models are developed that incorporate the complex molecular and microstructural properties, mechanical properties at nanoscale and structural levels and mechanical properties evolution during degradation and tissue formation in the polymer nanocomposite

  11. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health.

    Science.gov (United States)

    Maresz, Katarzyna

    2015-02-01

    Inadequate calcium intake can lead to decreased bone mineral density, which can increase the risk of bone fractures. Supplemental calcium promotes bone mineral density and strength and can prevent osteoporosis. Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening. An adequate intake of vitamin K2 has been shown to lower the risk of vascular damage because it activates matrix GLA protein (MGP), which inhibits the deposits of calcium on the walls. Vitamin K, particularly as vitamin K2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. Vitamin K deficiency results in inadequate activation of MGP, which greatly impairs the process of calcium removal and increases the risk of calcification of the blood vessels. An increased intake of vitamin K2 could be a means of lowering calcium-associated health risks.

  12. The influence of anthropometry and body composition on children's bone health: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark.

    Science.gov (United States)

    Heidemann, Malene; Holst, René; Schou, Anders J; Klakk, Heidi; Husby, Steffen; Wedderkopp, Niels; Mølgaard, Christian

    2015-02-01

    Overweight, physical inactivity and sedentary behaviour have become increasing problems during the past decade. Increased sedentary behaviour may change the body composition (BC) by increasing the fat mass relative to the lean mass (LM). These changes may influence bone health to describe how anthropometry and BC predict the development of the bone accruement. The longitudinal study is a part of The CHAMPS study-DK. Children were DXA scanned at baseline and at 2-year follow-up. BC (LM, BF %) and BMC, BMD and BA were measured. The relationship between bone traits, anthropometry and BC was analysed by multilevel regression analyses. Of the invited children, 742/800 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow-up. Mean (range) of age at baseline was 9.5 years (7.7-12.1). Height, BMI, LM and BF % predicted bone mineral accrual and bone size positively and independently. Height and BMI are both positive predictors of bone accruement. LM is a more precise predictor of bone traits than BF % in both genders. The effects of height and BMI and LM on bone accruement are nearly identical in the two genders, while changes in BF % have different but positive effects on bone accretion in both boys and girls.

  13. Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

    Science.gov (United States)

    Romanos, Georgios E; Basha-Hijazi, Abdulaziz; Gupta, Bhumija; Ren, Yan-Fang; Malmstrom, Hans

    2014-04-01

    Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p bone. © 2012 Wiley Periodicals, Inc.

  14. Development and design of a bone-equivalent cortical shell phantom to determine accuracy measures on DXA and PQCT scanners

    International Nuclear Information System (INIS)

    Khoo, B.C.C.; Beck, T.J. Johns; Turk, B.; Price, R.I.

    2004-01-01

    Full text: Hip Structural Analysis (HSA), is an algorithm that computes bone-structural geometry from dual energy X-ray absorptiometry (DXA) derived hip images and may be used in a complementary manner to DXA areal bone mineral density (BMD) for bone strength interpretation. DXA is normally used to facilitate the diagnosis and management of bone metabolic diseases such as osteoporosis. HSA provides a biomechanical interpretation of BMD, using its mass profiles to compute cross-sectional structural geometry. In essence, HSA provides insight into bone structural and biomechanical properties, particularly of long bones, which BMD alone cannot. While conventional (vendor-provided) phantoms calibrate DXA machines for densitometric precision, analogous phantoms for calibrating structural geometry are lacking. This paper describes the design and preliminary testing of a densitometric bone-equivalent cylindrical phantom with 'cortical' shells and 'cancellous' core, and the use of this phantom to do a performance test of structural geometry variables such as cortical thickness, bone width and section modulus derived, from pQCT and DXA scan data. Powdered calcium-sulphate (CSC) was water-mixed in vacuum and cured. This mixture exhibited hydroxyapatite-like DXA photon-attenuation properties with density monotonically related to added water-mass. Its mass and BMD maintained temporal stability (CV%=0.03%, n=4 specimens over 321 d). Using CSC designed for a BMD=1.04g/cm, (for plate-thickness 10mm), a cylindrical phantom with cortical shell thicknesses of 0.5, 1.0, 2.0, 4.0mm, an acrylic-based internal core diameter of 26mm, and an acrylic surrounding 'soft-tissue' were constructed. The phantom was scanned using a DXA scanner (Hologic QDRl000W) and pQCT (Stratec XCT2000, pixel resolution 0.15mm). Selected cortical structural-geometric variables, derived from calculated geometry; pQCT mass-projections, and DXA HSA. In conclusion, dimensions of this novel cortical-shell phantom

  15. Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects

    Science.gov (United States)

    2016-12-01

    of HA using an air/water/ hydroxyapatite phantom scanned under the same conditions. Bone threshold was set at 1300 mg HA/cm3 (747 HU). The analyzed...of HA using an air/water/ hydroxyapatite phantom scanned under the same conditions. Bone threshold was set at 1300 mg HA/cm3 (747 HU). The analyzed...that can be used to manipulate the Masquelet induced membrane to create a graft bed that optimizes bone regeneration. The effect of surgical

  16. Numerical evaluation of bone remodelling and adaptation considering different hip prosthesis designs.

    Science.gov (United States)

    Levadnyi, Ievgen; Awrejcewicz, Jan; Gubaua, José Eduardo; Pereira, Jucélio Tomás

    2017-12-01

    The change in mechanical properties of femoral cortical bone tissue surrounding the stem of the hip endoprosthesis is one of the causes of implant instability. We present an analysis used to determine the best conditions for long-term functioning of the bone-implant system, which will lead to improvement of treatment results. In the present paper, a finite element method coupled with a bone remodelling model is used to evaluate how different three-dimensional prosthesis models influence distribution of the density of bone tissue. The remodelling process begins after the density field is obtained from a computed tomography scan. Then, an isotropic Stanford model is employed to solve the bone remodelling process and verify bone tissue adaptation in relation to different prosthesis models. The study results show that the long-stem models tend not to transmit loads to proximal regions of bone, which causes the stress-shielding effect. Short stems or application in the calcar region provide a favourable environment for transfer of loads to the proximal region, which allows for maintenance of bone density and, in some cases, for a positive variation, which causes absence of the aseptic loosening of an implant. In the case of hip resurfacing, bone mineral density changes slightly and is closest to an intact femur. Installation of an implant modifies density distribution and stress field in the bone. Thus, bone tissue is stimulated in a different way than before total hip replacement, which evidences Wolff's law, according to which bone tissue adapts itself to the loads imposed on it. The results suggest that potential stress shielding in the proximal femur and cortical hypertrophy in the distal femur may, in part, be reduced through the use of shorter stems, instead of long ones, provided stem fixation is adequate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Design for Change : EPIC pillars for Persuasive Design for Health

    NARCIS (Netherlands)

    Tjin-Kam-Jet-Siemons, Liseth; van Gemert-Pijnen, Julia E.W.C.

    2016-01-01

    What makes technology now truly empathic? How to develop designs that matter? We apply the EPIC for change model for persuasive and empathic designs. EPIC stands for: • Engagement: Creating experience, flow using persuasive strategies and triggers in development, using positive psychology concepts;

  18. A novel method for biomaterial scaffold internal architecture design to match bone elastic properties with desired porosity.

    Science.gov (United States)

    Lin, Cheng Yu; Kikuchi, Noboru; Hollister, Scott J

    2004-05-01

    An often-proposed tissue engineering design hypothesis is that the scaffold should provide a biomimetic mechanical environment for initial function and appropriate remodeling of regenerating tissue while concurrently providing sufficient porosity for cell migration and cell/gene delivery. To provide a systematic study of this hypothesis, the ability to precisely design and manufacture biomaterial scaffolds is needed. Traditional methods for scaffold design and fabrication cannot provide the control over scaffold architecture design to achieve specified properties within fixed limits on porosity. The purpose of this paper was to develop a general design optimization scheme for 3D internal scaffold architecture to match desired elastic properties and porosity simultaneously, by introducing the homogenization-based topology optimization algorithm (also known as general layout optimization). With an initial target for bone tissue engineering, we demonstrate that the method can produce highly porous structures that match human trabecular bone anisotropic stiffness using accepted biomaterials. In addition, we show that anisotropic bone stiffness may be matched with scaffolds of widely different porosity. Finally, we also demonstrate that prototypes of the designed structures can be fabricated using solid free-form fabrication (SFF) techniques.

  19. A Patient Specific Biomechanical Analysis of Custom Root Analogue Implant Designs on Alveolar Bone Stress: A Finite Element Study

    Directory of Open Access Journals (Sweden)

    David Anssari Moin

    2016-01-01

    Full Text Available Objectives. The aim of this study was to analyse by means of FEA the influence of 5 custom RAI designs on stress distribution of peri-implant bone and to evaluate the impact on microdisplacement for a specific patient case. Materials and Methods. A 3D surface model of a RAI for the upper right canine was constructed from the cone beam computed tomography data of one patient. Subsequently, five (targeted press-fit design modification FE models with five congruent bone models were designed: “Standard,” “Prism,” “Fins,” “Plug,” and “Bulbs,” respectively. Preprocessor software was applied to mesh the models. Two loads were applied: an oblique force (300 N and a vertical force (150 N. Analysis was performed to evaluate stress distributions and deformed contact separation at the peri-implant region. Results. The lowest von Mises stress levels were numerically observed for the Plug design. The lowest levels of contact separation were measured in the Fins model followed by the Bulbs design. Conclusions. Within the limitations of the applied methodology, adding targeted press-fit geometry to the RAI standard design will have a positive effect on stress distribution, lower concentration of bone stress, and will provide a better primary stability for this patient specific case.

  20. Bone strength and management of postmenopausal fracture risk with antiresorptive therapies: considerations for women’s health practice

    Directory of Open Access Journals (Sweden)

    Cheung AM

    2016-09-01

    Full Text Available Angela M Cheung,1–3 Heather Frame,4 Michael Ho,5 Erin S Mackinnon,6 Jacques P Brown7 1Department of Medicine, University of Toronto, 2Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network (UHN, 3Mount Sinai Hospital, University of Toronto, Toronto, ON, 4Assiniboine Clinic, Winnipeg, MB, 5University Health Network, Toronto, 6Amgen Canada, Inc, Mississauga, ON, 7Rheumatology Division, CHU de Québec Research Centre, Laval University, Quebec City, QC, Canada Abstract: Bone strength – and, hence, fracture risk – reflects the structural and material properties of the skeleton, which changes with bone turnover during aging and following effective pharmacotherapy. A variety of powerful new techniques (quantitative computed tomography, as well as peripheral quantitative computed tomography and high-resolution peripheral quantitative computed tomography provide precise images of bone structure and can be used to model the response of specific bones to different types of mechanical load. This review explores the various components of bone strength and the clinical significance of measures, such as bone mineral density, bone turnover markers, and modern imaging data, with regard to fracture risk in women with postmenopausal osteoporosis, before and after initiating antiresorptive therapy. These imaging and related techniques offer an ever-clearer picture of the changes in bone structure and bone mineral metabolism during normal aging and in osteoporosis, as well as in response to treatment. However, because the newer techniques are not yet available in routine practice, validated tools for absolute fracture risk assessment remain essential for clinical decision making. These tools, which are tailored to patient risk data in individual countries, are based on bone mineral density and other readily available clinical data. In addition, bone turnover marker measurements can be useful in

  1. The influence of anthropometry and body composition on children's bone health

    DEFF Research Database (Denmark)

    Heidemann, Malene; Holst, René; Schou, Anders J

    2015-01-01

    . Height and BMI are both positive predictors of bone accruement. LM is a more precise predictor of bone traits than BF % in both genders. The effects of height and BMI and LM on bone accruement are nearly identical in the two genders, while changes in BF % have different but positive effects on bone...

  2. Effects of calcium-fortified ice cream on markers of bone health.

    Science.gov (United States)

    Ferrar, L; van der Hee, R M; Berry, M; Watson, C; Miret, S; Wilkinson, J; Bradburn, M; Eastell, R

    2011-10-01

    Premenopausal women with low calcium intakes consumed calcium-fortified ice cream daily for 28 days. Bone markers, NTX, CTX and PTH decreased significantly by 7 days, with some evidence of a calcium dose-dependent effect. Bone marker responses were observed within 1 h of consuming ice cream. Body weight remained constant over 28 days. Dietary calcium is important for lifelong bone health. Milk is a good source of bioavailable calcium, but consumption has declined among young adults. The aims were to determine whether calcium-fortified ice cream, a palatable source of calcium, produces significant, sustainable changes in bone turnover markers and parathyroid hormone (PTH) in premenopausal women with calcium intake below recommended UK levels. Eighty women, ages 20-39 years (calcium intake ice cream containing 96, 244, 459 or 676 mg calcium daily for 28 days. Urinary NTX/Cr, serum CTX, PINP, 1,25D and PTH were measured (baseline, days 1, 7 and 28). Acute changes in CTX and PTH were measured over 5 h (n = 29 women). There were significant mean decreases by 7 days in NTX/Cr, CTX, PTH and 1,25D and increases in PINP (one sample t tests), with a significant dose-dependent effect on CTX analysis of covariance. Only CTX remained suppressed at 28 days. Serum CTX and PTH decreased within 1 h. Body weight did not change significantly between baseline and 28 days. Daily consumption of calcium-fortified ice cream by premenopausal women may significantly reduce levels of the bone resorption marker serum CTX, without stimulating weight gain. The ice cream could be incorporated into the diet to replace low-calcium snacks and thus help individuals with habitually low calcium intakes to meet recommended intakes. The 244 mg calcium preparation would provide more than a quarter of the UK daily recommended nutrient intake for premenopausal women.

  3. Design health village with the approach of sustainable architecture ...

    African Journals Online (AJOL)

    Journal Home > Vol 8, No 3 (2016) > ... a natural environment and away from the pollution of urban life , traditional medical care, hydrotherapy, sports and ... Keywords: Health; city health; smart; sustainability in architecture; architectural design ...

  4. Biomimetic design of a bacterial cellulose/hydroxyapatite nanocomposite for bone healing applications

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, Kristen A., E-mail: kazimmer@vt.edu [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); School of Biomedical Engineering Sciences, Virginia Tech, Blacksburg, VA 24060 (United States); LeBlanc, Jill M.; Sheets, Kevin T.; Fox, Robert W. [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); Gatenholm, Paul [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); School of Biomedical Engineering Sciences, Virginia Tech, Blacksburg, VA 24060 (United States)

    2011-01-01

    This study describes the design and synthesis of bacterial cellulose/hydroxyapatite nanocomposites for bone healing applications using a biomimetic approach. Bacterial cellulose (BC) with various surface morphologies (pellicles and tubes) was negatively charged by the adsorption of carboxymethyl cellulose (CMC) to initiate nucleation of calcium-deficient hydroxyapatite (cdHAp). The cdHAp was grown in vitro via dynamic simulated body fluid (SBF) treatments over a one week period. Characterization of the mineralized samples was done with X-ray Photoelectron Spectroscopy (XPS) and Field Emission Scanning Electron Microscopy (FESEM) with Energy Dispersive Spectroscopy (EDS). The amount of cdHAp observed varied among different samples. XPS demonstrated that the atomic presence of calcium and phosphorus ranged from 0.44 at.% to 7.71 at.% Ca and 0.27 at.% to 11.18 at.% P. The Ca/P overall ratio ranged from 1.22 to 1.92. FESEM images showed that the cdHAp crystal size increased with increasing nanocellulose fibril density. To determine the viability of the scaffolds in vitro, the morphology and differentiation of osteoprogenitor cells was analyzed using fluorescence microscopy and alkaline phosphatase gene expression. The presence of cdHAp crystals on BC surfaces resulted in increased cell attachment.

  5. Skeletal health in long-duration astronauts: nature, assessment, and management recommendations from the NASA Bone Summit.

    Science.gov (United States)

    Orwoll, Eric S; Adler, Robert A; Amin, Shreyasee; Binkley, Neil; Lewiecki, E Michael; Petak, Steven M; Shapses, Sue A; Sinaki, Mehrsheed; Watts, Nelson B; Sibonga, Jean D

    2013-06-01

    Concern about the risk of bone loss in astronauts as a result of prolonged exposure to microgravity prompted the National Aeronautics and Space Administration to convene a Bone Summit with a panel of experts at the Johnson Space Center to review the medical data and research evidence from astronauts who have had prolonged exposure to spaceflight. Data were reviewed from 35 astronauts who had served on spaceflight missions lasting between 120 and 180 days with attention focused on astronauts who (1) were repeat fliers on long-duration missions, (2) were users of an advanced resistive exercise device (ARED), (3) were scanned by quantitative computed tomography (QCT) at the hip, (4) had hip bone strength estimated by finite element modeling, or (5) had lost >10% of areal bone mineral density (aBMD) at the hip or lumbar spine as measured by dual-energy X-ray absorptiometry (DXA). Because of the limitations of DXA in describing the effects of spaceflight on bone strength, the panel recommended that the U.S. space program use QCT and finite element modeling to further study the unique effects of spaceflight (and recovery) on bone health in order to better inform clinical decisions. Copyright © 2013 American Society for Bone and Mineral Research.

  6. Low-carbohydrate, high-fat diets have sex-specific effects on bone health in rats

    DEFF Research Database (Denmark)

    Zengin, Ayse; Kropp, Benedikt; Chevalier, Yan

    2016-01-01

    the effects in female rats remain unknown. Therefore, we investigated whether sex-specific effects of LC-HF diets on bone health exist. METHODS: Twelve-week-old male and female Wistar rats were isoenergetically pair-fed either a control diet (CD), "Atkins-style" protein-matched diet (LC-HF-1), or ketogenic......PURPOSE: Studies in humans suggest that consumption of low-carbohydrate, high-fat diets (LC-HF) could be detrimental for growth and bone health. In young male rats, LC-HF diets negatively affect bone health by impairing the growth hormone/insulin-like growth factor axis (GH/IGF axis), while...... low-protein diet (LC-HF-2) for 4 weeks. In females, microcomputed tomography and histomorphometry analyses were performed on the distal femur. Sex hormones were analysed with liquid chromatography-tandem mass spectrometry, and endocrine parameters including GH and IGF-I were measured by immunoassay...

  7. Bone Health and Impact of Tenofovir Treatment in Men with Hepatitis-B Related Chronic Liver Disease.

    Science.gov (United States)

    Sajith, Kattiparambil G; Kapoor, Nitin; Shetty, Sahana; Goel, Ashish; Zachariah, Uday; Eapen, Chundamannil E; Paul, Thomas V

    2018-03-01

    Chronic Liver Disease (CLD) has been shown to have an adverse impact on bone health. Hepatitis-B related CLD and its treatment with tenofovir may have additional effects on skeleton. To study the impact of HBV related CLD and its treatment with Tenofovir on bone health in Indian subjects. This cross sectional study included men (18-60 years) and comprised of three groups: Group-1 was treatment naïve HBV related CLD ( n  = 79), Group-2 those with HBV related CLD on tenofovir for at least 1 year ( n  = 136), Group-3 age, sex and Body Mass Index (BMI) matched healthy controls ( n  = 58). Bone biochemistry and Bone Mineral Density (BMD) at spine, Femoral Neck (FN) and forearm were studied. Independent t -test or ANOVA was used to compare the means of continuous variables and chi-square test for categorical variables. Multiple logistic regression was used to assess the factors causing Low Bone Mass (LBM) at FN. A significantly greater proportion ( P  CLD (group 1 and group 2) had vitamin D deficiency (CLD than controls. The prevalence of LBM was higher in group 1 at the spine (31%) and forearm (18.4%) when compared to controls (8.1% and 7.8% respectively) ( P  10,000 IU/ml) emerged as significant risk factors for LBM at FN. The impact of hepatitis-B related CLD as well as its treatment on bone health is significant. Bone health need to be periodically evaluated in these subjects especially in older men who are lean and have a higher viral load.

  8. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) ; Guidance on the scientific requirements for health claims related to bone, joints, skin and oral health

    DEFF Research Database (Denmark)

    Tetens, Inge

    The Panel on Dietetic Products, Nutrition and Allergies (NDA) has been asked by the European Food Safety Authority (EFSA) to draft guidance on the scientific requirements for health claims related to bone, joints, skin, and oral health. This guidance has been drawn from scientific opinions...

  9. Leveraging design thinking to build sustainable mobile health systems.

    Science.gov (United States)

    Eckman, Molly; Gorski, Irena; Mehta, Khanjan

    Mobile health, or mHealth, technology has the potential to improve health care access in the developing world. However, the majority of mHealth projects do not expand beyond the pilot stage. A core reason why is because they do not account for the individual needs and wants of those involved. A collaborative approach is needed to integrate the perspectives of all stakeholders into the design and operation of mHealth endeavours. Design thinking is a methodology used to develop and evaluate novel concepts for systems. With roots in participatory processes and self-determined pathways, design thinking provides a compelling framework to understand and apply the needs of diverse stakeholders to mHealth project development through a highly iterative process. The methodology presented in this article provides a structured approach to apply design thinking principles to assess the feasibility of novel mHealth endeavours during early conceptualisation.

  10. Association between the awareness of osteoporosis and the quality of care for bone health among Korean women with osteoporosis.

    Science.gov (United States)

    Shin, Hyun-Young; Kang, Hee Cheol; Lee, Kiheon; Park, Sang Min

    2014-10-04

    The prevalence of osteoporosis is increasing and is a socio-economic burden worldwide. Although screening tests for osteoporosis in Korea are easily accessible, this condition remains undertreated. Evaluating post-diagnostic behavior changes may be helpful for improving the quality of care for bone health in osteoporotic patients. After reviewing the Fourth Korean National Health and Nutrition Examination Survey 2008-2009, 1,114 women with osteoporosis aged >50 years were included in this cross-sectional study. Factors related to bone health were categorized into the following groups: (1) behavioral health (smoking, alcohol consumption, and physical activity); (2) measured factors (lean body mass [kg], appendicular skeletal muscle mass [kg], and serum vitamin D level [nmol/L]); and (3) nutritional factors (calcium intake, vitamin/mineral supplementation, and healthy supplementary food). Logistic regression analysis and analysis of covariance was conducted after adjusting for age, education, income, residential area, height, weight, and self-perceived health using a weighted method. Doctors diagnosed 39.5% of patients with osteoporosis, and these patients were compared with the control group. The awareness group, who had been diagnosed with osteoporosis by a doctor, had a lower proportion of smokers and higher serum vitamin D level than the control group, who had never been diagnosed with osteoporosis. No other associations were found for quality of bone health care variables. The awareness group had higher odds ratios of vitamin/mineral replacement and healthy supplementary food but no other differences were observed, indicating the patients' beliefs in bone health care do not follow the recommended clinical guidelines (e.g. higher physical activity, lower alcohol consumption). To improve the quality of care for bone health in osteoporotic patients, an initial step should be the development of post-diagnostic procedures such as patient counseling and education

  11. Health physics in fusion reactor design

    International Nuclear Information System (INIS)

    Wong, K.Y.; Dinner, P.J.

    1984-06-01

    Experience in the control of tritium exposures to workers and the public gained through the design and operation of Ontario Hydro's nuclear stations has been applied to fusion projects and to design studies on emerging fusion reactor concepts. Ontario Hydro performance in occupational tritium exposure control and environmental impact is reviewed. Application of tritium control technologies and dose management methodology during facility design is highlighted

  12. Investigation of Bone Health Subsequent to Vitamin D Supplementation in Children Following Burn Injury.

    Science.gov (United States)

    Mayes, Theresa; Gottschlich, Michele M; Khoury, Jane; Kagan, Richard J

    2015-12-01

    The effect of supplemental vitamin D on fracture occurrence following burn injuries is unclear. The objective of this study was to evaluate postintervention incidence of fractures in children during the rehabilitative phase postburn (PB) following participation in a randomized clinical trial of vitamin D supplementation. Follow-up for fracture evaluation was obtained in 39 of 50 patients randomized to daily enteral vitamin D2, D3, or placebo throughout the acute burn course. Serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, D2, D3, calcitonin, and bone alkaline phosphatase (BAP) measurements were obtained PB day 7, midpoint, discharge, and 1-year PB. Urinary calcium was obtained PB day 7 and midpoint. Dual-energy x-ray absorptiometry (DXA) was performed at discharge and 1-year PB. Fractures were reported in 6 of 39 respondents. Four fractures occurred in the placebo group, 2 in the D2 group, and none in the D3 group. Serum vitamin D, calcitonin, BAP, and urinary calcium were similar between fracture groups. The group with fracture morbidity had larger burn size (83.8% ± 4.9% vs 53.0% ± 2.9%, P vitamin D3 in reducing postdischarge fracture risk. Results reaffirm the importance of monitoring bone health in pediatric patients postburn. © 2015 American Society for Parenteral and Enteral Nutrition.

  13. Including customers in health service design.

    Science.gov (United States)

    Perrott, Bruce E

    2013-01-01

    This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

  14. Designing and Conducting Health Systems Research Projects ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Giving girls and women the power to decide. Addressing Africa's unmet need for family planning by intensifying sexual and reproductive and adolescent health research. View moreGiving girls and women the power to decide ...

  15. Co-designing person-centred mental health care

    DEFF Research Database (Denmark)

    2016-01-01

    Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions.......Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions....

  16. Oral health- related quality of life in patients with rare inherited diseases affecting bone and teeth

    DEFF Research Database (Denmark)

    Gjørup, Hans; Haubek, Dorte

    Background X-linked hypophosphatemia (XLH) is a rare hereditary disease characterized by insufficient bone mineralization. Osteogenesis imperfecta (OI) is another rare inherited disease characterized by fragile bones because of defective collagen synthesis. Both diseases may have impact on teeth...

  17. The influence of pregnancy and lactation on maternal bone health: a systematic review.

    Directory of Open Access Journals (Sweden)

    Pooneh Salari

    2014-12-01

    Full Text Available Osteoporosis is considered as an important public health problem especially in postmenopausal women. There are some hypotheses support the contributory effect of pregnancy and lactation on osteoporosis later in life. High calcium demand during pregnancy and lactation and low estrogenic state support those hypotheses. Numerous studies have investigated on the issue but there is no consensus about the contributory effect of pregnancy and lactation on osteoporosis. To explore the current state of fact, in the present study, all bibliographic databases were searched and all relevant studies on the topic of osteoporosis, lactation, and pregnancy were reviewed. The review shows that despite of controversial results, pregnancy may have protective effect on bone especially if followed by lactation.

  18. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management

    Science.gov (United States)

    Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Alman, Benjamin A; Apkon, Susan D; Blackwell, Angela; Case, Laura E; Cripe, Linda; Hadjiyannakis, Stasia; Olson, Aaron K; Sheehan, Daniel W; Bolen, Julie; Weber, David R; Ward, Leanne M

    2018-01-01

    A coordinated, multidisciplinary approach to care is essential for optimum management of the primary manifestations and secondary complications of Duchenne muscular dystrophy (DMD). Contemporary care has been shaped by the availability of more sensitive diagnostic techniques and the earlier use of therapeutic interventions, which have the potential to improve patients’ duration and quality of life. In part 2 of this update of the DMD care considerations, we present the latest recommendations for respiratory, cardiac, bone health and osteoporosis, and orthopaedic and surgical management for boys and men with DMD. Additionally, we provide guidance on cardiac management for female carriers of a disease-causing mutation. The new care considerations acknowledge the effects of long-term glucocorticoid use on the natural history of DMD, and the need for care guidance across the lifespan as patients live longer. The management of DMD looks set to change substantially as new genetic and molecular therapies become available. PMID:29395990

  19. Osteoporosis: Modern Paradigms for Last Century's Bones.

    Science.gov (United States)

    Kruger, Marlena C; Wolber, Frances M

    2016-06-17

    The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

  20. Low to moderate alcohol consumption on serum vitamin D and other indicators of bone health in postmenopausal women in a controlled feeding study

    Science.gov (United States)

    Heavy alcohol drinking adversely affects vitamin D status and bone health. However, data from randomized, placebo-controlled trials (RCTs) on the effects of low to moderate alcohol consumption on vitamin D status and bone health in humans is unavailable. The objective of this cross-over RCT was to e...

  1. Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women.

    Science.gov (United States)

    Southmayd, Emily A; Hellmers, Adelaide C; De Souza, Mary Jane

    2017-10-01

    The review aims to summarize our current knowledge surrounding treatment strategies aimed at recovery of bone mass in energy-deficient women suffering from the Female Athlete Triad. The independent and interactive contributions of energy status versus estrogen status on bone density, geometry, and strength have recently been reported, highlighting the importance of addressing both energy and estrogen in treatment strategies for bone health. This is supported by reports that have identified energy-related features (low body weight and BMI) and estrogen-related features (late age of menarche, oligo/amenorrhea) to be significant risk factors for low bone mineral density and bone stress injury in female athletes and exercising women. Nutritional therapy is the recommended first line of treatment to recover bone mass in energy-deficient female athletes and exercising women. If nutritional therapy fails after 12 months or if fractures or significant worsening in BMD occurs, pharmacological therapy may be considered in the form of transdermal estradiol with cyclic oral progestin (not COC).

  2. Top 10 Research Questions Related to Physical Activity and Bone Health in Children and Adolescents

    Science.gov (United States)

    Janz, Kathleen F.; Thomas, David Q.; Ford, M. Allison; Williams, Skip M.

    2015-01-01

    Evidence strongly supports a positive, causal effect of physical activity on bone strength and suggests long-term benefits of childhood physical activity to the prevention of osteoporosis. The contribution of healthy bone development in youth is likely to be as important to fracture prevention as the amount of late adulthood bone loss. Families,…

  3. Active Learning by Design: An Undergraduate Introductory Public Health Course

    Directory of Open Access Journals (Sweden)

    Karin eYeatts

    2014-12-01

    Full Text Available Principles of active learning were used to design and implement an introductory public health course. Students were introduced to the breadth and practice of public health through team and individual-based activities. Team assignments covered topics in epidemiology, biostatistics, health behavior, nutrition, maternal and child health, environment, and health policy. Students developed an appreciation of the population perspective through an experience trip and related intervention project in a public health area of their choice. Students experienced several key critical component elements of a public health undergraduate major; they cover key public health domains, experience public health practice, and integrated concepts with their assignments. In this paper, course assignments, lessons learned, and student successes are described. Given the increased growth in the undergraduate public health major, these active learning assignments may be of interest to undergraduate public health programs at both liberal arts colleges and research universities.

  4. Steps Toward Technology Design to Beat Health Inequality

    DEFF Research Database (Denmark)

    Bertelsen, Pernille Scholdan; Kanstrup, Anne Marie; Madsen, Jacob

    2017-01-01

    workers in the neighbourhood and how this participatory approach supported a first step toward HIT design that tackles health inequality. This is important, as people in neighbourhoods with high health risks are not the target audience for the health technology innovation currently taking place despite...

  5. Healthy Gaming - Video Game Design to promote Health.

    Science.gov (United States)

    Brox, E; Fernandez-Luque, L; Tøllefsen, T

    2011-01-01

    There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game. The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects. Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles. The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasive games seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose. There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health care games it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion.

  6. Healthy Gaming – Video Game Design to promote Health

    Science.gov (United States)

    Brox, E.; Fernandez-Luque, L.; Tøllefsen, T.

    2011-01-01

    Background There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game. Objective The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects. Methods Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles. Results The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasive games seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose. Conclusion There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health care games it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion. PMID:23616865

  7. Designing minimum data sets of health smart card system

    OpenAIRE

    Mohtaram Nematollahi

    2014-01-01

    Introduction: Nowadays different countries benefit from health system based on health cards and projects related to smart cards. Lack of facilities which cover this technology is obvious in our society. This paper aims to design Minimum Data Sets of Health Smart Card System for Iran. Method: This research was an applied descriptive study. At first, we reviewed the same projects and guidelines of selected countries and the proposed model was designed in accordance to the country’s ...

  8. A health information system in radiotherapy to support health personnel in evaluation of standard pain in patients with bone metastases

    International Nuclear Information System (INIS)

    Santos, Maria E.M.; Vieira, Jose W.; Melo, Jonathan A.; Lima, Fernando R.A.

    2013-01-01

    Radiation therapy is a medical specialty that uses ionizing radiation sources, and can be applied to relieve the pain. The Numerical Dosimetry Group (GDN) of Recife-PE, Brazil presented in June 2012 the SISRAD (Health information system in radiotherapy), developed to organize information about data of patients with bone metastasis, aiming to evaluate patterns of pain after radiation treatment. They have since been carried out interviews with this type of patient and the answers have been added to a data file of the software. Were developed some graphical visualization tools as well as data sheets. The current version of SISRAD reads the data file and displays graphics and numerical results, with options to save them or print them. In this paper is presented a roadmap for the health care professional use with efficiency the SISRAD to form quantitative profiles of intensity of pain that their patients, on their responsibility, feel after the radiation treatment. A hypothesis used in SISRAD consists of organizing the responses of the patients supposing them free from other effects other than those arising from the permanence of the pain he felt before treatment or modification by the treatment. So the way the information is handled in the SISRAD enable the trader can discern patterns of pain and, consequently, improve the quality of treatment. In this sense the computational tool here presented can be classified as educational software for health professionals

  9. Health and Safety Audit Design Manual

    Energy Technology Data Exchange (ETDEWEB)

    Ternes, Mark P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Langley, Brandon R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Accawi, Gina K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Malhotra, Mini [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-10-01

    The Health and Safety Audit is an electronic audit tool developed by the Oak Ridge National Laboratory to assist in the identification and selection of health and safety measures when a home is being weatherized (i.e., receiving home energy upgrades), especially as part of the US Department of Energy (DOE) Weatherization Assistance Program, or during home energy-efficiency retrofit or remodeling jobs. The audit is specifically applicable to existing single-family homes (including mobile homes), and is generally applicable to individual dwelling units in low-rise multifamily buildings. The health and safety issues covered in the audit are grouped in nine categories: mold and moisture, lead, radon, asbestos, formaldehyde and volatile organic compounds (VOCs), combustion, pest infestation, safety, and ventilation. Development of the audit was supported by the US Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control and the DOE Weatherization Assistance Program.

  10. Omics analysis of human bone to identify genes and molecular networks regulating skeletal remodeling in health and disease.

    Science.gov (United States)

    Reppe, Sjur; Datta, Harish K; Gautvik, Kaare M

    2017-08-01

    The skeleton is a metabolically active organ throughout life where specific bone cell activity and paracrine/endocrine factors regulate its morphogenesis and remodeling. In recent years, an increasing number of reports have used multi-omics technologies to characterize subsets of bone biological molecular networks. The skeleton is affected by primary and secondary disease, lifestyle and many drugs. Therefore, to obtain relevant and reliable data from well characterized patient and control cohorts are vital. Here we provide a brief overview of omics studies performed on human bone, of which our own studies performed on trans-iliacal bone biopsies from postmenopausal women with osteoporosis (OP) and healthy controls are among the first and largest. Most other studies have been performed on smaller groups of patients, undergoing hip replacement for osteoarthritis (OA) or fracture, and without healthy controls. The major findings emerging from the combined studies are: 1. Unstressed and stressed bone show profoundly different gene expression reflecting differences in bone turnover and remodeling and 2. Omics analyses comparing healthy/OP and control/OA cohorts reveal characteristic changes in transcriptomics, epigenomics (DNA methylation), proteomics and metabolomics. These studies, together with genome-wide association studies, in vitro observations and transgenic animal models have identified a number of genes and gene products that act via Wnt and other signaling systems and are highly associated to bone density and fracture. Future challenge is to understand the functional interactions between bone-related molecular networks and their significance in OP and OA pathogenesis, and also how the genomic architecture is affected in health and disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence

    DEFF Research Database (Denmark)

    Jefferson, Amanda; Leonard, Helen; Siafarikas, Aris

    2016-01-01

    OBJECTIVES: We developed clinical guidelines for the management of bone health in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. METHODS: An initial guidelines draft was created which included statements based upon literature review and 11 open-ended que...

  12. Designing and Conducting Health Systems Research Projects ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... and field testing (Part 1) and with data analysis and report writing (Part 2). ... New website will help record vital life events to improve access to services for all ... How are public health actors working with the food and drinks industry to ...

  13. Comparison of the Pullout Strength of Different Pedicle Screw Designs and Augmentation Techniques in an Osteoporotic Bone Model.

    Science.gov (United States)

    Kiyak, Gorkem; Balikci, Tevfik; Heydar, Ahmed Majid; Bezer, Murat

    2018-02-01

    Mechanical study. To compare the pullout strength of different screw designs and augmentation techniques in an osteoporotic bone model. Adequate bone screw pullout strength is a common problem among osteoporotic patients. Various screw designs and augmentation techniques have been developed to improve the biomechanical characteristics of the bone-screw interface. Polyurethane blocks were used to mimic human osteoporotic cancellous bone, and six different screw designs were tested. Five standard and expandable screws without augmentation, eight expandable screws with polymethylmethacrylate (PMMA) or calcium phosphate augmentation, and distal cannulated screws with PMMA and calcium phosphate augmentation were tested. Mechanical tests were performed on 10 unused new screws of each group. Screws with or without augmentation were inserted in a block that was held in a fixture frame, and a longitudinal extraction force was applied to the screw head at a loading rate of 5 mm/min. Maximum load was recorded in a load displacement curve. The peak pullout force of all tested screws with or without augmentation was significantly greater than that of the standard pedicle screw. The greatest pullout force was observed with 40-mm expandable pedicle screws with four fins and PMMA augmentation. Augmented distal cannulated screws did not have a greater peak pullout force than nonaugmented expandable screws. PMMA augmentation provided a greater peak pullout force than calcium phosphate augmentation. Expandable pedicle screws had greater peak pullout forces than standard pedicle screws and had the advantage of augmentation with either PMMA or calcium phosphate cement. Although calcium phosphate cement is biodegradable, osteoconductive, and nonexothermic, PMMA provided a significantly greater peak pullout force. PMMA-augmented expandable 40-mm four-fin pedicle screws had the greatest peak pullout force.

  14. Participation in ball sports may represent a prehabilitation strategy to prevent future stress fractures and promote bone health in young athletes.

    Science.gov (United States)

    Tenforde, Adam Sebastian; Sainani, Kristin Lynn; Carter Sayres, Lauren; Milgrom, Charles; Fredericson, Michael

    2015-02-01

    Sports participation has many benefits for the young athlete, including improved bone health. However, a subset of athletes may attain suboptimal bone health and be at increased risk for stress fractures. This risk is greater for female than for male athletes. In healthy children, high-impact physical activity has been shown to improve bone health during growth and development. We offer our perspective on the importance of promoting high-impact, multidirectional loading activities, including ball sports, as a method of enhancing bone quality and fracture prevention based on collective research. Ball sports have been associated with greater bone mineral density and enhanced bone geometric properties compared with participation in repetitive, low-impact sports such as distance running or nonimpact sports such as swimming. Runners and infantry who participated in ball sports during childhood were at decreased risk of future stress fractures. Gender-specific differences, including the coexistence of female athlete triad, may negate the benefits of previous ball sports on fracture prevention. Ball sports involve multidirectional loading with high ground reaction forces that may result in stiffer and more fracture-resistant bones. Encouraging young athletes to participate in ball sports may optimize bone health in the setting of adequate nutrition and in female athletes, eumenorrhea. Future research to determine timing, frequency, and type of loading activity could result in a primary prevention program for stress fracture injuries and improved life-long bone health. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  15. Bone health nutraceuticals alter microarray mRNA gene expression: A randomized, parallel, open-label clinical study.

    Science.gov (United States)

    Lin, Yumei; Kazlova, Valentina; Ramakrishnan, Shyam; Murray, Mary A; Fast, David; Chandra, Amitabh; Gellenbeck, Kevin W

    2016-01-15

    Dietary intake of fruits and vegetables has been suggested to have a role in promoting bone health. More specifically, the polyphenols they contain have been linked to physiological effects related to bone mineral density and bone metabolism. In this research, we use standard microarray analyses of peripheral whole blood from post-menopausal women treated with two fixed combinations of plant extracts standardized to polyphenol content to identify differentially expressed genes relevant to bone health. In this 28-day open-label study, healthy post-menopausal women were randomized into three groups, each receiving one of three investigational fixed combinations of plant extracts: an anti-resorptive (AR) combination of pomegranate fruit (Punica granatum L.) and grape seed (Vitis vinifera L.) extracts; a bone formation (BF) combination of quercetin (Dimorphandra mollis Benth) and licorice (Glycyrrhiza glabra L.) extracts; and a fixed combination of all four plant extracts (AR plus BF). Standard microarray analysis was performed on peripheral whole blood samples taken before and after each treatment. Annotated genes were analyzed for their association to bone health by comparison to a gene library. The AR combination down-regulated a number of genes involved in reduction of bone resorption including cathepsin G (CTSG) and tachykinin receptor 1 (TACR1). The AR combination also up-regulated genes associated with formation of extracellular matrix including heparan sulfate proteoglycan 2 (HSPG2) and hyaluronoglucosaminidase 1 (HYAL1). In contrast, treatment with the BF combination resulted in up-regulation of bone morphogenetic protein 2 (BMP-2) and COL1A1 (collagen type I α1) genes which are linked to bone and collagen formation while down-regulating genes linked to osteoclastogenesis. Treatment with a combination of all four plant extracts had a distinctly different effect on gene expression than the results of the AR and BF combinations individually. These results could

  16. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  17. Comparison of different hip prosthesis shapes considering micro-level bone remodeling and stress-shielding criteria using three-dimensional design space topology optimization.

    Science.gov (United States)

    Boyle, Christopher; Kim, Il Yong

    2011-06-03

    Since the late 1980s, computational analysis of total hip arthroplasty (THA) prosthesis components has been completed using macro-level bone remodeling algorithms. The utilization of macro-sized elements requires apparent bone densities to predict cancellous bone strength, thereby, preventing visualization and analysis of realistic trabecular architecture. In this study, we utilized a recently developed structural optimization algorithm, design space optimization (DSO), to perform a micro-level three-dimensional finite element bone remodeling simulation on the human proximal femur pre- and post-THA. The computational simulation facilitated direct performance comparison between two commercially available prosthetic implant stems from Zimmer Inc.: the Alloclassic and the Mayo conservative. The novel micro-level approach allowed the unique ability to visualize the trabecular bone adaption post-operation and to quantify the changes in bone mineral content by region. Stress-shielding and strain energy distribution were also quantified for the immediate post-operation and the stably fixated, post-remodeling conditions. Stress-shielding was highest in the proximal region and remained unchanged post-remodeling; conversely, the mid and distal portions show large increases in stress, suggesting a distal shift in the loadpath. The Mayo design conserves bone mass, while simultaneously reducing the incidence of stress-shielding compared to the Alloclassic, revealing a key benefit of the distinctive geometry. Several important factors for stable fixation, determined in clinical evaluations from the literature, were evident in both designs: high levels of proximal bone loss and distal bone densification. The results suggest this novel computational framework can be utilized for comparative hip prosthesis shape, uniquely considering the post-operation bone remodeling as a design criterion. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Why Health Care Needs Design Research

    DEFF Research Database (Denmark)

    Knutz, Eva; Ammentorp, Jette; Kofoed, Poul-Erik

    2015-01-01

    Today's pediatric health care lacks methods to tap into the emotional state of hospitalized pediatric patients (age 4-6 years). The most frequently used approaches were developed for adults and fail to acknowledge the importance of imaginary experiences and the notion of play that may appeal...... of the preliminary tests show that games could serve as a system in which children are willing to express their emotions through play. The results are based on two comparative analyses of the CPgame through which it is possible to identify three different types of players among the patients playing the game...

  19. Design and validation of a dynamic cell-culture system for bone biology research and exogenous tissue-engineering applications.

    Science.gov (United States)

    Allori, Alexander C; Davidson, Edward H; Reformat, Derek D; Sailon, Alexander M; Freeman, James; Vaughan, Adam; Wootton, David; Clark, Elizabeth; Ricci, John L; Warren, Stephen M

    2016-10-01

    Bone lacunocanalicular fluid flow ensures chemotransportation and provides a mechanical stimulus to cells. Traditional static cell-culture methods are ill-suited to study the intricacies of bone biology because they ignore the three-dimensionality of meaningful cellular networks and the lacunocanalicular system; furthermore, reliance on diffusion alone for nutrient supply and waste product removal effectively limits scaffolds to 2-3 mm thickness. In this project, a flow-perfusion system was custom-designed to overcome these limitations: eight adaptable chambers housed cylindrical cell-seeded scaffolds measuring 12 or 24 mm in diameter and 1-10 mm in thickness. The porous scaffolds were manufactured using a three-dimensional (3D) periodic microprinting process and were composed of hydroxyapatite/tricalcium phosphate with variable thicknesses, strut sizes, pore sizes and structural configurations. A multi-channel peristaltic pump drew medium from parallel reservoirs and perfused it through each scaffold at a programmable rate. Hermetically sealed valves permitted sampling or replacement of medium. A gas-permeable membrane allowed for gas exchange. Tubing was selected to withstand continuous perfusion for > 2 months without leakage. Computational modelling was performed to assess the adequacy of oxygen supply and the range of fluid shear stress in the bioreactor-scaffold system, using 12 × 6 mm scaffolds, and these models suggested scaffold design modifications that improved oxygen delivery while enhancing physiological shear stress. This system may prove useful in studying complex 3D bone biology and in developing strategies for engineering thick 3D bone constructs. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd.

  20. Microbial Therapeutics Designed for Infant Health.

    LENUS (Irish Health Repository)

    Watkins, Claire

    2017-10-01

    Acknowledgment of the gut microbiome as a vital asset to health has led to multiple studies attempting to elucidate its mechanisms of action. During the first year of life, many factors can cause fluctuation in the developing gut microbiome. Host genetics, maternal health status, mode of delivery, gestational age, feeding regime, and perinatal antibiotic usage, are known factors which can influence the development of the infant gut microbiome. Thus, the microbiome of vaginally born, exclusively breastfed infants at term, with no previous exposure to antibiotics, either directly or indirectly from the mother, is to be considered the "gold standard." Moreover, the use of prebiotics as an aid for the development of a healthy gut microbiome is equally as important in maintaining gut homeostasis. Breastmilk, a natural prebiotic source, provides optimal active ingredients for the growth of beneficial microbial species. However, early life disorders such as necrotising enterocolitis, childhood obesity, and even autism have been associated with an altered\\/disturbed gut microbiome. Subsequently, microbial therapies have been introduced, in addition to suitable prebiotic ingredients, which when administered, may aid in the prevention of a microbial disturbance in the gastrointestinal tract. The aim of this mini-review is to highlight the beneficial effects of different probiotic and prebiotic treatments in early life, with particular emphasis on the different conditions which negatively impact microbial colonisation at birth.

  1. Biosecurity through Public Health System Design.

    Energy Technology Data Exchange (ETDEWEB)

    Beyeler, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arndt, William [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walser, Alex Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-11-01

    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulates key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.

  2. Microbial Therapeutics Designed for Infant Health

    Directory of Open Access Journals (Sweden)

    Claire Watkins

    2017-10-01

    Full Text Available Acknowledgment of the gut microbiome as a vital asset to health has led to multiple studies attempting to elucidate its mechanisms of action. During the first year of life, many factors can cause fluctuation in the developing gut microbiome. Host genetics, maternal health status, mode of delivery, gestational age, feeding regime, and perinatal antibiotic usage, are known factors which can influence the development of the infant gut microbiome. Thus, the microbiome of vaginally born, exclusively breastfed infants at term, with no previous exposure to antibiotics, either directly or indirectly from the mother, is to be considered the “gold standard.” Moreover, the use of prebiotics as an aid for the development of a healthy gut microbiome is equally as important in maintaining gut homeostasis. Breastmilk, a natural prebiotic source, provides optimal active ingredients for the growth of beneficial microbial species. However, early life disorders such as necrotising enterocolitis, childhood obesity, and even autism have been associated with an altered/disturbed gut microbiome. Subsequently, microbial therapies have been introduced, in addition to suitable prebiotic ingredients, which when administered, may aid in the prevention of a microbial disturbance in the gastrointestinal tract. The aim of this mini-review is to highlight the beneficial effects of different probiotic and prebiotic treatments in early life, with particular emphasis on the different conditions which negatively impact microbial colonisation at birth.

  3. A new condyle implant design concept for an alloplastic temporomandibular joint in bone resorption cases.

    Science.gov (United States)

    Ramos, António; Mesnard, Michel

    2016-10-01

    The purpose of this article is to present and evaluate an innovative intramedullary implant concept developed for total alloplastic reconstruction in bone resorption cases. The main goal of this innovative concept is to avoid the main problems experienced with temporomandibular (TMJ) devices on the market, associated with bone fixation and changes in kinematics. A three-dimensional finite element model was developed based on computed tomography (CT) scan images, before and after implantation of the innovative implant concept. To validate the numerical model, a clean cadaveric condyle was instrumented with four rosettes and loaded before and after implantation with the innovative concept TMJ implant. The experimental results validate the numerical models comparing the intact and implanted condyles, as they present good correlation. They show that the most critical region is around rosette #1, with an increase in strains in the proximal region of the condyle of 140%. The maximum principal strain and stress generated with the implant is less than 2200 με and 75 MPa in the posterior region of the cortical bone. Shortly after insertion of this press-fit implant, stress and strain results appear to be within the normal limits and show some similarities with the intact condyle. If these responses do not change over time, the screw fixation used at present could be avoided or replaced. This solution reduces bone resection and lessens surgical damage to the muscles. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture.

    Science.gov (United States)

    Sinaki, Mehrsheed

    2007-08-01

    Locomotion has always been a major criterion for human survival. Thus, it is no surprise that science supports the dependence of bone health on weight-bearing physical activities. The effect of physical activity on bone is site-specific. Determining how to perform osteogenic exercises, especially in individuals who have osteopenia or osteoporosis, without exceeding the biomechanical competence of bone always poses a dilemma and must occur under medical advice. This article presents the hypothesis that back exercises performed in a prone position, rather than a vertical position, may have a greater effect on decreasing the risk for vertebral fractures without resulting in compression fracture. The risk for vertebral fractures can be reduced through improvement in the horizontal trabecular connection of vertebral bodies.

  5. Geometry Design Optimization of Functionally Graded Scaffolds for Bone Tissue Engineering: A Mechanobiological Approach.

    Directory of Open Access Journals (Sweden)

    Antonio Boccaccio

    Full Text Available Functionally Graded Scaffolds (FGSs are porous biomaterials where porosity changes in space with a specific gradient. In spite of their wide use in bone tissue engineering, possible models that relate the scaffold gradient to the mechanical and biological requirements for the regeneration of the bony tissue are currently missing. In this study we attempt to bridge the gap by developing a mechanobiology-based optimization algorithm aimed to determine the optimal graded porosity distribution in FGSs. The algorithm combines the parametric finite element model of a FGS, a computational mechano-regulation model and a numerical optimization routine. For assigned boundary and loading conditions, the algorithm builds iteratively different scaffold geometry configurations with different porosity distributions until the best microstructure geometry is reached, i.e. the geometry that allows the amount of bone formation to be maximized. We tested different porosity distribution laws, loading conditions and scaffold Young's modulus values. For each combination of these variables, the explicit equation of the porosity distribution law-i.e the law that describes the pore dimensions in function of the spatial coordinates-was determined that allows the highest amounts of bone to be generated. The results show that the loading conditions affect significantly the optimal porosity distribution. For a pure compression loading, it was found that the pore dimensions are almost constant throughout the entire scaffold and using a FGS allows the formation of amounts of bone slightly larger than those obtainable with a homogeneous porosity scaffold. For a pure shear loading, instead, FGSs allow to significantly increase the bone formation compared to a homogeneous porosity scaffolds. Although experimental data is still necessary to properly relate the mechanical/biological environment to the scaffold microstructure, this model represents an important step towards

  6. The Copenhagen Oral Health Senior Cohort: design, population and dental health

    DEFF Research Database (Denmark)

    Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow

    2011-01-01

    Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe...

  7. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

    OpenAIRE

    Golds, Gary; Houdek, Devon; Arnason, Terra

    2017-01-01

    It is well recognized that bone loss accelerates in hypogonadal states, with female menopause being the classic example of sex hormones affecting the regulation of bone metabolism. Underrepresented is our knowledge of the clinical and metabolic consequences of overt male hypogonadism, as well as the more subtle age-related decline in testosterone on bone quality. While menopause and estrogen deficiency are well-known risk factors for osteoporosis in women, the effects of age-related testoster...

  8. Microlearning mApp raises health competence: hybrid service design.

    Science.gov (United States)

    Simons, Luuk P A; Foerster, Florian; Bruck, Peter A; Motiwalla, Luvai; Jonker, Catholijn M

    Work place health support interventions can help support our aging work force, with mApps offering cost-effectiveness opportunities. Previous research shows that health support apps should offer users enough newness and relevance each time they are used. Otherwise the 'eHealth law of attrition' applies: 90 % of users are lost prematurely. Our research study builds on this prior research with further investigation on whether a mobile health quiz provides added value for users within a hybrid service mix and whether it promotes long term health? We developed a hybrid health support intervention solution that uses a mix of electronic and physical support services for improving health behaviours, including a mobile micro-learning health quiz. This solution was evaluated in a multiple-case study at three work sites with 86 users. We find that both our mobile health quiz and the overall hybrid solution contributed to improvements in health readiness, -behaviour and -competence. Users indicated that the micro-learning health quiz courses provided new and relevant information. Relatively high utilization rates of the health quiz were observed. Participants indicated that health insights were given that directly influenced every day health perceptions, -choices, coping and goal achievement strategies, plus motivation and self-norms. This points to increased user health self-management competence. Moreover, even after 10 months they indicated to still have improved health awareness, -motivation and -behaviours (food, physical activity, mental recuperation). A design analysis was conducted regarding service mix efficacy; the mobile micro-learning health quiz helped fulfil a set of key requirements that exist for designing ICT-enabled lifestyle interventions, largely in the way it was anticipated.

  9. Diabetes mellitus and bone health: epidemiology, etiology and implications for fracture risk stratification.

    Science.gov (United States)

    Valderrábano, Rodrigo J; Linares, Maria I

    2018-01-01

    Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice.

  10. Impact of antiepileptic drugs on bone health: Need for monitoring, treatment, and prevention strategies

    Directory of Open Access Journals (Sweden)

    Ekta Arora

    2016-01-01

    Full Text Available Epilepsy is the most common neurological disorder affecting approximately 50 million people worldwide. In India, overall prevalence of epilepsy is reported to be 5.59/1000 population. Antiepileptic drugs (AEDs constitute the main-stay of treatment with a large number of AEDs available in the market. High incidence of adverse effects is a major limitation with AEDs. One of the major concerns is significant metabolic effects on the bone. However, little attention has been paid to this issue because most of the bone effects remain subclinical for a long time and may take years to manifest clinically. The main effects include hypocalcemia, hypophosphatemia, reduced serum levels of Vitamin D, increase in parathormone (PTH levels, and alterations in bone turnover markers. The CYP450 enzyme-inducing AEDs such as phenytoin, phenobarbital, carbamazepine, and primidone are the most common AEDs associated with bone disorders while the data regarding the effect of valproate and newer AEDs such as lamotrigine, gabapentin, vigabatrin, levetiracetam, and topiramate on bone metabolism and bone density are scanty and controversial. Deficiency of Vitamin D is commonly described as a cause for the bone loss in epileptic patients while others being decreased absorption of calcium, increased PTH levels, and inhibition of calcitonin secretion, etc. However, there are no formal practical guidelines for the management of bone disease among those taking AEDs. Evidence-based strategies regarding monitoring, prevention, and treatment of bone diseases in patients on AED therapy are needed.

  11. Serotonin reuptake inhibitors and bone health: A review of clinical studies and plausible mechanisms

    Directory of Open Access Journals (Sweden)

    Ravisha Wadhwa

    2017-06-01

    Full Text Available Selective serotonin reuptake inhibitors (SSRIs are currently the treatment of choice in depression and constitute major portion of prescription in depressive patients. The role of serotonin receptors in bone is emerging, raising certain questions regarding the effect of blockade of serotonin reuptake in the bone metabolism. Clinical studies have reported an association of SSRI antidepressants which with increase in fracture and decrease in bone mineral density. This review focus on recent evidence that evaluate the association of SSRIs with the risk of fracture and bone mineral density and also the probable mechanisms that might be involved in such effects.

  12. Ionic Liquids in Polymer Design: From Energy to Health

    Science.gov (United States)

    2016-10-19

    of Papers published in non peer- reviewed journals: Final Report: Ionic Liquids in Polymer Design: From Energy to Health Report Title ACS Symposium...SECURITY CLASSIFICATION OF: ACS Symposium: Ionic Liquids in Polymer Design: From Energy to Health at Fall 2015 ACS Meeting in Boston, MA The...combination of ionic liquids and polymers has emerged as an active field of exploration in polymer science, where new materials have be realized for

  13. Designing health promotion programs by watching the market.

    Science.gov (United States)

    Gelb, B D; Bryant, J M

    1992-03-01

    More health care providers and payors are beginning to see health promotion programs as a significant tool for attracting patients, reducing costs, or both. To help design programs that take into account the values and lifestyles of the target group, naturalistic observation can be useful. The authors illustrate the approach in a study of pipeline workers that provided input for the design of nutrition and smoking cessation programs.

  14. Vladimir Byurchiev, Ankle Bones

    OpenAIRE

    Churyumov, Anton

    2017-01-01

    Vladimir says that today not many children play with ankle bones. He recalls when he was young, children played with bones more often. According to Vladimir, various games using ankle bones develop flexibility, agility, and muscle in children’s hands. Ankles bones are taken from the back legs of a cow or a sheep. It is possible to determine the age and health of animals by examining this particular bone. Arcadia

  15. Are Sexual and Reproductive Health Policies Designed for All?

    DEFF Research Database (Denmark)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-01-01

    BACKGROUND: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity fo...

  16. Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review.

    Science.gov (United States)

    Julián-Almárcegui, C; Gómez-Cabello, A; Huybrechts, I; González-Agüero, A; Kaufman, J M; Casajús, J A; Vicente-Rodríguez, G

    2015-03-01

    Osteoporosis is a major public health concern worldwide. Understanding the roles of diet and physical activity in ensuring adequate bone mass accrual during childhood and adolescence may help identify strategies to reduce the risk of osteoporotic fractures later in life. The present systematic review was conducted to provide an overview of the current knowledge of the combined effects of physical activity and diet on bone mass accrual in children and adolescents. Data were obtained via searches of the PubMed, EMBASE, SPORTDiscus, and ISI Web of Science databases. Studies published in English and Spanish between 1887 and August 2013 were eligible for inclusion. Two investigators evaluated the studies against the inclusion and exclusion criteria. A total of 14 studies (7 cross-sectional and 7 experimental) were included in the review. The Pedro score and the Black and Down's checklist were used to evaluate the methodological quality of the experimental and the cross-sectional studies, respectively. Study characteristics were summarized in accordance with the review's PICO criteria. Significant exercise-by-calcium interaction was detected at several different bone sites. Although the results of cross-sectional studies were inconsistent, the results of randomized controlled trials showed that exercise has the potential to improve bone health under conditions of adequate calcium intake. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. The relation between dietary protein, calcium and bone health in women: results from the EPIC-Potsdam cohort.

    Science.gov (United States)

    Weikert, Cornelia; Walter, Dietmar; Hoffmann, Kurt; Kroke, Anja; Bergmann, Manuela M; Boeing, Heiner

    2005-01-01

    The role of dietary protein in bone health is controversial. The objective of the present study was to examine the association between protein intake, dietary calcium, and bone structure measured by broadband ultrasound attenuation (BUA). Our analysis includes 8,178 female study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam Study. Ultrasound bone measurements were performed on the right os calcis, and BUA was determined. Dietary intake was assessed by a standardized food frequency questionnaire. We applied linear regression models to estimate the association between dietary protein and BUA. After multivariate adjustment, high intake of animal protein was associated with decreased BUA values (beta = -0.03; p = 0.010) whereas high vegetable protein intake was related to an increased BUA (beta = 0.11; p = 0.007). The effect of dietary animal protein on BUA was modified by calcium intake. High consumption of protein from animal origin may be unfavourable, whereas a higher vegetable protein intake may be beneficial for bone health. Our results strengthen the hypothesis that high calcium intake combined with adequate protein intake based on a high ratio of vegetable to animal protein may be protective against osteoporosis. Copyright (c) 2005 S. Karger AG, Basel.

  18. Factors Associated with Bone Health in Malaysian Middle-Aged and Elderly Women Assessed via Quantitative Ultrasound.

    Science.gov (United States)

    Chin, Kok-Yong; Low, Nie Yen; Dewiputri, Wan Ilma; Ima-Nirwanaa, Soelaiman

    2017-07-06

    Risk factors for osteoporosis may vary according to different populations. We aimed to investigate the relationship between risk factors of osteoporosis and bone health indices determined via calcaneal quantitative ultrasound (QUS) in a group of Malaysian women aged 50 years or above. A cross-sectional study was performed on 344 Malaysian women recruited from a tertiary medical centre in Kuala Lumpur, Malaysia. They answered a self-administered questionnaire on their social-demographic details, medical history, lifestyle, and physical activity status. Their height was measured using a stadiometer, and their body composition estimated using a bioelectrical impedance device. Their bone health status was determined using a water-based calcaneal QUS device that generated three indices, namely speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI). A T-score was computed from SI values using a reference database from a mainland Chinese population. Women with three or more lifetime pregnancies, who were underweight and not drinking coffee had a significantly lower BUA. Stepwise multiple linear regression showed that SOS was predicted by age alone, BUA and SI by years since menopause, body mass index (BMI), and number of lifetime pregnancies, and T-score by years since menopause and percentage of body fat. As a conclusion, suboptimal bone health in middle-aged and elderly Malaysian women as indicated by QUS is associated with old age, being underweight, having a high body fat percentage, and a high number of lifetime pregnancies. Women having several risk factors should be monitored more closely to protect their bones against accelerated bone loss.

  19. Design and production of sintered β-tricalcium phosphate 3D scaffolds for bone tissue regeneration

    International Nuclear Information System (INIS)

    Santos, Carlos F.L.; Silva, Abílio P.; Lopes, Luís; Pires, Inês; Correia, Ilidio J.

    2012-01-01

    The characteristics of sintered β-tricalcium phosphate (β-TCP) scaffolds produced by 3D printing were studied by means of X-ray diffraction, Scanning Electron Microscopy, Fourier transform infrared spectroscopy, uniaxial compression tests and cytotoxicity tests, using human osteoblast cells. The results reported include details of the β-TCP scaffolds' porosity, density, phase stability, mechanical behavior and cytotoxic profile. Collectively, these properties are fundamental for the future application of these scaffolds as bone substitutes for individualized therapy. Highlights: ► β-Tricalcium phosphate (β-TCP) 3D scaffolds were produced by rapid prototyping. ► Scaffold properties were assessed by SEM, FTIR, XRD and by mechanical tests. ► The cytotoxic profile of the scaffolds was characterized by in vitro assays. ► Scaffolds have good properties for its application as bone substitutes for individualized therapy.

  20. Design and production of sintered {beta}-tricalcium phosphate 3D scaffolds for bone tissue regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Carlos F.L. [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal); Silva, Abilio P. [Centro de Ciencia e Tecnologia Aeroespaciais, Universidade da Beira Interior, Covilha (Portugal); Lopes, Luis [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal); Pires, Ines [Instituto de Engenharia Mecanica - Lisboa (IDMEC Lisboa/IST/UTL), Avenida Rovisco Pais, 1049-001 Lisboa (Portugal); Correia, Ilidio J., E-mail: icorreia@ubi.pt [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal)

    2012-07-01

    The characteristics of sintered {beta}-tricalcium phosphate ({beta}-TCP) scaffolds produced by 3D printing were studied by means of X-ray diffraction, Scanning Electron Microscopy, Fourier transform infrared spectroscopy, uniaxial compression tests and cytotoxicity tests, using human osteoblast cells. The results reported include details of the {beta}-TCP scaffolds' porosity, density, phase stability, mechanical behavior and cytotoxic profile. Collectively, these properties are fundamental for the future application of these scaffolds as bone substitutes for individualized therapy. Highlights: Black-Right-Pointing-Pointer {beta}-Tricalcium phosphate ({beta}-TCP) 3D scaffolds were produced by rapid prototyping. Black-Right-Pointing-Pointer Scaffold properties were assessed by SEM, FTIR, XRD and by mechanical tests. Black-Right-Pointing-Pointer The cytotoxic profile of the scaffolds was characterized by in vitro assays. Black-Right-Pointing-Pointer Scaffolds have good properties for its application as bone substitutes for individualized therapy.

  1. Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

    DEFF Research Database (Denmark)

    Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

    2018-01-01

    INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

  2. Computer-aided designed, three dimensional-printed hemipelvic prosthesis for peri-acetabular malignant bone tumour.

    Science.gov (United States)

    Wang, Baichuan; Hao, Yongqiang; Pu, Feifei; Jiang, Wenbo; Shao, Zengwu

    2018-03-01

    Prosthetic reconstruction may be a promising treatment for peri-acetabular malignant bone tumour; however, it is associated with a high complication rate. Therefore, prosthetic design and approach of prosthetic reconstruction after tumour resection warrant study. We retrospectively analyzed 11 patients with peri-acetabular malignant bone tumours treated by personalized 3D-printed hemipelvic prostheses after en bloc resection between 2015 and 2016. Pre-operative and post-operative pain at rest was assessed according to a 10-cm VAS score. The results of functional improvement were evaluated using the MSTS-93 score at the final follow-up. We also analyzed tumour recurrence, metastases, and complications associated with the reconstruction procedure. All patients were observed for six to 24 months with an average follow-up of 15.5 months. One patient had occasional pain of the involved hip at the final follow-up (VAS, pre vs. post 8 months: 3 vs. 2). The mean MSTS-93 score was 19.2 (range, 13-25). Hip dislocation was detected in two patients, while delayed wound healing occurred in one patient. One patient with mesenchymal chondrosarcoma had a left iliac bone metastasis. Local tumour recurrence was not observed. Reconstruction of bony defect after tumour resection using personalized 3D-printed hemipelvic prostheses can obtain acceptable functional results without severe complications. Based on previous reports and our results, we believe that reconstruction arthroplasty using 3D-printed hemipelvic prostheses will provide a promising alternative for those patients with peri-acetabular malignant bone tumours. Level IV, therapeutic study.

  3. Data Requirements and the Basis for Designing Health Information Kiosks.

    Science.gov (United States)

    Afzali, Mina; Ahmadi, Maryam; Mahmoudvand, Zahra

    2017-09-01

    Health kiosks are an innovative and cost-effective solution that organizations can easily implement to help educate people. To determine the data requirements and basis for designing health information kiosks as a new technology to maintain the health of society. By reviewing the literature, a list of information requirements was provided in 4 sections (demographic information, general information, diagnostic information and medical history), and questions related to the objectives, data elements, stakeholders, requirements, infrastructures and the applications of health information kiosks were provided. In order to determine the content validity of the designed set, the opinions of 2 physicians and 2 specialists in medical informatics were obtained. The test-retest method was used to measure its reliability. Data were analyzed using SPSS software. In the proposed model for Iran, 170 data elements in 6 sections were presented for experts' opinion, which ultimately, on 106 elements, a collective agreement was reached. To provide a model of health information kiosk, creating a standard data set is a critical point. According to a survey conducted on the various literature review studies related to the health information kiosk, the most important components of a health information kiosk include six categories; information needs, data elements, applications, stakeholders, requirements and infrastructure of health information kiosks that need to be considered when designing a health information kiosk.

  4. Design for behaviour change for health and wellbeing

    NARCIS (Netherlands)

    Ludden, Geke; Cain, Rebecca; MacKrill, James; Allen, Frances; Niedderer, Kristina; Clune, Stephen; Ludden, Geke

    2017-01-01

    With an ageing population, increase in stress-related diseases and unhealthy lifestyles, to name but a few, there are a myriad of challenges for improving both health and wellbeing of people. These challenges might be addressed by design. Design within this domain can aim to elicit positive

  5. Bioresorbable scaffolds for bone tissue engineering: optimal design, fabrication, mechanical testing and scale-size effects analysis.

    Science.gov (United States)

    Coelho, Pedro G; Hollister, Scott J; Flanagan, Colleen L; Fernandes, Paulo R

    2015-03-01

    Bone scaffolds for tissue regeneration require an optimal trade-off between biological and mechanical criteria. Optimal designs may be obtained using topology optimization (homogenization approach) and prototypes produced using additive manufacturing techniques. However, the process from design to manufacture remains a research challenge and will be a requirement of FDA design controls to engineering scaffolds. This work investigates how the design to manufacture chain affects the reproducibility of complex optimized design characteristics in the manufactured product. The design and prototypes are analyzed taking into account the computational assumptions and the final mechanical properties determined through mechanical tests. The scaffold is an assembly of unit-cells, and thus scale size effects on the mechanical response considering finite periodicity are investigated and compared with the predictions from the homogenization method which assumes in the limit infinitely repeated unit cells. Results show that a limited number of unit-cells (3-5 repeated on a side) introduce some scale-effects but the discrepancies are below 10%. Higher discrepancies are found when comparing the experimental data to numerical simulations due to differences between the manufactured and designed scaffold feature shapes and sizes as well as micro-porosities introduced by the manufacturing process. However good regression correlations (R(2) > 0.85) were found between numerical and experimental values, with slopes close to 1 for 2 out of 3 designs. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Hae-Dong Jang

    Full Text Available Among a variety of relevant factors of osteoporosis, the association between alcohol intake and postmenopausal women's bone mineral density (BMD by using data from the Korean National Health and Nutrition Examination Survey was evaluated in this study.Among a total of 31,596 subjects, males, premenopausal women, participants without BMD data were excluded. Finally, a total number of subjects in the study was 3,312. The frequency and amount of alcohol intake were determined by self-reported questionnaires, and BMD was measured by dual-energy x-ray absorptiometry.Mean femoral BMD for light drinkers was statistically significantly greater than that for heavy drinkers and non-drinkers. We observed the characteristic trends for BMD by drinking frequency; the mean BMD gradually increased from non-drinkers to the participants who drank 2-3 times per week; these participants exhibited the highest BMD. Participants who drank alcohol greater than 4 times per week showed a lower BMD. In the risk factor analysis, the adjusted odds ratio for osteoporosis (at femoral neck was 1.68 in non-drinkers and 1.70 in heavy drinkers compared with light drinkers.Light alcohol intake (2-3 times per week and 1-2 or 5-6 glasses per occasion in South Korean postmenopausal women was related to high femoral BMD. Non-drinkers and heavy drinkers had approximately a 1.7-times greater risk for osteoporosis than light drinkers.

  7. Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health.

    Science.gov (United States)

    Cuenca-Sánchez, Marta; Navas-Carrillo, Diana; Orenes-Piñero, Esteban

    2015-05-01

    Long-term consumption of a high-protein diet could be linked with metabolic and clinical problems, such as loss of bone mass and renal dysfunction. However, although it is well accepted that a high-protein diet may be detrimental to individuals with existing kidney dysfunction, there is little evidence that high protein intake is dangerous for healthy individuals. High-protein meals and foods are thought to have a greater satiating effect than high-carbohydrate or high-fat meals. The effect of high-protein diets on the modulation of satiety involves multiple metabolic pathways. Protein intake induces complex signals, with peptide hormones being released from the gastrointestinal tract and blood amino acids and derived metabolites being released in the blood. Protein intake also stimulates metabolic hormones that communicate information about energy status to the brain. Long-term ingestion of high amounts of protein seems to decrease food intake, body weight, and body adiposity in many well-documented studies. The aim of this article is to provide an extensive overview of the efficacy of high protein consumption in weight loss and maintenance, as well as the potential consequences in human health of long-term intake. © 2015 American Society for Nutrition.

  8. Workplace design contributions to mental health and well-being.

    Science.gov (United States)

    Veitch, Jennifer A

    2011-01-01

    People spend much of their waking time in their workplaces (approximately 33% on a weekly basis), which raises the possibility that the conditions they experience at work influence their health and well-being. The workplace design literature has given scant attention to mental health outcomes, instead focusing on healthy populations. Conversely, the mental health literature gives scant attention to the potential contribution of workplace design in preventing mental health problems; nor does it provide much insight into facilitating return to work. Taken together, however, the literature does suggest both lines of research and possible interventions. Existing knowledge proposes that workplace design can influence mental health via the effects of light exposure on circadian regulation, social behaviour and affect; the effects of aesthetic judgement on at-work mood and physical well-being and at-home sleep quality; access to nature and recovery from stressful experiences; and privacy regulation and stimulus control. This paper includes a short review of the literature in this area, proposals for new research directions and consideration of the implications of this information on the design choices made by business owners, designers and facility managers. Providing suitable working conditions for all employees avoids stigmatizing employees who have mental health problems, while facilitating prevention and return to work among those who do. Copyright © 2011 Longwoods Publishing.

  9. User-Centered Design and Interactive Health Technologies for Patients

    Science.gov (United States)

    De Vito Dabbs, Annette; Myers, Brad A.; Mc Curry, Kenneth R.; Dunbar-Jacob, Jacqueline; Hawkins, Robert P.; Begey, Alex; Dew, Mary Amanda

    2010-01-01

    Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design (UCD) is an approach that involves end-users throughout the development process so that technology support tasks, are easy to operate, and are of value to users. In this paper we provide an overview of UCD and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH), to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes. PMID:19411947

  10. Animal versus plant protein and adult bone health: A systematic review and meta-analysis from the National Osteoporosis Foundation.

    Directory of Open Access Journals (Sweden)

    Marissa M Shams-White

    Full Text Available Protein may have both beneficial and detrimental effects on bone health depending on a variety of factors, including protein source.The aim was to conduct a systematic review and meta-analysis evaluating the effects of animal versus plant protein intake on bone mineral density (BMD, bone mineral content (BMC and select bone biomarkers in healthy adults.Searches across five databases were conducted through 10/31/16 for randomized controlled trials (RCTs and prospective cohort studies in healthy adults that examined the effects of animal versus plant protein intake on 1 total body (TB, total hip (TH, lumbar spine (LS or femoral neck (FN BMD or TB BMC for at least one year, or 2 select bone formation and resorption biomarkers for at least six months. Strength of evidence (SOE was assessed and random effect meta-analyses were performed.Seven RCTs examining animal vs. isoflavone-rich soy (Soy+ protein intake in 633 healthy peri-menopausal (n = 1 and post-menopausal (n = 6 women were included. Overall risk of bias was medium. Limited SOE suggests no significant difference between Soy+ vs. animal protein on LS, TH, FN and TB BMD, TB BMC, and bone turnover markers BSAP and NTX. Meta-analysis results showed on average, the differences between Soy+ and animal protein groups were close to zero and not significant for BMD outcomes (LS: n = 4, pooled net % change: 0.24%, 95% CI: -0.80%, 1.28%; TB: n = 3, -0.24%, 95% CI: -0.81%, 0.33%; FN: n = 3, 0.13%, 95% CI: -0.94%, 1.21%. All meta-analyses had no statistical heterogeneity.These results do not support soy protein consumption as more advantageous than animal protein, or vice versa. Future studies are needed examining the effects of different protein sources in different populations on BMD, BMC, and fracture.

  11. Geometric and mechanical properties evaluation of scaffolds for bone tissue applications designing by a reaction-diffusion models and manufactured with a material jetting system

    Directory of Open Access Journals (Sweden)

    Marco A. Velasco

    2016-10-01

    Full Text Available Scaffolds are essential in bone tissue engineering, as they provide support to cells and growth factors necessary to regenerate tissue. In addition, they meet the mechanical function of the bone while it regenerates. Currently, the multiple methods for designing and manufacturing scaffolds are based on regular structures from a unit cell that repeats in a given domain. However, these methods do not resemble the actual structure of the trabecular bone which may work against osseous tissue regeneration. To explore the design of porous structures with similar mechanical properties to native bone, a geometric generation scheme from a reaction-diffusion model and its manufacturing via a material jetting system is proposed. This article presents the methodology used, the geometric characteristics and the modulus of elasticity of the scaffolds designed and manufactured. The method proposed shows its potential to generate structures that allow to control the basic scaffold properties for bone tissue engineering such as the width of the channels and porosity. The mechanical properties of our scaffolds are similar to trabecular tissue present in vertebrae and tibia bones. Tests on the manufactured scaffolds show that it is necessary to consider the orientation of the object relative to the printing system because the channel geometry, mechanical properties and roughness are heavily influenced by the position of the surface analyzed with respect to the printing axis. A possible line for future work may be the establishment of a set of guidelines to consider the effects of manufacturing processes in designing stages.

  12. Health Information Needs and Reliability of Sources Among Nondegree Health Sciences Students: A Prerequisite for Designing eHealth Literacy.

    Science.gov (United States)

    Haruna, Hussein; Tshuma, Ndumiso; Hu, Xiao

    Understanding health information needs and health-seeking behavior is a prerequisite for developing an electronic health information literacy (EHIL) or eHealth literacy program for nondegree health sciences students. At present, interest in researching health information needs and reliable sources paradigms has gained momentum in many countries. However, most studies focus on health professionals and students in higher education institutions. The present study was aimed at providing new insight and filling the existing gap by examining health information needs and reliability of sources among nondegree health sciences students in Tanzania. A cross-sectional study was conducted in 15 conveniently selected health training institutions, where 403 health sciences students were participated. Thirty health sciences students were both purposely and conveniently chosen from each health-training institution. The selected students were pursuing nursing and midwifery, clinical medicine, dentistry, environmental health sciences, pharmacy, and medical laboratory sciences courses. Involved students were either in their first year, second year, or third year of study. Health sciences students' health information needs focus on their educational requirements, clinical practice, and personal information. They use print, human, and electronic health information. They lack eHealth research skills in navigating health information resources and have insufficient facilities for accessing eHealth information, a lack of specialists in health information, high costs for subscription electronic information, and unawareness of the availability of free Internet and other online health-related databases. This study found that nondegree health sciences students have limited skills in EHIL. Thus, designing and incorporating EHIL skills programs into the curriculum of nondegree health sciences students is vital. EHIL is a requirement common to all health settings, learning environments, and

  13. Design of ceramic-based cements and putties for bone graft substitution

    Directory of Open Access Journals (Sweden)

    M Bohner

    2010-07-01

    Full Text Available In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements, and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.

  14. Design and implementation of the TRACIA: intracoronary autologous transplant of bone marrow-derived stem cells for acute ST elevation myocardial infarction

    OpenAIRE

    Peña-Duque, Marco A.; Martínez-Ríos, Marco A.; Calderón G, Eva; Mejía, Ana M.; Gómez, Enrique; Martínez-Sánchez, Carlos; Figueroa, Javier; Gaspar, Jorge; González, Héctor; Bialoztosky, David; Meave, Aloha; Uribe-González, Jhonathan; Alexánderson, Erick; Ochoa, Victor; Masso, Felipe

    2011-01-01

    Objective: To describe the design of a protocol of intracoronary autologous transplant of bone marrow-derived stem cells for acute ST-elevation myocardial infarction (STEMI) and to report the safety of the procedure in the first patients included. Methods: The TRACIA study was implemented following predetermined inclusion and exclusion criteria. The protocol includes procedures such as randomization, bone marrow retrieval, stem cells processing, intracoronary infusion of stem cells in the inf...

  15. The importance of vitamins D and K for the bone health and immune function in inflammatory bowel disease.

    Science.gov (United States)

    Iijima, Hideki; Shinzaki, Shinichiro; Takehara, Tetsuo

    2012-11-01

    This review summarizes the recent literature about the roles of vitamins D and K in bone metabolism and immunity-mediated inflammatory processes in inflammatory bowel diseases (IBDs). The levels of vitamins D and K are lower than normal in patients with IBD, especially in Crohn's disease. Although vitamins D and K are important for the maintenance of bone mineral density in non-IBD patients, an association between vitamins D or K and bone metabolism is not apparent in IBD patients. Recent studies showed that vitamins D and K are suggested to have immune-suppressive effects, both in animal models of colitis and human trials. In particular, vitamin D suppresses dendritic and T-cell functions by inhibiting the production of proinflammatory cytokines. Insufficiency of vitamin D is associated with the activated phenotype of IBD. Vitamins D and K potentially contribute to the maintenance of bone health in IBD, but this effect may be diminished by other factors such as steroid use, reduced exposure to sunlight, and inflammatory cytokines. Vitamin D and possibly vitamin K are suggested to be involved in the suppression of immune-mediated inflammation and modulation of disease activity.

  16. Designing calcium phosphate-based bifunctional nanocapsules with bone-targeting properties

    Energy Technology Data Exchange (ETDEWEB)

    Khung, Yit-Lung; Bastari, Kelsen; Cho, Xing Ling; Yee, Wu Aik; Loo, Say Chye Joachim, E-mail: joachimloo@ntu.edu.sg [Nanyang Technological University, School of Materials Science and Engineering (Singapore)

    2012-06-15

    Using sodium dodecyl sulphate micelles as template, hollow-cored calcium phosphate nanocapsules were produced. The surfaces of the nanocapsule were subsequently silanised by a polyethylene glycol (PEG)-based silane with an N-hydroxysuccinimide ester end groups which permits for further attachment with bisphosphonates (BP). Characterisations of these nanocapsules were investigated using Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy, Fourier Transform Infra-Red Spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Dynamic Light Scattering. To further validate the bone-targeting potential, dentine discs were incubated with these functionalised nanocapsules. FESEM analysis showed that these surface-modified nanocapsules would bind strongly to dentine surfaces compared to non-functionalised nanocapsules. We envisage that respective components would give this construct a bifunctional attribute, whereby (1) the shell of the calcium phosphate nanocapsule would serve as biocompatible coating aiding in gradual osteoconduction, while (2) surface BP moieties, acting as targeting ligands, would provide the bone-targeting potential of these calcium phosphate nanocapsules.

  17. Designing calcium phosphate-based bifunctional nanocapsules with bone-targeting properties

    International Nuclear Information System (INIS)

    Khung, Yit-Lung; Bastari, Kelsen; Cho, Xing Ling; Yee, Wu Aik; Loo, Say Chye Joachim

    2012-01-01

    Using sodium dodecyl sulphate micelles as template, hollow-cored calcium phosphate nanocapsules were produced. The surfaces of the nanocapsule were subsequently silanised by a polyethylene glycol (PEG)-based silane with an N-hydroxysuccinimide ester end groups which permits for further attachment with bisphosphonates (BP). Characterisations of these nanocapsules were investigated using Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy, Fourier Transform Infra-Red Spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Dynamic Light Scattering. To further validate the bone-targeting potential, dentine discs were incubated with these functionalised nanocapsules. FESEM analysis showed that these surface-modified nanocapsules would bind strongly to dentine surfaces compared to non-functionalised nanocapsules. We envisage that respective components would give this construct a bifunctional attribute, whereby (1) the shell of the calcium phosphate nanocapsule would serve as biocompatible coating aiding in gradual osteoconduction, while (2) surface BP moieties, acting as targeting ligands, would provide the bone-targeting potential of these calcium phosphate nanocapsules.

  18. Front end design of smartphone-based mobile health

    Science.gov (United States)

    Zhang, Changfan; He, Lingsong; Gao, Zhiqiang; Ling, Cong; Du, Jianhao

    2015-02-01

    Mobile health has been a new trend all over the world with the rapid development of intelligent terminals and mobile internet. It can help patients monitor health in-house and is convenient for doctors to diagnose remotely. Smart-phone-based mobile health has big advantages in cost and data sharing. Front end design of it mainly focuses on two points: one is implementation of medical sensors aimed at measuring kinds of medical signal; another is acquisition of medical signal from sensors to smart phone. In this paper, the above two aspects were both discussed. First, medical sensor implementation was proposed to refer to mature measurement solutions with ECG (electrocardiograph) sensor design taken for example. And integrated chip using can simplify design. Then second, typical data acquisition architecture of smart phones, namely Bluetooth and MIC (microphone)-based architecture, were compared. Bluetooth architecture should be equipped with an acquisition card; MIC design uses sound card of smart phone instead. Smartphone-based virtual instrument app design corresponding to above acquisition architecture was discussed. In experiments, Bluetooth and MIC architecture were used to acquire blood pressure and ECG data respectively. The results showed that Bluetooth design can guarantee high accuracy during the acquisition and transmission process, and MIC design is competitive because of low cost and convenience.

  19. Module for applications of bone scan in cancer patients

    International Nuclear Information System (INIS)

    Morales, Rosanna; Cano, Roque; Velasquez, Maria; Vasquez, Edinson; Diaz, Pepe; Vasquez, Mario; Rojas, Peter

    2013-01-01

    This paper reports the application of a software which enables the complete register of patient data, for delivering appropriate information in bone scan reports. Bone scan is a frequent study in Nuclear Medicine, which enables physicians to diagnose a primary bone cancer or metastases. The software was designed in order to complete data given by oncologists and constitutes an aid for the health team attending patients. (authors).

  20. Assessment of Bone Health in Men and Women Comparing DXA to Calcaneal Ultrasound

    National Research Council Canada - National Science Library

    Murphy, M

    2002-01-01

    ...) were assessed for bone mineral density (BMD, g/sq cm) and broadband ultrasound attenuation (BUA, db/MHz). BMD of the total body, regional and lumbar spine was measured via dual-energy X-ray absorptiometry...

  1. Smart health monitoring systems: an overview of design and modeling.

    Science.gov (United States)

    Baig, Mirza Mansoor; Gholamhosseini, Hamid

    2013-04-01

    Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

  2. Rethinking behavioral health processes by using design for six sigma.

    Science.gov (United States)

    Lucas, Anthony G; Primus, Kelly; Kovach, Jamison V; Fredendall, Lawrence D

    2015-02-01

    Clinical evidence-based practices are strongly encouraged and commonly utilized in the behavioral health community. However, evidence-based practices that are related to quality improvement processes, such as Design for Six Sigma, are often not used in behavioral health care. This column describes the unique partnership formed between a behavioral health care provider in the greater Pittsburgh area, a nonprofit oversight and monitoring agency for behavioral health services, and academic researchers. The authors detail how the partnership used the multistep process outlined in Design for Six Sigma to completely redesign the provider's intake process. Implementation of the redesigned process increased access to care, decreased bad debt and uncollected funds, and improved cash flow--while consumer satisfaction remained high.

  3. [How to design workshops to promote health in community groups].

    Science.gov (United States)

    Hernández-Díaz, Josefina; Paredes-Carbonell, Joan J; Marín Torrens, Rosa

    2014-01-01

    One of the strategies of health promotion is to develop life skills people considering themselves as the main health resource. A workshop has to get its participants become «asset» to make decisions and create health, focusing on the development and acquisition of skills in a motivating group and in order to achieve health objectives. The concepts behind the design of a workshop are: participatory planning, training, meaningful learning, group learning and participatory techniques. The steps to follow to design a workshop and facilitate their application are: Stage 0, founding; initial stage, host and initial evaluation; central or construction stage based learning in the acquisition of knowledge, attitudes and skills, and final stage or evaluation. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Body composition and reproductive function exert unique influences on indices of bone health in exercising women.

    Science.gov (United States)

    Mallinson, Rebecca J; Williams, Nancy I; Hill, Brenna R; De Souza, Mary Jane

    2013-09-01

    Reproductive function, metabolic hormones, and lean mass have been observed to influence bone metabolism and bone mass. It is unclear, however, if reproductive, metabolic and body composition factors play unique roles in the clinical measures of areal bone mineral density (aBMD) and bone geometry in exercising women. This study compares lumbar spine bone mineral apparent density (BMAD) and estimates of femoral neck cross-sectional moment of inertia (CSMI) and cross-sectional area (CSA) between exercising ovulatory (Ov) and amenorrheic (Amen) women. It also explores the respective roles of reproductive function, metabolic status, and body composition on aBMD, lumbar spine BMAD and femoral neck CSMI and CSA, which are surrogate measures of bone strength. Among exercising women aged 18-30 years, body composition, aBMD, and estimates of femoral neck CSMI and CSA were assessed by dual-energy x-ray absorptiometry. Lumbar spine BMAD was calculated from bone mineral content and area. Estrone-1-glucuronide (E1G) and pregnanediol glucuronide were measured in daily urine samples collected for one cycle or monitoring period. Fasting blood samples were collected for measurement of leptin and total triiodothyronine. Ov (n = 37) and Amen (n = 45) women aged 22.3 ± 0.5 years did not differ in body mass, body mass index, and lean mass; however, Ov women had significantly higher percent body fat than Amen women. Lumbar spine aBMD and BMAD were significantly lower in Amen women compared to Ov women (p < 0.001); however, femoral neck CSA and CSMI were not different between groups. E1G cycle mean and age of menarche were the strongest predictors of lumbar spine aBMD and BMAD, together explaining 25.5% and 22.7% of the variance, respectively. Lean mass was the strongest predictor of total hip and femoral neck aBMD as well as femoral neck CSMI and CSA, explaining 8.5-34.8% of the variance. Upon consideration of several potential osteogenic stimuli, reproductive function appears to play

  5. Using Participatory Design to design and develop mHealth for women with osteoporosis

    DEFF Research Database (Denmark)

    Jakobsen, Pernille; Kock Wiil, Uffe; Søndergaard, Jens

    2017-01-01

    and sick, and the women should be aided in learning to live with osteoporosis and how to prevent fractures (2). The effects of mHealth on self-care and self-management appear to be promising (3). Involvement of users in health care research is important, especially when developing new technologies...... The design and development of mHealth is based on a participatory design process. In the first phase, needs among the users are identified using qualitative methods as participant observations (10 hours), semi structured interviews (n=17) and focus groups (n=3). In the second phase, ideas and concepts...

  6. eHealth literacy issues, constructs, models, and methods for health information technology design and evaluation

    Directory of Open Access Journals (Sweden)

    Helen Monkman

    2015-12-01

    Full Text Available The concept of eHealth literacy is beginning to be recognized as a being of key importance in the design and adoption of effective and efficient health information systems and applications targeted to lay people and patients. Indeed, many systems such as patient portals and personal health records have not been adopted due to a mismatch between the level of eHealth literacy demanded by a system and the level of eHealth literacy possessed by end users. The purpose of this paper is to present an overview of important concepts related to eHealth literacy, as well as how the notion of eHealth literacy can be applied to improve the design and adoption of consumer health information systems. This paper begins with describing the importance of eHealth literacy with respect to design of health applications for the general public paired with examples of consumer health information systems whose limited success and adoption has been attributed to the lack of consideration for eHealth literacy. This is followed by definitions of what eHealth literacy is and how it emerged from the related concept of health literacy. A model for conceptualizing the importance of aligning consumers’ eHealth literacy skills and the demands systems place on their skills is then described. Next, current tools for assessing consumers’ eHealth literacy levels are outlined, followed by an approach to systematically incorporating eHealth literacy in the deriving requirements for new systems is presented. Finally, a discussion of evolving approaches for incorporating eHealth literacy into usability engineering methods is presented.

  7. The Oslo Health Study: Is bone mineral density higher in affluent areas?

    Science.gov (United States)

    Alver, Kari; Søgaard, Anne J; Falch, Jan A; Meyer, Haakon E

    2007-11-23

    Based on previously reported differences in fracture incidence in the socioeconomic less affluent Oslo East compared to the more privileged West, our aim was to study bone mineral density (BMD) in the same socioeconomic areas in Oslo. We also wanted to study whether possible associations were explained by socio-demographic factors, level of education or lifestyle factors. Distal forearm BMD was measured in random samples of the participants in The Oslo Health Study by single energy x-ray absorptiometry (SXA). 578 men and 702 women born in Norway in the age-groups 40/45, 60 and 75 years were included in the analyses. Socioeconomic regions, based on a social index dividing Oslo in two regions - East and West, were used. Age-adjusted mean BMD in women living in the less affluent Eastern region was 0.405 g/cm2 and significantly lower than in West where BMD was 0.419 g/cm2. Similarly, the odds ratio of low BMD (Z-score Oslo East compared to West. The same tendency, although not statistically significant, was also present in men. Multivariate analysis adjusted for education, marital status, body mass index, physical inactivity, use of alcohol and smoking, and in women also use of post-menopausal hormone therapy and early onset of menopause, did hardly change the association. Additional adjustments for employment status, disability pension and physical activity at work for those below the age of retirement, gave similar results. We found differences in BMD in women between different socioeconomic regions in Oslo that correspond to previously found differences in fracture rates. The association in men was not statistically significant. The differences were not explained by socio-demographic factors, level of education or lifestyle factors.

  8. Bone mineral density in midlife women: the Study of Women's Health in Qatar.

    Science.gov (United States)

    Gerber, L M; Bener, A; Al-Ali, H M; Hammoudeh, M; Liu, L Q; Verjee, M

    2015-04-01

    The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index (BMI), menopause status, and nationality, on BMD of the spine and femur. A cross-sectional study was conducted among women aged 40-60 years recruited from nine primary-care health centers in Qatar. BMD (g/m(2)) was assessed at the lumbar spine and the femur. The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values < 0.001). As BMI increased, BMD increased at both the spine and femur. Women who menstruated in the past 12 months had 0.82 g/cm(2) and 0.61 g/cm(2) greater BMD at the spine and femur, respectively, compared with women who had not menstruated in 12 months. Nationality was not associated with mean BMD of the spine or the femur. No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for the femur in the age group 55-60, where values were lower among non-Qataris (p = 0.04). Multivariable analyses showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed.

  9. The Oslo Health Study: Is bone mineral density higher in affluent areas?

    Directory of Open Access Journals (Sweden)

    Søgaard Anne J

    2007-11-01

    Full Text Available Abstract Background Based on previously reported differences in fracture incidence in the socioeconomic less affluent Oslo East compared to the more privileged West, our aim was to study bone mineral density (BMD in the same socioeconomic areas in Oslo. We also wanted to study whether possible associations were explained by socio-demographic factors, level of education or lifestyle factors. Methods Distal forearm BMD was measured in random samples of the participants in The Oslo Health Study by single energy x-ray absorptiometry (SXA. 578 men and 702 women born in Norway in the age-groups 40/45, 60 and 75 years were included in the analyses. Socioeconomic regions, based on a social index dividing Oslo in two regions – East and West, were used. Results Age-adjusted mean BMD in women living in the less affluent Eastern region was 0.405 g/cm2 and significantly lower than in West where BMD was 0.419 g/cm2. Similarly, the odds ratio of low BMD (Z-score ≤ -1 was 1.87 (95% CI: 1.22–2.87 in women in Oslo East compared to West. The same tendency, although not statistically significant, was also present in men. Multivariate analysis adjusted for education, marital status, body mass index, physical inactivity, use of alcohol and smoking, and in women also use of post-menopausal hormone therapy and early onset of menopause, did hardly change the association. Additional adjustments for employment status, disability pension and physical activity at work for those below the age of retirement, gave similar results. Conclusion We found differences in BMD in women between different socioeconomic regions in Oslo that correspond to previously found differences in fracture rates. The association in men was not statistically significant. The differences were not explained by socio-demographic factors, level of education or lifestyle factors.

  10. Electronic health records challenges in design and implementation

    CERN Document Server

    Sittig, Dean F

    2013-01-01

    This book provides an overview of the challenges in electronic health records (EHR) design and implementation along with an introduction to the best practices that have been identified over the past several years. The book examines concerns surrounding EHR use and proposes eight examples of proper EHR use. It discusses the complex strategic planning that accompanies the systemic organizational changes associated with EHR programs and highlights key lessons learned regarding health information-including technology errors and risk management concerns.

  11. Project HealthDesign: enhancing action through information.

    Science.gov (United States)

    Brennan, Patricia Flatley; Casper, Gail; Downs, Stephen; Aulahk, Veenu

    2009-01-01

    Project HealthDesign is a country-wide initiative in the United States designed to stimulate innovation in personal health records (PHRs). Nine grantee teams engaged in an 18-month long design and prototyping process. Two teams addressed the needs of children and adolescents; three created novel approaches to help adults prevent or manage metabolic syndrome; three groups employed interface innovations to assist patients with chronic care management and one team devised a novel calendaring system to assist patients undergoing complex medical/surgical treatments to integrate care processes into their daily lives. These projects not only included development and testing of novel personal health records applications, but also served as the starting point to specify and implement a common technical core platform. The project advanced PHR development in two key ways: intensive user-centered design and a development architecture that separates applications of PHRs from the infrastructure that supports them. The initiative also allowed systematic investigation of significant ethical, legal and social issues, including how privacy considerations are changed when information technology innovations are used in the home and the rebalancing of the authority structure of health care decision making when patient-centered approaches guide the design of PHRs.

  12. A user-centered model for designing consumer mobile health (mHealth) applications (apps).

    Science.gov (United States)

    Schnall, Rebecca; Rojas, Marlene; Bakken, Suzanne; Brown, William; Carballo-Dieguez, Alex; Carry, Monique; Gelaude, Deborah; Mosley, Jocelyn Patterson; Travers, Jasmine

    2016-04-01

    Mobile technologies are a useful platform for the delivery of health behavior interventions. Yet little work has been done to create a rigorous and standardized process for the design of mobile health (mHealth) apps. This project sought to explore the use of the Information Systems Research (ISR) framework as guide for the design of mHealth apps. Our work was guided by the ISR framework which is comprised of 3 cycles: Relevance, Rigor and Design. In the Relevance cycle, we conducted 5 focus groups with 33 targeted end-users. In the Rigor cycle, we performed a review to identify technology-based interventions for meeting the health prevention needs of our target population. In the Design Cycle, we employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app. Through an iterative process, we identified barriers and facilitators to the use of mHealth technology for HIV prevention for high-risk MSM, developed 'use cases' and identified relevant functional content and features for inclusion in a design document to guide future app development. Findings from our work support the use of the ISR framework as a guide for designing future mHealth apps. Results from this work provide detailed descriptions of the user-centered design and system development and have heuristic value for those venturing into the area of technology-based intervention work. Findings from this study support the use of the ISR framework as a guide for future mHealth app development. Use of the ISR framework is a potentially useful approach for the design of a mobile app that incorporates end-users' design preferences. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Methodological design of the National Health and Nutrition Survey 2016

    OpenAIRE

    Martín Romero-Martínez; Teresa Shamah-Levy; Lucia Cuevas-Nasu; Ignacio Méndez Gómez-Humarán; Elsa Berenice Gaona-Pineda; Luz María Gómez-Acosta; Juan Ángel Rivera-Dommarco; Mauricio Hernández-Ávila

    2017-01-01

    Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the in­habitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organizat...

  14. Novel Osteogenic Ti-6Al-4V Device For Restoration Of Dental Function In Patients With Large Bone Deficiencies: Design, Development And Implementation.

    Science.gov (United States)

    Cohen, D J; Cheng, A; Kahn, A; Aviram, M; Whitehead, A J; Hyzy, S L; Clohessy, R M; Boyan, B D; Schwartz, Z

    2016-02-08

    Custom devices supporting bone regeneration and implant placement are needed for edentulous patients with large mandibular deficiencies where endosteal implantation is not possible. We developed a novel subperiosteal titanium-aluminum-vanadium bone onlay device produced by additive manufacturing (AM) and post-fabrication osteogenic micro-/nano-scale surface texture modification. Human osteoblasts produced osteogenic and angiogenic factors when grown on laser-sintered nano-/micro-textured surfaces compared to smooth surfaces. Surface-processed constructs caused higher bone-to-implant contact, vertical bone growth into disk pores (microCT and histomorphometry), and mechanical pull-out force at 5 and 10 w on rat calvaria compared to non surface-modified constructs, even when pre-treating the bone to stimulate osteogenesis. Surface-modified wrap-implants placed around rabbit tibias osseointegrated by 6 w. Finally, patient-specific constructs designed to support dental implants produced via AM and surface-processing were implanted on edentulous mandibular bone. 3 and 8 month post-operative images showed new bone formation and osseointegration of the device and indicated stability of the dental implants.

  15. Sound & Vibration 20 Design Guidelines for Health Care Facilities

    CERN Document Server

    Tocci, Gregory; Cavanaugh, William

    2013-01-01

    Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...

  16. Designing minimum data sets of health smart card system

    Directory of Open Access Journals (Sweden)

    Mohtaram Nematollahi

    2014-10-01

    Full Text Available Introduction: Nowadays different countries benefit from health system based on health cards and projects related to smart cards. Lack of facilities which cover this technology is obvious in our society. This paper aims to design Minimum Data Sets of Health Smart Card System for Iran. Method: This research was an applied descriptive study. At first, we reviewed the same projects and guidelines of selected countries and the proposed model was designed in accordance to the country’s needs, taking people’s attitude about it by Delphi technique. A data analysis in study stage of MDS(Minimum Data Sets of Health Smart Card in the selective countries was done by comparative tables and determination of similarities and differences of the MDS. In the stage of gaining credit for model, it was accomplished with descriptive statistics to the extent of absolute and relative frequency through SPSS (version 16. Results: MDS of Health Smart Card for Iran is presented in the patient’s card and health provider’s card on basisof studiesin America, Australia, Turkey and Belgium and needs of our country and after doing Delphi technique with 94 percent agreement confirmed. Conclusion: Minimum Data Sets of Health Smart Card provides continuous care for patients and communication among providers. So, it causes a decrease in the complications of threatening diseases. Collection of MDS of diseases increases the quality of care assessment

  17. Artificial Gravity: Will it Preserve Bone Health on Long-Duration Missions?

    Science.gov (United States)

    Davis-Street, Janis; Paloski, William H.

    2005-01-01

    Prolonged microgravity exposure disrupts bone, muscle, and cardiovascular homeostasis, sensory-motor coordination, immune function, and behavioral performance. Bone loss, in particular, remains a serious impediment to the success of exploration-class missions by increasing the risks of bone fracture and renal stone formation for crew members. Current countermeasures, consisting primarily of resistive and aerobic exercise, have not yet proven fully successful for preventing bone loss during long-duration spaceflight. While other bone-specific countermeasures, such as pharmacological therapy and dietary modifications, are under consideration, countermeasure approaches that simultaneously address multiple physiologic systems may be more desirable for exploration-class missions, particularly if they can provide effective protection at reduced mission resource requirements (up-mass, power, crew time, etc). The most robust of the multi-system approaches under consideration, artificial gravity (AG), could prevent all of the microgravity-related physiological changes from occurring. The potential methods for realizing an artificial gravity countermeasure are reviewed, as well as selected animal and human studies evaluating the effects of artificial gravity on bone function. Future plans for the study of the multi-system effects of artificial gravity include a joint, cooperative international effort that will systematically seek an optimal prescription for intermittent AG to preserve bone, muscle, and cardiovascular function in human subjects deconditioned by 6 degree head-down-tilt-bed rest. It is concluded that AG has great promise as a multi-system countermeasure, but that further research is required to determine the appropriate parameters for implementation of such a countermeasure for exploration-class missions.

  18. Relationship Between Aldosterone and Parathyroid Hormone, and the Effect of Angiotensin and Aldosterone Inhibition on Bone Health

    DEFF Research Database (Denmark)

    L.S., Bislev; T., Sikjaer; L., Rolighed

    2015-01-01

    Emerging evidence suggests a stimulating effect of parathyroid hormone (PTH) on the reninnullangiotensinnullaldosterone system (RAAS). In primary hyperparathyroidism, chronic-elevated PTH levels seem to stimulate the RAAS which may explain the increased risk of cardiovascular disease (CVD......). In addition to increased PTH levels, low vitamin D levels may also directly increase risk of CVD, as vitamin D, itself, has been shown to inhibit the RAAS. Angiotensin II, aldosterone and cortisol all negatively impact bone health. Hyperaldosteronism is associated with a reversible secondary...... hyperparathyroidism due to increased renal calcium excretion. Moreover, the angiotensin II receptor is expressed by human parathyroid tissue, and angiotensin may therefore directly stimulates PTH secretion. An increased bone loss is found in patients with hyperaldosteronism. The angiotensin II receptor seems main...

  19. System perspectives for mobile platform design in m-Health

    Science.gov (United States)

    Roveda, Janet M.; Fink, Wolfgang

    2016-05-01

    Advances in integrated circuit technologies have led to the integration of medical sensor front ends with data processing circuits, i.e., mobile platform design for wearable sensors. We discuss design methodologies for wearable sensor nodes and their applications in m-Health. From the user perspective, flexibility, comfort, appearance, fashion, ease-of-use, and visibility are key form factors. From the technology development point of view, high accuracy, low power consumption, and high signal to noise ratio are desirable features. From the embedded software design standpoint, real time data analysis algorithms, application and database interfaces are the critical components to create successful wearable sensor-based products.

  20. Quantitative ultrasound and bone health Ultrasonido cuantitativo y salud ósea

    Directory of Open Access Journals (Sweden)

    Karen M Knapp

    2009-01-01

    Full Text Available This review of quantiative ultrasound (QUS and bone health uses the current literature to summarise the clinical and research effectiveness of QUS. QUS has been demonstrated to have the ability to predict fracture, particularly at the hip. However, the magnitude of prediction is fracture-site, measurement-site and device dependent. The correlations between dual X-ray absorptiometry (DXA and bone mineral density (BMD are weak to moderate, resulting in different subjects being identified as being at risk of fracture by the two different methods. QUS is sensitive to age and menopause-related changes and to clinical risk factors and lifestyle factors associated with osteoporosis. Whilst a limited ability of QUS to monitor therapeutic intervention has been demonstrated, this is still an area where it's poorer precision, in comparison to DXA, results in limited applicability. Whilst DXA remains the gold standard for the diagnosis of osteoporosis, QUS may be of use for the prediction of those at risk of future fracture in areas where there is limited availability of DXA.En esta revisión sobre el Ultrasonido Cuantitativo (QUS y su aplicación en la evaluación de la salud de los huesos, se analiza detalladamente la literatura disponible para conocer su papel y efectividad en la clínica cotidiana y en los programas de investigación. El QUS ha probado ser útil para predecir fracturas, especialmente de la cadera. Sin embargo, la exactitud de la predicción depende del sitio de fractura que se desea evaluar, del sitio anatómico donde se realiza la medición y de los diferentes instrumentos. La correlación que existe entre densitometría de rayos X (DXA y QUS puede ser débil a moderada, porque ambos métodos determinan diferentes componentes de la masa ósea relacionados con la presentación de las fracturas. El resultado del QUS como el del DXA también es sensible a la edad, cambios relacionados con la menopausia, a factores de riesgo clínicos y de

  1. Prevalence of low bone health using quantitative ultrasound in Indian women aged 41-60 years: Its association with nutrition and other related risk factors.

    Science.gov (United States)

    Shenoy, Shweta; Chawla, Jasmine Kaur; Gupta, Swati; Sandhu, Jaspal Singh

    2017-01-01

    The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41-60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.

  2. Anorexia Nervosa and Bone

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiologic estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  3. Impact of an osteoporosis specialized unit on bone health in breast cancer survivals treated with aromatase inhibitors.

    Science.gov (United States)

    Martínez, Purificación; Galve, Elena; Arrazubi, Virginia; Sala, M Ángeles; Fernández, Seila; Pérez, Clara E; Arango, Juan F; Torre, Iñaki

    2017-10-11

    Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  4. [Vitamin D, determinant of bone and extrabone health. Importance of vitamin D supplementation in milk and dairy products].

    Science.gov (United States)

    Navarro Valverde, Cristina; Quesada Gómez, José Manuel

    2015-04-07

    Vitamin D is obtained mainly from ultraviolet irradiation of 7-dehydrocholesterol in the skin to form cholecalciferol (vitamin D3), and minimally from diet, unless vitamin D fortified food is taken, mainly enriched milk. In some countries, vitamin D is added to diet as ergocalciferol (vitamin D2). In the liver, vitamin D3 is hydroxylated to form 25-hydroxyvitamin D3 (marker of body nutritional status of vitamin D). Subsequently, in the kidney, 25OHD3 is hydroxylated to form 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). By VDR stimulation, (1,25)OH)2D3 controls calcium homeostasis and bone health and, what is more, many other cells and tissues including skin, muscle, cardiovascular and immune systems as well as glucose homeostasis. Thus, about 3% of the human genome is regulated by this hormone. Association and recent intervention studies describe beneficial effects on bone, cardiovascular disease, hypertension, diabetes mellitus type 2,colorectal cancer, breast cancer, multiple sclerosis, immune function inflammation etc. A minimum target for public health should be to achieve serum 25OHD levels above 20 ng/ml to ensure optimum status for bone health. However, levels above 30 ng/ml should be reached to achieve other health goals. Paradoxically, inadequacy (or even deficiency) in vitamin D levels is highly prevalent in children and youth in Spain. This deficit persists in adults, as well as in postmenopausal women (osteoporotic or not) and the elderly (especially amongst those institutionalized). Seasonal variation barely normalizes serum 25OHD levels after summer-autumn. Treated postmenopausal osteoporotic women also show high prevalence of inadequate levels of vitamin D, a major contributor to antiresortive treatments failure. A normalization of serum vitamin D enables diet to provide the calcium necessary to achieve a good bone health and an adequate response to antiresortive drugs. Given the difficulty to get adequate levels of vitamin D by UV irradiation and diet, a

  5. Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

    Directory of Open Access Journals (Sweden)

    Alexander H. G. Paterson

    2013-12-01

    Full Text Available Bone loss is common in patients with breast cancer. Bone modifying agents (BMAs, such as bisphosphonates and denosumab, have been shown to reverse or stabilize bone loss and may be useful in the primary and metastatic settings. The purpose of this review is to provide clear evidence-based strategies for the management of bone loss and its symptoms in breast cancer. A systematic review of clinical trials and meta-analyses published between 1996 and 2012 was conducted of MEDLINE and EMBASE. Reference lists were hand-searched for additional publications. Recommendations were developed based on the best available evidence. Zoledronate, pamidronate, clodronate, and denosumab are recommended for metastatic breast cancer patients; however, no one agent can be recommended over another. Zoledronate or any oral bisphosphonate and denosumab should be considered in primary breast cancer patients who are postmenopausal on aromatase inhibitor therapy and have a high risk of fracture and/or a low bone mineral density and in premenopausal primary breast cancer patients who become amenorrheic after therapy. No one agent can be recommended over another. BMAs are not currently recommended as adjuvant therapy in primary breast cancer for the purpose of improving survival, although a major Early Breast Cancer Cooperative Trialists’ Group meta-analysis is underway which may impact future practice. Adverse events can be managed with appropriate supportive care.

  6. Bone tumors

    International Nuclear Information System (INIS)

    Unni, K.K.

    1988-01-01

    This book contains the proceedings on bone tumors. Topics covered include: Bone tumor imaging: Contribution of CT and MRI, staging of bone tumors, perind cell tumors of bone, and metastatic bone disease

  7. Developments in Participatory Design of Health Information Technology

    DEFF Research Database (Denmark)

    Kanstrup, Anne Marie; Madsen, Jacob; Nøhr, Christian

    2017-01-01

    The landscape of Participatory Design (PD) of Health Information Technology (HIT) is diverse and constantly evolving. This paper reviews the publications in the proceedings from the Participatory Design Conferences (PDCs) that have been held every two years since 1990. We used the Matrix Method...... procedures, records, secondary healthcare and health professionals. However, the analysis also shows a development from a primary focus on health workers and hospitals to a recent attention on HIT in everyday life and PD with patients, relatives, neighbourhoods and citizens in general. Additionally......, the review shows a growing number of PD methods being applied. This paper concludes that research on PD and HIT appears to be maturing and developing with ongoing technological and societal development....

  8. Integrating Health Behavior Theory and Design Elements in Serious Games.

    Science.gov (United States)

    Cheek, Colleen; Fleming, Theresa; Lucassen, Mathijs Fg; Bridgman, Heather; Stasiak, Karolina; Shepherd, Matthew; Orpin, Peter

    2015-01-01

    Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better informed serious games. To elucidate design elements important in SPARX, a serious game for adolescents with depression, from a user-centered perspective. We proposed a model based on an established theory of health behavior change and practical features of serious game design to organize ideas and rationale. We analyzed data from 5 studies comprising a total of 22 focus groups and 66 semistructured interviews conducted with youth and families in New Zealand and Australia who had viewed or used SPARX. User perceptions of the game were applied to this framework. A coherent framework was established using the three constructs of self-determination theory (SDT), autonomy, competence, and relatedness, to organize user perceptions and design elements within four areas important in design: computer game, accessibility, working alliance, and learning in immersion. User perceptions mapped well to the framework, which may assist developers in understanding the context of user needs. By mapping these elements against the constructs of SDT, we were able to propose a sound theoretical base for the model. This study's method allowed for the articulation of design elements in a serious game from a user-centered perspective within a coherent overarching framework. The framework can be used to deliberately incorporate serious game design elements that support a user's sense of autonomy, competence, and relatedness, key constructs which have been found to mediate motivation at all stages of the change

  9. [Participatory design guide for mental health promotion in prisons].

    Science.gov (United States)

    Bustamante Navarro, R; Paredes-Carbonell, J J; Aviñó Juan-Ulpiano, D; González Rubio, J; Pitarch Monzó, C; Martínez Martínez, L; Arroyo-Cobo, J M

    2013-01-01

    [corrected] The main aim was to describe the issues and the participatory process required to design a Guide to promotemental health in prison through group activities. We reviewed the bibliography, the mental health policies, the workshops about healthy mental habits, and a video about protection and risk factors. We identified the stakeholders and sought their points of view about the topics included in the Guide. We decided on the contents of the Guide and the incorporation of the health assets model and the perspectives provided by gender and cultural diversity. After the initial design of the modules and sessions, we started a pilot in the Prison of Valencia and the Prison of Zaragoza with women and men from different cultures, incorporating the suggested improvements, unifying contents and the discursive style. The guide is formed by: a preface, introduction, description, modules, sessions and evaluation. It has 6 modules and 19 sessions on: health and motivation; self-esteem; health and emotions; more assets to improve health: relax, positive thinking, keeping calm, communication and problem resolution; progress is possible: resiliency and starring in my own change. Each session consists of: activities (objectives, material, allocated time and development), theoretical material and tabbed sheets for activities. The guide is available in print and online versions. A guide has been elaborated with involved stakeholders and the opinion of the prison population.

  10. [Methodological design of the National Health and Nutrition Survey 2016].

    Science.gov (United States)

    Romero-Martínez, Martín; Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Humarán, Ignacio Méndez; Gaona-Pineda, Elsa Berenice; Gómez-Acosta, Luz María; Rivera-Dommarco, Juan Ángel; Hernández-Ávila, Mauricio

    2017-01-01

    Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.

  11. In vitro cytocompatibility evaluation of chitosan/graphene oxide 3D scaffold composites designed for bone tissue engineering.

    Science.gov (United States)

    Dinescu, Sorina; Ionita, Mariana; Pandele, Andreea Madalina; Galateanu, Bianca; Iovu, Horia; Ardelean, Aurel; Costache, Marieta; Hermenean, Anca

    2014-01-01

    Extensively studied nowadays, graphene oxide (GO) has a benefic effect on cell proliferation and differentiation, thus holding promise for bone tissue engineering (BTE) approaches. The aim of this study was not only to design a chitosan 3D scaffold improved with GO for optimal BTE, but also to analyze its physicochemical properties and to evaluate its cytocompatibility and ability to support cell metabolic activity and proliferation. Overall results show that the addition of GO in the scaffold's composition improved mechanical properties and pore formation and enhanced the bioactivity of the scaffold material for tissue engineering. The new developed CHT/GO 3 wt% scaffold could be a potential candidate for further in vitro and in vivo osteogenesis studies and BTE approaches.

  12. Assessment and management of bone health in women with oestrogen receptor-positive breast cancer receiving endocrine therapy: Position statement of the Endocrine Society of Australia, the Australian and New Zealand Bone & Mineral Society, the Australasian Menopause Society and the Clinical Oncology Society of Australia.

    Science.gov (United States)

    Grossmann, Mathis; Ramchand, Sabashini; Milat, Frances; Vincent, Amanda; Lim, Elgene; Kotowicz, Mark A; Hicks, Jill; Teede, Helena

    2018-05-09

    To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy. Representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing five key questions. Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman on tamoxifen have accelerated bone loss and increased fracture risk. Both bisphosphonates and denosumab prevent bone loss, additionally denosumab has proven anti-fracture benefit. Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density (BMD) measurement, with monitoring based on risk factors. Weight-bearing exercise, vitamin D and calcium sufficiency is recommended routinely. Antiresorptive treatment should be considered in women with prevalent or incident clinical or morphometric fractures, a T-score (or Z-scores in women <50 years) of <-2.0 at any site, or if annual bone loss is ≥5%, considering baseline BMD and other fracture risk factors. Duration of antiresorptive treatment can be individualised based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with antiresorptive treatments are low. Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimised by nonpharmacological intervention and where indicated antiresorptive treatment, in an individualised, multidisciplinary approach. Clinical trials are needed to better delineate long-term fracture risks of adjuvant endocrine therapy, and to determine the efficacy of interventions designed to minimise these risks. This article is protected by copyright. All rights reserved. This

  13. Simulated Space Radiation and Weightlessness: Vascular-Bone Coupling Mechanisms to Preserve Skeletal Health

    Science.gov (United States)

    Globus, R. K.; Alwood, J.; Tahimic, C.; Schreurs, A.-S.; Shirazi-Fard, Y.; Terada, M.; Zaragoza, J.; Truong, T.; Bruns, K.; Castillo, A.; hide

    2018-01-01

    We examined experimentally the effects of radiation and/or simulated weightlessness by hindlimb unloading on bone and blood vessel function either after a short period or at a later time after transient exposures in adult male, C57Bl6J mice. In sum, recent findings from our studies show that in the short term, ionizing radiation and simulate weightlessness cause greater deficits in blood vessels when combined compared to either challenge alone. In the long term, heavy ion radiation, but not unloading, can lead to persistent, adverse consequences for bone and vessel function, possibly due to oxidative stress-related pathways.

  14. From loquacious to reticent: understanding patient health information communication to guide consumer health IT design.

    Science.gov (United States)

    Valdez, Rupa S; Guterbock, Thomas M; Fitzgibbon, Kara; Williams, Ishan C; Wellbeloved-Stone, Claire A; Bears, Jaime E; Menefee, Hannah K

    2017-07-01

    It is increasingly recognized that some patients self-manage in the context of social networks rather than alone. Consumer health information technology (IT) designed to support socially embedded self-management must be responsive to patients' everyday communication practices. There is an opportunity to improve consumer health IT design by explicating how patients currently leverage social media to support health information communication. The objective of this study was to determine types of health information communication patterns that typify Facebook users with chronic health conditions to guide consumer health IT design. Seven hundred participants with type 2 diabetes were recruited through a commercial survey access panel. Cluster analysis was used to identify distinct approaches to health information communication both on and off Facebook. Analysis of variance (ANOVA) methods were used to identify demographic and behavioral differences among profiles. Secondary analysis of qualitative interviews ( n  = 25) and analysis of open-ended survey questions were conducted to understand participant rationales for each profile. Our analysis yielded 7 distinct health information communication profiles. Five of 7 profiles had consistent patterns both on and off Facebook, while the remaining 2 demonstrated distinct practices, with no health information communication on Facebook but some off Facebook. One profile was distinct from all others in both health information communication practices and demographic composition. Rationales for following specific health information communication practices were categorized under 6 themes: altruism, instrumental support, social support, privacy and stigma, convenience, and Facebook knowledge. Facebook has been widely adopted for health information communication; This study demonstrates that Facebook has been widely adopted for health information communication. It also shows that the ways in which patients communicate health

  15. Exercise therapy for bone and muscle health: an overview of systematic reviews.

    Science.gov (United States)

    Hagen, Kåre Birger; Dagfinrud, Hanne; Moe, Rikke Helene; Østerås, Nina; Kjeken, Ingvild; Grotle, Margreth; Smedslund, Geir

    2012-12-19

    Musculoskeletal conditions (MSCs) are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET) on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored. We included four common conditions: fibromyalgia (FM), low back pain (LBP), neck pain (NP), and shoulder pain (SP), and four specific musculoskeletal diseases: osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoporosis (OP). We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes. We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes (fractures). For LBP and knee OA, there was evidence

  16. Exercise therapy for bone and muscle health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Hagen Kåre

    2012-12-01

    Full Text Available Abstract Background Musculoskeletal conditions (MSCs are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored. Methods We included four common conditions: fibromyalgia (FM, low back pain (LBP, neck pain (NP, and shoulder pain (SP, and four specific musculoskeletal diseases: osteoarthritis (OA, rheumatoid arthritis (RA, ankylosing spondylitis (AS, and osteoporosis (OP. We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes. Results We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes

  17. Applying the Ottawa Charter to inform health promotion programme design.

    Science.gov (United States)

    Fry, Denise; Zask, Avigdor

    2017-10-01

    There is evidence of a correlation between adoption of the Ottawa Charter's framework of five action areas and health promotion programme effectiveness, but the Charter's framework has not been as fully implemented as hoped, nor is generally used by formal programme design models. In response, we aimed to translate the Charter's framework into a method to inform programme design. Our resulting design process uses detailed definitions of the Charter's action areas and evidence of predicted effectiveness to prompt greater consideration and use of the Charter's framework. We piloted the process by applying it to the design of four programmes of the Healthy Children's Initiative in New South Wales, Australia; refined the criteria via consensus; and made consensus decisions on the extent to which programme designs reflected the Charter's framework. The design process has broad potential applicability to health promotion programmes; facilitating greater use of the Ottawa Charter framework, which evidence indicates can increase programme effectiveness. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys.

    Directory of Open Access Journals (Sweden)

    Eunjoo Choi

    Full Text Available Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women.A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011, who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA examination. Bone mineral density (BMD was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use.After adjusting for various demographic and lifestyle confounders (including hormonal factors, subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015. This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively. In addition, age- and body mass index (BMI-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively.Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.

  19. The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys.

    Science.gov (United States)

    Choi, Eunjoo; Choi, Kyung-Hyun; Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung

    2016-01-01

    Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.

  20. The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys

    Science.gov (United States)

    Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung

    2016-01-01

    Purpose Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. Methods A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008–2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. Results After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43–0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Conclusions Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association. PMID:26816211

  1. The effect of implant design and bone quality on insertion torque, resonance frequency analysis, and insertion energy during implant placement in low or low- to medium-density bone.

    Science.gov (United States)

    Wang, Tong-Mei; Lee, Ming-Shu; Wang, Juo-Song; Lin, Li-Deh

    2015-01-01

    This study investigated the effect of implant design and bone quality on insertion torque (IT), implant stability quotient (ISQ), and insertion energy (IE) by monitoring the continuous change in IT and ISQ while implants were inserted in artificial bone blocks that simulate bone of poor or poor-to-medium quality. Polyurethane foam blocks (Sawbones) of 0.16 g/cm³ and 0.32 g/cm³ were respectively used to simulate low density and low- to medium-density cancellous bone. In addition, some test blocks were laminated with a 1-mm 0.80 g/cm³ polyurethane layer to simulate cancellous bone with a thin cortical layer. Four different implants (Nobel Biocare Mk III-3.75, Mk III-4.0, Mk IV-4.0, and NobelActive-4.3) were placed into the different test blocks in accordance with the manufacturer's instructions. The IT and ISQ were recorded at every 0.5-mm of inserted length during implant insertion, and IE was calculated from the torque curve. The peak IT (PIT), final IT (FIT), IE, and final ISQ values were statistically analyzed. All implants showed increasing ISQ values when the implant was inserted more deeply. In contrast to the ISQ, implants with different designs showed dissimilar IT curve patterns during the insertion. All implants showed a significant increase in the PIT, FIT, IE, and ISQ when the test-block density increased or when the 1-mm laminated layer was present. Tapered implants showed FIT or PIT values of more than 40 Ncm for all of the laminated test blocks and for the nonlaminated test blocks of low to medium density. Parallel-wall implants did not exhibit PIT or FIT values of more than 40 Ncm for all of the test blocks. NobelActive-4.3 showed a significantly higher FIT, but a significantly lower IE, than Mk IV-4.0. While the existence of cortical bone or implant designs significantly affects the dynamic IT profiles during implant insertion, it does not affect the ISQ to a similar extent. Certain implant designs are more suitable than others if high IT is

  2. Early identification and intervention matters: A comprehensive review of current evidence and recommendations for the monitoring of bone health in patients with cancer.

    Science.gov (United States)

    Brodowicz, Thomas; Hadji, Peyman; Niepel, Daniela; Diel, Ingo

    2017-12-01

    Bone metastases are common in patients with advanced solid tumors, and many individuals experience debilitating skeletal-related events (SREs; e.g. pathologic fracture, hypercalcemia, radiotherapy or surgery to bone, and spinal cord compression). These events substantially affect disease outcomes, including survival and quality of life, and healthcare systems. Plain radiography is the most widely used imaging modality for the detection of bone metastases; skeletal scintigraphy, computed tomography, positron emission tomography and magnetic resonance imaging offer greater sensitivity but their use in routine practice is restricted by high costs and limited availability. Biomarkers of bone turnover may also have a role in the early detection of bone metastases and can provide valuable prognostic information on disease progression. SREs can be delayed or prevented using agents such as the receptor activator of nuclear factor kappa B ligand (RANKL) inhibitor, denosumab, and bisphosphonates. Painful bone metastases can be treated with radiofrequency ablation, radiotherapy, or radionuclides such as radium-223 dichloride, which has been shown to delay the onset of SREs in men with castration-resistant prostate cancer. Close monitoring of bone health in patients with advanced cancer may lead to early identification of individuals with bone metastases who could benefit from early intervention to prevent SREs. This review examines current guideline recommendations for assessing and monitoring bone health in patients with advanced cancer, use of biomarkers and treatment of patients with bone metastases. The emerging evidence for the potential survival benefit conferred by early intervention with denosumab and bisphosphonates is also discussed, together with best practice recommendations. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Health-economic evaluation in implant trials: design considerations.

    Science.gov (United States)

    Alt, Volker; Pavlidis, Theodoros; Szalay, Gabor; Heiss, Christian; Schnettler, Reinhard

    2009-01-01

    In today's world, demonstration of the safety, efficacy, and quality of a new treatment strategy is no longer sufficient in many countries for market entry and reimbursement in the public healthcare system. This implies that new implants in orthopedic and orthopedic trauma surgery not only must be shown to lead to better medical outcome compared with the standard of care implant, but also must be shown to exhibit "good value" for the money for the public health-care system based on sound economic data from health-economic studies. The purpose of this article is to elucidate a framework for health-economic aspects alongside implant trials, with the assumption that the new implant is more costly but potentially better than the control implant. Cost-effectiveness, cost-utility, and cost-benefit studies are suitable for the assessment of the health-economic value of a new implant. The following criteria should be considered for a health-economic study design in the context with an implant: i) it should state medical benefits of the new implant compared with the control implant; ii) it should precise the type of health economic study; iii) it should define the methodological approach, perspective of the study, and types of costs; iv) if necessary, it should state discount costs and/benefits; and v) a sound sensitivity analysis should be included. Furthermore, close cooperation between researchers, clinicians, and health economists is essential.

  4. Physical Activity, Bone Health, and Obesity in Peri-/Pre- and Postmenopausal Women: Results from the EPIC-Potsdam Study.

    Science.gov (United States)

    Menzel, Juliane; di Giuseppe, Romina; Wientzek, Angelika; Kroke, Anja; Boeing, Heiner; Weikert, Cornelia

    2015-10-01

    Physical activity (PA) is suggested to increase the peak bone mass and to minimize age-related bone loss, and thereby to reduce the risk of osteoporosis. However, the relation between PA and bone health considering the obesity status is unclear so far. The present study examines the association between PA levels and calcaneal broadband ultrasound attenuation (BUA), particularly under consideration of obesity. Data from a population-based sample of 6776 German women from the EPIC-Potsdam cohort were analyzed. Calibrated PA data were used. Statistical analyses were stratified by menopausal and obesity status. Multiple linear regression was used to model the relationship between PA and BUA levels after adjustment for age, body mass index (BMI), smoking status, education, alcohol and calcium intake, and hormone use. Peri-/premenopausal had higher BUA levels (112.39 ± 10.05 dB/MHz) compared to postmenopausal women (106.44 ± 9.95 dB/MHz). In both groups, BUA levels were higher in the fourth compared to the lowest quartile of PA (p for trend obesity, a significant positive relationship was also observed in women with BMI < 30 kg/m(2) but with higher waist circumference or BF%. In conclusion, our results strengthen the hypothesis that PA has a positive influence on BUA levels, though dependent on weight.

  5. Plasma dimethylglycine, nicotine exposure and risk of low bone mineral density and hip fracture: the Hordaland Health Study.

    Science.gov (United States)

    Øyen, J; Svingen, G F T; Gjesdal, C G; Tell, G S; Ueland, P M; Lysne, V; Apalset, E M; Meyer, K; Vollset, S E; Nygård, O K

    2015-05-01

    In the large community-based Hordaland Health Study, low plasma dimethylglycine was associated with low bone mineral density in both middle-aged and elderly subjects and to an increased risk of subsequent hip fracture among the elderly. These associations seemed to be particularly strong among subjects exposed to nicotine. Dimethylglycine (DMG) is a product of the choline oxidation pathway and formed from betaine during the folate-independent remethylation of homocysteine (Hcy) to methionine. Elevated plasma DMG levels are associated with atherosclerotic cardiovascular disease and inflammation, which in turn are related to osteoporosis. High plasma total Hcy and low plasma choline are associated with low bone mineral density (BMD) and hip fractures, but the role of plasma DMG in bone health is unknown. We studied the associations of plasma DMG with BMD among 5315 participants (46-49 and 71-74 years old) and with hip fracture among 3310 participants (71-74 years old) enrolled in the Hordaland Health Study. In age and sex-adjusted logistic regression models, subjects in the lowest versus highest DMG tertile were more likely to have low BMD (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.43-1.99). The association was stronger in participants exposed compared to those unexposed to nicotine (OR 2.31, 95% CI 1.73-3.07 and OR 1.43, 95% CI 1.16-1.75, respectively, p interaction = 0.008). In the older cohort, Cox regression analyses adjusted for sex showed that low plasma DMG was associated with an increased risk of hip fracture (hazard ratio [HR] 1.70, 95% CI 1.28-2.26). A trend toward an even higher risk was found among women exposed to nicotine (HR 3.41, 95% CI 1.40-8.28). Low plasma DMG was associated with low BMD and increased risk of hip fractures. A potential effect modification by nicotine exposure merits particular attention.

  6. Bone Health and Osteoporosis: A Guide for Asian Women Aged 50 and Older

    Science.gov (United States)

    ... D You need calcium to help maintain healthy, strong bones throughout your life. Adults up to age 50 need 1,000 mg (milligrams) of calcium every day. Women over age 50 and men over age 70 should increase their intake to ...

  7. Vitamin B12: a novel indicator of bone health in vulnerable groups

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.

    2004-01-01

    Background: A number of modifiable predictors for osteoporosis and fractures have been identified, including nutritional factors, such as vitamin D deficiency and low calcium intake. Cobalamin deficiency has been suggested to affect bone metabolism. Pernicious anaemia, which can result in cobalamin

  8. Instrumental activation and X-ray fluorescent analysis of human bone in health and disease

    International Nuclear Information System (INIS)

    Zaichick, V.Y.

    1994-01-01

    A complex of methods for the in-vitro and in-vivo bone analysis was developed. Among the in-vitro methods are: INAA with reactor and 14 MeV neutrons, IGAA with 25 MeV linear accelerator; XRF with 55 Fe, 109 Cd, 241 Am radionuclide sources. Twenty-five elements could be analyzed by it: N, F, Na, Mg, P, Cl, K, Ca, Sc, Cr, Mn, Fe, Co, Zn, Se, Br, Rb, Sr, Ag, Sb, Cs, Ba, Tb, Hg, and Pb. Among the in-vivo methods are: INAA of band, foot and spine Ca and limb bone tumour Ca, Na and Cl with 238 Pu-Be neutron sources; IGAA of N and P in limb bone tumours; XRF of tooth Ca, Zn, Sr and Pb with 109 Cs radionuclide sources. The methods developed were used both in clinical and experimental medicine for studying the healthy human and animal bone with different diseases and environmental influence. (author) 28 refs.; 7 tabs

  9. Osteosarcoma and MFH of Bone Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Osteosarcoma and malignant fibrous histiocytoma (MFH) of bone are most successfully treated with a combination of systemic chemotherapy and complete resection of all clinically detectable disease. Get detailed information about the presentation, diagnosis, genomics, prognosis and treatment of osteosarcoma and MFH in this summary for clinicians.

  10. Advanced computer-aided design for bone tissue-engineering scaffolds.

    Science.gov (United States)

    Ramin, E; Harris, R A

    2009-04-01

    The design of scaffolds with an intricate and controlled internal structure represents a challenge for tissue engineering. Several scaffold-manufacturing techniques allow the creation of complex architectures but with little or no control over the main features of the channel network such as the size, shape, and interconnectivity of each individual channel, resulting in intricate but random structures. The combined use of computer-aided design (CAD) systems and layer-manufacturing techniques allows a high degree of control over these parameters with few limitations in terms of achievable complexity. However, the design of complex and intricate networks of channels required in CAD is extremely time-consuming since manually modelling hundreds of different geometrical elements, all with different parameters, may require several days to design individual scaffold structures. An automated design methodology is proposed by this research to overcome these limitations. This approach involves the investigation of novel software algorithms, which are able to interact with a conventional CAD program and permit the automated design of several geometrical elements, each with a different size and shape. In this work, the variability of the parameters required to define each geometry has been set as random, but any other distribution could have been adopted. This methodology has been used to design five cubic scaffolds with interconnected pore channels that range from 200 to 800 microm in diameter, each with an increased complexity of the internal geometrical arrangement. A clinical case study, consisting of an integration of one of these geometries with a craniofacial implant, is then presented.

  11. Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women.

    Science.gov (United States)

    Chilibeck, Philip D; Candow, Darren G; Landeryou, Tim; Kaviani, Mojtaba; Paus-Jenssen, Lisa

    2015-08-01

    Our primary purpose was to determine the effect of 12 months of creatine (Cr) supplementation during a supervised resistance training program on properties of bone in postmenopausal women. Participants were randomized (double-blind) into two groups: resistance training (3 d·wk) and Cr supplementation (0.1 g·kg·d) or resistance training and placebo (Pl). Our primary outcome measures were lumbar spine and femoral neck bone mineral density (BMD). Secondary outcome measures were total hip and whole-body BMD, bone geometric properties at the hip, speed of sound at the distal radius and tibia, whole-body lean tissue mass, muscle thickness, and bench press and hack squat strength. Forty-seven women (57 (SD, 6) yr; Cr, n = 23; Pl, n = 24) were randomized, with 33 analyzed after 12 months (Cr, n = 15; Pl, n = 18). Cr attenuated the rate of femoral neck BMD loss (-1.2%; absolute change (95% confidence interval), -0.01 (-0.025 to 0.005) g·cm) compared with Pl (-3.9%; -0.03 (-0.044 to -0.017) g·cm; P < 0.05) and also increased femoral shaft subperiosteal width, a predictor of bone bending strength (Cr, 0.04 (-0.09 to 0.16) cm); Pl, -0.12 (-0.23 to -0.01) cm; P < 0.05). Cr increased relative bench press strength more than Pl (64% vs 34%; P < 0.05). There were no differences between groups for other outcome measures. There were no differences between groups for reports of serum liver enzyme abnormalities, and creatinine clearance was normal for Cr participants throughout the intervention. Twelve months of Cr supplementation during a resistance training program preserves femoral neck BMD and increases femoral shaft superiosteal width, a predictor of bone bending strength, in postmenopausal women.

  12. NUDGING FOR HEALTH: ON PUBLIC POLICY AND DESIGNING CHOICE ARCHITECTURE

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a ‘nudge unit’ with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives. PMID:24081425

  13. Nudging for health: on public policy and designing choice architecture.

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a 'nudge unit' with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives.

  14. Comparison of two different abutment designs on marginal bone loss and soft tissue development

    NARCIS (Netherlands)

    Patil, Ratnadeep C.; den Hartog, Laurens; van Heereveld, Christiaan; Jagdale, Aditi; Dilbaghi, Anjali; Cune, Marco S.

    2014-01-01

    PURPOSE: To assess the response of soft tissues around two different abutment designs in healed sites in the esthetic zone. MATERIALS AND METHODS: Twenty-six subjects received two endosseous implants in healed, bilateral implant sites in the esthetic zone in the maxilla or the mandible. After 17 to

  15. Active design in affordable housing: A public health nudge

    Directory of Open Access Journals (Sweden)

    Elizabeth Garland

    2018-06-01

    Full Text Available This pilot study investigates the impact of active design (AD strategies on physical activity (PA among adults living in two Leadership in Energy and Environmental Design (LEED certified affordable housing developments in the South Bronx, New York. One building incorporates LEED Innovation in Design (ID Credit: Design for Health through Increased Physical Activity. Tenants in an affordable housing building (AH incorporating active design strategies completed PA self-assessments at their lease signing and one year later in 2015. Trained research assistants obtained body measurements. Residents of neighboring non-AD affordable housing (MCV served as a comparison. Thirty four adults were recruited from AH and 29 from MCV, retention was 56% (n = 19 and 52% (n = 15 respectively at one year. The two groups' body mass index (BMI and high-risk waist-to-hip ratio (WHR were not statistically significantly different when analyzed as continuous variables, although BMI category had a greater decline at AH than at MCV (p = 0.054. There was a 31.5% increase in AH participants meeting MPA requirements and a statistically significant improvement in females (p = 0.031; while there was no change in the MCV participants overall or when stratified by gender. AH participants were significantly more likely to have reported increased stair use and less likely to have reported no change or decreased stair use than participants from MCV participants (p = 0.033. Housing has a role in individual health outcomes and behavior change, broad adoption of active design strategies in affordable housing is warranted to improve physical activity measures. Keywords: Active design, Physical activity, Built environment, Affordable housing

  16. Using optical tweezers for measuring the interaction forces between human bone cells and implant surfaces: System design and force calibration

    International Nuclear Information System (INIS)

    Andersson, Martin; Madgavkar, Ashwin; Stjerndahl, Maria; Wu, Yanrong; Tan, Weihong; Duran, Randy; Niehren, Stefan; Mustafa, Kamal; Arvidson, Kristina; Wennerberg, Ann

    2007-01-01

    Optical tweezers were used to study the interaction and attachment of human bone cells to various types of medical implant materials. Ideally, the implant should facilitate cell attachment and promote migration of the progenitor cells in order to decrease the healing time. It is therefore of interest, in a controlled manner, to be able to monitor the cell adhesion process. Results from such studies would help foresee the clinical outcome of integrating medical implants. The interactions between two primary cell culture models, human gingival fibroblasts and bone forming human osteoblast cells, and three different implant materials, glass, titanium, and hydroxyapatite, were studied. A novel type of optical tweezers, which has a newly designed quadrant detector and a powerful 3 W laser was constructed and force calibrated using two different methods: one method in which the stiffness of the optical trap was obtained by monitoring the phase lag between the trap and the moved object when imposing a forced oscillation on the trapped object and another method in which the maximum trapping force was derived from the critical velocity at which the object escapes the trap. Polystyrene beads as well as cells were utilized for the calibrations. This is the first time that cells have been used directly for these types of force calibrations and, hence, direct measurements of forces exerted on cells can be performed, thus avoiding the difficulties often encountered when translating the results obtained from cell measurements to the calibrations obtained with reference materials. This more straightforward approach represents an advantage in comparison to established methods

  17. Introducing an attractive method for total biomimetic creation of a synthetic biodegradable bioactive bone scaffold based on statistical experimental design.

    Science.gov (United States)

    Shahbazi, Sara; Zamanian, Ali; Pazouki, Mohammad; Jafari, Yaser

    2018-05-01

    A new total biomimetic technique based on both the water uptake and degradation processes is introduced in this study to provide an interesting procedure to fabricate a bioactive and biodegradable synthetic scaffold, which has a good mechanical and structural properties. The optimization of effective parameters to scaffold fabrication was done by response surface methodology/central composite design (CCD). With this method, a synthetic scaffold was fabricated which has a uniform and open-interconnected porous structure with the largest pore size of 100-200μm. The obtained compressive ultimate strength of ~35MPa and compression modulus of 58MPa are similar to some of the trabecular bone. The pore morphology, size, and distribution of the scaffold were characterized using a scanning electron microscope and mercury porosimeter. Fourier transform infrared spectroscopy, EDAX and X-ray diffraction analyses were used to determine the chemical composition, Ca/P element ratio of mineralized microparticles, and the crystal structure of the scaffolds, respectively. The optimum biodegradable synthetic scaffold based on its raw materials of polypropylene fumarate, hydroxyethyl methacrylate and nano bioactive glass (PPF/HEMA/nanoBG) as 70/30wt/wt%, 20wt%, and 1.5wt/wt% (PHB.732/1.5) with desired porosity, pore size, and geometry were created by 4weeks immersion in SBF. This scaffold showed considerable biocompatibility in the ranging from 86 to 101% for the indirect and direct contact tests and good osteoblast cell attachment when studied with the bone-like cells. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Dental Implants in an Aged Population: Evaluation of Periodontal Health, Bone Loss, Implant Survival, and Quality of Life.

    Science.gov (United States)

    Becker, William; Hujoel, Philippe; Becker, Burton E; Wohrle, Peter

    2016-06-01

    To evaluate aged partially and fully edentulous patients who received dental implants and were maintained over time. Further, to determine how the partially and edentulous ageing populations (65 and above) with dental implants maintain bone levels, proper oral hygiene, and perceive benefits of dental implants. Since 1995, patients receiving dental implants have been prospectively entered into an Access-based computerized program (Triton Tacking System). Patient demographics (age, sex), bone quality, quantity, implant location, and type of surgery have been continuously entered into the database. The database was queried for patients receiving implants (first stage) between 66 and 93 years of age. Thirty-one patients were within this age group. Twenty-five patients returned to the clinic for periodontal and dental implant evaluation. The Periodontal Index was used to evaluate selected teeth in terms of probing depth, bleeding on probing, plaque accumulation, and mobility. Using NIH Image J, radiographs taken at second stage and last examination were measured for changes in interproximal bone levels. Once identified, each patient anomalously filled out an abbreviated quality of health life form. Due to small sample size, descriptive statistics were used to compare clinical findings. Fifteen males ranging from 78 to 84 (mean age 84 years) years and 16 females from 66 to 93 (mean age 83 years) (age range 66-93) were contacted by phone or mail and asked to return to our office for a re-examination. For this group, the first dental implants were placed in 1996 (n = initial two implants) and continuously recorded through 2013 (n = last seven implants). Thirty-one patients received a total of 84 implants. Two patients were edentulous, and the remaining were partially edentulous. Four implants were lost. Between implant placement and 6- to 7-year interval, 13 patients with 40 implants had a cumulative survival rate of 94.6%. Of the original group (n = 33), three

  19. Vitamin D Intake among Premenopausal Women Living in Jeddah: Food Sources and Relationship to Demographic Factors and Bone Health

    Directory of Open Access Journals (Sweden)

    Tahani A. Zareef

    2018-01-01

    Full Text Available Background. Saudi women depend on food sources to maintain their serum 25(OH D concentrations because covering by traditional clothing and time spent indoors limit their sun exposure. Little is known about vitamin D intake and its main food sources in Saudi Arabia. In addition, the association between vitamin D and calcium intake and bone mineral density (BMD in young women is not well researched. Objectives. To assess the adequacy of vitamin D intake among Saudi women as compared to the estimated average requirements (EARs, to identify dietary vitamin D sources, to examine potential determinants of vitamin D intake, and to assess bone health and the association of calcium and vitamin D intake with BMD. Methods. This cross-sectional study was conducted in 257 premenopausal women aged 20–50 years in Jeddah, Saudi Arabia. Dietary vitamin D and calcium were assessed by the Semiquantitative Food Frequency Questionnaire. BMD was measured using dual-energy X-ray absorptiometry (DXA in a subset of women n=102 at the lumbar spine and femur neck. Results. Sixty-five percent of women were below the EAR for vitamin D, and 61% fell below the EAR for calcium. Dairy products, supplements, and fish contributed most to vitamin D intake. Increased age was an independent determinant of sufficient vitamin D intake p<0.001. The prevalence of osteopenia was 33% in the lumbar spine and 30% in the femur neck. There was a significant positive association between calcium intake and BMD at the lumbar spine p=0.043 after controlling for body mass index and energy intake. Vitamin D intake was not significantly different between women with low and normal bone mass. Conclusion. Premenopausal women in Jeddah have insufficient vitamin D and calcium intakes. Public health strategies to improve nutrition in young women are needed, and expanding fortification programs to include all dairy products would be useful.

  20. Exposure to urban air pollution and bone health in clinically healthy six-year-old children.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Mora-Tiscareño, Antonieta; Francolira, Maricela; Torres-Jardón, Ricardo; Peña-Cruz, Bernardo; Palacios-López, Carolina; Zhu, Hongtu; Kong, Linglong; Mendoza-Mendoza, Nicolás; Montesinoscorrea, Hortencia; Romero, Lina; Valencia-Salazar, Gildardo; Kavanaugh, Michael; Frenk, Silvestre

    2013-01-01

    Air pollution induces systemic inflammation, as well as respiratory, myocardial and brain inflammation in children. Peak bone mass is influenced by environmental factors. We tested the hypothesis that six-year-olds with lifetime exposures to urban air pollution will have alterations in inflammatory markers and bone mineral density (BMD) as opposed to low-polluted city residents when matched for BMI, breast feeding history, skin phototype, age, sex and socioeconomic status. This pilot study included 20 children from Mexico City (MC) (6.17 years ± 0.63 years) and 15 controls (6.27 years ± 0.76 years). We performed full paediatric examinations, a history of outdoor exposures, seven-day dietary recalls, serum inflammatory markers and dual-energy X-ray absorptiometry (DXA). Children in MC had significantly higher concentrations of IL-6 (p=0.001), marked reductions in total blood neutrophils (p= 0.0002) and an increase in monocytes (p=0.005). MC children also had an insufficient Vitamin D intake and spent less time outdoors than controls (p<0.001) in an environment characterized by decreased UV light, with ozone and fine particulates concentrations above standard values. There were no significant differences between the cohorts in DXA Z scores. The impact of systemic inflammation, vitamin D insufficiency, air pollution, urban violence and poverty may have long-term bone detrimental outcomes in exposed paediatric populations as they grow older, increasing the risk of low bone mass and osteoporosis. The selection of reference populations for DXA must take into account air pollution exposures.

  1. The Impact of Sweat Calcium Loss on Bone Health in Soldiers: A Pilot Study

    Science.gov (United States)

    2013-02-06

    Metabolic Status. Predicting decrements in physiological and cognitive performance. IOM, The National Academies Press, Washington, D.C. pp 352- 353... basketball players. The investigators were able to link decreases in total bone mineral content (6.1% overall, 10.5% in legs) to the high calcium...such information on physiologic measures into ongoing studies. Over the past 5 years there have been a few published descriptive studies (Lester et

  2. The Consequences of Modern Military Deployment on Calcium Status and Bone Health

    Science.gov (United States)

    2010-01-01

    tissue disorders were the predominant illness and injury- related category for ambulatory visits in military clinics and facilities in 2008, accounting...tobacco use, high bone turnover rates, and family history of osteoporosis all contribute to a higher risk of osteoporosis .23 During the physical...Soldiers reported they did not consume large quantities of milk in Baghdad because of its unpleasant taste. Increased skin pigmen- tation, obesity , and

  3. Evaluation of a "Just-in-Time" Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Roblin, Douglas W; Zelman, David; Plummer, Sally; Robinson, Brandi E; Lou, Yiyue; Edmonds, Stephanie W; Wolinsky, Fredric D; Saag, Kenneth G; Cram, Peter

    2017-01-01

    Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes. To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care. Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662). After DXA, consenting adults age 50 years or older were randomly assigned to 3 groups: nurse consultation, PAADRN intervention (mailed letter with individualized fracture risk and an educational brochure), or usual care (control). Nurse consultation included reviewing DXA results, counseling on bone health, and ordering needed follow-up tests or physician referrals. Change from baseline to 52 weeks in participant-reported osteoporosis-related pharmacotherapy, lifestyle, activation and self-efficacy, and osteoporosis care satisfaction. Nurse consultation participants (n = 104) reported 52-week improvements in strengthening and weight-bearing exercise (p = 0.09), calcium intake (p Just-in-time" nurse consultation yielded a few improvements over 52 weeks in osteoporosis-related outcomes; however, most changes were not different from those obtained through the lower-cost PAADRN intervention or usual care.

  4. Active design in affordable housing: A public health nudge.

    Science.gov (United States)

    Garland, Elizabeth; Garland, Victoria; Peters, Dominique; Doucette, John; Thanik, Erin; Rajupet, Sritha; Sanchez, Sadie H

    2018-06-01

    This pilot study investigates the impact of active design (AD) strategies on physical activity (PA) among adults living in two Leadership in Energy and Environmental Design (LEED) certified affordable housing developments in the South Bronx, New York. One building incorporates LEED Innovation in Design (ID) Credit: Design for Health through Increased Physical Activity. Tenants in an affordable housing building (AH) incorporating active design strategies completed PA self-assessments at their lease signing and one year later in 2015. Trained research assistants obtained body measurements. Residents of neighboring non-AD affordable housing (MCV) served as a comparison. Thirty four adults were recruited from AH and 29 from MCV, retention was 56% (n = 19) and 52% (n = 15) respectively at one year. The two groups' body mass index (BMI) and high-risk waist-to-hip ratio (WHR) were not statistically significantly different when analyzed as continuous variables, although BMI category had a greater decline at AH than at MCV (p = 0.054). There was a 31.5% increase in AH participants meeting MPA requirements and a statistically significant improvement in females (p = 0.031); while there was no change in the MCV participants overall or when stratified by gender. AH participants were significantly more likely to have reported increased stair use and less likely to have reported no change or decreased stair use than participants from MCV participants (p = 0.033). Housing has a role in individual health outcomes and behavior change, broad adoption of active design strategies in affordable housing is warranted to improve physical activity measures.

  5. Metabolic control and bone health in adolescents with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Mohan Subburaman

    2011-10-01

    Full Text Available Abstract Background Adults with type 1 diabetes (T1D have decreased bone mineral density (BMD and increased fracture risk, yet the etiologies remain elusive. Early detection of derangements in bone biomarkers during adolescence could lead to timely recognition. In adolescents with T1D, we evaluated the relationships between metabolic control, BMD, and bone anabolic and turnover markers. Methods Cross-sectional study of 57 adolescent subjects with T1D who had HbA1c consistently ≥ 9% (Poor Control, PC n = 27 or Results There were no differences between HbA1c groups in BMD, components of the IGF system, or 25-hydroxyvitamin D status. The prevalence of 25-hydroxyvitamin D abnormalities was similar to that seen in the general adolescent population. Few patients met the recommended dietary allowance (RDA for vitamin D or calcium. Conclusions These data provide no evidence of association between degree of metabolic control and BMD in adolescents with T1D. Adolescents with T1D have a high prevalence of serum 25-hydroxyvitamin D abnormalities. Longitudinal studies are needed to evaluate the predictive value of vitamin D abnormalities on fracture risk.

  6. Analysis of the relationships between edentulism, periodontal health, body composition, and bone mineral density in elderly women

    Directory of Open Access Journals (Sweden)

    Ignasiak Z

    2016-03-01

    Full Text Available Zofia Ignasiak,1 Malgorzata Radwan-Oczko,2 Krystyna Rozek-Piechura,3 Marta Cholewa,4 Anna Skrzek,5 Tomasz Ignasiak,6 Teresa Slawinska1 1Department of Biostructure, University School of Physical Education, Wroclaw, Poland; 2Department of Periodontology, Wroclaw Medical University, Wroclaw, Poland; 3Department of Physiotherapy and Occupation Therapy in Internal Diseases, University School of Physical Education, Wroclaw, Poland; 4DENTARAMA Dentistry Center, Walbrzych, Poland; 5Department of Physiotherapy and Ocupation Therapy in Motor-System Dysfunction, University School of Physical Education, Wroclaw, Poland; 6Karkonosze State Higher School in Jelenia Gora, Jelenia Gora, Poland Objective: The relationship between bone mineral density (BMD and tooth loss in conjunction with periodontal disease is not clear. The suggested effects include alteration in bone remodeling rates as well as the multifaceted etiology of edentulism. There is also a question if other body-related variables besides BMD, such as body composition, may be associated with tooth number and general periodontal health. The aim of this study was to evaluate if tooth number and marginal periodontal status are associated with body composition and BMD in a sample of elderly women. Materials and methods: The study involved 91 postmenopausal women. Data included basic anthropometric characteristics, body composition via bioelectrical impedance analysis, and BMD analysis at the distal end of the radial bone of the nondominant arm via peripheral dual-energy X-ray absorptiometry. A dental examination was performed to assess tooth number, periodontal pocket depth (PD, and gingival bleeding. Results: In nonosteoporotic women, a significant positive correlation was found between BMD and lean body mass, total body water, and muscle mass. The indicators of bone metabolism correlated negatively with PD. Such relationships did not appear in osteoporotic women. In both groups, basic anthropometric

  7. Design of smart neonatal health monitoring system using SMCC.

    Science.gov (United States)

    De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

    2017-02-01

    Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

  8. Design and application of hybrid maxillomandibular fixation for facial bone fractures.

    Science.gov (United States)

    Park, Kang-Nam; Oh, Seung-Min; Lee, Chang-Youn; Kim, Jwa-Young; Yang, Byoung-Eun

    2013-01-01

    A novel maxillomandibular fixation (MMF) procedure using a skeletal anchorage screw (SAS) (in the maxilla) and an arch bar (in the mandible), which we call "hybrid maxillomandibular fixation," was explored in this study. The aims of the study were to examine the efficacy of our hybrid MMF method and to compare periodontal tissue health and occlusal rehabilitation among 3 MMF methods. In total, 112 patients who had undergone open reduction at the Department of Oral and Maxillofacial Surgery between September 2005 and December 2012 were selected for this study. The participants were assigned to one of the following groups: SAS (maxilla), SAS (mandible), SAS-arch bar, or arch bar-arch bar. Periodontal health was evaluated using the Gingival Index, and the perioperative occlusal reproducibility was evaluated using a score of 1 to 3. Statistical analysis was performed using parametric tests (Student t test or 1-way analysis of variance followed by post hoc Tukey test). In the Gingival Index comparison performed 1 month after the surgery, only the group using the arch bars and wiring was significantly different from the other groups (P fractures. In addition, it overcomes many problems presented by previous MMF methods.

  9. Mechanical characterization of structurally porous biomaterials built via additive manufacturing: experiments, predictive models, and design maps for load-bearing bone replacement implants.

    Science.gov (United States)

    Melancon, D; Bagheri, Z S; Johnston, R B; Liu, L; Tanzer, M; Pasini, D

    2017-11-01

    Porous biomaterials can be additively manufactured with micro-architecture tailored to satisfy the stringent mechano-biological requirements imposed by bone replacement implants. In a previous investigation, we introduced structurally porous biomaterials, featuring strength five times stronger than commercially available porous materials, and confirmed their bone ingrowth capability in an in vivo canine model. While encouraging, the manufactured biomaterials showed geometric mismatches between their internal porous architecture and that of its as-designed counterpart, as well as discrepancies between predicted and tested mechanical properties, issues not fully elucidated. In this work, we propose a systematic approach integrating computed tomography, mechanical testing, and statistical analysis of geometric imperfections to generate statistical based numerical models of high-strength additively manufactured porous biomaterials. The method is used to develop morphology and mechanical maps that illustrate the role played by pore size, porosity, strut thickness, and topology on the relations governing their elastic modulus and compressive yield strength. Overall, there are mismatches between the mechanical properties of ideal-geometry models and as-manufactured porous biomaterials with average errors of 49% and 41% respectively for compressive elastic modulus and yield strength. The proposed methodology gives more accurate predictions for the compressive stiffness and the compressive strength properties with a reduction of the average error to 11% and 7.6%. The implications of the results and the methodology here introduced are discussed in the relevant biomechanical and clinical context, with insight that highlights promises and limitations of additively manufactured porous biomaterials for load-bearing bone replacement implants. In this work, we perform mechanical characterization of load-bearing porous biomaterials for bone replacement over their entire design

  10. Prosthetically guided bone sculpturing for a maxillary complete-arch implant-supported monolithic zirconia fixed prosthesis based on a digital smile design: A clinical report.

    Science.gov (United States)

    Rojas-Vizcaya, Fernando

    2017-11-01

    A digital smile design was used to create an average smile and to develop a removable interim restoration for an edentulous patient with a high smile line and different bone levels in the maxilla. The interim restoration was used as a guide to perform bone sculpturing to create space for the biological width and to restore a monolithic zirconia implant-supported fixed restoration. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  11. Inulin supplementation reduces the negative effect of a high-fat diet rich in SFA on bone health of growing pigs.

    Science.gov (United States)

    Sobol, Monika; Raj, Stanisława; Skiba, Grzegorz

    2018-05-01

    Consumption of a high-fat diet, rich in SFA, causes deterioration of bone properties. Some studies suggest that feeding inulin to animals may increase mineral absorption and positively affect bone quality; however, these studies have been carried out only on rodents fed a standard diet. The primary objective of this study was to determine the effect of inulin on bone health of pigs (using it as an animal model for humans) fed a high-fat diet rich in SFA, having an unbalanced ratio of lysine:metabolisable energy. It was hypothesised that inulin reduces the negative effects of such a diet on bone health. At 50 d of age, twenty-one pigs were randomly allotted to three groups: the control (C) group fed a standard diet, and two experimental (T and TI) groups fed a high-fat diet rich in SFA. Moreover, TI pigs consumed an extra inulin supply (7 % of daily feed intake). After 10 weeks, whole-body bone mineral content (P=0·0054) and bone mineral density (P=0·0322) were higher in pigs of groups TI and C compared with those of group T. Femur bone mineral density was highest in pigs in group C, lower in group TI and lowest in group T (P=0·001). Femurs of pigs in groups TI and C had similar, but higher, maximum strength compared with femurs of pigs in group T (P=0·0082). In conclusion, consumption of a high-fat diet rich in SFA adversely affected bone health, but inulin supplementation in such a diet diminishes this negative effect.

  12. Impact of Futsal and Swimming Participation on Bone Health in Young Athletes

    Directory of Open Access Journals (Sweden)

    Seabra André

    2017-12-01

    Full Text Available Physical activity plays a crucial role in bone mass acquisition during childhood and adolescence, with weightbearing and high-impact sport activities being more beneficial. This study sought to evaluate the impact of different sports activities on bone mineral density and content in male Portuguese athletes. Seventy adolescent boys (aged 12-15 years including 28 futsal players (FG, 20 swimmers (SG and 22 non-athletic adolescents used as control subjects (CG, participated in the current study. Areal bone mineral density (aBMD and areal bone mineral content (aBMC were measured by dual energy x-ray absorptiometry (DEXA. Futsal players had significantly higher aBMD (lumbar spine - FG: 0.95 ± 0.18, SG: 0.80 ± 0.13, CG: 0.79 ± 0.13 g/cm2, p = 0.001; pelvis - FG: 1.17 ± 0.21, SG: 0.91 ± 0.12, CG: 0.98 ± 0.10 g/cm2, p < 0.001; lower limbs - FG: 1.21 ± 0.19, SG: 0.97 ± 0.10, CG: 0.99 ± 0.09 g/cm2, p < 0.001 and aBMC (lumbar spine - FG: 51.07 ± 16.53, SG: 40.19 ± 12.47, CG: 40.50 ± 10.53 g, p = 0.013; pelvis - FG: 299.5 ± 110.61, SG: 170.02 ± 55.82, CG: 183.11 ± 46.78 g, p < 0.001; lower limbs - FG: 427.21 ± 117.11, SG: 300.13 ± 76.42, CG: 312.26 ± 61.86 g/cm2, p < 0.001 than swimmers and control subjects. Data suggest that futsal, as a weightbearing and high or odd-impact sport, may improve bone mass during childhood and adolescence.

  13. Mechanism of action study to evaluate the effect of rosiglitazone on bone in postmenopausal women with type 2 diabetes mellitus: rationale, study design and baseline characteristics

    Science.gov (United States)

    Fitzpatrick, Lorraine A.; Bilezikian, John P.; Wooddell, Margaret; Paul, Gitanjali; Kolatkar, Nikheel S.; Nino, Antonio J.; Miller, Colin G.; Bogado, Cesar E.; Arnaud, Claude D.; Cobitz, Alexander R.

    2012-01-01

    Objectives Post-hoc analyses have shown an increase incidence of fractures among type 2 diabetes (T2DM) patients treated with thiazolidinediones (TZDs). The mechanisms by which TZDs may be associated with increased fracture risk is not well understood. This article describes the study design and baseline characteristics for a prospective, randomized, double-blind, active-controlled trial to evaluate the effects of rosiglitazone on changes in measures of skeletal structure, surrogates of bone strength and metabolism. Methods Postmenopausal women without osteoporosis and diagnosed with T2DM were randomized in a double-blind design to either rosiglitazone or metformin for 52 weeks, then all subjects received open-label metformin for 24 weeks. Study endpoints included changes in bone mineral density (BMD), quantitative computed tomography (QCT), digitized hip radiography (HXR) and high resolution magnetic resonance imaging (hrMRI). Serum markers of bone metabolism and indices of glycemic control were assessed within and between treatment groups. Results A total of 226 subjects were randomized. Baseline characteristics included: age 63.8 ± 6.5 years; years postmenopausal 16.9 ± 8.4; duration of diabetes 3.5 (1.8–7.8) years; body mass index (BMI) 31.4 ± 5.9 kg/m2; and glycated hemoglobin (HbA1c) 6.4 ± 0.65%. At baseline, mean T-scores were −0.95 ± 0.91 at the femoral neck, −0.02 ± 0.97 at the total hip and −0.55 ± 1.25 at the total spine. Since there are no well recognized techniques to determine bone mass and structure at the distal limbs (cortical bone sites where fractures were reported in RSG subjects), using the femoral neck as a surrogate for these areas may be a potential limitation of the study. Conclusion This is the first randomized trial utilizing multiple techniques to evaluate bone mass, structure, serum markers of bone remodeling, and potential reversibility of changes after discontinuation of rosiglitazone. This

  14. Design for Health and Well Being: Knitted Products for Diabetics

    Science.gov (United States)

    Gault, A.

    2016-07-01

    This paper will discuss the design development, manufacturing and testing of knitted products maximizing the use of new innovations in Nano- technology and the integration of Phase Changing Materials specifically for diabetics. The project identified key aspects requiring design solutions to bring improvement to the circulatory problems with specific reference to the diabetic condition. Diabetics have particular difficulty in regulating their body temperature and this can result in the condition worsening, and resulting in loss of digits or limbs. The design of products to prevent the deterioration of the diabetic condition and to help those with limb loss was developed in collaboration with a Northern Ireland diabetic consultant, a product engineer and a knitwear designer. The fusion of ideas between the stakeholders resulted in the development and manufacture of a range of products that have been successfully tested at the yarn and fabric development stage and have been proven to maintain body temperature by either cooling or warming and therefore bring improvement to health and well-being. Whilst the product has a performance element the design ideas created desirable products that not only provided solutions to the brief but also resulted in products that had further market applications.

  15. Designing food structures for nutrition and health benefits.

    Science.gov (United States)

    Norton, Jennifer E; Wallis, Gareth A; Spyropoulos, Fotis; Lillford, Peter J; Norton, Ian T

    2014-01-01

    In addition to providing specific sensory properties (e.g., flavor or textures), there is a need to produce foods that also provide functionality within the gastrointestinal (GI) tract, over and above simple nutrition. As such, there is a need to understand the physical and chemical processes occurring in the mouth, stomach, small intestine, and large intestine, in addition to the food structure-physiology interactions. In vivo techniques and in vitro models have allowed us to study and simulate these processes, which aids us in the design of food microstructures that can provide functionality within the human body. Furthermore, it is important to be aware of the health or nutritional needs of different groups of consumers when designing food structures, to provide targeted functionality. Examples of three groups of consumers (elderly, obese, and athletes) are given to demonstrate their differing nutritional requirements and the formulation engineering approaches that can be utilized to improve the health of these individuals. Eating is a pleasurable process, but foods of the future will be required to provide much more in terms of functionality for health and nutrition.

  16. Molecular interactions in biomineralized hydroxyapatite amino acid modified nanoclay: In silico design of bone biomaterials

    International Nuclear Information System (INIS)

    Katti, Dinesh R.; Sharma, Anurag; Ambre, Avinash H.; Katti, Kalpana S.

    2015-01-01

    A simulations driven approach to design of a novel biomaterial nanocomposite system is described in this study. Nanoclays modified with amino acids (OMMT) were used to mineralize hydroxyapatite (HAP), mimicking biomineralization. Representative models of organically modified montmorillonite clay (OMMT) and OMMT-hydroxyapatite (OMMT-HAP) were constructed using molecular dynamics and validated using X-ray Diffraction (XRD), Fourier Transforms Infrared (FTIR) spectroscopy and Transmission Electron Microscopy (TEM). Attractive interactions exist between Ca atoms of HAP and C=O group of aminovaleric acid, indicating chelate formation in OMMT-HAP. Interaction energy maps describe molecular interactions among different constituents and their quantitative contributions in the OMMT and OMMT-HAP systems at both parallel and perpendicular orientations. High attractive and high repulsive interactions were found between PO 4 3− and MMT clay as well as aminovaleric molecules in OMMT-HAP perpendicular and parallel models. Large non-bonded interactions in OMMT-HAP indicate influence of neighboring environment on PO 4 3− in in situ HAPclay. Extensive hydrogen bonds were observed between functional hydrogen atoms of modifier and MMT clay in OMMT-HAP as compared to OMMT. Thus, HAP interacts with clay through the aminovaleric acid. This computational study provides a framework for materials design and selection for biomaterials used in tissue engineering and other areas of regenerative medicine. - Highlights: • Representative models of a hybrid nanoclay-hydroxyapatite biomaterial are built. • Interaction energy maps are constructed using a molecular dynamics. • Quantitative interactions between the three components of the biomaterial are found. • The modeling and experimental approach provides insight into the complex nanomaterial

  17. Methodological design of the National Health and Nutrition Survey 2016

    Directory of Open Access Journals (Sweden)

    Martín Romero-Martínez

    2017-05-01

    Full Text Available Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the in­habitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. Results. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. Conclusions. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on over­weight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.

  18. Structural health monitoring feature design by genetic programming

    International Nuclear Information System (INIS)

    Harvey, Dustin Y; Todd, Michael D

    2014-01-01

    Structural health monitoring (SHM) systems provide real-time damage and performance information for civil, aerospace, and other high-capital or life-safety critical structures. Conventional data processing involves pre-processing and extraction of low-dimensional features from in situ time series measurements. The features are then input to a statistical pattern recognition algorithm to perform the relevant classification or regression task necessary to facilitate decisions by the SHM system. Traditional design of signal processing and feature extraction algorithms can be an expensive and time-consuming process requiring extensive system knowledge and domain expertise. Genetic programming, a heuristic program search method from evolutionary computation, was recently adapted by the authors to perform automated, data-driven design of signal processing and feature extraction algorithms for statistical pattern recognition applications. The proposed method, called Autofead, is particularly suitable to handle the challenges inherent in algorithm design for SHM problems where the manifestation of damage in structural response measurements is often unclear or unknown. Autofead mines a training database of response measurements to discover information-rich features specific to the problem at hand. This study provides experimental validation on three SHM applications including ultrasonic damage detection, bearing damage classification for rotating machinery, and vibration-based structural health monitoring. Performance comparisons with common feature choices for each problem area are provided demonstrating the versatility of Autofead to produce significant algorithm improvements on a wide range of problems. (paper)

  19. Maternal High Fat Feeding Does Not Have Long-Lasting Effects on Body Composition and Bone Health in Female and Male Wistar Rat Offspring at Young Adulthood

    Directory of Open Access Journals (Sweden)

    Paula M. Miotto

    2013-12-01

    Full Text Available High fat diets adversely affect body composition, bone mineral and strength, and alter bone fatty acid composition. It is unclear if maternal high fat (HF feeding permanently alters offspring body composition and bone health. Female rats were fed control (CON or HF diet for 10 weeks, bred, and continued their diets throughout pregnancy and lactation. Male and female offspring were studied at weaning and 3 months, following consumption of CON diet. At weaning, but not 3 months of age, male and female offspring from dams fed HF diet had lower lean mass and higher fat and bone mass, and higher femur bone mineral density (females only than offspring of dams fed CON diet. Male and female offspring femurs from dams fed HF diet had higher monounsaturates and lower n6 polyunsaturates at weaning than offspring from dams fed CON diet, where females from dams fed HF diet had higher saturates and lower n6 polyunsaturates at 3 months of age. There were no differences in strength of femurs or lumbar vertebrae at 3 months of age in either male or female offspring. In conclusion, maternal HF feeding did not permanently affect body composition and bone health at young adulthood in offspring.

  20. Health impact assessment in planning: Development of the design for health HIA tools

    International Nuclear Information System (INIS)

    Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

    2010-01-01

    How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

  1. A synergistic approach to the design, fabrication and evaluation of 3D printed micro and nano featured scaffolds for vascularized bone tissue repair

    International Nuclear Information System (INIS)

    Holmes, Benjamin; Bulusu, Kartik; Plesniak, Michael; Zhang, Lijie Grace

    2016-01-01

    3D bioprinting has begun to show great promise in advancing the development of functional tissue/organ replacements. However, to realize the true potential of 3D bioprinted tissues for clinical use requires the fabrication of an interconnected and effective vascular network. Solving this challenge is critical, as human tissue relies on an adequate network of blood vessels to transport oxygen, nutrients, other chemicals, biological factors and waste, in and out of the tissue. Here, we have successfully designed and printed a series of novel 3D bone scaffolds with both bone formation supporting structures and highly interconnected 3D microvascular mimicking channels, for efficient and enhanced osteogenic bone regeneration as well as vascular cell growth. Using a chemical functionalization process, we have conjugated our samples with nano hydroxyapatite (nHA), for the creation of novel micro and nano featured devices for vascularized bone growth. We evaluated our scaffolds with mechanical testing, hydrodynamic measurements and in vitro human mesenchymal stem cell (hMSC) adhesion (4 h), proliferation (1, 3 and 5 d) and osteogenic differentiation (1, 2 and 3 weeks). These tests confirmed bone-like physical properties and vascular-like flow profiles, as well as demonstrated enhanced hMSC adhesion, proliferation and osteogenic differentiation. Additional in vitro experiments with human umbilical vein endothelial cells also demonstrated improved vascular cell growth, migration and organization on micro-nano featured scaffolds. (paper)

  2. A synergistic approach to the design, fabrication and evaluation of 3D printed micro and nano featured scaffolds for vascularized bone tissue repair

    Science.gov (United States)

    Holmes, Benjamin; Bulusu, Kartik; Plesniak, Michael; Zhang, Lijie Grace

    2016-02-01

    3D bioprinting has begun to show great promise in advancing the development of functional tissue/organ replacements. However, to realize the true potential of 3D bioprinted tissues for clinical use requires the fabrication of an interconnected and effective vascular network. Solving this challenge is critical, as human tissue relies on an adequate network of blood vessels to transport oxygen, nutrients, other chemicals, biological factors and waste, in and out of the tissue. Here, we have successfully designed and printed a series of novel 3D bone scaffolds with both bone formation supporting structures and highly interconnected 3D microvascular mimicking channels, for efficient and enhanced osteogenic bone regeneration as well as vascular cell growth. Using a chemical functionalization process, we have conjugated our samples with nano hydroxyapatite (nHA), for the creation of novel micro and nano featured devices for vascularized bone growth. We evaluated our scaffolds with mechanical testing, hydrodynamic measurements and in vitro human mesenchymal stem cell (hMSC) adhesion (4 h), proliferation (1, 3 and 5 d) and osteogenic differentiation (1, 2 and 3 weeks). These tests confirmed bone-like physical properties and vascular-like flow profiles, as well as demonstrated enhanced hMSC adhesion, proliferation and osteogenic differentiation. Additional in vitro experiments with human umbilical vein endothelial cells also demonstrated improved vascular cell growth, migration and organization on micro-nano featured scaffolds.

  3. Biomechanical Influence of Implant Neck Designs on Stress Distribution over Adjacent Bone: A Three-Dimensional Non-Linear Finite Element Analysis

    Science.gov (United States)

    Ikman Ishak, Muhammad; Shafi, Aisyah Ahmad; Mohamad, Su Natasha; Jizat, Noorlindawaty Md

    2018-03-01

    The design of dental implant body has a major influence on the stress dissipation over adjacent bone as numbers of implant failure cases reported in past clinical studies. Besides, the inappropriate implant features may cause excessive high or low stresses which could possibly contribute to pathologic bone resorption or atrophy. The aim of this study is to evaluate the effect of different configurations of implant neck on stress dispersion within the adjacent bone via three-dimensional (3-D) finite element analysis (FEA). A set of computed tomography (CT) images of craniofacial was used to reconstruct a 3-D model of mandible using an image-processing software. The selected region of interest was the left side covering the second premolar, first molar and second molar regions. The bone model consisted of both compact (cortical) and porous (cancellous) structures. Three dental implant sets (crown, implant body, and abutment) with different designs of implant neck – straight, tapered with 15°, and tapered with 30° were modelled using a computer-aided design (CAD) software and all models were then analysed via 3-D FEA software. Top surface of first molar crown was subjected to occlusal forces of 114.6 N, 17.2 N, and 23.4 N in the axial, lingual, and mesio-distal directions, respectively. All planes of the mandible model were rigidly constrained in all directions. The result has demonstrated that the straight implant body neck is superior in attributing to high stress generation over adjacent bone as compared to others. This may associate with lower frictional resistance produced than those of tapered designs to withstand the applied loads.

  4. A summary of the influence of exogenous estrogen administration across the lifespan on the GH/IGF-1 axis and implications for bone health.

    Science.gov (United States)

    Southmayd, Emily A; De Souza, Mary Jane

    2017-02-01

    Bone growth, development, and remodeling are modulated by numerous circulating hormones. Throughout the lifespan, the extent to which each of the hormones impacts bone differs. Understanding the independent and combined impact of these hormones on controlling bone remodeling allows for the development of more informed decision making regarding pharmacology, specifically the use of hormonal medication, at all ages. Endocrine control of bone health in women is largely dictated by the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and the hypothalamic-pituitary-ovarian (HPO) axis. Growth hormone, secreted from the pituitary gland, stimulates cells in almost every tissue to secrete IGF-1, although the majority of circulating IGF-1 is produced hepatically. Indeed, systemic IGF-1 concentrations have been found to be correlated with bone mineral density (BMD) in both pre- and post-menopausal women and is often used as a marker of bone formation. Sex steroids produced by the ovaries, namely estradiol, mediate bone resorption through binding to estrogen receptors on osteoclasts and osteoblasts. Specifically, by increasing osteoclast apoptosis and decreasing osteoblast apoptosis, adequate estrogen levels prevent excessive bone resorption, which helps to explain the rapid decline in bone mass that occurs with the menopausal decrease in estrogen production. Though there are documented correlations between endogenous estrogen concentrations and GH/IGF-1 dynamics, this relationship changes across the lifespan as sex-steroid dynamics fluctuate and, possibly, as tissue responsiveness to GH stimulation decreases. Aside from the known role of endogenous sex steroids on bone health, the impact of exogenous estrogen administration is of interest, as exogenous formulations further modulate GH and IGF-1 production. However, the effect and extent of GH and IGF-1 modulation seems to be largely dependent on age at administration and route of administration. Specifically

  5. Designing smart analytical data services for a personal health framework.

    Science.gov (United States)

    Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas

    2016-01-01

    Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.

  6. Smart practice: smart card design considerations in health care.

    Science.gov (United States)

    Lindley, R A; Pacheco, F

    1995-01-01

    Recent innovations in microelectronics and advances in cryptography are driving the appearance of a new generation of smart cards with wider applications; this has important repercussions for our society in the coming years. Essentially, these breakthroughs include built-in microprocessors capable of generating cryptographic transactions (e.g.,Jelectronic blinded signatures, digital pseudonyms, and digital credentials), developments toward a single electronic card offering multi-access to services such as transport, telecommunications, health, financial, and entertainment (Universal Access Services), and incorporation of personal identification technologies such as voice, eye, or skin pattern recognition. For example, by using electronic representatives or cryptographic blinded signatures, a smart card can be used for multi transactions across different organizations and under different generated pseudonyms. These pseudonyms are capable of recognizing an individual unambiguously, while none of her records can be linked [1]. Moreover, tamper-proof electronic observers would make smart cards a very attractive technology for high-security based applications, such as those in the health care field. New trends in smart card technology offer excellent privacy and confidentiality safeguards. Therefore, smart cards constitute a promising technology for the health sector in Australia and other countries around the world in their pursuit of technology to support the delivery of quality care services. This paper addresses the main issues and the key design criteria which may be of strategic importance to the success of future smart card technology in the health care sector.

  7. Exercise-induced amenorrhea and bone health in the adolescent athlete.

    Science.gov (United States)

    Warren, Michelle P; Chua, Abigail T

    2008-01-01

    Female participation in high school athletics has increased 800% in the last 30 years. The problem of exercise-induced amenorrhea was initially thought to be analogous to hypoestrogenism, but recent studies suggest that nutritional issues underlie most of the pathophysiology and that the mechanism is different from that seen in the primary hypogonadal state. Exercise-induced amenorrhea can be an indicator of an energy drain, and the presence of the other components of the female athlete triad-bone density loss and eating disorders-must be determined as well. Addressing skeletal problems related to nutritional and hormonal deficiencies in this population is of very high priority.

  8. The Study on Mental Health at Work: Design and sampling.

    Science.gov (United States)

    Rose, Uwe; Schiel, Stefan; Schröder, Helmut; Kleudgen, Martin; Tophoven, Silke; Rauch, Angela; Freude, Gabriele; Müller, Grit

    2017-08-01

    The Study on Mental Health at Work (S-MGA) generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. This paper describes the study design, sampling procedures and data collection, and presents a summary of the sample characteristics. S-MGA is a representative study of German employees aged 31-60 years subject to social security contributions. The sample was drawn from the employment register based on a two-stage cluster sampling procedure. Firstly, 206 municipalities were randomly selected from a pool of 12,227 municipalities in Germany. Secondly, 13,590 addresses were drawn from the selected municipalities for the purpose of conducting 4500 face-to-face interviews. The questionnaire covers psychosocial working and employment conditions, measures of mental health, work ability and functioning. Data from personal interviews were combined with employment histories from register data. Descriptive statistics of socio-demographic characteristics and logistic regressions analyses were used for comparing population, gross sample and respondents. In total, 4511 face-to-face interviews were conducted. A test for sampling bias revealed that individuals in older cohorts participated more often, while individuals with an unknown educational level, residing in major cities or with a non-German ethnic background were slightly underrepresented. There is no indication of major deviations in characteristics between the basic population and the sample of respondents. Hence, S-MGA provides representative data for research on work and health, designed as a cohort study with plans to rerun the survey 5 years after the first assessment.

  9. The Study on Mental Health at Work: Design and sampling

    Science.gov (United States)

    Rose, Uwe; Schiel, Stefan; Schröder, Helmut; Kleudgen, Martin; Tophoven, Silke; Rauch, Angela; Freude, Gabriele; Müller, Grit

    2017-01-01

    Aims: The Study on Mental Health at Work (S-MGA) generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. This paper describes the study design, sampling procedures and data collection, and presents a summary of the sample characteristics. Methods: S-MGA is a representative study of German employees aged 31–60 years subject to social security contributions. The sample was drawn from the employment register based on a two-stage cluster sampling procedure. Firstly, 206 municipalities were randomly selected from a pool of 12,227 municipalities in Germany. Secondly, 13,590 addresses were drawn from the selected municipalities for the purpose of conducting 4500 face-to-face interviews. The questionnaire covers psychosocial working and employment conditions, measures of mental health, work ability and functioning. Data from personal interviews were combined with employment histories from register data. Descriptive statistics of socio-demographic characteristics and logistic regressions analyses were used for comparing population, gross sample and respondents. Results: In total, 4511 face-to-face interviews were conducted. A test for sampling bias revealed that individuals in older cohorts participated more often, while individuals with an unknown educational level, residing in major cities or with a non-German ethnic background were slightly underrepresented. Conclusions: There is no indication of major deviations in characteristics between the basic population and the sample of respondents. Hence, S-MGA provides representative data for research on work and health, designed as a cohort study with plans to rerun the survey 5 years after the first assessment. PMID:28673202

  10. Rather unspectacular: design choices in National Health Service glasses

    Directory of Open Access Journals (Sweden)

    Dr Joanne Gooding

    2017-04-01

    Full Text Available This article considers the design and production of spectacles in Britain following the introduction of standardised frame styles under the National Health Service. NHS spectacles were provided as a functional, durable medical appliance to be delivered cost-effectively and there was no explicit concern for fashion or the patient experience. The actions of the government and professional bodies greatly affected the trade in eyewear and thus restricted opportunities for innovative design and consumer choice. Within the range of state regulation frames there was no active concern for ‘design’ in terms of appearance and it was only through the purchase of private frames that significant choice and variety in eyewear could be attained. The scope for the public to select a more fashionable frame whilst receiving an element of state aid was through the purchase of NHS hybrid private frames.

  11. Visual design: a step towards multicultural health care.

    Science.gov (United States)

    Alvarez, Juliana

    2014-02-01

    Standing at the crossroads of anthropology, communication, industrial design and new technology theories, this article describes the communication challenges posed during hospital emergencies resulting from linguistic and cultural differences between health care professionals and patients. In order to overcome communication barriers, the proposal of a visual solution was analyzed. Likewise, the problem was studied based on the concepts of perception, comprehension, interpretation and graphic representation according to visual culture and semiotics theories. One hundred and ffty images showing symptoms were analyzed in order to identify a pluricultural iconographic code. Results enabled to develop a list of design criteria and create the application: "My Symptoms Translator" as an option to overcome verbal language barriers and cultural differences.

  12. Association between mental health status and bone mineral density: Analysis of the 2008-2010 Korea national health and nutrition examination survey.

    Directory of Open Access Journals (Sweden)

    Changtae Hahn

    Full Text Available The current study aimed to investigate the association between mental health status and bone mineral density (BMD using data from the Korean National Health and Nutrition Examination Survey (KNHANES 2008-2010. We enrolled 15,876 South Korean participants (4,010 postmenopausal females, 4,836 premenopausal females, and 7,016 males, all aged 20 years or older. BMD was measured using dual-energy radiography absorptiometry at the femoral neck (NK, lumbar spine (LSP, and total femur (TFM. Mental health status data were obtained from a self-report questionnaire that assessed psychological stress, depressed mood, and suicidal ideation. Psychological stress was negatively correlated with BMD in the LSP, NK, and TFM for the male group. Depressed mood was associated with lower BMD in the LSP, NK and TFM for the premenopausal female group, and in the LSP for the male group. Suicidal ideation was associated with lower BMD in the NK and TFM for the male group. Mental health problems were associated with lower BMD, especially in premenopausal females and males. Future investigations should focus on the shared pathophysiology between mental health problems and BMD, and the interrelationship between increased BMD and recovery from mental health problems.

  13. Lower bone turnover markers in metabolic syndrome and diabetes: the population-based Study of Health in Pomerania.

    Science.gov (United States)

    Lerchbaum, E; Schwetz, V; Nauck, M; Völzke, H; Wallaschofski, H; Hannemann, A

    2015-05-01

    Accumulating evidence demonstrates an important interaction between bone and energy metabolism. We aimed to study the associations of three bone turnover markers (BTM: osteocalcin, beta-crosslaps, procollagen type 1 N-terminal propeptide) as well as of 25-hydroxyvitamin D and parathyroid hormone with metabolic syndrome (MetS) or type 2 diabetes mellitus (T2DM) in a large population-based cohort. This cross-sectional study comprised 2671 adult men and women participating in the first follow-up of the population-based Study of Health in Pomerania (SHIP-1). Multivariable logistic regression analyses were performed to assess sex-specific associations between the BTMs, 25-hydroxyvitamin D or parathyroid hormone and metabolic disease. All models were adjusted for age, body mass index, smoking status, physical activity, estimated glomerular filtration rate and month of blood sampling. The models for women were further adjusted for menopausal status. Higher BTM or 25-hydroxyvitamin D concentrations were associated with significantly lower odds for metabolic disease, while there was no association between parathyroid hormone and MetS or T2DM. Our results contribute to the accumulating evidence of a cross-sectional association between high BTM or 25-hydroxyvitamin D concentrations and a lower prevalence of MetS or T2DM. Further research is necessary to evaluate the mechanisms underlying these results. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design.

    Science.gov (United States)

    Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C; Valdez, Rupa S

    2016-08-11

    Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients' health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients' health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients' needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Our aim was to characterize patients' use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients' communication needs and preferences. This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study's first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Participants' rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. The results of this

  15. Lifestyle guidelines for managing adverse effects on bone health and body composition in men treated with androgen deprivation therapy for prostate cancer: an update.

    Science.gov (United States)

    Owen, P J; Daly, R M; Livingston, P M; Fraser, S F

    2017-06-01

    Men treated with androgen deprivation therapy (ADT) for prostate cancer are prone to multiple treatment-induced adverse effects, particularly with regard to a deterioration in bone health and altered body composition including decreased lean tissue mass and increased fat mass. These alterations may partially explain the marked increased risk in osteoporosis, falls, fracture and cardiometabolic risk that has been observed in this population. A review was conducted that assessed standard clinical guidelines for the management of ADT-induced adverse effects on bone health and body composition in men with prostate cancer. Currently, standard clinical guidelines exist for the management of various bone and metabolic ADT-induced adverse effects in men with prostate cancer. However, an evaluation of the effectiveness of these guidelines into routine practice revealed that men continued to experience increased central adiposity, and, unless pharmacotherapy was instituted, accelerated bone loss and worsening glycaemia occurred. This review discusses the current guidelines and some of the limitations, and proposes new recommendations based on emerging evidence regarding the efficacy of lifestyle interventions, particularly with regard to exercise and nutritional factors, to manage ADT-related adverse effects on bone health and body composition in men with prostate cancer.

  16. Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

    Science.gov (United States)

    Peditto, Kathryn

    2018-04-01

    This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

  17. Design and Analysis of Architectures for Structural Health Monitoring Systems

    Science.gov (United States)

    Mukkamala, Ravi; Sixto, S. L. (Technical Monitor)

    2002-01-01

    During the two-year project period, we have worked on several aspects of Health Usage and Monitoring Systems for structural health monitoring. In particular, we have made contributions in the following areas. 1. Reference HUMS architecture: We developed a high-level architecture for health monitoring and usage systems (HUMS). The proposed reference architecture is shown. It is compatible with the Generic Open Architecture (GOA) proposed as a standard for avionics systems. 2. HUMS kernel: One of the critical layers of HUMS reference architecture is the HUMS kernel. We developed a detailed design of a kernel to implement the high level architecture.3. Prototype implementation of HUMS kernel: We have implemented a preliminary version of the HUMS kernel on a Unix platform.We have implemented both a centralized system version and a distributed version. 4. SCRAMNet and HUMS: SCRAMNet (Shared Common Random Access Memory Network) is a system that is found to be suitable to implement HUMS. For this reason, we have conducted a simulation study to determine its stability in handling the input data rates in HUMS. 5. Architectural specification.

  18. Green design for productivity, health and quality of life

    Energy Technology Data Exchange (ETDEWEB)

    Hartkopf, V. [Carnegie Mellon Univ., Pittsburgh, PA (United States). Center for Building Performance and Diagnostics

    2005-07-01

    The potential cost-benefits for quality construction of office buildings were discussed with particular reference to sick building costs and health building gains. Cost-benefits were indicated in terms of first cost, operational energy costs, individual productivity, organizational productivity, health, attraction, taxation, and waste. The measures of human response in buildings were also discussed with reference to comfort and satisfaction, individual productivity, health and absenteeism, attraction, spatial flexibility, motivation and collaboration. The building attributes that have the greatest impact include air, light, thermal control, ergonomics, privacy and interaction, access to nature, land use and mobility. It was suggested that natural ventilation should be maximized with mixed-mode heating, ventilating and air conditioning (HVAC) systems, and that ventilation air should be separate from thermal conditioning. It was also suggested that temperature control can increase productivity and reduce energy consumption. Several international case studies have shown that acoustic privacy also increases individual productivity at complex tasks. The presentation concluded by indicating that healthy and sustainable design also depends on changing approaches to land use and community planning in terms of pedestrian walkways, maximized loading of infrastructure and buildings, minimized abandonment and green roof development to reduce annual cooling loads. tabs., figs.

  19. Using conceptual work products of health care to design health IT.

    Science.gov (United States)

    Berry, Andrew B L; Butler, Keith A; Harrington, Craig; Braxton, Melissa O; Walker, Amy J; Pete, Nikki; Johnson, Trevor; Oberle, Mark W; Haselkorn, Jodie; Paul Nichol, W; Haselkorn, Mark

    2016-02-01

    This paper introduces a new, model-based design method for interactive health information technology (IT) systems. This method extends workflow models with models of conceptual work products. When the health care work being modeled is substantially cognitive, tacit, and complex in nature, graphical workflow models can become too complex to be useful to designers. Conceptual models complement and simplify workflows by providing an explicit specification for the information product they must produce. We illustrate how conceptual work products can be modeled using standard software modeling language, which allows them to provide fundamental requirements for what the workflow must accomplish and the information that a new system should provide. Developers can use these specifications to envision how health IT could enable an effective cognitive strategy as a workflow with precise information requirements. We illustrate the new method with a study conducted in an outpatient multiple sclerosis (MS) clinic. This study shows specifically how the different phases of the method can be carried out, how the method allows for iteration across phases, and how the method generated a health IT design for case management of MS that is efficient and easy to use. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Scenario-based design: a method for connecting information system design with public health operations and emergency management.

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne M

    2011-12-01

    Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Interview analysis identified 25 information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create 25 scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. A brief instrument to measure health-related quality of life in patients with bone metastasis: validation of the German version of Bone Metastases Quality-of-Life-10 (BOMET-QoL-10).

    Science.gov (United States)

    Marschner, Norbert; Wilke, Jochen; Reschke, Daniel; Kaiser, Florian; Schmoor, Claudia; Grugel, Renate; Boller, Emil

    2018-06-06

    This prospective, epidemiologic study was designed to translate the original Spanish Bone Metastases Quality-of-Life-10 (BOMET-QoL-10) questionnaire and undertake a validation of the translated German version of BOMET-QoL-10 in Germany to assess health-related quality of life (HRQoL) in patients with bone metastases (BM). The translation process included forward and backward translations, and a linguistic validation. Patients aged ≥18 years with histological confirmation of cancer, diagnosed with BM, life expectancy ≥6 months, and fluency in German were eligible for this study (enrolled consecutively in 33 outpatient centers in Germany). Patients were given the German version of BOMET-QoL-10 together with European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire QLQ-C30 and EORTC QLQ-BM22 questionnaires at inclusion, 6 weeks, 3 months, and 6 months after inclusion. A debriefing questionnaire was administered at inclusion to determine patient acceptability and understanding. Data include 364 patients with BM (median age: 68 years; female sex: 71.7%). The BOMET-QoL-10 is brief and clear (median completion time: 5 minutes; >90% of patients completed the questionnaire without assistance). The BOMET-QoL-10 forms only one overall scale. All 10 items showed a substantial correlation with the first factor (factor loading, range: 0.58 - 0.86). BOMET-QoL-10 exhibits high internal consistency and reproducibility (Cronbach's alpha: 0.91; intra-class correlation coefficient: 0.76). BOMET-QoL-10 showed significant correlations (range: 0.69 - 0.79) both with EORTC QLQ-C30 and EORTC QLQ-BM22 within the functioning (physical, social, interference) and symptom (fatigue, pain) scales, displayed significant sensitivity to change in EORTC QLQ-BM22 scores, and proved potential ability to detect change in HRQoL in patients with different disease status. There was a high proportion of females in our study which might represent a limitation. The

  2. The impact on children's bone health of a school-based physical education program and participation in leisure time sports

    DEFF Research Database (Denmark)

    Heidemann, Malene; Jespersen, Eva; Holst, René

    2013-01-01

    lessons per week) were compared to children at "traditional" schools (2×45min of PE lessons per week) in Svendborg, Denmark. Whole-body DXA scans were performed at baseline (2008) and at a two-year follow-up (2010). Bone mineral content (BMC), bone mineral density (BMD), and bone area (BA) were measured...

  3. Hierarchical Fabrication of Engineered Vascularized Bone Biphasic Constructs via Dual 3D Bioprinting: Integrating Regional Bioactive Factors into Architectural Design.

    Science.gov (United States)

    Cui, Haitao; Zhu, Wei; Nowicki, Margaret; Zhou, Xuan; Khademhosseini, Ali; Zhang, Lijie Grace

    2016-09-01

    A biphasic artificial vascularized bone construct with regional bioactive factors is presented using dual 3D bioprinting platform technique, thereby forming a large functional bone grafts with organized vascular networks. Biocompatible mussel-inspired chemistry and "thiol-ene" click reaction are used to regionally immobilize bioactive factors during construct fabrication for modulating or improving cellular events. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Three-dimensional model of the skull and the cranial bones reconstructed from CT scans designed for rapid prototyping process.

    Science.gov (United States)

    Skrzat, Janusz; Spulber, Alexandru; Walocha, Jerzy

    This paper presents the effects of building mesh models of the human skull and the cranial bones from a series of CT-scans. With the aid of computer so ware, 3D reconstructions of the whole skull and segmented cranial bones were performed and visualized by surface rendering techniques. The article briefly discusses clinical and educational applications of 3D cranial models created using stereolitographic reproduction.

  5. Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease.

    Science.gov (United States)

    O'Connor, Eibhlís M; Grealy, Geraldine; McCarthy, Jane; Desmond, Alan; Craig, Orla; Shanahan, Fergus; Cashman, Kevin D

    2014-10-14

    Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (vitamin K1). By conducting two RCT, the present study aimed to first establish whether supplementation with 1000 μg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum (%ucOC; marker of vitamin K status) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass. The initial dose-ranging RCT was conducted in adult patients with CD (n 10 per group) using 0 (placebo), 1000 or 2000 μg of phylloquinone daily for 2 weeks. In the main RCT, the effect of placebo v. 1000 μg vitamin K/d (both co-administered with Ca (500 mg/d) and vitamin D3 (10 μg/d)) for 12 months (n 43 per group) on the biochemical indices of bone turnover (determined by enzyme immunoassay) and bone mass (determined by dual-energy X-ray absorptiometry) were investigated. At baseline, the mean %ucOC was 47 %, and this was suppressed upon supplementation with 1000 μg of phylloquinone daily ( - 81 %; P0·1) on bone turnover markers or on the bone mass of the lumbar spine or femur, but modestly increased (Pvitamin D3) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency.

  6. Combined aerobic and resistance exercise is effective for achieving weight loss and reducing cardiovascular risk factors without deteriorating bone health in obese young adults

    Directory of Open Access Journals (Sweden)

    Jung Sub Lim

    2013-03-01

    Full Text Available PurposeWeight loss reduces cardiovascular risk factors in the obese. However, weight reduction through diet negatively affects long-term bone health. The aim of study was to determine the ability of combined aerobic and resistance exercise (CE to reduce weight and cardiovascular risk without diminishing bone health.MethodsTwenty-five young adults participated in an 8-week weight loss CE program. Subjects were allocated to an obese group or a control group by body mass index (BMI. Body weight, BMI, body composition, and bone mineral density (BMD of the lumbar spine and total hip were measured before and after the CE trial. Serum levels of metabolic markers, including adipokines and bone markers, were also evaluated.ResultsWeight loss was evident in the obese group after the 8 weeks CE trial. Fat mass was significantly reduced in both groups. Fasting insulin, homeostatic model assessment-insulin resistance (HOMA-IR, leptin and aminotransferases level were significantly reduced from baseline only in the obese group. High density lipoprotein cholesterol increased in both groups. Hip BMD increased in the obese group. In all study subjects, BMI changes were correlated with HOMA-IR, leptin, and HDL changes. BMI decreases were correlated with lumbar spine BMD increases, lumbar spine BMD increases were positively correlated with osteocalcin changes, and lumbar spine bone mineral content increases were correlated negatively with C-terminal telopeptide of type 1 collagen changes.ConclusionThese findings suggest that CE provides effective weight loss and improves cardiovascular risk factors without diminishing BMD. Furthermore, they indicate that lumbar spine BMD might be maintained by increasing bone formation and decreasing bone resorption.

  7. The Bt-DUX: Development of a subjective measure of health-related quality of life in patients who underwent surgery for lower extremity malignant bone tumor

    NARCIS (Netherlands)

    W.P. Bekkering (Peter); T.P.M. Vliet Vlieland (Theodora); H.M. Koopman (Hendrik); G.R. Schaap (Gerard); H.W.B. Schreuder; A. Beishuizen (Auke); W.J.E. Tissing (Wim); P.M. Hoogerbrugge (Peter); J.K. Anninga (Jacob); A.H.M. Taminiau (Antonie)

    2009-01-01

    textabstractBackground. To examine the practical applicability, internal consistency, and validity of the Bt-DUX, a disease-specific Health Related Quality of Life (HRQoL) instrument. The Bt-Dux was developed to examine patients' individual values of their life after a malignant bone tumor of the

  8. Biochemical Assessment of Bone Health in Working Obese Egyptian Females with Metabolic Syndrome; the Effect of Weight Loss by Natural Dietary Therapies

    Directory of Open Access Journals (Sweden)

    Maha I.A. Moaty

    2015-12-01

    CONCLUSION: These results confirm the benefit of doum in improving bone health parameter [25 (OH D/PTH axis] in the MetS patients, beside the MetS criteria. So, we can conclude that natural effective supplements lead towards the optimization of biochemical parameters in favor of a healthy outcome.

  9. In vivo strains in the femur of the Virginia opossum (Didelphis virginiana) during terrestrial locomotion: testing hypotheses of evolutionary shifts in mammalian bone loading and design.

    Science.gov (United States)

    Butcher, Michael T; White, Bartholomew J; Hudzik, Nathan B; Gosnell, W Casey; Parrish, John H A; Blob, Richard W

    2011-08-01

    Terrestrial locomotion can impose substantial loads on vertebrate limbs. Previous studies have shown that limb bones from cursorial species of eutherian mammals experience high bending loads with minimal torsion, whereas the limb bones of non-avian reptiles (and amphibians) exhibit considerable torsion in addition to bending. It has been hypothesized that these differences in loading regime are related to the difference in limb posture between upright mammals and sprawling reptiles, and that the loading patterns observed in non-avian reptiles may be ancestral for tetrapod vertebrates. To evaluate whether non-cursorial mammals show loading patterns more similar to those of sprawling lineages, we measured in vivo strains in the femur during terrestrial locomotion of the Virginia opossum (Didelphis virginiana), a marsupial that uses more crouched limb posture than most mammals from which bone strains have been recorded, and which belongs to a clade phylogenetically between reptiles and the eutherian mammals studied previously. The presence of substantial torsion in the femur of opossums, similar to non-avian reptiles, would suggest that this loading regime likely reflects an ancestral condition for tetrapod limb bone design. Strain recordings indicate the presence of both bending and appreciable torsion (shear strain: 419.1 ± 212.8 με) in the opossum femur, with planar strain analyses showing neutral axis orientations that placed the lateral aspect of the femur in tension at the time of peak strains. Such mediolateral bending was unexpected for a mammal running with near-parasagittal limb kinematics. Shear strains were similar in magnitude to peak compressive axial strains, with opossum femora experiencing similar bending loads but higher levels of torsion compared with most previously studied mammals. Analyses of peak femoral strains led to estimated safety factor ranges of 5.1-7.2 in bending and 5.5-7.3 in torsion, somewhat higher than typical mammalian values

  10. Effects of water-based exercise on bone health of middle-aged and older adults: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Simas V

    2017-03-01

    Full Text Available Vini Simas,1 Wayne Hing,1 Rodney Pope,1 Mike Climstein1,2 1Water-Based Research Unit, Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, 2Exercise, Health and Performance Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia Background: Age-related bone loss is a major health concern. Only exercises associated with high-impact and mechanical loading have been linked to a positive effect on bone turnover; however, these types of exercises may not always be appropriate for middle-aged and older adults due to physical decline or chronic disorders such as osteoarthritis. Water-based exercise (WBE has been shown to affect different components of physical fitness, has lower risks of traumatic fracture, and applies less stress to joints. However, the effects of WBE on bone health are unclear.Objective: This study aimed to explore whether WBE is effective in preventing age-related bone deterioration in middle-aged and older adults.Methods: A search of relevant databases and the references of identified studies was performed. Critical narrative synthesis and meta-analyses were conducted.Results: Eleven studies, involving 629 participants, met all inclusion criteria. All participants were postmenopausal women. Eight studies compared WBE to a sedentary control group, and four studies had land-based exercise (LBE participants as a comparison group. Meta-analyses revealed significant differences between WBE and control group in favor of WBE for changes in bone mineral density (BMD at the lumbar spine (mean difference [MD] 0.03 g/cm2; 95% confidence interval [CI]: 0.01 to 0.05 and femoral neck (MD 0.04 g/cm2; 95% CI: 0.02 to 0.07. Significant differences were also revealed between WBE and LBE in favor of LBE for changes in lumbar spine BMD (MD −0.04 g/cm2; 95% CI: −0.06 to −0.02. However, there was no significant difference between WBE and LBE for

  11. Broken English, broken bones? Mechanisms linking language proficiency and occupational health in a Montreal garment factory.

    Science.gov (United States)

    Premji, Stéphanie; Messing, Karen; Lippel, Katherine

    2008-01-01

    Language barriers are often cited as a factor contributing to ethnic inequalities in occupational health; however, little information is available about the mechanisms at play. The authors describe the multiple ways in which language influences occupational health in a large garment factory employing many immigrants in Montreal. Between 2004 and 2006, individual, semi-structured interviews were conducted with 15 women and 10 men from 14 countries of birth. Interviews were conducted in French and English, Canada's official languages, as well as in non-official languages with the help of colleague-interpreters. Observation within the workplace was also carried out at various times during the project. The authors describe how proficiency in the official languages influences occupational health by affecting workers' ability to understand and communicate information, and supporting relationships that can affect work-related health. They also describe workers' strategies to address communication barriers and discuss the implications of these strategies from an occupational health standpoint. Along with the longer-term objectives of integrating immigrants into the linguistic majority and addressing structural conditions that can affect health, policies and practices need to be put in place to protect the health and well-being of those who face language barriers in the short term.

  12. Evaluation of four designs of short implants placed in atrophic areas with reduced bone height: a three-year, retrospective, clinical and radiographic study.

    Science.gov (United States)

    Lopez Torres, J A; Gehrke, S A; Calvo Guirado, J L; Aristazábal, L F R

    2017-09-01

    The aim of the present study was to evaluate retrospectively the clinical and radiographic behaviour of four commercially-available short implants with different macrodesigns and microdesigns in areas in which the height of the bone was reduced. We took into account the success and survival, peri-implant crestal bone loss, and the level of probing at which the gum bled. Patients were included if they had been given one or more short implants (≤8.5mm long) in the posterior jaws at least three years earlier. Three hundred and ninety-one short implants were placed in 170 subjects, and were divided in four groups based on the brand of implant. The implants were evaluated one, two, and three years after they had been inserted. Short implants had a three-year survival and success rate of 90% in all groups, and bone loss was acceptable after three years with no significant differences between them. These results support the use of short implants as an effective and safe treatment. However, within the limitations of this study, the design of the implant does seem to influence the behaviour of peri-implant bone at the crestal level. Copyright © 2017. Published by Elsevier Ltd.

  13. Design, fabrication and evaluation of a new calibration phantom for in vivo measurement of bone-seeking radionuclides (invited paper)

    International Nuclear Information System (INIS)

    Spitz, H.B.; Lodwick, J.

    2000-01-01

    A new anthropometric phantom has been developed for use in calibrating in vivo measurements of bone-seeking radionuclides. The phantom has the external shape and appearance of the human adult knee and contains a realistic femur, patella, tibia, and fibula. Unique formulations of polyurethanes, CaCo 3 , and other trace materials are used in construction of the phantom to produce substitutes for human tissue having the same density, attenuation coefficient, and effective Z as that of human muscle and trabecular bone. The formulation for trabecular bone includes provision for a precisely known quantity of radioactive material that is either uniformly distributed throughout the bone matrix or deposited on the exterior surface. The knee phantom is assembled in three interlocking sections that simplify inserting the skeletal structures and prevent streaming. One or more detectors can easily be positioned on the top or sides of the phantom. Intercomparison measurements of 241 Am in bone using separate arrays of phoswich and germanium detectors demonstrate that a single knee phantom exhibits the same detection efficiency as that using the skull. In vivo measurement of the knee is a desirable alternative to the head if facial contamination is present or when evaluating recent exposure to bone seeking radionuclides, since bones of the knee exhibit more rapid uptake than the skull. In practice, greater measurement efficiency can be obtained by placing detectors over both knees since a larger fraction of the total body activity is observed. Calibration measurements using the new anthropometric knee phantom demonstrate that it is durable, easy to use, and provides consistent results over repeated measurements. (author)

  14. One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal

    Directory of Open Access Journals (Sweden)

    Ana Gloria Fonseca

    2018-03-01

    Full Text Available The increasing occurrence of human cysticercosis, a zoonotic neglected disease, is challenging the traditional prevention and control paradigm and calling for One Health (OH solutions in industrialized countries. OH solutions for health interventions are increasingly being used to capture expected and unexpected outcomes across people, animals, and the environment. The Network for Evaluation of One Health (NEOH proposes an evidence-based framework, relying on systems and mixed methods approaches to evaluate the One Health-ness. In this case study, this tool is used to evaluate the design of the Observatory of Taeniasis and Cysticercosis, as an example of intersectorial collaboration for surveillance in Portugal. The OH Initiative (drivers and expected outcomes and its system (boundaries, aim, dimensions, actors, and stakeholders were described. The different aspects of this Initiative were scored with values from 0 (=no OH approach to 1 (=perfect OH approach. The OH index was 0.31. Its OH ratio is 1.98. Overall scores were as follows: OH thinking 0.75; OH planning 0.60; OH working 0.60; OH sharing 0.35; OH learning 0.50; and systemic organization 0.50. Operational levels of the Initiative are the main strengths, indicating a comprehensive multidimensional innovative approach and transdisciplinarity. Critical issues in the supporting infrastructure were observed, related to communication, learning and organizational gaps in the project, with the evaluation being conducted as the project is being designed and implemented. The strengths and weaknesses detected may be used to refine the Initiative. This case study therefore exemplifies and supports OH assessment also for ongoing projects, at design and early implementation stages for guiding and guaranteeing an OH-oriented perspective.

  15. Exploring the Model Design Space for Battery Health Management

    Science.gov (United States)

    Saha, Bhaskar; Quach, Cuong Chi; Goebel, Kai Frank

    2011-01-01

    Battery Health Management (BHM) is a core enabling technology for the success and widespread adoption of the emerging electric vehicles of today. Although battery chemistries have been studied in detail in literature, an accurate run-time battery life prediction algorithm has eluded us. Current reliability-based techniques are insufficient to manage the use of such batteries when they are an active power source with frequently varying loads in uncertain environments. The amount of usable charge of a battery for a given discharge profile is not only dependent on the starting state-of-charge (SOC), but also other factors like battery health and the discharge or load profile imposed. This paper presents a Particle Filter (PF) based BHM framework with plug-and-play modules for battery models and uncertainty management. The batteries are modeled at three different levels of granularity with associated uncertainty distributions, encoding the basic electrochemical processes of a Lithium-polymer battery. The effects of different choices in the model design space are explored in the context of prediction performance in an electric unmanned aerial vehicle (UAV) application with emulated flight profiles.

  16. Iranian mental health survey: design and field proced.

    Directory of Open Access Journals (Sweden)

    Afarin Rahimi-Movaghar

    2014-06-01

    Full Text Available Iranian Mental Health Survey (IranMHS was conducted to assess the twelve-month prevalence and severity of psychiatric disorders in the Iranian adult population and to determine the pattern of health care utilization and cost of services. IranMHS is a cross-sectional national household survey with face-to-face interviews as the main data collection method. The study was carried out between January and June 2011. A three-stage probability sampling was applied for the selection of a representative sample from the non-institutionalized population aged 15 to 64. The primary instrument utilized for assessing the prevalence of mental disorders was the Persian version of Composite International Diagnosis Interview, version 2.1. The instruments for assessing the service and cost of mental illness were developed by the research team. The response rate was 86.2%, and a total of 7886 individuals participated in the study. Sampling weights were the joint product of inverse probability of unit selection, non-response weights and post-stratification weights. This paper presents an overview of the study design, fieldwork organization and procedures, weightings and analysis. The strengths and limitations of the study are also discussed.

  17. Digital health increasing the impact with personalized design

    OpenAIRE

    Empelen, P. van; Otten, W.; Molema, H.; Keijsers, J.; Mooij, R.

    2016-01-01

    Digital health is considered the ‘holy grail’ of effective and sustainable health(care). It uses the latest technology, apps and data to support and improve health. Digital health tools can benefit both patients and healthy individuals, with support and advice. But healthcare professionals, policymakers and scientist can also benefit from the (big) data and insights collected by digital health applications. A well-known example of digital health is eHealth, which provides information- and com...

  18. Maternal first-trimester diet and childhood bone mass: The Generation R Study

    NARCIS (Netherlands)

    D.H.M. Heppe (Denise); M.C. Medina-Gomez (Carolina); A. Hofman (Albert); O.H. Franco (Oscar); F. Rivadeneira Ramirez (Fernando); V.W.V. Jaddoe (Vincent)

    2013-01-01

    textabstractBackground: Maternal diet during pregnancy has been suggested to influence bone health in later life. Objective: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. Design: In a prospective cohort study in 2819 mothers and

  19. Health technology assessment of magnetic resonance imaging of the spine and bone marrow

    International Nuclear Information System (INIS)

    Verstraete, K.L.; Huysse, W.C.J.

    2008-01-01

    The high spatial resolution and the lack of ionizing radiation, makes magnetic resonance imaging the method of choice for imaging most spinal pathology, especially if associated with neurological symptoms. However, due to the high sensitivity of MR imaging, careful correlation between imaging findings and clinical findings is important to ensure appropriate treatment. Substituting radiographic evaluations for rapid MRI in the primary care setting may offer little additional benefit to patients. It may even increase the costs of care but the decisions about the use of imaging depend on judgments concerning whether the small observed improvement in outcome justifies additional cost. Because the presence of an abscess is a major factor in deciding between conservative and surgical treatment, MRI plays an essential role in the decision-making process concerning the treatment of spondylodiscitis. MR is also the method of choice for quantitative evaluation of bone marrow in lymphoma patients when a crucial therapeutic decision has to be made or for the qualitative evaluation of the spinal cord if compression is suspected in primary spinal malignancy or metastatic disease

  20. Health technology assessment of magnetic resonance imaging of the spine and bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Verstraete, K.L. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Koenraad.verstraete@ugent.be; Huysse, W.C.J. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Wouter.huysse@ugent.be

    2008-02-15

    The high spatial resolution and the lack of ionizing radiation, makes magnetic resonance imaging the method of choice for imaging most spinal pathology, especially if associated with neurological symptoms. However, due to the high sensitivity of MR imaging, careful correlation between imaging findings and clinical findings is important to ensure appropriate treatment. Substituting radiographic evaluations for rapid MRI in the primary care setting may offer little additional benefit to patients. It may even increase the costs of care but the decisions about the use of imaging depend on judgments concerning whether the small observed improvement in outcome justifies additional cost. Because the presence of an abscess is a major factor in deciding between conservative and surgical treatment, MRI plays an essential role in the decision-making process concerning the treatment of spondylodiscitis. MR is also the method of choice for quantitative evaluation of bone marrow in lymphoma patients when a crucial therapeutic decision has to be made or for the qualitative evaluation of the spinal cord if compression is suspected in primary spinal malignancy or metastatic disease.

  1. Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

    Science.gov (United States)

    Gonzalez, Stefanie M.

    2010-01-01

    The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

  2. Bridges analysis, design, structural health monitoring, and rehabilitation

    CERN Document Server

    Bakht, Baidar

    2015-01-01

    This book offers a valuable guide for practicing bridge engineers and graduate students in structural engineering; its main purpose is to present the latest concepts in bridge engineering in fairly easy-to-follow terms. The book provides details of easy-to-use computer programs for: ·      Analysing slab-on-girder bridges for live load distribution. ·      Analysing slab and other solid bridge components for live load distribution. ·      Analysing and designing concrete deck slab overhangs of girder bridges under vehicular loads. ·      Determining the failure loads of concrete deck slabs of girder bridges under concentrated wheel loads. In addition, the book includes extensive chapters dealing with the design of wood bridges and soil-steel bridges. Further, a unique chapter on structural health monitoring (SHM) will help bridge engineers determine the actual load carrying capacities of bridges, as opposed to their perceived analytical capacities. The chapter addressing structures...

  3. Heat generation during implant placement in low-density bone: effect of surgical technique, insertion torque and implant macro design.

    Science.gov (United States)

    Marković, Aleksa; Mišić, Tijana; Miličić, Biljana; Calvo-Guirado, Jose Luis; Aleksić, Zoran; Ðinić, Ana

    2013-07-01

    The study aimed to investigate the effect of surgical technique, implant macrodesign and insertion torque on bone temperature changes during implant placement. In the in vitro study, 144 self-tapping (blueSKY(®) 4 × 10 mm; Bredent) and 144 non-self-tapping (Standard implant(®) 4.1 × 10 mm; Straumann) were placed in osteotomies prepared in pig ribs by lateral bone condensing or bone drilling techniques. The maximum insertion torque values of 30, 35 and 40 Ncm were used. Real-time bone temperature measurement during implant placement was performed by three thermocouples positioned vertically, in tripod configuration around every osteotomy, at a distance of 5 mm from it and at depths of 1, 5 and 10 mm. Data were analysed using Kruskal-Wallis, Mann-Whitney U-tests and Regression analysis. Significant predictor of bone temperature at the osteotomy depth of 1 mm was insertion torque (P = 0.003) and at the depth of 10-mm implant macrodesign (P = 0.029), while no significant predictor at depth of 5 mm was identified (P > 0.05). Higher insertion torque values as well as non-self-tapping implant macrodesign were related to higher temperatures. Implant placement in sites prepared by bone drilling induced significantly higher temperature increase (P = 0.021) compared with bone condensing sites at the depth of 5 mm, while no significant difference was recorded at other depths. Compared with 30 Ncm, insertion torque values of 35 and 40 Ncm produced significantly higher temperature increase (P = 0.005; P = 0.003, respectively) at the depth of 1 mm. There was no significant difference in temperature change induced by 35 and 40 Ncm, neither by implant macrodesign at all investigated depths (P > 0.05). Placement of self-tapping implants with low insertion torque into sites prepared by lateral bone condensing technique might be advantageous in terms of thermal effect on bone. © 2012 John Wiley & Sons A/S.

  4. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  5. Bone Diseases

    Science.gov (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  6. An Innovative School Health Education Model Designed for Student Achievement.

    Science.gov (United States)

    Rohwer, John; Wandberg, Bob

    New threats to the health of American children, often psychosocial in nature due to societal changes, must be addressed. The Minnesota School Health Education Model is based on the integration of four primary components: (1) school health education goals aimed at health promotion, disease prevention, and long-term positive health effects on…

  7. Use of CTX-I and PINP as bone turnover markers: National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability.

    Science.gov (United States)

    Szulc, P; Naylor, K; Hoyle, N R; Eastell, R; Leary, E T

    2017-09-01

    The National Bone Health Alliance (NBHA) recommends standardized sample handling and patient preparation for C-terminal telopeptide of type I collagen (CTX-I) and N-terminal propeptide of type I procollagen (PINP) measurements to reduce pre-analytical variability. Controllable and uncontrollable patient-related factors are reviewed to facilitate interpretation and minimize pre-analytical variability. The IOF and the International Federation of Clinical Chemistry (IFCC) Bone Marker Standards Working Group have identified PINP and CTX-I in blood to be the reference markers of bone turnover for the fracture risk prediction and monitoring of osteoporosis treatment. Although used in clinical research for many years, bone turnover markers (BTM) have not been widely adopted in clinical practice primarily due to their poor within-subject and between-lab reproducibility. The NBHA Bone Turnover Marker Project team aim to reduce pre-analytical variability of CTX-I and PINP measurements through standardized sample handling and patient preparation. Recommendations for sample handling and patient preparations were made based on review of available publications and pragmatic considerations to reduce pre-analytical variability. Controllable and un-controllable patient-related factors were reviewed to facilitate interpretation and sample collection. Samples for CTX-I must be collected consistently in the morning hours in the fasted state. EDTA plasma is preferred for CTX-I for its greater sample stability. Sample collection conditions for PINP are less critical as PINP has minimal circadian variability and is not affected by food intake. Sample stability limits should be observed. The uncontrollable aspects (age, sex, pregnancy, immobility, recent fracture, co-morbidities, anti-osteoporotic drugs, other medications) should be considered in BTM interpretation. Adopting standardized sample handling and patient preparation procedures will significantly reduce controllable pre

  8. Bone health and risk factors of cardiovascular disease--a cross-sectional study in healthy young adults.

    Directory of Open Access Journals (Sweden)

    Satu Pirilä

    Full Text Available OBJECTIVE: Both osteoporosis and cardiovascular disease (CVD are diseases that comprise a growing medical and economic burden in ageing populations. They share many risk factors, including ageing, low physical activity, and possibly overweight. We aimed to study associations between individual risk factors for CVD and bone mineral density (BMD and turnover markers (BTMs in apparently healthy cohort. DESIGN: A cross-sectional assessment of 155 healthy 32-year-old adults (74 males was performed for skeletal status, CVD risk factors and lifestyle factors. METHODS: We analysed serum osteocalcin, procollagen I aminoterminal propeptide (P1NP, collagen I carboxy-terminal telopeptide (ICTP and urine collagen I aminoterminal telopeptide (U-NTX, as well as serum insulin, plasma glucose, triglyceride and HDL-cholesterol levels. BMD, fat and lean mass were assessed using DXA scanning. Associations were tested with partial correlations in crude and adjusted models. Bone status was compared between men with or without metabolic syndrome (defined according to the NCEP-ATPIII criteria with multivariate analysis. RESULTS: Osteocalcin and P1NP correlated inversely with insulin (R = -0.243, P = 0.003 and R = -0.187, P = 0.021 and glucose (R = -0.213, P = 0.009 and R = -0.190, P = 0.019, but after controlling for fat mass and lifestyle factors, the associations attenuated with insulin (R = -0.162, P = 0.053 and R = -0.093, P = 0.266 and with glucose (R = -0.099, P = 0.240 and R = -0.133, P = 0.110, respectively. Whole body BMD associated inversely only with triglycerides in fully adjusted model. In men with metabolic syndrome, whole body BMD, osteocalcin and P1NP were lower compared to healthy men, but these findings disappeared in fully adjusted model. CONCLUSIONS: In young adults, inverse associations between BTM/BMD and risk factors of CVD appeared in crude models, but after adjusting for fat mass

  9. Designer bFGF-incorporated D-form self-assembly peptide nanofiber scaffolds to promote bone repair

    Energy Technology Data Exchange (ETDEWEB)

    He, Bin, E-mail: binheing@163.com [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Ou, Yunsheng; Chen, Shuo; Zhao, Weikang; Zhou, Ao [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Zhao, Jinqiu [Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Li, Hong [School of Physical Science and Technology, Sichuan University, Chengdu 610000 (China); Jiang, Dianming [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Zhu, Yong, E-mail: 568731668@qq.com [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China)

    2017-05-01

    D-Form and L-form peptide nanofiber scaffolds can spontaneously form stable β-sheet secondary structures and nanofiber hydrogel scaffolds, and hold some promise in hemostasis and wound healing. We report here on the synthetic self-assembling peptide D-RADA16 and L-RADA16 are both found to produce stable β-sheet secondary structure and nanofiber hydrogel scaffolds based on circular dichroism (CD) spectroscopy, transmission electron microscopy (TEM) and rheology analysis etc. D-RADA16 hydrogel and L-RADA16 hydrogel can enhance obvious bone repair in femoral condyle defects of the Sprague-Dawley (SD) rat model compared to PBS treatment. Based on micro-computed tomography (CT), it was revealed that D-RADA16 hydrogel and L-RADA16 hydrogel were capable to obtain the extensive bone healing. Histological evaluation also found that these two hydrogels facilitate the presence of more mature bone tissue within the femoral condyle defects. Additionally, D-RADA16 hydrogel showed some potential in storing and releasing basic-fibroblast growth factor (bFGF) which was able to further promote bone regeneration based on micro-CT analysis. These results indicate that D-form peptide nanofiber hydrogel have some special capacity for bone repair. - Highlights: • Peptide D-RADA16 and L-RADA16 can form stable hydrogels. • D-RADA16 hydrogel can obtain the comparable and extensive promotion to bone healing compared to L-RADA16 hydrogel. • L-RADA16 hydrogel allows for slow release of bFGF.

  10. The Design and Use of Animal Models for Translational Research in Bone Tissue Engineering and Regenerative Medicine

    Science.gov (United States)

    2010-01-07

    collagen based matrix (osteoid) that is mineralized with a unique carbonated hydroxyapatite . This mineralized bone matrix provides the unique...distinguish bone matrix and true biological mineralization (carbonated microcrystalline hydroxyapatite ) from scar or regions of precipitation of...lu s R at tu s n or v eg ic u s= ra tt u s O ry ct ol ag u s cu n ic u lu s C an is fa m il ia ri s C ap ra h ir cu s O v is ar ie s S u s sc ro fa C

  11. Design and Validation of 3D Printed Complex Bone Models with Internal Anatomic Fidelity for Surgical Training and Rehearsal.

    Science.gov (United States)

    Unger, Bertram J; Kraut, Jay; Rhodes, Charlotte; Hochman, Jordan

    2014-01-01

    Physical models of complex bony structures can be used for surgical skills training. Current models focus on surface rendering but suffer from a lack of internal accuracy due to limitations in the manufacturing process. We describe a technique for generating internally accurate rapid-prototyped anatomical models with solid and hollow structures from clinical and microCT data using a 3D printer. In a face validation experiment, otolaryngology residents drilled a cadaveric bone and its corresponding printed model. The printed bone models were deemed highly realistic representations across all measured parameters and the educational value of the models was strongly appreciated.

  12. Improving Bone-Health Monitoring in Astronauts: Recommended Use of Quantitative Computed Tomography [QCT] for Clinical and Operational Decisions by NASA

    Science.gov (United States)

    Sibonga, J. D.; Truszkowski, P.

    2010-01-01

    DXA measurement of areal bone mineral density [aBMD,g/cm2] is required by NASA for assessing skeletal integrity in astronauts. Due to the abundance of population-based data that correlate hip and spine BMDs to fragility fractures, BMD is widely applied as a predictor of fractures in the general aging population. In contrast, QCT is primarily a research technology that measures three-dimensional , volumetric BMD (vBMD,mg/cm3) of bone and is therefore capable of differentiating between cortical and trabecular components. Additionally, when combined with Finite Element Modeling [FEM], a computational tool, QCT data can be used to estimate the whole bone strength of the hip [FE strength] for a specific load vector. A recent report demonstrated that aBMD failed to correlate with incurred changes in FE strength (for fall and stance loading) by astronauts over typical 180-day ISS (International Space Station) missions. While there are no current guidelines for using QCT data in clinical practice, QCT increases the understanding of how bone structure and mineral content are affected by spaceflight and recovery on Earth. In order to understand/promote/consider the use of QCT, NASA convened a panel of clinicians specializing in osteoporosis. After reviewing the available, albeit limited, medical and research information from long-duration astronauts (e.g., data from DXA, QCT, FEM, biochemistry analyses, medical records and in-flight exercise performance) the panelists were charged with recommending how current and future research data and analyses could inform clinical and operational decisions. The Panel recommended that clinical bone tests on astronauts should include QCT (hip and lumbar spine) for occupational risk surveillance and for the estimation of whole hip bone strength as derived by FEM. FE strength will provide an improved index that NASA could use to select astronauts of optimal bone health for extended duration missions, for repeat missions or for specific

  13. Data mining of mental health issues of non-bone marrow donor siblings.

    Science.gov (United States)

    Takita, Morihito; Tanaka, Yuji; Kodama, Yuko; Murashige, Naoko; Hatanaka, Nobuyo; Kishi, Yukiko; Matsumura, Tomoko; Ohsawa, Yukio; Kami, Masahiro

    2011-07-20

    Allogenic hematopoietic stem cell transplantation is a curative treatment for patients with advanced hematologic malignancies. However, the long-term mental health issues of siblings who were not selected as donors (non-donor siblings, NDS) in the transplantation have not been well assessed. Data mining is useful in discovering new findings from a large, multidisciplinary data set and the Scenario Map analysis is a novel approach which allows extracting keywords linking different conditions/events from text data of interviews even when the keywords appeared infrequently. The aim of this study is to assess mental health issues on NDSs and to find helpful keywords for the clinical follow-up using a Scenario Map analysis. A 47-year-old woman whose younger sister had undergone allogenic hematopoietic stem cell transplantation 20 years earlier was interviewed as a NDS. The text data from the interview transcriptions was analyzed using Scenario Mapping. Four clusters of words and six keywords were identified. Upon review of the word clusters and keywords, both the subject and researchers noticed that the subject has had mental health issues since the disease onset to date with being a NDS. The issues have been alleviated by her family. This single subject study suggested the advantages of data mining in clinical follow-up for mental health issues of patients and/or their families.

  14. Maintained hand function and forearm bone health 14 months after an in-home virtual-reality videogame hand telerehabilitation intervention in an adolescent with hemiplegic cerebral palsy.

    Science.gov (United States)

    Golomb, Meredith R; Warden, Stuart J; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C

    2011-03-01

    Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.

  15. Maintained Hand Function and Forearm Bone Health 14 Months After an In-Home Virtual-Reality Videogame Hand Telerehabilitation Intervention in an Adolescent With Hemiplegic Cerebral Palsy

    Science.gov (United States)

    Golomb, Meredith R.; Warden, Stuart J.; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C.

    2015-01-01

    Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article. PMID:21383228

  16. Digital health increasing the impact with personalized design

    NARCIS (Netherlands)

    Empelen, P. van; Otten, W.; Molema, H.; Keijsers, J.; Mooij, R.

    2016-01-01

    Digital health is considered the ‘holy grail’ of effective and sustainable health(care). It uses the latest technology, apps and data to support and improve health. Digital health tools can benefit both patients and healthy individuals, with support and advice. But healthcare professionals,

  17. Design and biological functionality of a novel hybrid Ti-6Al-4V/hydrogel system for reconstruction of bone defects.

    Science.gov (United States)

    Kumar, Alok; Nune, K C; Misra, R D K

    2018-04-01

    We have designed a unique injectable bioactive hydrogel comprising of alginate, gelatin, and nanocrystalline hydroxyapatite and loaded with osteoblasts, with the ability to infiltrate into three-dimensional Ti-6Al-4V scaffolds with interconnected porous architecture, fabricated by electron beam melting. A two-step crosslinking process using the EDC/NHS and CaCl 2 was adopted and found to be effective in the fabrication of cell-loaded hydrogel/Ti-6Al-4V scaffold system. This hybrid Ti-6Al-4V scaffold/hydrogel system was designed for the reconstruction of bone defects, which are difficult to heal in the absence of suitable support materials. The hybrid Ti-6Al-4V/hydrogel system favourably modulated the biological functions, namely, adhesion, proliferation, cell-to-cell, and cell-material communication because of the presence of extracellular matrix-like hydrogel in the interconnected porous structure of 3D printed Ti-6Al-4V scaffold. The hydrogel was cytocompatible, which was proven through live/dead assay, the expression level of prominent proteins for cell adhesion and cytoskeleton, including 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay. Furthermore, the high bone formation ability of the hydrogel was confirmed using alkaline phosphatase assay. A high equilibrium water content (~97%) in the hydrogel enables the delivery of cells and bioactive molecules, necessary for bone tissue growth. Although not studied, the presence of hydrogel in the pores of the scaffold can provide the space for the cell migration as well as vascularization through it, required for the effective exchange of nutrients. In conclusion, we underscore that the 3D-printed Ti-6Al-4V scaffold-loaded with bioactive hydrogel to treat the bone defects significantly impacted cellular functions and cell-material interaction. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Integrating Participatory Design and Health Literacy to Improve Research and Interventions.

    Science.gov (United States)

    Neuhauser, Linda

    2017-01-01

    Health communication is an essential health promotion strategy to convert scientific findings into actionable, empowering information for the public. Health communication interventions have shown positive outcomes, but many efforts have been disappointing. A key weakness is that expert-designed health communication is often overly generic and not adequately aligned with the abilities, preferences and life situations of specific audiences. The emergence of the field of health literacy is providing powerful theoretical guidance and practice strategies. Health literacy, in concert with other determinants of health, has greatly advanced understanding of factors that facilitate or hinder health promotion at individual, organizational and community settings. However, health literacy models are incomplete and interventions have shown only modest success to date. A challenge is to move beyond the current focus on individual comprehension and address deeper factors of motivation, self-efficacy and empowerment, as well as socio-environmental influences, and their impact to improve health outcomes and reduce health disparities. Integrating participatory design theory and methods drawn from social sciences and design sciences can significantly improve health literacy models and interventions. Likewise, researchers and practitioners using participatory design can greatly benefit from incorporating health literacy principles into their efforts. Such interventions at multiple levels are showing positive health outcomes and reduction of health disparities, but this approach is complex and not yet widespread. This chapter focuses on research findings about health literacy and participatory design to improve health promotion, and practical guidance and case examples for researchers, practitioners and policymakers.

  19. Design, fabrication and structural optimization of tubular carbon/Kevlar®/PMMA/graphene nanoplate composite for bone fixation prosthesis.

    Science.gov (United States)

    Nasiri, F; Ajeli, S; Semnani, D; Jahanshahi, M; Emadi, R

    2018-05-02

    The present work investigates the mechanical properties of tubular carbon/Kevlar ® composite coated with poly(methyl methacrylate)/graphene nanoplates as used in the internal fixation of bones. Carbon fibers are good candidates for developing high-strength biomaterials and due to better stress transfer and electrical properties, they can enhance tissue formation. In order to improve carbon brittleness, ductile Kevlar ® was added to the composite. The tubular carbon/Kevlar ® composites have been prepared with tailorable braiding technology by changing the fiber pattern and angle in the composite structure and the number of composite layers. Fuzzy analyses are used for optimizing the tailorable parameters of 80 prepared samples and then mechanical properties of selected samples are discussed from the viewpoint of mechanical properties required for a bone fixation device. Experimental results showed that with optimizing braiding parameters the desired composite structure with mechanical properties close to bone properties could be produced. Results showed that carbon/Kevlar ® braid's physical properties, fiber composite distribution and diameter uniformity resulted in matrix uniformity, which enhanced strength and modulus due to better ability for distributing stress on the composite. Finally, as graphene nanoplates demonstrated their potential properties to improve wound healing intended for bone replacement, so reinforcing the PMMA matrix with graphene nanoplates enhanced the composite quality, for use as an implant.

  20. Gender Diversity, Sexual Orientation, and Bone Health in the Maturing Dancer.

    Science.gov (United States)

    Brown, Derrick D

    2017-12-01

    Gender identity forms an important aspect of still developing youths. Gender is traditionally classified into two distinct categories, female and male. Transgender is a general term that describes individuals who self-identity as male, female, both, or neither (i.e., gender fluid) and do not match the assigned at-birth gender. Adolescent transgender individuals are currently a marginal population. There are limited demographics on youths, but as of 2014 an estimate of 1.4 million adults in the USA identified as transgender. It does seem, however, as more adults embrace their gender diversity and come out as transgender, in some cases opting for surgical reassignment, more adolescents and families are accepting their diversity. A growing body of research highlights transgender adolescents and their specific medical and mental health needs. This review seeks to underscore physiological phenomena relevant to trans-individuals, particularly in adolescents maturing into young adults, and disseminate this knowledge to dance, health, and education professionals.

  1. Recognizing critical mine spoil health characteristics to design ...

    Science.gov (United States)

    Biochar can be used as an amendment to remediate metal-contaminated mine spoils for improved site phytostabilization. For successful phytostabilization to occur, biochar amendments must improve mine spoil health with respect to plant rooting plus uptake of water and nutrients. An inappropriate biochar may negatively impact plant growth conditions resulting in poor plant establishment and growth. Matching the appropriate biochar for each mine site requires reconnaissance of spoil chemical and physical conditions and then identifying which properties need rectified to promote plant growth. A rectification hierarchy needs to be established with the primary limiting factor being addressed first, then successive limitations addressed simultaneously or thereafter. We posit that spoils at each site will have a unique chemical, physical, and biological signature that will affect plant growth. For example, some spoils may be extremely acidic, possess phytotoxic concentrations of heavy metals, or have physical conditions that limits water storage and root penetration. Quantifying these and other conditions beforehand allows for the production of designer biochar with specific characteristics tailored for specific plant growth deficiencies within each spoil. Additionally, we recommend the use of proximally located, undisturbed soils to establish spoil remediation targets. In our work, we have developed a decision-tree flow-chart that identifies salient chemical,

  2. Designing smartphone mental health applications for emergency service workers.

    Science.gov (United States)

    Deady, M; Peters, D; Lang, H; Calvo, R; Glozier, N; Christensen, H; Harvey, S B

    2017-08-01

    Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. Design and Implementation of Ubiquitous Health System U-Health Using Smart-Watches Sensors

    Science.gov (United States)

    Razavi Termeh, V.; Sadeghi Niaraki, A.

    2015-12-01

    Today as diseases grow rapidly, the responsibilities of the health clinics in giving services to patients increase and patients have to be more monitored and controlled. Remote systems of monitoring patients result in reducing cost, ease of movement, and also persistent control of patients by their doctors, so that patient can be monitored without need to go to the clinic. Recent advances in the field of ubiquitous sciences as well as using smartphones have resulted in increasingly use of this devices in remote monitoring of patients. The aim of this paper is to design and implement a ubiquitous health system using smartphones and sensors of smart-watches. This is accomplished through the information sent to the smartphone from the sensors of the watch, e.g. heart beat measurement sensor and ultraviolet ray. Then, this information is analyzed in the smartphone and some information based on the position of the patient and the path of him/her using GIS analyses as well as the information about the health level of the patient is sent to the doctor via SMS or phone call. Unnatural heart beats can be resulted in diseases such as Heart Failure and Arterial Fibrillation. With the approach adopted in this study, the patient or the doctor could be aware of these diseases at any time. The proposed approach is a low cost, without need to complex and resilient equipment, system in ubiquitous health that does not limit the movement of the patient.

  4. Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

    Science.gov (United States)

    Velez, Olivia

    2011-01-01

    Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce…

  5. Viewing Ascension Health From A Design Thinking Perspective

    OpenAIRE

    Natalie W. Nixon

    2013-01-01

    In this commentary, I discuss how the design thinking concepts of empathy, related worlds, prototyping, ethnography, and story could enhance Ascension Health’s organizational design and ultimately its delivery of healthcare services.  When organization design integrates a design thinking lens, more meaningful and innovative processes are developed both internally among organizational actors and externally with end users.

  6. Social media for health promotion in diabetes: study protocol for a participatory public health intervention design.

    Science.gov (United States)

    Gabarron, E; Bradway, M; Fernandez-Luque, L; Chomutare, T; Hansen, A H; Wynn, R; Årsand, E

    2018-06-05

    Participatory health approaches are increasingly drawing attention among the scientific community, and could be used for health promotion programmes on diabetes through social media. The main aim of this project is to research how to best use social media to promote healthy lifestyles with and within the Norwegian population. The design of the health promotion intervention (HPI) will be participatory, and will involve both a panel of healthcare experts and social media users following the Norwegian Diabetes Association. The panel of experts will agree on the contents by following the Delphi method, and social media users will participate in the definition of the HPI by expressing their opinions through an adhoc online questionnaire. The agreed contents between both parties to be used in the HPI will be posted on three social media channels (Facebook, Twitter and Instagram) along 24 months. The 3 months before starting the HPI, and the 3 months after the HPI will be used as control data. The effect of the HPI will be assessed by comparing formats, frequency, and reactions to the published HPI messages, as well as comparing potential changes in five support-intended communication behaviours expressed on social media, and variations in sentiment analysis before vs during and after the HPI. The HPI's effect on social media users' health-related lifestyles, online health behaviours, and satisfaction with the intervention will be assessed every 6 months through online questionnaires. A separate questionnaire will be used to assess the panel of experts' satisfaction and perceptions of the benefits for health professionals of a HPI as this one. The time constraints of today's medical practice combined with the piling demand of chronic conditions such as diabetes make any additional request of extra time used by health care professionals a challenge. Social media channels provide efficient, ubiquitous and user-friendly platforms that can encourage participation

  7. Maternal serum retinol and β-carotene concentrations and neonatal bone mineralization

    DEFF Research Database (Denmark)

    Händel, Mina N; Moon, Rebecca J.; Titcombe, Philip

    2016-01-01

    were assessed prepregnancy and at 11 and 34 wk of gestation. In late pregnancy, maternal serum retinol and β-carotene concentrations were measured. Offspring total body bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were measured within 2 wk after birth. RESULTS: In total......BACKGROUND: Studies in older adults and animals have suggested contrasting relations between bone health and different vitamin A compounds. To our knowledge, the associations between maternal vitamin A status and offspring bone development have not previously been elucidated. OBJECTIVE: We examined...... the associations between maternal serum retinol and β-carotene concentrations during late pregnancy and offspring bone mineralization assessed at birth with the use of dual-energy X-ray absorptiometry. DESIGN: In the Southampton Women's Survey mother-offspring birth cohort, maternal health, lifestyle, and diet...

  8. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study.

    NARCIS (Netherlands)

    Gerritsen, A.A.M.; Bramsen, I.; Devillé, W.; Willigen, L.H.M. van; Hovens, J.E.; Ploeg, H.M. van der

    2004-01-01

    BACKGROUND: This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of

  9. Gender-Specific Associations of Serum Insulin-Like Growth Factor-1 With Bone Health and Fractures in Older Persons

    NARCIS (Netherlands)

    van Varsseveld, N.C.; Sohl, E.; Drent, M.L.; Lips, P.

    2015-01-01

    Context: IGF-1 plays a role in bone metabolism. Although IGF-1 and bone mass both decrease with advancing age, their relationship in older individuals remains to be elucidated. Objective: The objective was to investigate associations of serum IGF-1 cross-sectionally with quantitative ultrasound and

  10. A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures.

    Science.gov (United States)

    Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan

    2011-01-01

    Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

  11. Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design

    Directory of Open Access Journals (Sweden)

    Douglas R. Wholey

    2018-05-01

    Full Text Available We describe a master’s level public health informatics (PHI curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master’s and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs.

  12. Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design

    Science.gov (United States)

    Wholey, Douglas R.; LaVenture, Martin; Rajamani, Sripriya; Kreiger, Rob; Hedberg, Craig; Kenyon, Cynthia

    2018-01-01

    We describe a master’s level public health informatics (PHI) curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master’s and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs. PMID:29770321

  13. Microlearning mApp raises health competence : Hybrid service design

    NARCIS (Netherlands)

    Simons, L.P.A.; Foerster, F.; Bruck, P.A.; Motiwalla, L.; Jonker, C.M.

    2015-01-01

    Work place health support interventions can help support our aging work force, with mApps offering cost-effectiveness opportunities. Previous research shows that health support apps should offer users enough newness and relevance each time they are used. Otherwise the ‘eHealth law of attrition’

  14. Design of the national health security preparedness index.

    Science.gov (United States)

    Uzun Jacobson, Evin; Inglesby, Tom; Khan, Ali S; Rajotte, James C; Burhans, Robert L; Slemp, Catherine C; Links, Jonathan M

    2014-01-01

    The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts.

  15. Comparison of our self-designed rotary self-locking intramedullary nail and interlocking intramedullary nail in the treatment of long bone fractures.

    Science.gov (United States)

    Liu, Bailian; Xiong, Ying; Deng, Hong; Gu, Shao; Jia, Fu; Li, Qunhui; Wang, Daxing; Gan, Xuewen; Liu, Wei

    2014-07-21

    The purpose of this study is to compare the clinical effects of our self-designed rotary self-locking intramedullary nail (RSIN) and interlocking intramedullary nail (IIN) for long bone fractures. A retrospective study was performed in 1,704 patients who suffered bone fractures and underwent RSIN or IIN operation in our hospital between March 1999 and March 2013, including 494 with femoral fractures, 572 with humeral fractures, and 638 with tibial fractures. Among them, 634 patients were followed up for more than 1 year. The operative time, intraoperative blood loss, postoperative complications, healing rate, and the excellent and good rate of functional recovery were compared between two groups. Compared with IIN group, RSIN group exhibited significantly shorter operative time and less intraoperative blood loss no matter for humeral, femoral, or tibial fractures (all p fractures (both p fracture. In IIN group, nail breakage or loosening occurred in 7 patients with femoral fractures and 16 patients with tibial fractures, radial nerve injury was observed in 8 patients with humeral fractures, and incision infection was present in 2 patients with humeral fractures and 1 patient with femoral fracture. The complication rate of IIN group was significantly higher than that of RSIN group (p knee, and ankle joint functional recovery between RSIN group and IIN group. RSIN may be a reliable and practical alternative method for the treatment of long bone fractures.

  16. Effect of macro-design of immediately loaded implants on micromotion and stress distribution in surrounding bone using finite element analysis.

    Science.gov (United States)

    Fazel, Akbar; Aalai, Shima; Rismanchian, Mansour

    2009-08-01

    Macro-design influences the initial stability of implant and reduces micromotions. The aim of this study was to determine and compare micromotions and stress distribution in the bone around immediately loaded Maestro and Xive implants using finite element analysis. In this experimental study, accurate, clear photos were prepared of Xive and Maestro implants 12 and 13 mm long and 4 and 3.8 mm in diameter, respectively, using a Nikon Digital Camera with a resolution 5.24-megapixels with 8x Optical Zoom and 4x Digital Zoom. After accurate measurements, 3-D models of the implants inside the lower mandible (D2) were processed in Solidworks Version 2003 environment and transferred into Ansys for finite element analysis. After loading of 500 N angled at 70 degrees from the horizontal plane, the micromotion of the implant and Von Misses stresses around the bone were measured. The measured micromotion in Maestro implant was 148 mum and that in Xive was 284 mum. Stress distribution in the bone surrounding Maestro implant was better than Xive, but maximum stress surrounding Xive implants (30 MPa) was lower than Maestro (33 MPa). Based on the results obtained in the present study, maximum micromotion in maestro was less than that in Xive implants. This finding can guarantee the application of maestro implants for immediate loading.

  17. Alginate/nanohydroxyapatite scaffolds with designed core/shell structures fabricated by 3D plotting and in situ mineralization for bone tissue engineering.

    Science.gov (United States)

    Luo, Yongxiang; Lode, Anja; Wu, Chengtie; Chang, Jiang; Gelinsky, Michael

    2015-04-01

    Composite scaffolds, especially polymer/hydroxyapatite (HAP) composite scaffolds with predesigned structures, are promising materials for bone tissue engineering. Various methods including direct mixing of HAP powder with polymers or incubating polymer scaffolds in simulated body fluid for preparing polymer/HAP composite scaffolds are either uncontrolled or require long times of incubation. In this work, alginate/nano-HAP composite scaffolds with designed pore parameters and core/shell structures were fabricated using 3D plotting technique and in situ mineralization under mild conditions (at room temperature and without the use of any organic solvents). Light microscopy, scanning electron microscopy, microcomputer tomography, X-ray diffraction, and Fourier transform infrared spectroscopy were applied to characterize the fabricated scaffolds. Mechanical properties and protein delivery of the scaffolds were evaluated, as well as the cell response to the scaffolds by culturing human bone-marrow-derived mesenchymal stem cells (hBMSC). The obtained data indicate that this method is suitable to fabricate alginate/nano-HAP composite scaffolds with a layer of nano-HAP, coating the surface of the alginate strands homogeneously and completely. The surface mineralization enhanced the mechanical properties and improved the cell attachment and spreading, as well as supported sustaining protein release, compared to pure alginate scaffolds without nano-HAP shell layer. The results demonstrated that the method provides an interesting option for bone tissue engineering application.

  18. Using design science and artificial intelligence to improve health communication: ChronologyMD case example.

    Science.gov (United States)

    Neuhauser, Linda; Kreps, Gary L; Morrison, Kathleen; Athanasoulis, Marcos; Kirienko, Nikolai; Van Brunt, Deryk

    2013-08-01

    This paper describes how design science theory and methods and use of artificial intelligence (AI) components can improve the effectiveness of health communication. We identified key weaknesses of traditional health communication and features of more successful eHealth/AI communication. We examined characteristics of the design science paradigm and the value of its user-centered methods to develop eHealth/AI communication. We analyzed a case example of the participatory design of AI components in the ChronologyMD project intended to improve management of Crohn's disease. eHealth/AI communication created with user-centered design shows improved relevance to users' needs for personalized, timely and interactive communication and is associated with better health outcomes than traditional approaches. Participatory design was essential to develop ChronologyMD system architecture and software applications that benefitted patients. AI components can greatly improve eHealth/AI communication, if designed with the intended audiences. Design science theory and its iterative, participatory methods linked with traditional health communication theory and methods can create effective AI health communication. eHealth/AI communication researchers, developers and practitioners can benefit from a holistic approach that draws from theory and methods in both design sciences and also human and social sciences to create successful AI health communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. The intensity of physical activity influences bone mineral accrual in childhood: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark.

    Science.gov (United States)

    Heidemann, Malene; Mølgaard, Christian; Husby, Steffen; Schou, Anders J; Klakk, Heidi; Møller, Niels Chr; Holst, René; Wedderkopp, Niels

    2013-03-02

    Studies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and Bone Area (BA) accretion. This longitudinal study is a part of The CHAMPS study-DK. Whole-body DXA scans were performed at baseline and after two years follows up. BMC, BMD, and BA were measured. The total body less head (TBLH) values were used. Physical activity (PA) was recorded by accelerometers (ActiGraph, model GT3X). Percentages of different PA intensity levels were calculated and log odds of two intensity levels of activity relative to the third level were calculated. Multilevel regression analyses were used to assess the relationship between the categories of physical activity and bone traits. Of 800 invited children, 742 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow up. Complete datasets were obtained in 602/742 (81%) children. Mean (range) of age was 11.5 years (9.7-13.9). PA at different intensity levels was for boys and girls respectively, sedentary 62% and 64%, low 29% for both genders and moderate to high 9% and 7% of the total time. Mean (range) BMC, BMD, and BA was 1179 g (563-2326), 0.84 g/cm2 (0.64-1.15) and 1393 cm2 (851-2164), respectively. Valid accelerometer data were obtained for a mean of 6.1 days, 13 hours per day. There 7was a positive relationship between the log odds of moderate to high-level PA versus low level activity and BMC, BMD and BA. Children with an increased proportion of time in moderate to high-level activity as opposed to sedentary and low-level activity achieved positive effects on BMC, BMD and BA.

  20. Usefulness of calcaneal quantitative ultrasound stiffness for the evaluation of bone health in HIV-1-infected subjects: comparison with dual X-ray absorptiometry.

    Science.gov (United States)

    Fantauzzi, Alessandra; Floridia, Marco; Ceci, Fabrizio; Cacciatore, Francesco; Vullo, Vincenzo; Mezzaroma, Ivano

    2016-01-01

    With the development of effective treatments and the resulting increase in life expectancy, bone mineral density (BMD) alteration has emerged as an important comorbidity in human immunodeficiency virus type-1 (HIV-1)-infected individuals. The potential contributors to the pathogenesis of osteopenia/osteoporosis include a higher prevalence of risk factors, combined antiretroviral therapy (cART)-exposure, HIV-1 itself and chronic immune activation/inflammation. Dual-energy X-ray absorptiometry (DXA) is the "gold standard" technique for assessing bone status in HIV-1 population. We conducted a cross-sectional study to investigate bone mineral status in a group of 158 HIV-1-infected subjects. The primary endpoint was the feasibility of calcaneal quantitative ultrasound (QUS) as a screening tool for BMD. All subjects were receiving stable cART and were virologically suppressed (HIV-RNA HIV-1-specific characteristics, also including cART strategies. In the univariate analyses BMD, QUS indexes, and Fracture Risk Assessment Tool scores conversely showed significant associations with one or more demographic or HIV-1-related variables. Moreover, a significant relationship between calcaneal quantitative ultrasound index/stiffness and femoral/lumbar BMD values from DXA was described. The multivariate analysis showed an independent association between calcaneal quantitative ultrasound index/stiffness and body mass index, higher CD4+ T-cell numbers and low 25-OH D2/D3 vitamin D levels HIV-1-infected patients for assessing bone health impairment. In fact, the results obtained confirm that calcaneal QUS may be useful for monitoring bone status, being a noninvasive and inexpensive technique, especially in those subjects with the classical traditional risk factors for bone damage that were observed earlier in HIV-1 population.

  1. Designing a community-based lay health advisor training curriculum to address cancer health disparities.

    Science.gov (United States)

    Gwede, Clement K; Ashley, Atalie A; McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B; Wathington, Deanna; Dash-Pitts, Lolita; Green, B Lee

    2013-05-01

    Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. APPROACH AND STRATEGIES: Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic-community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research.

  2. Factors in secondary prevention subsequent to distal radius fracture : Focus on physical function, co-morbidity, bone mineral density and health-related quality of life

    OpenAIRE

    Nordvall, Helena

    2009-01-01

    In Sweden approximately 25000 distal radius fractures occur annually, which is 37 % of all fractures related to osteoporosis. In this thesis, risk factors for osteoporosis, bone mineral density (BMD) and health-related quality of life (the SF-36) were compared in patients who suffered a distal radius fracture after low energy trauma with a control group matched on the basis of age, gender, and municipality of residence. The aim was also to analyse, among these patients, whether a risk factor ...

  3. Choropleth map legend design for visualizing community health disparities

    Directory of Open Access Journals (Sweden)

    Cromley Ellen K

    2009-09-01

    Full Text Available Abstract Background Disparities in health outcomes across communities are a central concern in public health and epidemiology. Health disparities research often links differences in health outcomes to other social factors like income. Choropleth maps of health outcome rates show the geographical distribution of health outcomes. This paper illustrates the use of cumulative frequency map legends for visualizing how the health events are distributed in relation to social characteristics of community populations. The approach uses two graphs in the cumulative frequency legend to highlight the difference between the raw count of the health events and the raw count of the social characteristic like low income in the geographical areas of the map. The approach is applied to mapping publicly available data on low birth weight by town in Connecticut and Lyme disease incidence by town in Connecticut in relation to income. The steps involved in creating these legends are described in detail so that health analysts can adopt this approach. Results The different health problems, low birth weight and Lyme disease, have different cumulative frequency signatures. Graphing poverty population on the cumulative frequency legends revealed that the poverty population is distributed differently with respect to the two different health problems mapped here. Conclusion Cumulative frequency legends can be useful supplements for choropleth maps. These legends can be constructed using readily available software. They contain all of the information found in standard choropleth map legends, and they can be used with any choropleth map classification scheme. Cumulative frequency legends effectively communicate the proportion of areas, the proportion of health events, and/or the proportion of the denominator population in which the health events occurred that falls within each class interval. They illuminate the context of disease through graphing associations with other

  4. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  5. Diet-dependent net endogenous acid load of vegan diets in relation to food groups and bone health-related nutrients: results from the German Vegan Study.

    Science.gov (United States)

    Ströhle, Alexander; Waldmann, Annika; Koschizke, Jochen; Leitzmann, Claus; Hahn, Andreas

    2011-01-01

    Dietary composition has been shown to affect acid-base homeostasis and bone health in humans. We investigated the potential renal acid load (PRAL) and the estimated diet-dependent net acid load (net endogenous acid production, NEAP) in adult vegans and evaluated the relationships between NEAP, food groups and intake of bone health-related nutrients. The German Vegan Study (GVS) is a cross-sectional study. Data from healthy men (n = 67) and women (n = 87), aged 21-75 years, who fulfilled the study criteria (vegan diet for ≥1 year prior to study start; age ≥18 years, and no pregnancy/childbirth during the last 12 months) were included in the analysis. NEAP values were calculated from diet composition using two models: one based on the protein/potassium quotient and another taking into account an anthropometry-based loss of urinary organic anions. Mean daily intakes of phosphorus, potassium, sodium, magnesium and vitamin C were above, and vitamin D and calcium below Dietary Reference Intake (DRI). Regardless of the model used, the diet in the GVS was characterized by a nearly neutral NEAP. A strong correlation was observed between the NEAP values of the two models (r(s) = 0.873, p vegan diets do not affect acid-base homeostasis. With respect to bone health, the significance of this finding needs further investigation. Copyright © 2011 S. Karger AG, Basel.

  6. Design of an indicator for health and safety governance

    OpenAIRE

    Minguillón, Roberto F.; Yacuzzi, Enrique

    2009-01-01

    Occupational Health and Safety Governance (OHSG) is a branch of Corporate Governance by which the board directs and controls labor risks created by their own enterprise. The OHSG concept is relatively new; unlike Occupational Health and Safety Management, which is mostly related to the work of managerial ranks, OHSG deals with principles, the interests of stakeholders, and the work of directors. The paper defines the new concept, OHSG, develops an original health and safety indicator, and pre...

  7. Maternal Nutrition During Pregnancy: Intake of Nutrients Important for Bone Health.

    Science.gov (United States)

    Hyde, Natalie K; Brennan-Olsen, Sharon L; Bennett, Kathy; Moloney, David J; Pasco, Julie A

    2017-04-01

    Objectives Maternal nutrition during pregnancy plays an important role in predisposing offspring to the development of chronic disease in adulthood, including osteoporosis. Our aim was to investigate maternal dietary intakes during pregnancy, with a focus on nutrients important for skeletal development in the offspring. Methods In this case-control study, cases were pregnant women recruited for the Vitamin D in Pregnancy Study (n = 350, age 20-40 years) and controls were non-pregnant peers participating in the Geelong Osteoporosis Study (n = 305, age 20-40 years). Dietary intakes of nutrients were quantified using a validated food frequency questionnaire. Results Compared to controls, cases consumed more energy [median (interquartile range): 7831 (6506-9461) vs. 7136 (6112-8785) kJ/day]; median intakes for cases were greater for carbohydrates [206.2 (172.5-249.9) vs. 188.2 (147.7-217.5) g/day], fat [77.9 (60.3-96.6) vs. 72.1 (53.3-87.4) g/day], potassium [2860 (2363-3442) vs. 2606 (2166-3442) mg/day] and calcium [1022 (819-1264) vs. 918 (782-1264) mg/day] (all p ≤ 0.05). However, pregnant women were not consuming greater amounts of those nutrients which had an increased demand (protein, magnesium, phosphorus and zinc). Similarly, this translated to the likelihood of achieving national recommendations for corresponding nutrients. Conclusions for Practice Compared to their non-pregnant peers, pregnant women were more likely to meet dietary recommendations for calcium and potassium; however, this was not the pattern observed for protein, magnesium and zinc. Future public health messages should perhaps focus on increasing awareness of the importance of all these nutrients during pregnancy.

  8. Design of an online health-promoting community: negotiating user community needs with public health goals and service capabilities.

    Science.gov (United States)

    Ekberg, Joakim; Timpka, Toomas; Angbratt, Marianne; Frank, Linda; Norén, Anna-Maria; Hedin, Lena; Andersen, Emelie; Gursky, Elin A; Gäre, Boel Andersson

    2013-07-04

    An online health-promoting community (OHPC) has the potential to promote health and advance new means of dialogue between public health representatives and the general public. The aim of this study was to examine what aspects of an OHPC that are critical for satisfying the needs of the user community and public health goals and service capabilities. Community-based participatory research methods were used for data collection and analysis, and participatory design principles to develop a case study OHPC for adolescents. Qualitative data from adolescents on health appraisals and perspectives on health information were collected in a Swedish health service region and classified into categories of user health information exchange needs. A composite design rationale for the OHPC was completed by linking the identified user needs, user-derived requirements, and technical and organizational systems solutions. Conflicts between end-user requirements and organizational goals and resources were identified. The most prominent health information needs were associated to food, exercise, and well-being. The assessment of the design rationale document and prototype in light of the regional public health goals and service capabilities showed that compromises were needed to resolve conflicts involving the management of organizational resources and responsibilities. The users wanted to discuss health issues with health experts having little time to set aside to the OHPC and it was unclear who should set the norms for the online discussions. OHPCs can be designed to satisfy both the needs of user communities and public health goals and service capabilities. Compromises are needed to resolve conflicts between users' needs to discuss health issues with domain experts and the management of resources and responsibilities in public health organizations.

  9. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  10. Module for applications of bone scan in cancer patients; Modulo para solicitudes de gammagrafia osea en pacientes con cancer

    Energy Technology Data Exchange (ETDEWEB)

    Morales, Rosanna; Cano, Roque; Velasquez, Maria [Centro de Medicina Nuclear, Instituto Peruano de Energia Nuclear, Lima (Peru); Vasquez, Edinson; Diaz, Pepe; Vasquez, Mario; Rojas, Peter [Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos 2520, Surquillo, Lima (Peru)

    2013-07-01

    This paper reports the application of a software which enables the complete register of patient data, for delivering appropriate information in bone scan reports. Bone scan is a frequent study in Nuclear Medicine, which enables physicians to diagnose a primary bone cancer or metastases. The software was designed in order to complete data given by oncologists and constitutes an aid for the health team attending patients. (authors).

  11. Personal Health Records: Design considerations for the South African context

    CSIR Research Space (South Africa)

    Mxoli, A

    2014-09-01

    Full Text Available A Personal Health Record (PHR) is a set of internet-based tools that allow individuals to create, store and coordinate their lifelong health information in one place making it available to relevant parties. It typically contains the individual’s...

  12. Human-centred design in global health: A scoping review of applications and contexts.

    Directory of Open Access Journals (Sweden)

    Alessandra N Bazzano

    Full Text Available Health and wellbeing are determined by a number of complex, interrelated factors. The application of design thinking to questions around health may prove valuable and complement existing approaches. A number of public health projects utilizing human centered design (HCD, or design thinking, have recently emerged, but no synthesis of the literature around these exists. The results of a scoping review of current research on human centered design for health outcomes are presented. The review aimed to understand why and how HCD can be valuable in the contexts of health related research. Results identified pertinent literature as well as gaps in information on the use of HCD for public health research, design, implementation and evaluation. A variety of contexts were identified in which design has been used for health. Global health and design thinking have different underlying conceptual models and terminology, creating some inherent tensions, which could be overcome through clear communication and documentation in collaborative projects. The review concludes with lessons learned from the review on how future projects can better integrate design thinking with global health research.

  13. CT assisted biomimetic artificial bone des

    Institute of Scientific and Technical Information of China (English)

    WANG Xian-gang; ZHANG Chao-zong; GUO Zhi-ping; TIAN Jie-mo

    2001-01-01

    @@ In the recent years, bioceramic materials have been widely used in the clinics. They are mainly fabricated as the substitution of human hard tissue, such as artificial bone and false tooth. As a medical implant, those that have similar structure to human bone have better biocompatibility and osteoinductional property. So it is necessary to design bone model close to human bone.

  14. Chronic Alcohol Abuse Leads to Low Bone Mass with No General Loss of Bone Structure or Bone Mechanical Strength

    DEFF Research Database (Denmark)

    Ulhøi, Maiken Parm; Meldgaard, Karoline; Steiniche, Torben

    2017-01-01

    Chronic alcohol abuse (CAA) has deleterious effects on skeletal health. This study examined the impact of CAA on bone with regard to bone density, structure, and strength. Bone specimens from 42 individuals with CAA and 42 individuals without alcohol abuse were obtained at autopsy. Dual-energy X......-ray absorptiometry (DEXA), compression testing, ashing, and bone histomorphometry were performed. Individuals with CAA had significantly lower bone mineral density (BMD) in the femoral neck and significantly lower bone volume demonstrated by thinner trabeculae, decreased extent of osteoid surfaces, and lower mean...... wall thickness of trabecular osteons compared to individuals without alcohol abuse. No significant difference was found for bone strength and structure. Conclusion: CAA leads to low bone mass due to a decrease in bone formation but with no destruction of bone architecture nor a decrease in bone...

  15. Controlled Release Strategies for Bone, Cartilage, and Osteochondral Engineering—Part I: Recapitulation of Native Tissue Healing and Variables for the Design of Delivery Systems

    Science.gov (United States)

    Santo, Vítor E.; Mano, João F.; Reis, Rui L.

    2013-01-01

    The potential of growth factors to stimulate tissue healing through the enhancement of cell proliferation, migration, and differentiation is undeniable. However, critical parameters on the design of adequate carriers, such as uncontrolled spatiotemporal presence of bioactive factors, inadequate release profiles, and supraphysiological dosages of growth factors, have impaired the translation of these systems onto clinical practice. This review describes the healing cascades for bone, cartilage, and osteochondral interface, highlighting the role of specific growth factors for triggering the reactions leading to tissue regeneration. Critical criteria on the design of carriers for controlled release of bioactive factors are also reported, focusing on the need to provide a spatiotemporal control over the delivery and presentation of these molecules. PMID:23268651

  16. Prognostics Design Solutions in Structural Health Monitoring Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — The chapter describes the application of prognostic techniques to the domain of structural health and demonstrates the efficacy of the methods using fatigue data...

  17. Personas: The Linking Pin in Holistic Design for eHealth

    NARCIS (Netherlands)

    van Velsen, Lex Stefan; van Gemert-Pijnen, Julia E.W.C.; Nijland, N.; Beaujean, Desirée; van Steenbergen, Jim

    2012-01-01

    Personas, lively descriptions of distinctive user groups for a technology, have the potential to be a useful tool for designing useful and usable eHealth services. In this paper we discuss the role of personas in a holistic design approach for eHealth: the CeHRes roadmap. We show, using the case of

  18. Bone tumors

    International Nuclear Information System (INIS)

    Moylan, D.J.; Yelovich, R.M.

    1991-01-01

    Primary bone malignancies are relatively rare with less than 4,000 new cases per year. Multiple myeloma (more correctly a hematologic malignancy) accounts for 40%; osteosarcomas, 28%; chondrosarcomas, 13%; fibrosarcomas arising in bone, 4%; and Ewing's sarcoma, 7%. The authors discuss various treatments for bone tumors, including radiotherapy, chemotherapy and surgery

  19. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    Science.gov (United States)

    Lee, Eunji

    2016-01-01

    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  20. Influence of implant neck design on facial bone crest dimensions in the esthetic zone analyzed by cone beam CT: a comparative study with a 5-to-9-year follow-up.

    Science.gov (United States)

    Chappuis, Vivianne; Bornstein, Michael M; Buser, Daniel; Belser, Urs

    2016-09-01

    To examine the influence of two different neck designs on facial bone crest dimensions in esthetic single implant sites after a 5-to-9-year follow-up analyzed by cone beam computed tomography (CBCT). Sixty-one patients with an implant-borne single crown following early implant placement in the esthetic zone were enrolled. The test group consisted of a bone level (BL) neck design exhibiting a hydrophilic micro-rough surface combined with a platform-switching interface (PS) (n = 20). The control group comprised a soft tissue level (STL) neck design exhibiting a hydrophobic machined surface with a matching butt-joint interface (n = 41). Standardized clinical, radiologic, and esthetic parameters were applied. The facial bone crest dimensions were assessed by CBCT. Soft tissue parameters and pink esthetic scores yielded no significant differences between the two designs. Major differences were only observed at the implant shoulder level. The height of the facial bone crest for the BL design was located 0.2 mm above the implant shoulder level, whereas for the STL design, its location was 1.6 mm below. The width of the peri-implant saucer-like bone defect was reduced by 40% for the BL implant design. No differences were observed 2 mm below the shoulder level. The results of this comparative study suggest better crestal bone stability on the facial aspect of single implant sites in the esthetic zone for a BL design with a platform-switching concept when compared with STL implants with a butt-joint interface. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Creativity as a Key Driver for Designing Context Sensitive Health Informatics.

    Science.gov (United States)

    Zhou, Chunfang; Nøhr, Christian

    2017-01-01

    In order to face the increasing challenges of complexity and uncertainty in practice of health care, this paper aims to discuss how creativity can contribute to design new technologies in health informatics systems. It will firstly introduce the background highlighting creativity as a missing element in recent studies on context sensitive health informatics. Secondly, the concept of creativity and its relationship with activities of technology design will be discussed from a socio-culture perspective. This will be thirdly followed by understanding the roles of creativity in designing new health informatics technologies for meeting needs of high context sensitivity. Finally, a series of potential strategies will be suggested to improve creativity among technology designers working in healthcare industries. Briefly, this paper innovatively bridges two areas studies on creativity and context sensitive health informatics by issues of technology design that also indicates its important significances for future research.

  2. Leveraging health information exchange to improve population health reporting processes: lessons in using a collaborative-participatory design process.

    Science.gov (United States)

    Revere, Debra; Dixon, Brian E; Hills, Rebecca; Williams, Jennifer L; Grannis, Shaun J

    2014-01-01

    Surveillance, or the systematic monitoring of disease within a population, is a cornerstone function of public health. Despite significant investment in information technologies (IT) to improve the public's health, health care providers continue to rely on manual, spontaneous reporting processes that can result in incomplete and delayed surveillance activities. Participatory design principles advocate including real users and stakeholders when designing an information system to ensure high ecological validity of the product, incorporate relevance and context into the design, reduce misconceptions designers can make due to insufficient domain expertise, and ultimately reduce barriers to adoption of the system. This paper focuses on the collaborative and informal participatory design process used to develop enhanced, IT-enabled reporting processes that leverage available electronic health records in a health information exchange to prepopulate notifiable-conditions report forms used by public health authorities. Over nine months, public health stakeholders, technical staff, and informatics researchers were engaged in a multiphase participatory design process that included public health stakeholder focus groups, investigator-engineering team meetings, public health survey and census regarding high-priority data elements, and codesign of exploratory prototypes and final form mock-ups. A number of state-mandated report fields that are not highly used or desirable for disease investigation were eliminated, which allowed engineers to repurpose form space for desired and high-priority data elements and improve the usability of the forms. Our participatory design process ensured that IT development was driven by end user expertise and needs, resulting in significant improvements to the layout and functionality of the reporting forms. In addition to informing report form development, engaging with public health end users and stakeholders through the participatory design

  3. Implicit Communication of Food Product Healthfulness through Package Design: A Content Analysis

    DEFF Research Database (Denmark)

    Festila, Alexandra; Chrysochou, Polymeros

    2018-01-01

    of twelve food product categories across two countries (Denmark and USA), our findings indicate that: (a) implicit package design elements (colors, imagery, material, shape) differ between health-positioned and regular products, and (b) these differences are product category-specific rather than universal......How do food companies use package design to communicate healthfulness? The present study addresses this question by investigating the most typical implicit package design elements used by food companies for their health-positioned food products. Using a content analysis on the packaging design...

  4. Action Design Research for Social Innovation: Lessons from Designing a Health and Wellbeing Platform

    NARCIS (Netherlands)

    de Reuver, G.A.; Keijzer-Broers, W.J.W.

    2016-01-01

    IT artifacts play an important role in solving societal problems and realizing social innovations. Existing practice-inspired design science research (DSR) approaches, such as Action Design Research (ADR), do not consider social innovation as an explicit starting point for design iterations. In this

  5. Effects of mechanical repetitive load on bone quality around implants in rat maxillae.

    Directory of Open Access Journals (Sweden)

    Yusuke Uto

    Full Text Available Greater understanding and acceptance of the new concept "bone quality", which was proposed by the National Institutes of Health and is based on bone cells and collagen fibers, are required. The novel protein Semaphorin3A (Sema3A is associated with osteoprotection by regulating bone cells. The aims of this study were to investigate the effects of mechanical loads on Sema3A production and bone quality based on bone cells and collagen fibers around implants in rat maxillae. Grade IV-titanium threaded implants were placed at 4 weeks post-extraction in maxillary first molars. Implants received mechanical loads (10 N, 3 Hz for 1800 cycles, 2 days/week for 5 weeks from 3 weeks post-implant placement to minimize the effects of wound healing processes by implant placement. Bone structures, bone mineral density (BMD, Sema3A production and bone quality based on bone cells and collagen fibers were analyzed using microcomputed tomography, histomorphometry, immunohistomorphometry, polarized light microscopy and birefringence measurement system inside of the first and second thread (designated as thread A and B, respectively, as mechanical stresses are concentrated and differently distributed on the first two threads from the implant neck. Mechanical load significantly increased BMD, but not bone volume around implants. Inside thread B, but not thread A, mechanical load significantly accelerated Sema3A production with increased number of osteoblasts and osteocytes, and enhanced production of both type I and III collagen. Moreover, mechanical load also significantly induced preferential alignment of collagen fibers in the lower flank of thread B. These data demonstrate that mechanical load has different effects on Sema3A production and bone quality based on bone cells and collagen fibers between the inside threads of A and B. Mechanical load-induced Sema3A production may be differentially regulated by the type of bone structure or distinct stress distribution

  6. Research designs and making causal inferences from health care studies.

    Science.gov (United States)

    Flannelly, Kevin J; Jankowski, Katherine R B

    2014-01-01

    This article summarizes the major types of research designs used in healthcare research, including experimental, quasi-experimental, and observational studies. Observational studies are divided into survey studies (descriptive and correlational studies), case-studies and analytic studies, the last of which are commonly used in epidemiology: case-control, retrospective cohort, and prospective cohort studies. Similarities and differences among the research designs are described and the relative strength of evidence they provide is discussed. Emphasis is placed on five criteria for drawing causal inferences that are derived from the writings of the philosopher John Stuart Mill, especially his methods or canons. The application of the criteria to experimentation is explained. Particular attention is given to the degree to which different designs meet the five criteria for making causal inferences. Examples of specific studies that have used various designs in chaplaincy research are provided.

  7. Designing serious video games for health behavior change: Current status and future directions

    Science.gov (United States)

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of o...

  8. Designing an Health Insurance Scheme for Government Employees in Bangladesh: A Concept Paper

    OpenAIRE

    Hamid, Syed Abdul

    2014-01-01

    Introducing compulsory health insurance for government employees bears immense importance for stepping towards universal healthcare coverage in Bangladesh. Lack of scientific study on designing such scheme, in the Bangladesh context, motivates this paper. The study aims at designing a comprehensive insurance package simultaneously covering health, life and accident related disability risks of the public employees, where the health component would extend to all dependent family members. ...

  9. Public Participation in Design of Health Empowering Information Systems

    DEFF Research Database (Denmark)

    Barlach, Anders

    2009-01-01

    as a result of information being accessible. The British Choose and Book portal (www.healthspace.nhs.uk) and Danish e-health portal (www.sundhed.dk) are examples of making knowledge and services available to the individual citizens: Sundhed.dk is the official Danish eHealth Portal for the public Danish...... other.(www.sundhed.dk, accessed 13 November 2008) Sundhed.dk serves as a reservoir of knowledge or source of information for the patients to empower the general public (Johannsen and Kensing 2005). Kensing and Johannsen raise the question of which type of information is the Information System (IS) going...

  10. Transcutaneous Raman Spectroscopy of Bone

    Science.gov (United States)

    Maher, Jason R.

    Clinical diagnoses of bone health and fracture risk typically rely upon measurements of bone density or structure, but the strength of a bone is also dependent upon its chemical composition. One technology that has been used extensively in ex vivo, exposed-bone studies to measure the chemical composition of bone is Raman spectroscopy. This spectroscopic technique provides chemical information about a sample by probing its molecular vibrations. In the case of bone tissue, Raman spectra provide chemical information about both the inorganic mineral and organic matrix components, which each contribute to bone strength. To explore the relationship between bone strength and chemical composition, our laboratory has contributed to ex vivo, exposed-bone animal studies of rheumatoid arthritis, glucocorticoid-induced osteoporosis, and prolonged lead exposure. All of these studies suggest that Raman-based predictions of biomechanical strength may be more accurate than those produced by the clinically-used parameter of bone mineral density. The utility of Raman spectroscopy in ex vivo, exposed-bone studies has inspired attempts to perform bone spectroscopy transcutaneously. Although the results are promising, further advancements are necessary to make non-invasive, in vivo measurements of bone that are of sufficient quality to generate accurate predictions of fracture risk. In order to separate the signals from bone and soft tissue that contribute to a transcutaneous measurement, we developed an overconstrained extraction algorithm that is based upon fitting with spectral libraries derived from separately-acquired measurements of the underlying tissue components. This approach allows for accurate spectral unmixing despite the fact that similar chemical components (e.g., type I collagen) are present in both soft tissue and bone and was applied to experimental data in order to transcutaneously detect, to our knowledge for the first time, age- and disease-related spectral

  11. Rigorous Clinical Trial Design in Public Health Emergencies Is Essential

    DEFF Research Database (Denmark)

    Ellenberg, Susan S; Keusch, Gerald T; Babiker, Abdel G

    2018-01-01

    Randomized clinical trials are the most reliable approaches to evaluating the effects of new treatments and vaccines. During the 2014-15 West African Ebola epidemic, many argued that such trials were neither ethical nor feasible in an environment of limited health infrastructure and severe disease...

  12. Designing and conducting health system research projects, volume ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    These 'green modules'* found their way to Malaysia, where Indra ..... They determine nutritional and hygiene practices, alert children to dangers, provide care in ... money from taxes and donor agencies to finance the health care system. .... The principle of cost-effectiveness is important in the selection of research projects.

  13. Design for sustainable development : environmental management and safety and health

    NARCIS (Netherlands)

    Zwetsloot, G.; Bos, J.

    1998-01-01

    This is a report on the EU's environmental management and audit scheme and its interaction with the management of safety and health. The focus is on the interactions at company and at policy level. To illustrate the relevance of the interactions at company level, the Annex includes five case studies

  14. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... (HPSAs) as of April 1, 2012, available on the Health Resources and Services Administration (HRSA) Web... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, Department of Health and Human Services. ACTION: Notice. SUMMARY...

  15. Bone banking.

    Science.gov (United States)

    Howard, W

    1999-04-01

    The use of human organs and tissues for transplantation in Australia has increased significantly over the past 30 years. In 1997, the Australian Coordinating Committee on Organ Registries and Donation (ACCORD) reported a total number of 190 organ donors, 636 corneal donors and 1509 bone donors Australia wide. Of the 1509 bone donations, 143 came from cadaveric sources and 1366 were made by living donors. Bone transplantation is not as widely recognised as solid organ or corneal transplantation. Due to improved technology and surgical skills, the demand for bone transplantation has increased markedly. This Clinical Update will provide an overview of the physiological aspects of bone transplantation and explore bone banking, a key step in the complex and critical process of bone transplantation.

  16. Accreditation and Participatory Design in the Health-Care Sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes...... specifying, realizing, and measuring effects from using an information technology. This approach aligns with much of the logic inherent in accreditation and it supports challenging parts of the accreditation process. Effects-driven IT development furthermore might support effects related to clinical evidence......-based thinking. We describe and compare effects- driven IT development with accreditation and discuss the prospects and challenges for this approach to participatory design within the healthcare domain....

  17. Calcium and vitamin D supplementation through fortified dairy products counterbalances seasonal variations of bone metabolism indices: the Postmenopausal Health Study.

    Science.gov (United States)

    Tenta, Roxane; Moschonis, George; Koutsilieris, Michael; Manios, Yannis

    2011-08-01

    To assess the effectiveness of a dietary intervention combined with fortified dairy products on bone metabolism and bone mass indices in postmenopausal women. Forty postmenopausal women (55-65 years old) were equally randomized into a dietary group (DG), receiving daily and for 30 months, 1,200 mg of calcium and 7.5 μg of vitamin D(3) for the first 12 months that increased to 22.5 μg for the remaining 18 months of intervention through fortified dairy products; and a control group (CG). Differences in the changes of bone metabolism and bone mass indices were examined with repeated measures ANOVA. A significant increase was observed for PTH levels only in the CG during the first six winter months of intervention (p = 0.049). After 30 months of intervention, during winter, serum 25(OH)D significantly decreased in the CG while remained in the same high levels as in the summer period in the DG. Serum RANKL levels decreased significantly in the DG compared with the increase in the CG during the 30-month intervention period (p = 0.005). Serum CTx decreased significantly in the DG after six (-0.08; -0.12 to -0.03) and 12 (-0.03; -0.08 to -0.02) months of intervention. Finally, the DG had more favorable changes in total body BMD than the CG (p effective in producing favorable changes in several bone metabolism and bone mass indices and in counterbalancing seasonal variations in hormonal and biochemical molecules.

  18. Exercise Brings Bone Benefits that Last

    Science.gov (United States)

    ... Subscribe May 2014 Print this issue Health Capsule Exercise Brings Bone Benefits that Last En español Send ... lose bone. Studies of animals have shown that exercise during periods of rapid growth can lead to ...

  19. Racializing drug design: implications of pharmacogenomics for health disparities.

    Science.gov (United States)

    Lee, Sandra Soo-Jin

    2005-12-01

    Current practices of using "race" in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an "infrastructure of racialization" created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry. The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice.

  20. Design and evaluation of the ONC health information technology curriculum.

    Science.gov (United States)

    Mohan, Vishnu; Abbott, Patricia; Acteson, Shelby; Berner, Eta S; Devlin, Corkey; Hammond, William E; Kukafka, Rita; Hersh, William

    2014-01-01

    As part of the Heath Information Technology for Economic and Clinical Health (HITECH) Act, the Office of the National Coordinator for Health Information Technology (ONC) implemented its Workforce Development Program, which included initiatives to train health information technology (HIT) professionals in 12 workforce roles, half of them in community colleges. To achieve this, the ONC tasked five universities with established informatics programs with creating curricular materials that could be used by community colleges. The five universities created 20 components that were made available for downloading from the National Training and Dissemination Center (NTDC) website. This paper describes an evaluation of the curricular materials by its intended audience of educators. We measured the quantity of downloads from the NTDC site and administered a survey about the curricular materials to its registered users to determine use patterns and user characteristics. The survey was evaluated using mixed methods. Registered users downloaded nearly half a million units or components from the NTDC website. We surveyed these 9835 registered users. 1269 individuals completed all or part of the survey, of whom 339 identified themselves as educators (26.7% of all respondents). This paper addresses the survey responses of educators. Successful aspects of the curriculum included its breadth, convenience, hands-on and course planning capabilities. Several areas were identified for potential improvement. The ONC HIT curriculum met its goals for community college programs and will likely continue to be a valuable resource for the larger informatics community in the future.