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Background Dual-energy X-ray absorptiometry (DXA) is the reference standard for the measurement of bone mineral density (BMD) and subsequent diagnosis of osteoporosis. Since various computed tomography (CT) protocols are scanned for various indications, we can incidentally measure BMD using CT. Previous studies have revealed a correlation between BMD and Hounsfield unit (HU) values obtained with different CT protocols. Purpose To compare the diagnostic value of CT protocols (lumbar spine CT [LSCT], abdomen-pelvis contrast-enhanced CT [APCT], and low-dose chest CT [LDCT]) for osteoporosis. Material and Methods We retrospectively included 17 patients (6 men, 11 women; mean age=68 years) who had undergone all four imaging studies within six months, during 2011–2021. HU values were manually measured at the center of the L1 vertebra by a radiology resident. Pearson correlation test was performed between HU values and BMD of L1 vertebra. The diagnostic performance of each CT protocol was assessed with receiver operating characteristic (ROC) analysis. Intra-individual concordance of the four tests to diagnose osteoporosis was analyzed by tabulating. Results The mean HU values were 104.4 ± 47.2 HU with LSCT, 149.0 ± 56.9 HU with APCT, and 114.3 ± 60.0 HU with LDCT. HU values from each protocol were positively correlated (r = 0.676-0.735; P Conclusion LDCT had the highest diagnostic performance for osteoporosis with predetermined cutoff value. APCT requires the increase of cutoff value for osteoporosis diagnosis.

Objective: To assess if posterior oblique ligament and distal semi-membranosus tendon tears are associated with posterior horn medial meniscus tears on MRI. Methods: From January 1, 2018 to December 31, 2019, 56 patients who met the inclusion criteria were enrolled in this study. Of the 56 patients, 43 patients who had a posterior horn of medial meniscus tear were included in the study group. A control group of 13 individuals was formed for comparison. Two radiologists reviewed the MR images and recorded the presence and grades of posterior oblique ligament and distal semi-membranosus tendon tears. We used the independent t-test and one-way ANOVA to compare the tear grades. Interobserver agreement was analyzed using a Cohen’s κ coefficient (κ value) for categorical variables. Results: The mean grades for the posterior oblique ligament and distal semi-membranosus tendon tears were significantly higher in the study group (all, p < 0.001). Interobserver agreement between the two readers was substantial in assessing the grade of posterior oblique ligament tear (κ = 0.653±0.087) and almost perfect in assessing the grade of distal semi-membranosus tendon tear (κ = 0.876±0.060). Conclusion: Posterior oblique ligament and distal semi-membranosus tendon tears are significantly associated with posterior horn of medial meniscus tear and medial meniscus posterior root tears, and the peel-back mechanism could be related to this association. Advances in knowledge: Presenting this paper could adjust radiologist search patterns and potentially help orthopedists with management and pre-surgical planning for the posteromedial corner injury of the knee.

The U.S. Food and Drug Administration has prohibited epidural steroid injection (ESI) with particulate steroids. Thus, this study aimed to compare the efficacy and safety of ESI with two nonparticulate steroids, dexamethasone and betamethasone.The eligible patients (n = 600) who received ESI (0 week) with dexamethasone (ESI-dexa) or betamethasone (ESI-beta) had follow-up visits at 2, 4, and 8 weeks with a phone interview at 12 weeks. The primary endpoint was the proportion of effective responders without pain or who were much improved at 2 weeks. The secondary endpoints were the proportion of crossover injections at 2 weeks; changes in the visual analog scale (VAS) and disability index scores at 2, 4, and 8 weeks; the number of additional ESIs in 12 weeks; the number of participants having spinal surgery, as well as the incidence of adverse events over the 12 weeks.The proportion of effective responders at 2 weeks was not different between ESI-beta (72/216, 33.3%) and ESI-dexa (63/200, 31.5%;Betamethasone would be more appropriate for ESI.

The Undiagnosed Disease Program in South Africa (UDP) sought to prospectively evaluate the clinical utility of exome sequencing (ES) in a phenotypically diverse, multi-ethnic cohort of South African patients with suspected rare genetic disorders. ES was undertaken in 100 sequential patients (93 singletons, 3 duos, and 4 trios) recruited to the UDP at Stellenbosch University. The data were analyzed through two separate bioinformatics pipelines (EVIDENCE from 3 billion and our in-house pipeline). A definitive diagnosis could be reached in 51% (51/100) patients, with 46% (46/100) patients having either pathogenic or likely pathogenic single-nucleotide variants/indels (SNVs/indels), and 5 patients with likely-pathogenic copy number variants (CNVs) (5/100). The CNVs were subsequently confirmed on microarray or MLPA analysis. Detailed phenotyping and HPO terms enabled analysis and variant identification. Twenty-five novel variants in 22 genes are reported here. We provide data from the first year of this UDP and show that even amongst mainly singletons from an understudied, diverse African population, ES is a valuable diagnostic tool, especially if it includes CNV analysis. The remaining undiagnosed patients present a unique opportunity for further research and novel gene discovery.

Poor survival of grafted cells is the major impediment of successful cell-based therapies for bone regeneration. Implanted cells undergo rapid death in an ischemic environment largely because of hypoxia and metabolic stress from glucose deficiency. Understanding the intracellular metabolic processes and finding genes that can improve cell survival in these inhospitable conditions are necessary to enhance the success of cell therapies. Thus, the purpose of this study was to investigate changes of metabolic profile in glucose-deprived human bone marrow stromal/stem cells (hBMSCs) through metabolomics analysis and discover genes that could promote cell survival and osteogenic differentiation in a glucose-deprived microenvironment. Metabolomics analysis was performed to determine metabolic changes in a glucose stress metabolic model. In the absence of glucose, expression levels of all metabolites involved in glycolysis were significantly decreased than those in a glucose-supplemented state. In glucose-deprived osteogenic differentiation, reliance on tricarboxylic acid cycle (TCA)-predicted oxidative phosphorylation instead of glycolysis as the main mechanism for energy production in osteogenic induction. By comparing differentially expressed genes between glucose-deprived and glucose-supplemented hBMSCs, NR2F1 (Nuclear Receptor Subfamily 2 Group F Member 1) gene was discovered to be associated with enhanced survival and osteogenic differentiation in cells under metabolic stress. Small, interfering RNA (siRNA) for NR2F1 reduced cell viability and osteogenic differentiation of hBMSCs under glucose-supplemented conditions whereas NR2F1 overexpression enhanced osteogenic differentiation and cell survival of hBMSCs in glucose-deprived osteogenic conditions via the protein kinase B (AKT)/extracellular signal-regulated kinase (ERK) pathway. NR2F1-transfected hBMSCs significantly enhanced new bone formation in a critical size long-bone defect of rats compared with control vector-transfected hBMSCs. In conclusion, the results of this study provide an understanding of the metabolic profile of implanted cells in an ischemic microenvironment and demonstrate that NR2F1 treatment may overcome this deprivation by enhancing AKT and ERK regulation. These findings can be utilized in regenerative medicine for bone regeneration. © 2022 American Society for Bone and Mineral Research (ASBMR).

While previous studies showed that persuasive games can have positive effects on attitudes and behavioral intentions, little is known about the underlying processes that cause these effects. This study investigates immersion and involvement in order to provide a better understanding of the effects of persuasive games. We conducted an experiment with 152 college students in which participants either played a persuasive game or watched the playback of the game. Our results showed that affective and ludic involvement and immersion mediated the relationship between interactivity (gameplay vs. playback) and persuasive outcomes (attitude and behavioral intention).

Background Dual-layer spectral detector computed tomography (DLCT) may potentially improve CT arthrography through enhanced image quality and analysis of the chemical composition of tissue. Purpose To evaluate the image quality of monoenergetic reconstructions from DLCT arthrography of the shoulder and assess the additional diagnostic value in differentiating calcium from iodine. Material and Methods Images from consecutive shoulder DLCT arthrography examinations performed between December 2016 and February 2018 were retrospectively reviewed for hyperattenuating lesions within the labrum and tendons. The mean attenuation of the target lesion, noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of the virtual monoenergetic images obtained at 40–200 keV were compared with conventional 140-kVp images. Two evaluators independently classified each target lesion as contrast media or calcification, without and with DLCT spectral data. Receiver operating curve (ROC) analysis was performed to assess the diagnostic performance of shoulder DLCT arthrography, without and with the aid of spectral data. Results The study included 20 target lesions (18 DLCT arthrography examinations of 17 patients). The SNRs of the monoenergetic images at 40–60 keV were significantly higher than those of conventional images ( P Conclusion DLCT had no additive value in differentiating calcium from iodine in small, hyperattenuating lesions in the labrum and tendons.

The initial introduction of utilizing double helix structural oligonucleotides known as SNP typing with excellent specificity (STexS) in a standard PCR greatly improved the detection of single nucleotide polymorphisms (SNP) by enhancing amplification rates of primer-matching strands and interrupting mismatched strands by constant instability of kinetics regarding alignment attaching and detaching. The model was beneficial overall in detecting SNP variants consisting of large amounts of wildtype strands such as EGFR mutation genotyping for early detection of non-small cell lung cancer. While the STexS PCR is advantageous in detecting SNPs and biomarkers, limitations were yet observed. Despite the ability to detect variants 10 times more effective than a typical amplification-refractory mutation system PCR, it could only perform optimally in DNA concentrations around 101 ~ 105. To further enhance STexS specificity to perform detecting viral-RNA variants such as the infamous SARS-CoV-2, a novel improvement of the regular TaqMan Probe using Com-probes to inhibit high copy wild targets and amplify low copy mutant targets. By introducing the novel STexS II, omicron variants of SARS-CoV-2 were able to be successfully detected in high concentrations of normal genes.

BackgroundCondom use remains the most effective behavioural method for the prevention of HIV and unplanned pregnancies. However, condom use remains inconsistent among young people. Exploring the condom use decision-making processes that adolescents engage in might provide information that would assist in the prevention of many challenges related to poor sexual and reproductive health outcomes. This study therefore aimed to explore the factors that influenced decision-making about sexual debut and condom use of adolescents from two schools in the Western Cape, South Africa.MethodsA sample of 16 adolescents were selected using purposive sampling. Data were collected using semi-structured, individual interviews. Thematic analysis was used to analyse the data generated.ResultsThe link between sexual debut and affective processes was frequently discussed in condom use decision-making. Decisions about sexual debut were influenced by the belief that sex was a perceived symbol of ‘true love’ on the one hand, and respect for perceived parental expectations of age-appropriate sex, on the other. Condom use decision-making was shaped by adolescents’ concerns about their future and lack of stability in their lives. Adolescents’ fears of pregnancy, parenthood and disease shaped their condom use decision-making. It became evident that rational and affective decision-making in condom use choice were not mutually exclusive, but that these processes happened simultaneously.ConclusionsThe study highlighted the role of affective states as part of the process of examining alternatives when deciding to use a condom or not. Interventions to strengthen condom use decision-making should therefore incorporate not only rational but also affective processes to improve adolescent sexual and reproductive outcomes.

Guided by the moral foundation theory, this study examined how moral framing interacted with local constituents’ ideological leaning to affect public engagement outcomes of government agencies’ COVID-19 vaccine communication on Facebook. We analyzed a dataset of over 5,000 U.S. government agencies’ Facebook posts on COVID-19 vaccines in 2021 (N=70,671), assessed their use of moral language using a newly developed computational method, and examined how political divide manifests itself at the collective level. Findings from both fixed and random effects models suggest that: 1) the use of moral language is positively associated with public engagement outcomes on government agencies’ social media accounts; 2) five types of moral foundations have distinct effects on three types of public engagement (affective, cognitive, and retransmission); 3) moral foundations and local politics interact to affect public engagement, in that followers of government agencies in liberal states/counties prefer messages emphasizing the care/harm and fairness/cheating dimensions while those in conservative states/counties prefer the loyalty/betrayal dimension. The study demonstrates how a strategic employment of moral language can contribute to public engagement of government agencies’ mass communication campaigns.

Nowadays companies are increasingly engaging in social-political issues. In light of the Construal Level Theory, this study examined the polarizing/depolarizing effects of perceived psychological d...

An understanding of the common MRI findings observed after decompression surgery is important. However, to date, no study addressing this has been published. The aim of this study was to analyze and describe the immediate postoperative MRI findings after lumbar decompression surgery. We retrospectively analyzed the immediate postoperative MRIs of 121 consecutive patients who underwent lumbar decompression surgery between July 2017 and June 2018. Changes in stenosis at the decompressed and adjacent levels, epidural fat edema, epidural and subdural fluid collections, nerve root swelling, facet joint effusions, intervertebral disc signal, and paravertebral muscle edema were correlated with clinical characteristics. Both groups had reduced central canal stenosis postoperatively (p 0.001) but worsened stenosis at adjacent segments. Fluid collection, hemorrhagic or non-hemorrhagic, at the laminectomy site was the commonest finding (one-level: 73.8%, two-level: 88.5%), with a higher percentage of severe central canal compromise in the two-level decompression group (p = 0.003). Other postoperative MRI findings, such as epidural fat edema, nerve root swelling, subdural fluid collection, and facet joint effusion, were noted without statistical significance. In conclusion, even with successful decompression for lumbar canal stenosis, increased central canal stenosis at adjacent segments is common on immediate postoperative MRI scans, showing no statistically significant correlation with the immediate postoperative outcome. Postoperative fluid collection at the laminectomy site is the commonest imaging finding, and higher rates of hemorrhagic fluid and more severe central canal compromise occur in two-level decompression, but rarely cause clinical problems.

Individualized health-care is gaining traction recently due to the advances in sensor technology, edge computing and the improvement in communication technologies. In this work, we show the application of wearable device for mobile health-care along with supporting algorithms using photoplethysmogram (PPG) as our signal source. We introduce the design of our wearable device equipped PPG sensors for extracting valuable bio-information from the human body. Using our device, we introduce Centralized State Sensing (CSS), an algorithm that improves the estimation of different health parameters. By using heart rate estimation as an example, the proposed algorithm is 26.8% better in terms of mean absolute error when compared with the average reading taken across sensors. We also propose a deep neural network model applied to a PPG-glucose dataset containing 349 samples provided by our industry partner for non-invasive blood glucose estimation achieving an accuracy of 84.29% based on ISO:15197:2013 standard.

While bone has an inherent capacity to heal itself, it is very difficult to reconstitute large bone defects. Regenerative medicine, including stem cell implantation, has been studied as a novel solution to treat these conditions. However, when the local vascularity is impaired, even the transplanted cells undergo rapid necrosis before differentiating into osteoblasts and regenerating bone. Thus, to increase the effectiveness of stem cell transplantation, it is quintessential to improve the viability of the implanted stem cells. In this study, given that the regulation of glucose may hold the key to stem cell survival and osteogenic differentiation, we investigated the molecules that can replace the effect of glucose under ischemic microenvironment of stem cell transplantation in large bone defects. By analyzing differentially expressed genes under glucose-supplemented and glucose-free conditions, we explored markers such as methyltransferase-like protein 7A (METTL7A) that are potentially related to cell survival and osteogenic differentiation. Overexpression of METTL7A gene enhanced the osteogenic differentiation and viability of human bone marrow stem cells (hBMSCs) in glucose-free conditions. When the in vivo effectiveness of METTL7A-transfected cells in bone regeneration was explored in a rat model of critical-size segmental long-bone defect, METTL7A-transfected hBMSCs showed significantly better regenerative potential than the control vector-transfected hBMSCs. DNA methylation profiles showed a large difference in methylation status of genes related to osteogenesis and cell survival between hBMSCs cultured in glucose-supplemented condition and those cultured in glucose-free condition. Interestingly, METTL7A overexpression altered the methylation status of related genes to favor osteogenic differentiation and cell survival. In conclusion, it is suggested that a novel factor METTL7A enhances osteogenic differentiation and viability of hBMSCs by regulating the methylation status of genes related to osteogenesis or survival.

In this paper, we find the optimal transmission of messages in computer networks. This problem has been formulated as a nondelayed optimal control problem in several recent papers on TCP (transmission control protocol). Since the actual transmission of messages from origins to destinations should consist of both forward transmission delays of the buffers and latency of the links, we remodel the problem as a time-delayed optimal control problem consisting of both control-dependent time-delayed arguments and discrete time-delayed arguments. We then develop a modified control parameterization method for solving this time-delayed optimal control problem. The gradients of the new objective function and constraint functions generated by this modified control parametrization method are derived. A numerical example is solved by using the time-delayed version of the problem that we formulate, as well as the nondelayed version of the problem in the literature. Numerical results clearly illustrate the efficiency of the modified control parameterization method for solving both versions of this optimal transmission problem. Comparison of results of the two versions concerning the optimal transmission rates at the origins, the optimal output flow rates at the destination, and the queue sizes at the buffers are obtained. These comparison results clearly reflect how the optimal transmission of messages in computer networks in real life can be affected by both the forward transmission delays of the buffers and the latency of the links.

The initial introduction of utilizing double helix structural oligonucleotides known as SNP typing with excellent specificity (STexS) in a standard PCR greatly improved detecting single nucleotide polymorphisms (SNP) by enhancing amplification rates of primer-matching strands and interrupting mismatched strands by constant instability of kinetics regarding alignment attaching and detaching. The model was overall beneficial in detecting SNP mutations which were consisting large amounts of wildtype strands such as EGFR mutation genotyping for early detection of non-small cell lung cancer. While the STexS PCR is advantageous in detecting SNPs and biomarkers, limitations were yet observed. Despite the ability of detecting variants 10 times more effective than a typical amplification-refractory mutation system (ARMS) PCR, it could only perform optimally in DNA concentrations around 101~105. To further enhance STexS specificity to perform detecting viral-RNA variants such as the infamous SARS-CoV-2, a novel improvement of the regular TaqMan Probe using Com-probes to inhibit high copy wild targets and amplify low copy mutant targets. By introducing the novel STexS Ⅱ, omicron variants of SARS-CoV-2 was able to be successfully detected in high concentrations of normal genes.