Dental age assessment of young Iranian adults using third molars: A multivariate regression study

BackgroundIn recent years, a noticeable increase in forensic age estimations of living individuals has been observed. Radiologic assessment of the mineralisation stage of third molars is of particular importance, with regard to the relevant age group. To attain a referral database and regression equations for dental age estimation of unaccompanied minors in an Iranian population was the goal of this study. Moreover, determination was made concerning the probability of an individual being over the age of 18 in case of full third molar(s) development.Materials and methodsUsing the scoring system of Gleiser and Hunt, modified by Köhler, an investigation of a cross-sectional sample of 1274 orthopantomograms of 885 females and 389 males aged between 15 and 22 years was carried out. Using kappa statistics, intra-observer reliability was tested. With Spearman correlation coefficient, correlation between the scores of all four wisdom teeth, was evaluated. We also carried out the Wilcoxon signed-rank test on asymmetry and calculated the regression formulae.ResultsA strong intra-observer agreement was displayed by the kappa value. No significant difference (p-value for upper and lower jaws were 0.07 and 0.59, respectively) was discovered by Wilcoxon signed-rank test for left and right asymmetry. The developmental stage of upper right and upper left third molars yielded the greatest correlation coefficient. The probability of an individual being over the age of 18 is 95.6% for males and 100.0% for females in case four fully developed third molars are present. Taking into consideration gender, location and number of wisdom teeth, regression formulae were arrived at.ConclusionUse of population-specific standards is recommended as a means of improving the accuracy of forensic age estimates based on third molars mineralisation. To obtain more exact regression formulae, wider age range studies are recommended.     

Effectiveness of an innovative hip energy storage walking orthosis for improving paraplegic walking: A pilot randomized controlled study

BackgroundThe high energy cost of paraplegic walking using a reciprocating gait orthosis (RGO) is attributed to limited hip motion and excessive upper limb loading for support. To address the limitation, we designed the hip energy storage walking orthosis (HESWO) which uses a spring assembly on the pelvic shell to store energy from the movements of the healthy upper limbs and flexion-extension of the lumbar spine and hip and returns this energy to lift the pelvis and lower limb to assist with the swing and stance components of a stride. Our aim was to evaluate gait and energy cost indices for the HESWO compared to the RGO in patients with paraplegia.MethodsThe cross-over design was used in the pilot study. Twelve patients with a complete T4-L5 chronic spinal cord injury underwent gait training using the HESWO and RGO. Gait performance (continuous walking distance, as well as the maximum and comfortable walking speeds) and energy expenditure (at a walking speed of 3.3 m/min on a treadmill) were measured at the end of the 4-week training session.ResultsCompared to the RGO, the HESWO increased continuous walking distance by 24.7% (P < 0.05), maximum walking speed by 20.4% (P < 0.05) and the comfortable walking speed by 15.3% (P < 0.05), as well as decreasing energy expenditure by 13.9% (P < 0.05).ConclusionOur preliminary results provide support for the use of the HESWO as an alternative support for paraplegic walking.     

Exergames for unsupervised balance training at home: A pilot study in healthy older adults

Exercise videogames (exergames) are gaining popularity as tools for improving balance ability in older adults, yet few exergames are suitable for home-based use. The purpose of the current pilot study was to examine the effects of a 6-week unsupervised home-based exergaming training program on balance performance. Ten community dwelling healthy older adults (age: 75.9 ± 7.2 years) played a newly developed ice skating exergame for six weeks at home. In the game, the speed and direction of a virtual ice skater on a frozen canal were controlled using lateral weight shifts, which were captured using Kinect. Sway characteristics during quiet standing in eyes open (EO), eyes closed (EC) and dual task (DT) conditions were assessed in time and frequency domain before, and after two, four and six weeks of training. Balance was also evaluated using the narrow ridge balance test (NRBT). Multilevel modeling was applied to examine changes in balance ability. Participants played 631 (±124) min over the intervention period and no subjects dropped out. Balance in terms of sway characteristics improved on average by 17.4% (EO) and 23.3% (EC) after six weeks of training (p < 0.05). Differences in rate of improvement (p < 0.05) were observed between participants. No intervention effects were found for quiet standing in DT conditions and on the NRBT. In conclusion, the pilot study showed that unsupervised home-based exergaming is feasible in community dwelling older adults, but also that participants do not benefit equally from the program, thereby emphasizing the need for more personalized exergame training programs.     

Mobile phone use is detrimental for gait stability in young adults

BackgroundHuman walking is a highly automated motor task, however if the individual’s attention is divided, gait can be negatively affected. Although the effect of divided attention has been usually tested with standardised cognitive tasks, the common task of walking while talking on the phone may represent an ecological dual task scenario.Research questionWhat is the effect of divided attention on locomotion when using a mobile phone?MethodsThirty-seven healthy participants were asked to walk while performing different cognitive tasks: counting and spelling backwards, talking on the phone (handset by the ear and hands-free), and texting. As a control, extra postural conditions were tested: holding the phone by the ear (without talking) and carrying the phone as in the texting task. These tasks were compared with normal walking (no other cognitive or postural task). Twenty participants also performed the same tasks with the addition of an obstacle halfway through the walkway. Gait performance was measured using non-invasive inertial sensors. Step time and mediolateral acceleration range were calculated.ResultsStep time increased when counting (mean ± standard error 0.63 ± 0.02 s, p < 0.001), spelling backwards (0.67 ± 0.03 s, p < 0.001) and texting (0.61 ± 0.02 s, p = 0.005) compared to normal walking (0.56 ± 0.02 s). Compared to normal walking (8.03 ± 0.58 m/s²), mediolateral acceleration decreased when counting (6.43 ± 0.39 m/s², p < 0.001), spelling backwards (6.67 ± 0.44 m/s², p < 0.001), when talking on the phone while holding the phone (7.28 ± 0.48 m/s², p = 0.003), or hands-free (7.28 ± 0.40 m/s², p = 0.004), or texting (6.71 ± 0.50 m/s², p < 0.001). Introducing an obstacle confirmed these results.SignificanceThis study shows that even in young and healthy individuals, gait is affected by divided attention. Furthermore, the results show that common and ecological cognitive tasks, such as phone use, could induce measurable worsening of gait performance. Individuals should be careful when walking and performing other tasks that could distract them, by dividing their attention.     

Towards an empirical model of performance enhancing supplement use: A pilot study among high performance UK athletes

This paper addressed a gap in the literature of empirically derived models of performance enhancing supplement use by developing a demographic and psychosocially based model of athlete supplement use. Selected questions were used from a larger survey conducted by UK Sport into British athletes' experiences, knowledge, attitudes and opinions in relation to anti-doping activities. Forward conditional step wise logistic regression was employed on data from n=757 athletes to develop a model that discriminated supplement non-users from users. The model identified that British athletes most likely to use supplements were younger (under 23) males who were more likely to see doping as a problem in their sport and were more knowledgeable about testing procedures than their non-user counterparts. Post hoc analysis reinforced that non-users saw doping as less of a problem in their sport and were less knowledgeable about drug testing procedures relative to those using supplements. The pattern of results indicated gender-specific interventions on supplement use for young male athletes may yield significant benefits. The relationship between supplement use and perception of a doping problem suggested more work is needed to understand supplement use culture within sports. The relationship between knowledge of testing procedures and supplement use suggested further research is needed to see whether this is a positive or negative effect of detection-based doping deterrence activity.     

The effect of an exertional field-test on sport concussion assessment tool 5 subcomponents in University rugby and wrestling athletes: A pilot prospective case series

ObjectivesTo evaluate how an exertional field-test impacts the Sport Concussion Assessment Tool 5 (SCAT5) subcomponents in uninjured athletes.DesignProspective case-series.SettingSports medicine setting.ParticipantsA total of 37 rugby and wrestling athletes (76% female) with a median age of 19 years (range: 18–23). Twenty-one (57%) had a history of concussion.Main outcome measuresThe SCAT5 was administered prior-to and following a volitionally fatiguing, field-based 30-15 Intermittent Fitness Test. The primary outcome measures included: total symptom scores and severity, standardized assessment of concussion, neurological screening, and balance errors during the modified balance error scoring system. Wilcoxon signed-rank tests examined differences in ordinal data between pre- and post-exertion with Bonferroni corrections (alpha = 0.006). Data were also stratified into time to SCAT5 administration post-exertion and compared via Cliff's Delta (d).ResultsThe SCAT5 was administered a median of 20-min (interquartile range: 14-26-min) following exertion. No differences were found pre- and post-exertion across all SCAT5 metrics (p > 0.048). Within the post-exertion 0-10-min stratification, total symptoms and severity scores appeared to be elevated with a large effect size (d ≥ 0.64).ConclusionsWhile SCAT5 metrics were not statistically altered when quantified a median of 20-min following high-intensity exertion; greater symptom reporting may occur 10-min following exertion.     

The assessment of path linearity in swimming: a pilot study

The lateral-medial displacement (LF) and the overall drift from a straight path (DT) were quantified and compared in 5 top-level (TLS) and 5 low-level (LLS) crawl swimmers. Sixteen repetitions of 25-m crawl at increasing intensity were performed and videotaped. The performances were divided into 3 intensities (< 80 %, 80 - 90 % and > 90 % of maximal speed). LF was expressed as overlength swum (OLS) and coefficient of variation (CV) of the Z-component movement. OLS revealed a significant main effect for swimmer level (p < 0.01), intensity (p < 0.01) and their interaction (0.48, 0.37, 0.31-m for TLS and 0.47, 0.43, 0.44-m for LLS, p < 0.05). CV was significantly higher in LLS at the lowest (0.69 vs. 0.22, p < 0.05) and highest intensity (0.71 vs. 0.33, p < 0.05). DT, expressed as the slope of the linear regression of position data vs. time, was significantly higher in LLS only at the highest intensity (0.025 vs. 0.013, p < 0.05). The amount of dissipated energy due to LF, quantified by means of discrete Fourier analysis, revealed a difference only when the 0 - 5 Hz and 5 - 10 Hz spectral windows were analysed separately. While LF has a practical significance since it contributes to increase drag, DT is negligible at least for short-distance events.     

The use of coronary artery calcium scoring in young adults

Although overall atherosclerotic cardiovascular disease (ASCVD) incidence has been declining in the United States, there is evidence that the incidence of ASCVD events in young adults is increasing. The early initiation of preventive therapies could result in a greater number of life-years saved, and therefore determining the appropriate way to identify high-risk young adults is becoming increasingly important. The coronary artery calcium (CAC) score, an established marker of coronary artery atherosclerosis, can improve discrimination for ASCVD risk beyond established risk prediction tools. Based on abundant evidence, the American College of Cardiology/American Heart Association (ACC/AHA) guidelines currently recommend an approach of using CAC scores as a tool for risk assessment and decision-making regarding drug therapy for primary prevention in middle-aged individuals. However, CAC scoring is not recommended for universal screening in young adults, where its yield and utility for altering clinical decisions are limited. Recent studies have demonstrated the nonnegligible prevalence of CAC and its strong association with ASCVD in young adults, suggesting its potential to reclassify risk and improve selection of young adults most likely to benefit from early preventive therapies. Although convincing clinical trials have not been performed in this population yet, CAC scores should be used selectively in young adults whose ASCVD risk may be sufficiently high to warrant a CAC score assessment. This review summarizes the evidence available regarding CAC scoring in young adults, and discusses an appropriate future role of CAC scores in preventing ASCVD in this population.     

Optimal exposure parameters for digital radiography of the infant skull: a pilot study

AIM: To determine optimal exposure parameters when performing digital skull radiographs in infants with suspected non-accidental injury (NAI). METHOD: Anteroposterior and lateral post-mortem skull radiographs of six consecutive infants with suspected NAI were made at six exposure levels for each projection. Entrance surface doses ranged from 75-351 microGy. Exposures were made with a Fuji 5000R computed radiography system onto a standard resolution imaging plate. In three patients exposures were repeated using a high-resolution imaging plate. Hard copy images with an edge-enhancement factor of 0.5 were produced. Six observers assessed and scored the radiographs from 1=poor to 5=excellent for visualization of five criteria. The criteria scored included outer table of skull vault, inner table of skull vault, suture margins, vascular markings and soft tissues of the scalp. Radiographs were then ranked in order of overall image quality. Film density and sensitivity values were recorded. Local research committee approval was obtained. RESULTS: Current parameters give an average entrance surface dose of 253 microGy and 246 microGy for anteroposterior and lateral radiographs, respectively. The study demonstrated no perceived improvement in image quality above an entrance surface dose of 200 microGy (80% of current dose) or by the use of a high-resolution imaging plate. CONCLUSION: The potential exists to reduce radiation exposure in infants. A study has commenced to determine the effects of dose reduction on diagnostic accuracy in suspected NAI.     

Three-dimensional prediction of nose morphology in Chinese young adults: a pilot study combining cone-beam computed tomography and 3dMD photogrammetry system

International Journal of Legal Medicine - The nose is the most prominent part of the face and is a crucial factor for facial esthetics as well as facial reconstruction. Although some studies have...     

Evidence of knee extensor dysfunction during sit-to-stand following distal femoral extension osteotomy and patellar tendon advancement in young adults with cerebral palsy: A pilot study

A distal femoral extension osteotomy with patellar tendon advancement (DFEO + PTA) is a common treatment for individuals with cerebral palsy (CP) who walk in crouch. Musculoskeletal modeling suggests that the typical patella baja position post-DFEO + PTA may limit one’s abilities to perform sit-to-stand (STS) tasks; however, STS function has not been assessed. Our purpose was to compare how well individuals who received a DFEO + PTA can perform a 5-times STS test (FTSST) eight or more years after surgery compared to their peers who did not receive a DFEO + PTA (non-DFEO + PTA group).Twenty-one participants completed the task (12 DFEO + PTA, 9 non-DFEO + PTA). Three-dimensional kinematics and kinetics were captured. Kinetics were non-dimensionalized to facilitate group comparisons.Non-DFEO + PTA participants performed the FTSST moderately faster than the DFEO + PTA group (median(IQR), 14.6(9.3) seconds vs. 20.3(10.1) seconds, non-parametric effect size ɣ = 0.97, p = 0.241). Peak negative knee power was larger for the non-DFEO + PTA group (Mean ± SD, −0.063 ± 0.025 vs. −0.048± 0.020, Cohen’s d = 0.66, p = 0.165). A similar but weaker trend was observed for negative hip power (median(IQR) −0.120(0.066) vs. −0.105(0.044), ɣ = 0.43, p = 0.671). Both groups used their hips approximately twice as much as their knees to perform the task.The functional deficit among DFEO + PTA participants may be due to patella baja decreasing the knee extensor moment arm, which concurs with the modeling prediction. The group differences may also be due to the non-DFEO + PTA group being slightly higher functioning. Future research is warranted to determine if optimizing patella position during a DFEO + PTA may improve unaided STS function without compromising gait improvements.     

A profile of tobacco use among teenage dependents.

This study profiles tobacco use by 2,241 dependent teenagers in grades 6-12 at two Army posts. Data were collected in February 1989 by self-administered questionnaires. Results show 40.9% of dependent teenagers have tried smoking and 16.4% have tried smokeless tobacco. Most youths who tried tobacco did so experimentally. Current use is 10.4% smoking and 2.8% smokeless tobacco. While there is little difference in the proportion of boys and girls who have tried or currently smoke, trial and current use of smokeless tobacco is almost exclusively by males. Whites are more likely to ever use tobacco than other ethnic groups.     

The use of wearable technology as an assessment tool to identify between-limb differences during functional tasks following ACL reconstruction. A scoping review

ObjectiveTo report how wearable sensors have been used to identify between-limb deficits during functional tasks following ACL reconstruction and critically examine the methods used.MethodsWe performed a scoping review of studies including participants with ACL reconstruction as the primary surgical procedure, who were assessed using wearable sensors during functional movement tasks (e.g., balance, walking or running, jumping and landing) at all postsurgical time frames.ResultsEleven studies met the inclusion criteria. The majority examined jumping-landing tasks and reported kinematic and kinetic differences between limbs (involved vs. unninvolved) and groups (injured vs. controls). Excellent reliability and moderate-strong agreement with laboratory protocols was indicated, with IMU sensors providing an accurate estimation of kinetics, but the number of studies and range of tasks used were limited. Methodological differences were present including, sensor placement, sampling rate, time post-surgery and type of assessment which appear to affect the outcome.ConclusionsWearable sensors consistently identified between-limb and group deficits following ACL reconstruction. Preliminary evidence suggests these technologies could be used to monitor knee function during rehabilitation, but further research is needed including, validation against criterion measures. Practitioners should also consider how the methods used can affect the accuracy of the outcome.     

A pilot study to evaluate the use of virtual lectures for undergraduate radiology teaching

Purpose

To demonstrate that virtual lectures can substitute conventional lectures in radiology education for medical students.

Methods and materials

During the course 2005–2006, 89 out from 191 (46.6%) third year students of a subject entitled “General Radiology”, participated voluntarily in a pilot study including 22 virtual lectures (Flash presentations translated from the same PowerPoint presentations of conventional lectures, adding recorded narration and navigation tools). Participants (P) studied by means of virtual lectures, while non-participants (NP) assisted to conventional lectures.The results of the final oral exam classified from 0 to 3, and a 60-questions evaluation on image interpretation were used to compare both groups after training. Finally, 34 students from the group P (38.2%) fulfilled a 10-points scale quality survey about the project.

Results

Final exam qualifications were significantly higher for P than for NP (2.11 ± 0.85 versus 1.73 ± 1.04) as well as the number of correct answers of the evaluation on image interpretation (24.2 ± 6.2 versus 21.2 ± 5.4), but differences could obey to different attitudes between both groups. The usefulness of virtual lectures to learn General Radiology obtained the highest global scoring (8.82 ± 1.00). Contents were generally better evaluated than the design of the presentations.

Conclusion

Virtual lectures can substitute conventional lectures in radiology education for medical students with no detriment to students’ learning. Their potential advantage is that magisterial lectures can be used to discuss contents with students in a more participative way if virtual lectures are provided before.     

Symptom-limited graded treadmill exercise testing in young adults in the CARDIA study.

Symptom-limited, graded exercise treadmill testing was performed by 4,968 white and black adults, ages 18-30 yr, during the baseline examination for the CARDIA study. The mean estimated maximal exercise capacity by race/gender, expressed as metabolic units (METS), was: white men 13.8, black men 13.0, white women 11.1, and black women 9.4. Exercise test duration was higher in nonsmokers, positively related to physical activity score and pulmonary function (FEV1.ht-2), and inversely related to body mass index. Men had higher mean values than women for both test duration and a measure of submaximal performance, the workload 130 (WL130, the exercise test duration to a heart rate of 130 beats.min-1). Adjusted for age and education, white men had a longer mean test duration than black men (53 s longer, P less than 0.001), but nearly equal mean WL130. White women had higher mean values than black women for both test duration (114 s longer, P less than 0.001) and WL130 (36 s longer, P less than 0.001). Men had higher mean values than women for both outcome measures (P less than 0.001). Thus, in young adults significant gender and ethnic differences exist for exercise test performance, part of which can be explained by personal habits or traits.     

Work stress in radiologists. A pilot study

PURPOSE: We studied occupational stress and its psychosocial effects in a sample of Italian radiologists and radiotherapists: MATERIALS AND METHODS: Radiologists and radiotherapists attending two medical conferences were invited to complete a questionnaire comprising four sections investigating the risk of occupational stress (organisational discomfort, Karasek's Job Content Questionnaire, Siegrist's Effort-Reward Imbalance, Warr's Job Satisfaction) and four sections investigating the health effects of such stress (Goldberg's Anxiety and Depression Scales, General Health Questionnaire, Lifestyles Questionnaire). RESULTS: Radiologists and radiotherapists generally expressed high levels of control, reward and satisfaction. However, 38.5% complained of severe organisational discomfort, 24% reported job strain, 28% reported effort/reward imbalance and 25% were dissatisfied. Female radiologists and radiotherapists showed higher levels of organisational discomfort than their male colleagues. Younger and less experienced radiologists and radiotherapists had higher strain scores than their older and more experienced colleagues. A significant correlation was observed between stress predictors and the effects of stress on health, including depression and anxiety, psychological distress and unhealthy lifestyles. CONCLUSIONS: Radiologists and radiotherapists are exposed to major occupational stress factors, and a significant percentage of them suffer from workplace stress. A special effort is required to prevent this condition.     

A 10-yr study of smokeless tobacco use in a professional baseball organization

PURPOSE: Professional baseball players frequently use smokeless tobacco and are at risk of oral leukoplakia. There are limited long-term data on current trends in tobacco use and resultant oral health in this high-risk group. The purpose of this study was to monitor the prevalence of smokeless tobacco use in a professional baseball organization over a 10-yr period, looking for changes in the patterns of use and resultant changes in the incidence of oral leukoplakia. METHODS: During 10 successive spring training camps (1991-2000), players and management personnel were surveyed on their use of smokeless tobacco. A detailed mouth examination of each participant was performed by an examiner blinded to the questionnaire results. The main outcome measures were trends in self-reported tobacco use and the presence of oral leukoplakia on examination. RESULTS: We performed 2266 mouth examinations on participants with a completed questionnaire, with the yearly sample size ranging from 190 to 259. The prevalence of smokeless tobacco use declined, falling from 41.1% in year 1 to 25.6% in year 10 (P=0.029). Tobacco use was strongly associated with the prevalence of oral leukoplakia. As the overall prevalence of smokeless tobacco use fell, the prevalence of oral leukoplakia in the entire population declined; falling from 22.6% of all participants in year 1 to only 9.4% in year 10 (P<0.001). CONCLUSIONS: The prevalence of smokeless tobacco use showed a steady decline in this professional baseball organization over the 10 yr of the study, with a concomitant decline in the prevalence of oral leukoplakia in this population. We postulate that changes in league rules regarding tobacco use and regular education and support for tobacco cessation might explain the declining use.