Denosumab Reduces Cortical Porosity of the Proximal Femoral Shaft in Postmenopausal Women With Osteoporosis

Hip fractures account for over one‐half the morbidity, mortality, and cost associated with osteoporosis. Fragility of the proximal femur is the result of rapid and unbalanced bone remodeling events that excavate more bone than they deposit, producing a porous, thinned, and fragile cortex. We hypothesized that the slowing of remodeling during treatment with denosumab allows refilling of the many cavities excavated before treatment now opposed by excavation of fewer new resorption cavities. The resulting net effect is a reduction in cortical porosity and an increase in proximal femur strength. Images were acquired at baseline and 36 months using multidetector CT in 28 women receiving denosumab and 22 women receiving placebo in a substudy of FREEDOM, a randomized, double‐blind, placebo‐controlled trial involving women with postmenopausal osteoporosis. Porosity was quantified using StrAx1.0 software. Strength was estimated using finite element analysis. At baseline, the higher the serum resorption marker, CTx, the greater the porosity of the total cortex (r = 0.34, p = 0.02), and the higher the porosity, the lower the hip strength (r = –0.31, p = 0.03). By 36 months, denosumab treatment reduced porosity of the total cortex by 3.6% relative to baseline. Reductions in porosity relative to placebo at 36 months were 5.3% in total cortex, 7.9% in compact‐appearing cortex, 5.6% in outer transitional zone, and 1.8% in inner transitional zone (all p < 0.01). The improvement in estimated hip integral strength of 7.9% from baseline (p < 0.0001) was associated with the reduction in total porosity (r = –0.41, p = 0.03). In summary, denosumab reduced cortical porosity of the proximal femoral shaft, resulting in increased mineralized matrix volume and improved strength, changes that may contribute to the reduction in hip and nonvertebral fractures reported with denosumab therapy. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).     

Tie – an Accessory Fashion Detail or a Symbol?

Aim

The first aim of this study was to establish the frequency of wearing a tie or business neckerchief on different occasions and in relation to age and educational level. The second aim was to establish whether men who frequently wear a tie were attributed certain characteristics more often than men who rarely wear a tie and to establish whether there were differences in the attribution of these characteristics according to sex, age, educational level, and the frequency of wearing a tie.

Method

Data were collected in 2005 by a method of face to face interview on a national representative sample (n = 1007). Participants estimated how often they wore a tie or business neckerchief on 9 different occasions. They also estimated whether each of 14 characteristics was more pronounced in men who frequently wear a tie.

Results

Tie was most frequently worn on festive and formal occasions, such as weddings and festive gatherings, and least frequently on family gatherings and when traveling. On all occasions, tie was more often worn by men of higher educational level and of older and middle age. A relatively small proportion of Croatian citizens based their conclusions on men’s characteristics on the frequency of wearing a tie. Men who frequently wear a tie were relatively most often attributed the characteristics of ambition, politeness, and respectability, with significant differences found between persons who attributed these characteristics according to sex, age, educational level, and the frequency of wearing a tie by the participants themselves.

Conclusion

Wearing a tie or neckerchief is an exception rather than a rule for most of the Croatian population, and is associated only with specific, primarily festive and formal occasions. Such use of the tie suggests that people adapt their style of clothing to the expectations of others and use it as a specific symbol of the occasion.Clothing is a form of non-verbal communication and represents a systematic way of conscious or unconscious information transmission (1). What distinguishes clothing from other forms of non-verbal communication is that it is the first thing we notice when we meet a person for the first time. Clothing can influence our first impression of a person, create stereotypes, and influence our behavior toward that person (2,3). Therefore, we use clothing as a channel of non-verbal communication for self-presentation and impression management (4). Clothing is also important for our self-concept, since it allows us to feel safer, more assertive, more powerful, and more comfortable in a given situation (4,5). Besides that, the clothes we wear are an example of normative social influence (6), ie the influence we conform to in order to be accepted by a desired social group.More systematic investigation on the influence of clothes on interpersonal relations began in the 1970s and by now a large number of studies have confirmed that people form the impressions on other people on the basis of their physical appearance, especially clothes (7). For example, Damhorst (8), in his review, concluded that 94% of the analyzed experimental studies showed an influence of clothes on the impression formation. Research showed that the way a person is dressed influences the conclusions other people make on their traits and characteristics, such as reliability, competence, power/status, or their workplace (9-13). People not only base their conclusions on clothes itself but also on the appropriateness of clothes to the occasion (7). Different roles or social positions and different occupations or work places are often related to different social norms, including the clothing norm (4,14-16). Even when we do not place much importance on social roles, we still use clothing to adapt to the situation because we care about the reactions of others. Also, appropriate clothing facilitates social interaction and helps us feel more comfortable (4,5). People use clothes to demonstrate similarities in values and beliefs with members of their own group, as well as differences from the groups they do not belong to (17-19). The choice of clothes can show our disagreement with certain norms or terminate unwanted social interactions.The greatest part of the research on the influence of clothes on impression formation and management was conducted in business situations and is related to conventional or classic clothing style (14-16,20). These studies have shown that the applicant’s clothing at interview has an influence on whether he or she will get a job, and that classically or conventionally dressed people are more positively evaluated. Classic or conventional clothing includes a suit for both men and women and a tie for men. It has been proven that this style of clothing is associated with competence and authority in both men and women, not only in business situations (15,21-25).According to the available data, 600-700 million people across the world wear a tie every day, and more than two billion Euro is spent on ties every year, which is more than a yearly budget of some smaller states (26). According to Johnson (27), the earliest known version of the tie was found in the mausoleum of the first emperor of China, Shih Huang Ti, who was buried in 210 BC. Tie’s modern history began in the 17th century, when Croatian soldiers fighting in the Thirty Years'' War spread its forerunner, known as the cravat, all over Europe. In his monograph Le grande histoire de la cravate, Francois Chaille confirms and discusses the Croatian origin of the cravat (Figure 1), while the Encyclopćdia Britannica states that the noun “cravat” originated from the words Crabata, Cravata, and Croatian, mentioning the year 1656 as the year of its appearance (26). The French readily accepted the special way of tying a piece of cloth around the neck “a la Croate” and citizens of Paris soon took it to be a symbol of progress (26). During the French revolution, black cravats were worn as a sign of protest against reactionary ideas, and the cravat soon became a symbol of culture and elegance (26). While the French saw the cravat as a decoration and a symbol of progress, for the Croatian it was primarily a symbol of fidelity. According to the popular tradition, wives and girlfriends would give cravats to soldiers as a token of their love, to give them courage and comfort in difficulties and danger. On the other hand, by wearing a cravat, the soldier would show the respect for his beloved. This custom symbolized a man''s loyalty to a woman, as well as established loyalty as a virtue (28). Therefore, through the history, the tie has symbolized loyalty, culture, refinement, style, and elegance; according to Johnson (27) the tie has symbolized social status, occupation/work place, identity, as well as group belonging.Open in a separate windowFigure 1Tie with a traditional Croatian pattern called pleter.In order to examine contemporary symbolical connotations of the tie, we analyzed the frequency of wearing a tie on various occasions among the citizens of Croatia of different age and educational level, as well as the characteristics attributed to men who frequently wear a tie. Since tie is a garment worn usually by men, we analyzed the frequency of wearing a business neckerchief among women.Specific aims of the study were: 1) to establish the frequency of wearing a tie orbusiness neckerchief on different occasions among people of different age and educational levels; 2) to establish whether men who frequently wear a tie were attributed certain characteristics more often than men who wear a tie rarely and to establish whether there were differences in the attribution of these characteristics according to age and educational levels; and 3) to establish whether there are differences between men in the attribution of characteristics to other men who frequently wear a tie with regard to the number of different situations in which men themselves frequently wear a tie.     

(GγAγδβ)0$({}^{\rm G}{\gamma}{}^{\rm A}{\gamma}\delta\beta)^0$-Thalassemia: Report of two cases in a family

Case 1 presented with severe anemia and received an intrauterine blood cell transfusion at 33 weeks of gestation. The anemia spontaneously improved in early infancy. Case 2, the father of Case 1, had an uneventful birth with no evidence of anemia, though microcytic anemia was observed during childhood. The genetic analysis of the β-globin gene cluster identified a novel heterozygous deletion of DNA extending from the Gγ-globin gene downstream to the β-globin gene, confirming a diagnosis of (^Gγ^Aγδβ)⁰-thalassemia. In cases where thalassemia is suspected based on blood tests, a genetic diagnosis should be performed for the sake of the offspring.     

Anticancer properties of green-synthesised zinc oxide nanoparticles using Hyssopus officinalis extract on prostate carcinoma cells and its effects on testicular damage and spermatogenesis in Balb/C mice

The unclear bio-safety issue and potential risk of nanoparticles (NPs) on various organelles can be considered as a major challenge. In the present study, we have assessed the green synthesis of ZnO nanoparticles using Hyssop (Hyssopus officinalis) extract and their effects on PC3 cell line and BALB/c mice model. The cytotoxicity of the ZnO-NPs was assessed on PC3 cell line by MTT test after characterisation. Apoptotic effect of ZnO-NPs was determined by in vitro AO/PI staining. The histopathological assessments and determination of LH and FSH levels carried out as in vivo analysis in BALB/c adult male mice. The expression of major genes involved in spermatogenesis and sperm maturation (Adam3, Prm1, Spata19, Tnp2, Gpx5) were also analysed. The obtained result demonstrated that the IC₅₀ for PC3 cell line treated with green-synthesised ZnO-NPs during 24 and 48 hr was reported 8.07 and 5 µg/ml respectively. Meanwhile, the induced apoptosis was recorded 26.6% ± 0.05, 44% ± 0.12 and 80% ± 0.07 of PC3 cells. The results of gene expression analysis revealed that the increase in the concentration of ZnO-NPs significantly (p < .05) down-regulated the Adam3, Prm1, Spata-19, Tnp2 and Gpx5 genes. The overall results of this research elucidated that ZnO-NPs impaired spermatogenesis, sperm maturation process and sperm motility.     

Sex judgment using color fundus parameters in elementary school students

Graefe's Archive for Clinical and Experimental Ophthalmology - Recently, artificial intelligence has been used to determine sex using fundus photographs alone. We had earlier reported that sex...     

Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements

Esophagus - Development of gastroesophageal reflux disease (GERD) after gastrostomy remains debatable. Therefore, this study aimed to evaluate whether laparoscopy-aided gastrostomy (LAG) influence...     

First Outbreak of an H5N8 Highly Pathogenic Avian Influenza Virus on a Chicken Farm in Japan in 2020

On 5 November 2020, a confirmed outbreak due to an H5N8 highly pathogenic avian influenza virus (HPAIV) occurred at an egg-hen farm in Kagawa prefecture (western Japan). This virus, A/chicken/Kagawa/11C/2020 (Kagawa11C2020), was the first HPAI poultry isolate in Japan in 2020 and had multiple basic amino acids—a motif conferring high pathogenicity to chickens—at the hemagglutinin cleavage site. Mortality of chickens was 100% through intravenous inoculation tests performed according to World Organization for Animal Health criteria. Phylogenetic analysis showed that the hemagglutinin of Kagawa11C2020 belongs to clade 2.3.4.4B of the H5 Goose/Guangdong lineage and clusters with H5N8 HPAIVs isolated from wild bird feces collected in Hokkaido (Japan) and Korea in October 2020. These H5N8 HPAIVs are closely related to H5N8 HPAIVs isolated in European countries during the winter of 2019–2020. Intranasal inoculation of chickens with 10⁶ fifty-percent egg infectious doses of Kagawa11C2020 revealed that the 50% chicken lethal dose was 10^4.63 and the mean time to death was 134.4 h. All infected chickens demonstrated viral shedding beginning on 2 dpi—before clinical signs were observed. These results suggest that affected chickens could transmit Kagawa11C2020 to surrounding chickens in the absence of clinical signs for several days before they died.     

Cortical Porosity Identifies Women With Osteopenia at Increased Risk for Forearm Fractures

Most fragility fractures arise among the many women with osteopenia, not the smaller number with osteoporosis at high risk for fracture. Thus, most women at risk for fracture assessed only by measuring areal bone mineral density (aBMD) will remain untreated. We measured cortical porosity and trabecular bone volume/total volume (BV/TV) of the ultradistal radius (UDR) using high‐resolution peripheral quantitative computed tomography, aBMD using densitometry, and 10‐year fracture probability using the country‐specific fracture risk assessment tool (FRAX) in 68 postmenopausal women with forearm fractures and 70 age‐matched community controls in Olmsted County, MN, USA. Women with forearm fractures had 0.4 standard deviations (SD) higher cortical porosity and 0.6 SD lower trabecular BV/TV. Compact‐appearing cortical porosity predicted fracture independent of aBMD; odds ratio (OR) = 1.92 (95% confidence interval [CI] 1.10–3.33). In women with osteoporosis at the UDR, cortical porosity did not distinguish those with fractures from those without because high porosity was present in 92% and 86% of each group, respectively. By contrast, in women with osteopenia at the UDR, high porosity of the compact‐appearing cortex conferred an OR for fracture of 4.00 (95% CI 1.15–13.90). In women with osteoporosis, porosity is captured by aBMD, so measuring UDR cortical porosity does not improve diagnostic sensitivity. However, in women with osteopenia, cortical porosity was associated with forearm fractures. © 2014 American Society for Bone and Mineral Research.