The Effect of Simulated Leg-Length Discrepancy on the Dynamic Parameters of the Feet during Gait-Cross-Sectional Research

Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects. Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels. Results: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% (p < 0.001), mean pressure of the short leg increased by 1.23% (p = 0.005), and decreased by 5.89% in the long leg (p < 0.001). Peak pressure of the short leg decreased by 2.58% (p = 0.031) and the long leg decreased by 12.11% (p < 0.001). Conclusions: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg

Hallux Limitus Influence on Plantar Pressure Variations during the Gait Cycle: A Case-Control Study

´[Abstract] Background: Hallux limitus is a common foot disorder whose incidence has increased in the school-age population. Hallux limitus is characterized by musculoskeletal alteration that involves the metatarsophalangeal joint causing structural disorders in different anatomical areas of the locomotor system, affecting gait patterns. The aim of this study was to analyze dynamic plantar pressures in a school-aged population both with functional hallux and without. Methods: A full sample of 100 subjects (50 male and 50 female) 7 to 12 years old was included. The subjects were identified in two groups: the case group (50 subjects characterized as having hallux limitus, 22 male and 28 female) and control group (50 subjects characterized as not having hallux limitus, 28 male and 22 female). Measurements were obtained while subjects walked barefoot in a relaxed manner along a baropodometric platform. The hallux limitus test was realized in a seated position to sort subjects out into an established study group. The variables checked in the research were the surface area supported by each lower limb, the maximum peak pressure of each lower limb, the maximum mean pressure of each lower limb, the body weight on the hallux of each foot, the body weight on the first metatarsal head of each foot, the body weight at the second metatarsal head of each foot, the body weight at the third and fourth metatarsal head of each foot, the body weight at the head of the fifth metatarsal of each foot, the body weight at the midfoot of each foot, and the body weight at the heel of each foot. Results: Non-significant results were obtained in the variable of pressure peaks between both study groups; the highest pressures were found in the hallux with a p-value of 0.127 and in the first metatarsal head with a p-value 0.354 in subjects with hallux limitus. A non-significant result with a p-value of 0.156 was obtained at the second metatarsal head in healthy subjects. However, significant results were observed for third and fourth metatarsal head pressure in healthy subjects with a p-value of 0.031 and regarding rearfoot pressure in subjects with functional hallux limitus with a p-value of 0.023. Conclusions: School-age subjects with hallux limitus during gait exhibit more average peak plantar pressure in the heel and less peak average plantar pressure in the third and fourth metatarsal head as compared to healthy children aged between 7 and 12 years old

Assessment and indicators of hallux limitus related with quality of life and foot health in school children

Background: Functional Hallux Limitus (FHL) is a dynamic foot dysfunction characterized by a limitation of hallux dorsiflexion when the first metatarsal head is under load. FHL plays a role in the development of osteoarthrosis in the first metatarsophalangeal joint (IMTPJ). Forefoot disorders can significantly impact an individual's quality of life, leading to dysfunction and pain. The aim of this project was to evaluate the quality of life of school-aged individuals with and without FHL using the Foot Health Status Questionnaire (FHSQ). Methods: A case-control study was conducted to evaluate the outcomes in paediatric age. A total sample of 116 children between 6 and 12 years old was used to conduct this research. The sample was divided into two groups: (i) the healthy group (n = 58) and the FHL group (n = 58). The FHSQ was completed and the FHL test was performed in a seated position to classify the patients into the selected group. Results: Non-significant changes were observed when the mean values of the FHSQ domains were compared between the groups with and without FHL, except for the "general foot health" domain (p = 0,024) associated with the specific foot health section (section 1) of the Questionnaire. For the domains linked with the general well-being section (section 2), there was not a statistically difference in the mean of the scores obtained between the two school-aged groups with and without FHL, being slightly lower in the group with the presence of FHL for the overall health and physical function domains. Both the healthy and case groups obtained and identical range of scores (10-100) for the "foot pain" domain. Nevertheless, the mean of the score was lower for the participants with FHL. Conclusions: The perception of the quality of general foot health was poorer in the school-aged group with FHL. Variables such as foot pain and footwear are likely contributors influencing the perception of foot health quality. The school-aged population with FHL faces a decline in the quality of foot life. Ensuring adequate foot control in children and implementing future foot programs for this population are imperative for enhancing school children's perception of foot health and managing the development of pain and footwear-related issues.Departamento de Biología Ambiental y Salud Públic

Multivariate Spatial Modeling of HIV Risk

We analyze data from the Los Angeles LGBT Center, a community-based healthcare organization. When patients visit the clinic, they are given a comprehensive risk-assessment questionnaire. We develop three methods that allow us to identify the risk factors associated with HIV seroconversion and predict who is most likely to become HIV positive. First, we construct a two-stage multivariate logistic regression model, where stage one models a patient's history of illicit drug use and their history of STIs other than HIV, and stage two models their risk of contracting HIV. Each stage of the model has ZIP code random effects that are correlated over space. We propose a statistic called the geometric mean ratio (GMR), which measures how much of the variability in the ZIP code random effects for HIV is explained by the stage one random effects. We find that the stage one random effects are negligible in the HIV model and that where a person lives is not predictive of their risk of contracting HIV. Next, we jointly model a patient's time until HIV seroconversion with their clinic visit frequency through shared frailties. We show that if clinic visit frequency is correlated with survival, then the censoring is informative. We examine how the informativeness of the censoring depends on the frailty distributions. We find that patients who visit the clinic more frequently tend to have a higher probability of contracting HIV, suggesting that patients are accurately assessing that they have a higher risk of disease.Finally, we reduce the items from the risk assessment questionnaire into a set of latent measures of patient riskiness with a factor analysis model. Because patients come to the clinic multiple times, we allow the factors to be correlated within a patient over time, and between patients over space. We then use the factor scores from one visit to predict whether or not a patient will seroconvert by their next visit. We show that this model is equivalent to a larger longitudinal factor model and that the factor scores are predictive of future risk of HIV

Multivariate Spatial Modeling of HIV Risk

We analyze data from the Los Angeles LGBT Center, a community-based healthcare organization. When patients visit the clinic, they are given a comprehensive risk-assessment questionnaire. We develop three methods that allow us to identify the risk factors associated with HIV seroconversion and predict who is most likely to become HIV positive. First, we construct a two-stage multivariate logistic regression model, where stage one models a patient's history of illicit drug use and their history of STIs other than HIV, and stage two models their risk of contracting HIV. Each stage of the model has ZIP code random effects that are correlated over space. We propose a statistic called the geometric mean ratio (GMR), which measures how much of the variability in the ZIP code random effects for HIV is explained by the stage one random effects. We find that the stage one random effects are negligible in the HIV model and that where a person lives is not predictive of their risk of contracting HIV. Next, we jointly model a patient's time until HIV seroconversion with their clinic visit frequency through shared frailties. We show that if clinic visit frequency is correlated with survival, then the censoring is informative. We examine how the informativeness of the censoring depends on the frailty distributions. We find that patients who visit the clinic more frequently tend to have a higher probability of contracting HIV, suggesting that patients are accurately assessing that they have a higher risk of disease.Finally, we reduce the items from the risk assessment questionnaire into a set of latent measures of patient riskiness with a factor analysis model. Because patients come to the clinic multiple times, we allow the factors to be correlated within a patient over time, and between patients over space. We then use the factor scores from one visit to predict whether or not a patient will seroconvert by their next visit. We show that this model is equivalent to a larger longitudinal factor model and that the factor scores are predictive of future risk of HIV

Differences in the Association of Physical Activity and Children’s Overweight and Obesity Status Among the Major Racial and Ethnic Groups of U.S. Children

ObjectiveTo examine the relationship of exercise with overweight and obesity among an ethnically diverse sample of U.S. children.MethodData from the 2011-2012 National Survey of Children's Health were analyzed to examine the relationship of daily exercise with children's weight status. Propensity score covariate adjustment and multivariate logistic regression with survey weights were used to control for child, home, and community characteristics.ResultsApproximately 22% of all children ages 10 to 17 years engaged in daily exercise for at least 20 minutes. In the adjusted model for the entire sample, daily exercise was associated with children having a lower likelihood of being overweight or obese (odds ratio = 0.79; 95% confidence interval = 0.68-0.91). In a stratified analysis of the major racial and ethnic groups, however, while White children who exercised daily were found to have a lower odds of being overweight or obese (odds ratio = 0.70; 95% confidence interval = 0.60-0.82), this relationship was not found for most minority children.ConclusionsRacial and ethnic minority children were not found to have the same weight status relationship with exercising daily. These findings suggest that some population-average exercise recommendations may not be as applicable to minority children

Low-Dose Parenteral Soybean Oil for the Prevention of Parenteral Nutrition–Associated Liver Disease in Neonates With Gastrointestinal Disorders

Zagreb, kao glavni grad Hrvatske je kulturno, obrazovno te gospodarsko središte. Zbog svojih kulturnih ljepota privlači mnoge turiste, kako poslovne, tako i one željne umjetnosti, kulture i manifestacija. Iako Zagreb ima široku ponudu u turizmu, postoji vrsta turizma koja nije razvijena, ali ima velikog potencijala. Radi se o mračnome turizmu, vrsti turizma koja spaja tragediju sa obrazovanjem te empatijom. Iako mračni turizam sa sobom nosi moralna pitanja i ograničenja, aplikacija mračnoga turizma na Zagreb otvara nove mogućnosti te širenje na nova turistička tržišta. Svojim legendama, mitovima, stradanjima u poplavi i potresu te ubijanjima žena u prošlosti, Zagreb otvara nove mogućnosti za razvoj i unapređenje turizma. Uz pomoć stručnjaka, Zagreb bi mogao postati jedna od na najrazvijenijih destinacija mračnoga turizma. Potrebno je pažljivo odabrati ciljnu skupinu i uvesti Zageb na delikatno tržište mračnoga turizma gradnjom infrastruktura i „pričanjem priča“ o Zagrebu i tajnama koje on skriva

QSAR, DFT and molecular modeling studies of peptides from HIV-1 to describe their recognition properties by MHC-I

<p>Human immunodeficiency virus type-1 (HIV-1) has infected more than 40 million people around the world. HIV-1 treatment still has several side effects, and the development of a vaccine, which is another potential option for decreasing human infections, has faced challenges. This work presents a computational study that includes a quantitative structure activity relationship(QSAR) using density functional theory(DFT) for reported peptides to identify the principal quantum mechanics descriptors related to peptide activity. In addition, the molecular recognition properties of these peptides are explored on major histocompatibility complex I (MHC-I) through docking and molecular dynamics (MD) simulations accompanied by the Molecular Mechanics Generalized Born Surface Area (MMGBSA) approach for correlating peptide activity reported elsewhere vs. theoretical peptide affinity. The results show that the carboxylic acid and hydroxyl groups are chemical moieties that have an inverse relationship with biological activity. The number of sulfides, pyrroles and imidazoles from the peptide structure are directly related to biological activity. In addition, the HOMO orbital energy values of the total absolute charge and the Ghose–Crippen molar refractivity of peptides are descriptors directly related to the activity and affinity on MHC-I. Docking and MD simulation studies accompanied by an MMGBSA analysis show that the binding free energy without considering the entropic contribution is energetically favorable for all the complexes. Furthermore, good peptide interaction with the most affinity is evaluated experimentally for three proteins. Overall, this study shows that the combination of quantum mechanics descriptors and molecular modeling studies could help describe the immunogenic properties of peptides from HIV-1.</p

High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study

Rates of abnormal visual inspection with acetic acid and prevalence of high-risk human papillomavirus (HPV) subtypes have not been well characterized in HIV-infected women in Malawi. We performed a prospective cohort study of visual inspection with acetic acid (N = 440) in HIV-infected women aged 25--59 years, with a nested study of HPV subtypes in first 300 women enrolled. Of 440 women screened, 9.5% (N = 42) had abnormal visual inspection with acetic acid with 69.0% (N = 29) having advanced disease not amenable to cryotherapy. Of 294 women with HPV results, 39% (N = 114) of women were positive for high-risk HPV infection. Only lower CD4 count (287 cells/mm(3) versus 339 cells/mm(3), p = 0.03) and high-risk HPV (66.7% versus 35.6%, p &lt; 0.01) were associated with abnormal visual inspection with acetic acid. The most common high-risk HPV subtypes in women with abnormal visual inspection with acetic acid were 35 (33.3%), 16 (26.7%), and 58 (23.3%). Low CD4 cell count was associated with abnormal visual inspection with acetic acid and raises the importance of early antiretroviral therapy and expanded availability of visual inspection with acetic acid. HPV vaccines targeting additional non-16/18 high-risk HPV subtypes may have greater protective advantages in countries such as Malawi

High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study

INTRODUCTION: Rates of abnormal visual inspection with acetic acid (VIA) and prevalence of high-risk human papillomavirus (HPV) subtypes have not been well characterized in HIV-infected women in Malawi. METHODS: We performed a prospective cohort study of VIA (N=440) in HIV-infected women ages 25-59, with a nested study of HPV subtypes in first 300 women enrolled. Wilcoxon's Rank-Sum Test was used to compare continuous variables and Fisher's exact test was used to compare categorical variables between women with normal versus abnormal VIA. Results: Of 440 women screened, 9.5% (N=42) had abnormal VIA with 69.0% (N=29) having advanced disease not amenable to cryotherapy. Of 294 women with HPV results, 39% (N=114) of women were positive for high-risk HPV infection. Only lower CD4 count (287 cells/mm(3) vs. 339 cells/mm(3), p=0.03) and high-risk HPV (66.7% versus 35.6%, p<0.01) were associated with abnormal VIA. The most common high-risk HPV subtypes in women with abnormal VIA were 35 (33.3%), 16 (26.7%), and 58 (23.3%). CONCLUSION: Low CD4 cell count was associated with abnormal VIA and raises the importance of early ART and expanded availability of VIA. HPV vaccines targeting additional non-16/18 high-risk HPV subtypes may have greater protective advantages in countries such as Malawi