Factors predictive of Ponseti casting for treating clubfoot: analysis of Bayesian Poisson regression model.

OBJECTIVE: Clubfoot is a growing public health concern in Bangladesh, with the incidence of approximately 0.64 to 6.8 in every 1000 live births. For over a decade, Ponseti method has been considered a gold standard for treating the clubfoot. Despite few studies have been estimating the number of casts required to correct the clubfoot deformities by Ponseti method, the subject of interest has always remained. Therefore, this current study aimed to investigate the significant predictive factors for the number of casts required to correct congenital clubfoot. PATIENTS AND METHODS: In this retrospective cohort study, we used Bayesian Poisson Regression Model to investigate the influencing factors that could predict how many casts are needed to correct the clubfoot. We included 69 patients with 99 affected feet, who completed their corrective phase of treatment in the Ponseti method. For this cohort study, we integrated only pre-tenotomy casting data with no age restrictions. We used Bayesian Poisson regression analysis technique to estimate the predictive factors. RESULTS: In Bayesian Poisson model, age was the most influencing predictive factor (24.3%) for increasing the number of castings to correct the clubfoot deformity. The clubfoot offspring of the ≤1-year-old was positive, and the incidence rate increased significantly with the casting number. The number of Ponseti casts in male clubfoot children was 28% higher than in female, and this was marginally statistically significant. There was no marked change estimated in the pattern of clubfoot, foot involvement and Pirani score of the severity. CONCLUSIONS: We concluded that the age factor may influence the number of casts required for the correction of clubfoot and specifically ≤ 1-year-old children are highly impacted. Treating clubfoot at an early age is suggested in this study to increase the success of clubfoot treatment and decrease the risk of relapse.

Antioxidant defense of fish collagen peptides attenuates oxidative stress in gastric mucosa of experimentally ulcer-induced rats.

The aim of the present study was to investigate the ability of fish collagen peptides (FCP) from the skin of great hammerhead shark (Sphyrna mokarran) to avert the occurrence of gastric ulcer in experimental rats. FCP treatment prevented the formation of ulcerative lesions on gastric tissues with 86% of inhibition. The histopathology analysis of gastric tissue revealed that the FCP intake prevented the occurrence of hemorrhage and erosion in gastric tissue with formation of mild edema and necrosis, as well as normalized the pH and volume of gastric juice. It also downregulated the expression of pro-inflammatory marker interferon-ɤ (IFN-ɤ) and upregulated the anti-inflammatory marker interleukin-4 (IL-4) in gastric tissue. FCP is capable to modulate the oxidative stress by enhancing the activity of antioxidant defense enzymes superoxide dismutase (SOD) and catalase and by lowering the levels of membrane lipid peroxidation.

Impact of COVID-19 pandemic lockdown on occupational therapy practice and use of telerehabilitation - A cross sectional study.

OBJECTIVE: COVID-19 has become a global public health emergency affecting 223 countries and territories, and it drastically changed the life of public and health care delivery systems. Although many guidelines have been proposed to avoid infection from COVID-19 and to promote the use of telerehabilitation, there is still no clear answer for the current scenario and strategies of therapists' practice during the COVID-19 pandemic lockdown. This study aimed to explore the impact of COVID-19 lockdown on Occupational Therapists' (OTs) practice, the use of telerehabilitation strategies by OTs, and their employment and mental health. Also, this study aimed to explore the OTs perspective on the role of telerehabilitation during this pandemic lockdown. MATERIALS AND METHODS: Online cross-sectional survey was conducted between April 2020 and May 2020. RESULTS: 114 OTs completed the survey. The results of this study showed that 52.8% of therapists had stress and anxiety due to COVID-19 lockdown. We found that 60.7% of OTs (n=65) used telerehabilitation, versus 36.1% (n=39) before the lockdown. Telerehabilitation approaches were mostly implemented during this lockdown for children with autistic problems (66.6%), stroke (12.9%), cerebral palsy (6.4%), learning disabilities (9.6%), Parkinson's diseases (1.6%), and other medical conditions (2.8%). 10% of therapists reported that they lost their job, and 76% reported that this lockdown affected their income negatively. Overall, 87.8% of therapists reported that mobile technology was very useful to overcome the stress due to COVID-19 related lockdown, social isolation, and social distancing. CONCLUSIONS: The COVID-19 pandemic lockdown experiences made us rethink the current approach of therapy services into alternative method (mixed mode) delivery of occupational therapy practice, which is including the combined method of video-based (telerehabilitation) consultation and face to face intervention.

Ambient assisted living technologies for older adults with cognitive and physical impairments: a review.

The global number of people over the age of 60 years is expected to increase from 970 million to 2.1 billion in 2050 and 3.1 billion in 2100. About 80% of the aging population will be in the developing countries. Aging population may suffer from various physical, cognitive, and social problems, due to aging process such as impairment of physical related functions (decreased mobility and walking speed, falls, frailty, decreased walking speed, difficulties in basic, and instrumental activities of daily living), cognitive related functions (memory-related issues), sensory functions (hearing loss, cataracts and refractive errors, presbyopia, decreased vestibular function), behavioural and psychological disorders, social isolation issues, and poor quality of life. Over the period of the last few decades, emerging technologies such as internet of things (IoT), artificial intelligence (AI), sensors, cloud computing, wireless communication technologies, and assistive robotics have given the vision to develop various ambient or active assisted living (AAL) approaches for supporting an elderly people to live safely and independently in their living environment and participate in their daily and community activities, as well as supporting them to maintain their physical, mental health, and quality of their life. The aim of this paper is to review the use of Ambient or Active Assisted Living for older adults with physical, cognitive impairments, and their social participation.

A novel 3D evaluation method for assessing bone to bone relationships in clubfoot.

OBJECTIVE: Clubfoot is a complex congenital three-dimensional foot deformity, which affects 150,000-200,000 newborn babies annually around the world. A good understanding of the alignment of the two osseous columns and the lower leg of the ankle and foot complex is essential for evaluating the severity of clubfoot. The purposes of this study were to (1) develop an automated three-dimensional (3D) surface model of severe clubfoot based on two-dimensional (2D) slices of computed tomography (CT) images, (2) evaluate the alignment of foot bones relative to the ankle in severe clubfoot, and (3) examine the structural changes in the shape of the clubfoot. PATIENTS AND METHODS: Two-dimensional CT image was taken from a four-year-old child with a severe clubfoot. Subsequently, an automated and detailed 3D surface model of the severe clubfoot was developed from the 2D images by using MATLAB software programming. Then, the x, y, and z coordinate angles were automatically calculated for each bone in the foot relative to the ankle (lower end of the tibia) to determine the orientations and relationships among the bones. RESULTS: The relative position or orientation of each bone of the foot to the ankle of the severe clubfoot was objectively measured which was used to determine the orientation of each bone in the foot. Among the x, y, and z axes of the interested tarsal bones, the z axis represents the smallest moment of inertia, and the results showed that the bones in the x axis shifted medially with higher relative angle. CONCLUSIONS: This 3D objective measurement method for assessing clubfoot can be used to determine and classify the severity of clubfoot, as well as evaluate and monitor the progress of the clubfoot intervention based on the relative position of the tarsal bones. The method can also be used to quantify the relationship between the tarsal bones of the foot and lower end of the tibia. In addition, angular measurements can be used to assess other pathological conditions of the foot such as pes cavus and pes planus.

Dietary supplementation of thiamine and pyridoxine-loaded vanillic acid-grafted chitosan microspheres enhances growth performance, metabolic and immune responses in experimental rats.

In the present investigation, the effect of dietary supplementation of thiamine and pyridoxine loaded vanillic acid-grafted chitosan microspheres (TPVGC) on growth, metabolic and immune responses in Wistar strain albino rats was studied. Eight experimental groups, namely four groups each for male and female rats were fed with 0, 0.4, 0.8 and 1.6% of TPVGC in the diet. At the end of 45days feeding trials, both male and female rats supplemented with TPVGC had higher weight gain% and specific growth rate than the control groups. Significantly (p<0.05) lower blood glucose level and higher respiratory burst activity were recorded in the treatment groups than the control groups of both male and female rats. Activity of metabolic enzymes (aspartate amino transferase, alanine aminotransferase, alkaline phosphatase and acid phosphatase) and antioxidant enzymes (superoxide dismutase, catalase and glutathione S-transferase) were significantly higher (p<0.05) in the control groups and a decreasing trend in the same was observed with a gradual increase in the inclusion level of TPVGC in the diet of the treatment groups. However, a reverse trend was observed for acetylcholine esterase. It was inferred that dietary supplementation of thiamine and pyridoxine loaded vanillic acid-grafted chitosan enhanced the growth performance, metabolic and immune responses in the animal-model.

Kinetic and kinematic analysis of gait pattern of 13 year old children with unilateral genu valgum.

OBJECTIVE: Genu valgum is a common knee deformity in growing children. It alters the alignment of the lower extremity, body posture, and gait pattern of the children. Understanding of kinematic and kinetic parameters of gait in genu valgum is essential for planning and implementing the intervention to correcting the valgus deformity. The aim of this paper is to investigate the kinetic and kinematic gait differences in children with genu valgum. PATIENTS AND METHODS: A 13-year old girl with left side unilateral genu valgum and a closely matched healthy counterpart were recruited to compare the kinetic and kinematic parameters of their gait performances, and they were captured by The VICON motion analysis system. RESULTS: The results showed that the child with genu valgum had lower left and right knee angles (39.6˚; 30.2˚) and higher ankle angles (35.6˚; 28.4˚) than the healthy subject (64.2˚, 60.2˚). In addition, the child with genu valgum had lower moments on the left side of the knee (42.1 mm.N) than unaffected right knee (73.9 mm.N). Also, the ground reaction force was (0.7 N) lower in the affected knee of the child with genu valgum than the normal subject. CONCLUSIONS: This study revealed that there were decreased knee and ankle moments and lower knee and ankle ground reaction forces in the affected genu valgum extremity when compared with the healthy counterpart. These changes might be responsible for the altering gait pattern of the child with genu valgum.

Effect of sodium, potassium, magnesium, and calcium salt cations on pH, proteolysis, organic acids, and microbial populations during storage of full-fat Cheddar cheese.

Sodium reduction in cheese can assist in reducing overall dietary Na intake, yet saltiness is an important aspect of cheese flavor. Our objective was to evaluate the effect of partial substitution of Na with K on survival of lactic acid bacteria (LAB) and nonstarter LAB (NSLAB), pH, organic acid production, and extent of proteolysis as water-soluble nitrogen (WSN) and protein profiles using urea-PAGE, in Cheddar cheese during 9mo of storage. Seven Cheddar cheeses with molar salt contents equivalent to 1.7% salt but with different ratios of Na, K, Ca, and Mg cations were manufactured as well as a low-salt cheese with 0.7% salt. The 1.7% salt cheeses had a mean composition of 352g of moisture/kg, 259g of protein/kg and 50% fat-on-dry-basis, and 17.5g of salt/kg (measured as Cl(-)). After salting, a faster initial decrease in cheese pH occurred with low salt or K substitution and it remained lower throughout storage. No difference in intact casein levels or percentage WSN levels between the various cheeses was observed, with the percentage WSN increasing from 5% at d 1 to 25% at 9mo. A greater decrease in intact αs1-casein than ß-casein was detected, and the ratio of αs1-casein (f121-199) to αs1-casein could be used as an index of ripening. Typical changes in bacteria microflora occurred during storage, with lactococci decreasing gradually and NSLAB increasing. Lowering the Na content, even with K replacement, extended the crossover time when NSLAB became dominant. The crossover time was 4.5mo for the control cheese and was delayed to 5.2, 6.0, 6.1, and 6.2mo for cheeses with 10, 25, 50, and 75% K substitution. Including 10% Mg or Ca, along with 40% K, further increased crossover time, whereas the longest crossover time (7.3mo) was for low-salt cheese. By 9mo, NSLAB levels in all cheeses had increased from initial levels of ≤10(2) to approximately 10(6)cfu/g. Lactococci remained at 10(6) cfu/g in the low-salt cheese even after 9mo of storage. The propionic acid concentration in the cheese increased when NSLAB numbers were high. Few other trends in organic acid concentration were observed as a function of Na content.

Probiotic bacteria survive in Cheddar cheese and modify populations of other lactic acid bacteria.

AIMS: Starter lactic acid bacteria in Cheddar cheese face physico-chemical stresses during manufacture and ageing that alter their abilities to survive and to interact with other bacterial populations. Nonstarter bacteria are derived from milk handling, cheese equipment and human contact during manufacture. Probiotic bacteria are added to foods for human health benefits that also encounter physiological stresses and microbial competition that may mitigate their survival during ageing. We added probiotic Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus paracasei and Bifidobacterium animalis subsp. lactis to full-fat, reduced-fat and low-fat Cheddar cheeses, aiming to study their survival over 270 days of ageing and to determine the role of the cheese matrix in their survival. METHODS AND RESULTS: Probiotic and other lactic acid bacterial populations were enumerated by quantitative PCR using primers specifically targeting the different bacterial genera or species of interest. Bifidobacteria were initially added at 10(6) CFU g(-1) cheese and survived variably in the different cheeses over the 270-day ageing process. Probiotic lactobacilli that were added at 10(7) CFU g(-1) cheese and incident nonstarter lactobacilli (initially at 10(8) CFU g(-1) cheese) increased by 10- to 100-fold over 270 days. Viable bacterial populations were differentiated using propidium monoazide followed by species-specific qPCR assays, which demonstrated that the starter and probiotic microbes survived over ageing, independent of cheese type. Addition of probiotic bacteria, at levels 100-fold below that of starter bacteria, modified starter and nonstarter bacterial levels. CONCLUSIONS: We demonstrated that starter lactococci, nonstarter lactobacilli and probiotic bacteria are capable of surviving throughout the cheesemaking and ageing process, indicating that delivery via hard cheeses is possible. Probiotic addition at lower levels may also alter starter and nonstarter bacterial survival. SIGNIFICANCE AND IMPACT OF THE STUDY: We applied qPCR to study multispecies survival and viability and distinctly enumerated bacterial species in commercial-scale Cheddar cheese manufacture.

Antiaging effect of dietary chitosan supplementation on glutathione-dependent antioxidant system in young and aged rats.

Aging has been defined as the changes that occur in living organisms with the passage of time that lead to functional impairment and ultimately to death. Free radical-induced oxidative damage has long been thought to be the most important consequence of the aging process. In the present study, an attempt has been made to study the salubrious effects of dietary supplementation of chitosan on glutathione-dependent antioxidant defense system in young and aged rats. The dietary supplementation of chitosan significantly reduced the age-associated dyslipidemic abnormalities noted in the levels of total cholesterol, HDL-cholesterol, and LDL-cholesterol in plasma and heart tissue. Its administration significantly (P < 0.05) attenuated the oxidative stress in the heart tissue of aged rats through the counteraction of free radical formation by maintaining the enzymatic [glutathione peroxidase (GPx) and glutathione reductase (GR)] and non-enzymatic [reduced glutathione (GSH)] status at levels comparable to that of normal young rats. Our results conclude that dietary intake of chitosan restores the depleted myocardial antioxidant status and suggest that it could be an effective therapeutic agent in treatment of age-associated disorders where hypercholesterolemia and oxidative stress are the major causative factors.

Dietary chitosan supplementation attenuates isoprenaline-induced oxidative stress in rat myocardium.

Despite considerable advances in diagnosis and management over the last three decades, acute myocardial infarction continues to be a major public health problem. It is predicted that ischemic heart diseases will constitute the major disease-burden worldwide in the year 2020. In the present study, an attempt has been made to examine the effects of dietary chitosan supplementation on lipid peroxidation and cardiac antioxidant defense system in isoprenaline-induced myocardial infarction in rats, an animal model of myocardial infarction in man. Dietary chitosan intake significantly attenuated the isoprenaline-induced lipid peroxidation and maintained the level of reduced glutathione at near normal. Its administration demonstrated an antioxidant effect by maintaining the activities of myocardial glutathione dependent antioxidant enzymes (glutathione peroxidase and glutathione-S-transferase) and antiperoxidative enzymes (superoxide dismutase and catalase) at levels comparable to that of controls. The results of the present study indicate that the salubrious effects of dietary supplementation of chitosan is probably related to a counteraction of free radicals and/or to normal maintenance of the activities of free radical enzymes and the level of GSH, which protect myocardial membrane against oxidative damage by decreasing lipid peroxidation.

Fortification of Cheddar cheese with vitamin D does not alter cheese flavor perception.

Currently, dietary guidelines for vitamin D consumption are under review, considering new information that >50% of the US population is vitamin D deficient, and may lead to a recommendation of a higher dietary intake of this vitamin. Vitamin D fortification of cheese aims to improve the current availability of fortified dairy foods beyond liquid milk. However, cheese is susceptible to undesirable flavor changes during long-term cheese ripening, and cheese bacteria and enzymes may degrade added vitamins. To test the retention of vitamin D(3) in Cheddar cheese curd, cheese milk was fortified initially during manufacture at a level of 150 IU/serving, using commercial sources that contained vitamin D(3) in powder, oil, or emulsion form, with and without homogenization of the fortified milk. When fortification was done directly to the cheese milk, we found that more than 80% vitamin D(3) was retained in cheese curd, irrespective of homogenization or form of fortification. Further, Cheddar cheese was fortified with the emulsion form of vitamin D(3) directly in cheese milk at 200 and 400 IU/serving to test stability and flavor changes. Vitamin D(3) fortified in this manner was stable for up to 9 mo in Cheddar cheese. Consumer acceptance and descriptive analysis of flavor profiles of cheese were also conducted and showed that vitamin D(3) fortified cheeses were equally liked by consumers, and cheese taste and flavor remained unaltered with vitamin D(3) addition even after aging for 9 mo.

Antioxidant defense of betaine against isoprenaline-induced myocardial infarction in rats.

We investigated the antioxidant preventive effect of betaine on isoprenaline-induced myocardial infarction in male albino rats. Isoprenaline induced myocardial infarction was manifested by a moderate elevation in the levels of diagnostic marker enzymes (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and creatine phosphokinase) and homocysteine in plasma of experimental rats. Significant rise in the level of lipid peroxidation with a concomitant decline in the levels of myocardial non-enzymic (reduced glutathione) and enzymic antioxidants (glutathione peroxidase, glutathione-S-transferase, catalase and superoxide dismutase) was also observed. Oral pretreatment with betaine significantly prevented isoprenaline-induced alterations in the levels of diagnostic marker enzymes and homocysteine in plasma of experimental groups of rats. It counteracted the isoprenaline-induced lipid peroxidation and maintained the myocardial antioxidant defense system at near normal. Histopathological observations also confirmed the protective effect of betaine against isoprenaline-induced myocardial infarction. The results of the present investigation indicate that the protective effect of betaine is probably related to its ability to strengthen the myocardial membrane by its membrane stabilizing action or to a counteraction of free radicals by its antioxidant property.

Temperamental traits of breath holding children: A case control study.

BACKGROUND: Clinical observation and few anecdotal reports suggest that the children with breath holding spells (BHS) have certain temperamental traits, which predispose them to behave in certain way. They seem to have low frustration tolerance, which leads to adamant behavior. Vigorous crying, through various mechanisms, precipitates BHS. MATERIALS AND METHODS: We assessed the temperamental traits of 30 children with BHS and compared them with 30 normal children after matching for age, sex, and socioeconomic status. Temperament was measured using 'Temperament measurement Schedule'. RESULTS: The data were analyzed using Mann-Whitney U test. The following temperamental traits, threshold of responsiveness (P<0.001), mood (P<0.001), activity level (P<0.001), intensity of emotions (P<0.001), distractibility (P<0.001) and rhythmicity (P<0.05) were found to be significantly different from the control group. Two factors, namely sociability (P<0.05) and energy level (P<0.001) were significantly higher in breath holders. CONCLUSIONS: Significantly differing temperamental traits in breath holders suggests that these could influence the behavioral pattern exhibited by them. Breath holding spells can act as an easy marker for difficult temperamental traits, which gives an early opportunity to shape their difficult behavior.

Protective effect of dietary squalene supplementation on mitochondrial function in liver of aged rats.

Mitochondria are an important intracellular source and target of reactive oxygen species. The life span of a species is thought to be determined, in part, by the rate of mitochondrial damage inflicted by oxygen free radicals during the course of normal cellular metabolism. In the present study, we have investigated the protective effect of squalene supplementation for 15 days and 30 days on energy status and antioxidant defense system in liver mitochondria of 18 young and 18 aged rats. The dietary supplementation of 2% squalene significantly minimized aging associated alterations in mitochondrial energy status by maintaining the activities of TCA cycle enzymes (isocitrate dehydrogenase, alpha-ketoglutarate dehydrogenase, succinate dehydrogenase and malate dehydrogenase) and respiratory marker enzymes (NADH dehydrogenase and cytochrome-c-oxidase) at higher level in the liver mitochondria of aged rats compared with unsupplemented controls. It exerted an antioxidant effect by inhibiting mitochondrial lipid peroxidation (malondialdehyde) in liver of young and aged rats. Supplementation with squalene also maintained the mitochondrial antioxidant defense system at higher rate by increasing the level of reduced glutathione and the activities of glutathione-dependent antioxidant enzymes (glutathione peroxidase and glutathione-S-transferase) and antiperoxidative enzymes (superoxide dismutase and catalase) in the liver of young and aged rats. The results of this study provide evidence that dietary supplementation with squalene can improve liver mitochondrial function during aging and minimize the age-associated disorders in which reactive oxygen species are a major cause.

Comparative genomics of the lactic acid bacteria.

Lactic acid-producing bacteria are associated with various plant and animal niches and play a key role in the production of fermented foods and beverages. We report nine genome sequences representing the phylogenetic and functional diversity of these bacteria. The small genomes of lactic acid bacteria encode a broad repertoire of transporters for efficient carbon and nitrogen acquisition from the nutritionally rich environments they inhabit and reflect a limited range of biosynthetic capabilities that indicate both prototrophic and auxotrophic strains. Phylogenetic analyses, comparison of gene content across the group, and reconstruction of ancestral gene sets indicate a combination of extensive gene loss and key gene acquisitions via horizontal gene transfer during the coevolution of lactic acid bacteria with their habitats.