Objective: To examine whether the amount of patella cartilage in healthy, middle-aged subjects is... more Objective: To examine whether the amount of patella cartilage in healthy, middle-aged subjects is stable or changes over time, and what factors may influence the changes. Methods: Eighty-five subjects (28 men and 57 women, mean age 55.5 yrs) had magnetic resonance imaging of their dominant knee at baseline and 2 years later. Patella and tibial cartilage volume was measured at baseline and followup. Risk factors assessed at baseline were tested for their association with change in patella cartilage volume over time. Results: Mean annual percentage loss of patella cartilage was 2.1 (95% confidence interval: 1.1-3.2; p < 0.001). Age, gender, body mass index, and initial cartilage volume did not affect rate of change of patellar cartilage volume. There was a weak association between change in patellar cartilage volume and change in lateral tibial cartilage volume (R = 0.23, p = 0.03) but not medial tibial cartilage volume (R = 0.09, p = 0.43). Conclusion: In healthy subjects, a significant amount of patella cartilage is lost annually. The poor correlation between patella and tibial cartilage loss suggests that pathogenetic mechanisms for osteoarthritis in the patellofemoral and tibiofemoral joint may differ. Further work will be required to determine whether the rate of patella cartilage loss in healthy subjects is steady or phasic, and to determine which factors can be modified to reduce cartilage loss.
BACKGROUND Internship programs are important components of teaching and learning that provide med... more BACKGROUND Internship programs are important components of teaching and learning that provide medical students with opportunities for real-life learning. The study aimed at evaluating the internship program for students of Shahid Sadoughi University of Medical Sciences (SSU) using the CIPP model. OBJECTIVE Internship programs are important components of teaching and learning that provide medical students with opportunities for real-life learning. The study aimed at evaluating the internship program for students of Shahid Sadoughi University of Medical Sciences (SSU) using the CIPP model. METHODS A cross-sectional descriptive analysis was performed on 305 students and 15 faculty members of SSU. Data were collected using a CIPP model questionnaire. The internship program was evaluated in four areas: input, context, process and product from the perspective of students and faculty members. The scores obtained for each domain were analyzed using SPSS v.21. RESULTS The perspective of students and faculty members in the areas of evaluation of the internship program indicated a significant discrepancy between students and faculty members in the area of context, process and product (p-value &lt;0.001). No significant difference was observed in the area of input (p-value =0.32). Significant relationships were observed between context and input (r = 0.769, p &lt;0.001), context and process (r = 0.733, p &lt;0.001), and context and product (r = 0.724, p &lt;0.001). In the correlation matrix, from the students' perspective, there was a positive and significant correlation between the domains. Between field and input (r = 0.769, p &lt;0.001), field and process (r = 0.733, p &lt;0.001), and field and product (r = 0.724, p &lt;0.001) significant relationships were observed. CONCLUSIONS The design and implementation of evaluation programs based on the CIPP model may help improve internship programs and achieve students' professional competencies. The positive and negative findings in this study should be considered by decision makers and healthcare officials when designing and implementing internship programs. Further longitudinal studies may be required to confirm these findings.
Introduction: Vitamin D deficiency and osteoporosis are highly prevalent among stroke patients. T... more Introduction: Vitamin D deficiency and osteoporosis are highly prevalent among stroke patients. The adverse effects of vitamin D deficiency on bone metabolism seem to be aggravated by immobilization of paretic extremities. Objectives: The purpose of this study was to determine the level of vitamin D in patients with osteoporosis following a stroke. Material and methods: In this cross-sectional study participants consisted of 40 patients (33 women, 7 men) with mean age of 66.5 ± 9.8 years. The inclusion criteria were patients after a first stroke (≤ 1.5 years from a stroke), who were treated at the Medical Rehabilitation Clinic, Clinical Center of Vojvodina in Novi Sad, Serbia. Lunar Prodigy Primo densitometer was used to determine the bone mineral density in patients after stroke. DXA measurement was performed at the lumbar spine L2-L4 segment in anterio-posterior (AP) position. Vitamin D was determined as follow; reference values: 25 (OH) vitD ˃30 ng / dl, total calcium 2.1-2.60 mmol/l, phosphorus 3.0-4.5 mg/dl, parathyroid hormone (PTH) 14.0-72.0 pg/ml. Results: Seventeen (42.50%) patients had osteoporosis of the lumbar spine, while 6 (15%) had osteoporosis of the femur. The study also showed that 10 patients (25%) had levels of serum 25 (OH) vitamin D ˂ than 30 ng/dl, while 30 patients (75%) had serum levels of 25 (OH) vitamin D ≥30 ng/dl. The average values of PTH were 48,71± 36 pg/ml, and phosporusa 3.51±0.72 mg/dl. Only 2.5% of the patients were receiving antiresorptive bone therapy and vitamin D supplementation at the time of the initial evaluation. Conclusion: Low BMD (bone mineral density) and low levels of serum 25(OH) vitamin D are common amongst patients with history of stroke. Vitamin D supplementation and antiresorptive therapy prevent further bone loss, falls and fracture in poststroke patients, however, longitudinal studies are needed to confirm this hypothesis
This circadian timing system consists of a pacemaker in the brain’s suprachiasmatic nucleus (SCN)... more This circadian timing system consists of a pacemaker in the brain’s suprachiasmatic nucleus (SCN) and subsidiary oscillators in nearly all body cells. The SCN entrains the phase of peripheral clocks through a variety of systemic signals. While feeding rhythms driven by rest-activity cycles are the most dominant Zeitgebers for most peripheral oscillators, the SCN also employs blood-borne and body temperaturedependent signals to set the phase in peripheral tissues. In the first part of the talk I will address the issue of how the SCN and feeding rhythms synchronize circadian oscillators in the liver. To this end we engineered the RT-Biolumicorder, a device enabling us to record circadian gene expression in the liver of unconstrained, freely moving mice during months. Using this approach, we can readily determine the velocity of feeding-induced phase shifting, a parameter that is obviously much more sensitive to the disruption of an individual signaling pathway than the steady-state phase. The results indicate that the SCN uses both indirect pathways (depending on restactivity cycles and feeding rhythms) and more direct (feedingindependent pathways) to synchronize liver clocks. Moreover, our studies suggest that hepatocyte clocks are strongly coupled between cells. In the second part of my talk I will present a novel strategy, dubbed Synthetic Tandem Repeat Promoter Screening (STAR-PROM), capable of identifying in an unbiased manner the signaling pathways participating in the systemic regulation of circadian gene expression. The principle underlying this approach is the high frequency of transcription factor binding sites in random synthetic DNA. Using STAR-PROM, we have identified signaling pathways depending on rhythmic blood-borne signals in humans and laboratory rodents. They involve the diurnal activation of SRFand forkhead transcription factordependent genes. The STAR-PROM technology can be used for the unbiased identification of signaling pathways in a wide variety of biological systems. We acknowledge support from the Swiss National Science Foundation (SNF 31-113565, SNF 31-128656/1, NCCR Frontiers in Genetics), the European Research Council (ERC-AdG-TimeSignal), the Canton of Geneva, and the Louis Jeantet Foundation of Medicine.
Objective: To examine whether the amount of patella cartilage in healthy, middle-aged subjects is... more Objective: To examine whether the amount of patella cartilage in healthy, middle-aged subjects is stable or changes over time, and what factors may influence the changes. Methods: Eighty-five subjects (28 men and 57 women, mean age 55.5 yrs) had magnetic resonance imaging of their dominant knee at baseline and 2 years later. Patella and tibial cartilage volume was measured at baseline and followup. Risk factors assessed at baseline were tested for their association with change in patella cartilage volume over time. Results: Mean annual percentage loss of patella cartilage was 2.1 (95% confidence interval: 1.1-3.2; p < 0.001). Age, gender, body mass index, and initial cartilage volume did not affect rate of change of patellar cartilage volume. There was a weak association between change in patellar cartilage volume and change in lateral tibial cartilage volume (R = 0.23, p = 0.03) but not medial tibial cartilage volume (R = 0.09, p = 0.43). Conclusion: In healthy subjects, a significant amount of patella cartilage is lost annually. The poor correlation between patella and tibial cartilage loss suggests that pathogenetic mechanisms for osteoarthritis in the patellofemoral and tibiofemoral joint may differ. Further work will be required to determine whether the rate of patella cartilage loss in healthy subjects is steady or phasic, and to determine which factors can be modified to reduce cartilage loss.
BACKGROUND Internship programs are important components of teaching and learning that provide med... more BACKGROUND Internship programs are important components of teaching and learning that provide medical students with opportunities for real-life learning. The study aimed at evaluating the internship program for students of Shahid Sadoughi University of Medical Sciences (SSU) using the CIPP model. OBJECTIVE Internship programs are important components of teaching and learning that provide medical students with opportunities for real-life learning. The study aimed at evaluating the internship program for students of Shahid Sadoughi University of Medical Sciences (SSU) using the CIPP model. METHODS A cross-sectional descriptive analysis was performed on 305 students and 15 faculty members of SSU. Data were collected using a CIPP model questionnaire. The internship program was evaluated in four areas: input, context, process and product from the perspective of students and faculty members. The scores obtained for each domain were analyzed using SPSS v.21. RESULTS The perspective of students and faculty members in the areas of evaluation of the internship program indicated a significant discrepancy between students and faculty members in the area of context, process and product (p-value &lt;0.001). No significant difference was observed in the area of input (p-value =0.32). Significant relationships were observed between context and input (r = 0.769, p &lt;0.001), context and process (r = 0.733, p &lt;0.001), and context and product (r = 0.724, p &lt;0.001). In the correlation matrix, from the students' perspective, there was a positive and significant correlation between the domains. Between field and input (r = 0.769, p &lt;0.001), field and process (r = 0.733, p &lt;0.001), and field and product (r = 0.724, p &lt;0.001) significant relationships were observed. CONCLUSIONS The design and implementation of evaluation programs based on the CIPP model may help improve internship programs and achieve students' professional competencies. The positive and negative findings in this study should be considered by decision makers and healthcare officials when designing and implementing internship programs. Further longitudinal studies may be required to confirm these findings.
Introduction: Vitamin D deficiency and osteoporosis are highly prevalent among stroke patients. T... more Introduction: Vitamin D deficiency and osteoporosis are highly prevalent among stroke patients. The adverse effects of vitamin D deficiency on bone metabolism seem to be aggravated by immobilization of paretic extremities. Objectives: The purpose of this study was to determine the level of vitamin D in patients with osteoporosis following a stroke. Material and methods: In this cross-sectional study participants consisted of 40 patients (33 women, 7 men) with mean age of 66.5 ± 9.8 years. The inclusion criteria were patients after a first stroke (≤ 1.5 years from a stroke), who were treated at the Medical Rehabilitation Clinic, Clinical Center of Vojvodina in Novi Sad, Serbia. Lunar Prodigy Primo densitometer was used to determine the bone mineral density in patients after stroke. DXA measurement was performed at the lumbar spine L2-L4 segment in anterio-posterior (AP) position. Vitamin D was determined as follow; reference values: 25 (OH) vitD ˃30 ng / dl, total calcium 2.1-2.60 mmol/l, phosphorus 3.0-4.5 mg/dl, parathyroid hormone (PTH) 14.0-72.0 pg/ml. Results: Seventeen (42.50%) patients had osteoporosis of the lumbar spine, while 6 (15%) had osteoporosis of the femur. The study also showed that 10 patients (25%) had levels of serum 25 (OH) vitamin D ˂ than 30 ng/dl, while 30 patients (75%) had serum levels of 25 (OH) vitamin D ≥30 ng/dl. The average values of PTH were 48,71± 36 pg/ml, and phosporusa 3.51±0.72 mg/dl. Only 2.5% of the patients were receiving antiresorptive bone therapy and vitamin D supplementation at the time of the initial evaluation. Conclusion: Low BMD (bone mineral density) and low levels of serum 25(OH) vitamin D are common amongst patients with history of stroke. Vitamin D supplementation and antiresorptive therapy prevent further bone loss, falls and fracture in poststroke patients, however, longitudinal studies are needed to confirm this hypothesis
This circadian timing system consists of a pacemaker in the brain’s suprachiasmatic nucleus (SCN)... more This circadian timing system consists of a pacemaker in the brain’s suprachiasmatic nucleus (SCN) and subsidiary oscillators in nearly all body cells. The SCN entrains the phase of peripheral clocks through a variety of systemic signals. While feeding rhythms driven by rest-activity cycles are the most dominant Zeitgebers for most peripheral oscillators, the SCN also employs blood-borne and body temperaturedependent signals to set the phase in peripheral tissues. In the first part of the talk I will address the issue of how the SCN and feeding rhythms synchronize circadian oscillators in the liver. To this end we engineered the RT-Biolumicorder, a device enabling us to record circadian gene expression in the liver of unconstrained, freely moving mice during months. Using this approach, we can readily determine the velocity of feeding-induced phase shifting, a parameter that is obviously much more sensitive to the disruption of an individual signaling pathway than the steady-state phase. The results indicate that the SCN uses both indirect pathways (depending on restactivity cycles and feeding rhythms) and more direct (feedingindependent pathways) to synchronize liver clocks. Moreover, our studies suggest that hepatocyte clocks are strongly coupled between cells. In the second part of my talk I will present a novel strategy, dubbed Synthetic Tandem Repeat Promoter Screening (STAR-PROM), capable of identifying in an unbiased manner the signaling pathways participating in the systemic regulation of circadian gene expression. The principle underlying this approach is the high frequency of transcription factor binding sites in random synthetic DNA. Using STAR-PROM, we have identified signaling pathways depending on rhythmic blood-borne signals in humans and laboratory rodents. They involve the diurnal activation of SRFand forkhead transcription factordependent genes. The STAR-PROM technology can be used for the unbiased identification of signaling pathways in a wide variety of biological systems. We acknowledge support from the Swiss National Science Foundation (SNF 31-113565, SNF 31-128656/1, NCCR Frontiers in Genetics), the European Research Council (ERC-AdG-TimeSignal), the Canton of Geneva, and the Louis Jeantet Foundation of Medicine.
Uploads
Papers by Fahad Hanna