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Evaluation of Single-Photon Emission Computed Tomography Myocardial Perfusion Detection Capability through Physical Descriptors
No full textA comprehensive validation of data acquired by different myocardial perfusion imaging (MPI) systems was performed to evaluate contrast, self-attenuation properties, and perfusion detection capability. An anthropomorphic phantom with a myocardial insert and perfusion defect was used to simulate 99mTc-tetrofosmin distribution. Different MPI systems were evaluated: a SPECT system with iterative reconstruction algorithms and resolution recovery (IRR) with/without scatter correction (SPECT-IRR-SC and SPECT-IRR), and a cardio-centric IQ SPECT/CT system with IRR, with/without scatter and attenuation corrections (IQ-IRR-SC-AC and IQ-IRR). The image quality was assessed through physical descriptors: the contrast between the left ventricular (LV) wall and LV inner chamber (CLV/LVIC), intrinsic contrast (IC), and net contrast (NC). CLV/LVIC was found to be superior for IQ-IRR-SC-AC. The IC results showed non-uniformity of the signal intensity in the LV wall for the SPECT systems. The lowest IC values were obtained for IQ-IRR-SC-AC, except for septal position, where an underestimation of the signal intensity was revealed. The NC was found to be the highest for IQ-IRR-SC-AC and SPECT-IRR-SC. Additionally, for IQ-IRR-SC-AC, the NC increased in posterior and septal positions compared to IQ-IRR, enabling better perfusion detection capability over short-axis images. IQ-IRR showed performances comparable to SPECT-IRR. The characterization and evaluation perfusion detection capability of the MPI systems enabled the investigation of the systems’ performance and limitations
Automated Vertebral Bone Quality Determination from T1-Weighted Lumbar Spine MRI Data Using a Hybrid Convolutional Neural Network–Transformer Neural Network
No full textVertebral bone quality (VBQ) is a promising new method that can improve screening for osteoporosis. The drawback of the current method is that it requires manual determination of the regions of interest (ROIs) of vertebrae and cerebrospinal fluid (CSF) by a radiologist. In this work, an automatic method for determining the VBQ is proposed, in which the ROIs are obtained using a trained neural network model. A large, publicly available dataset of sagittal lumbar spine MRI images with ground truth segmentations was used to train a BRAU-Net++ hybrid CNN–transformer neural network. The performance of the trained model was evaluated using the dice similarity coefficient (DSC), accuracy, precision, recall and intersection-over-union (IoU) metrics. The trained model performed similarly to state-of-the-art lumbar spine segmentation models, with an average DSC value of 0.914 ± 0.007 for the vertebrae and 0.902 for the spinal canal. Four different methods of VBQ determination with automatic segmentation are presented and compared with one-way ANOVA. These methods use different algorithms for CSF extraction from the segmentation of the spinal canal using T1- and T2-weighted image data and applying erosion to the vertebral ROI to avoid a sharp change in SI at the edge of the vertebral body
Bioethics in Sport
No full textRekreativni ali profesionalni šport je sestavni del človekovega življenja, zaradi česar je njegov vsakodnevni vpliv v družbi nesporen. Zato je pomembno opredeliti vlogo moralnih vrednot in etike v športu, ki lahko pomagajo zagotoviti pravičnost in ohraniti integriteto profesionalnega športa. V zadnjih letih se vse bolj zavedamo pomena uveljavljanja teh vrednot v profesionalnem športu, saj je ključnega pomena, da se sicer zagotovi telesna zmogljivost, ne pa da se pri tem ogroža samo bistvo športa. Uporaba prepovedanih snovi in metod v profesionalnem športu je danes vse bolj zaskrbljujoče etično vprašanje, zlasti na področju športne medicine. Glavni cilj športne znanosti, predvsem športne fiziologije, je pomagati športnikom izboljšati njihovo zmogljivost ter preprečevati in obvladovati poškodbe. Ob tem pa je glavni cilj športnega menedžmenta in nekaterih športnikov večinoma zmagati, kar lahko vodi do uporabe neetičnih sredstev, da se cilj doseže. Takšno ravnanje sproži veliko etičnih pomislekov in poudarja potrebo po orodju za premaganje teh sodobnih izzivov, s katerimi se danes pogosto sooča profesionalni šport. Bioetika lahko obvladuje tovrstne izzive tako, da preuči etične, družbene, moralne in pravne posledice, ki jih nudi napredek znanosti, zlasti medicine. Z upoštevanjem vrednot, načel in norm, na katerih temeljijo medicinske in znanstvene prakse, lahko bioetika v okviru športa zagotovi smernice in priporočila za bioetično odločanje, povezano z bioetičnimi dvomi ali spornostjo, ki se lahko pojavijo pri uporabi zdravil za izboljšanje zmogljivosti, neterapevtski uporabi genskega zdravljenja in uporabi novih tehnologij. Članek ima torej za cilj poudarjati pomen bioetike kot povezovalne znanosti v športu v okviru bioetičnih izzivov, ki so danes vse bolj in bolj značilni za vključevanje posameznih strok v športno dejavnost
A perspective on muscle phenotyping in musculoskeletal research
No full textMusculoskeletal research should synergistically investigate bone and muscle to inform approaches for maintaining mobility and to avoid bone fractures. The relationship between sarcopenia and osteoporosis, integrated in the term 'osteosarcopenia', is underscored by the close association shown between these two conditions in many studies, whereby one entity emerges as a predictor of the other. In a recent workshop of Working Group (WG) 2 of the EU Cooperation in Science and Technology (COST) Action 'Genomics of MusculoSkeletal traits Translational Network' (GEMSTONE) consortium (CA18139), muscle characterization was highlighted as being important, but currently under-recognized in the musculoskeletal field. Here, we summarize the opinions of the Consortium and research questions around translational and clinical musculoskeletal research, discussing muscle phenotyping in human experimental research and in two animal models: zebrafish and mouse
Transferability of new methods for health technology assessment in the field of diabetes between early and late adopters’ countries
No full textThis study aimed to investigate the transferability of novel artificial intelligence (AI) methods for prediction modelling of diabetes based on real-world data (RWD) between early and late adopters of emerging health technologies from the perspective of developers and health technology assessment (HTA) experts. A two-step approach was used. Developers of the new AI methods within HTx consortium completed a survey about the benefits, usability, barriers associated with implementing the new prediction models in routine HTA practices. Then, HTA experts from Central and Eastern European (CEE) countries participated in a focus group discussion. Developers generally expressed optimism regarding the transferability of the methods, while acknowledging potential disparities across CEE countries. Key benefits that were identified included enhanced understanding of diabetes, improved cost-effectiveness modelling, and refined patient stratification, all of which could contribute to clinical and reimbursement decisions across various jurisdictions. The focus group underscored the value of real-world data for diabetes prediction modelling, serving as a beneficial resource for both clinicians and HTA agencies. However, there was a recognized need to clarify the processes of integrating randomized clinical trial data with real-world data. For the other stakeholders, the advancement of the methodology will improve the diagnosis and therapy during the process of decision making. Experts from CEE countries recognized the potential of artificial intelligence-based methods employing real-world data for diabetes modelling. These methods are seen as instrumental in elucidating the heterogeneous nature of the disease, supporting clinician decision-making and holding promises for HTA purposes
Smanjenje udjela ukupnih fenola u djevičanskom maslinovom ulju kao mediju za konzerviranje skute i tofua tijekom hladnog skladištenja
No full textResearch background. Virgin olive oil, known as a good source of health-promoting hydrophilic phenols, is traditionally used as a medium for preserving various foods. Phenols in general can form complexes with proteins, but there is little information on the direct contact of virgin olive oil with protein-rich food during long-term storage. In this study, the dynamics of the decline of total phenols in oil used as preservation medium for a traditional (whey cheese skuta) and a modern product (tofu) were compared.
Experimental approach. Pieces of skuta or tofu immersed in virgin olive oil at different food-to-oil mass ratios were stored in the refrigerator for up to 21 days. The oil quality indices, water content and the total count of aerobic mesophilic bacteria in the immersed materials were monitored. To determine the total phenols in the oil, the optimal conditions of the Fast Blue BB test, which is a suitable alternative to the standard method, were tested and selected.
Results and conclusions. The effect of both materials on the indicators of hydrolytic and oxidative deterioration of the oil is almost identical (a gradual decrease), which is most likely due to the continuous release of water from the immersed food. A sharp decrease in total phenols in the oil (by about 50 %) after seven days of storage in contact with both materials indicates a combination of causes (water-to-oil migration and phenol-protein interactions). The form of the rational function is highly representative of the decrease in total phenols during the first seven days of tofu/oil storage, indicating a very rapid interaction with tofu proteins. The preservative effect of virgin olive oil in terms of microbiological spoilage was not observed.
Novelty and scientific contribution. The results of this study contribute to the knowledge on the dynamics of phenol-protein interactions and emphasise the need for further investigations on traditional or newly used protein-rich foods preserved in direct contact with virgin olive oil, taking into account possible changes in the functional, nutritional and sensory properties of phenols and proteins.Pozadina istraživanja. Djevičansko maslinovo ulje, poznato kao dobar izvor hidrofilnih fenola koji povoljno utječu na zdravlje, tradicionalno se koristi kao sredstvo za konzerviranje raznih namirnica. Fenoli općenito mogu stvarati komplekse s bjelančevinama, ali malo je podataka o izravnom kontaktu djevičanskog maslinovog ulja s hranom bogatom bjelančevinama tijekom dugotrajnog skladištenja. U ovom je istraživanju uspoređena dinamika smanjenja udjela ukupnih fenola u ulju koje se koristilo kao sredstvo za konzerviranje tradicionalnog (skuta) i netradicionalnog proizvoda (tofu).
Eksperimentalni pristup. Komadići skute ili tofua uronjeni u djevičansko maslinovo ulje u različitim masenim omjerima materijala i ulja pohranjeni su u hladnjaku do 21 dan. Praćeni su pokazatelji kakvoće ulja, udjel vode i ukupni broj aerobnih mezofilnih bakterija u uronjenim materijalima. Za određivanje ukupnih fenola u ulju testirani su i odabrani optimalni uvjeti Fast Blue BB-testa, koji je prikladna alternativa standardnoj metodi.
Rezultati i zaključci. Učinak oba materijala na pokazatelje hidrolitičkog i oksidacijskog kvarenja ulja gotovo je identičan (postupno smanjenje), što je najvjerojatnije posljedica kontinuiranog otpuštanja vode iz uronjene hrane. Oštar pad udjela ukupnih fenola u ulju (za oko 50 %) nakon sedam dana skladištenja u kontaktu s oba materijala upućuje na kombinaciju uzroka (migracija voda-ulje i interakcije fenoli-bjelančevine). Oblik racionalne funkcije izrazito je reprezentativan za smanjenje udjela ukupnih fenola tijekom prvih sedam dana skladištenja tofua u ulju, što upućuje na vrlo brzu interakciju s proteinima tofua. Konzervirajući učinak djevičanskog maslinovog ulja u smislu sprečavanja mikrobiološkog kvarenja nije uočen.
Novina i znanstveni doprinos. Rezultati ovog istraživanja pridonose spoznajama o dinamici interakcija između fenola i bjelančevina te naglašavaju potrebu za daljnjim istraživanjima tradicionalne ili netradicionalne hrane bogate bjelančevinama koja se čuva u izravnom kontaktu s djevičanskim maslinovim uljem, uzimajući u obzir moguće promjene u funkcionalnim, nutritivnim i senzorskim svojstvima fenola i bjelančevina
THE IMPACT OF POSTTRAUMATIC STRESS DISORDER ON THE OCCURENCE OF SEXUAL DYSFUNCTIONS AMONG CROATIAN WAR VETERANS
No full textCilj istraživanja: Rastući broj istraživanja je potvrdio klinički relevantne probleme u
seksualnom funkcioniranju osoba koje boluju od posttraumatskog stresnog poremećaja (PTSPa). Glavni cilj istraživanja je bio ispitati utjecaj simptoma PTSP-a na seksualno funkcioniranje
veterana Domovinskog rata (DR) izloženih ratnoj psihotraumatizaciji te sustavno identificirati
prediktore seksualnih disfunkcija (SD) kod veterana oboljelih od PTSP-a.
Ispitanici i metode: U istraživanje je uključeno ukupno 487 veterana. U prvi dio analize
uključeno je 250 veterana oboljelih od PTSP-a i 187 veterana bez PTSP-a, a u drugi je dio, radi
utvrđivanja prediktora SD, uključeno 300 veterana oboljelih od PTSP-a. Primijenjen je
Međunarodni neuropsihijatrijski intervju (MINI) te su ispitanici ispunili sljedeće
samoprocjenske upitnike: PTSP ljestvica za DSM-5 s kriterijem A (PCL-5), Lista životnih
događaja za DSM-5 (LEC-5), Međunarodni indeks erektilne funkcije (IIEF), Dijagnostički
upitnik preuranjene ejakulacije (PEDT), Ljestvica za procjenu zadovoljstva vezom (RAS) i
sociodemografski upitnik kreiran za potrebe ovog istraživanja. Provedeno je više hijerarhijskih
regresijskih analiza kako bi se ispitali najbolji prediktorni modeli za različite vrste SD.
Rezultati: Veterani oboljeli od PTSP-a su imali značajno veću učestalost seksualnih smetnji u
usporedbi s veteranima bez PTSP-a, i to u svim domenama seksualnog funkcioniranja (želja,
uzbuđenje, orgazam i razrješenje), kao i u zadovoljstvu seksualnim odnosom te ukupnom
seksualnom zadovoljstvu. Također, istraživanje je pokazalo da veterani oboljeli od PTSP-a
imaju češće psihijatrijske i somatske komorbiditete, kao i propisane lijekove koji mogu
pridonijeti pojavi i pogoršanju SD. Značajni pojedinačni prediktori za pojavu svih vrsta SD kod
veterana oboljelih od PTSP-a su intenzitet D skupine simptoma PTSP-a (negativne promjene u
kogniciji i raspoloženju povezane s traumom) i status u vezi/zadovoljstvo vezom za sve SD,
osim preuranjenje ejakulacije.
Zaključak: Istraživanje naglašava važnost procjene seksualnog zdravlja kod veterana oboljelih
od PTSP-a. Terapeutske intervencije trebaju biti usmjerene na D skupinu simptoma PTSP-a i
namijenjene poboljšanju funkcioniranja interpersonalnih odnosa s ciljem smanjenja učestalosti
SD. Adekvatnim izborom psihofarmaka s odgovarajućim farmakološkim profilom može se
smanjiti mogućnost pojave seksualnih nuspojava. Odgovarajuća prevencija, probir i liječenje
određenih zdravstvenih stanja mogu poboljšati seksualno funkcioniranje kod veterana oboljelih
od PTSP-a.Objectives: A growing number of studies have confirmed clinically relevant problems in the
sexual functioning of persons suffering from PTSD. The main goal of this research was to
examine the impact of PTSD symptoms on the sexual functioning of Croatian Homeland War
veterans exposed to war related traumatization and to systematically identify predictors of
sexual dysfunction (SD) in veterans suffering from PTSD.
Patients and Methods: A total of 487 veterans were included in the research. The first part of
the analysis included 250 veterans with PTSD and 187 veterans without PTSD, and the second
part, to determine predictors of SD, included 300 veterans with PTSD. The International
Neuropsychiatric Interview (MINI) was applied, and the subjects filled out the following selfreport questionnaires: PTSD Scale for DSM-5 with Criterion A (PCL-5), List of Life Events
for DSM-5 (LEC-5), International Index of Erectile Function (IIEF), Premature Ejaculation
Diagnostic Questionnaire (PEDT), Relationship Satisfaction Assessment Scale (RAS) and
sociodemographic questionnaire created for the purposes of this research. Multiple hierarchical
regression analyses were performed to examine the best predictive models for different types
of SD.
Results: Veterans with PTSD had a significantly higher frequency of sexual disturbances
compared to veterans without PTSD, in all domains of sexual functioning (desire, arousal,
orgasm and release), as well as in satisfaction with sexual intercourse and the overall sexual
satisfaction. Also, veterans suffering from PTSD have more frequent psychiatric and somatic
comorbidities, as well as prescribed medications that can contribute to the occurrence and
worsening of SD. Significant individual predictors for occurrence of all types of SD in veterans
with PTSD were intensity of PTSD group D symptoms (trauma-related negative changes in
cognition and mood) and relationship status/relationship satisfaction for all SDs, except for
premature ejaculation.
Conclusion: The research highlights the importance of assessing sexual health in veterans with
PTSD. Therapeutic interventions should be directed at the D symptoms of PTSD and intended
to improve the functioning of interpersonal relationships with the aim of reducing the frequency
of SD. Adequate selection of psychotropic drugs with an appropriate pharmacological profile
can reduce the possibility of sexual side effects. Appropriate prevention, screening, and
treatment of certain medical conditions can improve sexual functioning in veterans with PTSD
Akcesorni mišići gležnja i stopala
No full textAkcesorni mišići pronalaze se slučajno kod 1%–36% ljudi. Najčešće su asimptomatski, iako mogu stvarati tegobe poput bolova, odebljanja oko gležnja ili kliničke slike tarzalnog tunela. Dijagnoza se postavlja na temelju slikovnog prikaza magnetskom rezonancijom. Varijabilni mišić je peroneus tertius (PT) koji se javlja u do 90% ljudi i nalazi se u anterolateralnom kompartmentu potkoljenice i gležnja i rijetko stvara tegobe. Peroneus quartus (PQ) je najčešći akcesorni mišić gležnja. Nalazi se posterolateralno i najčešće stvara simptome kod različitih sportskih ozljeda gležnja (uganuća, kontuzije). Zbog svoje lokalizacije često je povezan i s rupturama peronealnih tetiva. Tendinopatije nakon ozljeda stopala može uzrokovati i akcesorni peroneus digiti quinti (PDQ) koji se nalazi u anterolateralnom odjeljku i završava na bazi pete metatarzalne kosti ili na petom prstu. Ovaj mišić nalazimo u oko 18% ljudi. Najčešći akcesorni mišić medijalne strane gležnja je fleksor digitorum akcesorius longus (FDAL) koji se javlja u 5%–14% ljudi. On često daje kliničku sliku sindroma tarzalnog tunela ili tendinopatije fleksor halucis longusa. Akcesorni soleus (SA) možemo naći kod 6% ljudi i često se kod sportaša javlja kao bolno odebljanje iza gležnja kojem je uzrok ishemija voluminoznog mišića u naporu. Opisane su i kliničke slike tarzalnog tunela uzrokovanog akcesornim soleusom kojeg uzrokuju i nešto rjeđe pojavni peroneokalkaneus internus (PCI) ili tibiokalkaneus internus (TCI). Liječenje simptoma koje uzrokuju akcesorni mišići najčešće je operacijsko – uklanjanjem mišića koji svojom aktivnošću stvara pritisak na okolne neuralne ili vaskularne strukture ili izaziva bol radi ishemije kod napora. Očekivani oporavak nakon ovakvih zahvata je potpun i sportaši se mogu vratiti sportskoj aktivnosti nakon 4 tjedna po operaciji