Association of Trabecular Bone Score-Adjusted Fracture Risk Assessment Tool with Coronary Artery Calcification in Women

The trabecular bone score (TBS) was found to be significantly associated with moderate coronary artery calcification (CAC). The aim of this study was to further explore the association between TBS-adjusted Fracture Risk Assessment Tool (FRAX) and CAC score in women. The electronic medical record database of a regional teaching hospital in southern Taiwan yielded women who received both coronary computed tomography and bone mineral density (BMD) measurement during their general health examination. Health history, anthropomorphic measurements, laboratory results, BMD, and T-scores were obtained. TBS values were calculated from database spine dual-energy X-ray absorptiometry files. Linear regression analyses tested the association between CAC score and 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) determined by TBS-adjusted FRAX. Of the 116 women (mean age 55.8 years) studied, 24.1% had osteoporosis. Simple linear regression showed a significant association of CAC score with an increase in MOF and HF risk as measured by TBS-adjusted FRAX. In multiple linear regression adjusted for potential confounders, CAC score remained significantly associated with TBS-adjusted FRAX for right MOF (p = 0.002), left MOF (p = 0 006), right HF (p = 0.005), and left HF (p = 0.015). In conclusion, clinicians should be vigilant to the potential increased risk of coronary events among women with increased TBS-adjusted FRAX for MOF and HF.

Impact of multiple factors on the incidence of developmental dysplasia of the hip: risk assessment tool

Introduction: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. Not treated DDH leads to disability, gait abnormalities, limb shortening and chronic pain. Our study aims to determine the impact of multiple risk factors on the occurrence of DDH and develop an interactive risk assessment tool.Materials and Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of University Hospital. The Graf classification system was used for ultrasonographic universal screening. In total, 3102 infants met the eligibility criteria (n =6204 hip joints). Results: The incidence of DDH was 4.45%. In multivariate analysis, risk factors for DDH were weight (OR = 2.17 (1.41-3.32)), week of delivery (OR = 1.18 (1.00-1.37)), gender (OR = 8.16 (4.86-13.71)), breech delivery presentation (OR = 5.92 (3.37-10.40)), symptoms of DDH (25.28 (8.77-72.83)) and positive family history in siblings (5.74 (2.68-12.31)). Multivariate logistic regression predictive model was used to construct the interactive risk calculator.Conclusion: We confirmed well-known DDH risk factors in the studied population. Our results support the recent hypothesis that preterm infants (37 < week) have lower rate of DDH. The DDH risk calculator was built but needs external validation in prospective study before being used in a clinical setting.Level of Evidence: Retrospective cohort study: Level III

A Risk Assessment Tool for Identifying Osteoporosis in Older Women with Type 2 Diabetes Mellitus

Purpose To develop a simple and clinically useful assessment tool for osteoporosis in older women with type 2 diabetes mellitus (T2DM). Methods A total of 601 women over 60 years of age with T2DM were enrolled in this study. The levels of serum sex hormones and bone metabolism markers were compared between the osteoporosis and non-osteoporosis groups. The least absolute shrinkage and selection operator regularization (LASSO) model was applied to generate a risk assessment tool. The risk score formula was evaluated using receiver operating characteristic analysis and the relationship between the risk score and the bone mineral density (BMD) and T-value were investigated. Results Serum sex hormone-binding globulin (SHBG), cross-linked C-telopeptide of type 1 collagen (CTX), and osteocalcin (OC) were significantly higher in the osteoporosis group. After adjustment for age and body mass index (BMI), SHBG was found to be correlated with the T-value or BMD. Then, a risk score was specifically generated with age, BMI, SHBG, and CTX using the LASSO model. The risk score was significantly negatively correlated with the T-value and BMD of the lumbar spine, femoral neck, and total hip (all P<0.05). Conclusion A risk score using age, BMI, SHBG, and CTX performs well for identifying osteoporosis in older women with T2DM.

Relationship between Skeletal Maturity, BMI Percentile and Dental Caries Experience among Taster and Non-taster Children

Introduction: Ability of an individual to taste phenylthiocarbamide (PTC) substance divides the population in tasters and non-tasters. The objective of this study was to investigate the relationship between the taste ability for PTC substance with BMI percentile, skeletal maturity and dental caries experience within taster and non-taster children of age 8-12 years. Hypotheses: Tasting ability for PTC affects the BMI percentile, skeletal maturity and dental caries experience and emerge as a useful caries risk assessment tool. Evaluation of Hypotheses (Materials and Method): One hundred children of 8-12 years were randomly selected and their taste perception was assessed using PTC sensitivity test. Radiovisiography (RVG) of middle phalanx was obtained to determine the skeletal maturity by using Rajgopal and Kansal modification 2005. Anthropometric measurements were recorded to obtain BMI value and then BMI percentile was calculated using CDC Pediatric growth charts. For dental caries assessment, deft/DMFT scores were recorded. Results: The non-tasters had early skeletal maturation, higher caries experience and higher BMI percentile than the tasters. Conclusion and Clinical Relevance: PTC Sensitivity is a genetically controlled trait showing strong association with dental caries. From the results of this study we can conclude that the genetic ability of tasting PTC affects the BMI percentile, skeletal maturity and dental caries experience. Thus it can emerge as a useful caries risk assessment tool helping in planning the preventive measures and interceptive orthodontics in children.

Will You Run? The Development of a Risk Assessment Tool to Predict Absconding from Secure Youth Justice Residences

<p>Absconding, or escaping, from usually state-based custody is a growing problem in different settings across the world, including New Zealand’s secure youth justice residences. This thesis provides an in-depth review of absconding from Oranga Tamariki’s secure youth justice residences in New Zealand, providing important insight that will be useful in preventing absconding in the future. A review of the international and New Zealand absconding literature was conducted looking at the risk and protective factors associated with absconding risk. From this, a coding framework of absconding related factors was developed, and then applied to historic absconding incident reports and interviews with Oranga Tamariki staff members. These were analysed to confirm potential absconding risk or protective factors and identify any new factors. Results fell into four key categories: individual (e.g. previous absconding history), relational (e.g. avoidance goals), contextual risk factors (e.g. significant life stressors), and protective factors (e.g. positive staff relationships). Several implications and conclusions were drawn from the findings. Absconding factors identified in international research were also present in the current research adding weight to these as potential risk and protective factors in a New Zealand context (Martin et al., 2018; Powers et al., 2018; Pyrooz, 2012). Novel absconding related factors were identified which were not found in the extant literature, such as planning indications, ringleaders, and hope. The reasons young people abscond are complex and individual, however, they abscond for reasons that make sense—often as a coping strategy—and thus are identifiable. By identifying these underlying reasons, it is possible to intervene and reduce their absconding motivations. A preliminary risk assessment tool aimed at doing this, was created for Oranga Tamariki use, incorporating factors drawn from the current research and the wider literature.</p>

Will You Run? The Development of a Risk Assessment Tool to Predict Absconding from Secure Youth Justice Residences

<p>Absconding, or escaping, from usually state-based custody is a growing problem in different settings across the world, including New Zealand’s secure youth justice residences. This thesis provides an in-depth review of absconding from Oranga Tamariki’s secure youth justice residences in New Zealand, providing important insight that will be useful in preventing absconding in the future. A review of the international and New Zealand absconding literature was conducted looking at the risk and protective factors associated with absconding risk. From this, a coding framework of absconding related factors was developed, and then applied to historic absconding incident reports and interviews with Oranga Tamariki staff members. These were analysed to confirm potential absconding risk or protective factors and identify any new factors. Results fell into four key categories: individual (e.g. previous absconding history), relational (e.g. avoidance goals), contextual risk factors (e.g. significant life stressors), and protective factors (e.g. positive staff relationships). Several implications and conclusions were drawn from the findings. Absconding factors identified in international research were also present in the current research adding weight to these as potential risk and protective factors in a New Zealand context (Martin et al., 2018; Powers et al., 2018; Pyrooz, 2012). Novel absconding related factors were identified which were not found in the extant literature, such as planning indications, ringleaders, and hope. The reasons young people abscond are complex and individual, however, they abscond for reasons that make sense—often as a coping strategy—and thus are identifiable. By identifying these underlying reasons, it is possible to intervene and reduce their absconding motivations. A preliminary risk assessment tool aimed at doing this, was created for Oranga Tamariki use, incorporating factors drawn from the current research and the wider literature.</p>