IVA in addition to BMD can change the osteoporosis management in 25% of clinical routine patients

Introduction Vertebral fracture is one of the major osteoporoticfractures which are unfortunately very often undetected. In addition,it is well known that prevalent vertebral fracture increases dramaticallythe risk of future additional fracture. Instant Vertebral Assessment(IVA) has been introduced in DXA device a couple of years ago toease the detection of such fracture when routine DXA are performed.To correctly use such tool, ISCD provided clinical recommendationon when and how to use it. The aim of our study was to evaluate theISCD guidelines in clinical routine patients and see how often itmay change of patient management.Methods During two months (March and April 2010), a medicalquestionnaire was systematically given to our clinical routine patientto check the validity of ISCD IVA recommendations in our population.In addition, all women had BMD measurement at AP spine,femur and 1/3 radius using a Discovery A System (Hologic, Waltham,USA). When appropriate, IVA measurement had been performedon the same DXA system and had been centrally evaluated by twotrained doctors for fracture status according to the semi-quantitativemethod of Genant. The reading had been performed when possiblebetween L5 and T4.Results Out of 210 women seen in the consultation, 109 (52 %)of them (mean age 68.2 ± 11.5 years) fulfilled the necessary criteriato have an IVA measurement. Out of these 109 women, 43 (incidence39.4 %) had osteoporosis at one of the three skeletal sitesand 31 (incidence 28.4 %) had at least one vertebral fracture. 14.7 %of women had both osteoporosis and at least one vertebral fractureclassifying them as "severe osteoporosis" while 46.8 % did not haveosteoporosis and no vertebral fracture. 24.8 % of the women hadosteoporosis but no vertebral fracture while 13.8 % of women didhave osteoporosis but vertebral fracture (clinical osteoporosis).Conclusions In 52 % of our patients, IVA was needed accordingto ISCD criteria. In half of them the IVA test influenced of patientmanagement either may changing the type of treatment of simplyby classifying patient as "clinical osteoporosis". IVA appears to bean important tool in clinical routine but unfortunately is not yetvery often use in most of the centers.

Climate change, anthropogenic disturbance and the northward range expansion of Lactuca serriola (Asteraceae)

The distribution range of Lactuca serriola, a species native to the summer-dry mediterranean climate, has expanded northwards during the last 250 years. This paper assesses the influence of climate on the range expansion of this species and highlights the importance of anthropogenic disturbance to its spread. Location Central and Northern Europe. Methods Data on the geographic distribution of L. serriola were assembled through a literature search as well as through floristic and herbarium surveys. Maps of the spread of L. serriola in Central and Northern Europe were prepared based on herbarium data. The spread was assessed more precisely in Germany, Austria and Great Britain by pooling herbarium and literature data. We modelled the bioclimatic niche of the species using occurrence and climatic data covering the last century to generate projections of suitable habitats under the climatic conditions of five time periods. We tested whether the observed distribution of L. serriola could be explained for each time period, assuming that the climatic niche of the species was conserved across time. Results The species has spread northwards since the beginning of the 19th century. We show that climate warming in Europe increased the number of sites suitable for the species at northern latitudes. Until the late 1970s, the distribution of the species corresponded to the climatically suitable sites available. For the last two decades, however, we could not show any significant relationship between the increase in suitable sites and the distributional range change of L. serriola. However, we highlight potential areas the species could spread to in the future (Great Britain, southern Scandinavia and the Swedish coast). It is predominantly non-climatic influences of global change that have contributed to its rapid spread. Main conclusions The observation that colonizing species are not filling their climatically suitable range might imply that, potentially, other ruderal species could expand far beyond their current range. Our work highlights the importance of historical floristic and herbarium data for understanding the expansion of a species. Such historical distributional data can provide valuable information for those planning the management of contemporary environmental problems, such as species responses to environmental change.

Potential impact of climate change on vegetation in the European Alps: a review

Based on conclusions drawn from general climatic impact assessment in mountain regions, the review synthesizes results relevant to the European Alps published mainly from 1994 onward in the fields of population genetics, ecophysiology, phenology, phytogeography, modeling, paleoecology and vegetation dynamics. Other important factors of global change interacting synergistically with climatic factors are also mentioned, such as atmospheric CO2 concentration, eutrophication, ozone or changes in land-use. Topics addressed are general species distribution and populations (persistence, acclimation, genetic variability, dispersal, fragmentation, plant/animal interaction, species richness, conservation), potential response of vegetation (ecotonal shift - area, physiography - changes in the composition, structural changes), phenology, growth and productivity, and landscape. In conclusion, the European Alps appear to have a natural inertia and thus to tolerate an increase of 1-2 K of mean air temperature as far as plant species and ecosystems are concerned in general. However, the impact of land-use is very likely to negate this buffer in many areas. For a change of the order of 3 K or more, profound changes may be expected.

Ultrasound evaluation of synovitis in RA: Correlation with clinical disease activity and sensitivity to change in an observational cohort study.

OBJECTIVE: To evaluate the correlation between clinical measures of disease activity and a ultrasound (US) scoring system for synovitis applied by many different ultrasonographers in a daily routine care setting within the Swiss registry for RA (SCQM) and further to determine the sensitivity to change of this US Score. METHODS: One hundred and eight Swiss rheumatologists were trained in performing the Swiss Sonography in Arthritis and Rheumatism (SONAR) score. US B-mode and Power Doppler (PwD) scores were correlated with DAS28 and compared between the clinical categories in a cross-sectional cohort of patients. In patients with a second US (longitudinal cohort), we investigated if change in US score correlated with change in DAS and evaluated the responsiveness of both methods. RESULTS: In the cross-sectional cohort with 536 patients, correlation between the B-mode score and DAS28 was significant but modest (Pearson coefficient r=0.41, P<0.0001). The same was true for the PwD score (r=0.41, P<0.0001). In the longitudinal cohort with 183 patients we also found a significant correlation between change in B-mode and in PwD score with change in DAS28 (r=0.54, P<0.0001 and r=0.46, P<0.0001, respectively). Both methods of evaluation (DAS and US) showed similar responsiveness according to standardized response mean (SRM). CONCLUSIONS: The SONAR Score is practicable and was applied by many rheumatologists in daily routine care after initial training. It demonstrates significant correlations with the degree of as well as change in disease activity as measured by DAS. On the level of the individual, the US score shows many discrepancies and overlapping results exist.

Timing of Capacity Change: Models for Capital Intensive Industry

The suitable timing of capacity investments is a remarkable issue especially in capital intensive industries. Despite its importance, fairly few studies have been published on the topic. In the present study models for the timing of capacity change in capital intensive industry are developed. The study considers mainly the optimal timing of single capacity changes. The review of earlier research describes connections between cost, capacity and timing literature, and empirical examples are used to describe the starting point of the study and to test the developed models. The study includes four models, which describe the timing question from different perspectives. The first model, which minimizes unit costs, has been built for capacity expansion and replacement situations. It is shown that the optimal timing of an investment can be presented with the capacity and cost advantage ratios. After the unit cost minimization model the view is extended to the direction of profit maximization. The second model states that early investments are preferable if the change of fixed costs is small compared to the change of the contribution margin. The third model is a numerical discounted cash flow model, which emphasizes the roles of start-up time, capacity utilization rate and value of waiting as drivers of the profitable timing of a project. The last model expands the view from project level to company level and connects the flexibility of assets and cost structures to the timing problem. The main results of the research are the solutions of the models and analysis or simulations done with the models. The relevance and applicability of the results are verified by evaluating the logic of the models and by numerical cases.

A comparative study of the change in diatom inferred ph of a staircase of lakes in the Algoma District, Northern Ontario /

Four staircase lakes occupying a single watershed located in the Algoma District, north of Lake Superior were chosen for this study. I examined the subfossil diatom assemblage in the top twenty centimeters of the surface sediments in each of these four lakes in an attempt to reconstruct their respective past pH history. From these analyses it was possible to test the hypothesis that the rate of change of diatom inferred pH was not significantly different in lakes located one below the other in a single "staircase" within a single watershed system. My results indicated that the four Z lakes had been acid for at least the last century. The water color of the three upper Z lakes (Z1, Z2 and Z3) was brown (>30 Pt Co units). The bottom lake (Z4) was the only clear water lake in the system «5 Pt Co units). This bottom staircase lake had no muskeg development around its shoreline. The alkaliphilous diatoms in the Z watershed system were important in determining the diatom inferred pH of the four Z lakes. The centric diatoms were extremely rare in the clearwater bottom lake (Z4). The ecology of the Eupodiscales is perhaps important in the interpretation of sediment in the more acid environment. Lake Z4 was the only one that had a progressive as well as a significant decrease in its downcore diatom inferred pH since the early 1960's. This lead me to speculate that the humic substances present in the upper three brown water lakes (Z1, Z2 and Z3) were perhaps Important in buffering them against a further decrease in water pH even though they were located within an area which was sensitive to acid precipitation.

The Impact of a Corporate Name Change on Stock Price and Trading Volume of Canadian Companies

This thesis examines the impact of a corporate name change on stock price and trading volume of Canadian companies around the announcement date, the approval date, and the adoption date over the time period from 1997 to 2011. Name changes are classified into six categories: major and minor, structural and pure, diversified and focused, accompanied with a change in ticker symbol and without a change in ticker symbol, “Gold” name addition and deletion, and different reasons for name changes (e.g., merger and acquisition, change of structure, change of strategy, and better image). The thesis uses the standard event study methodology to perform abnormal return and trading volume analyses. In addition, regression analysis is employed to examine which type of a name change has the largest impact on cumulative abnormal returns. Sample stocks exhibit a significant positive abnormal return one-day prior to the approval day and one day after the adoption date. Around the approval date we observe significant abnormal returns for stocks with a structural name change. On the day after the adoption date we document abnormal returns for stocks with major, minor, structural, pure, focused, and ticker symbol name changes. If a merger or acquisition is the reason for a name change, companies tend to experience a significant positive abnormal return one-day before the approval date and on the adoption date. If a change of structure is the reason for a name change, companies exhibit a significant positive abnormal return on the approval date and a significant negative abnormal return on the adoption date. In case of a change of strategy as the reason for a name change, companies show a significant negative abnormal return around the approval date and a significant positive abnormal return around the adoption date.

Technical instruments and conceptual definitions: theoretical and practical implications of the change on the definition of unemployment in Colombia

En junio de 2000 el Departamento Nacional de Estadística de Colombia adopto una nueva definición de medición de desempleo siguiendo los estándares sugeridos por la organización Internacional del Trabajo (OIT). El cambio de definición implico una reducción de la tasa de desempleo en cerca de dos puntos porcentuales. En este documento contrastamos la experiencia colombiana con otra experiencias internacionales, y analizamos las implicaciones empíricas y teóricas de este cambio de definición usando dos tipos de estimaciones cuantitativas: en la primera se contrasta las principales características de las diferentes categorías clasificadas según la definición nueva y vieja de desempleo (empleado, desempleado y fuera de la fuerza laboral) usando el algoritmo EM; en la segunda se pone a prueba la implicación del desempleo estructural y su relación con el perfil educacional de personas desempleadas y las características teóricas que enfrentan los estándares de la OIT en la definición de empleo.

Exploring behavioural change through an agent-oriented system dynamics model: the use of personal protective equipment among pesticide applicators in Colombia

The misuse of Personal Protective Equipment results in health risk among smallholders in developing countries, and education is often proposed to promote safer practices. However, evidence point to limited effects of education. This paper presents a System Dynamics model which allows the identification of risk-minimizing policies for behavioural change. The model is based on the IAC framework and survey data. It represents farmers' decision-making from an agent-oriented standpoint. The most successful intervention strategy was the one which intervened in the long term, targeted key stocks in the systems and was diversified. However, the results suggest that, under these conditions, no policy is able to trigger a self sustaining behavioural change. Two implementation approaches were suggested by experts. One, based on constant social control, corresponds to a change of the current model's parameters. The other, based on participation, would lead farmers to new thinking, i.e. changes in their decision-making structure.

The benefits of a compute cluster approach to high spatial resolution biodiversity richness modelling: projecting the impact of climate change on Mediterranean flora

High spatial resolution environmental data gives us a better understanding of the environmental factors affecting plant distributions at fine spatial scales. However, large environmental datasets dramatically increase compute times and output species model size stimulating the need for an alternative computing solution. Cluster computing offers such a solution, by allowing both multiple plant species Environmental Niche Models (ENMs) and individual tiles of high spatial resolution models to be computed concurrently on the same compute cluster. We apply our methodology to a case study of 4,209 species of Mediterranean flora (around 17% of species believed present in the biome). We demonstrate a 16 times speed-up of ENM computation time when 16 CPUs were used on the compute cluster. Our custom Java ‘Merge’ and ‘Downsize’ programs reduce ENM output files sizes by 94%. The median 0.98 test AUC score of species ENMs is aided by various species occurrence data filtering techniques. Finally, by calculating the percentage change of individual grid cell values, we map the projected percentages of plant species vulnerable to climate change in the Mediterranean region between 1950–2000 and 2020.

A method for incorporating climate variability in climate change impact assessments: sensitivity of river flows in the Eden catchment to precipitation scenarios

Interest in the impacts of climate change is ever increasing. This is particularly true of the water sector where understanding potential changes in the occurrence of both floods and droughts is important for strategic planning. Climate variability has been shown to have a significant impact on UK climate and accounting for this in future climate cahgne projections is essential to fully anticipate potential future impacts. In this paper a new resampling methodology is developed which includes the variability of both baseline and future precipitation. The resampling methodology is applied to 13 CMIP3 climate models for the 2080s, resulting in an ensemble of monthly precipitation change factors. The change factors are applied to the Eden catchment in eastern Scotland with analysis undertaken for the sensitivity of future river flows to the changes in precipitation. Climate variability is shown to influence the magnitude and direction of change of both precipitation and in turn river flow, which are not apparent without the use of the resampling methodology. The transformation of precipitation changes to river flow changes display a degree of non-linearity due to the catchment's role in buffering the response. The resampling methodology developed in this paper provides a new technique for creating climate change scenarios which incorporate the important issue of climate variability.

A Possible Change in Mass Balance of Greenland and Antarctic Ice Sheets in the Coming Century

A high-resolution GCM is found to simulate precipitation and surface energy balance of high latitudes with high accuracy. This opens new possibilities to investigate the future mass balance of polar glaciers and its effect on sea level. The surface mass balance of the Greenland and the Antarctic ice sheets is simulated using the ECHAM3 GCM with TI06 horizontal resolution. With this model, two 5-year integrations for the present and doubled carbon dioxide conditions based on the boundary conditions provided by the ECHAM1/T21 transient experiment have been conducted. A comparison of the two experiments over Greenland and Antarctica shows to what extent the effect of climate change on the mass balance on the two largest glaciers of the world can differ. On Greenland one sees a slight decrease in accumulation and a substantial increase in melt, while on Antarctica a large increase in accumulation without melt is projected. Translating the mass balances into terms of sea-level equivalent. the Greenland discharge causes a sea level rise of 1.1 mm yr−1, while the accumulation on Antarctica tends to lower it by 0.9 mm yr−1. The change in the combined mass balance of the two continents is almost zero. The sea level change of the next century can be affected more effectively by the thermal expansion of seawater and the mass balance of smaller glaciers outside of Greenland and Antarctica.

The role of rules-based compliance systems in the new EU regulatory landscape: perspectives of institutional change and agency

The financial crisis of 2007-2009 and the subsequent reaction of the G20 have created a new global regulatory landscape. Within the EU, change of regulatory institutions is ongoing. The research objective of this study is to understand how institutional changes to the EU regulatory landscape may affect corresponding institutionalized operational practices within financial organizations and to understand the role of agency within this process. Our motivation is to provide insight into these changes from an operational management perspective, as well as to test Thelen and Mahoney?s (2010) modes of institutional change. Consequently, the study researched implementations of an Investment Management System with a rules-based compliance module within financial organizations. The research consulted compliance and risk managers, as well as systems experts. The study suggests that prescriptive regulations are likely to create isomorphic configurations of rules-based compliance systems, which consequently will enable the institutionalization of associated compliance practices. The study reveals the ability of some agents within financial organizations to control the impact of regulatory institutions, not directly, but through the systems and processes they adopt to meet requirements. Furthermore, the research highlights the boundaries and relationships between each mode of change as future avenues of research.

Homogeneity assessment of a station climate series (1933-2005) in the Metropolitan Area of São Paulo: instruments change and urbanization effects

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

An assessment of the economic and social impacts of climate change on the Coastal and Marine Sector in the Caribbean

Climate change poses special challenges for Caribbean decision makers related to the uncertainties inherent in future climate projections and the complex linkages between climate change, physical and biological systems, and socioeconomic sectors. At present, however, the Caribbean subregion lacks the adaptive capacity needed to address these challenges. The present report assesses the economic and social impacts of climate change on the coastal and marine sector in the Caribbean until 2050. It aims both to provide Caribbean decision makers with cutting edge information on the vulnerability to climate change of the subregion, and to facilitate the development of adaptation strategies informed by both local experience and expert knowledge.