Iron supplementation in a large Swiss cohort of IBD patients demonstrates a shift from oral to intravenous iron over time

Background: The 2007 European Crohn's and Colitis Organization guidelines on anemia in inflammatory bowel disease (IBD) favour intravenous (iv) over oral (po) iron supplementation due to better effectiveness and tolerance. We aimed to determine the percentage of IBD patients under iron supplementation therapy and the dynamics of prescription habits (iv versus po) over time. Methods: Helsana, a leading Swiss health insurance company provides coverage for approximately 18% of the Swiss population, corresponding to about 1.2 million enrollees. Patients with Crohn's disease (CD) and ulcerative colitis (UC) were analyzed from the anonymised Helsana database. Results: In total, 629 CD (61% female) and 398 UC (57% female) patients were identified, mean observation time was 31.8 months for CD and 31.0 months for UC patients. Of the entire study population, 27.1% were prescribed iron (21.1% in males and 31.1% in females). Patients treated with IBDspecific drugs (steroids, immunomodulators, anti-TNF agents) were more frequently treated with iron compared to patients without any medication (35.0% vs. 20.9%, OR 1.91, 95%- CI 1.41 2.61). The prescription of iv iron increased from 2006/2007 (48.8% of all patients receiving any iron priscription) to 65.2% in 2008/2009 by a factor of 1.89. Conclusions: One third of the IBD population was treated with iron supplementation. A gradual shift from oral to iv iron was observed over time. This switch in prescription habits goes along with the implementation of the ECCO consensus guidelines on anemia in IBD.

Cognitive Issues in Fingerprint Analysis: Inter- and Intra-Expert Consistency and the Effect of a "Target" Comparison

Deciding whether two fingerprint marks originate from the same source requires examination and comparison of their features. Many cognitive factors play a major role in such information processing. In this paper we examined the consistency (both between- and within-experts) in the analysis of latent marks, and whether the presence of a 'target' comparison print affects this analysis. Our findings showed that the context of a comparison print affected analysis of the latent mark, possibly influencing allocation of attention, visual search, and threshold for determining a 'signal'. We also found that even without the context of the comparison print there was still a lack of consistency in analysing latent marks. Not only was this reflected by inconsistency between different experts, but the same experts at different times were inconsistent with their own analysis. However, the characterization of these inconsistencies depends on the standard and definition of what constitutes inconsistent. Furthermore, these effects were not uniform; the lack of consistency varied across fingerprints and experts. We propose solutions to mediate variability in the analysis of friction ridge skin.

Consensus interdisciplinaire CHUV-HUG sur la prise en charge des douleurs du dos. Son application lausannoise dans la filière du dos [Inter-hospital CHUV-HUG medical consensus of back pain management. Its application in care pathways within CHUV of Lausanne].

Back pain is a considerable economical burden in industrialised countries. Its management varies widely across countries, including Switzerland. Thus, the University Hospital and University of Lausanne (CHUV) recently improved intern processes of back pain care. In an already existing collaborative context, the two university hospitals in French-speaking Switzerland (CHUV, University Hospital of Geneva), felt the need of a medical consensus, based on a common concept. This inter-hospital consensus produced three decisional algorithms that bear on recent concepts of back pain found in literature. Eventually, a fast track was created at CHUV, to which extern physicians will have an organised and rapid access. This fast track aims to reduce chronic back pain conditions and provides specialised education for general practitioners-in-training.

Reaudit letter to the City of Ottumwa for the period July 1, 2005 through June 30, 2006, as well as certain issues applicable to the year ended June 30, 2005 and subsequent periods

Reaudit letter to the City of Ottumwa for the period July 1, 2005 through June 30, 2006, as well as certain issues applicable to the year ended June 30, 2005 and subsequent periods

The biochemistry of drug metabolism : an introduction : part 6, Inter-individual factors affecting drug metabolism.

This review is part of a series of review articles on the metabolism of drugs and other xenobiotics published in Chemistry & Biodiversity. After a thorough discussion of metabolic reactions and their enzymes, this article focuses on genetically determined differences in drug and xenobiotic metabolism. After a short introduction on the causes for genetic differences, the first focus is on species differences in drug and xenobiotic metabolism. A major chapter is then dedicated to clinically relevant genetic polymorphisms in human drug metabolism and resultant ethnic differences. The last two chapters deal with sex-dependent differences in drug metabolism and personalized pharmacotherapy related to inter-individual differences in drug metabolism.

Shift of spawning season and effects of climate warming on developmental stages of a grayling (Salmonidae)

River-dwelling fish, such as European graylings (Thymallus thymallus), are susceptible to changes in climate because they can often not avoid suboptimal temperatures, especially during early developmental stages. We analyzed data collected in a 62-year-long (1948-2009) population monitoring program. Male and female graylings were sampled about three times/week during the yearly spawning season in order to follow the development of the population. The occurrence of females bearing ripe eggs was used to approximate the timing of each spawning season. In the last years of the study, spawning season was more than 3 weeks earlier than in the first years. This shift was linked to increasing water temperatures as recorded over the last 39 years with a temperature logger at the spawning site. In early spring water temperatures rose more slowly than in later spring. Thus, embryos and larvae were exposed to increasingly colder water at a stage that is critical for sex determination and pathogen resistance in other salmonids. In summer, however, fry were exposed to increasingly warmer temperatures. The changes in water temperatures that we found embryos, larvae, and fry were exposed to could be contributing to the decline in abundance that has occurred over the last 30-40 years.

The carbon-isotope shift at the Permian/ Triassic boundary in the southern Alps is gradual

Carbon isotope ratios in marine carbonate rocks have been shown to shift at some of the time boundaries associated with extinction events; for example, Cretaceous/Tertiary and Ordovician/ Silurian. The Permian/Triassic boundary, the greatest extinction event of the Phanerozoic, is also marked by a large d13C depletion. New carbon isotope results from sections in the southern Alps show that this depletion did not actually represent a single event, but was a complex change that spanned perhaps a million years during the late Permian and early Triassic. These results suggest that the Permian/Triassic (P/Tr) extinction may have been in part gradual and in part 'stepwise', but was not in any case a single catastrophic event.

Resistência inter e intra-agregados em ensaios de cisalhamento direto de um nitossolo vermelho distrófico

Para solos agregados, a envoltória da resistência ao cisalhamento pode ser dividida em dois segmentos, com declividades e interceptos diferentes. Um primeiro segmento mais inclinado e com intercepto menor representaria a envoltória de ruptura definida pelo atrito e coesão interagregados, enquanto o segundo segmento, menos inclinado e com intercepto maior, seria a envoltória definida pelo atrito e coesão intra-agregados. O presente estudo foi realizado com o objetivo de avaliar se a envoltória de resistência ao cisalhamento de agregados do horizonte superficial de um Nitossolo Vermelho pode ser subdividida em segmentos distintos, com coeficientes angulares diferentes, e se isso está relacionado à existência de agregados nele. Inicialmente, amostras coletadas na superfície de um Nitossolo Vermelho distrófico latossólico de textura argilosa foram submetidas ao ensaio de cisalhamento direto com pressões normais de 24,4; 48,9; 98,2; 196,4; 294,6; 392,8 e 491,8 kPa. Posteriormente, o ensaio foi realizado com amostras de agregados de cinco classes de diâmetro: < 0,25; 0,25-0,50; 0,50-1,00; 1,00-2,00 e 2,00-4,00 mm, empregando-se pressões normais de 24,4; 48,9; 73,5; 147,3; 294,6; 441,9; 589,2 e 736,6 kPa. Em todos os ensaios, verificou-se que as envoltórias obtidas podem ser divididas em dois segmentos de reta. Os resultados indicam que a agregação deve ser considerada na definição das cargas normais a serem utilizadas no ensaio de cisalhamento direto, bem como na análise dos resultados, pois ela tem efeitos sobre a envoltória de resistência ao cisalhamento. Para o Nitossolo Vermelho distrófico usado neste estudo, constatou-se que, na umidade em que as amostras foram ensaiadas, os agregados definem a resistência ao cisalhamento do solo para cargas normais de até 294,6 kPa.

Inter-relações entre as propriedades físicas e os coeficientes da curva de retenção de água de um latossolo sob diferentes sistemas de uso

O comportamento físico e hídrico do solo fundamenta as práticas de seu uso e manejo. O objetivo deste trabalho foi avaliar as inter-relações entre as propriedades físicas e os coeficientes da curva de retenção de água de um Latossolo Vermelho distrófico sob diferentes sistemas de uso. Em 2004, foram selecionadas três áreas contíguas utilizadas por mais de vinte anos com mata (nativa), pousio (Brachiaria decumbens) e cultivo (culturas anuais). Foram coletadas 25 amostras de solo com estrutura não deformada na camada de 0-0,15 m de profundidade, que foram utilizadas para determinação das curvas de retenção de água do solo. As curvas de retenção de água foram ajustadas pela equação de van Genuchten, obtendo-se os coeficientes qs, qr, a e n. Também foram mensuradas as variáveis densidade do solo, teor de C orgânico e teor de argila do solo (grupo I). Essas variáveis e os coeficientes das curvas de retenção do solo (grupo II) foram submetidos às análises de correlações canônicas. Verificou-se que a intensificação do uso do solo (mata, pousio e cultivo) resultou em maiores valores de densidade do solo e na redução dos teores de C orgânico e argila. O primeiro par das variáveis canônicas indicou dependência de qs em relação a densidade, e o segundo par distinguiu os sistemas de uso do solo verificado pela dependência de qr em relação aos teores de argila e de C orgânico. As modificações dos teores de C orgânico e da densidade do solo sugerem a degradação da qualidade física e hídrica do solo.

Inter-relação biomassa vegetal subterrânea-estabilidade de agregados-erosão hídrica em solo submetido a diferentes formas de manejo

O aumento da biomassa vegetal subterrânea e da estabilidade dos agregados do solo pelo seu manejo adequado aumentam sua capacidade para infiltrar água da chuva e resistir à erosão hídrica. Baseado nesta premissa, foi realizado um estudo de erosão em campo, sob chuva simulada, na Estação Experimental Agronômica da Universidade Federal do Rio Grande do Sul - EEA/UFRGS, em Eldorado do Sul (RS), no verão de 2003/2004, utilizando um experimento de manejo do solo com 7,5 anos de duração. O objetivo da pesquisa foi investigar relações entre variáveis de manejo e de erosão, relacionadas à história de uso e manejo do solo e suas condições físicas superficiais momentâneas, criadas por tratamentos de seu preparo e de cobertura por resíduo cultural, os quais foram aplicados imediatamente antes da realização de testes de erosão com chuva simulada. Utilizou-se um Argissolo Vermelho distrófico típico, com textura superficial franco-argilo-arenosa e declividade média de 0,115 m m-1. Foram estudadas quatro seqüências culturais, com ou sem preparo (gradagem) e cobertura (resíduo cultural) do solo. Realizaram-se três testes de erosão com chuva simulada, cada um na intensidade de 64 mm h-1 e duração de 1,5 h, usando o aparelho simulador de braços rotativos. Avaliaram-se a massa de raízes mortas das plantas, o diâmetro médio ponderado de agregados do solo, a taxa constante de infiltração de água no solo e a perda total de água e de solo por erosão. A infiltração de água no solo foi maior e, inversamente, a perda de água menor no solo recém-mobilizado (superfície solta e rugosa) do que no solo não-mobilizado (superfície firme e praticamente lisa), mesmo o primeiro estando descoberto e o segundo tanto coberto quanto descoberto, com diferenças entre as seqüências culturais. No solo não-mobilizado e coberto, a perda foi pequena em todas as seqüências culturais, enquanto no solo descoberto, tanto não-mobilizado quanto recém-mobilizado, ela foi pequena somente naquelas seqüências culturais que propiciaram altos valores de massa de raízes mortas das plantas e de diâmetro médio ponderado de agregados do solo. No solo recém-mobilizado e descoberto, a diminuição da perda de solo também se deveu à rugosidade superficial criada pelo preparo. As relações da perda total de água e da perda total de solo, com a massa de raízes mortas das plantas e com o diâmetro médio ponderado de agregados do solo, foram significativas a 5 %.

The mechanisms of agglomeration: Evidence from the effect of inter-industry relations on the location of new firms

The objective of this paper is to explore the relative importance of each of Marshall's agglomeration mechanisms by examining the location of new manufacturing firms in Spain. In particular, we estimate the count of new firms by industry and location as a function of (pre-determined) local employment levels in industries that: 1) use similar workers (labor market pooling); 2) have a customer- supplier relationship (input sharing); and 3) use similar technologies (knowledge spillovers). We examine the variation in the creation of new firms across cities and across municipalities within large cities to shed light on the geographical scope of each of the three agglomeration mechanisms. We find evidence of all three agglomeration mechanisms, although their incidence differs depending on the geographical scale of the analysis.

Soil phosphorus fractions in sandy soils amended with cattle manure for long periods

Phosphorus fractions were determined in soil samples from areas fertilized or not with farmyard cattle manure (FYM) and in samples of FYM used in the semi-arid region of Paraiba state, Brazil. Soil samples were taken from the 0-20; 20-40 and 40-60 cm layers of 18 cultivated areas, which, according to interviews with farmers, had been treated with 12 to 20 t ha-1 FYM annually, for the past 2 to 40 years. Soil samples were also collected from four unfertilized pasture areas as controls. Phosphorus in the soil samples was sequentially extracted with water (Pw), resin (Pres), NaHCO3 (Pi bic and Po bic), NaOH (Pi hid and Po hid), H2SO4 (Pacid) and, finally, by digestion with H2SO4/H2O2 (Presd). Nine FYM samples were extracted with water, resin, Mehlich-1, H2SO4, NaOH or digestion with H2SO4/H2O2, not sequentially, and the extracts analyzed for P. The sampled areas had homogeneous, sandy and P-deficient soils; increases in total soil P (Pt) above the mean value of the control areas (up to 274 mg kg-1 in the 0-20 cm layer of the most P-enriched samples) were therefore attributed to FYM applications, which was the only external P input in the region. Regression analysis was used to study the relationship between soil P fractions and Pt. The Pacid fraction, related to Ca-P forms, showed the greatest increases (p < 0.01) as a result of FYM applications, rising from 8.4 mg kg-1 in a non-fertilized sample to 43.8 mg kg-1 in the sample with the highest Pt content. The sum of Pw, Pres and Pi bic, considered as labile P, showed comparable increases with Pacid, while Pi hid showed the smallest increase due to FYM applications. Organic P forms also increased, more so the fraction Po hid, considered less labile, than the more labile one, Po bic. The residual P fraction was practically half of Pt, independently of the Pt value. Increases in labile P, Pacid and organic P were justified by the high average concentration of Pw (36 %), Pacid (34 %), and Po hid (30 %) in the FYM. Significant changes in the proportion of P forms among soil layers indicated the downward movement of P in organic forms.

Continuous phase shift of sinusoidal signals using injection locked oscillators

This work presents an alternative to generate continuous phase shift of sinusoidal signals based on the use of super harmonic injection locked oscillators (ILO). The proposed circuit is a second harmonic ILO with varactor diodes as tuning elements. In the locking state, by changing the varactor bias, a phase shift instead of a frequency shift is observed at the oscillator output. By combining two of these circuits, relative phases up to 90 could be achieved. Two prototypes of the circuit have been implemented and tested, a hybrid version working in the range of 200-300 MHz and a multichip module (MCM) version covering the 900¿1000 MHz band.

The mechanisms of agglomeration: Evidence from the effect of inter-industry relations on the location of new firms

The objective of this paper is to explore the relative importance of each of Marshall's agglomeration mechanisms by examining the location of new manufacturing firms in Spain. In particular, we estimate the count of new firms by industry and location as a function of (pre-determined) local employment levels in industries that: 1) use similar workers (labor market pooling); 2) have a customer- supplier relationship (input sharing); and 3) use similar technologies (knowledge spillovers). We examine the variation in the creation of new firms across cities and across municipalities within large cities to shed light on the geographical scope of each of the three agglomeration mechanisms. We find evidence of all three agglomeration mechanisms, although their incidence differs depending on the geographical scale of the analysis.