A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX

Trabecular bone score (TBS) is a grey-level textural index of bone microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry (DXA) images. TBS is a BMD-independent predictor of fracture risk. The objective of this meta-analysis was to determine whether TBS predicted fracture risk independently of FRAX probability and to examine their combined performance by adjusting the FRAX probability for TBS. We utilized individual level data from 17,809 men and women in 14 prospective population-based cohorts. Baseline evaluation included TBS and the FRAX risk variables and outcomes during follow up (mean 6.7 years) comprised major osteoporotic fractures. The association between TBS, FRAX probabilities and the risk of fracture was examined using an extension of the Poisson regression model in each cohort and for each sex and expressed as the gradient of risk (GR; hazard ratio per 1SD change in risk variable in direction of increased risk). FRAX probabilities were adjusted for TBS using an adjustment factor derived from an independent cohort (the Manitoba Bone Density Cohort). Overall, the GR of TBS for major osteoporotic fracture was 1.44 (95% CI: 1.35-1.53) when adjusted for age and time since baseline and was similar in men and women (p > 0.10). When additionally adjusted for FRAX 10-year probability of major osteoporotic fracture, TBS remained a significant, independent predictor for fracture (GR 1.32, 95%CI: 1.24-1.41). The adjustment of FRAX probability for TBS resulted in a small increase in the GR (1.76, 95%CI: 1.65, 1.87 vs. 1.70, 95%CI: 1.60-1.81). A smaller change in GR for hip fracture was observed (FRAX hip fracture probability GR 2.25 vs. 2.22). TBS is a significant predictor of fracture risk independently of FRAX. The findings support the use of TBS as a potential adjustment for FRAX probability, though the impact of the adjustment remains to be determined in the context of clinical assessment guidelines. This article is protected by copyright. All rights reserved.

Geistesgeschichtliche Grundlagen der Wissenschaft des Judentums : (Motive des Kulturvereins vom Jahre 1819)

Siegfried Ucko

Ms. germ. fol. 44 - Beschreibung zum Gedenken des im Jahr 1785 viel und großen Schnees und lang aushaltender Kälte, als die Ursache der großen Ueberschwemmung der Oder bey Franckfurth und dem Unglücklichen Tode des Herzogs Maximilian Julius Leopold von Braunschweig und Lüneburg

Vorbesitzer: Friedrich Wilhelm Lua; Königlich Preussische Garnisonschule zu Frankfurt/Oder; alte Signatur: Tit.IV Nr. 1; Akzessionsnummer: 51/1040x1

Retention in care during the first 3 years of antiretroviral therapy for women in Malawi's option B+ programme: an observational cohort study

Background Studies of Malawi's option B+ programme for HIV-positive pregnant and breastfeeding women have reported high loss to follow-up during pregnancy and at the start of antiretroviral therapy (ART), but few data exist about retention during breastfeeding and after weaning. We examined loss to follow-up and retention in care in patients in the option B+ programme during their first 3 years on ART. Methods We analysed two data sources: aggregated facility-level data about patients in option B+ who started ART between Oct 1, 2011, and June 30, 2012, at 546 health facilities; and patient-level data from 20 large facilities with electronic medical record system for HIV-positive women who started ART between Sept 1, 2011, and Dec 31, 2013, under option B+ or because they had WHO clinical stages 3 or 4 disease or had CD4 counts of less than 350 cells per μL. We used facility-level data to calculate representative estimates of retention and loss to follow-up. We used patient-level data to study temporal trends in retention, timing of loss to follow-up, and predictors of no follow-up and loss to follow-up. We defined patients who were more than 60 days late for their first follow-up visit as having no follow-up and patients who were more than 60 days late for a subsequent visit as being lost to follow-up. We calculated proportions and cumulative probabilities of patients who had died, stopped ART, had no follow-up, were lost to follow-up, or were retained alive on ART for 36 months. We calculated odds ratios and hazard ratios to examine predictors of no follow-up and loss to follow-up. Findings Analysis of facility-level data about patients in option B+ who had not transferred to a different facility showed retention in care to be 76·8% (20 475 of 26 658 patients) after 12 months, 70·8% (18 306 of 25 849 patients) after 24 months, and 69·7% (17 787 of 25 535 patients) after 36 months. Patient-level data included 29 145 patients. 14 630 (50·2%) began treatment under option B+. Patients in option B+ had a higher risk of having no follow-up and, for the first 2 years of ART, higher risk of loss to follow-up than did patients who started ART because they had CD4 counts less than 350 cells per μL or WHO clinical stage 3 or 4 disease. Risk of loss to follow-up during the third year was low and similar for patients retained for 2 years. Retention rates did not change as the option B+ programme matured. Interpretation Our data suggest that pregnant and breastfeeding women who start ART immediately after they are diagnosed with HIV can be retained on ART through the option B+ programme, even after many have stopped breastfeeding. Interventions might be needed to improve retention in the first year on ART in option B+. Funding Bill & Melinda Gates Foundation, Partnerships for Enhanced Engagement in Research Health, and National Institute of Allergy and Infectious Diseases.

Le personnage de la femme-artiste chez l'écrivain polonaise Narcyza Żmichowska (1819-1876) : Helusia héritière de Corinne de Mme de Staël et de Consuelo de George Sand

Si les hommes bénéficient d’emblée de mythes (Pygmalion, Orphée) qui légitiment et motivent leur créativité, il faut attendre Corinne (1807) de Mme Staël et Consuelo (1842) de George Sand pour que le mythe de la femme créatrice trouve enfin, dans la littérature européenne, à se concrétiser et à se développer sous la forme de Künstlerromane féminins. Corinne la poétesse et Consuelo la cantatrice sont devenues des exemples littéraires non seulement pour les femmes victoriennes, comme le montre par exemple le livre de Linda Lewis intitulé Germaine de Staël, George Sand and the Victorian Woman Artist, mais également pour les femmes polonaises issues des classes favorisées - qui lisaient d’ailleurs couramment en français. En effet, même si elles ont été officiellement décriées par la critique conservatrice polonaise pour leur « immoralité », George Sand et Mme de Staël ont été lues, bien lues et même beaucoup lues par leurs contemporaines polonaises - comme le témoigne la correspondance de ces dernières, dans laquelle elles ont moins de peine à se livrer. Le thème de la femme artiste déchirée entre la carrière publique et la vie privée, tel qu’il est représenté dans Corinne et dans Consuelo, a en particulier attiré toute leur attention et suscité chez les femmes écrivains le désir d’apporter de nouvelles manières de résoudre ce conflit. Dans cet article, le Künstlerinroman polonais Książka Pamiątek (Livre des souvenirs, 1846) de Narcyza Żmichowska fait l’objet d’une analyse comparative détaillée avec les deux Künstlerinromane français dont par ailleurs il se réclame.

Viscountess Fauconberg [Illustration] : (Tochter von Oliver Cromwell)

Samuel Cooper

Der literarische Kampf um die Emanzipation in den Jahren 1816-1819

Selma Stern

Petition englischer Juden an Oliver Cromwell [Illustration] : (Faksimile)

Scan von Monochrom-Mikroform

Oliver Cromwell [Illustration] : (Porträt)

Samuel Cooper

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 474 - Kontoauszug des Handelshauses Abraham Ludwig Muhl über die Überweisungen Schopenhauers von 1818-1819

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Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 723 - Erklärungen der schwierigen finanziellen und privaten Umstände nach dem Bankrott des Bankhauses Muhl 1819

u.a.: Zahnschmerzen; Unmündigkeit in Finanzangelegenheiten; Rückzahlung von Darlehen; Umzug von Weimar nach Bonn; Ohrarsche Ländereien; Bankrott des Bankhauses Peter de Bihl; Cholera;

A Szegedi zsidók 1785-től 1885-ig

írták Löw Immánuel és Kulinyi Zsigmond