Quantitative ultrasound of bone in institutionalized elderly women: a cross-sectional and longitudinal study.

Quantitative ultrasound of bone is a promising method for bone assessment: radiation-free, portable and predictive of hip fracture. Its portability allowed us to study the relationships between ultrasonic parameters of bone with age and with non-vertebral fractures in elderly women living in 19 nursing homes. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the calcaneus were measured (and the stiffness index calculated) in a sample of 270 institutionalized women, aged 85 +/- 7 years, using an Achilles bone densitometer (Lunar). The effects of age, history of non-vertebral and non-traumatic fractures, body mass index, triceps skinfold and arm circumference were assessed on BUA, SOS and stiffness index. Furthermore, to evaluate longitudinally the influence of aging on the ultrasound parameters of bone, 60 subjects from the same group had a second ultrasound measurement after 1 year. The cross-sectional analysis of the data on all 270 women showed a significant decrease (p < 0.001) with age in BUA, SOS and stiffness index (-0.47%, -0.06%, and -1.01% respectively per year). In the 94 women, (35%) with a history of previous non-vertebral fractures, ultrasound parameters were significantly lower (p < 0.0001) than in the 176 women with no history of fracture (-8.3% for BUA, -1.3% for SOS, -18.9% for stiffness index). In contrast, there was no significant difference in anthropometric measurements between the groups with and without previous non-vertebral fractures, although the measurements decreased significantly with age. In the longitudinal study, repeated quantitative ultrasound after 11.4 +/- 0.8 months showed no significant decrease in BUA (-1%) but a significant decrease in SOS (-0.3%, p < 0.0001) and in stiffness index (-3.6%, p < 0.0002). In conclusion, quantitative ultrasound of the calcaneus measures properties of bone which continue to decline in institutionalized elderly women, and is able to discriminate women with previous non-vertebral fractures.

Analysis of significant factors influencing visual acuity in ocular syphilis.

BACKGROUND: The aim of this study is to determine whether statistical associations can be demonstrated in ocular syphilis between baseline clinical and laboratory parameters with visual acuity at presentation and with any change in visual acuity after treatment. METHODS: Charts of 26 patients (42 eyes) with ocular syphilis presenting to the Uveitis clinic of the Jules-Gonin Eye Hospital were reviewed. A baseline cross-sectional analysis was performed in order to identify any association between visual acuity at presentation and demographic, clinical or laboratory parameters. After treatment, any analogy between these parameters and a change in visual acuity was subsequently assessed in a series of univariate comparisons. RESULTS: The following factors were associated with worse initial visual acuity: severity of visual field impairment at presentation (p=0.012), macular oedema (p=0.004) and optic neuropathy (p=0.031). There was a borderline association with the presence of vasculitis on fluroangiography (p=0.072). Improvement in best corrected visual acuity after treatment was significantly associated with the presence of vasculitis on fluroangiography (p=0.005), neurosyphilis, according to lumbar puncture findings (p=0.037) and marginally with anterior uveitis (p=0.070). Inflammation relapse was associated with the coexistence of pain as presenting sign (p<0.001) and with a longer duration of symptoms prior to the initial visit (p=0.023). CONCLUSIONS: Severe ocular inflammation associated with vasculitis, vitritis or anterior uveitis in ocular syphilis would appear to be a reversible phenomenon that responds well to appropriate antibiotic treatment, resulting in improvement in visual acuity. Prompt treatment enables a good visual prognosis, while any delay in therapy increases the risk of subsequent relapse.

Relationship of aerobic fitness and motor skills with memory and attention in preschoolers (Ballabeina): A cross-sectional and longitudinal study.

Background: The debate about a possible relationship between aerobic fitness and motor skills with cognitive development in children has recently re-emerged, because of the decrease in children's aerobic fitness and the concomitant pressure of schools to enhance cognitive performance. As the literature in young children is scarce, we examined the cross-sectional and longitudinal relationship of aerobic fitness and motor skills with spatial working memory and attention in preschool children.Methods: Data from 245 ethnically diverse preschool children (mean age: 5.2 (0.6) years, girls: 49.4%) analyzed at baseline and 9 months later. Assessments included aerobic fitness (20 m shuttle run) and motor skills with agility (obstacle course) and dynamic balance (balance beam). Cognitive parameters included spatial working memory (IDS) and attention (KHV-VK). All analyses were adjusted for age, sex, BMI, migration status, parental education, native language and linguistic region. Longitudinal analyses were additionally adjusted for the respective baseline value.Results: In the cross-sectional analysis, aerobic fitness was associated with better attention (r = 0.16, p = 0.03). A shorter time in the agility test was independently associated with a better performance both in working memory (r = -0.17, p = 0.01) and in attention (r = -0.20, p = 0.01). In the longitudinal analyses, baseline aerobic fitness was independently related to improvements in attention (r = 0.16, p = 0.03), while baseline dynamic balance was associated with improvements in working memory (r = 0.15, p = 0.04).Conclusions: In young children, higher baseline aerobic fitness and motor skills were related to a better spatial working memory and/or attention at baseline, and to some extent also to their future improvements over the following 9 months.

Impact of job insecurity on sexual desire: an exploratory analysis.

To explore, for the first time, the impact of job insecurity on sexual desire. Cross-sectional analysis of a nationally representative sample of 7247 individuals aged 20-64 years working as full or part-time employees in Switzerland. The logistic regression analysis showed that workers aged 20-49 years perceiving high levels of job insecurity are exposed to a significantly higher risk of decrease of sexual desire compared to the reference group. The risk is 53% higher among men (OR 1.53; 95% CI 1.16-2.01) and 47% for woman (OR 1.47; 1.13-1.91). No increased risk was found for employees aged 50-64 years old. An increasing fear of job loss is associated with a deterioration in sexual desire. These first preliminary findings should promote further epidemiological and clinical prospective studies on the impact of job insecurity on intimate relationships and sexual dysfunction.

Cross-Sectional and Longitudinal Associations between Body Mass Index and Cardiometabolic Risk Factors in Adolescents in a Country of the African Region.

We assessed the association between several cardiometabolic risk factors (CRFs) (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, uric acid, and glucose) in 390 young adults aged 19-20 years in Seychelles (Indian Ocean, Africa) and body mass index (BMI) measured either at the same time (cross-sectional analysis) or at the age of 12-15 years (longitudinal analysis). BMI tracked markedly between age of 12-15 and age of 19-20. BMI was strongly associated with all considered CRFs in both cross-sectional and longitudinal analyses, with some exceptions. Comparing overweight participants with those having a BMI below the age-specific median, the odds ratios for high blood pressure were 5.4/4.7 (male/female) cross-sectionally and 2.5/3.9 longitudinally (P < 0.05). Significant associations were also found for most other CRFs, with some exceptions. In linear regression analysis including both BMI at age of 12-15 and BMI at age of 19-20, only BMI at age of 19-20 remained significantly associated with most CRFs. We conclude that CRFs are predicted strongly by either current or past BMI levels in adolescents and young adults in this population. The observation that only current BMI remained associated with CRFs when including past and current levels together suggests that weight control at a later age may be effective in reducing CRFs in overweight children irrespective of past weight status.

A qualitative analysis of reflection in undergraduate and graduate programs

The purpose ofthis study was to explore various types ofreflection and to explore reflection on action, reflection as a practice, and reflection as a process. In doing this, the intent was to discover the perceived benefits of reflection in the classroom and to provide guidelines for future use at the undergraduate and graduate level. The qualitative components in this study included the data collection strategy of semistructured interviews with 2 undergraduate students, 2 graduate students, 1 undergraduate studies professor, and 1 graduate studies professor. The data analysis strategies included a within-case analysis and a cross-case analysis. Through the interviews participants discussed their experiences with the use ofreflection in the classroom. Through the completion ofthis analysis the researcher expected to discover the benefits ofreflection at this level of education, as well as provide suggestions for future use. Both undergraduate and graduate students and professors were found to benefit from the use of reflection in the classroom. The use ofreflection in the undergraduate and graduate classroom was found to improve student/teacher and student/peer relationships, foster critical thinking, allow for connections between learned theory and life experience, and improve students' writing abilities. Based on the results ofthe study the implications ofreflection for the undergraduate and graduate classroom and for further research are provided.

Les transformations microbiennes de l’azote dans les grandes rivières

Les rivières reçoivent de l'azote de leurs bassins versants et elles constituent les derniers sites de transformations des nutriments avant leur livraison aux zones côtières. Les transformations de l’azote inorganique dissous en azote gazeux sont très variables et peuvent avoir un impact à la fois sur l’eutrophisation des côtes et les émissions de gaz à effet de serre à l’échelle globale. Avec l’augmentation de la charge en azote d’origine anthropique vers les écosystèmes aquatiques, les modèles d’émissions de gaz à effet de serre prédisent une augmentation des émissions d’oxyde nitreux (N2O) dans les rivières. Les mesures directes de N2O dans le Lac Saint-Pierre (LSP), un élargissement du Fleuve Saint-Laurent (SLR) indiquent que bien qu’étant une source nette de N2O vers l'atmosphère, les flux de N2O dans LSP sont faibles comparés à ceux des autres grandes rivières et fleuves du monde. Les émissions varient saisonnièrement et inter-annuellement à cause des changements hydrologiques. Les ratios d’émissions N2O: N2 sont également influencés par l’hydrologie et de faibles ratios sont observés dans des conditions de débit d'eau plus élevée et de charge en N élevé. Dans une analyse effectuée sur plusieurs grandes rivières, la charge hydraulique des systèmes semble moduler la relation entre les flux de N2O annuels et les concentrations de nitrate dans les rivières. Dans SLR, des tapis de cyanobactéries colonisant les zones à faible concentration de nitrate sont une source nette d’azote grâce à leur capacité de fixer l’azote atmosphérique (N2). Étant donné que la fixation a lieu pendant le jour alors que les concentrations d'oxygène dans la colonne d'eau sont sursaturées, nous supposons que la fixation de l’azote est effectuée dans des micro-zones d’anoxie et/ou possiblement par des diazotrophes hétérotrophes. La fixation de N dans les tapis explique le remplacement de près de 33 % de la perte de N par dénitrification dans tout l'écosystème au cours de la période d'étude. Dans la portion du fleuve Hudson soumis à la marée, la dénitrification et la production de N2 est très variable selon le type de végétation. La dénitrification est associée à la dynamique en oxygène dissous particulière à chaque espèce durant la marée descendante. La production de N2 est extrêmement élevée dans les zones occupées par les plantes envahissantes à feuilles flottantes (Trapa natans) mais elle est négligeable dans la végétation indigène submergée. Une estimation de la production de N2 dans les lits de Trapa durant l’été, suggère que ces lits représentent une zone très active d’élimination de l’azote. En effet, les grands lits de Trapa ne représentent que 2,7% de la superficie totale de la portion de fleuve étudiée, mais ils éliminent entre 70 et 100% de l'azote total retenu dans cette section pendant les mois d'été et contribuent à près de 25% de l’élimination annuelle d’azote.

Analysis of water-level response to rainfall and implications for recharge pathways in the Chalk aquifer, SE England

Water table response to rainfall was investigated at six sites in the Upper, Middle and Lower Chalk of southern England. Daily time series of rainfall and borehole water level were cross-corretated to investigate seasonal variations in groundwater-level response times, based on periods of 3-month duration. The time tags (in days) yielding significant correlations were compared with the average unsaturated zone thickness during each 3-month period. In general, for cases when the unsaturated zone was greater than 18 m thick, the time tag for a significant water-level response increased rapidly once the depth to the water table exceeded a critical value, which varied from site to site. For shallower water tables, a linear relationship between the depth to the water table and the water-level response time was evident. The observed variations in response time can only be partially accounted for using a diffusive model for propagation through the unsaturated matrix, suggesting that some fissure flow was occurring. The majority of rapid responses were observed during the winter/spring recharge period, when the unsaturated zone is thinnest and the unsaturated zone moisture content is highest, and were more likely to occur when the rainfall intensity exceeded 5 mm/day. At some sites, a very rapid response within 24 h of rainfall was observed in addition to the longer term responses even when the unsaturated zone was up to 64 m thick. This response was generally associated with the autumn period. The results of the cross-correlation analysis provide statistical support for the presence of fissure flow and for the contribution of multiple pathways through the unsaturated zone to groundwater recharge. (c) 2006 Elsevier B.V. All rights reserved.

The dependence of high-latitude dayside ionospheric flows on the North-South component of the IMF: A high time resolution correlation analysis using EISCAT “Polar” and AMPTE UKS and IRM data

In 1984 and 1985 a series of experiments was undertaken in which dayside ionospheric flows were measured by the EISCAT “Polar” experiment, while observations of the solar wind and interplanetary magnetic field (IMF) were made by the AMPTE UKS and IRM spacecraft upstream from the Earth's bow shock. As a result, 40 h of simultaneous data were acquired, which are analysed in this paper to investigate the relationship between the ionospheric flow and the North-South (Bz) component of the IMF. The ionospheric flow data have 2.5 min resolution, and cover the dayside local time sector from ∼ 09:30 to ∼ 18:30 M.L.T. and the latitude range from 70.8° to 74.3°. Using cross-correlation analysis it is shown that clear relationships do exist between the ionospheric flow and IMF Bz, but that the form of the relations depends strongly on latitude and local time. These dependencies are readily interpreted in terms of a twinvortex flow pattern in which the magnitude and latitudinal extent of the flows become successively larger as Bz becomes successively more negative. Detailed maps of the flow are derived for a range of Bz values (between ± 4 nT) which clearly demonstrate the presence of these effects in the data. The data also suggest that the morning reversal in the East-West component of flow moves to earlier local times as Bz, declines in value and becomes negative. The correlation analysis also provides information on the ionospheric response time to changes in IMF Bz, it being found that the response is very rapid indeed. The most rapid response occurs in the noon to mid-afternoon sector, where the westward flows of the dusk cell respond with a delay of 3.9 ± 2.2 min to changes in the North-South field at the subsolar magnetopause. The flows appear to evolve in form over the subsequent ~ 5 min interval, however, as indicated by the longer response times found for the northward component of flow in this sector (6.7 ±2.2 min), and in data from earlier and later local times. No evidence is found for a latitudinal gradient in response time; changes in flow take place coherently in time across the entire radar field-of-view.

Alguns gestores de fundos de ações são melhores do que outros? Uma análise cross-sectional das características dos gestores e do desempenho dos fundos

A área de fundos de investimento tem crescido no Brasil nos últimos 7 anos. Movimento semelhante tem sido observado no percentual destinado a fundos de ações. Parte deste movimento pode ser creditado à entrada de atores sem familiaridade com o universo financeiro, mas que vislumbram neste segmento uma oportunidade para investir seu dinheiro. O desconhecimento do funcionamento do universo financeiro leva o novo investidor a eleger critérios para seleção de onde alocar os seus recursos, já que se espera que um gestor profissional faça as melhores escolhas. Segundo Chevalier & Ellison (1999), a imprensa financeira produz um grande volume e variedade de informação sobre as pessoas que gerenciam esses fundos, mas pouco se fala de seus antecedentes educacionais. Este trabalho tem como objetivo analisar se o desempenho dos fundos de ações esta relacionado com as características dos gestores desses fundos. Em particular, se estudou a relação entre o desempenho dos fundos e a formação dos gestores, a qualidade das escolas em que cursaram, bem como o fato de possuírem pós-graduação Lato Sensu ou Stricto Sensu, além da idade e seu “tempo de experiência” no mercado financeiro. Utilizamos como base os dados coletados pelo sistema QUANTUN AXIS (Quantun Avaliação de Fundos de Investimento), tendo como referência o período de setembro/2007 a 2008. Consultamos currículos dos 81 gestores da amostra por meio de buscas aos sites das empresas administradoras, consulta por telefone aos gestores, e currículos via difusores de informação como o Bloomberg. Foram então realizadas as análises Cross-Section. Para tal, foi utilizada uma corrente de investigação que analisou o impacto dos antecedentes educacionais dos gestores de fundos sobre os resultados dos mesmos nos EUA, destacando os trabalhos de Golec (1996), Chevalier & Ellison (1999) e Gottesman & Morey (2006). O resultado deste trabalho sugere que existe diferença na análise cross-sectional entre o desempenho dos fundos de ações no Brasil e a qualidade do curso de graduação do gestor. Futuras pesquisas poderiam, utilizando a mesma amostra de gestores, acompanhar a evolução dos dados do currículo em comparação ao desempenho dos fundos administrados em uma perspectiva temporal utilizando dados de painel.

Um modelo cross layer para predição de parâmetros de desempenho em redes sem fio baseados em OFDM

Esta dissertação tem como objetivo o desenvolvimento de um modelo matemático capaz de ajustar dados obtidos através de campanhas de medição por meio de um protótipo de um cenário da tecnologia WiMAX. As campanhas de medição foram feitas na Universidade Federal do Pará. Foram utilizadas antenas WiMAX, sendo uma como servidor, localizada em cima do prédio do Laboratório de Planejamento de Redes de Alto Desempenho (LPRAD), e a outra, receptora, que ficou em cima de um móvel para que os pontos fossem coletados. O método de ajuste utilizado foi o dos Mínimos Quadrados Lineares. Por meio dos dados coletados, aplica-se o método e estuda seu comportamento, verificando o quanto a otimização foi eficiente nos casos apresentados. A utilização da tecnologia em questão como acesso à Internet em alguns programas como o NAVEGAPARÁ, a busca de melhoramentos ou criação de modelos de propagação e a análise cross-layer das métricas utilizadas no trabalho, como a influência da relação sinal-ruído na perda de quadros, são fatores motivadores para a pesquisa desta dissertação.

Modelling and analysis of thin-walled beams in the context of the Generalized Beam Theory

In this work, the Generalized Beam Theory (GBT) is used as the main tool to analyze the mechanics of thin-walled beams. After an introduction to the subject and a quick review of some of the most well-known approaches to describe the behaviour of thin-walled beams, a novel formulation of the GBT is presented. This formulation contains the classic shear-deformable GBT available in the literature and contributes an additional description of cross-section warping that is variable along the wall thickness besides along the wall midline. Shear deformation is introduced in such a way that the classical shear strain components of the Timoshenko beam theory are recovered exactly. According to the new kinematics proposed, a reviewed form of the cross-section analysis procedure is devised, based on a unique modal decomposition. Later, a procedure for a posteriori reconstruction of all the three-dimensional stress components in the finite element analysis of thin-walled beams using the GBT is presented. The reconstruction is simple and based on the use of three-dimensional equilibrium equations and of the RCP procedure. Finally, once the stress reconstruction procedure is presented, a study of several existing issues on the constitutive relations in the GBT is carried out. Specifically, a constitutive law based on mirroring the kinematic constraints of the GBT model into a specific stress field assumption is proposed. It is shown that this method is equally valid for isotropic and orthotropic beams and coincides with the conventional GBT approach available in the literature. Later on, an analogous procedure is presented for the case of laminated beams. Lastly, as a way to improve an inherently poor description of shear deformability in the GBT, the introduction of shear correction factors is proposed. Throughout this work, numerous examples are provided to determine the validity of all the proposed contributions to the field.

HIV testing and burden of HIV infection in black cancer patients in Johannesburg, South Africa: a cross-sectional study.

BACKGROUND HIV infection is a known risk factor for cancer but little is known about HIV testing patterns and the burden of HIV infection in cancer patients. We did a cross-sectional analysis to identify predictors of prior HIV testing and to quantify the burden of HIV in black cancer patients in Johannesburg, South Africa. METHODS The Johannesburg Cancer Case-control Study (JCCCS) recruits newly-diagnosed black cancer patients attending public referral hospitals for oncology and radiation therapy in Johannesburg . All adult cancer patients enrolled into the JCCCS from November 2004 to December 2009 and interviewed on previous HIV testing were included in the analysis. Patients were independently tested for HIV-1 using a single ELISA test . The prevalence of prior HIV testing, of HIV infection and of undiagnosed HIV infection was calculated. Multivariate logistic regression models were fitted to identify factors associated with prior HIV testing. RESULTS A total of 5436 cancer patients were tested for HIV of whom 1833[33.7% (95% CI=32.5-35.0)] were HIV-positive. Three-quarters of patients (4092 patients) had ever been tested for HIV. The total prevalence of undiagnosed HIV infection was 11.5% (10.7-12.4) with 34% (32.0-36.3) of the 1833 patients who tested HIV-positive unaware of their infection. Men >49 years [OR 0.49(0.39-0.63)] and those residing in rural areas [OR 0.61(0.39-0.97)] were less likely to have been previously tested for HIV. Men with at least a secondary education [OR 1.79(1.11-2.90)] and those interviewed in recent years [OR 4.13(2.62 - 6.52)] were likely to have prior testing. Women >49 years [OR 0.33(0.27-0.41)] were less likely to have been previously tested for HIV. In women, having children <5 years [OR 2.59(2.04-3.29)], hormonal contraceptive use [OR 1.33(1.09-1.62)], having at least a secondary education [OR:2.08(1.45-2.97)] and recent year of interview [OR 6.04(4.45-8.2)] were independently associated with previous HIV testing. CONCLUSIONS In a study of newly diagnosed black cancer patients in Johannesburg, over a third of HIV-positive patients were unaware of their HIV status. In South Africa black cancer patients should be targeted for opt-out HIV testing.

Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: results from a cross-sectional study.

BACKGROUND Patients with electrolyte imbalances or disorders have a high risk of mortality. It is unknown if this finding from sodium or potassium disorders extends to alterations of magnesium levels. METHODS AND PATIENTS In this cross-sectional analysis, all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland, were included. A multivariable logistic regression model was performed to assess the association between magnesium levels and in-hospital mortality up to 28days. RESULTS A total of 22,239 subjects were screened for the study. A total of 5339 patients had plasma magnesium concentrations measured at hospital admission and were included into the analysis. A total of 6.3% of the 352 patients with hypomagnesemia and 36.9% of the 151 patients with hypermagnesemia died. In a multivariate Cox regression model hypermagnesemia (HR 11.6, p<0.001) was a strong independent risk factor for mortality. In these patients diuretic therapy revealed to be protective (HR 0.5, p=0.007). Hypomagnesemia was not associated with mortality (p>0.05). Age was an independent risk factor for mortality (both p<0.001). CONCLUSION The study does demonstrate a possible association between hypermagnesemia measured upon admission in the emergency department, and early in-hospital mortality.

Hyperphosphatemia Is an Independent Risk Factor for Mortality in Critically Ill Patients: Results from a Cross-Sectional Study.

BACKGROUND Phosphate imbalances or disorders have a high risk of morbidity and mortality in patients with chronic kidney disease. It is unknown if this finding extends to mortality in patients presenting at an emergency room with or without normal kidney function. METHODS AND PATIENTS This cross sectional analysis included all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland. A multivariable cox regression model was applied to assess the association between phosphate levels and in-hospital mortality up to 28 days. RESULTS 22,239 subjects were screened for the study. Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died. In univariate analysis, phosphate levels were associated with mortality, age, diuretic therapy and kidney function (all p<0.001). In a multivariate Cox regression model, hyperphosphatemia (OR 3.29, p<0.001) was a strong independent risk factor for mortality. Hypophosphatemia was not associated with mortality (p>0.05). CONCLUSION Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.