Joint Official Positions of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX(®). Executive Summary of the 2010 Position Development Conference on Interpretation and use of FRAX® in clinical practice.

The International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) convened the FRAX(®) Position Development Conference (PDC) in Bucharest, Romania, on November 14, 2010, following a two-day joint meeting of the ISCD and IOF on the "Interpretation and Use of FRAX(®) in Clinical Practice." These three days of critical discussion and debate, led by a panel of international experts from the ISCD, IOF and dedicated task forces, have clarified a number of important issues pertaining to the interpretation and implementation of FRAX(®) in clinical practice. The Official Positions resulting from the PDC are intended to enhance the quality and clinical utility of fracture risk assessment worldwide. Since the field of skeletal assessment is still evolving rapidly, some clinically important issues addressed at the PDCs are not associated with robust medical evidence. Accordingly, some Official Positions are based largely on expert opinion. Despite limitations inherent in such a process, the ISCD and IOF believe it is important to provide clinicians and technologists with the best distillation of current knowledge in the discipline of bone densitometry and provide an important focus for the scientific community to consider. This report describes the methodology and results of the ISCD-IOF PDC dedicated to FRAX(®).

Eligibility to treatment and economic effect of the implementation of the new U.S. or European Society of Hypertension/European Society of Cardiology hypertension guidelines.

OBJECTIVE: To evaluate the population and economic impact of implementing the new Joint National Committee (JNC) or European Society of Hypertension (ESH)/European Society of Cardiology (ESC) hypertension guidelines in the Swiss population. METHODS: Cross-sectional, population-based sample (6708 participants) collected between 2003 and 2006 in the city of Lausanne, Switzerland. Blood pressure categories were defined according to both the JNC (JNC-7 and JNC-8) and the ESH/ESC (2007 and 2013) guidelines. RESULTS: The proportion of participants aged 35-60 years eligible for drug treatment was 25.6% [95% confidence interval (CI) 24.4-26.9%] and 24.8% (95% CI 23.6-26.0%) for the JNC-7 and the JNC-8 guidelines, respectively; for participants aged 60-75 years, the values were 62.3% (95% CI 60.1-64.5%) and 46.8% (95% CI 44.5-49.0%), respectively. Shifting from the JNC-7 to the JNC-8 guidelines would lead to an annual saving of 163.6 million Swiss francs (187.7 million US dollars or 134.5 million European euro). The proportion of participants aged 35-75 years without chronic kidney disease, diabetes mellitus or reported history of cardiovascular disease and eligible for treatment was 30.2% (95% CI 29.0-31.4%) for the ESH/ESC 2007 and 2013 guidelines. For participants with chronic kidney disease, diabetes mellitus or reported history of cardiovascular disease, the values were 73.6% (95% CI 70.8-76.3%) and 55.6% (95% CI 52.5-58.8%), respectively. Shifting from the ESH/ESC 2007 to the ESH/ESC 2013 guidelines would lead to an annual saving of 86.9 million Swiss francs (99.5 million US dollars or 71.4 million European euro). CONCLUSION: In Switzerland, shifting from the JNC-7 to the JNC-8 guidelines or from the ESH/ESC 2007 to the ESH/ESC 2013 guidelines would decrease the prevalence of patients eligible for treatment and increase the percentage of treated patients within blood pressure goals. Both strategies lead to potential savings in antihypertensive drug treatment.

The Methods of Possible Joint Treatment of Manure and Sewage Sludge in the Leningrad Region

The nutrient load to the Gulf of Finland has started to increase as a result of the strong economic recovery in agriculture and livestock farming in the Leningrad region. Also sludge produced from municipal wastewater treatment plant of the Leningrad region causes the great impact on the environment, but still the main options for its treatment is disposal on the sludge beds or Landfills. The aim of this study was to evaluate the implementation of possible joint treatment methods of manure form livestock and poultry enterprises and sewage sludge produced from municipal wastewater treatment plants in the Leningrad region. The study is based on published data. The most attention was put on the anaerobic digestion and incineration methods. The manure and sewage sludge generation for the whole Leningrad region and energy potential produced from their treatment were estimated. The calculations showed that total amount of sewage sludge generation is 1 348 000 t/a calculated on wet matter and manure generation is 3 445 000 t/a calculated on wet matter. The potential heat release from anaerobic digestion process and incineration process is 4 880 000 GJ/a and 5 950 000 GJ/a, respectively. Furthermore, the work gives the overview of the general Russian and Finnish legislation concerning manure and sewage sludge treatment. In the Gatchina district it was chosen the WWTP and livestock and poultry enterprises for evaluation of the centralized treatment plant implementation based on anaerobic digestion and incineration methods. The electricity and heat power of plant based on biogas combustion process is 4.3 MW and 7.8 MW, respectively. The electricity and heat power of plant based on manure and sewage sludge incineration process is 3.0 MW and 6.1 MW, respectively.

Developing co-operation of business units – exploring synergies and a joint business model

The purpose of this study was to develop co-operation between business units of the company operating in graphic industry. The development was done by searching synergy opportunities between these business units. The final aim was to form a business model, which is based on co-operation of these business units.The literature review of this thesis examines synergies and especially the process concerning the search and implementation of synergies. Also the concept of business model and its components are examined. The research was done by using qualitative research method. The main data acquiring method to the empirical part was theme interviews. The data was analyzed using thematisation and content analysis.The results of the study include seven identified possible synergies and a business model, which is based on the co-operation of the business units. The synergy opportunities are evaluated and the implementation order of the synergies is suggested. The presented synergies create the base for the proposed business model.

Power Electronic Converters in Low-Voltage Direct Current Distribution – Analysis and Implementation

Over the recent years, smart grids have received great public attention. Many proposed functionalities rely on power electronics, which play a key role in the smart grid, together with the communication network. However, “smartness” is not the driver that alone motivates the research towards distribution networks based on power electronics; the network vulnerability to natural hazards has resulted in tightening requirements for the supply security, set both by electricity end-users and authorities. Because of the favorable price development and advancements in the field, direct current (DC) distribution has become an attractive alternative for distribution networks. In this doctoral dissertation, power electronic converters for a low-voltage DC (LVDC) distribution system are investigated. These include the rectifier located at the beginning of the LVDC network and the customer-end inverter (CEI) on the customer premises. Rectifier topologies are introduced, and according to the LVDC system requirements, topologies are chosen for the analysis. Similarly, suitable CEI topologies are addressed and selected for study. Application of power electronics into electricity distribution poses some new challenges. Because the electricity end-user is supplied with the CEI, it is responsible for the end-user voltage quality, but it also has to be able to supply adequate current in all operating conditions, including a short-circuit, to ensure the electrical safety. Supplying short-circuit current with power electronics requires additional measures, and therefore, the short-circuit behavior is described and methods to overcome the high-current supply to the fault are proposed. Power electronic converters also produce common-mode (CM) and radio-frequency (RF) electromagnetic interferences (EMI), which are not present in AC distribution. Hence, their magnitudes are investigated. To enable comprehensive research on the LVDC distribution field, a research site was built into a public low-voltage distribution network. The implementation was a joint task by the LVDC research team of Lappeenranta University of Technology and a power company Suur-Savon S¨ahk¨o Oy. Now, the measurements could be conducted in an actual environment. This is important especially for the EMI studies. The main results of the work concern the short-circuit operation of the CEI and the EMI issues. The applicability of the power electronic converters to electricity distribution is demonstrated, and suggestions for future research are proposed.

Design and Implementation of a Flexible Robot

This robot has low natural frequencies of vibration. Insights into the problems of designing joint and link flexibility are discussed. The robot has three flexible rotary actuators and two flexible, interchangeable links, and is controlled by three independent processors on a VMEbus. Results from experiments on the control of residual vibration for different types of robot motion are presented. Impulse prefiltering and slowly accelerating moves are compared and shown to be effective at reducing residual vibration.

Fitting models for the joint action of two drugs using SAS(R)

Combinations of drugs are increasingly being used for a wide variety of diseases and conditions. A pre-clinical study may allow the investigation of the response at a large number of dose combinations. In determining the response to a drug combination, interest may lie in seeking evidence of synergism, in which the joint action is greater than the actions of the individual drugs, or of antagonism, in which it is less. Two well-known response surface models representing no interaction are Loewe additivity and Bliss independence, and Loewe or Bliss synergism or antagonism is defined relative to these. We illustrate an approach to fitting these models for the case in which the marginal single drug dose-response relationships are represented by four-parameter logistic curves with common upper and lower limits, and where the response variable is normally distributed with a common variance about the dose-response curve. When the dose-response curves are not parallel, the relative potency of the two drugs varies according to the magnitude of the desired effect and the models for Loewe additivity and synergism/antagonism cannot be explicitly expressed. We present an iterative approach to fitting these models without the assumption of parallel dose-response curves. A goodness-of-fit test based on residuals is also described. Implementation using the SAS NLIN procedure is illustrated using data from a pre-clinical study. Copyright © 2007 John Wiley & Sons, Ltd.

Joint servoing for robust manipulator force control

An experimental and theoretical comparison is made of force control performance with different types of innerloop joint servoing techniques. The problem of disturbance rejection and sensitivity to plant dynamics variations (robustness) is addressed. Position, velocity, strain gauge derived joint torque, and current servos are designed and implemented on a specially instrumented industrial robot, and the end-effector force feedback performances achieved are compared. Joint strain derived torque servoing is found to provide the best overall robust force control performance. Experimental results of the robust hard-on-hard contact achieved with the novel force controller implementation based on joint torque sensing are provided. Conclusions are drawn on the force control performance achievable on a geared robot given the joint servoing technique.

Report of the Joint Meeting of the SIDS Bureau and the Inter-Agency Collaborative Group

Summary An account of the proceedings of the meeting which discussed the following agenda items: report on regional implementation of the SIDS POA; status of regional projects for submission to the meeting of prospective donors and representatives of Small Island Developing States; the regional position on UNDP compendium of project proposals; status of consultations with CARIFORUM and the EU; budget for the regional co-ordinating mechanism and consultation; preparation for the Special Session on the UN General Assembly (UNGASS); to discuss the SIDS plan of action; and a Ministerial meeting on SIDS POA implementation.

Maritime and port security in South America: implementation costs

This edition of the Bulletin is based on a document prepared by ECLAC and the Technical Coordination Committee of the presidential initiative for Regional Infrastructure Integration in South America (IIRSA), which is composed of the Inter-American Development Bank (IDB), the Andean Development Corporation (ADC) and the Financial Fund for the Development of the River Plate Basin (FONPLATA). The document was prepared as a joint activity on maritime and port security in South America in the context of the IIRSA sectoral integration process in relation to operational systems for maritime transport. It served as an input for the meeting on that subject held by representatives of the authorities of the South American countries in Montevideo, Uruguay, on 22 June 2004.This edition presents the results of the implementation cost assessment for the new compulsory regulations for maritime and port security of the International Maritime Organization (IMO) and also considers the costs of the voluntary measures.

Trade Facilitation and Paperless Trade Implementation Survey 2015

The Global Survey on Trade Facilitation and Paperless Trade Implementation 2014-2015 is a global effort led by the Economic and Social Commission for Asia and the Pacific (ESCAP) in collaboration with the other four United Nations Regional Commissions, namely, the Economic Commission for Latin America and the Caribbean (ECLAC), the Economic and Social Commission for Western Asia (ESCWA), the Economic Commission for Africa (ECA) and the Economic Commission for Europe (UNECE). The goal of the Global Survey is to gather information from the member states of the respective Regional Commissions on trade facilitation and paperless trade measures and strategies implemented at the national and regional levels. The results of the survey will enable countries and development partners to better understand and monitor progress on trade facilitation, support evidence-based public policies, share best practices and identify capacity building and technical assistance needs.

Caribbean synthesis review and appraisal report on the implementation of the Beijing Declaration and Platform for Action

The Caribbean sub-regional synthesis report, covering 12 countries, assesses progress towards the gender equality goals articulated in the 1995 World Conference on Women, which produced the Beijing Platform for Action (BPfA). The process leading to the preparation of the report has involved a series of national, regional and global consultations that will culminate in the Beijing + 20 Review. The process has also led to the formulation of the Caribbean Joint Statement on Gender Equality and the Post-2015, as well as the SIDS Agenda, both of which express Caribbean perspectives and expectations regarding gender equality.

"Influence of lower-limb joint models on subject-specific musculoskeletal model predictions during gait" ( "modelli muscoloscheletrici personalizzati dell'arto inferiore: Analisi dell'effetto della modellazione dei giunti sulla predizione dei carichi agenti sul sistema scheletrico durante il cammino").

The aim of the present thesis was to investigate the influence of lower-limb joint models on musculoskeletal model predictions during gait. We started our analysis by using a baseline model, i.e., the state-of-the-art lower-limb model (spherical joint at the hip and hinge joints at the knee and ankle) created from MRI of a healthy subject in the Medical Technology Laboratory of the Rizzoli Orthopaedic Institute. We varied the models of knee and ankle joints, including: knee- and ankle joints with mean instantaneous axis of rotation, universal joint at the ankle, scaled-generic-derived planar knee, subject-specific planar knee model, subject-specific planar ankle model, spherical knee, spherical ankle. The joint model combinations corresponding to 10 musculoskeletal models were implemented into a typical inverse dynamics problem, including inverse kinematics, inverse dynamics, static optimization and joint reaction analysis algorithms solved using the OpenSim software to calculate joint angles, joint moments, muscle forces and activations, joint reaction forces during 5 walking trials. The predicted muscle activations were qualitatively compared to experimental EMG, to evaluate the accuracy of model predictions. Planar joint at the knee, universal joint at the ankle and spherical joints at the knee and at the ankle produced appreciable variations in model predictions during gait trials. The planar knee joint model reduced the discrepancy between the predicted activation of the Rectus Femoris and the EMG (with respect to the baseline model), and the reduced peak knee reaction force was considered more accurate. The use of the universal joint, with the introduction of the subtalar joint, worsened the muscle activation agreement with the EMG, and increased ankle and knee reaction forces were predicted. The spherical joints, in particular at the knee, worsened the muscle activation agreement with the EMG. A substantial increase of joint reaction forces at all joints was predicted despite of the good agreement in joint kinematics with those of the baseline model. The introduction of the universal joint had a negative effect on the model predictions. The cause of this discrepancy is likely to be found in the definition of the subtalar joint and thus, in the particular subject’s anthropometry, used to create the model and define the joint pose. We concluded that the implementation of complex joint models do not have marked effects on the joint reaction forces during gait. Computed results were similar in magnitude and in pattern to those reported in literature. Nonetheless, the introduction of planar joint model at the knee had positive effect upon the predictions, while the use of spherical joint at the knee and/or at the ankle is absolutely unadvisable, because it predicted unrealistic joint reaction forces.

A policy-driven architecture for supporting joint degrees through e-learning services

En un mercado de educación superior cada vez más competitivo, la colaboración entre universidades es una efectiva estrategia para acceder al mercado global. El desarrollo de titulaciones conjuntas es un importante mecanismo para fortalecer las colaboraciones académicas y diversificar los conocimientos. Las titulaciones conjuntas están siendo cada vez más implementadas en las universidades de todo el mundo. En Europa, el proceso de Bolonia y el programa Erasmus, están fomentado el reconocimiento de titulaciones conjuntas y dobles y promoviendo la colaboración entre las instituciones académicas. En el imparable proceso de la globalización y convergencia educativa, el uso de sistemas de e-learning para soportar cursos tanto semipresencial como online es una tendencia en crecimiento. Dado que los sistemas de e-learning soportan una amplia variedad de cursos, es necesario encontrar una solución adecuada que permita a las universidades soportar y gestionar las titulaciones conjuntas a través de sus sistemas de e-learning en conformidad con los acuerdos de colaboración establecidos por las universidades participantes. Esta tesis doctoral abordará las siguientes preguntas de investigación: 1. ¿Qué factores deben tenerse en cuenta en la implementación y gestión de titulaciones conjuntas? 2. ¿Cómo pueden los sistemas actuales de e-learning soportar el desarrollo de titulaciones conjuntas? 3. ¿Qué otros servicios y sistemas necesitan ser adaptados por las universidades interesadas en participar en una titulación conjunta a través de sus sistemas de e-learning? La implementación de titulaciones conjuntas a través de sistemas de e-learning es compleja e implica retos técnicos, administrativos, culturales, financieros, jurídicos y de seguridad. Esta tesis doctoral propone una serie de contribuciones que pueden ayudar a resolver algunos de los retos identificados. En primer lugar se ha elaborado un modelo conceptual que incluye la información del contexto de las titulaciones conjuntas que es relevante para la implementación de estas titulaciones en los sistemas de e-learning. Después de definir el modelo conceptual, se ha propuesto una arquitectura basada en políticas para la implementación de titulaciones interinstitucionales a través de sistemas de e-learning de acuerdo a los términos estipulados en los acuerdos de colaboración que son firmados por las universidades participantes. El autor se ha centrado en el componente de gestión de flujos de trabajo de esta arquitectura. Por último y con el fin de permitir la interoperabilidad de repositorios de objetos educativos, los componentes básicos a implementar han sido identificados y validados. El uso de servicios multimedia en educación es una tendencia creciente, proporcionando servicios de e-learning que permiten mejorar la comunicación y la interacción entre profesores y alumnos. Dentro de estos servicios, nos hemos centrado en el uso de la videoconferencia y la grabación de clases como servicios adecuados para el desarrollo de cursos impartidos en escenarios de educación colaborativos. Las contribuciones han sido validadas en proyectos de investigación de ámbito nacional y europeo en los que el autor ha participado. Abstract In an increasingly competitive higher education market, collaboration between universities is an effective strategy for gaining access to the global market. The development of joint degrees is an important mechanism for strengthening academic research collaborations and diversifying knowledge. Joint degrees are becoming increasingly implemented in universities around the world. In Europe, the Bologna process and the Erasmus programme have encouraged both the global recognition of joint and double degrees and promoted close collaboration between academic institutions. In the unstoppable process of globalization and educational convergence, the use of e-learning systems for supporting both blended and online courses is becoming a growing trend. Since e-learning systems covers a wide range of courses, it becomes necessary to find a suitable solution that enables universities to support and manage joint degrees through their e-learning systems in accordance with the collaboration agreements established by the universities involved. This dissertation will address the following research questions: 1. What factors need to be considered in the implementation and management of joint degrees? 2. How can the current e-learning systems support the development of joint degrees? 3. What other services and systems need to be adapted by universities interested in participating in a joint degree through their e-learning systems? The implementation of joint degrees using e-learning systems is complex and involves technical, administrative, security, cultural, financial and legal challenges. This dissertation proposes a series of contributions to help solve some of the identified challenges. One of the cornerstones of this proposal is a conceptual model of all the relevant issues related to the support of joint degrees by means of e-learning systems. After defining the conceptual model, this dissertation proposes a policy-driven architecture for implementing inter-institutional degree collaborations through e-learning systems as stipulated by a collaboration agreement signed by two universities. The author has focused on the workflow management component of this architecture. Finally, the building blocks for achieving interoperability of learning object repositories have been identified and validated. The use of multimedia services in education is a growing trend, providing rich e-learning services that improve the communication and interaction between teachers and students. Within these e-learning services, we have focused on the use of videoconferencing and lecture recording as the best-suited services to support collaborative learning scenarios. The contributions have been validated within national and European research projects that the author has been involved in.

Efficient implementation of general negation using abstract interpretation

While negation has been a very active área of research in logic programming, comparatively few papers have been devoted to implementation issues. Furthermore, the negation-related capabilities of current Prolog systems are limited. We recently presented a novel method for incorporating negation in a Prolog compiler which takes a number of existing methods (some modified and improved) and uses them in a combined fashion. The method makes use of information provided by a global analysis of the source code. Our previous work focused on the systematic description of the techniques and the reasoning about correctness and completeness of the method, but provided no experimental evidence to evalúate the proposal. In this paper, after proposing some extensions to the method, we provide experimental data which indicates that the method is not only feasible but also quite promising from the efficiency point of view. In addition, the tests have provided new insight as to how to improve the proposal further. Abstract interpretation techniques (in particular those included in the Ciao Prolog system preprocessor) have had a significant role in the success of the technique.