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

Introduction: Vertebral fracture is one of the major osteoporotic fractures which are unfortunately very often undetected. In addition, it is well known that prevalent vertebral fracture increases dramatically the risk of future additional fracture. Instant Vertebral Assessment (IVA) has been introduced in DXA device couple years ago to ease the detection of such fracture when routine DXA are performed. To correctly use such tool, ISCD provided clinical recommendation on when and how to use it. The aim of our study was to evaluate the ISCD guidelines in clinical routine patients and see how often it may change of patient management. Methods: During two months (March and April 2010), a medical questionnaire was systematically given to our clinical routine patient to 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 performed on the same DXA system and had been centrally evaluated by two trained Doctors for fracture status according to the semi-quantitative method of Genant. The reading had been performed when possible between 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 criteria to have an IVA measurement. Out of these 109 women, 43 (incidence 39.4%) had osteoporosis at one of the three skeletal sites and 31 (incidence 28.4%) had at least one vertebral fracture. 14.7% of women had both osteoporosis and at least one vertebral fracture classifying them as "severe osteoporosis" while 46.8% did not have osteoporosis nor vertebral fracture. 24.8% of the women had osteoporosis but no vertebral fracture while 13.8% of women did have osteoporosis and vertebral fracture (clinical osteoporosis). Conclusion: In conclusion, in 52% of our patients, IVA was needed according to ISCD criteria. In half of them the IVA test influenced of patient management either by changing the type of treatment of simply by classifying patient as "clinical osteoporosis". IVA appears to be an important tool in clinical routine but unfortunately is not yet very often used in most of the centers.

Mesoclitic Romance futures and conditionals vs participle preposing

(INFINITIVE + CLITIC + AUX) is an evidential configuration in Old Spanish and Old Catalan, whereas (PARTICIPLE + CLITIC + AUX) is an instance of weak or unmarked focus fronting. The evidentiality of mesoclitic structures can be put forward on the bases of three main arguments: a) mesoclisis is not compulsory (i.e., whenever you have a clitic, you can either have mesoclisis or proclisis/enclisis); b) mesoclitic futures and conditionals areattested in interrogative sentences (with wh- elements); and c) they are not found in derived adverbial clauses (which is what you expect if they have an evidential value, since they bring about intervention effects corresponding to the derivational account of conditional and temporal sentences, for example - see Haegeman 2007 and ff.), and are related to high modal expressions (thus interfering with MoodPIrrealis)

Compositional data analysis: where we are and where should we be heading?

We take stock of the present position of compositional data analysis, of what has beenachieved in the last 20 years, and then make suggestions as to what may be sensibleavenues of future research. We take an uncompromisingly applied mathematical view,that the challenge of solving practical problems should motivate our theoreticalresearch; and that any new theory should be thoroughly investigated to see if it mayprovide answers to previously abandoned practical considerations. Indeed a main themeof this lecture will be to demonstrate this applied mathematical approach by a number ofchallenging examples

Alternative ways to estimate change points in multinomial sequences. An application to an authorship attribution problem

The statistical analysis of literary style is the part of stylometry that compares measurable characteristicsin a text that are rarely controlled by the author, with those in other texts. When thegoal is to settle authorship questions, these characteristics should relate to the author’s style andnot to the genre, epoch or editor, and they should be such that their variation between authors islarger than the variation within comparable texts from the same author.For an overview of the literature on stylometry and some of the techniques involved, see for exampleMosteller and Wallace (1964, 82), Herdan (1964), Morton (1978), Holmes (1985), Oakes (1998) orLebart, Salem and Berry (1998).Tirant lo Blanc, a chivalry book, is the main work in catalan literature and it was hailed to be“the best book of its kind in the world” by Cervantes in Don Quixote. Considered by writterslike Vargas Llosa or Damaso Alonso to be the first modern novel in Europe, it has been translatedseveral times into Spanish, Italian and French, with modern English translations by Rosenthal(1996) and La Fontaine (1993). The main body of this book was written between 1460 and 1465,but it was not printed until 1490.There is an intense and long lasting debate around its authorship sprouting from its first edition,where its introduction states that the whole book is the work of Martorell (1413?-1468), while atthe end it is stated that the last one fourth of the book is by Galba (?-1490), after the death ofMartorell. Some of the authors that support the theory of single authorship are Riquer (1990),Chiner (1993) and Badia (1993), while some of those supporting the double authorship are Riquer(1947), Coromines (1956) and Ferrando (1995). For an overview of this debate, see Riquer (1990).Neither of the two candidate authors left any text comparable to the one under study, and thereforediscriminant analysis can not be used to help classify chapters by author. By using sample textsencompassing about ten percent of the book, and looking at word length and at the use of 44conjunctions, prepositions and articles, Ginebra and Cabos (1998) detect heterogeneities that mightindicate the existence of two authors. By analyzing the diversity of the vocabulary, Riba andGinebra (2000) estimates that stylistic boundary to be near chapter 383.Following the lead of the extensive literature, this paper looks into word length, the use of the mostfrequent words and into the use of vowels in each chapter of the book. Given that the featuresselected are categorical, that leads to three contingency tables of ordered rows and therefore tothree sequences of multinomial observations.Section 2 explores these sequences graphically, observing a clear shift in their distribution. Section 3describes the problem of the estimation of a suden change-point in those sequences, in the followingsections we propose various ways to estimate change-points in multinomial sequences; the methodin section 4 involves fitting models for polytomous data, the one in Section 5 fits gamma modelsonto the sequence of Chi-square distances between each row profiles and the average profile, theone in Section 6 fits models onto the sequence of values taken by the first component of thecorrespondence analysis as well as onto sequences of other summary measures like the averageword length. In Section 7 we fit models onto the marginal binomial sequences to identify thefeatures that distinguish the chapters before and after that boundary. Most methods rely heavilyon the use of generalized linear models

Sobre geografía moral

Els geògrafs s’inclouen tant en el camp de les ciències de la terra com en el de les ciències socials, tot i que també es poden considerar filòsofs morals, perquè es preocupen i s’interessen pels valors, els costums i les aspiracions humanes de no només limitar-se a sobreviure, sinó també d’aconseguir una vida fructuosa i agradable. En aquest intent per aconseguir una bona vida, els éssers humans han hagut d’organitzar-se i servir-se del poder, amb el qual és fàcil, per altra banda, cometre abusos contra els més febles i també contra la natura. El vessant moral és inevitable en qualsevol detallada consideració de la realitat humana. Aquest article pretén explorar l’esmentat vessant en societats senzilles i complexes, és a dir, tant entre els pobles caçadors-recol·lectors com en aquelles cultures més sofisticades que han transformat el camp, el jardí i la ciutat

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Different arbuscular mycorrhizal (AMF) fungal taxa have a differential effect on the growth of co-existing plant species. This means that in order to fully understand the role of these fungi in plant communities, information is needed on whether the symbiosis is specific. In this chapter, I briefly review the ecological consequences of specificity versus non-specificity in the arbuscular mycorrhizal symbiosis on plant ecology. Both from a theoretical approach, and based on observations, there has been an underlying assumption that no specificity exists in the arbuscular mycorrhizal symbiosis. I consider why these assumptions have been made. Direct evidence for or against specificity in the symbiosis is scant and the reason is mainly due to the difficulty in describing AMF community structure in natural communities (see Clapp et al., Chap.8, this Vol.). Here, I take an evolutionary, as well as an ecological, approach to look at the evidence that predicts that evolution of specificity in the arbuscular mycorrhizal symbiosis could occur. I then consider alternative hypotheses and evidence that could explain why the evolution of specificity might not occur. These hypotheses are based on the growth habit, reproductive strategies and foraging behaviour of AMF and on new findings concerning ANF genetics.

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

Vertebral fracture is one of the major osteoporotic fractures which are unfortunately very often undetected. In addition, it is well known that prevalent vertebral fracture increases dramatically the risk of future additional fracture. Instant Vertebral Assessment (IVA) has been introduced in DXA device couple years ago to ease the detection of such fracture when routine DXA are performed. To correctly use such tool, ISCD provided clinical recommendation on when and how to use it. The aim of our study was to evaluate the ISCD guidelines in clinical routine patients and see how often it may change of patient management. During two months (March and April 2010), a medical questionnaire was systematically given to our clinical routine patient to 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 performed on the same DXA system and had been centrally evaluated by two trained Doctors for fracture status according to the semi-quantitative method of Genant. The reading had been performed when possible between L5 and T4. Out of 210 women seen in the consultation, 109 (52%) of them (mean age 68.2±11.5 years) fulfilled the necessary criteria to have an IVA measurement. Out of these 109 women, 43 (incidence 39.4%) had osteoporosis at one of the three skeletal sites and 31 (incidence 28.4%) had at least one vertebral fracture. 14.7% of women had both osteoporosis and at least one vertebral fracture classifying them as "severe osteoporosis" while 46.8% did not have osteoporosis not vertebral fracture. 24.8% of the women had osteoporosis but no vertebral fracture while 13.8% of women did have osteoporosis but vertebral fracture (Clinical osteoporosis). In conclusion, in 52% of our patients, IVA was needed according to ISCD criteria. In half of them the IVA test influenced of patient management either my changing the type of treatment of simply by classifying patient as "clinical osteoporosis". IVA appears to be an important tool in clinical routine but unfortunately is not yet very often use in most of the centers.

Is a Virtual Library cost effective?

The Andalusian Public Health System Virtual Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA), was created in June 2006. In this paper an evaluation is made to see whether the investment made by the Andalusian Government has been worthwhile. The cost-effectiveness and efficiency of the project together with the management criteria are explored.

Single-injection or continuous femoral nerve block for total knee arthroplasty?

BACKGROUND: The ideal local anesthetic regime for femoral nerve block that balances analgesia with mobility after total knee arthroplasty (TKA) remains undefined. QUESTIONS/PURPOSES: We compared two volumes and concentrations of a fixed dose of ropivacaine for continuous femoral nerve block after TKA to a single injection femoral nerve block with ropivacaine to determine (1) time to discharge readiness; (2) early pain scores and analgesic consumption; and (3) functional outcomes, including range of motion and WOMAC scores at the time of recovery. METHODS: Ninety-nine patients were allocated to one of three continuous femoral nerve block groups for this randomized, placebo-controlled, double-blind trial: a high concentration group (ropivacaine 0.2% infusion), a low concentration group (ropivacaine 0.1% infusion), or a placebo infusion group (saline 0.9% infusion). Infusions were discontinued on postoperative Day (POD) 2. The primary outcome was time to discharge readiness. Secondary outcomes included opioid consumption, pain, and functional outcomes. Ninety-three patients completed the study protocol; the study was halted early because of unanticipated changes to pain protocols at the host institution, by which time only 61% of the required number of patients had been enrolled. RESULTS: With the numbers available, the mean time to discharge readiness was not different between groups (high concentration group, 62 hours [95% confidence interval [CI], 51-72 hours]; low concentration group, 73 hours [95% CI, 63-83 hours]; placebo infusion group 65 hours [95% CI, 56-75 hours]; p = 0.27). Patients in the low concentration group consumed significantly less morphine during the period of infusion (POD 1, high concentration group, 56 mg [95% CI, 42-70 mg]; low concentration group, 35 mg [95% CI, 27-43 mg]; placebo infusion group, 48 mg [95% CI, 38-59 mg], p = 0.02; POD 2, high concentration group, 50 mg [95% CI, 41-60 mg]; low concentration group, 33 mg [95% CI, 24-42 mg]; placebo infusion group, 39 mg [95% CI, 30-48 mg], p = 0.04); however, there were no important differences in pain scores or opioid-related side effects with the numbers available. Likewise, there were no important differences in functional outcomes between groups. CONCLUSIONS: Based on this study, which was terminated prematurely before the desired sample size could be achieved, we were unable to demonstrate that varying the concentration and volume of a fixed-dose ropivacaine infusion for continuous femoral nerve block influences time to discharge readiness when compared with a conventional single-injection femoral nerve block after TKA. A low concentration of ropivacaine infusion can reduce postoperative opioid consumption but without any important differences in pain scores, side effects, or functional outcomes. These pilot data may be used to inform the statistical power of future randomized trials. LEVEL OF EVIDENCE: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Student's watcher : comparison between ASP.NET and PHP+CSS

"Student’s Watcher” is a small Web application which wants to show in a visual, simple and fast way, the evolution of the students. The main project table displays such things as marks and comments about students. We can add a comment for each mark to explain why this mark. The objective is to be able to know if some student has a problem, how is going his year, marks in other courses, or even, to know if he has a bad week in a different subjects. We can see the evolution of students in past years to do an objective comparison. It also allows inserting global comments of student, we have a list of these, and all professors can add new ones, where we can see more general valuations. “Student’s Watcher” was begun in ASP.net, but finally my project would be developed in PHP, HTML and CSS. This project wants to be a comparison between two of most important languages used nowadays, ASPX and PHP

Spatial learning by rats across visually disconnected environments

Experiments were designed to examine some properties of spatial representations in rats. Adult subjects were trained to escape through a hole at a fixed position in a large circular arena (see Schenk 1989). The experiments were conducted in the dark, with a limited number of controlled visual light cues in order to assess the minimal cue requirement for place learning. Three identical light cues (shape, height and distance from the table) were used. Depending on the condition, they were either permanently on, or alternatively on or off, depending on the position of the rat in the field. Two questions were asked: a) how many identical visual cues were necessary for spatial discrimination in the dark, and b) could rats integrate the relative positions of separate cues, under conditions in which the rat was never allowed to perceive all three cues simultaneously. The results suggest that rats are able to achieve a place discrimination task even if the three cues necessary for efficient orientation can never be seen simultaneously. A dissociation between the discrimination of the spatial position of the goal and the capacity to reach it by a direct path suggests that a reduced number of cues might require prolonged locomotion to allow an accurate orientation in the environment.

El espacio como producto social: variables arqueológicas para un análisis de la organización social en prehistoria

El espacio social es un concepto ambiguo cuyo componente material está determinado por el carácter del componente social, puesto que la organización de los objetos en el espacio y el espacio mismo, responden a las normas sociales del comportamiento humano. Partimos de la premisa que los residuos generados durante el proceso de producción y del consumo tienden a tener una distribución relativamente regular en el espacio físico. La ausencia de la aleatoriedad en la dispersión de estos restos solo significa que habían sido acumulados y depositados como restos de acciones previamente planificadas no-aleatoriamente. En este trabajo planteamos estudiar la organización y la producción del espacio social de una sociedad cazadora-recolectora concreta – la sociedad yámana - a través del análisis de las actividades cotidianas que figuran en las fuentes etnográficas y en el registro arqueológico. Con este fin creamos una metodología de trabajo interdisciplinaria, basada en un enfoque etnoarqueológico, y a través del estudio de las fuentes etnográficas, los trabajos etnoarqueológicos previos y el registro arquelógico concreto, descubrimos cuáles son las posibilidades y limitaciones de este tipo de estudios. Pudimos reconocer la regularidad espacial de los procesos de producción y reproducción social y a resolver algunas preguntas acerca del estudio de la organización social en prehistoria trabajando con los datos etnoarqueológicos obtenidos en los yacimientos Lanashuaia y Túnel VII (Tierra del Fuego, Argentina), analizando el registro extraido y trabajado en varias campañas de excavaciones arqueológicas en ultimos 25 años. El presente trabajo al fondo es un experimento etnoarqueológico estándar: partiendo de la observación etnográfica registramos unas recurrencias específicas entre algunas variables (por ejemplo: mujer/lugar/tipo de trabajo), intentamos extraer las variables definitorias de esas recurrencias, y finalmente las buscamos en el espacio definido arqueológicamente.  

Anàlisi de les competències comunicatives en les titulacions de Grau en Enginyeria Informàtica a les universitats de l'estat espanyol

Aquest document és un projecte de recerca sobre les competències comunicatives en els estudis de Grau en Enginyeria Informàtica. Aquest projecte consta de dues parts molt diferenciades. La primera, teòrica, en què es definirà què s'entén per competència i es veuran els diversos tipus de competències que hi ha i com és classifiquen. Mentre que la segona part del PFC consisteix en una investigació sobre les memòries de Grau en Enginyeria Informàtica de les universitats de l'estat espanyol per tal de veure com s'hi treballen les competències a estudiar.

Biomarqueurs en immunologie générale [Biomarkers in clinical immunology].

In a current perspective of individualized medicine, biomarkers appear as a simple and readily available aid to assist clinicians in the identification and monitoring of diseases whose diagnosis is difficult. Basically, we know the limited performance of medical history and of clinical examination; therefore, the use of laboratory tests is often seen as the panacea to solve the clinical enigma. The purpose of this article is to analyze a few biomarkers commonly processed in the immunology laboratory (AAN, ANCA, anti-tTG, rheumatoid factor and anti-CCP) and to review the principle, the usefulness and the performance of these tests in specific clinical situations. We will see that, far from supplanting history and physical examination, these immunological biomarkers take their full value as a supplement to clinical information!

Anti-impérialisme et nouvelle gauche radicale dans la Suisse des années 68

Cette thèse entend apporter un éclairage sur l'histoire politique et sociale de la Suisse des années 68, en étudiant l'articulation entre les mouvements anti-impérialistes et la nouvelle gauche radicale, alors foisonnante. Il s'agit d'analyser cette période de contestation au prisme de l'anti-impérialisme révolutionnaire, lequel, dans le contexte de l'opposition à la guerre du Vietnam, a fortement imprégné le mouvement protestataire, en assignant notamment au tiers-monde le rôle de sujet de l'émancipation mondiale. Combinant une triple approche - chronologique, thématique et biographique - ce travail est structuré en quatre parties. La première partie esquisse un panorama des mouvements anti-impérialistes des années 1960 et 1970 en Suisse, avec une focalisation sur les «années anti-imp», entre 1968 et 1975. La deuxième interroge le rapport entre anti¬impérialisme et nouvelle gauche radicale, en proposant une typologie des principaux courants. La troisième partie s'attache à examiner le système de représentations du monde et de la Suisse véhiculé par le discours de l'extrême gauche. Prenant pour objet le militantisme, la dernière partie esquisse un portrait de groupe de la « génération anti-imp », fondé sur une enquête prosopographique et sur un corpus d'entretiens réalisés avec des militants de l'époque. L'étude révèle que l'anti-impérialisme a fourni à la contestation soixante-huitarde un cadre conceptuel et analytique, un facteur de structuration, ainsi qu'un vecteur de mobilisation. Il a en particulier permis à la gauche radicale suisse d'inscrire sa lutte anticapitaliste locale dans un horizon global d'émancipation. L'analyse de l'anti-impérialisme révolutionnaire, qui a connu son apogée dans les années 68 avant de connaître un déclin rapide et presque total, invite à appréhender cette « décennie mouvementée » comme la fin d'un long cycle politique. -- This thesis aims to shed light on the social and political history of Switzerland in the 1960s and 1970s by studying the relationship between anti-imperialist movements and the emerging new radical left. It analyses this time of rebellion through the prism of revolutionary anti-imperialism. In the context of opposition to the Vietnam War, anti-imperialism strongly influenced protest movements, notably by assigning to the Third World the role of main actor in the fight for global emancipation. Combining a threefold approach - chronological, thematic and biographical - this work is structured in four parts. The first part provides a panorama of the anti-imperialist movements of the long 1960s in Switzerland with a focus on the « anti-imp years » between 1968 and 1975. The second part questions the relationship between anti-imperialism and the new radical left and proposes a typology of its main currents. The third part examines how the radical left's discourse represented the world, and Switzerland in particular. The last part addresses the question of activism and outlines a group portrait of the « anti-imp generation » based on a prosopographical study and on a body of interviews with former activists. This study reveals that anti-imperialism, besides serving as an agent of mobilization, provided a conceptual and ideological framework, as well as a structuring factor, to the protest movements. In particular, it enabled the Swiss radical left to fit its local anti-capitalist struggle into a global horizon of emancipation. This analysis of revolutionary anti- imperialism, which had its heyday in the 1960s and 1970s before experiencing a rapid and almost total decline, thus invites us to see this « turbulent decade » as the end of a long political cycle.