Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX® and include this in decision-making. However, quantitative adjustment of the FRAX® estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX® model would be ideal.

Retrieving Cloud Characteristics from Ground-Based Daytime Color All-Sky Images

A discussion is presented of daytime sky imaging and techniques that may be applied to the analysis of full-color sky images to infer cloud macrophysical properties. Descriptions of two different types of skyimaging systems developed by the authors are presented, one of which has been developed into a commercially available instrument. Retrievals of fractional sky cover from automated processing methods are compared to human retrievals, both from direct observations and visual analyses of sky images. Although some uncertainty exists in fractional sky cover retrievals from sky images, this uncertainty is no greater than that attached to human observations for the commercially available sky-imager retrievals. Thus, the application of automatic digital image processing techniques on sky images is a useful method to complement, or even replace, traditional human observations of sky cover and, potentially, cloud type. Additionally, the possibilities for inferring other cloud parameters such as cloud brokenness and solar obstruction further enhance the usefulness of sky imagers

Haemophilia registry of the medical committee of the Swiss Haemophilia Society. Update and annual survey 2009.

The Swiss Haemophilia Registry of the Medical Committee of the Swiss Haemophilia Society started in 1996 but was set as an internet-based, double password-protected facility in the year 2000. With the inclusion of patients' data from two new centres in 2009, we assume a coverage rate of about 90% of all patients with inherited bleeding disorders in our country. Data concerning the phenotype and genotype of the disorder, its severity, its therapy, the prevalence of inhibitors are readily available to the registered users, allowing quality control of haemophilia therapy at a national level, but also rapid care of the patient visiting the emergency room of another treatment centre. Basing on the available data, about two thirds of the WFH global survey can be answered; the mortality statistics shows that bleeding remains a cause of death in haemophiliacs, also in the 21th century. The Registry allows for comparisons with international datasets, especially with respect to treatment (prophylaxis vs. on-demand therapy), factor consumption and costs.

Establishing Load Transfer in Existing Jointed Concrete Pavements, HR-1041, 1985

In this paper are described the results of a research project that had the objective of developing construction procedures for restoring load transfer in existing jointed concrete pavements and of evaluating the effectiveness of the restoration methods. A total of 28 test sections with various load transfer devices were placed. The devices include split pipe, figure eight, vee, double vee, and dowel bars. Patching materials used on the project included three types of fast-setting grouts, three brands of polymer concrete, and plain portland cement concrete. The number and spacing of the devices and dowel bars were also variables in the project. Dowel bars and double vee devices were used on the major portion of the project. Performance evaluations were based on deflection tests conducted with a 20,000-lb axle load. Horizontal joint movement measurements and visual observations were also made. The short-term performance data indicate good results with the dowel bar installations regardless of patching materials. The sections with split pipe, figure eight, and vee devices failed in bond during the first winter cycle. The results with the double vee sections indicate the importance of the patching material to the success or failure of the load transfer system: some sections are performing well and other sections are performing poorly with double vee devices. Horizontal joint movement measurements indicate that neither the dowel bars nor the double vee devices are restricting joint movement.

Establishing Strategies for a Transportation MS4 [Municipal Separate Storm Sewer System], RB36-013, 2015

The objective of this project has been to identify best practices and approaches to Municipal Separate Storm Sewer System (MS4) program planning for the Iowa Department of Transportation. Information is primarily based on existing state MS4 programs as examples and references for use as an agency-based MS4 program is developed.

Anamnèse familiale: utile ou futile. [Family history: useful or futile?]

Family history (FH) represents an important tool in clinical practice that allows assessing an increased risk to develop certain diseases as it captures genetic and environmental factors within a family. FH was shown to be important for several conditions such as type 2 diabetes mellitus and cardiovascular diseases as it allows identifying subjects who can potentially benefit from specific diagnostic and therapeutic measures. We also show that FH remains an important tool even in this period of recent progress in molecular genetics and that it is probably underused in the clinical setting.

Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial.

BACKGROUND: Most patients with glioblastoma are older than 60 years, but treatment guidelines are based on trials in patients aged only up to 70 years. We did a randomised trial to assess the optimum palliative treatment in patients aged 60 years and older with glioblastoma. METHODS: Patients with newly diagnosed glioblastoma were recruited from Austria, Denmark, France, Norway, Sweden, Switzerland, and Turkey. They were assigned by a computer-generated randomisation schedule, stratified by centre, to receive temozolomide (200 mg/m(2) on days 1-5 of every 28 days for up to six cycles), hypofractionated radiotherapy (34·0 Gy administered in 3·4 Gy fractions over 2 weeks), or standard radiotherapy (60·0 Gy administered in 2·0 Gy fractions over 6 weeks). Patients and study staff were aware of treatment assignment. The primary endpoint was overall survival. Analyses were done by intention to treat. This trial is registered, number ISRCTN81470623. FINDINGS: 342 patients were enrolled, of whom 291 were randomised across three treatment groups (temozolomide n=93, hypofractionated radiotherapy n=98, standard radiotherapy n=100) and 51 of whom were randomised across only two groups (temozolomide n=26, hypofractionated radiotherapy n=25). In the three-group randomisation, in comparison with standard radiotherapy, median overall survival was significantly longer with temozolomide (8·3 months [95% CI 7·1-9·5; n=93] vs 6·0 months [95% CI 5·1-6·8; n=100], hazard ratio [HR] 0·70; 95% CI 0·52-0·93, p=0·01), but not with hypofractionated radiotherapy (7·5 months [6·5-8·6; n=98], HR 0·85 [0·64-1·12], p=0·24). For all patients who received temozolomide or hypofractionated radiotherapy (n=242) overall survival was similar (8·4 months [7·3-9·4; n=119] vs 7·4 months [6·4-8·4; n=123]; HR 0·82, 95% CI 0·63-1·06; p=0·12). For age older than 70 years, survival was better with temozolomide and with hypofractionated radiotherapy than with standard radiotherapy (HR for temozolomide vs standard radiotherapy 0·35 [0·21-0·56], p<0·0001; HR for hypofractionated vs standard radiotherapy 0·59 [95% CI 0·37-0·93], p=0·02). Patients treated with temozolomide who had tumour MGMT promoter methylation had significantly longer survival than those without MGMT promoter methylation (9·7 months [95% CI 8·0-11·4] vs 6·8 months [5·9-7·7]; HR 0·56 [95% CI 0·34-0·93], p=0·02), but no difference was noted between those with methylated and unmethylated MGMT promoter treated with radiotherapy (HR 0·97 [95% CI 0·69-1·38]; p=0·81). As expected, the most common grade 3-4 adverse events in the temozolomide group were neutropenia (n=12) and thrombocytopenia (n=18). Grade 3-5 infections in all randomisation groups were reported in 18 patients. Two patients had fatal infections (one in the temozolomide group and one in the standard radiotherapy group) and one in the temozolomide group with grade 2 thrombocytopenia died from complications after surgery for a gastrointestinal bleed. INTERPRETATION: Standard radiotherapy was associated with poor outcomes, especially in patients older than 70 years. Both temozolomide and hypofractionated radiotherapy should be considered as standard treatment options in elderly patients with glioblastoma. MGMT promoter methylation status might be a useful predictive marker for benefit from temozolomide. FUNDING: Merck, Lion's Cancer Research Foundation, University of Umeå, and the Swedish Cancer Society.

Is a pre-anaesthetic information form really useful?

BackgroundAll patients should be fully informed about the risks and benefits of anaesthetic procedures before giving a written consent. Moreover, the satisfaction level may vary in proportion to the information given. We aimed to determine, in a single-blind randomized-controlled study, whether an information form given before the pre-anaesthetic consultation could improve perceived information, information gain and satisfaction level.MethodsTwo hundred patients ASA 1-3 scheduled for an elective orthopaedic surgery were randomized into two groups: a group that received an information form before the pre-anaesthetic consultation (IF group) and a control group (no information form). A standardized questionnaire was submitted after the pre-anaesthetic consultation and after the operation. This 17-item questionnaire explored perceived information (five items), information gain (three items) and satisfaction level (nine items). The items of each topic were pooled and compared between groups.ResultsOne hundred and eighty-five patients (92.5%) completed the study. The IF group had better perceived information (IF group 73% vs. control group 63%, P=0.002), higher information gain (IF group 75% vs. control group 62%, P=0.001) and a higher satisfaction level (IF group 95% vs. control group 92%, P=0.048).ConclusionsOur study suggests that an information form given before the pre-anaesthetic consultation enhances perceived information, information gain and satisfaction level.

Localitzador gràfic d'adreces IP

Internet s'ha convertit en una font extraordinària de recursos per una audiència en constant creixement arreu el món. A l'igual que en altres activitats de la nostra societat, el coneixement de la localització geogràfica d'aquests recursos i de la gent que hi accedeix és útil tant pels usuaris com pels proveïdors d'informació. La geolocalització IP, però, pot donar informació errònia o amb un nivell de precisió que no vagi més enllà de la referència a un país.Aquest treball recull els diferents actors que formen part de la geolocalització IP i s'ha analitzat el paper que juguen en aquest procés així com la seva influència en el nivell de fiabilitat i exactitud final. Amb aquests sòlids fonaments s'ha desenvolupat una aplicació per representar gràficament en un mapa la geolocalització IP d'un dispositiu i la dels nodes que formen el camí realitzat fins arribar-hi, així com tota la informació addicional que de cada IP s'ha pogut obtenir.El resultat ha estat una memòria tècnica de tot el treball de recerca juntament amb una aplicació que s'executa en l'entorn de Microsoft Windows i plataforma .NET, caracteritzada per la seva facilitat d'ús gràcies a un disseny simple molt intuïtiu i efectiu, la rapidesa d'execució per què aprofita la programació de fils, i un positiu impacte visual ja que fa servir l'API de Google Maps per a la representació visual de la traça.

Entropic stochastic resonance

We present a novel scheme for the appearance of stochastic resonance when the dynamics of a Brownian particle takes place in a confined medium. The presence of uneven boundaries, giving rise to an entropic contribution to the potential, may upon application of a periodic driving force result in an increase of the spectral amplification at an optimum value of the ambient noise level. The entropic stochastic resonance, characteristic of small-scale systems, may constitute a useful mechanism for the manipulation and control of single molecules and nanodevices.

Kinetic equations for difussion in the presence of entropic barriers

We use the mesoscopic nonequilibrium thermodynamics theory to derive the general kinetic equation of a system in the presence of potential barriers. The result is applied to a description of the evolution of systems whose dynamics is influenced by entropic barriers. We analyze in detail the case of diffusion in a domain of irregular geometry in which the presence of the boundaries induces an entropy barrier when approaching the exact dynamics by a coarsening of the description. The corresponding kinetic equation, named the Fick-Jacobs equation, is obtained, and its validity is generalized through the formulation of a scaling law for the diffusion coefficient which depends on the shape of the boundaries. The method we propose can be useful to analyze the dynamics of systems at the nanoscale where the presence of entropy barriers is a common feature.