Use of quantitative ultrasound scans of the calcaneus to diagnose osteoporosis in patients with rheumatoid arthritis

Background: Patients with rheumatoid arthritis are recognized as being at risk for osteoporosis as a result of the disease process as well as the medication used to treat it. This study was conducted to consider the use of calcaneal scanning with quantitative ultrasound—contact ultrasound bone analysis (CUBA)—to diagnose osteoporosis in patients with rheumatoid arthritis.Methods: Forty-six patients (11 men and 35 women) with established rheumatoid arthritis underwent dual-energy x-ray absorptiometry (DEXA) of the nondominant wrist andCUBA of the nondominant heel. Sensitivity, specificity, and positive and negative predictive values were used to determine the correlation between osteoporosis as diagnosedby the CUBA heel scan compared with the DEXA wrist scan given that DEXA is widely seen as the gold standard for the diagnosis of osteoporosis.Results: The CUBA heel scan revealed a sensitivity of 90% and a specificity of 44% for a diagnosis of osteoporosis compared with DEXA. The positive predictive value of theCUBA scan was 31%, and the negative predictive value was 94%. Therefore, if normal bone density is found using CUBA, there is 94% certainty this is correct. However, if osteoporosis is diagnosed using CUBA, there is only 31% certainty this is correct. In such instances a secondary scan using a different method (eg, DEXA) would be required. Future work should consider the effect of minor alterations to the equipment or scanning protocol, because this may improve diagnosis.Conclusions: The CUBA unit could be used as a primary screening device. Given the cost and accessibility issues associated with DEXA, quantitative ultrasound may have arole in screening for osteoporosis in the primary-care setting to determine the most appropriate routes of referral for patients requiring further investigations. <br/

Label-Less Library Logistics: Implementing Labor-Saving Practices in Massachusetts’ High-Volume Resource Sharing System

This paper presents important aspects and issues related to the merging of six regional library delivery services in a single statewide system that serves more than 550 libraries, that together circulate more than 15 million items annually throughout the Commonwealth of Massachusetts. The purpose of marrying the six distinct systems was to reduce redundancies and incorporate innovative features to improve library processing efficiency. Most libraries are members of one of nine separate shared integrated library systems. The paper covers the background, objectives, benefits, issues, lessons learned, and a successful request for proposal procurement process for this complex project

Haptoglobin type neither influences iron accumulation in normal subjects nor predicts clinical presentation in HFE C282Y haemochromatosis: phenotype and genotype analysis

In the UK, 90% of patients with hereditary haemochromatosis (HH) are homozygous for HFE C282Y, as are one in 150 people in the general population. However, only a minority of these will develop clinical haemochromatosis. Iron loss modifies iron accumulation but so may other genetic factors. Haptoglobin (Hp) exists as three major types (Hp 1-1, Hp 2-1 or Hp 2-2) and binds free plasma haemoglobin. In men, Hp 2-2 has been shown to be associated with increased macrophage iron accumulation and serum ferritin concentration. Furthermore, the frequency of Hp 2-2 was shown to be increased in patients with HH. We determined Hp types by phenotyping and genotyping 265 blood donor control subjects and 173 subjects who were homozygous for HFE C282Y. The latter group included 66 blood donors lacking clinical features suggestive of haemochromatosis and without a known family history, and 68 patients presenting clinically with haemochromatosis. Hp 2-2 frequencies did not differ in control subjects and C282Y homozygotes. Hp 2-2 was not a risk factor for disease development in HH. To investigate the relationship between iron accumulation and haptoglobin type, we determined transferrin saturation and serum ferritin concentration in 192 male, first-time blood donors aged 20-40 years who lacked both HFE C282Y and H63D. Transferrin saturation and serum ferritin concentrations did not vary with Hp type

YOUNG PEOPLE FEEL WISE, OLD PEOPLE FEEL ENERGETIC: COMPARING AGE STEREOTYPES AND SELF-EVALUATIONS ACROSS ADULTHOOD

Using questionnaire data from the MIDUS study (N=6.325) we examined the extent to which people in their late 20s, 40s, and 60s think that positive stereotypic “old” and “young” characteristics describe themselves, their age peers, and other age groups. A constellation of “old” characteristics (e.g., wise, caring, calm) was seen as more descriptive of older adults, while a constellation of “young” characteristics (e.g., healthy, energetic) was seen as more descriptive of younger adults. Self-evaluations were highly positive and largely consistent across age groups. Compared to their age peers, younger adults saw themselves as having as many positive “young” characteristics but more positive “old” characteristics whereas older adults saw themselves as having more positive “young” characteristics but fewer positive “old” characteristics. The results support the stability of the aging self despite the existence of age stereotypes and the role of negative age stereotypes as a frame of reference for making self-evaluations

Optical Characterization of Chromophoric Dissolved Organic Matter (CDOM) and Fe(II) Concentrations in Soil Porewaters Along a Channel-Bank Transect in a Salt Marsh

Chromophoric dissolved organic matter (CDOM) optical properties were measured in surface and porewaters as a function of depth and distance from the channel in a transect up the bank in a southern California salt marsh. Higher absorbance coefficients and fluorescence intensities in porewaters at depth vs. surface waters and shallower porewaters suggest soil porewater is a reservoir of CDOM in the marsh. Higher values were observed at the marsh sites compared to the channel site, suggesting increased production and storage in the marsh sites, and reduced leaching into overlying surface waters, is occurring. Spectral slope ratios decreased with depth, consistent with more aromatic, higher molecular weight material in the deeper porewaters, possibly due to different bacterial processing in the anaerobic vs. aerobic zones. Fe(II) concentrations, indicative of anaerobic bacterial processing, increased significantly at depth to values \u3e 1000 μM, consistent with active anaerobic microbial processing occurring at depth. The transitions to higher reduced iron concentrations correlated with increased absorbance and fluorescence, suggesting processing by anaerobic iron-reducing bacteria in these deeper zones may not mineralize as much carbon as in the shallower aerobic zones. Alternatively, this may be due to reduction of solid iron oxides coated with organic matter releasing both DOM and Fe(II). The ratio of humic-like fluorescence to the absorption coefficient decreased with increasing iron concentration, possibly due to optical interference by iron species. Taken together, the data indicate that marsh sites in the salt marsh act as a reservoir for higher molecular weight, more aromatic organic matter

A pilot investigation of the prevalence of US-detectable forefoot joint pathology and reported foot-related disability in participants with systemic lupus erythematosus

The main aim of this study was to determine the prevalence of US-detectable forefoot bursae, metatarsophalangeal (MTP) joint and metacarpophalangeal (MCP) joint synovial hypertrophy (SH), Power Doppler (PD) signal or erosion in participants with systemic lupus erythematosus (SLE). A secondary aim was to determine the strength of potential association between patient reported foot-related disability and US-detected forefoot bursae, MTP joint SH, PD signal or erosion in participants with SLE.A cross-sectional observational study of 20 participants with SLE was completed to determine the prevalence of US-detected forefoot bursal, MTP and MCP joint pathology. Patient-reported foot-related impairment and activity limitation (accumulatively referred to as disability) were also recorded. Spearmans' Rank Correlation analyses were completed to determine the potential strength of association between US-detected pathology and patient report disability.The prevalence of MTP joint SH and PD was 80 % (16/20) and 10 % (2/20), respectively. The prevalence of MCP joint SH and PD was 60 % (12/20) and 30 % (6/20) respectively. A significant association was noted between PD scores for the MTP joints and MCP joints (r = 0.556; p = 0.011) although this was not demonstrated for SH scores (r = 0.176; p = 0.459). Significant associations between forefoot bursal prevalence and MTP joint PD were noted (r = 0.467; p = 0.038). The prevalence of bursae and bursal PD (grade 2 or above) was 100 % (20/20) and 10 % (2/20), respectively. Moderate foot-related impairment and activity limitation was reported by 95 and 85 % of participants respectively.This pilot study suggests that US-detected MTP, MCP joint and forefoot bursal abnormalities may be prevalent in participants with SLE and they may experience a moderate level of foot-related disability. Further research is required to substantiate these preliminary findings

SNS programming environment user's guide

The computing environment is briefly described for the Supercomputing Network Subsystem (SNS) of the Central Scientific Computing Complex of NASA Langley. The major SNS computers are a CRAY-2, a CRAY Y-MP, a CONVEX C-210, and a CONVEX C-220. The software is described that is common to all of these computers, including: the UNIX operating system, computer graphics, networking utilities, mass storage, and mathematical libraries. Also described is file management, validation, SNS configuration, documentation, and customer services

Dairy foods and dairy protein consumption is inversely related to markers of adiposity in obese men and women

A number of intervention studies have reported that the prevalence of obesity may be in part inversely related to dairy food consumption while others report no association. We sought to examine relationships between energy, protein and calcium consumption from dairy foods (milk, yoghurt, cheese, dairy spreads, ice-cream) and adiposity including body mass index (BMI), waist (WC) and hip circumference (HC), and direct measures of body composition using dual energy X-ray absorptiometry (% body fat and abdominal fat) in an opportunistic sample of 720 overweight/obese Australian men and women. Mean (SD) age, weight and BMI of the population were 51 ± 10 year, 94 ± 18 kg and 32.4 ± 5.7 kg/m2, respectively. Reduced fat milk was the most commonly consumed dairy product (235 ± 200 g/day), followed by whole milk (63 ± 128 g/day) and yoghurt (53 ± 66 g/day). Overall dairy food consumption (g/day) was inversely associated with BMI, % body fat and WC (all p < 0.05). Dairy protein and dairy calcium (g/day) were both inversely associated with all adiposity measures (all p < 0.05). Yoghurt consumption (g/day) was inversely associated with % body fat, abdominal fat, WC and HC (all p < 0.05), while reduced fat milk consumption was inversely associated with BMI, WC, HC and % body fat (all p < 0.05). Within a sample of obese adults, consumption of dairy products, dairy protein, and calcium was associated with more favourable body composition