Systematic assessment of the quality of osteoporosis guidelines

BACKGROUND: Numerous agencies have developed clinical practice guidelines for the management of postmenopausal osteoporosis. The study objective was to conduct a systematic assessment of the quality of osteoporosis guidelines produced since 1998. METHODS: Guidelines were identified by searching MEDLINE (1998+), the world wide web, known guideline developer websites, bibliographies of retrieved guidelines, and through consultation with content experts. Each guideline was then assessed by three independent appraisers using the 'Appraisal Instrument for Clinical Guidelines' (version 1) by Cluzeau. RESULTS: We identified 26 unique guidelines from 1998–2001 and 21 met our inclusion criteria. Of the 21 guidelines reviewed, 8 were developed by medical societies, 6 by national groups, 6 by government agencies, and 1 by an international group. Twelve of the guidelines were published, 7 were organizational reports, and 2 were accessible only from the web. Half or more of the 20 items assessing the rigor of guideline development were met by 15% (median quality score 23%, range 5–80%, (95% CI 16.5, 34.7)), 81% met at least half of the 12 items assessing guideline content and context (median score 58%, range 17–83%, (95% CI 50.8, 65.5)), and none met half or more of the items assessing guideline application (median score 0%, range 0–47%, (95% CI -0.5 to 12.6)). Eight guidelines described the method used to assess the strength of evidence, and in 6 there was an explicit link between recommendations and the supporting evidence. Ten guidelines were judged not suitable for use in practice, 10 were acceptable with modification, and one was acceptable for use without modification. CONCLUSION: The methodological quality of current osteoporosis guidelines is low, although their scores for clinical content were higher. Virtually no guidelines covered dissemination issues. Few guidelines were judged as acceptable for use in their current format

Application of nanomaterials in two-terminal resistive-switching memory devices

Nanometer materials have been attracting strong attention due to their interesting structure and properties. Many important practical applications have been demonstrated for nanometer materials based on their unique properties. This article provides a review on the fabrication, electrical characterization, and memory application of two-terminal resistive-switching devices using nanomaterials as the active components, including metal and semiconductor nanoparticles (NPs), nanotubes, nanowires, and graphenes. There are mainly two types of device architectures for the two-terminal devices with NPs. One has a triple-layer structure with a metal film sandwiched between two organic semiconductor layers, and the other has a single polymer film blended with NPs. These devices can be electrically switched between two states with significant different resistances, i.e. the ‘ON’ and ‘OFF’ states. These render the devices important application as two-terminal non-volatile memory devices. The electrical behavior of these devices can be affected by the materials in the active layer and the electrodes. Though the mechanism for the electrical switches has been in argument, it is generally believed that the resistive switches are related to charge storage on the NPs. Resistive switches were also observed on crossbars formed by nanotubes, nanowires, and graphene ribbons. The resistive switches are due to nanoelectromechanical behavior of the materials. The Coulombic interaction of transient charges on the nanomaterials affects the configurable gap of the crossbars, which results into significant change in current through the crossbars. These nanoelectromechanical devices can be used as fast-response and high-density memory devices as well

On the complexity of color-avoiding site and bond percolation

The mathematical analysis of robustness and error-tolerance of complex networks has been in the center of research interest. On the other hand, little work has been done when the attack-tolerance of the vertices or edges are not independent but certain classes of vertices or edges share a mutual vulnerability. In this study, we consider a graph and we assign colors to the vertices or edges, where the color-classes correspond to the shared vulnerabilities. An important problem is to find robustly connected vertex sets: nodes that remain connected to each other by paths providing any type of error (i.e. erasing any vertices or edges of the given color). This is also known as color-avoiding percolation. In this paper, we study various possible modeling approaches of shared vulnerabilities, we analyze the computational complexity of finding the robustly (color-avoiding) connected components. We find that the presented approaches differ significantly regarding their complexity.Comment: 14 page

Lifshitz-like space-time from intersecting branes in string/M theory

We construct 1/4 BPS, threshold F-D$p$ bound states (with $0\leq p \leq 5$) of type II string theories by applying S- and T-dualities to the D1-D5 system of type IIB string theory. These are different from the known 1/2 BPS, non-threshold F-D$p$ bound states. The near horizon limits of these solutions yield Lifshitz-like space-times with varying dynamical critical exponent $z=2(5-p)/(4-p)$, for $p\neq 4$, along with the hyperscaling violation exponent $\theta = p - (p-2)/(4-p)$, showing how Lifshitz-like space-time can be obtained from string theory. The dilatons are in general non-constant (except for $p=1$). We discuss the holographic RG flows and the phase structures of these solutions. For $p=4$, we do not get a Lifshitz-like space-time, but the near horizon limit in this case leads to an AdS$_2$ space.Comment: 20 pages, no figure, v2: proper identification of hyperscaling violation exponent has been made, abstract and the text has been changed accordingly, note added, v3: minor changes, refs added, version to appear in JHE

Aspects of holography for theories with hyperscaling violation

We analyze various aspects of the recently proposed holographic theories with general dynamical critical exponent z and hyperscaling violation exponent $\theta$. We first find the basic constraints on $z, \theta$ from the gravity side, and compute the stress-energy tensor expectation values and scalar two-point functions. Massive correlators exhibit a nontrivial exponential behavior at long distances, controlled by $\theta$. At short distance, the two-point functions become power-law, with a universal form for $\theta > 0$. Next, the calculation of the holographic entanglement entropy reveals the existence of novel phases which violate the area law. The entropy in these phases has a behavior that interpolates between that of a Fermi surface and that exhibited by systems with extensive entanglement entropy. Finally, we describe microscopic embeddings of some $\theta \neq 0$ metrics into full string theory models -- these metrics characterize large regions of the parameter space of Dp-brane metrics for $p\neq 3$. For instance, the theory of N D2-branes in IIA supergravity has z=1 and $\theta = -1/3$ over a wide range of scales, at large $g_s N$.Comment: 35 pages; v2: new references added; v3: proper reference [14] added; v4: minor clarification

Schr\"odinger Holography with and without Hyperscaling Violation

We study the properties of the Schr\"odinger-type non-relativistic holography for general dynamical exponent z with and without hyperscaling violation exponent \theta. The scalar correlation function has a more general form due to general z as well as the presence of \theta, whose effects also modify the scaling dimension of the scalar operator. We propose a prescription for minimal surfaces of this "codimension 2 holography," and demonstrate the (d-1) dimensional area law for the entanglement entropy from (d+3) dimensional Schr\"odinger backgrounds. Surprisingly, the area law is violated for d+1 < z < d+2, even without hyperscaling violation, which interpolates between the logarithmic violation and extensive volume dependence of entanglement entropy. Similar violations are also found in the presence of the hyperscaling violation. Their dual field theories are expected to have novel phases for the parameter range, including Fermi surface. We also analyze string theory embeddings using non-relativistic branes.Comment: 62 pages and 6 figures, v2: several typos in section 5 corrected, references added, v3: typos corrected, references added, published versio

Benefits and risks of the hormetic effects of dietary isothiocyanates on cancer prevention

The isothiocyanate (ITC) sulforaphane (SFN) was shown at low levels (1-5 µM) to promote cell proliferation to 120-143% of the controls in a number of human cell lines, whilst at high levels (10-40 µM) it inhibited such cell proliferation. Similar dose responses were observed for cell migration, i.e. SFN at 2.5 µM increased cell migration in bladder cancer T24 cells to 128% whilst high levels inhibited cell migration. This hormetic action was also found in an angiogenesis assay where SFN at 2.5 µM promoted endothelial tube formation (118% of the control), whereas at 10-20 µM it caused significant inhibition. The precise mechanism by which SFN influences promotion of cell growth and migration is not known, but probably involves activation of autophagy since an autophagy inhibitor, 3-methyladenine, abolished the effect of SFN on cell migration. Moreover, low doses of SFN offered a protective effect against free-radical mediated cell death, an effect that was enhanced by co-treatment with selenium. These results suggest that SFN may either prevent or promote tumour cell growth depending on the dose and the nature of the target cells. In normal cells, the promotion of cell growth may be of benefit, but in transformed or cancer cells it may be an undesirable risk factor. In summary, ITCs have a biphasic effect on cell growth and migration. The benefits and risks of ITCs are not only determined by the doses, but are affected by interactions with Se and the measured endpoint

The distinct category of healthcare associated bloodstream infections

<p>Abstract</p> <p>Background</p> <p>Bloodstream infections (BSI) have been traditionally classified as either community acquired (CA) or hospital acquired (HA) in origin. However, a third category of healthcare-associated (HCA) community onset disease has been increasingly recognized. The objective of this study was to compare and contrast characteristics of HCA-BSI with CA-BSI and HA-BSI.</p> <p>Methods</p> <p>All first episodes of BSI occurring among adults admitted to hospitals in a large health region in Canada during 2000-2007 were identified from regional databases. Cases were classified using a series of validated algorithms into one of HA-BSI, HCA-BSI, or CA-BSI and compared on a number of epidemiologic, microbiologic, and outcome characteristics.</p> <p>Results</p> <p>A total of 7,712 patients were included; 2,132 (28%) had HA-BSI, 2,492 (32%) HCA-BSI, and 3,088 (40%) had CA-BSI. Patients with CA-BSI were significantly younger and less likely to have co-morbid medical illnesses than patients with HCA-BSI or HA-BSI (p < 0.001). The proportion of cases in males was higher for HA-BSI (60%; p < 0.001 vs. others) as compared to HCA-BSI or CA-BSI (52% and 54%; p = 0.13). The proportion of cases that had a poly-microbial etiology was significantly lower for CA-BSI (5.5%; p < 0.001) compared to both HA and HCA (8.6 vs. 8.3%). The median length of stay following BSI diagnosis 15 days for HA, 9 days for HCA, and 8 days for CA (p < 0.001). Overall the most common species causing bloodstream infection were <it>Escherichia coli, Staphylococcus aureus</it>, and <it>Streptococcus pneumoniae</it>. The distribution and relative rank of importance of these species varied according to classification of acquisition. Twenty eight day all cause case-fatality rates were 26%, 19%, and 10% for HA-BSI, HCA-BSI, and CA-BSI, respectively (p < 0.001).</p> <p>Conclusion</p> <p>Healthcare-associated community onset infections are distinctly different from CA and HA infections based on a number of epidemiologic, microbiologic, and outcome characteristics. This study adds further support for the classification of community onset BSI into separate CA and HCA categories.</p

Angular and Current-Target Correlations in Deep Inelastic Scattering at HERA

Correlations between charged particles in deep inelastic ep scattering have been studied in the Breit frame with the ZEUS detector at HERA using an integrated luminosity of 6.4 pb-1. Short-range correlations are analysed in terms of the angular separation between current-region particles within a cone centred around the virtual photon axis. Long-range correlations between the current and target regions have also been measured. The data support predictions for the scaling behaviour of the angular correlations at high Q2 and for anti-correlations between the current and target regions over a large range in Q2 and in the Bjorken scaling variable x. Analytic QCD calculations and Monte Carlo models correctly describe the trends of the data at high Q2, but show quantitative discrepancies. The data show differences between the correlations in deep inelastic scattering and e+e- annihilation.Comment: 26 pages including 10 figures (submitted to Eur. J. Phys. C