Randomized comparison of the effects of the vitamin D(3 )adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients

BACKGROUND: For adults, vitamin D intake of 100 mcg (4000 IU)/day is physiologic and safe. The adequate intake (AI) for older adults is 15 mcg (600 IU)/day, but there has been no report focusing on use of this dose. METHODS: We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OH)D <61 nmol/L) were given 15 or 100 mcg/day vitamin D in December 2001. Biochemical responses were followed at subsequent visits that were part of clinical care; 37 patients completed a wellbeing questionnaire in December 2001 and February 2002. Subjects for Study 2 were recruited if their 25(OH)D was <51 nmol/L in summer 2001. 66 outpatients were given vitamin D; 51 completed a wellbeing questionnaire in both December 2002 and February 2003. RESULTS: In Study 1, basal summer 25-hydroxyvitamin D [25(OH)D] averaged 48 ± 9 (SD) nmol/L. Supplementation for more than 6 months produced mean 25(OH)D levels of 79 ± 30 nmol/L for the 15 mcg/day group, and 112 ± 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036). In Study 2, 25(OH)D averaged 39 ± 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p < 0.001). CONCLUSION: The highest AI for vitamin D brought summertime 25(OH)D to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D(3 )in patients who needed additional vitamin D

A discharge summary adapted to the frail elderly to ensure transfer of relevant information from the hospital to community settings: a model

<p>Abstract</p> <p>Background</p> <p>Elderly patients admitted to Geriatric Assessment Units (GAU) typically have complex health problems that require multi-professional care. Considering the scope of human and technological resources solicited during hospitalization, as well as the many risks and discomforts incurred by the patient, it is important to ensure the communication of pertinent information for quality follow-up care in the community setting. Conventional discharge summaries do not adequately incorporate the elements specific to an aging clientele.</p> <p>Objective</p> <p>To develop a discharge summary adapted to the frail elderly patient (D-SAFE) in order to communicate relevant information from hospital to community services.</p> <p>Methods</p> <p>The items to be included in the D-SAFE have been determined by means of a modified Delphi method through consultation with clinical experts from GAUs (11 physicians and 5 pharmacists) and the community (10 physicians and 5 pharmacists). The consensus analysis and the level of agreement among the experts were reached using a modified version of the RAND^®/University of California at Los Angeles appropriateness method.</p> <p>Results</p> <p>A consensus was reached after two rounds of consultation for all the items evaluated, where none was judged «inappropriate». Among the items proposed, four were judged to be « uncertain » and were eliminated from the final D-SAFE, which was divided into two sections: the medical discharge summary (22 main items) and the discharge prescription (14 main items).</p> <p>Conclusions</p> <p>The D-SAFE was developed as a more comprehensive tool specifically designed for GAU inpatients. Additional research to validate its acceptability and practical impact on the continuity of care is needed before it can be recommended for use on a broader scale.</p

Instrumentation Plan for the ERA MS and BMS Test

A measurement plan for the modal survey and boosted modal survey test (MST and BMST) of the European Robotic Arm (ERA) is proposed. The report focuses on the measurement locations on ERA itself, whereas the pick-up plan for the LIR and the vibration adapter can be found in the more general document provided by Fokker Space. The proposal is backed up with FE calculations

Use of Finite Element-Models for Preparation of Ground Vibration Test

The paper discusses possibilities to make use of the finite element model (FE model) to prepare and analyse ground vibration tests (GVT) on large aircrafts. It reports about experiences gained in the preparation stage and of a research GVT on an Airbus A340-300. The observability and controllability of the expected structural modes can be investigated on the basis of FE calculations during the preparation of the GVT. By this means, the engineering skill strictly necessary to set up a GVT can be backed up with analytical findings potentially resulting in improvements of the pick-up and excitation plan. During and after the test the performance of orthogonality checks as well as the calculation of generalized masses on the basis of the measured mode shapes and the analytical mass matrix provide usefull additional information for the evaluation and interpretation of test results. The detection of deviations of the measurements from the analytical model might influence the test procedure drawing the attention towards the least precisely predicted modes which can prove to be very useful for the updating of the FE model. A prerequisite for any activity related to the FE model is a proper association of the test data with the analytical calculations. For this task the use of a generalized static expansion technique is recommended which is a suitable tool during both, the preparation and analysis stage of a GVT

The Use of the Finite-Element Model to Prepare the Airbus A340-300 Ground Vibration Test

Within the framework of the Flexible Aircraft WP 2500 program a research ground vibration test on the Airbus A340 MSN 1 is scheduled for September/October 1999. It will be performed by a combined DLR/ONERA team. The main aim is to test new methods and improve existing ones in order to gain time at equivalent quality. Apart from experimental aspects, cost reduction concerning the number of pick-ups, exciters and exciter positions shall be analysed. The report covers the evaluation of accelerometer positions to ensure the observability and the evaluation and optimization of exciter configurations to guarantee the controllability of the modes of interest, on the basis of the FE model. By this means it is shown that the mathematical model provides considerable help to set-up and optimize a ground vibration test program. Furthermore, a relationship between the dynamic mathematical model and the measured degrees-of-freedom necessary to allow orthogonality tests is established using the FE model

Vergleich zwischen gemessenen und berechneten modalen Parametern

Ziel von Modaltests ist häufig, neben der direkten Verwendung des identifizierten modalen Modells, die Verbesserung des mathematischen Modells, zumeist ein Finite-Elemente Modell (FE-Modell). In einem ersten Schritt müssen dazu zunächst die experimentell bestimmten modalen Parameter mit denjenigen des FE-Modells korreliert werden, d.h. insbesondere müssen gemessene und analytische Eigenformen einander zugeordnet werden. In Abschnitt 2 werden wesentliche Korrelationsmaße vorgestellt und an Beispielen erläutert. Im Abschnitt 3 werden einige hier relevante Aspekte der praktischen Durchführung von Experimenten, zum Beispiel der Einfluß der Randbedingungen auf die Ergebnisse, behandelt. In den weiteren Abschnitten werden dann Techniken für das Aufbereiten der Meßdaten oder des analytischen Modells erläutert, die die Anwendung bestimmter Korrelationsmaße überhaupt erst ermöglichen. Zu nennen sind die Handhabung gemessener komplexer Eigenvektoren sowie Reduktions- und Expansionsverfahren, um das Problem der typischerweise unterschiedlichen Größe von experimentellen und analytischen Modellen bzw. Datensätzen zu lösen

Use of Finite Element Models for Prediction of Ground Vibration Test

The paper discusses possibilities to make use of the finite element model (FE model) to prepare and analyse ground vibration tests (GVT) on large aircraft. It reports about experiences gained in the preparation stage and of a research GVT on an Airbus A340-300. The observability and controllability of the expected structural modes can be investigated on the basis of FE calculations during the preparation of the GVT. By this means, the engineering skill strictly necessary to set up a GVT can be backed up with analytical findings potentially resulting in improvements of the pick-up and excitation plan. During and after the test the performance of orthogonality checks as well as the calculation of generalized masses on the basis of the measured mode shapes and the analytical mass matrix provide useful additional information for the evaluation and interpretation of test results. The detection of deviations of the measurements from the analytical model might influence the test procedure drawing the attention towards the least precisely predicted modes which can prove to be very useful for the updating of the FE model. A prerequisite for any activity related to the FE model is a proper association of the test data with the analytical calculations. For this task the use of a generalized static expansion technique is recommended which is a suitable tool during both, the preparation and analysis stage of a GVT

Beitrag zur Aeroelastizitaet rotierender Tragfluegel Modellierung und experimentelle Identifikation der aerodynamischen Kraefte, numerische Berechnung des dynamischen Verhaltens

SIGLEAvailable from TIB Hannover: RR 2040(1997,3) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

ERA Qualification Feasibility Study

Within the framework of the qualification of the European Robotic Arm (ERA), the intention is to apply a multi-point excitation instead of a multi-axial base excitation. This report explores the feasibility of this approach in order to prepare the test and to assess the achievable results. The study is based on a FE model of ERA and its external interfaces on the launcher, i.e. the Space Shuttle

Using Mode Shape Expansion Techniques for Pretest Analysis and Correlation

When comparing analytical data from a FE model with experimental data from a modal survey test, the number of degrees-of-freedom in the analytical model is usually by far greater than the number of measured degrees-of-freedom. To overcome this problem, a reduction of the FE model is often considered to be the most reliable way. However, in some cases it is inevitable to expand mode shapes, for example in the presence of rotational degees-of freedom in the dynamic model. A situation which is frequently encountered in aircraft simulation. The paper evaluates the benefits of several mode shape expansion techniques like the SEREP method, a purely geometric interpolation scheme and a generalized static expansion method. This is done not only in view of correlation purposes after the test, but also for pretest analysis. Some of the methods can be used to assess the quality of the accelerometer plan and, thus, to optimize the set of measurement locations. Using two examples, a simple beam model and an aircraft model, it is shown that the generalized static expansion technique provides a good trade-off between accuracy, simplicity and robustness with respect to noise in the measured data and errors in the FE model. It also provides an excellent measure for the quality of the pick-up plan