900 research outputs found

    Diminished linear growth during intermittent calcitriol therapy in children undergoing CCPD

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    Diminished linear growth during intermittent calcitriol therapy in children undergoing CCPD. Daily calcitriol therapy has been reported to improve linear growth in children with renal bone disease, and 1,25-dihydroxyvitamin D is a key regulator of chondrocyte proliferation and differentiation. Whereas large intermittent doses of calcitriol can lower serum parathyroid hormone (PTH) levels and reverse the skeletal changes of secondary hyperparathyroidism, the impact of intermittent calcitriol therapy on linear growth in children is not known. Thus, we studied 16 pre-pubertal patients with bone biopsy-proven secondary hyperparathyroidism who completed a 12-month prospective clinical trial of intermittent calcitriol therapy. Biochemical results and growth data obtained during intermittent calcitriol therapy were compared to values determined during the preceding 12 months of daily calcitriol therapy in each study subject; changes in bone histology were assessed after one year of intermittent calcitriol therapy. Z-scores for height did not change during 12 months of daily calcitriol therapy. Although the skeletal lesions of secondary hyperparathyroidism improved in most patients, Z-scores for height decreased from -1.8 ± 0.32 to -2.0 ± 0.33, P < 0.01, during intermittent calcitriol therapy. The largest reductions were seen in patients who developed adynamic bone lesions after 12 months of treatment. Delta Z-scores for height correlated with serum PTH, r = 0.71, P < 0.01, and alkaline phosphatase levels, r = 0.67, P < 0.01, during intermittent calcitriol therapy but not during daily calcitriol therapy. The data suggest that high dose intermittent calcitriol therapy adversely affects linear growth, particularly in patients with the adynamic lesion. The higher doses of calcitriol or the intermittent schedule of calcitriol administration may directly inhibit chondrocyte activity within growth plate cartilage of children with end-stage renal disease

    GOES-R Geostationary Lightning Mapper Performance Specifications and Algorithms

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    The Geostationary Lightning Mapper (GLM) is a single channel, near-IR imager/optical transient event detector, used to detect, locate and measure total lightning activity over the full-disk. The next generation NOAA Geostationary Operational Environmental Satellite (GOES-R) series will carry a GLM that will provide continuous day and night observations of lightning. The mission objectives for the GLM are to: (1) Provide continuous, full-disk lightning measurements for storm warning and nowcasting, (2) Provide early warning of tornadic activity, and (2) Accumulate a long-term database to track decadal changes of lightning. The GLM owes its heritage to the NASA Lightning Imaging Sensor (1997- present) and the Optical Transient Detector (1995-2000), which were developed for the Earth Observing System and have produced a combined 13 year data record of global lightning activity. GOES-R Risk Reduction Team and Algorithm Working Group Lightning Applications Team have begun to develop the Level 2 algorithms and applications. The science data will consist of lightning "events", "groups", and "flashes". The algorithm is being designed to be an efficient user of the computational resources. This may include parallelization of the code and the concept of sub-dividing the GLM FOV into regions to be processed in parallel. Proxy total lightning data from the NASA Lightning Imaging Sensor on the Tropical Rainfall Measuring Mission (TRMM) satellite and regional test beds (e.g., Lightning Mapping Arrays in North Alabama, Oklahoma, Central Florida, and the Washington DC Metropolitan area) are being used to develop the prelaunch algorithms and applications, and also improve our knowledge of thunderstorm initiation and evolution

    Inflammation in benign prostate tissue and prostate cancer in the finasteride arm of the Prostate Cancer Prevention Trial

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    BACKGROUND: A previous analysis of the placebo arm of the Prostate Cancer Prevention Trial (PCPT) reported 82% overall prevalence of intraprostatic inflammation and identified a link between inflammation and higher-grade prostate cancer and serum PSA. Here we studied these associations in the PCPT finasteride arm. METHODS: Prostate cancer cases (N=197) detected either on a clinically indicated biopsy or on protocol-directed end-of-study biopsy, and frequency-matched controls (N=248) with no cancer on an end-of-study biopsy were sampled from the finasteride arm. Inflammation in benign prostate tissue was visually assessed using digital images of H&E stained sections. Logistic regression was used for statistical analysis. RESULTS: In the finasteride arm, 91.6% of prostate cancer cases and 92.4% of controls had at least one biopsy core with inflammation in benign areas; p < 0.001 for difference compared to placebo arm. Overall, the odds of prostate cancer did not differ by prevalence (OR=0.90, 95% CI 0.44-1.84) or extent (P-trend=0.68) of inflammation. Inflammation was not associated with higher-grade disease (prevalence: OR=1.07, 95% CI 0.43-2.69). Furthermore, mean PSA concentration did not differ by the prevalence or extent of inflammationin either cases or controls. CONCLUSION: The prevalence of intraprostatic inflammation was higher in the finasteride than placebo arm of the PCPT, with no association with higher-grade prostate cancer. IMPACT: Finasteride may attenuate the association between inflammation and higher-grade prostate cancer. Moreover, the missing link between intraprostatic inflammation and PSA suggests that finasteride may reduce inflammation-associated PSA elevation

    Temporal variability and statistics of the Strehl ratio in adaptive-optics images

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    We have investigated the temporal variability and statistics of the "instantaneous" Strehl ratio. The observations were carried out with the 3.63-m AEOS telescope equipped with a high-order adaptive optics system. In this paper Strehl ratio is defined as the peak intensity of a single short exposure. We have also studied the behaviour of the phase variance computed on the reconstructed wavefronts. We tested the Marechal approximation and used it to explain the observed negative skewness of the Strehl ratio distribution. The estimate of the phase variance is shown to fit a three-parameter Gamma distribution model. We show that simple scaling of the reconstructed wavefronts has a large impact on the shape of the Strehl ratio distribution.Comment: submitted to PAS

    Increased bone strontium levels in hemodialysis patients with osteomalacia

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    Increased bone strontium levels in hemodialysis patients with osteomalacia.BackgroundIn this study, we report on the association between increased bone strontium levels and the presence of osteomalacia in end-stage renal failure patients treated by hemodialysis.MethodsWe performed a histologic examination and determined the strontium content and strontium/calcium ratios in bone biopsies of 100 hemodialysis patients recruited from various centers all over the world. Aside from the bone strontium concentration, the bone aluminum content was assessed. The bone zinc concentration, a nonrelevant element for bone toxicity, was also measured.ResultsBone strontium levels and bone strontium/calcium ratios were increased in subjects with osteomalacia when compared with those with the other types of renal osteodystrophy. Bone strontium and bone calcium levels correlated with each other. The slope of the linear regression curve correlating these parameters was much steeper in the osteomalacic group (Y = 2.22X - 120) as compared with the other types of renal osteodystrophy (Y = 0.52X - 5.7). Within the group of patients with osteomalacia, bone strontium levels also significantly correlated with the bone aluminum content (r = 0.72, P = 0.018). No such correlation was found for the other types of renal osteodystrophy. The bone zinc concentration of subjects with normal renal function did not differ significantly from the values noted for the various types of renal osteodystrophy taken as separate groups, nor could increased bone zinc concentrations be associated with a particular bone lesion.ConclusionsOur data demonstrate an association between osteomalacia and increased bone strontium concentrations in dialysis patients. Further studies are warranted to establish whether strontium plays either a primary, secondary, or contributive role in the development of the latter type of renal osteodystrophy

    Матеріали інформаційно-методичного забезпечення дисципліни «Правоохоронне право (Суд)»

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    Одержані знання дозволять студентам сформувати фаховий світогляд, пізнати органічні зв’язки даної навчальної дисципліни з іншими академічними курсами. Вибіркова дисципліна «Правоохоронне право (Суд)» межує з такими правовими дисциплінами, як ”Судові та правоохоронні органи України”, «Цивільне право», «Кримінальне право», «Цивільний процес», «Кримінальний процес», «Адміністративне судочинство», «Господарське право», «Господарський процес» та інші.Вибіркова дисципліна «Правоохоронне право (Суд)» займає особливе місце в навчальному плані і є невід’ємним фактором правової системи й основним недержавним інститутом захисту особистості, її прав і свобод. Зміст цієї навчальної дисципліни складається із знань, що регулюють діяльність суду – захисника у сфері судочинства, судового захисту прав та інтересів людей

    Introducing Health Promotion Agenda-Setting for Health Education Practitioners

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    Health professionals must continuously address health promotion issues using the latest strategies and research. Currently in health care, too often an underdeveloped and under supported agenda prioritizes problems, issues, and solutions. Further, an ongoing competition exists among issues due to an undocumented agenda-setting process to gain the attention of media, public, and policy makers. Agendasetting is based on the belief that the media influence what we talk about, rather than controlling what we think, and how often an issue appears in the media influences the policy agenda (Dearing &amp; Rogers, 1996). If an issue is “salient” and receives frequent or expansive coverage by media, audience members will talk more about that issue than one that is not as salient. A Health Promotion Agenda-Setting approach works to specify and prioritize problems and alternative solutions for increasing media exposure and setting agendas for “sustained” courses of action, (Kozel et al., 2003). The crucial link between agenda-setting and the process of establishing effective legislation, policy, and programs has been researched. However, many health practitioners do not understand what agenda setting is, nor how to apply agenda setting within the field of health education. Professional development in Health Promotion Agenda-Setting offers health education practitioners new knowledge, skills, methods, and opportunities to strengthen practices that influence the public health agenda and transform health promotion leadership

    Monitoring clinical quality in rare disease services – experience in England

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    After some well-publicised problems with paediatric cardiac surgery, there has been great interest in England in monitoring clinical quality in specialised medical services. The National Commissioning Group plans, funds and monitors a set of highly specialised services for the National Health Service in England. We have developed systems for monitoring clinical quality that perform two interrelated but distinct functions: performance measurement and performance improvement. The aim is to collect information on all patients seen during each year – a 100% consecutive case series. Generally, there is no conceptual difficulty identifying an appropriate outcome for surgical interventions: the indication for surgery usually defines the outcome to monitor. This is not so for the medical and psychiatric services, where the relevant outcome to monitor is sometimes not obvious. There are a number of problems in interpreting, and acting on, outcome data for rare conditions and treatments. These problems include statistical problems due to small numbers, the need to risk adjust data and coding problems

    Prevalence of the Metabolic Syndrome Among U.S. Workers

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    This is the final version of the article. Available from American Diabetes Association via the DOI in this record.OBJECTIVE: Differences in the prevalence of cardiovascular disease (CVD) and its risk factors among occupational groups have been found in several studies. Certain types of workers (such as shift workers) may have a greater risk for metabolic syndrome, a precursor of CVD. The objective of this study was to assess the differences in prevalence and risk of metabolic syndrome among occupational groups using nationally representative data of U.S. workers. RESEARCH DESIGN AND METHODS: Data from 8,457 employed participants (representing 131 million U.S. adults) of the 1999-2004 National Health and Nutrition Examination Survey were used. Unadjusted and age-adjusted prevalence and simple and multiple logistic regression analyses were conducted, adjusting for several potential confounders (BMI, alcohol drinking, smoking, physical activity, and sociodemographic characteristics) and survey design. RESULTS: Of the workers, 20% met the criteria for the metabolic syndrome, with "miscellaneous food preparation and food service workers" and "farm operators, managers, and supervisors" having the greatest age-adjusted prevalence (29.6-31.1%) and "writers, artists, entertainers, and athletes," and "engineers, architects, scientists" the lowest (8.5-9.2%). In logistic regression analyses "transportation/material moving" workers had significantly greater odds of meeting the criteria for metabolic syndrome relative to "executive, administrative, managerial" professionals (odds ratio 1.70 [95% CI 1.49-2.52]). CONCLUSIONS: There is variability in the prevalence of metabolic syndrome by occupational status, with "transportation/material moving" workers at greatest risk for metabolic syndrome. Workplace health promotion programs addressing risk factors for metabolic syndrome that target workers in occupations with the greatest odds may be an efficient way to reach at-risk populations.This research was supported in part by the National Institute on Occupational Safety and Health (grant R01-0H-03915)
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