In vivo precision of the GE Lunar iDXA for the measurement of visceral adipose tissue in adults: the influence of body mass index.

CoreScan is a new software for the GE Lunar iDXA, which provides a quantification of visceral adipose tissue (VAT). The objective of this study was to determine the in vivo precision of CoreScan for the measurement of VAT mass in a heterogeneous group of adults. Forty-five adults (aged 34.6 (8.6) years), ranging widely in body mass index (BMI 26.0 (5.2)  kg/m(2); 16.7-42.4 kg/m(2)), received two consecutive total body scans with repositioning. The sample was divided into two subgroups based on BMI, normal-weight and overweight/obese, for precision analyses. Subgroup analyses revealed that precision errors (RMSSD:%CV; root mean square standard deviation:% coefficient of variation) for VAT mass were 20.9 g:17.0% in the normal-weight group and 43.7 g:5.4% in overweight/obese groups. Our findings indicate that precision for DXA-VAT mass measurements increases with BMI, but caution should be used with %CV-derived precision error in normal BMI subjects.European Journal of Clinical Nutrition advance online publication, 15 October 2014; doi:10.1038/ejcn.2014.213

Imperial connection? Contrasting accounting practices in the coal mines of north-east England and Nova Scotia, 1825-1900

The archives of the General Mining Association (GMA), a London-based enterprise with substantial holdings in the Nova Scotian coal-mining industry during the 19th century, are investigated in this paper. The historical record was examined with particular reference to the degree to which industrial costing techniques were transplanted via engineers/managers within the British Empire. The findings support the hypothesis that linkages to Newcastle were evident in Canadian coal mining, but that the accounting emphases differed somewhat between the two locales. In Nova Scotia, there was a great attention to day-to-day expense control. A similar concern was apparent also in the North-East of England, but here there appeared the additional sophistications of costing capital improvement projects and estimating the profitabil­ity of new workings. With regard to labor, the managers of the GMA\u27s Canadian operations, like their counterparts in the North-East Coalfield, seemed disinterested in tracking the efficiency and productivity of individual miners. We hypothesize that this inattention typified an environment wherein labor was scarce and employment alternatives existed for the work force

Effect of Hand Positioning on DXA Total and Regional Bone and Body Composition Parameters, Precision Error, and Least Significant Change

Dual-energy X-ray absorptiometry (DXA) body composition measurements are performed in both clinical and research settings for estimations of total and regional fat mass, lean tissue mass, and bone mineral content. Subject positioning influences precision and positioning instructions vary between manufacturers. The aim of the study was to determine the effect of hand position and scan mode on regional and total body bone and body composition parameters and determine protocol-specific body composition precision errors. Thirty-eight healthy subjects (men; mean age: 27.1 ± 12.1 yr) received 4 consecutive total body GE-Lunar iDXA (enCORE v 15.0) scans with re-positioning, and scan mode was dependent on body size. Twenty-three subjects received scans in standard mode and 15 received scans in thick scan modes. Two scans per subject were conducted with subject hands prone and 2 with hands mid-prone. The precision error (root mean squared standard deviation; percentage coefficient of variation) and least significant change for each protocol were determined using the International Society for Clinical Densitometry calculator. Hands placed in the mid-prone position increased arm bone mineral density (BMD) (standard mode: 0.185 g*cm−2, thick mode: 0.265 g*cm−2; p < 0.05), total body BMD (standard mode: 0.051 g*cm−2, thick mode: 0.069 g*cm−2; p < 0.001), and total body BMD Z-score (standard mode: 0.5. thick mode: 0.7; p < 0.001). This was due to reductions in bone area and bone mineral content. In standard mode, hands mid-prone reduced fat mass (0.05 kg, p < 0.05) and increased lean mass (0.11 kg, p < 0.05). There were no differences in body composition for thick mode scans. Hands mid-prone reduced lean mass precision error at the arms, trunk, and total body (p < 0.01). DXA clinical and research centers are advised to maintain consistency in their hand positioning and scan mode protocols, and consideration should be given to the hand positioning used for reference data. As a best practice recommendation, published DXA-based studies and reports for clinic-based total body assessments should ensure that subject positioning is fully described

Accounting, coercion and social control during apprenticeship: Converting slave workers to wage workers in the British West Indies, c1834-1838

The paper describes the nature and role of accounting during apprenticeship the transition period from slavery to waged labor in the British West Indies. Planters, colonial legislators, and Parliamentary leaders all feared that freed slaves would flee to open lands unless they were bound to plantations. Thus, rather than relying entirely on economic incentives to maintain viable plantations, the Abolition Act and subsequent local ordinances embodied a complex synthesis of paternalism, categorization, penalties, punishments, and social controls that were collectively intended to create a class of willing waged laborers. The primary role of accounting within this structure was to police work arrangements rather than to induce ap­prentices to become willing workers. This post-emancipation, pre­industrial formalization of punishment, valuation, and task systems furnish powerful insights into the extent of accountancy\u27s role in sustaining Caribbean slave regimes

The Polonnaruwa meteorite: oxygen isotope, crystalline and biological composition

Results of X-Ray Diffraction (XRD) analysis, Triple Oxygen Isotope analysis and Scanning Electron Microscopic (SEM) studies are presented for stone fragments recovered from the North Central Province of Sri Lanka following a witnessed fireball event on 29 December 2012. The existence of numerous nitrogen depleted highly carbonaceous fossilized biological structures fused into the rock matrix is inconsistent with recent terrestrial contamination. Oxygen isotope results compare well with those of CI and CI-like chondrites but are inconsistent with the fulgurite hypothesis.Comment: 7 pages, 7 figures, 4 table

Development of three dimensional constitutive theories based on lower dimensional experimental data

Most three dimensional constitutive relations that have been developed to describe the behavior of bodies are correlated against one dimensional and two dimensional experiments. What is usually lost sight of is the fact that infinity of such three dimensional models may be able to explain these experiments that are lower dimensional. Recently, the notion of maximization of the rate of entropy production has been used to obtain constitutive relations based on the choice of the stored energy and rate of entropy production, etc. In this paper we show different choices for the manner in which the body stores energy and dissipates energy and satisfies the requirement of maximization of the rate of entropy production that leads to many three dimensional models. All of these models, in one dimension, reduce to the model proposed by Burgers to describe the viscoelastic behavior of bodies.Comment: 23 pages, 6 figure

Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial

Aim: We assessed the management and outcomes of non-ST segment elevation myocardial infarction (NSTEMI) patients randomly assigned to fractional flow reserve (FFR)-guided management or angiography-guided standard care. Methods and results: We conducted a prospective, multicentre, parallel group, 1 : 1 randomized, controlled trial in 350 NSTEMI patients with &#8805; coronary stenosis &#8805;30% of the lumen diameter assessed visually (threshold for FFR measurement) (NCT01764334). Enrolment took place in six UK hospitals from October 2011 to May 2013. Fractional flow reserve was disclosed to the operator in the FFR-guided group (n = 176). Fractional flow reserve was measured but not disclosed in the angiography-guided group (n = 174). Fractional flow reserve &#8804;0.80 was an indication for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). The median (IQR) time from the index episode of myocardial ischaemia to angiography was 3 (2, 5) days. For the primary outcome, the proportion of patients treated initially by medical therapy was higher in the FFR-guided group than in the angiography-guided group [40 (22.7%) vs. 23 (13.2%), difference 95% (95% CI: 1.4%, 17.7%), P = 0.022]. Fractional flow reserve disclosure resulted in a change in treatment between medical therapy, PCI or CABG in 38 (21.6%) patients. At 12 months, revascularization remained lower in the FFR-guided group [79.0 vs. 86.8%, difference 7.8% (−0.2%, 15.8%), P = 0.054]. There were no statistically significant differences in health outcomes and quality of life between the groups. Conclusion: In NSTEMI patients, angiography-guided management was associated with higher rates of coronary revascularization compared with FFR-guided management. A larger trial is necessary to assess health outcomes and cost-effectiveness

Influence of contrast media dose and osmolality on the diagnostic performance of contrast fractional flow reserve

Background—Contrast fractional flow reserve (cFFR) is a method for assessing functional significance of coronary stenoses, which is more accurate than resting indices and does not require adenosine. However, contrast media volume and osmolality may affect the degree of hyperemia and therefore diagnostic performance. Methods and Results—cFFR, instantaneous wave–free ratio, distal pressure/aortic pressure at rest, and FFR were measured in 763 patients from 12 centers. We compared the diagnostic performance of cFFR between patients receiving low or iso-osmolality contrast (n=574 versus 189) and low or high contrast volume (n=341 versus 422) using FFR≤0.80 as a reference standard. The sensitivity, specificity, and overall accuracy of cFFR for the low versus iso-osmolality groups were 73%, 93%, and 85% versus 87%, 90%, and 89%, and for the low versus high contrast volume groups were 69%, 99%, and 83% versus 82%, 93%, and 88%. By receiver operating characteristics (ROC) analysis, cFFR provided better diagnostic performance than resting indices regardless of contrast osmolality and volume (P&lt;0.001 for all groups). There was no significant difference between the area under the curve of cFFR in the low- and iso-osmolality groups (0.938 versus 0.957; P=0.40) and in the low- and high-volume groups (0.939 versus 0.949; P=0.61). Multivariable logistic regression analysis showed that neither contrast osmolality nor volume affected the overall accuracy of cFFR; however, both affected the sensitivity and specificity. Conclusions—The overall accuracy of cFFR is greater than instantaneous wave–free ratio and distal pressure/aortic pressure and not significantly affected by contrast volume and osmolality. However, contrast volume and osmolality do affect the sensitivity and specificity of cFFR