Measured Behavior of a Deep Excavation in Weathered Rock

An instrumented deep excavation in weathered rock adjacent to a deflection-sensitive historical building is described. Two permanent shoring systems were used, presenting an opportunity to measure and compare their behaviors. Adjacent to the historic structure, a tied-back drilled pier wall was used, while the remainder of the excavation was supported by a tied-back shotcrete wall constructed in top-down fashion. Instrumentation included inclinometers, tiltmeters, and tieback load cells, supplemented by optical surveys. Both support systems performed well, with movements within acceptable ranges. The maximum horizontal deflection of the drilled piers was 0.33 inch (8 mm), one-third to one-fifth that of the shotcrete. Settlements behind the drilled piers were significantly less than behind the shotcrete. Isolated minor cracking and widening of existing cracks occurred in the existing building. Tieback load cell data indicate that the source of movements can extend beyond the theoretical failure wedge

Sizing Of Trousers and Shirts for Indian Army Personnel : An Anthropometric Application

The paper describes how anthropometric data obtained on 4400 Indian Army personnel was utilized in evolving size rolls for the trousers and shirts. A bivariate frequency distribution of abdominal circumference and abdominal height indicated that the data could be grouped into 14 sizes and such grouping could provide good fitting trousers to 92.52 percent of the troops. For shirts, the bivariate frequency distribution of chest circumference and arm length grouped army personnel again into 14 sizes. Such grouping encompassed 84.22 percent of the personnel studied. An extra large size has been provided for those not covered by these 14 size. In this study, 95 army officers’ clothing measurements essential for their good fitting trousers and shirts were taken along with the relevant body measurements. A stepwise linear regression analysis was also carried out to predict clothing measurements from body measurements. These regression equations were used to work out the dimensions of the trousers and shirts for different sizes from the classified anthropometric data

Regression of Body Density on Skinfold Thicknesses in High Altitude Natives: Decline in the Predictive Efficiency on De-Acclimatisation to Low Altitude

Body density, stature, body weight and skinfold thickness at 11 sites were experimentally measured on two groups of high altitude natives (HAN) of Ladakh. Group 1, consisting of 38 similar volunteers was studied after 4-week stay at an altitude of 3658 m and Group 2, consisting of 38 similar volunteers was studied after 4-week stay at Delhi (altitude, 200m). Although, there was a strong relationship between skinfolds, other anthropometric measurements and body density (R=0.898) at high altitude (HA), this relationship was significantly reduced at Delhi (R=0.642). Appropriate regression equations predicting body density from skinfold thicknesses, stature and body weight are given for HAN at both the locations. It is concluded that hyperhydration of the lean body and the adipose tissue may be responsible for the weakening of the multiple Rs on de-acclimatisation to low altitude

Five-year efficacy and safety of asfotase alfa therapy for adults and adolescents with hypophosphatasia

Hypophosphatasia (HPP) features low tissue-nonspecific alkaline phosphatase (TNSALP) isoenzyme activity resulting in extracellular accumulation of its substrates including pyridoxal 5\u27-phosphate (PLP), the principal circulating form of vitamin B6, and inorganic pyrophosphate (PPi), a potent inhibitor of mineralization. Asfotase alfa is an enzyme replacement therapy developed to treat HPP. This multinational, randomized, open-label study (NCT01163149; EudraCT 2010-019850-42) evaluated the efficacy and safety of asfotase alfa in adults and adolescents 13-66 years of age with HPP. The study comprised a 6-month primary treatment period and a 4.5-year extension phase. In the primary treatment period, 19 patients were randomized to receive asfotase alfa 0.3 mg/kg/d subcutaneously (SC; n = 7), asfotase alfa 0.5 mg/kg/d SC (n = 6), or no treatment (control; n = 6) for 6 months. In the extension phase, patients received asfotase alfa (0.5 mg/kg/d for 6 mo-1 y, then 1 mg/kg/d 6 d/wk). During the primary treatment period, changes from Baseline to Month 6 in plasma PLP and PPi concentrations (coprimary efficacy measure) were greater in the combined asfotase alfa group compared with the control group, reaching statistical significance for PLP (P = 0.0285) but not for PPi (P = 0.0715). However, for the total cohort, the within subject changes in both PLP and PPi after 6 months and over 5 years of treatment with asfotase alfa were significant (P \u3c 0.05). Secondary efficacy measures included transiliac crest histomorphometry, dual-energy X-ray absorptiometry (DXA), and the 6-Minute Walk Test (6MWT). A significant decrease from Baseline in mineralization lag time was observed in the combined asfotase alfa group at Year 1. There were no significant differences between treated and control patients in DXA mean bone mineral density results at 6 months; Z-scores and T-scores were within the expected range for age at Baseline and remained so over 5 years of treatment. On the 6MWT, median (min, max) distance walked increased from 355 (10, 620; n = 19) meters before treatment to 450 (280, 707; n = 13) meters at 5 years (P \u3c 0.05). Results for the exploratory outcome measures suggested improvements in gross motor function, muscle strength, and patient-reported functional disability over 5 years of treatment. There were no deaths during this study. Asfotase alfa was generally well tolerated; the most common adverse events were mild to moderate injection site reactions. This study suggests that in adults and adolescents with pediatric-onset HPP, treatment with asfotase alfa is associated with normalization of circulating TNSALP substrate levels and improved functional abilities

Hearing loss in Pompe disease revisited: results from a study of 24 children

Little information is available regarding the auditory function in Pompe patients. Hearing loss has been reported in classic infantile patients, but it is still unknown whether central nervous system involvement interferes with auditory function and whether enzyme replacement therapy can improve hearing. Audi

Growth and disease burden in children with hypophosphatasia

Hypophosphatasia, an inborn error of metabolism characterized by impaired bone mineralization, can affect growth. This study evaluated relationships between anthropometric parameters (height, weight, and body mass index) and clinical manifestations of hypophosphatasia in children. Design: Data from children (aged < third percentile) and those with normal stature. Methods: Anthropometric parameters were evaluated by age group (< third percentile) and those with normal stature. Results: This analysis included 215 children (54.4% girls). Short stature presented in 16.1% of children aged<2 years and 20.4% of those aged≥2 years at assessment. Among those with available data (n = 62), height was below the target height (mean: −0.66 standard deviations). Substantial worsening of growth (mean delta height z score: −1.45; delta weight z score: −0.68) occurred before 2 years of age, while in those aged≥2 years, anthropometric trajectories were maintained (delta height z score: 0.08; delta weight z score: 0.13). Broad-ranging hypophosphatasia manifestations (beyond dental) were observed in most children. Conclusions: Short stature was not a consistent characteristic of children with hypophosphatasia, but growth impairment was observed in those aged<2 years, indicating that hypophosphatasia might affect growth plate activity during infancy. In addition, a broad range of clinical manifestations occurred in those above and below the third percentile for height, suggesting that height alone may not accurately reflect hypophosphatasia disease burden and that weight is less affected than longitudinal growt

Detection of iron deficiency in children with Down syndrome

Purpose Current American Academy of Pediatrics guidelines for children with Down syndrome (DS) recommend a complete blood count (CBC) at birth and hemoglobin annually to screen for iron deficiency (ID) and ID anemia (IDA) in low-risk children. We aimed to determine if macrocytosis masks the diagnosis of ID/IDA and to evaluate the utility of biochemical and red blood cell indices for detecting ID/IDA in DS. Methods We reviewed data from 856 individuals from five DS specialty clinics. Data included hemoglobin, mean corpuscular volume, red cell distribution width (RDW), percent transferrin saturation (TS), ferritin, and c-reactive protein. Receiver operating characteristic curves were calculated. Results Macrocytosis was found in 32% of the sample. If hemoglobin alone was used for screening, all individuals with IDA would have been identified, but ID would have been missed in all subjects. RDW had the highest discriminability of any single test for ID/IDA. The combination of RDW with ferritin or TS led to 100% sensitivity, and RDW combined with ferritin showed the highest discriminability for ID/IDA. Conclusion We provide evidence to support that a CBC and ferritin be obtained routinely for children over 1 year old with DS rather than hemoglobin alone for detection of ID