441 research outputs found
Eye movements of learning disabled children based on norm scored tests
Various tests have been devised to assess eye movement abilities. Although they have been normed to a general population, comparisons between those with learning/reading difficulties and the normal population has not been thoroughly investigated. This study attempts to evaluate the eye movement abilities of a reading delayed population. Seventy-four reading delayed subjects were given three different eye movement tests as an adjunct to the standard vision screening procedure. The Groffman Visual Tracing Test, the Pierce Saccade Test and the Stern Saccadic Fixation Test were administered to the subjects at the end of a primary screening. Eye movements were analyzed based on the subject\u27s actual age scores and expected age scores . The subjects were found to have eye movement deficiencies significant to the 0.005 level. The findings suggest that eye movements measured on the Groffman, Stern, and Pierce may provide another screening method for detecting individuals with reading deficiencies
Longer Duration of Diabetes Strongly Impacts Fracture Risk Assessment: The Manitoba BMD Cohort
Context: Type 2 diabetes is associated with a higher risk for major osteoporotic fracture (MOF) and
hip fracture than predicted by the World Health Organization fracture risk assessment (FRAX) tool.
Objective: The objective of the study was to examine the impact of diabetes duration on fracture
risk.
Methods: Using a clinical dual-energy x-ray absorptiometry registry linked with the Manitoba
administrative databases, we identified all women age 40 years or older with 10 or more years of
prior health care coverage undergoing hip dual-energy x-ray absorptiometry measurements
(1996 –2013). Incident MOF and incident hip fractures were each studied over 7 years. Cox proportional
hazards models were adjusted for FRAX (FRAX adjusted) and then FRAX plus comorbidity,
falls, osteoporosis therapy, or insulin (fully adjusted). FRAX calibration was assessed comparing
observed vs predicted probabilities.
Results: There were 49 098 women without and 8840 women with diabetes (31.4%10 y duration;
20.1% 5–10 y; 23.7%5 y; 24.8% new onset). In FRAX-adjusted analyses, only duration longer than
10 years was associated with a higher risk for MOF (hazard ratio [HR] 1.47, 95% confidence interval
[CI] 1.30 –1.66), and this was similar in the fully adjusted models (HR 1.34, 95% CI 1.17–1.54). In
contrast, a higher risk for hip fracture was seen for all durations in a dose-dependent fashion (eg,
FRAX adjusted HR 2.10, 95% CI 1.71–2.59 for duration 10 y vs HR 1.32, 95% CI 1.03–1.69 for new
onset). FRAX significantly underestimated the MOF risk (calibration ratio 1.24, 95% CI 1.08 –1.39)
and hip fracture risk (1.93, 95% CI 1.50 –2.35) in those with a diabetes duration longer than 10 years.
Conclusion: Diabetes is a FRAX-independent risk factor for MOF only in women with a long duration
of diabetes, but diabetes increases hip fracture risk, regardless of duration. Those with
diabetes longer than 10 years are at particularly high risk of fracture, and this elevated risk is
currently underestimated by FRAX
Reassessment intervals for transition from low to high fracture risk among adults older than 50 years
Importance
Fracture risk scores are used to identify individuals at high risk of major osteoporotic fracture or hip fracture for antiosteoporosis treatment. For those not meeting treatment thresholds at baseline, the optimal interval for reassessing fracture risk is uncertain.
Objective
To examine reassessment intervals for transition from low to high fracture risk under guidelines-defined treatment thresholds.
Design, Setting, and Participants
This retrospective cohort study included persons aged 50 years or older with fracture risk below treatment thresholds at baseline who had fracture risk reassessed at least 1 year later. Data were obtained from a population-based bone mineral density registry (baseline assessment during 1996-2015; reassessment to 2016) in the Province of Manitoba, Canada. Primary analysis was performed from May to June 2019. Analysis for the revision was performed in October 2019.
Main Outcomes and Measures
The primary outcome was time to transition from low (below the treatment threshold) to high fracture risk (treatment-qualifying risk score using osteoporosis clinical practice guidelines strategies for Canada, the United States, and the United Kingdom).
Results
The study population consisted of 10 564 individuals (94.1% women; mean [SD] age at baseline, 63.2 [8.2] years). At the time of reassessment (a mean [SD] interval of 5.2 [2.9] years between initial and subsequent fracture risk assessment), 690 (6.6%) had reached the fixed major osteoporotic fracture treatment threshold of 20%, 1546 (16.2%) had reached the fixed hip treatment threshold of 3%, and 932 (9.4%) had reached the age-dependent major osteoporotic fracture treatment threshold. Among those below 25% of the treatment threshold at baseline for each guideline, few (0%-3.0%) reached guidelines-defined high fracture risk at follow-up. In contrast, among those at the upper end of the scale for each guideline (75%-99% of the treatment threshold at baseline), 30.6% to 74.4% reached guidelines-defined high fracture risk. An increased number of clinical risk factors was associated with increased likelihood of reaching guidelines-defined high fracture risk (range for 3 guidelines, 17.1%-28.2%) compared with unchanged or decreased clinical risk factors (range for 3 guidelines, 3.3%-12.8%) (P < .001). Estimated time for 10% of the population to reach treatment-qualifying high fracture risk ranged from fewer than 3 years to more than 15 years.
Conclusions and Relevance
The findings suggest that baseline fracture risk (as a fraction of the treatment threshold) and change in clinical risk factors can identify individuals with low and high probability of guidelines-defined high fracture risk during follow-up, thereby potentially helping to inform the reassessment interval
Many worlds in one
A generic prediction of inflation is that the thermalized region we inhabit
is spatially infinite. Thus, it contains an infinite number of regions of the
same size as our observable universe, which we shall denote as \O-regions. We
argue that the number of possible histories which may take place inside of an
\O-region, from the time of recombination up to the present time, is finite.
Hence, there are an infinite number of \O-regions with identical histories up
to the present, but which need not be identical in the future. Moreover, all
histories which are not forbidden by conservation laws will occur in a finite
fraction of all \O-regions. The ensemble of \O-regions is reminiscent of
the ensemble of universes in the many-world picture of quantum mechanics. An
important difference, however, is that other \O-regions are unquestionably
real.Comment: 9 pages, 2 figures, comments and references adde
Fracture risk assessment in celiac disease: a registry-based cohort study
Summary
Celiac disease is associated with an increased fracture risk but is not a direct input to the FRAX® calculation. When celiac disease is considered as a secondary osteoporosis risk factor or BMD is included in the FRAX assessment, FRAX accurately predicts fracture risk.
Introduction
The fracture risk assessment tool (FRAX®) uses clinical factors and bone mineral density (BMD) measurement to predict 10-year major osteoporotic (MOF) fracture probability. The study aim was to determine whether celiac disease affects MOF risk independent of FRAX score.
Methods
The Manitoba BMD Registry includes clinical data, BMD measurements, 10-year probability of MOF calculated for each individual using the Canadian FRAX tool and diagnosed celiac disease. Using linkage to population-based healthcare databases, we identified incident MOF diagnoses over the next 10 years for celiac disease and general population cohorts.
Results
Celiac disease (N = 693) was associated with increased fracture risk adjusted for FRAX score computed without secondary osteoporosis or BMD (adjusted hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.11–1.86). Celiac disease was no longer a significant risk factor for fracture when secondary osteoporosis or BMD were included in the FRAX calculation (p > 0.1). In subjects with celiac disease, each SD increase in FRAX score (calculated with and without secondary osteoporosis or BMD) was associated with higher risk of incident MOF (adjusted HR 1.66 to 1.80), similar to the general population (p-interaction > 0.2). Including celiac disease as secondary osteoporosis or including BMD in FRAX 10-year MOF probability calculations (10.1% and 8.6% respectively) approximated the observed cumulative 10-year MOF probability (10.8%, 95% CI 7.8–13.9%).
Conclusions
Celiac disease is associated with an increased risk of major osteoporotic fractures. When celiac disease is considered as a secondary osteoporosis risk factor or BMD is included in FRAX assessment, FRAX accurately predicts fracture risk
Fracture prediction from FRAX for Canadian ethnic groups: a registry-based cohort study
Summary
We identified large between-ethnicity calibration differences in the Canadian FRAX® tool which substantially overestimated the major osteoporotic fracture (MOF) risk in Asian women and Black women, and overestimated hip fracture risk in Asian women.
Purpose
FRAX® is calibrated using population-specific fracture and mortality data. The need for FRAX to accommodate ethnic diversity within a country is uncertain. We addressed this question using the population-based Manitoba Bone Mineral Density (BMD) Program registry and self-reported ethnicity.
Methods
The study population was women aged 40 years or older with baseline FRAX assessments (Canadian and other ethnic calculators), fracture outcomes, and self-reported ethnicity (White N = 68,907 [referent], Asian N = 1910, Black N = 356). Adjusted hazard ratios (HR) with 95% confidence intervals (CI) for time to MOF and hip fracture were estimated. We examined candidate variables from DXA that might contribute to ethnic differences including skeletal size, hip axis length (HAL), trabecular bone score (TBS), and estimated body composition.
Results
Adjusted for baseline risk using the Canadian FRAX tool with BMD, Asian women compared with White women were at much lower risk for MOF (HR 0.46, 95% CI 0.35–0.59) and hip fracture (0.16, 95% CI 0.08–0.34). Black women were also at lower MOF risk (HR 0.58, 95% CI 0.32–1.00); there were no hip fractures. The US ethnic-specific FRAX calculators accounted for most of the between-ethnicity differences in MOF risk (86% for Asian, 92% for Black) but only partially accounted for lower hip fracture risk in Asian women (40%). The candidate variables explained only a minority of the effect of ethnicity. Gradient of risk in analyses was similar (p-interactions ethnicity*FRAX non-significant).
Conclusions
We identified significant ethnic differences in performance of the Canadian FRAX tool with fracture probability overestimated among Asian and Black women. The US ethnic calculators helped to address this discrepancy for MOF risk assessment, but not for hip fracture risk among Asian women
Branching Fractions for D0 -> K+K- and D0 -> pi+pi-, and a Search for CP Violation in D0 Decays
Using the large hadroproduced charm sample collected in experiment E791 at
Fermilab, we have measured ratios of branching fractions for the two-body
singly-Cabibbo-suppressed charged decays of the D0:
(D0 -> KK)/(D0 -> Kpi) = 0.109 +- 0.003 +- 0.003,
(D0 -> pipi)/(D0 -> Kpi) = 0.040 +- 0.002 +- 0.003, and
(D0 -> KK)/(D0 -> pipi) = 2.75 +- 0.15 +- 0.16. We have looked for
differences in the decay rates of D0 and D0bar to the CP eigenstates K+K- and
pi+pi-, and have measured the CP asymmetry parameters
A_CP(K+K-) = -0.010 +- 0.049 +- 0.012 and
A_CP(pi+pi-) = -0.049 +- 0.078 +- 0.030, both consistent with zero.Comment: 10 Postscript pages, including 2 figures. Submitted to Phys. Lett.
Search for CP Violation in Charged D Meson Decays
We report results of a search for CP violation in the singly
Cabibbo-suppressed decays D+ -> K- K+ pi+, phi pi+, K*(892)0 K+, and pi- pi+
pi+ based on data from the charm hadroproduction experiment E791 at Fermilab.
We search for a difference in the D+ and D- decay rates for each of the final
states. No evidence for a difference is seen. The decay rate asymmetry
parameters A(CP), defined as the difference in the D+ and D- decay rates
divided by the sum of the decay rates, are measured to be: A(CP)(K K pi) =
-0.014 +/- 0.029, A(CP)(phi pi) = -0.028 +/- 0.036, A(CP)(K*(892) K) = -0.010
+/- 0.050, and A(CP)(pi pi pi) = -0.017 +/- 0.042.Comment: 13 pages, 5 figures, 1 table; Elsevier LaTe
Search for Rare and Forbidden Dilepton Decays of the D+, Ds, and D0 Charmed Mesons
We report the results of a search for flavor-changing neutral current,
lepton-flavor violating, and lepton-number violating decays of D+, Ds, and D0
mesons (and their antiparticles) into modes containing muons and electrons.
Using data from Fermilab charm hadroproduction experiment E791, we examine the
pi,l,l and K,l,l decay modes of D+ and Ds and the l+l- decay modes of D0. No
evidence for any of these decays is found. Therefore, we present
branching-fraction upper limits at 90% confidence level for the 24 decay modes
examined. Eight of these modes have no previously reported limits, and fourteen
are reported with significant improvements over previously published results.Comment: 12 pages, 3 figures, LaTeX, elsart.cls, epsf.sty, amsmath.sty
Submitted to Physics Letters
Asymmetries between the production of D+ and D- mesons from 500 GeV/c pi- nucleon interactions as a function of xF and pt**2
We present asymmetries between the production of D+ and D- mesons in Fermilab
experiment E791 as a function of xF and pt**2. The data used here consist of
74,000 fully-reconstructed charmed mesons produced by a 500 GeV/c pi- beam on C
and Pt foils. The measurements are compared to results of models which predict
differences between the production of heavy-quark mesons that have a light
quark in common with the beam (leading particles) and those that do not
(non-leading particles). While the default models do not agree with our data,
we can reach agreement with one of them, PYTHIA, by making a limited number of
changes to parameters used
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