Medical management of patients after atypical femur fractures: a systematic review and recommendations from the European Calcified Tissue Society

Context Atypical femur fractures (AFFs) are serious adverse events associated with bisphosphonates and often show poor healing. Evidence acquisition We performed a systematic review to evaluate effects of teriparatide, raloxifene, and denosumab on healing and occurrence of AFF. Evidence synthesis We retrieved 910 references and reviewed 67 papers, including 31 case reports, 9 retrospective and 3 prospective studies on teriparatide. There were no RCTs. We pooled data on fracture union (n = 98 AFFs on teriparatide) and found that radiological healing occurred within 6 months of teriparatide in 13 of 30 (43%) conservatively managed incomplete AFFs, 9 of 10 (90%) incomplete AFFs with surgical intervention, and 44 of 58 (75%) complete AFFs. In 9 of 30 (30%) nonoperated incomplete AFFs, no union was achieved after 12 months and 4 (13%) fractures became complete on teriparatide. Eight patients had new AFFs during or after teriparatide. AFF on denosumab was reported in 22 patients, including 11 patients treated for bone metastases and 8 without bisphosphonate exposure. Denosumab after AFF was associated with recurrent incomplete AFFs in 1 patient and 2 patients of contralateral complete AFF. Eight patients had used raloxifene before AFF occurred, including 1 bisphosphonate-naïve patient. Conclusions There is no evidence-based indication in patients with AFF for teriparatide apart from reducing the risk of typical fragility fractures, although observational data suggest that teriparatide might result in faster healing of surgically treated AFFs. Awaiting further evidence, we formulate recommendations for treatment after an AFF based on expert opinion

Prediction of Zamorano cheese quality by near-infrared spectroscopy assessing false non-compliance and false compliance at minimum permitted limits stated by designation of origin regulations

Near-infrared transmittance (NIT) spectroscopy was used to predict the percentage in weight of the fat, dry matter, protein and fat/dry matter contents in Zamorano cheeses, protected with a Designation of Origin by the European Union. A total of 42 cheeses submitted to official control were analysed by reference methods. Samples were scanned (850–1050 nm) and predictive equations were developed using Partial Least Squares regression with a cross-validation step. Eight pretreatments independent from the remaining calibration samples were first considered. The most adequate one was that performing the second derivative (using a Savitzky–Golay method with a nine-point window and a second-order polynomial) followed by the standard normal variate transformation. Percentages of the root mean square error in cross-validation, the coefficient of determination and the mean of the absolute value of relative errors found were, respectively, for fat (0.62; 96.16; 1.05), dry matter (0.76; 96.03; 0.83), protein (0.41; 97.82; 0.81) and the fat/dry matter ratio (0.61; 92.51; 0.66). At a 99% confidence level, the trueness of the NIT+PLS methods for fat, dry matter and protein was verified. The official regulation for Zamorano cheese demands minimum permitted limits on the percentages in weight for protein (25%), dry matter (55%) and the ratio of fat to dry matter (45%). The adaptation of both the decision limit and the detection capability to the case of a minimum permitted limit (CDα and CDβ, respectively) when a Partial Least Squares calibration is used has been applied for the first time for a food product protected by a Designation of Origin. The values of CDα with a probability of false non-compliance equal to 0.05 and of CDβ when, in addition, the probability of false compliance was equal to or less than 0.05, both provided by the corresponding NIT+PLS-based method, were, respectively, for protein (24.78%; 24.57%), dry matter (54.14%; 53.28%) and the fat/dry matter ratio (44.39%; 43.78%).authorsthankthefinancialsupportprovidedbyMinisterio de CienciaeInnovacio´n (CTQ2011-26022)andJuntadeCastillay Leo´n (BU108A11-2

Toward a Multifaceted Heuristic of Digital Reading to Inform Assessment, Research, Practice, and Policy

In this commentary, the author explores the tension between almost 30 years of work that has embraced increasingly complex conceptions of digital reading and recent studies that risk oversimplifying digital reading as a singular entity analogous with reading text on a screen. The author begins by tracing a line of theoretical and empirical work that both informs and complicates our understanding of digital literacy and, more specifically, digital reading. Then, a heuristic is proposed to systematically organize, label, and define a multifaceted set of increasingly complex terms, concepts, and practices that characterize the spectrum of digital reading experiences. Research that informs this heuristic is used to illustrate how more precision in defining digital reading can promote greater clarity across research methods and advance a more systematic study of promising digital reading practices. Finally, the author discusses implications for assessment, research, practice, and policy

Mossbauer spectroscopy applied to the oxidized and semi-reduced states of the iron-molybdenum cofactor of nitrogenase

Mossbauer parameters at 125K for both the oxidized and semi-reduced states of FeMoco isolated from the MoFe protein of nitrogenase of [delta]/Fe=0.32 and 0.37 mm/s and [Delta]Eq=0.84 and 0.71 mm/s, respectively, are reported. FeMoco(ox) fits the Debye model perfectly from 4.2-125K and has a S=0 ground state. FeMoco(ox) apparently contains 10-20% FeMoco(s-r) and , possibly as a result of the spontaneous oxidation phenomenon. Quantitation of the spectra indicates a Fe:Mo ratio of 5+/-1:1 and the similar quadrupole splittings and isomer shifts suggest a similar environment for all iron atoms.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27843/1/0000253.pd

Representational predicaments for employees: Their impact on perceptions of supervisors\u27 individualized consideration and on employee job satisfaction

A representational predicament for a subordinate vis-à-vis his or her immediate superior involves perceptual incongruence with the superior about the subordinate\u27s work or work context, with unfavourable implications for the employee. An instrument to measure the incidence of two types of representational predicament, being neglected and negative slanting, was developed and then validated through an initial survey of 327 employees. A subsequent substantive survey with a fresh sample of 330 employees largely supported a conceptual model linking being neglected and negative slanting to perceptions of low individualized consideration by superiors and to low overall job satisfaction. The respondents in both surveys were all Hong Kong Chinese. Two case examples drawn from qualitative interviews illustrate and support the conceptual model. Based on the research findings, we recommend some practical exercises to use in training interventions with leaders and subordinates. © 2013 Copyright Taylor and Francis Group, LLC

Cortical brain abnormalities in 4474 individuals with schizophrenia and 5098 control subjects via the enhancing neuro Imaging genetics through meta analysis (ENIGMA) Consortium

BACKGROUND: The profile of cortical neuroanatomical abnormalities in schizophrenia is not fully understood, despite hundreds of published structural brain imaging studies. This study presents the first meta-analysis of cortical thickness and surface area abnormalities in schizophrenia conducted by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Schizophrenia Working Group. METHODS: The study included data from 4474 individuals with schizophrenia (mean age, 32.3 years; range, 11-78 years; 66% male) and 5098 healthy volunteers (mean age, 32.8 years; range, 10-87 years; 53% male) assessed with standardized methods at 39 centers worldwide. RESULTS: Compared with healthy volunteers, individuals with schizophrenia have widespread thinner cortex (left/right hemisphere: Cohen's d = -0.530/-0.516) and smaller surface area (left/right hemisphere: Cohen's d = -0.251/-0.254), with the largest effect sizes for both in frontal and temporal lobe regions. Regional group differences in cortical thickness remained significant when statistically controlling for global cortical thickness, suggesting regional specificity. In contrast, effects for cortical surface area appear global. Case-control, negative, cortical thickness effect sizes were two to three times larger in individuals receiving antipsychotic medication relative to unmedicated individuals. Negative correlations between age and bilateral temporal pole thickness were stronger in individuals with schizophrenia than in healthy volunteers. Regional cortical thickness showed significant negative correlations with normalized medication dose, symptom severity, and duration of illness and positive correlations with age at onset. CONCLUSIONS: The findings indicate that the ENIGMA meta-analysis approach can achieve robust findings in clinical neuroscience studies; also, medication effects should be taken into account in future genetic association studies of cortical thickness in schizophrenia

A search for the decay B+→K+ννˉB^+ \to K^+ \nu \bar{\nu}

We search for the rare flavor-changing neutral-current decay $B^+ \to K^+ \nu \bar{\nu}$ in a data sample of 82 fb$^{-1}$ collected with the {\sl BABAR} detector at the PEP-II B-factory. Signal events are selected by examining the properties of the system recoiling against either a reconstructed hadronic or semileptonic charged-B decay. Using these two independent samples we obtain a combined limit of ${\mathcal B}(B^+ \to K^+ \nu \bar{\nu})<5.2 \times 10^{-5}$ at the 90% confidence level. In addition, by selecting for pions rather than kaons, we obtain a limit of ${\mathcal B}(B^+ \to \pi^+ \nu \bar{\nu})<1.0 \times 10^{-4}$ using only the hadronic B reconstruction method.Comment: 7 pages, 8 postscript figures, submitted to Phys. Rev. Let