Use of depot medroxyprogesterone acetate and fracture risk

Depot medroxyprogesterone acetate (DMPA), which has a high rate of use among teenagers in Europe and the United States, has been associated with impaired bone mineral acquisition during adolescence and accelerated bone loss in later life. Studies on the association between DMPA use and fracture risk are limited.; We aimed at evaluating the relationship between use of hormonal contraceptives, specifically DMPA, and fracture risk.; We conducted a case-control analysis using the United Kingdom-based General Practice Research Database.; Participants were females aged 20-44 yr with an incident fracture diagnosis between 1995 and 2008.; Odds ratios (OR) with 95% confidence intervals (CI) of incident fracture in relation to exposure to DMPA or combined oral contraceptives were assessed. Adjustments were made for smoking, body mass index, and additional potential confounders.; We identified 17,527 incident fracture cases and 70,130 control patients (DMPA exposure: 11 and 8%, respectively). Compared with nonuse, current use of one to two, three to nine, or 10 or more DMPA prescriptions yielded adjusted OR for fractures of 1.18 (95% CI = 0.93-1.49), 1.36 (95% CI = 1.15-1.60), and 1.54 (95% CI = 1.33-1.78), respectively. Fracture risk was highest after longer treatment duration (<2-3 yr), and there was no difference in patients below and above the age of 30 yr. For users of combined estrogen-containing oral contraceptives, the OR were around 1.; This population-based study suggests that use of DMPA is associated with a slightly increased risk of fractures

Building CMS Pixel Barrel Detectur Modules

For the barrel part of the CMS pixel tracker about 800 silicon pixel detector modules are required. The modules are bump bonded, assembled and tested at the Paul Scherrer Institute. This article describes the experience acquired during the assembly of the first ~200 modules.Comment: 5 pages, 7 figures, Vertex200

Swiss ethnoveterinary knowledge on medicinal plants - a within-country comparison of Italian speaking regions with north-western German speaking regions

BACKGROUND: Ethnoveterinary knowledge in Europe may play an important role as a basis for sustainable treatment options for livestock. Aims of our study were (a) to compare the ethnoveterinary practices of two culturally and sociodemographically different regions of Switzerland, (b) to compare results with earlier ethnoveterinary studies conducted in Switzerland and in adjacent Italian regions and, (c) to evaluate possible reasons for regional differences in European ethnoveterinary medicine. METHODS: 25 interviews were conducted in 2014 in all Italian speaking regions (ItR) of Switzerland, and 31 interviews were held in five north-western German speaking Cantons (GeC). Semi-structured questionnaires were used to collect detailed information regarding plant species, mode of preparation, dosage, route of administration, category of use, origin of knowledge, frequency of use, and satisfaction with outcomes of the treatments. RESULTS: A total of 162 homemade remedies in ItR and 219 in GeC were reported, out of which 125 and 145, respectively, were reported to contain only one plant species (homemade single species herbal remedy report, HSHR). 44 ItR and 43 GeC plant species were reported to treat livestock, of which only a half were used in both regions. For each HSHR, we classified the treatment intention of all use reports (UR), leading to a total of 205 and 219 UR in ItR and GeC respectively. While cattle were the most often treated livestock species in both study regions, in ItR 40% of UR were administered to small ruminants. Main indications in both regions were gastrointestinal diseases and skin afflictions, but in ItR a high number of URs were reported as antiparasitics. URs were mainly handed down from the past generation, but in GeC the source of knowledge for 20% of URs were from courses. Regarding the used plant species, ItR showed a higher concordance with Swiss than Italian studies, but with some differences to all regions. A total of 22 (14 ItR; 8 GeC) plant species in this study have not been reported before in ethnoveterinary studies of Swiss and Italian alpine regions. CONCLUSIONS: ItR and GeC, show differences and similarities with respect to their own ethnoveterinary practices and earlier Swiss and Italian ethnoveterinary studies. Linguistic, geographical, as well as social and farm-structural conditions influence the regional ethnoveterinary knowledge. However, political borders seem to be more important than language or geographical barriers

Interpretation of Nuclear Quadrupole Resonance Spectra in Doped La2_2CuO4_4

The nuclear quadrupole resonance (NQR) spectrum of strontium doped La$_2$CuO$_4$ surprisingly resembles the NQR spectrum of La$_2$CuO$_4$ doped with excess oxygen, both spectra being dominated by a main peak and one principal satellite peak at similar frequencies. Using first-principles cluster calculations this is investigated here by calculating the electric field gradient (EFG) at the central copper site of the cluster after replacing a lanthanum atom in the cluster with a strontium atom or adding an interstitial oxygen to the cluster. In each case the EFG was increased by approximately 10 % leading unexpectedly to the explanation that the NQR spectra are only accidentally similar and the origins are quite different. Additionally the widths of the peaks in the NQR spectra are explained by the different EFG of copper centres remote from the impurity. A model, based on holes moving rapidly across the planar oxygen atoms, is proposed to explain the observed increase in frequency of both the main and satellite peaks in the NQR spectrum as the doping concentration is increased

Communication and optimal hierarchical networks

We study a general and simple model for communication processes. In the model, agents in a network (in particular, an organization) interchange information packets following simple rules that take into account the limited capability of the agents to deal with packets and the cost associated to the existence of open communication channels. Due to the limitation in the capability, the network collapses under certain conditions. We focus on when the collapse occurs for hierarchical networks and also on the influence of the flatness or steepness of the structure. We find that the need for hierarchy is related to the existence of costly connections.Comment: 7 pages, 2 figures. NATO ARW on Econophysic

Extended-spectrum β-lactamase-producing Gram-negative pathogens in community-acquired urinary tract infections: an increasing challenge for antimicrobial therapy

Background: Extended-spectrum β-lactamases (ESBLs) are an increasing challenge in the treatment of urinary tract infections (UTIs), and also in the community. We aimed to investigate the characteristics of patients with UTIs due to ESBL-producing Escherichia coli and to assess the risk factors for ESBLs in community-acquired isolates. Methods: We performed a retrospective study from January 1, 2007 to December 31, 2009 at a tertiary care teaching hospital in Switzerland, comparing patients with community-acquired versus healthcare-associated UTIs due to ESBL-producing E. coli. Additionally, we investigated the antimicrobial susceptibility of these isolates. Results: A total of 123 patients were studied, of whom 79 (64%) had community-acquired and 44 (36%) had healthcare-associated UTIs. Community-acquired isolates were associated with acute uncomplicated UTIs (odds ratio [OR] 6.62, 95% confidence interval [CI] 1.83-36.5, P<0.001). Risk factors were recurrent UTI (OR 3.04, 95% CI 1.14-9.14, P=0.022) and female sex (OR 2.46, 95% CI 1.01-6.08). Community-acquired ESBL-producing E. coli urinary isolates showed high resistance rates to most of the currently used oral antimicrobial agents, including β-lactam antibiotics (amoxicillin-clavulanic acid, 69.6% resistance), quinolones (ciprofloxacin, 84.8% resistance; norfloxacin, 83.9% resistance), and trimethoprim-sulfamethoxazole (75.9% resistance), except for nitrofurantoin (15% resistance) and fosfomycin (0% resistance). Conclusion: UTI due to ESBL-producing E. coli are emerging, and also in a country with low antibiotic use. Because of increasing antibiotic resistance rates of E. coli to current standard therapy and because of the resistance patterns of ESBL-producing E. coli, guidelines for the management of UTIs must be revised. Fosfomycin or nitrofurantoin are recommended for the first-line empirical oral treatment of community-acquired uncomplicated UTI

CMS Barrel Pixel Detector Overview

The pixel detector is the innermost tracking device of the CMS experiment at the LHC. It is built from two independent sub devices, the pixel barrel and the end disks. The barrel consists of three concentric layers around the beam pipe with mean radii of 4.4, 7.3 and 10.2 cm. There are two end disks on each side of the interaction point at 34.5 cm and 46.5 cm. This article gives an overview of the pixel barrel detector, its mechanical support structure, electronics components, services and its expected performance.Comment: Proceedings of Vertex06, 15th International Workshop on Vertex Detector

Exploring the use of strategic frameworks in dental practice

This paper explores the use of strategic frameworks in NHS and private dental practice. It reviews the policy context of dentistry and suggests the challenges in this context will require dental practices to prioritise understanding and engagement with a strategic approach. A strategic approach will be required in order to enhance and improve performance. Two specific strategic frameworks will be explored in terms of their relevance to NHS and private dental practic

Radiation hardness of CMS pixel barrel modules

Pixel detectors are used in the innermost part of the multi purpose experiments at LHC and are therefore exposed to the highest fluences of ionising radiation, which in this part of the detectors consists mainly of charged pions. The radiation hardness of all detector components has thoroughly been tested up to the fluences expected at the LHC. In case of an LHC upgrade, the fluence will be much higher and it is not yet clear how long the present pixel modules will stay operative in such a harsh environment. The aim of this study was to establish such a limit as a benchmark for other possible detector concepts considered for the upgrade. As the sensors and the readout chip are the parts most sensitive to radiation damage, samples consisting of a small pixel sensor bump-bonded to a CMS-readout chip (PSI46V2.1) have been irradiated with positive 200 MeV pions at PSI up to 6E14 Neq and with 21 GeV protons at CERN up to 5E15 Neq. After irradiation the response of the system to beta particles from a Sr-90 source was measured to characterise the charge collection efficiency of the sensor. Radiation induced changes in the readout chip were also measured. The results show that the present pixel modules can be expected to be still operational after a fluence of 2.8E15 Neq. Samples irradiated up to 5E15 Neq still see the beta particles. However, further tests are needed to confirm whether a stable operation with high particle detection efficiency is possible after such a high fluence.Comment: Contribution to the 11th European Symposium on Semiconductor Detectors June 7-11, 2009 Wildbad Kreuth, German

Accuracy of a New Wrist Cuff Oscillometric Blood Pressure Device: Comparisons with Intraarterial and Mercury Manometer Measurements

Accurate measurement of arterial blood pressure is of great importance for the diagnosis and treatment of hypertension. Because of the chronic nature of antihypertensive drug therapy, the involvement of the patient in blood pressure control is desirable. Such an involvement, however, is only feasible if simple, user-friendly, and precise blood pressure measurement devices are available. In this study we tested a new wrist cuff oscillometric blood pressure measurement device in 100 consecutive patients undergoing cardiac catheterization. Blood pressures were simultaneously taken intraarterially (axillary artery) and with a mercury manometer and stethoscope or noninvasive measurement device (OMRON R3). Intraarterial measurements were directly compared with two measurements taken in random order with either an arm cuff mercury manometer or the wrist cuff device. Systolic and diastolic blood pressure as assessed with the mercury manometer was higher, especially when compared with the intraarterial and the wrist cuff values, which were comparable. Correlations of blood pressure values with intraarterial measurement were 0.86 systolic and 0.75 diastolic (P < .01) for the wrist cuff and 0.84 systolic (P < .01) and 0.59 diastolic (P < .05) for the mercury manometer measurements. Reproducibility of both measurements was good for the wrist cuff device ([systolic/diastolic]: r = 0.94/0.92; P < .01) and the mercury manometer (r = 0.97/0.88; P < .01). Both methods overestimated high diastolic values, whereas only the wrist cuff underestimated high systolic values. Thus, the new oscillometric wrist cuff blood pressure measurement device measures arterial blood pressure with great accuracy and reproducibility. As compared with intraarterial values, the wrist cuff device overestimated high diastolic and underestimated high systolic blood pressure values. Blood pressure values as measured by the mercury manometer were higher than intraarterial values and those of the wrist cuff. Both noninvasive devices overestimated high diastolic value