Songs Without Words for Cello and Strings

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library

Daphne's Wedding

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library

Songs Without Words for Cello and Strings

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library

Can fall risk be incorporated into fracture risk assessment algorithms: a pilot study of responsiveness to clodronate

Fall risk does not significantly impact on the efficacy of the bisphosphonate clodronate in reducing the incidence of fracture. INTRODUCTION: The debate about the efficacy of skeletal therapies on fracture risk in women at increased risk of falling continues. We determined whether fall risk impeded the efficacy of clodronate to reduce osteoporotic fracture incidence. METHODS: This is a post hoc analysis of a 3-year placebo-controlled study of bisphosphonate clodronate involving 5,212 women aged 75 years or more. At entry, self-reported multiple falls in the previous month and ability to rise from a chair were documented. Their interaction with treatment efficacy was examined using Poisson regression. RESULTS: Oral doses of clodronate at 800 mg daily reduced osteoporotic fracture incidence by 24% (hazard ration (HR) 0.76, 95% confidence interval 0.63-0.93). The efficacy was similar in women with recent multiple falls compared to those without (HR 0.61 vs. 0.77, p value for interaction >0.30) or impaired ability in rising compared to those with no impairment (HR 0.79 vs. 0.74, respectively; p value > 0.30). CONCLUSION: Fall risk does not significantly impact on the anti-fracture efficacy of clodronate. If confirmed with other agents, fall risk may be incorporated into risk assessment tools designed to target skeletal therapies

Standards of performance - expectations and reality A study of the problems of interpreting the APU science survey

SIGLELD:1518.8279(APU-OP--3) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Reproducibility and diagnostic sensitivity of ultrasonometry of the phalanges to assess osteoporosis.

OBJECTIVE: The present study was designed to assess the reproducibility and the diagnostic sensitivity of the amplitude-dependent speed of sound (SoS) at the distal metaphysis of the proximal phalanges. METHOD: Fourteen presumably healthy volunteers were repeatedly measured every 6 weeks for approximately 6 months in order to assess the reproducibility of the SoS of the phalanges. We recruited 91 post-menopausal women, aged 55-75 years, who were divided in three groups according to their lumbar bone mineral density (BMD) and the existence of prevalent vertebral fractures. The objective was to evaluate the diagnostic sensitivity of SoS measurements. We used DBM Sonic 1200 equipment, and assessed the velocity at which US cross the phalanx in a lateral-medial direction. In post-menopausal women, BMD was measured by dual energy X-ray absorptiometry (DXA) at the level of the lumbar spine, the total zone of the non-dominant hip and the femoral neck zone of the non-dominant hip. RESULTS: The precision of the SoS measurements was 0.71+/-0.05% (mean+/-S.E.M) whereas the reproducibility was 0.95+/-0.06%. Subjects with low BMD or prevalent fractures had significantly lower values of SoS (P < 0.001) than the controls. ROC curve analysis applied to the study population confirmed that SoS was able to discriminate between the controls and osteoporotic subjects (area under the ROC curves were 0.82 (low bone mineral density) and 0.85 (prevalent fractures), respectively). Hip BMD was found to be the most significant variable when comparing the controls and the low density patients by stepwise discrimination and SoS significantly improved the discrimination between the groups when added to the hip BMD. The hip BMD was again the most discriminant variable when applying the same techniques to controls and patients with prevalent fractures, followed by SoS and lumbar BMD. A cut-off value of 1881 m/s is defined for SoS by logistic discrimination and likelihood ratio function. With this value, the sensitivity and the specificity for SoS used in the diagnosis of established osteoporosis were, 81.5% and 79.3%, respectively. Sensitivity and specificity were significantly improved when combining ultrasonometry and densitometry. CONCLUSION: Measurement of ultrasound velocity at the phalanges appears to be a precise and reproducible technique. SoS discriminates between normal post-menopausal women and patients with either low lumbar BMD or prevalent fractures to the same extent as BMD measurements

Quantitative ultrasound of bone and calcium intake in suburban males in Sri Lanka

Background: While only 30% of all hip fractures occurred in Asia in 1990, more than 50% will occur by the year 2050. We investigated the relationship between the Stiffness Index (SI), assessed with quantitative ultrasound, and calcium intake in a cross-sectional survey of suburban males of different ages. Methods: From 496 people who were invited, 274 participated (55%). A single operator performed quantitative ultrasound measurements at the right calcaneus using Lunar Achilles. We derived the Sri Lankan T-score values for SI. Calcium intake was measured using semiquantitative food frequency questionnaire to measure the previous 7 days intake. Results: There was gradual decrease in mean SI from the age of 30 years. Eighty percent of the men between 21–40 years had normal T-scores. This percentage value fell to high 60s in men between 41–70 years. After 71 years, 35% had normal T-scores and 30% had T-scores less than –2.5. The mean calcium intake was 197 mg/day (95% CI 187–287 mg). Conclusions: This is the first population-based study done in Sri Lanka regarding calcium intake and SI in males. Although few men had low T-scores according to SI after 40 years, bone health of elderly (after 71 years) is at risk levels. The overall prevalence of low SI was negligible (4%) even with low calcium intake. Age is the only factor that influenced SI