Use of quantitative ultrasound scans of the calcaneus to diagnose osteoporosis in patients with rheumatoid arthritis

Background: Patients with rheumatoid arthritis are recognized as being at risk for osteoporosis as a result of the disease process as well as the medication used to treat it. This study was conducted to consider the use of calcaneal scanning with quantitative ultrasound—contact ultrasound bone analysis (CUBA)—to diagnose osteoporosis in patients with rheumatoid arthritis.Methods: Forty-six patients (11 men and 35 women) with established rheumatoid arthritis underwent dual-energy x-ray absorptiometry (DEXA) of the nondominant wrist andCUBA of the nondominant heel. Sensitivity, specificity, and positive and negative predictive values were used to determine the correlation between osteoporosis as diagnosedby the CUBA heel scan compared with the DEXA wrist scan given that DEXA is widely seen as the gold standard for the diagnosis of osteoporosis.Results: The CUBA heel scan revealed a sensitivity of 90% and a specificity of 44% for a diagnosis of osteoporosis compared with DEXA. The positive predictive value of theCUBA scan was 31%, and the negative predictive value was 94%. Therefore, if normal bone density is found using CUBA, there is 94% certainty this is correct. However, if osteoporosis is diagnosed using CUBA, there is only 31% certainty this is correct. In such instances a secondary scan using a different method (eg, DEXA) would be required. Future work should consider the effect of minor alterations to the equipment or scanning protocol, because this may improve diagnosis.Conclusions: The CUBA unit could be used as a primary screening device. Given the cost and accessibility issues associated with DEXA, quantitative ultrasound may have arole in screening for osteoporosis in the primary-care setting to determine the most appropriate routes of referral for patients requiring further investigations. <br/

President’s Column: JUDGES HAVE A JOB TO DO

In recent times, there has been a marked increase in attacks on the independence of the judiciary in democratic societies—Pakistan, Venezuela, Turkey, Canada, and the United States. These attacks are significantly more damaging when they emanate from the other branches of government—the legislative and the executive. In response, judges must speak out to preserve and protect judicial independence, a vital pillar in the architecture of healthy and vibrant democracy. The concept of judicial independence can be traced back to 18th century England. At its simplest, it means that the judiciary needs to be separated from the other branches of government. Courts should not be subject to improper influence from the other branches of government or from private and partisan interests. Though not a huge fan of the judiciary, President Andrew Jackson did say that “all rights secured to the citizens under the Constitution are worth nothing, and a mere bubble, except guaranteed to them by an independent and virtuous judiciary.” I particularly enjoy the colorful phrasing of a 19th century British Prime Minister, Lord Salisbury: “The judicial salad requires both legal and political vinegar, but disastrous effects will follow if due preparation is not observed.

President’s Column: JUDGES HAVE A JOB TO DO

In recent times, there has been a marked increase in attacks on the independence of the judiciary in democratic societies—Pakistan, Venezuela, Turkey, Canada, and the United States. These attacks are significantly more damaging when they emanate from the other branches of government—the legislative and the executive. In response, judges must speak out to preserve and protect judicial independence, a vital pillar in the architecture of healthy and vibrant democracy. The concept of judicial independence can be traced back to 18th century England. At its simplest, it means that the judiciary needs to be separated from the other branches of government. Courts should not be subject to improper influence from the other branches of government or from private and partisan interests. Though not a huge fan of the judiciary, President Andrew Jackson did say that “all rights secured to the citizens under the Constitution are worth nothing, and a mere bubble, except guaranteed to them by an independent and virtuous judiciary.” I particularly enjoy the colorful phrasing of a 19th century British Prime Minister, Lord Salisbury: “The judicial salad requires both legal and political vinegar, but disastrous effects will follow if due preparation is not observed.

President’s Column: “A GOOD JUDGE”

Founded in 1959, the American Judges Association has long been “The Voice of the Judiciary®.” This role has been amplified in recent times with the mission of “Making Better Judges®,” which is premised on the assumption that our members are good judges already. Electors and governments choose those whom they consider will make good judges. The AJA seeks to make good judges better. What makes a good judge has been the subject of extensive debate and dispute over the years by numerous judges, lawyers, and other commentators. Whether a judge is elected or appointed, it matters not. Among the two foremost qualities of making good judges, I would submit, are professional excellence and judicial temperament

President’s Column: A TRULY BROADER JUDICIAL HORIZON

The American Judges Association recently completed its annual conference in Toronto, Canada, from September 26 to 29, 2016. The theme of the conference was comparative law in Canada and the United States. It focused on issues of common interest to judges on both sides of the border. These included such contemporary topics as “Judicial Ethics and Social Media,” “Wrongful Convictions Across Borders,” “Cannabis and the Greening of North America,” and “Judge’s Role in Ensuring Constitutional Right to Counsel.” All sessions featured leading academics and judges from Canada and the United States. On one panel we were pleased to have the Chief Justice of the Supreme Court of Guam, Robert Torres. A memorable highlight was the eloquent address by Justice Rosalie Abella of the Supreme Court of Canada. She emphasized the critical role of the judiciary in ensuring the protection of basic human rights in a democracy

Testing and validating the CERES-wheat (Crop Estimation through Resource and Environment Synthesis-wheat) model in diverse environments

CERES-Wheat is a computer simulation model of the growth, development, and yield of spring and winter wheat. It was designed to be used in any location throughout the world where wheat can be grown. The model is written in Fortran 77, operates on a daily time stop, and runs on a range of computer systems from microcomputers to mainframes. Two versions of the model were developed: one, CERES-Wheat, assumes nitrogen to be nonlimiting; in the other, CERES-Wheat-N, the effects of nitrogen deficiency are simulated. The report provides the comparisons of simulations and measurements of about 350 wheat data sets collected from throughout the world

Tungsten resonance integrals and Doppler coefficients First quarterly progress report, Jul. - Sep. 1965

Resonance integrals and Doppler coefficients of samples of natural tungsten, tungsten isotopes, and uranium oxide tungsten fue