The Relationship between Lower Extremity Bone Mass and Body Mass Index in a NHANES Adolescent Population

The effect of body mass index (BMI) on bone mineral content (BMC) among adolescents has been researched yielding mixed results. This study explored the relationship of left lower extremity (LLE) BMC on BMI across the spectrum of weight in a large nationally representative group of adolescents. This descriptive study used secondary data from the publically accessible, cross-sectional survey files of the 1999-2004 Continuous National Health Assessment and Nutritional Examination Survey (NHANES) that contained whole body dual energy X‑ray absorptiometry (DXA) data as well as BMI calculations looking at the adolescent population 12- to19-year-olds at the time of the exam. The sample contained 5416 adolescents with males 59.7%; with Caucasian 27.3%, African American 32.1%, and Mexican American 34.0%; and with underweight 3.5%, normal weight 61.8%, overweight 15.8% and obese 18.9%. The analysis of the data used SAS survey regression examining 90 domains from the sample based on the three demographic groups of gender, race/ethnicity, and age category and their possible permutations. Each domain survey regression was performed five times, once for each of the five imputations of DXA data from each survey participant\u27s DXA scan. The five regression results were averaged in accordance with NHANES guidelines to yield a composite regression estimates with associated standard errors as results for the different domains. Results revealed a positive, linear relationship between BMI to LLE BMC with p \u3c 0.0001 for most of the domains. Results also revealed that the relationship between BMI to LLE BMC depended greatly on the demographic factors of gender, race/ethnicity and age category. Conclusions: The greater the slope of the regression line for a particular domain meant that the domain\u27s LLE BMC was more influenced by change in BMI. The rate that BMI affects BMC varies according to gender, race/ethnicity, and age and must be examined accordingly

Aerodynamic and heat transfer studies in a combustor-fired, fixed-vane cascade with film cooling

Pressure and heat transfer data has been generated in a high-pressure, high-temperature vane cascade. This cascade differs from many others seen in typical low-pressure facilities using room temperature air. Primarily, a natural gas-fired combustor generates realistic turbulence profiles in the high-temperature exhaust gases that pass through the vane cascade. The fixed-vane cascade test sections have film cooling holes machined into the surfaces in arrangements that closely model configurations seen in real-life first-row nozzle guide vanes (NGV). Theoretical coolant jet-to-crossflow blowing ratios (M) range from 0.5 to 3.0. Coolant jet-to-crossflow theoretical density ratios (DR) used for typical tests vary between 1.0 and 2.5. A strong relationship has been observed between blowing ratio and density ratio. Mostly due to increased mass associated with the addition of combustion gases, pressure data for heated crossflows shows slight decreases in crossflow-to-surface pressure ratios (PR) when compared to non-heated data. Heat transfer data consists of normalized metal temperatures (NMT) and heat transfer coefficients (HTC). All sets of NMT and HTC data at different crossflow-to-coolant temperature ratios (TR) show general increases with rising blowing ratio. Temperature ratios can be altered with the combustor’s integrated fuel control system. NMT data typically indicates better coolant performance for lower temperature ratios. Averaged overall endwall NMT values go through regions dependent on blowing ratio where varying the temperature ratio gives best performance. Higher blowing ratios cause lower NMT generally due to reduced coolant coverage along the vane suction surface (SS). HTC data reflects similar trends as the NMT data. At low blowing ratios, high HTC values near the passage throat on the endwall signify defined flow acceleration toward the throat. Higher HTCs evolve on the endwall in the region upstream of the throat with increases in coolant associated with higher blowing ratios. Vane HTC data shows best performance near the leading edge of the midspan plane where many film cooling holes have been located

Can Health Care Services Attract Retirees And Contribute to the Economic Sustainability of Rural Places?

The search for engines to power rural economic growth has gone beyond the traditional boundaries of the food and fiber sector to industries such as tourism and to schemes such as attracting metropolitan workers to commuter communities with rural amenities. A group that has been somewhat overlooked is retirees, who may wish to trade in urban or suburban life-styles for a more peaceful rural retirement. An industry that has been neglected is the health care industry, which is the most rapidly growing industry nationally and of particular interest to retirees and aging populations. This paper examines the importance of rural health care services in attracting migrants age 65+ to rural counties in Michigan. Results indicate that the number of health care workers has a positive effect on net in-migration, and that this effect is large and statistically significant for the 70+ age group. Implications for rural development strategies are discussed.elder migration, health care, rural development, Community/Rural/Urban Development,

Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

Introduction: Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas.Methods: We abstracted data from ClinicalTrials.gov (February 2000 - September 2013) and used individual study National Clinical Trial numbers to identify published trials (January 2007 - September 2016). We used descriptive statistics and chi-square tests to examine study characteristics by EM and non-EM status, and Kaplan-Meier curves and log-rank tests to compare time to publication of completed EM and non-EM studies.Results: We found 638 interventional EM trials and 59,512 non-EM interventional trials conducted in the United States between February 2000 and September 2013, registered on ClinicalTrials.gov. EM studies were significantly less likely than non-EM studies to be National Institutes of Health-funded or to evaluate a drug or biologic. However, EM studies had significantly larger sample sizes, and were significantly more likely to use randomization and blinding. Overall, 34.3% of EM and 26.0% of non-EM studies were published in peer-reviewed journals. By subspecialty, more EM trials concerned medical/surgical and psychiatric/neurological conditions than trauma.Conclusion: Although EM studies were less likely to have received federal or industry funding, and the EM portfolio consisted of only 638 trials over the 14-year study period, the quality of EM trials surpassed that of non-EM trials, based on indices such as randomization and blinding. This novel finding bodes well for the future of clinical EM research, as does the higher proportion of published EM than non-EM trials. Our study also revealed that trauma studies were under-represented among EM studies. Periodic assessment of EM trials with the metrics used here could provide an informative and valuable longitudinal view of progress in clinical EM research

A preliminary study of extended magnetic field structures in the ionosphere

Several plasma phenomena which are to be expected around a magnet in LEO were identified and analyzed qualitatively. The ASTROMAG cusp magnet will create an extended field whose strength drops to the ambient level over a scale length of approx. 15 m; the combined field has a complex topology with ring nulls and open and closed field lines. The entire configuration is moving through the partially ionized F-layer of the ionosphere at a speed slow compared to the local Alfven speed but fast compared to the ion sound speed. The ambient plasma crosses the extended field structure in a time short compared to the ion Larmor period yet long relative to the electron Larmor period. Thus, electrons behave as a magnetized fluid while ions move ballistically until reflected from higher fields near the cusp. Since the Debye length is short compared to the field scale length, an electrostatic shock-like structure forms to equilibrate the flows and achieve quasi-neutrality. The ambient plasma will be excluded from a cavity near the magnet. The size and nature of the strong interaction region in which the magnet significantly perturbs the ambient flow were determined by studying ion orbits numerically. Lecture viewgraphs summarizing these results are presented

FULL-SCALE VEHICLE CRASH TEST ON THE IOWA STEEL TEMPORARY BARRIER RAIL

One full-scale vehicle crash test was conducted on the Iowa Steel Temporary Barrier Rail. Test 15-1 was conducted with at 5,500 pound vehicle at 22.5 degrees and 60.6 mph. The overall test length of the barrier was 200 feet. The barrier was shop fabricated and transported to the test site in 20 foot length sections. The cross-section of the barrier consisted of two stacked steel HP 14x73 (A36) shapes with the edges of the flanges placed back to back and held together by welded steel straps spaced 5 feet on centers. The inside box section between the HP shapes was filled with concrete. The height of the barrier was 29 inches. The 20 foot length sections were bolted together at the test site. The location of the vehicle impact was 100 feet from the end of the barrier installation. This was also the location where two sections were bolted together. The test was evaluated according to the safety criteria in NCHRP 230 and also in the AASHTO guide specifications, performance level 2. The safety performance of the Iowa Steel Temporary Barrier Rail was determined to be satisfactory

NASA Light-Emitting Diodes for the Prevention of Oral Mucositis in Pediatric Bone Marrow Transplant Patients

Objective: The purpose of this study was to determine the effects of prophylactic near-infrared light therapy from light-emitting diodes (LEDs) in pediatric bone marrow transplant (BMT) recipients. Background Data: Oral mucositis (OM) is a frequent side effect of chemotherapy that leads to increased morbidity. Near-infrared light has been shown to produce biostimulatory effects in tissues, and previous results using nearinfrared lasers have shown improvement in OM indices. However, LEDs may hold greater potential for clinical applications. Materials and Methods: We recruited 32 consecutive pediatric patients undergoing myeloablative therapy in preparation for BMT. Patients were examined by two of three pediatric dentists trained in assessing the Schubert oral mucositis index (OMI) for left and right buccal and lateral tongue mucosal surfaces, while the patients were asked to rate their current left and right mouth pain, left and right xerostomia, and throat pain. LED therapy consisted of daily treatment at a fluence of 4 J/cm2 using a 670-nm LED array held to the left extraoral epithelium starting on the day of transplant, with a concurrent sham treatment on the right. Patients were assessed before BMT and every 2–3 days through posttransplant day 14. Outcomes included the percentage of patients with ulcerative oral mucositis (UOM) compared to historical epidemiological controls, the comparison of left and right buccal pain to throat pain, and the comparison between sides of the buccal and lateral tongue OMI and buccal pain. Results: The incidence of UOM was 53%, compared to an expected rate of 70–90%. There was also a 48% and 39% reduction of treated left and right buccal pain, respectively, compared to untreated throat pain at about posttransplant day 7 (p \u3c 0.05). There were no significant differences between sides in OMI or pain. Conclusion: Although more studies are needed, LED therapy appears useful in the prevention of OM in pediatric BMT patients

Rural Economic Sustainability and Background Checks on Workers in Rural Health Care Settings: Evidence from the Michigan Pilot Background Check Program.

This paper examines the effects of conducting criminal background checks on health care employees on employment in and economic viability of rural communities.Health Economics and Policy,

A Case of Successful Surgical Treatment of Migraine Headaches in a Patient with Sporadic Pulmonary Arteriovenous Malformations

Pulmonary arteriovenous malformations (PAVMs) are thin-walled aneurysms caused by abnormal communication between the pulmonary arteries and veins. Migraine headaches are sometimes the presenting clinical manifestation of PAVMs. Although embolotherapy, using detachable balloons or stainless steel coils, is generally accepted as the best choice for the treatment of multiple PAVMs, the mode of intervention for solitary PAVMs remains a subject of debate. We present a 43-yr-old woman with a 10-yr history of chronic migraines and dyspnea on exertion. She was discovered to have a large solitary centrally located PAVM, placing her at high risk of complications if she were to undergo percutaneous transcatheter embolization. She underwent successful surgical resection of her right middle lobe without complications, resulting in subsequent symptomatic improvement