Bone Health Improvement Protocol

Introduction. Metabolic bone disease is a malady that causessignificant morbidity and mortality to a patient who has sustaineda fragility fracture. There is currently no protocol toprevent secondary fragility fracture at our institution. The objectiveof this study was to create an appropriate protocol forimplementing clinical pathways for physicians to diagnose andtreat osteoporosis and fragility fractures by educating patients. Methods. A multidisciplinary team created an appropriateprotocol that could be implemented in an inpatient setting.A thorough literature review was conducted to evaluatepotential barriers and efficacious methods of protocol design. Results. A bone health improvement protocol was developed.Any patient over the age of 50 who sustains a fracture from lowenergy trauma, such as a fall from standing or less, should beconsidered to place into this protocol. These patients receivededucation on metabolic bone disease, a prescription for highdose vitamin D therapy, and laboratory testing to determinethe etiology of their metabolic bone disease. Continuity of careof these patients with their primary care provider was providedfor further management of their metabolic bone disease andevaluation of their disease after discharged from the hospital. Conclusion. Comprehensive secondary prevention should consistof osteoporosis assessment and treatment together with afall risk assessment. With this protocol, secondary fragility fracturespotentially could be prevented. KS J Med 2017;10(3):62-66

Applying Conditional Latin Hypercube (cLHS) for selecting soil sampling location for Digital Soil Mapping at Parque Estadual da Mata Seca, MG, Brazil.

The use of the Conditional Latin Hypercube (cLHS) to select soil samples location to be used in the prediction of soil properties as soil organic carbon seems to be an important tool to decrease costs and subjectivity of sampling schemes. The main objective of this work was to test this method in a no sampled area, aiming to evaluate its efficiency in Digital Soil Mapping (DSM) procedures. The results show that this method was able to significantly increase the reliability in the spatial distribution of the sampled points in Parque Estadual da Mata Seca (PEMS). The study area is located in the North of Minas Gerais State, Brazil, in Tropical Dry Forest (TDF) ecosystems mainly. In this study, the cLHS algorithm developed by Minasny & McBratney (2006) was used, in addition to some ancillary data as Land Use/Land Cover and Normalized Difference Vegetation Index (NDVI), in order to select 60 soil sampling location to the study of soil organic carbon and others soil properties. The cLHS will be further analyzed in its performance to select representative points to be sampled and how this method could be helpful for DSM

Digital soil mapping for soil class prediction in a dry forest of Minas Gerais, Brazil.

Investment on soil survey has become scarce over the past decades. Digital Soil Mapping (DSM) techniques emerged as an economic alternative to produce soil maps. We applied a classification tree algorithm to predict soil suborders in a tropical dry forest area with 102 km2 in the north of Minas Gerais state, Brazil. We tested environmental covariates with different spatial resolutions as predictors, and used 361 observations to train the model and 64 independent observations to validate the map. Prediction models included three decision trees and one logistic regression model. The results showed that freely available environmental covariates with coarser spatial resolution can produce as good or better suborder predictions than more expensive covariates with finer resolution

Cardiovascular risk in patients without known cardiovascular disease

Understanding the risks of atherosclerotic cardiovascular disease (CVD) allows for better patient education and management. Multiple risk models have been validated in large patient populations and provide insights into the risks associated with CVD. When assessing such risks, we suggest using a model that predicts myocardial infarction, cardiovascular death, and/or cerebrovascular events. In this review, we analyze several risk models and stratify the risks associated with CVD. We suggest that appropriate profiling of patients at-risk of CVD will lead to better physician recognition and treatment of modifiable risk factors, appropriate application of ATP III treatment for hyperlipidemia, and achieving optimal blood pressure control.Understanding the risks of atherosclerotic cardiovascular disease (CVD) allows for better patient education and management. Multiple risk models have been validated in large patient populations and provide insights into the risks associated with CVD. When assessing such risks, we suggest using a model that predicts myocardial infarction, cardiovascular death, and/or cerebrovascular events. In this review, we analyze several risk models and stratify the risks associated with CVD. We suggest that appropriate profiling of patients at-risk of CVD will lead to better physician recognition and treatment of modifiable risk factors, appropriate application of ATP III treatment for hyperlipidemia, and achieving optimal blood pressure control

Sports review: A content analysis of the International Review for the Sociology of Sport, the Journal of Sport and Social Issues and the Sociology of Sport Journal across 25 years

The International Review for the Sociology of Sport, the Journal of Sport and Social Issues and Sociology of Sport Journal have individually and collectively been subject to a systematic content analysis. By focusing on substantive research papers published in these three journals over a 25-year time period it is possible to identify the topics that have featured within the sociology of sport. The purpose of the study was to identify the dominant themes, sports, countries, methodological frameworks and theoretical perspectives that have appeared in the research papers published in these three journals. Using the terms, identified by the author(s), that appear in the paper’s title, abstract and/or listed as a key word, subject term or geographical term, a baseline is established to reflect on the development of the sub-discipline as represented by the content of these three journals. It is suggested that the findings illustrate what many of the more experienced practitioners in the field may have felt subjectively. On the basis of this systematic, empirical study it is now possible to identify those areas have received extensive coverage and those which are under-researched within the sociology of sport. The findings are used to inform a discussion of the role of academic journals and the recent contributions made by Michael Silk, David Andrews, Michael Atkinson and Dominic Malcolm on the past, present and future of the ‘sociology of sport’

Implementing Groundness Analysis with Definite Boolean Functions

The domain of definite Boolean functions, Def, can be used to express the groundness of, and trace grounding dependencies between, program variables in (constraint) logic programs. In this paper, previously unexploited computational properties of Def are utilised to develop an efficient and succinct groundness analyser that can be coded in Prolog. In particular, entailment checking is used to prevent unnecessary least upper bound calculations. It is also demonstrated that join can be defined in terms of other operations, thereby eliminating code and removing the need for preprocessing formulae to a normal form. This saves space and time. Furthermore, the join can be adapted to straightforwardly implement the downward closure operator that arises in set sharing analyses. Experimental results indicate that the new Def implementation gives favourable results in comparison with BDD-based groundness analyses

Autoantibody detection for diagnosis in direct immunofluorescence negative mucous membrane pemphigoid: ocular and other sites compared

Objective: To assess whether a panel of serum pemphigoid autoantibody tests could be used to confirm an immunopathological diagnosis of mucous membrane pemphigoid (MMP) in direct immunofluorescent negative (DIF-) MMP patients. / Design: Prospective cross-sectional study. / Subjects and controls: 76 patients with MMP involving ocular and non-ocular sites with 45 matched controls. / Tests: Enzyme linked immunosorbent assays (ELISA) for BP180 and BP230 (MBL International®), IgA and IgG indirect immunofluorescence on human salt-split skin (IIF SSS) and the keratinocyte footprint assay for anti-laminin 332 antibodies. / Main outcome measures: Sensitivity and specificity of autoantibody detection; significant differences for individual tests and test combinations for MMP involving different sites. / Results: All DIF- Cases (24/76, 31.8%) had either ocular only disease or ocular involvement in multi-site disease. Serum pemphigoid autoantibodies were detected in 29/76 (38.2%) of all MMP patients compared to 3/45 (6.7%) of controls. Autoantibody reactivity detected by any one or more of the tests was present in 6/24 (25%) DIF- cases compared to 22/49 (44.9%) in DIF positive (DIF+). Compared to controls ocular only MMP serum reactivity was not significantly different for any test or test combination whereas DIF- multisite ocular MMP differed for one ELISA and 3/7 test combinations. By contrast, for DIF+ non ocular MMP all the individual tests, apart from IgA IIF, and all test combinations were significantly different compared to controls. For the whole MMP cohort the sensitivity of all tests was low having a maximum of 21.05% for BP180 reactivity, increasing to 38.16% for an optimal test combination. Disease activity was strongly associated with positive serology findings. / Conclusions: Pemphigoid serum autoantibody tests did not provide alternative immunopathological evidence of MMP in ocular only MMP patients but had limited value in DIF- multisite ocular MMP. The requirement for immunopathological confirmation of MMP by autoantibody detection is inappropriate for DIF- ocular only MMP resulting in missed diagnoses, delayed therapy and poor outcomes. Alternative diagnostic criteria for MMP with ocular involvement are required, to exclude the other causes of scarring conjunctivitis, until more sensitive and specific immunopathology tests become available