Standing Up to Osteoporosis

Educational Objectives 1. To provide basic information about osteoporosis, including risk factors, diagnostic testing, treatment, and prevention. 2. To get you to help us spread the word that osteoporosis can be diagnosed and treated, and that there are things you can do to decrease your future risk for developing osteoporosis

Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software

Community Recommendations for Improving Sustainable Scientific Software Practices

Multiple focus groups were conducted to elicit perspectives from members of the Earth science informatics community on the sustainability of scientific software. Recommendations that the participants offered for near-term community actions and activities are described

Complications of nephrogenic systemic fibrosis following repeated exposure to gadolinium in a man with hypothyroidism: a case report

Introduction Nephrogenic systemic fibrosis is a condition that has recently been recognized in patients with chronic renal disease and is associated with use of gadolinium-based contrast agents of ubiquitous use in magnetic resonance imaging scans. The condition is believed to arise through inadequate renal clearance of the gadolinium-based contrast agents, resulting in bodily deposition of the gadolinium; this is most widely recognized in the skin, but also occurs in other tissues. Case presentation We report the case of a 52-year-old Caucasian man with hypothyroidism and chronic renal disease who developed nephrogenic systemic fibrosis upon repeated exposure to gadolinium, and who presented with a subsequent malabsorption of levothyroxine. This malabsorption resolved only partially upon amelioration of other conditions that might contribute to malabsorption, including edema and infectious diarrhea. The presence of gadolinium was quantified in specimens from his gastrointestinal tract. Our patient otherwise demonstrated adequate gastrointestinal nutritive absorption, objectively shown by normal albumin levels, resolution of diarrhea, and maintenance of his bodily weight. Conclusions Our observations suggest that nephrogenic systemic fibrosis can also affect tissue of the gastrointestinal tract, potentially contributing to partial malabsorption of levothyroxine in patients with hypothyroidism

Lithio­marsturite, LiCa2Mn2Si5O14(OH)

Lithio­marsturite, ideally LiCa2Mn2Si5O14(OH), is a member of the pectolite–pyroxene series of pyroxenoids (hydro­pyroxenoids) and belongs to the rhodonite group. A previous structure determination of this mineral based on triclinic symmetry in space group P by Peacor et al. [Am. Mineral. (1990), 75, 409–414] converged with R = 0.18 without reporting any information on atomic coordinates and displacement param­eters. The current study redetermines its structure from a natural specimen from the type locality (Foote mine, North Carolina) based on single-crystal X-ray diffraction data. The crystal structure of lithio­marsturite is characterized by ribbons of edge-sharing CaO6 and two types of MnO6 octa­hedra as well as chains of corner-sharing SiO4 tetra­hedra, both extending along [110]. The octa­hedral ribbons are inter­connected by the rather irregular CaO8 and LiO6 polyhedra through sharing corners and edges, forming layers parallel to (1), which are linked together by the silicate chains. Whereas the coordination environments of the Mn and Li cations can be compared to those of the corresponding cations in nambulite, the bonding situations of the Ca cations are more similar to those in babingtonite. In contrast to the hydrogen-bonding scheme in babingtonite, which has one O atom as the hydrogen-bond donor and a second O atom as the hydrogen-bond acceptor, our study shows that the situation is reversed in lithio­marsturite for the same two O atoms, as a consequence of the differences in the bonding environments around O atoms in the two minerals

The declining representativeness of the British party system, and why it matters

In a recent article, Michael Laver has explained ‘Why Vote-Seeking Parties May Make Voters Miserable’. His model shows that, while ideological convergence may boost congruence between governments and the median voter, it can reduce congruence between the party system and the electorate as a whole. Specifically, convergence can increase the mean distance between voters and their nearest party. In this article we show that this captures the reality of today’s British party system. Policy scale placements in British Election Studies from 1987 to 2010 confirm that the pronounced convergence during the past decade has left the Conservatives and Labour closer together than would be optimal in terms of minimising the policy distance between the average voter and the nearest major party. We go on to demonstrate that this comes at a cost. Respondents who perceive themselves as further away from one of the major parties in the system tend to score lower on satisfaction with democracy. In short, vote-seeking parties have left the British party system less representative of the ideological diversity in the electorate, and thus made at least some British voters miserable

Universal screening of Tanzanian HIV-infected adult inpatients with the serum cryptococcal antigen to improve diagnosis and reduce mortality: an operational study

Cryptococcal meningitis is a leading cause of death among HIV-infected individuals in sub-Saharan Africa. Recent developments include the availability of intravenous fluconazole, cryptococcal antigen assays and new data to support fluconazole pre-emptive treatment. In this study, we describe the impact of screening HIV-positive adult inpatients with serum cryptococcal antigen (CRAG) at a Tanzanian referral hospital. All adults admitted to the medical ward of Bugando Medical Centre are counseled and tested for HIV. In this prospective cohort study, we consecutively enrolled HIV-positive patients admitted between September 2009 and January 2010. All patients were interviewed, examined and screened with serum CRAG. Patients with positive serum CRAG or signs of meningitis underwent lumbar puncture. Patients were managed according to standard World Health Organization treatment guidelines. Discharge diagnoses and in-hospital mortality were recorded.\ud Of 333 HIV-infected adults enrolled in our study, 15 (4.4%) had confirmed cryptococcal meningitis and 10 of these 15 (66%) died. All patients with cryptococcal meningitis had at least two of four classic symptoms and signs of meningitis: fever, headache, neck stiffness and altered mental status. Cryptococcal meningitis accounted for a quarter of all in-hospital deaths. Despite screening of all HIV-positive adult inpatients with the serum CRAG at the time of admission and prompt treatment with high-dose intravenous fluconazole in those with confirmed cryptococcal meningitis, the in-hospital mortality rate remained unacceptably high. Improved strategies for earlier diagnosis and treatment of HIV, implementation of fluconazole pre-emptive treatment for high-risk patients and acquisition of better resources for treatment of cryptococcal meningitis are needed

Lotharmeyerite, Ca(Zn,Mn)2(AsO4)2(H2O,OH)2

Lotharmeyerite, calcium bis­(zinc/manganese) bis­(arsenate) bis­(hydroxide/hydrate), Ca(Zn,Mn3+)2(AsO4)2(H2O,OH)2, is a member of the natrochalcite group of minerals, which are characterized by the general formula AM 2(XO4)2(H2O,OH)2, where A may be occupied by Pb2+, Ca2+, Na+, and Bi3+, M by Fe3+, Mn3+, Cu2+, Zn2+, Co2+, Ni2+, Al3+, and Mg2+, and X by PV, AsV, VV, and SVI. The minerals in the group display either monoclinic or triclinic symmetry, depending on the ordering of chemical components in the M site. Based on single-crystal X-ray diffraction data of a sample from the type locality, Mapimi, Durango, Mexico, this study presents the first structure determination of lotharmeyerite. Lotharmeyerite is isostructural with natrochalcite and tsumcorite. The structure is composed of rutile-type chains of edge-shared MO6 octa­hedra (site symmetry ) extending along [010], which are inter­connected by XO4 tetra­hedra (site symmetry 2) and hydrogen bonds to form [M 2(XO4)2(OH,H2O)2] sheets parallel to (001). These sheets are linked by the larger A cations (site symmetry 2/m), as well as by hydrogen bonds. Bond-valence sums for the M cation, calculated with the parameters for Mn3+ and Mn2+ are 2.72 and 2.94 v.u., respectively, consistent with the occupation of the M site by Mn3+. Two distinct hydrogen bonds are present, one with O⋯O = 2.610 (4) Å and the other O⋯O = 2.595 (3) Å. One of the H-atom positions is disordered over two sites with 50% occupancy, in agreement with observations for other natrochalcite-type minerals, such as natrochalcite and tsumcorite

Information Needs and Requirements for Decision Support in Primary Care: An Analysis of Chronic Pain Care

Decision support system designs often do not align with the information environments in which clinicians work. These work environments may increase Clinicians’ cognitive workload and harm their decision making. The objective of this study was to identify information needs and decision support requirements for assessing, diagnosing, and treating chronic noncancer pain in primary care. We conducted a qualitative study involving 30 interviews with 10 primary care clinicians and a subsequent multidisciplinary systems design workshop. Our analysis identified four key decision requirements, eight clinical information needs, and four decision support design seeds. Our findings indicate that clinicians caring for chronic pain need decision support that aggregates many disparate information elements and helps them navigate and contextualize that information. By attending to the needs identified in this study, decision support designers may improve Clinicians’ efficiency, reduce mental workload, and positively affect patient care quality and outcomes

Pyrosmalite-(Fe), Fe8Si6O15(OH,Cl)10

Pyrosmalite-(Fe), ideally FeII 8Si6O15(OH,Cl)10 [refined composition in this study: Fe8Si6O15(OH0.814Cl0.186)10·0.45H2O, octa­iron(II) hexa­silicate deca­(chloride/hydroxide) 0.45-hydrate], is a phyllosilicate mineral and a member of the pyrosmalite series (Fe,Mn)8Si6O15(OH,Cl)10, which includes pyrosmalite-(Mn), as well as friedelite and mcgillite, two polytypes of pyrosmalite-(Mn). This study presents the first structure determination of pyrosmalite-(Fe) based on single-crystal X-ray diffraction data from a natural sample from Burguillos del Cerro, Badajos, Spain. Pyrosmalite-(Fe) is isotypic with pyrosmalite-(Mn) and its structure is characterized by a stacking of brucite-type layers of FeO6-octa­hedra alternating with sheets of SiO4 tetra­hedra along [001]. These sheets consist of 12-, six- and four-membered rings of tetra­hedra in a 1:2:3 ratio. In contrast to previous studies on pyrosmalite-(Mn), which all assumed that Cl and one of the four OH-groups occupy the same site, our data on pyrosmalite-(Fe) revealed a split-site structure model with Cl and OH occupying distinct sites. Furthermore, our study appears to suggest the presence of disordered structural water in pyrosmalite-(Fe), consistent with infrared spectroscopic data measured from the same sample. Weak hydrogen bonding between the ordered OH-groups that are part of the brucite-type layers and the terminal silicate O atoms is present