A longitudinal study was conducted to assess the value of quantitative ultrasound (QUS) measurement in predicting the risk of fracture and to evaluate how QUS parameters change with ageing and the climacteric. A group of 211 female subjects underwent assessment by QUS at the distal metaphysis of the first phalanx of the last four fingers of the hand on two occasions 3 years apart. The subjects were selected from outpatients attending the orthopaedic clinic, provided they were not affected by metabolic disease or under treatment with drugs known to interfere with bone metabolism. In vivo the coefficient of variation and the standardized coefficient of variation of the QUS device were respectively 0.5% and 3.5%. The correlation between the values of the amplitude-dependent speed of sound (AD-SoS) in the two measurements was r = 0.92. In 77.3% of the subjects during the observation period we recorded a reduction in AD-SoS. During the study 22 fractures were observed in peripheral sites, 8 of which were associated with 'low-energy trauma'. By multiple logistic regression analysis we found that the relative risk of fracture for a 1 SD reduction in AD-SoS was 1.5 (95% CI 1.1-1.7) (p < 0.03). The percentage of low-energy fractures significantly increased among those subjects with an AD-SoS value lower than 1850 m/s (T-score < -3.5) at the first examination (p <0.0001). QUS investigation proved to be especially sensitive to hormonal changes associated with the climacteric: we observed a mean decrease of 56 m/s in the AD-SoS for women who entered the menopause between the first and the second QUS test (average time since menopause 2 years), as against 10 m/s in subjects remaining premenopausal. In a group of 146 subjects with 'normal' Ad-SoS at the first examination, we observed a significant reduction in AD-SoS only after 40 years of age. This study demonstrates that measurement of the AD-SoS at the phalanx is reproducible, can be employed to assess the risk of fracture, and is able to detect age-related alterations in bone tissue. 相似文献
The aim of this work was to discuss the suitability of the joining process called “RM-Wrap” (RM = Refractory Metals, ie, Mo, Nb, Ta, Zr) as a pressure-less and tailorable technique to join several different ceramics such as SiC, alumina, and mullite (3Al2O3.2SiO2). In the RM-Wrap joining technique the refractory metal foil is used as a wrap containing one or more silicon foils. It is performed at 1450°C, under flowing argon, and the resulting joining materials are in situ formed composites made of refractory metal disilicides (MoSi2, NbSi2, TaSi2, or ZrSi2) embedded in a silicon-rich matrix; their coefficient of thermal expansion has been calculated and the Laser Flash Method was used to measure the thermal diffusivity of one of them (MoSi2/Si) in 25°C-1000°C range, then to calculate its thermal conductivity. All the obtained joints are uniform, continuous, and crack free. Some preliminary oxidation tests were carried out on all joints at 1100°C, 6 hours in air, giving unchanged morphology of the interface and the joining materials itself; the joint strength of RM-Wrap joined SiC was measured at room temperature using three different mechanical tests: (a) single lap (SL), (b) single lap off-set (SLO) and (c) torsion on hourglass-shaped samples (THG) (on Mo-wrap joined SiC). 相似文献
BACKGROUND: Reports suggest that antituberculosis drugs are malabsorbed in patients with advanced HIV disease. OBJECTIVE: To evaluate the pharmacokinetics of antituberculosis agents in HIV-seropositive patients at different stages of disease. DESIGN: Parallel study. SETTING: Two hospital outpatient clinics. PARTICIPANTS: 12 healthy volunteers, 12 patients with asymptomatic HIV disease, 12 patients with symptomatic HIV disease, and 12 patients with symptomatic HIV disease and diarrhea. MEASUREMENTS: Drug plasma concentrations were measured over 24 hours on day 4 of concurrent therapy. INTERVENTION: Oral isoniazid (300 mg/d), rifampin (600 mg/d), pyrazinamide (1000 mg/d), and ethambutol (1000 mg/d). RESULTS: Reduced total drug exposure to rifampin and pyrazinamide was associated with D-xylose malabsorption in persons with HIV infection or AIDS. Peak drug exposure to isoniazid was lower in patients with diarrhea. CONCLUSIONS: Reduced total drug exposure may be related to malabsorption in persons with HIV infection or AIDS. 相似文献
Communication protocols generally rely on the existence of very long multihop paths to reach distant nodes. They disregard, however, how often such paths indeed occur, and how long they persist, especially in highly dynamic mobile networks. In this direction, this paper evaluates quantitatively the influence of node relative speed on path establishment and maintenance, using real and synthetic vehicular network traces. We propose a methodology for vehicular network analysis where both relative speeds and hop distances are used as parameters to characterize node vicinity. Results show that contact opportunities highly depend on the relative speed and the hop distance between nodes. In sparser scenarios, the number of contacts between nodes separated by more than 3 hops or even between neighbors with relative speed above 40 km/h is negligible. This confirms the intuition that contacts at lower relative speeds and at few hop distances happen more often. In addition, contacts last longer as the number of hops between nodes decreases. Nevertheless, we can still find multihop paths able to transmit messages at high relative speeds, even though less often. We also demonstrate that relative speeds reduce the number of useful contacts more severely when compared to the hop distance. For last, we show that it is possible to increase the number of successful packet transmissions by simply applying the outcomes of this work, without any sophisticated model, avoiding the waste of resources, such as energy and bandwidth.
Most work on Differentiated Services (DiffServ) handles Quality of Service (QoS) provisioning on a per node basis, which assumes that this strategy would provide QoS in the entire domain. Nevertheless, this approach could fail in large domains with multiple flow aggregation and unexpected input traffic. Therefore, provisioning techniques should be used to avoid unexpected overloads that result in QoS fluctuations. A proposal using fuzzy controllers to reconfigure DiffServ nodes according to both incoming traffic and the actual QoS is given. However, it is not easy to specify fuzzy rule bases and membership functions that optimize controller performance. Thus, we also propose a methodology to choose fuzzy controller parameters using the Wang–Mendel and genetic algorithms. Finally, we evaluate the performance of this model by simulation of an IP Telephony application in a DiffServ domain. 相似文献