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There are currently no studies investigating the in vivo stiffness of the most commonly used autografts for anterior cruciate ligament reconstruction (ACLR) using Shear wave elastography (SWE). We hypothesize that there are differences regarding the elastic properties between the three tendons commonly used for ACLR and that they are influenced by patient-related factors. 80 healthy subjects (25 females, 55 males, age: 25.33 ± 4.76 years, BMI: 23.76 ± 3.14 kg/m2, 40 semiprofessional athletes, athlete group [AG], age: 25.51 [19–29]; 40 healthy controls, control group [CG], age: 25.50 [20–29]) were recruited as participants. In addition to patient reported outcome scores, every participant underwent a standardized multimodal ultrasound protocol consisting of B-mode-ultrasound (B-US), Color Doppler-ultrasound (CD-US) and a SWE examination of the bilateral quadriceps tendon (QT), patellar tendon (PT) and semitendinosus tendon (ST). The highest shear wave velocity (SWV) were observed in ST (4.88 (4.35–5.52) m/s, ST vs QT, p = 0.005; ST vs PT, p < 0.001) followed by QT (4.61 (4.13–5.26) m/s, QT vs PT, p < 0.001) and PT (3.73 (3.30–4.68) m/s). Median QT, PT and ST stiffness was significantly higher in AG compared to CG. Male subjects tend to have stiffer QT and PT than female subjects. Positive correlation with SWV was obtained for age and activity level. There are significant differences regarding in vivo tendon stiffness between the most frequently used autograft tendon options for ACLR. The quantitative information obtained by SWE could be of particular interest for graft choice for ACLR. [ABSTRACT FROM AUTHOR]

Research has been conducted on the coordination orientation of ommatida in Drosophila eye. Results indicate that Fat action regulation is provided by the Dachsous expression across the eye and the Four-jointed action modulating Dachsous function.

Drosophila eye movement is controlled by the the activation of the SH2 domain-containing phosphotyrosine phosphatase Corkscrew (CSW), which, in turn, is activated by the sevenless receptor tyrosine kinase (SEV). The search for intermediaries between SEV and CSW has yielded the gene daughter of sevenless (dos), whose product DOS is essential in the signal activation of SEV, and consequently CSW. DOS is dephosphorylated to effect a signal transmission.

The recruitment and specification of the R7 photoreceptor cell constitutes an inductive signal that defines the parameters of differentiation essential for eye development in Drosophila. The sevenless and bride of sevenless (loss) genes constitute a signaling pathway that provides RT cell specification, with the RT cell differentiating as lens secreting cone cell. Mosaic experiments indicate that loss and sevenless proteins function as a ligand and its receptor and are required in the R8 and R7 precursor cells, respectively. The sevenless gene product (Sev)-lacking R7 precursor cells develop into cone cells while the cone cells with Sev activity form R7 cells, indicating that the cone cell and R7 precursors with a preference to R7 fate differentiate immediately following a receptor tyrosine kinase signal.

A study examines the processes involved when the Drosophila melanogaster's sevenless gene encodes the signal of the receptor protein-tyrosine kinase. One of the main results is that a gene named E(sev)2B, which is required for proper signaling by sevenless, encodes a protein of the structure SH3-SH2-SH3 and is required for and only for the activation of p21(Ras 1). Moreover, the E(sev)2B protein can bind in vitro to sevenless and to Son of sevenless, a putative quanine nucleotide exchange factor for p21(Ras 1). Thus, this protein may help Sos activate p21(Ras 1) by applying a signaling complex.

Simulation models are a fundamental tool for investigating hydrological processes and for water resource management. In this study, we introduce PyCoSMoS, a Python toolbox that enables researchers to simulate observed univariate time series mimicking hydroclimatic processes. This toolbox preserves arbitrary marginal distribution and autocorrelation functions, while significantly reducing computational burden. PyCoSMoS is built upon the mixed-Uniform CoSMoS method recently proposed by Papalexiou et al. (2023). The toolbox is designed to minimize the user's input, requiring only observed time series, marginal distribution, correlation function, and the number of lags. The output provides both visual and quantitative comparisons between the observed and simulated time series. We evaluate the performance of the package using various synthetic case studies and the results demonstrate satisfactory accuracy. Furthermore, we apply the toolbox to three real case studies: precipitation, temperature, and relative humidity, for which the toolbox can successfully simulate the observed time series in each case. • Python toolbox (PyCoSMoS) that simplifies hydroclimatic process simulation while preserving distribution and autocorrelation functions. • Minimal user input to provide visual and quantitative comparisons between observed and simulated time series. • Accurate simulation of real-world data for precipitation, temperature, and relative humidity. [ABSTRACT FROM AUTHOR]

Receptor tyrosine kinases (RTK) and specific outcomes from general signals are discussed in this review article which deals with why one cell may become a neuron in response to RTK activation and another might become an adipocyte. Topics include models for RTK signaling specificity, the role of the DER RTK in inducing specific gene expression in the developing Drosophila eye, evidence for a difference between Sevenless and DER signaling. Individual cells often have fates established by activating transmembrane receptors of the Receptor Tyrosine Kinase family.

The prevalence of pain in nursing home (NH) residents is high. Insufficiently treated pain reduces quality of life and often leads to negative health consequences. Pain experience in older people can be influenced by physical, psychosocial, emotional, and spiritual factors. To inform development of NH pain management interventions, we studied residents' pain related perceptions and needs. This was a qualitative descriptive substudy (embedded in ProQuaS, a larger pain project). Three Swiss NHs. A purposeful sample of eight NH residents with severe pain and no severe cognitive impairment, based on information from the Minimum Data Set. Eight semistructured interviews were conducted between October and December 2016. The audio-recorded interviews were transcribed verbatim and analyzed inductively using thematic analysis. Three central themes were identified from the interview data: dealing with major life changes, managing pain, and using formal care. The interviews highlighted the multidimensionality of pain experience in NH residents. In complex pain situations, participants perceived that care workers did not respond adequately to their needs. They had learned to cope with their pain using self-developed strategies and direct consultations with their physicians. The perceived lack of responsiveness may prompt NH residents to bypass care workers with their pain management concerns. This study's findings will inform the development of an educational intervention for NH care workers. [ABSTRACT FROM AUTHOR]

Comparative assessment of the effectiveness of computer-aided design and computer-aided manufacturing (CAD-CAM) technologies used to fabricate complete-coverage restorations is needed. A quantitative assessment requires precise documentation of the marginal adaptation and external surface contour of fabricated restorations. Limited information is currently available regarding the effects of milling mode on marginal adaptation and reproduction of the external surface contour for CAD-CAM–fabricated restorations. The purpose of this in vitro study was to evaluate the outcomes for 3 different digital workflows on the marginal gap and the external surface contour reproducibility of CAD-CAM–fabricated lithium disilicate complete-coverage restorations. Twelve Ivorine molars were prepared to receive lithium disilicate crowns. The preparations were digitally recorded using 2 intraoral scanners (TRIOS 3; 3Shape A/S and Planmeca PlanScan; E4D Technologies), and the restorations were designed using their associated design software with reference to the anatomy of an unprepared tooth. The designed restorations were then manufactured from lithium disilicate blocks using a 3-axis milling machine. Twelve restorations were manufactured using the detailed mode (Planmeca PlanScan detailed mode [PPD-D]), and 12 using the standard mode for the Planmeca system (Planmeca PlanScan standard mode [PPD-S]). Restorations from the 3Shape system were fabricated using the detailed mode (TRIOS 3Shape detailed mode [T3S-D]). The restorations were secured on their associated preparation with an elastomeric material. The marginal gap of each restoration was then measured in the ImageJ software using images captured by a stereo microscope at ×20 magnification. External surface reproducibility was evaluated by measuring undercut at 4-line angles using a dental surveyor. Differences in the marginal gaps of restorations fabricated using the 3 different workflows were compared by Brown-Forsythe robust ANOVA, followed by a post hoc test (α=.05). Chi-square analysis (α=.05) was used to evaluate differences in the contours of the external surface of the restorations, resistance form, and marginal integrity produced using the 3 workflows. The mean marginal gap for restorations fabricated using the T3S-D workflow was 60 μm, a distance significantly lower (P <.05) than that of PPD-D and PPD-S workflows, which yielded a marginal gap of 95 μm for the detailed mode and 124 μm for the standard mode of milling. Restorations fabricated using PPD-D and PPD-S workflows produced a significantly more reproducible external surface contour than those fabricated using the T3S-D workflow. Restorations fabricated using the T3S-D workflow produced the smallest marginal gap. However, reproducibility of the external surface contour for this workflow was the worst of the three workflows analyzed. [ABSTRACT FROM AUTHOR]

Compartment syndrome of the foot (CSF) is a surgical emergency, with high risk of morbidity and poor outcome, including persistent neurologic deficits or amputation. Uncertainty remains regarding surgical approaches, pressure monitoring values, and the extent of surgical treatment. This review provides a summary of the current knowledge and reports evidence-based diagnostic and therapeutic management options for CSF. Articles describing CSF were identified from MEDLINE, PubMed, and Cochrane databases up until February 2018. Experimental and original articles, systematic and nonsystematic reviews, case reports, and book chapters, independent of their level of evidence, were included. Crush injuries are the leading cause of CSF, but CSF can present after fractures of the tarsal or metatarsal bones and dislocations of the Lisfranc or Chopart joints. CSF is often associated with persistent neurologic deficits, claw toes, amputations, and skin healing problems. Diagnosis is made after accurate clinical evaluation combined with intracompartmental pressure monitoring. A threshold value of <20 mmHg difference between the diastolic blood pressure and the intracompartmental pressure is considered diagnostic. Management consists of surgery, whereby 2 dorsal incisions are combined with a medioplantar incision to the calcaneal compartment. The calcaneal compartment can serve as an "indicator compartment," as the highest-pressure values can regularly be measured within this compartment. Appropriately powered studies of CSF are necessary to further evaluate and compare diagnostic and therapeutic options. [ABSTRACT FROM AUTHOR]

Hydroclimatic processes come in all “shapes and sizes”. They are characterized by different spatiotemporal correlation structures and probability distributions that can be continuous, mixed-type, discrete or even binary. Simulating such processes by reproducing precisely their marginal distribution and linear correlation structure, including features like intermittency, can greatly improve hydrological analysis and design. Traditionally, modelling schemes are case specific and typically attempt to preserve few statistical moments providing inadequate and potentially risky distribution approximations. Here, a single framework is proposed that unifies, extends, and improves a general-purpose modelling strategy, based on the assumption that any process can emerge by transforming a specific “parent” Gaussian process. A novel mathematical representation of this scheme, introducing parametric correlation transformation functions, enables straightforward estimation of the parent-Gaussian process yielding the target process after the marginal back transformation, while it provides a general description that supersedes previous specific parameterizations, offering a simple, fast and efficient simulation procedure for every stationary process at any spatiotemporal scale. This framework, also applicable for cyclostationary and multivariate modelling, is augmented with flexible parametric correlation structures that parsimoniously describe observed correlations. Real-world simulations of various hydroclimatic processes with different correlation structures and marginals, such as precipitation, river discharge, wind speed, humidity, extreme events per year, etc., as well as a multivariate example, highlight the flexibility, advantages, and complete generality of the method. [ABSTRACT FROM AUTHOR]

As health care complexity increases, skilled care coordination is becoming increasingly necessary. This is especially true in homecare settings, where services tend to be highly interprofessional. Poor coordination can result in services being provided twice, at the wrong time, unnecessarily or not at all. In addition to risking harm to the client, such confusion leads to unnecessary costs. From the patient's perspective, then, professional coordination should help both to remove barriers limiting quality of care and to minimize costs. To date, though, studies examining the relationship between care coordination and care quality have faced multiple challenges, leading to mixed results. And in homecare contexts, where the clients are highly vulnerable and diverse care interfaces make coordination especially challenging, such studies are rare. Therefore, the aim of this study was to explore the relationship, from the perspectives of clients and of homecare professionals, between coordination and quality of care. For both groups, we hypothesized that better coordination would correlate with higher ratings of quality of care. For the clients, we predicted that higher coordination ratings would lead to lower incidence of unplanned health care use, i.e., emergency department (ED) visits, unscheduled urgent medical visits and hospitalizations. This study is part of a national multi-center cross-sectional study in the Swiss homecare setting. We recruited 88 homecare agencies and collected data between January and September 2021 through written questionnaires for agencies' managers, employees (n = 3223) and clients (n = 1509). To test our hypotheses, we conducted multilevel analyses. Employee-perceived care coordination ratings correlated positively with employee-rated quality of care (OR = 2.78, p <.001); client-perceived care coordination problems correlated inversely with client-reported quality of care (β = − 0.55, p <.001). Client-perceived coordination problems also correlated positively with hospitalizations (IRR = 1.20, p <.05) and unscheduled urgent medical visits (IRR = 1.18, p <.05), but not significantly with ED visits. No associations were discernible between employee-perceived coordination quality and either health care service use or client quality-of-care ratings. While results indicate relationships between coordination and diverse aspects of care quality, various coordination gaps (e.g., poor information flow) also became apparent. The measurement of both care coordination and quality of care remains a challenge. Further research should focus on developing and validating a coordination questionnaire that measures care coordination. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to analyze the general (Constant Murley score) and sports-specific (change in International Climbing and Mountaineering Federation [UIAA] grade) outcome after surgical repair of rotator cuff injuries in rock climbers.Methods: In a retrospective study, 12 rock climbers (10 men, 2 women; age 55 years; SD±9; range 28-66 years [mean±SD with range] with rotator cuff lesions were re-evaluated 27±16 (12-72) months after arthroscopic surgical repair of the rotator cuff of the shoulder. The etiology of the rotator cuff pathology was equally chronic (age 61±12 [28-66] years) and acute (age 53±5 [51-65] years). The postoperative general outcome, including the Constant Murley score, was assessed with a standardized questionnaire and clinical examination. The postoperative sports-specific outcome was analyzed using the UIAA metric scale.Results: The postoperative Constant Murley score was 92±7 (80-98). All participants had already started climbing again; 11 of 12 climbers regained a climbing level within ±1.33 UIAA metric grades of their initial capability.Conclusion: Arthroscopic repair of acute and chronic rotator cuff tears shows a good functional outcome, enabling most patients to regain a high level of rock climbing ability. [ABSTRACT FROM AUTHOR]

Readmissions to the intensive care unit are associated with poorer patient outcomes and health prognoses, alongside increased lengths of stay and mortality risk. To improve quality of care and patients' safety, it is essential to understand influencing factors relevant to specific patient populations and settings. A standardized tool for systematic retrospective analysis of readmissions would help healthcare professionals understand risks and reasons affecting readmissions; however, no such tool exists. This study's purpose was to develop a tool (We-ReAlyse) to analyze readmissions to the intensive care unit from general units by reflecting on affected patients' pathways from intensive care discharge to readmission. The results will highlight case-specific causes of readmission and potential areas for departmental- and institutional-level improvements. A root cause analysis approach guided this quality improvement project. The tool's iterative development process included a literature search, a clinical expert panel, and a testing in January and February 2021. The We-ReAlyse tool guides healthcare professionals to identify areas for quality improvement by reflecting the patient's pathway from the initial intensive care stay to readmission. Ten readmissions were analyzed by using the We-ReAlyse tool, resulting in key insights about possible root causes like the handover process, patient's care needs, the resources on the general unit and the use of different electronic healthcare record systems. The We-ReAlyse tool provides a visualization/objectification of issues related to intensive care readmissions, gathering data upon which to base quality improvement interventions. Based on the information on how multi-level risk profiles and knowledge deficits contribute to readmission rates, nurses can target specific quality improvements to reduce those rates. With the We-ReAlyse tool, we have the opportunity to collect detailed information about ICU readmissions for an in-depth analysis. This will allow health professionals in all involved departments to discuss and either correct or cope with the identified issues. In the long term, this will allow continuous, concerted efforts to reduce and prevent ICU readmissions. To obtain more data for analysis and to further refine and simplify the tool, it may be applied to larger samples of ICU readmissions. Furthermore, to test its generalizability, the tool should be applied to patients from other departments and other hospitals. Adapting it to an electronic version would facilitate the timely and comprehensive collection of necessary information. Finally, the tool's emphasis comprises reflecting on and analyzing ICU readmissions, allowing clinicians to develop interventions targeting the identified problems. Therefore, future research in this area will require the development and evaluation of potential interventions. [ABSTRACT FROM AUTHOR]

• Short-duration precipitation (P) analyzed with unique high-density network • Space-time correlation structure and marginal distribution of P vary seasonally • Parametric models for correlation structure and marginal distribution • Seasonal differences increase with the P resolution • Multisite stochastic simulations reveal insights into space-time P variability The statistical characterization of precipitation (P) at short durations (≤ 24 h) is crucial for practical and scientific applications. Here, we advance the knowledge of and ability to model the space-time correlation structure (STCS) and marginal distribution of short-duration P using a network of rain gages in central Arizona with one of the largest densities and spatial coverages in the world. We separately analyze summer and winter P sampled at multiple durations, Δ t , from 0.5 to 24 h. We first identify an analytical model and a three-parameter distribution that robustly capture the empirical STCS and marginal distribution of P, respectively, across Δ t 's. We then conduct Monte Carlo experiments consisting of multisite stochastic simulations of P time series to explore the spatial and seasonal variability of these properties. Significant seasonal differences emerge, especially at low Δ t. Summer (winter) P exhibits weak (strong) correlation structure and heavy- (light-)tailed distributions resulting from short-lived, isolated thunderstorms (widespread, long-lasting frontal systems). The STCS of P is most likely homogeneous and isotropic except for winter at Δ t ≥ 3 h, where anisotropy could be introduced via the motion of frontal storms. The spatial variability of the marginal distribution is reproduced by a regional parameterization dependent on elevation in all cases except, again, for winter at Δ t ≥ 3 h where additional factors are needed to explain the variability of the mean P intensity. This work provides insights to improve stochastic P models and validate convection-permitting models used to investigate the mechanisms driving changes in short-duration P. [ABSTRACT FROM AUTHOR]

To explore associations between care workers’ health and implicit rationing of care. Diverse studies have linked impaired health to reduced work performance — a factor measured through omission of required tasks. This cross-sectional study gathered data from 3239 care workers in 162 Swiss nursing homes. Data were analyzed via a linear logistic regression model using general estimating equations. Overall, rationing of care occurred “never” to “seldom.” Rationing of activities of daily living was positively associated with care workers’ joint pain (β 0.04, Cl 0.001 -0.07), emotional exhaustion (β 0.11, Cl 0.07-0.15), and presenteeism (β 0.05, Cl 0.004-0.09). Rationing of caring, rehabilitation, and monitoring was positively associated with care workers’ joint pain (β 0.05, Cl 0.01 -0.09) and emotional exhaustion (β 0.2, Cl 1.16-0.24). Care workers health complaints are strongly associated with rationing of tasks directly related to resident care. [ABSTRACT FROM AUTHOR]

To characterize the seasonal variation of the marginal distribution of daily precipitation, it is important to find which statistical characteristics of daily precipitation actually vary the most from month-to-month and which could be regarded to be invariant. Relevant to the latter issue is the question whether there is a single model capable to describe effectively the nonzero daily precipitation for every month worldwide. To study these questions we introduce and apply a novel test for seasonal variation (SV-Test) and explore the performance of two flexible distributions in a massive analysis of approximately 170,000 monthly daily precipitation records at more than 14,000 stations from all over the globe. The analysis indicates that: (a) the shape characteristics of the marginal distribution of daily precipitation, generally, vary over the months, (b) commonly used distributions such as the Exponential, Gamma, Weibull, Lognormal, and the Pareto, are incapable to describe “universally” the daily precipitation, (c) exponential-tail distributions like the Exponential, mixed Exponentials or the Gamma can severely underestimate the magnitude of extreme events and thus may be a wrong choice, and (d) the Burr type XII and the Generalized Gamma distributions are two good models, with the latter performing exceptionally well. [ABSTRACT FROM AUTHOR]

Objectives Although regular physical exercise clearly reduces cardiovascular morbidity risk, long-term endurance sports practice has been recognized as a risk factor for atrial fibrillation (AF). However, the mechanisms how endurance sports can lead to AF are not yet clear. The aim of our present study was to investigate the influence of long-term endurance training on vagal tone, atrial size, and inflammatory profile in professional elite soccer players. Methods A total of 25 professional major league soccer players (mean age 24 ± 4 years) and 20 sedentary controls (mean age 26 ± 3 years) were included in the study and consecutively examined. All subjects underwent a sports cardiology check-up with physical examination, electrocardiography, echocardiography, exercise testing on a bicycle ergometer, and laboratory analysis [standard laboratory and cytokine profile: interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-8, IL-10]. Results Athletes were divided into two groups according to presence or absence of an early repolarization (ER) pattern, defined as a ST-segment elevation at the J-point (STE) ≥0.1 mm in 2 leads. Athletes with an ER pattern showed significantly lower heart rate and an increased E/e′ ratio compared to athletes without an ER pattern. STE significantly correlated with E/e′ ratio as well as with left atrial (LA) volume. The pro-inflammatory cytokines IL-6, IL-8, TNF-α as well as the anti-inflammatory cytokine IL-10 were significantly elevated in all soccer players. However, athletes with an ER pattern had significantly higher IL-6 plasma levels than athletes without ER pattern. Furthermore, athletes with “high” level IL-6 had significantly larger LA volumes than players with “low” level IL-6. Conclusions Athletes with an ER pattern had significantly higher E/e′ ratios, reflecting higher atrial filling pressures, higher LA volume, and higher IL-6 plasma levels. All these factors may contribute to atrial remodeling over time and thus increase the risk of AF in long-term endurance sports. [ABSTRACT FROM AUTHOR]

Bacterial ATP-binding cassette (ABC) importers are primary active transporters that are critical for nutrient uptake. Based on structural and functional studies, ABC importers can be divided into two distinct classes, type I and type II. Type I importers follow a strict alternating access mechanism that is driven by the presence of the substrate. Type II importers accept substrates in a nucleotide-free state, with hydrolysis driving an inward facing conformation. The ribose transporter in Escherichia coli is a tripartite complex consisting of a cytoplasmic ATP-binding cassette protein, RbsA, with fused nucleotide binding domains; a transmembrane domain homodimer, RbsC2; and a periplasmic substrate binding protein, RbsB. To investigate the transport mechanism of the complex RbsABC2, we probed intersubunit interactions by varying the presence of the substrate ribose and the hydrolysis cofactors, ATP/ADP and Mg2+. We were able to purify a full complex, RbsABC2, in the presence of stable, transition state mimics (ATP, Mg2+, and VO4); a RbsAC complex in the presence of ADP and Mg2+; and a heretofore unobserved RbsBC complex in the absence of cofactors. The presence of excess ribose also destabilized complex formation between RbsB and RbsC. These observations suggest that RbsABC2 shares functional traits with both type I and type II importers, as well as possessing unique features, and employs a distinct mechanism relative to other ABC transporters. [ABSTRACT FROM AUTHOR]

Air source heat pump unlike water and geothermal source heat pumps are widely used in sanitary hot water production by virtue of the relative ease of harvesting, low grade aero-thermal energy and less complexity in operating and maintaining the heat pump unit. This research focused on performance monitoring of 1.2 kW air source heat pump, retrofitting a 200 L high pressure storage tank and operating under first hour heating rating for seven different climatic conditions. A data acquisition system was designed and built to measure the desired predictors of the power consumption and coefficient of performance of the ASHP water heater. A robust mathematical multiple linear regression models were built and were used in the modeled blocks in the simulation application developed in Simulink of MATLAB. Results indicated that the maximum coefficient of performance was associated with the maximum power consumption of the ASHP water heater. Finally, the simulation application could also be used by ASHP manufacturers and the energy saving company to quantify the energy reduced when geysers are retrofitted by ASHP. Optimization using constrained linear least squares solver in the optimization toolbox was also used to eliminate errors in the measurement from inclusion into the mathematical models. [ABSTRACT FROM AUTHOR]

Malnutrition is frequent in older adults, associated with increased morbidity, mortality, and higher costs. Nursing home residents are especially affected, and evidence on institutional factors associated with malnutrition is limited. We calculated the prevalence of malnutrition in Swiss nursing home residents and investigated which structure and process indicators of nursing homes are associated with residents' malnutrition. Subanalysis of the Swiss Nursing Homes Human Resources Project 2018, a multicenter, cross-sectional study conducted from 2018 to 2019 in Switzerland. This study included 76 nursing homes with a total of 5047 residents. Malnutrition was defined as a loss of bodyweight of ≥5% in the last 30 days or ≥10% in the last 180 days. Binomial generalized estimating equations (GEE) were applied to examine the association between malnutrition and structural (staffing ratio, grade mix, presence of a dietician, malnutrition guideline, support during mealtimes) and process indicators (awareness of malnutrition, food administration process). GEE models were adjusted for institutional (profit status, facility size) and specific resident characteristics. The prevalence of residents with malnutrition was 5%. A higher percentage of units per nursing home having a guideline on prevention and treatment of malnutrition was significantly associated with more residents with weight loss (OR 2.47, 95% CI 1.31-4.66, P =.005). Not having a dietician in a nursing home was significantly associated with a higher rate of residents with weight loss (OR 1.60, 95% CI 1.09-2.35, P =.016). Having a dietician as part of a multidisciplinary team in a nursing home is an important step to address the problem of residents' malnutrition. Further research is needed to clarify the role of a guideline on prevention and treatment of malnutrition to improve the quality of care in nursing homes. [ABSTRACT FROM AUTHOR]

Abstract: The principle of maximum entropy, along with empirical considerations, can provide consistent basis for constructing a consistent probability distribution model for highly varying geophysical processes. Here we examine the potential of using this principle with the Boltzmann–Gibbs–Shannon entropy definition in the probabilistic modeling of rainfall in different areas worldwide. We define and theoretically justify specific simple and general entropy maximization constraints which lead to two flexible distributions, i.e., the three-parameter Generalized Gamma (GG) and the four-parameter Generalized Beta of the second kind (GB2), with the former being a particular limiting case of the latter. We test the theoretical results in 11,519 daily rainfall records across the globe. The GB2 distribution seems to be able to describe all empirical records while two of its specific three-parameter cases, the GG and the Burr Type XII distributions perform very well by describing the 97.6% and 87.7% of the empirical records, respectively. [Copyright &y& Elsevier]

Purpose: To determine whether 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) are associated with a decreased risk of colorectal cancer. Methods: The population included 159,219 postmenopausal women enrolled in the Women’s Health Initiative in which 2000 pathologically confirmed cases of colorectal cancer were identified during an average of 10.7 (S.D. 2.9) years. Information on statins was collected at baseline and years 1, 3, 6, and 9. Self- and interviewer-administered questionnaires were used to collect information on other risk factors. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the use of Cox proportional hazards regression to evaluate the relationship between statin use and risk. Statistical tests were two-sided. Results: Statins were used by 12,030 (7.6%) women at baseline. The annualized colorectal cancer rate was 0.13% among users and 0.12% among nonusers. The multivariable adjusted HR for users versus nonusers was 0.99 (95% confidence interval [CI], 0.83–1.20, p = .95), and 0.79 (95% CI, 0.56–1.11) for users of ≥3 years. In the multivariable adjusted time-dependent model, the HR for lovastatin was 0.62 (95% CI, 0.39–0.99). There was no effect of tumor location, stage or grade. Conclusions: There was a reduction in colorectal cancer risk associated with lovastatin and a nonsignificant association with longer duration of use. [Copyright &y& Elsevier]