Governments are increasingly introducing odour impact criteria (OIC) to determine separation distances between odour sources and residential areas. Previous studies have shown the wide range of OIC ...available for this purpose, depending on the desired level of protection against odour annoyance. However, it is unclear whether OIC with similar levels of protection can ensure analogous separation distances, which would reasonably be expected. This study presents a comparative analysis of separation distances calculated at two sites for different OIC, but all related to an equivalent level of protection. Here, the equivalent level of protection was defined for urban residential areas (land use), swine odour (hedonic tone) and new facilities (facility type). In this manner, the regulatory criteria currently enforced in Germany, Ireland, and Queensland (Australia) were selected as references for the investigation. The results clearly show that, even for an equivalent level of protection, disparate separation distances can be obtained. Differences in separation distances were found to be greater in prevailing wind directions compared to distances in additional wind directions. Overall, the results demonstrate a risk of poor conclusions in odour assessments. This means that care must be taken when adopting OIC for decision making, principally in those countries that have not yet established specific regulations to manage environmental odours. Concomitantly, the results stress the need for better harmonisation of the concept of the odour impact criterion and components thereof. By using perturbation analysis, it has also been found that the stack exit temperature influences the separation distances in a distinct way, reliant on the criteria used to determine the distances. This finding is of significance for input data collection in future odour modelling studies. Furthermore, approaches used to derive OIC, equivalence between dispersion modelling and field inspections (European standard EN 16841-1), as well as implications of the findings for regulatory practice are summarised and discussed.
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•Distances from odour sources to receptors can be enforced to tackle odour annoyance.•Separation distances were determined for country-specific odour impact criteria.•Dissimilar distances were found even by relating the criteria to an equivalent level of protection.•The stack exit temperature was identified as a relevant predictor for the separation distance.•The findings of this work can support policymakers in designing odour regulations.
Abstract Background Postmenopausal osteoporosis results from bone loss and decreased bone strength mediated by an increased rate of bone remodeling secondary to reduced estrogen levels. Remodeling ...cycles are initiated by osteoclasts, the formation, function, and survival of which depend on RANK ligand (RANKL). RANKL inhibition therefore represents a novel strategy for reducing remodeling and its effects on fracture risk. Objectives The goal of this study was to review the preclinical and clinical evidence supporting the value of RANKL inhibition in conditions of bone loss and to provide the rationale for the use of the fully human antibody denosumab, a RANKL inhibitor, in such conditions. Methods We searched PubMed from January 2005 to May 2011 using the following terms: RANK Ligand , RANKL , denosumab , and NOT cancer, metastatic bone, or rheumatoid in the title. Results The search method retrieved 111 articles. Preclinical evidence from several bone disease models suggests that RANKL inhibition leads to increased bone volume, density, and strength. Denosumab prevents RANKL from binding to its receptor, decreasing osteoclast activity and thereby reducing bone resorption and increasing cortical and trabecular bone mass and strength. It has consistently been reported to reduce bone turnover, increase bone density, and reduce the risk of fracture in clinical studies of postmenopausal women. Phase III head-to-head trials comparing denosumab with the bisphosphonate alendronate reported that denosumab was associated with significantly greater increases in bone density. Eczema as an adverse event and cellulitis as a serious adverse event were more common with denosumab than with placebo. Conclusions Preclinical studies defined the role of RANKL in bone remodeling and provided evidence for the therapeutic potential of RANKL inhibition in conditions of bone loss. Clinical studies evaluating RANKL inhibition with denosumab in postmenopausal women have reported significant reductions in vertebral, nonvertebral, and hip fractures, providing evidence compatible with the use of denosumab in postmenopausal women with osteoporosis.
Introduction
Procollagen type I N-terminal propeptide (P1NP), a bone formation marker, reportedly predicts bone mineral density (BMD) response to teriparatide treatment in treatment-naive patients ...with osteoporosis. Results from a randomized, phase 3, open-label, active-controlled trial— STRUCTURE—showed that in patients previously treated with bisphosphonates, romosozumab led to gains in hip BMD, which were not observed with teriparatide. This post hoc analysis investigated the comparative utility of early changes in P1NP in predicting BMD response in patients who participated in the STRUCTURE trial, which enrolled patients who switched treatment from bisphosphonates to romosozumab/teriparatide.
Materials and methods
Postmenopausal women (aged 55–90 years) with osteoporosis who had previously taken bisphosphonates were randomized to receive open-label subcutaneous romosozumab (210 mg once monthly;
n
= 218) or teriparatide (20 µg once daily;
n
= 218) for 12 months. BMD was assessed by dual-energy X-ray absorptiometry at the proximal femur and lumbar spine (LS) at baseline and months 6 and 12. To assess the utility of P1NP, the positive predictive value of increase from baseline in P1NP of > 10 µg/L at month 1 and achievement of various thresholds of percent change from baseline in BMD at month 12 were evaluated.
Results
Overall, 95% (191/202) of patients in the romosozumab group and 91% (183/201) in the teriparatide group demonstrated an increase in P1NP of > 10 µg/L from baseline at month 1. Among these patients, 18% and 3% of romosozumab-treated patients versus 60% and 12% of teriparatide-treated patients showed no increase from baseline (i.e., ≤ 0%) in total hip and LS BMD, respectively, at month 12. These data indicate that in patients switching from bisphosphonates to a bone-forming therapy, increases in P1NP do not help predict the hip BMD response. Although most patients treated with either teriparatide or romosozumab showed an increase in P1NP, the majority of patients on romosozumab showed an increase in hip BMD, while more than half of the patients on teriparatide did not. Teriparatide therapy did not increase total hip BMD in the majority of patients who transitioned from bisphosphonates to teriparatide.
Conclusions
Thus, increases in P1NP were not predictive of BMD response in the teriparatide group because in approximately 60% of the patients who were administered teriparatide, the hip BMD decreased independent of the change in P1NP levels.
Numbers of large grazing bird (geese, swans, cranes) have increased all over Europe, but monitoring these species, e.g. for management purposes, can be time consuming and costly. In Bavaria, ...sedentary Greylag geese (Anser anser) are monitored during the winter by two different citizen-based monitoring schemes: the International Waterbird Census IWC and hunting bag statistics. We compared the results of both schemes for the seasons 1988/89 to 2010/11 by analysing annual indices calculated using the software TRends and Indices for Monitoring Data-TRIM.
We identified similar, highly significant rates of increase in both data sets for the entire region of Bavaria (IWC 14% 13-15%, bag 13% 12-14%). Furthermore, in all of the seven Bavarian regions, trends in annual indices of both data sets correlated significantly. The quality of both datasets as indicators of abundances in Greylag geese populations in Bavaria was not undermined by either weaknesses typically associated with citizen based monitoring or problems generally assumed for IWC and bag data. We also show that bag data are, under the German system of collecting bag statistics, a reliable indicator of species' distribution, especially for detecting newly colonized areas. Therefore, wildlife managers may want to consider bag data from citizen science led monitoring programmes as evidence supporting the decision making processes. We also discuss requirements for any bag monitoring schemes being established to monitor trends in species' distribution and abundance.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Accurate radiographic diagnosis of vertebral fractures is important. This multicenter, multinational study assessed radiographic diagnoses of vertebral fracture in 2451 postmenopausal women with ...osteoporosis. Comparison between local and central readings yielded a false‐negative rate of 34%. Underdiagnosis of vertebral fracture is a worldwide problem.
Introduction: Vertebral fractures are the most common complication of osteoporosis. Although they are associated with significant morbidity, they frequently do not come to clinical attention. Accurate radiographic diagnosis is important.
Materials and Methods: In a multicenter, multinational prospective study (the IMPACT trial), the accuracy of radiographic diagnosis of vertebral fracture was evaluated in postmenopausal women 65–80 years of age newly diagnosed with osteoporosis (based on BMD measurement). Lateral radiographs of the thoracolumbar spine were evaluated for identification of vertebral fractures, first locally and subsequently at a central reading center, using a validated semiquantitative method. False‐positive and false‐negative rates were calculated based on adjudicated discrepancies between the initial interpretation at the local site and the subsequent central reading, considered the “reference standard.”
Results: Of 2451 women with an evaluable radiograph both centrally and locally, 789 (32%) had at least one vertebral fracture. Adjudicated discrepancies (n = 350 patients) between local and central readings because of undetected vertebral fracture (68%) or equivocal terminology in the local radiology report (32%) yielded a false‐negative rate of 34%.
Conclusions: Underdiagnosis of vertebral fractures was observed in all geographic regions (false‐negative rates: North America, 45.2%; Latin America, 46.5%; Europe/South Africa/Australia, 29.5%). The false‐positive rate was 5% globally. Underdiagnosis of vertebral fracture is a worldwide problem attributable in part to a lack of radiographic detection, use of ambiguous terminology in the radiology report, or both. Efforts to improve accuracy and reduce variability in terminology and interpretation may increase the effectiveness of spinal radiography for detecting vertebral fractures in patients with osteoporosis.
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