Higher-order syzygies for the bracket algebra and for the ring of coordinates of the Grassmanian

A Poincaré resolution is given for the supersymmetric ring of brackets over a signed alphabet. As a consequence, a resolution is found for the ring of coordinates of the Grassmanian variety in projective space over any infinite field.     

Maximal expected benefits from lowering cholesterol in primary prevention for a high-risk population

Aims: The objective of this study was to estimate the maximal clinical benefit that could be reasonably expected from a cholesterol-lowering intervention.

Materials and methods: We used a hypothetical population at high risk of cardiovascular disease events from three risk assessment models including the Framingham risk function, the Score Canada and the Pooled Cohort Risk Assessment Equations. Our source population were all 55-year-old smoking men with diabetes, hypertension and low HDL. From this population, we identified two different subpopulations named “high” and “low”, referring to their cholesterol levels which were set at 8.60 and 4.14?mmol/L respectively. Both subpopulations were identified for each risk assessment model in order to estimate the maximal impact of lowering cholesterol on cardiovascular disease events.

Results: Our extrapolations estimated that the maximal theoretical efficacy of a cholesterol-lowering intervention corresponds to a risk ratio ranging between 0.46 and 0.66 over a 10-year period. The number of events prevented during this period were between 21 and 29 per 100 patients which corresponds to a number needed to treat varying from 3.47 to 4.76.

Conclusions: Our estimation showed the maximal clinical benefit that could be reasonably expected by an intervention that would lower total cholesterol in high-risk patients.     

No racial or ethnic disparity in treatment of long-bone fractures

Studies of data from the 1990s are often cited as evidence of racial and ethnic disparities in pain management. Subsequent evidence supporting this association has not been consistent. The objective was to assess whether there are racial or ethnic disparities in receipt of analgesics for pain from long-bone fractures more recently and in a different region of the United States. We conducted a retrospective chart review of 449 patients. Twenty-three percent (53/235) of Hispanic patients, 31% (41/133) of African American patients, and 26% (21/81) of white patients did not receive analgesics. Compared with white patients, the relative risk of not receiving analgesics was 1.31 (95% confidence interval, 0.74-2.03) for African Americans and 0.90 (95% confidence interval, 0.05-1.47) for Hispanic patients after controlling for age, sex, mechanism, marital status, mode of arrival, fracture reduction, fracture type, disposition, and insurance status. We did not find evidence of racial or ethnic disparities in the management of pain from long-bone fractures.     

MotherNature: establishing a Canadian research network for natural health products (NHPs) during pregnancy and lactation

BACKGROUND: It has been estimated that between 7% and 55% of expectant mothers use herbal medicines or other types of natural health products (NHPs). Unfortunately, the safety and efficacy of NHPs during pregnancy and lactation is largely unknown. The Motherisk Program, at the Hospital for Sick Children, Toronto, Ontario, Canada, the is the major Canadian group to counsel and monitor outcomes of women using medications or NHPs, or of women exposed to chemicals, radiation or infection during pregnancy and lactation. OBJECTIVE: To create a network for research on NHPs during pregnancy and lactation by forming longstanding collaborations among Canadian medical and complementary and alternative medicine (CAM) practitioners and scientists. METHODOLOGY: MotherNature Network members participated in three 2-day workshops and three conference calls throughout the length of this study. Each member was responsible to lead discussions surrounding one theme and address the following: initiation; development; presentation; and synthesis of comments of all members on the designated theme. RESULTS: We prioritized areas in high need for future research and collaborative means to conduct such research. NHPs were prioritized for their importance for future study. Areas for the prospective collection of data on NHP use in pregnancy and lactation were identified. A research and business plan was developed for the long-term sustainability of the Network. CONCLUSIONS: The MotherNature Network is well-situated to create a new climate in Canada, where data are collected and interpreted on the effects and safety of NHPs during pregnancy and lactation.     

Anxiolytic, sedative and hypnotic medication use in the elderly living in the community: Developing a conceptual framework

Inappropriate consumption of anxiolytic, sedative and hypnotic medication (ASH) in the elderly is an important public health issue. Almost 35 % of the elderly population living at home take these medications, approximately 206 days per year. According to Quebec data, people who are 65 and older take five times more ASH than people between 18 and 64. The use of ASH would not only be determined by the presence of symptoms, but also by psychosocial characteristics of the subjects. Moreover, several researchers have suggested that the family as well as the health system were environmental factors that could facilitate or inhibit consumption of these medications in the elderly. A conceptual framework is proposed to help specify more adequately the various explanatory hypotheses of this social health behavior and, consequently, better target interventions aiming at its modification.