Context: There is a controversy regarding the definition of vitamin D insufficiency as it relates to bone health. Objective: The objective of the study was to examine the evidence for a threshold value of serum 25-hydroxyvitamin D (25OHD) that defines vitamin D insufficiency as it relates to bone health. Design and Participants: This was a cross-sectional analysis of baseline data in 488 elderly Caucasian women, mean age 71 yr, combined with a literature review of 70 studies on the relationship of serum PTH to serum 25OHD. Setting: The study was conducted in independent-living women in the midwest United States. Main Outcome Measure: The relationship between serum 25OHD, serum PTH, and serum osteocalcin and 24-h urine N-telopeptides was evaluated. Results: Serum PTH was inversely correlated with serum 25OHD (r = −0.256, P < 0.0005), but no threshold as defined by suppression of serum PTH was found within the serum 25OHD range 6–60 ng/ml (15–150 nmol/liter). However, in contrast, there was a threshold for bone markers, serum osteocalcin and urine N-telopeptides, that increased only below a serum 25OHD of approximately 18 ng/ml (45 nmol/liter). Calcium absorption was not correlated with serum PTH and serum 25OHD, and no threshold was found. A literature review of 70 studies generally showed a threshold for serum PTH with increasing serum 25OHD, but there was no consistency in the threshold level of serum 25OHD that varied from 10 to 50 ng/ml (25–125 nmol/liter). Conclusions: Vitamin D insufficiency should be defined as serum 25OHD less than 20 ng/ml (50 nmol/liter) as it relates to bone.

Objectives: The aim of this study was to determine the recent trends of the rates of hospitalization, mortality of hospitalized patients, and associated health care utilization in patients with acute pancreatitis (AP). Methods: We identified adult patients with primary discharge diagnosis of AP from the National Inpatient Sample database. Patients with chronic pancreatitis and/or pancreatic cancer were excluded. Primary outcomes included age-adjusted incidence of AP and in-hospital mortality based on US standard population derived from the 2000 census data. Secondary outcomes were length of stay, inflation-adjusted hospital costs in 2014 US dollars, and procedural rates. Subgroup analysis included disease etiologies, age, race, sex, hospital region, hospital size, and institution type. Results: From 2001 to 2014, the rate of primary discharge diagnosis for AP increased from 65.38 to 81.88 per 100,000 US adults per year. In-hospital case fatality decreased from 1.68% to 0.69%. Mortality rate is higher in patients with AP who are older than 65 years (3.4%). Length of stay decreased, with a median of 3.8 days; cost per hospitalization decreased since 2007 from $7602 to $6766 in 2014. Conclusions: The rate of hospitalization related to AP in the United States continues to increase. Mortality, length of stay, and cost per hospitalization decrease. The increase in volume of hospitalization might contribute to an overall increase in health care resource utilization.

Objective. To develop a searchable database of educational technologies used at schools and colleges of pharmacy.Methods. A cross-sectional survey design was used to determine what educational technologies were being used and to identify an individual at each institution who could serve as an information resource for peer-to-peer questions.Results. Eighty-nine survey instruments were returned for a response rate of 75.4%. The resulting data illustrated the almost ubiquitous presence of educational technology. The most frequently used technology was course management systems and the least frequently used technology was microblogging.Conclusions. Educational technology use is trending toward fee-based products for enterprise-level applications and free, open-source products for collaboration and presentation. Educational technology is allowing educators to restructure classroom time for something other than simple transmission of factual information and to adopt an evidence-based approach to instructional i...

To determine whether aerobic fitness is more salient than weight status in predicting performance on standardized math and reading tests in fourth- to eighth-grade students. A cross-sectional study of data abstracted from 11,743 students in 47 public schools. Aerobic fitness was defined by entering the healthy fitness zone of Fitnessgram's Progressive Aerobic Cardiovascular Endurance Run, which has been shown to correlate highly with maximum oxygen consumption. Mixed-effects logistic regression analyses were conducted to model the student-level effect of aerobic fitness status on passing the Nebraska State Accountability (NeSA) math and reading tests after adjusting for body mass index (BMI) percentile, free/reduced lunch status, sex, race, grade level, and school type. After adjustment, aerobically fit students had greater odds of passing the NeSA math and reading tests compared with aerobically unfit students regardless of whether the students received free/reduced lunch; however, the effect of being aerobically fit on the standardized test scores was significantly greater for students not receiving free/reduced lunch. Weight status, as measured by BMI percentile, was not a significant predictor of passing the NeSA math or reading test after including free/reduced lunch status in the model. Aerobic fitness was a significant predictor of academic performance; weight status was not. Although decreasing BMI for an overweight or obese child undoubtedly improves overall health, results indicated all students benefit academically from being aerobically fit regardless of weight or free/reduced lunch status. Therefore, to improve academic performance, school systems should focus on the aerobic fitness of every student.