Impact of a centralized osteoporosis coordinator on post-fracture osteoporosis management: a cluster randomized trial

SUMMARY: We conducted a cluster randomized trial evaluating the effect of a centralized coordinator who identifies and follows up with fracture patients and their primary care physicians about osteoporosis. Compared with controls, intervention patients were five times more likely to receive BMD testing and two times more likely to receive appropriate management. INTRODUCTION: To determine if a centralized coordinator who follows up with fracture patients and their primary care physicians by telephone and mail (intervention) will increase the proportion of patients who receive appropriate post-fracture osteoporosis management, compared to simple fall prevention advice (attention control). METHODS: A cluster randomized controlled trial was conducted in small community hospitals in the province of Ontario, Canada. Hospitals that treated between 60 and 340 fracture patients per year were eligible. Patients 40 years and older presenting with a low trauma fracture were identified from Emergency Department records and enrolled in the trial. The primary outcome was ‘appropriate’ management, defined as a normal bone mineral density (BMD) test or taking osteoporosis medications. RESULTS: Thirty-six hospitals were randomized to either intervention or control and 130 intervention and 137 control subjects completed the study. The mean age of participants was 65 ± 12 years and 69% were female. The intervention increased the proportion of patients who received appropriate management within 6 months of fracture; 45% in the intervention group compared with 26% in the control group (absolute difference of 19%; adjusted OR, 2.3; 95% CI, 1.3–4.1). The proportion who had a BMD test scheduled or performed was much higher with 57% of intervention patients compared with 21% of controls (absolute difference of 36%; adjusted OR, 4.8; 95% CI, 3.0–7.0). CONCLUSIONS: A centralized osteoporosis coordinator is effective in improving the quality of osteoporosis care in smaller communities that do not have on-site coordinators or direct access to osteoporosis specialists

First 230 GHz VLBI Fringes on 3C 279 using the APEX Telescope

We report about a 230 GHz very long baseline interferometry (VLBI) fringe finder observation of blazar 3C 279 with the APEX telescope in Chile, the phased submillimeter array (SMA), and the SMT of the Arizona Radio Observatory (ARO). We installed VLBI equipment and measured the APEX station position to 1 cm accuracy (1 sigma). We then observed 3C 279 on 2012 May 7 in a 5 hour 230 GHz VLBI track with baseline lengths of 2800 M$\lambda$ to 7200 M$\lambda$ and a finest fringe spacing of 28.6 micro-arcseconds. Fringes were detected on all baselines with SNRs of 12 to 55 in 420 s. The correlated flux density on the longest baseline was ~0.3 Jy/beam, out of a total flux density of 19.8 Jy. Visibility data suggest an emission region <38 uas in size, and at least two components, possibly polarized. We find a lower limit of the brightness temperature of the inner jet region of about 10^10 K. Lastly, we find an upper limit of 20% on the linear polarization fraction at a fringe spacing of ~38 uas. With APEX the angular resolution of 230 GHz VLBI improves to 28.6 uas. This allows one to resolve the last-photon ring around the Galactic Center black hole event horizon, expected to be 40 uas in diameter, and probe radio jet launching at unprecedented resolution, down to a few gravitational radii in galaxies like M 87. To probe the structure in the inner parsecs of 3C 279 in detail, follow-up observations with APEX and five other mm-VLBI stations have been conducted (March 2013) and are being analyzed.Comment: accepted for publication in A&

Georeferenced soil information system: assessment of database

Land-use planning is a decision-making process that facilitates the allocation of land to different uses that provide optimal and sustainable benefit. As land-use is shaped by society–nature interaction, in land-use planning different components/facets play a significant role involving soil, water, climate, animal (ruminant/ non-ruminant) and others, including forestry and the environment needed for survival of mankind. At times these components are moderated by human interference. Thus land-use planning being a dynamic phenomenon is not guided by a single factor, but by a complex system working simultaneously,which largely affects the sustainability. To address such issues a National Agricultural Innovation Project (NAIP) on ‘Georeferenced soil information system for land-use planning and monitoring soil and land quality for agriculture’ was undertaken to develop threshold values of land quality parameters for land-use planning through quantitative land evaluation and crop modelling for dominant cropping systems in major agro-ecological sub-regions (AESRs) representing rice–wheat cropping system in the Indo-Gangetic Plains (IGP) and deep-rooted crops in the black soil regions (BSR). To assess the impact of landuse change, threshold land quality indicator values are used. A modified AESR map for agricultural landuse planning is generated for effective land-use planning

Soil information system: use and potentials in humid and semi-arid tropics

The articles presented in this special section emanated from the researches of consortium members of the National Agricultural Innovative Project (NAIP, Component 4) of the Indian Council of Agricultural Research (ICAR), New Delhi. These researches have helped develop a soil information system (SIS). In view of the changing scenario all over the world, the need of the hour is to get assistance from a host of researchers specialized in soils, crops, geology, geography and information technology to make proper use of the datasets. Equipped with the essential knowledge of data storage and retrieval for management recommendations, these experts should be able to address the issues of land degradation, biodiversity, food security, climate change and ultimately arrive at an appropriate agricultural land-use planning. Moreover, as the natural resource information is an essential prerequisite for monitoring and predicting global environmental change with special reference to climate and land use options, the SIS needs to be a dynamic exercise to accommodate temporal datasets, so that subsequently it should result in the evolution of the soil information technology. The database developed through this NAIP would serve as an example of the usefulness of the Consortium and the research initiative of ICAR involving experts from different fields to find out the potentials of the soils of humid and semi-arid bioclimatic systems of the country

Synthesis, characterization , electrical and biological studies of Cr(III), Mn(III), Fe(III),Ti(III), VO(IV), Th(IV), Zr(IV) and UO2(VI) polychelates with bis-bidentate Schiff base

1892-1896The polychelates of Cr(III), Mn(III), Fe(III), Ti(III ), VO(IV), Th(IV), Zr(IV ) and UO2 (VI) with bis-bidentate Schiff base derived from 4,4'-bis[salicylaldehyde-5)-azo] diphenyl methane and aniline have been synthesized. The resulting compounds have been characterized on the basis of elemental analyses, reflectance and infrared spectral studies, magnetic measurements and thermogravimetric analysis and are found to have the general formula [M (BPSADM) xH2O]n. The ligand (H2BPSADM) act as a bis-bidentate molecule coordinating through the phenolic oxygen and azomethine nitrogen atoms. The thermal data have been analyzed for the kinetic parameters by using Broido's method. The thermal stability of these chelates decreases in the order Zr>M n>Th>UO2>Cr>Ti>Fe>VO. The thermal activation energy lies in the range 38.68 to 55. 18 kj mol-1 and the decomposition follows first order kinetics. The solid state conductivity of the ligand and its polychelates have been studied over the temperature range 313-493 K and the chelates are found to show semiconducting behaviour. The activation energy of the electrical conduction lies in the range 0.912 to 0.315 eV. The ligand and its polychelates have also been screened for their antimicrobial activities using various microorganisms and all of them have been found to be moderately active against the organisms

Toward FPGA-Based Semantic Caching for Accelerating Data Analysis with Spark and HDFS

International audienc

Trabecular bone remodeling in the aging mouse: A micro-multiphysics agent-based in silico model using single-cell mechanomics

Bone remodeling is regulated by the interaction between different cells and tissues across many spatial and temporal scales. Notably, in silico models are regarded as powerful tools to further understand the signaling pathways that regulate this intricate spatial cellular interplay. To this end, we have established a 3D multiscale micro-multiphysics agent-based (micro-MPA) in silico model of trabecular bone remodeling using longitudinal in vivo data from the sixth caudal vertebra (CV6) of PolgA((D257A/D257A)) mice, a mouse model of premature aging. Our in silico model includes a variety of cells as single agents and receptor-ligand kinetics, mechanomics, diffusion and decay of cytokines which regulate the cells' behavior. We highlighted its capabilities by simulating trabecular bone remodeling in the CV6 of five mice over 4 weeks and we evaluated the static and dynamic morphometry of the trabecular bone microarchitecture. Based on the progression of the average trabecular bone volume fraction (BV/TV), we identified a configuration of the model parameters to simulate homeostatic trabecular bone remodeling, here named basal. Crucially, we also produced anabolic, anti-anabolic, catabolic and anti-catabolic responses with an increase or decrease by one standard deviation in the levels of osteoprotegerin (OPG), receptor activator of nuclear factor kB ligand (RANKL), and sclerostin (Scl) produced by the osteocytes. Our results showed that changes in the levels of OPG and RANKL were positively and negatively correlated with the BV/TV values after 4 weeks in comparison to basal levels, respectively. Conversely, changes in Scl levels produced small fluctuations in BV/TV in comparison to the basal state. From these results, Scl was deemed to be the main driver of equilibrium while RANKL and OPG were shown to be involved in changes in bone volume fraction with potential relevance for age-related bone features. Ultimately, this micro-MPA model provides valuable insights into how cells respond to their local mechanical environment and can help to identify critical pathways affected by degenerative conditions and ageing.ISSN:2296-418