Increased orthogeriatrician involvement in hip fracture care and its impact on mortality in England

OBJECTIVE: to describe the increase in orthogeriatrician involvement in hip fracture care in England and its association with improvements in time to surgery and mortality. STUDY DESIGN: analysis of Hospital Episode Statistics for 196,401 patients presenting with hip fracture to 150 hospitals in England between 1 April 2010 and 28 February 2014, combined with data on orthogeriatrician hours from a national organisational survey. METHODS: we examined changes in the average number of hours worked by orthogeriatricians in orthopaedic departments per patient with hip fracture, and their potential effect on mortality within 30 days of presentation. The role of prompt surgery (on day of or day after presentation) was explored as a potential confounding factor. Associations were assessed using conditional Poisson regression models with adjustment for patients’ sex, age and comorbidity and year, with hospitals treated as fixed effects. RESULTS: between 2010 and 2013, there was an increase of 2.5 hours per patient in the median number of hours worked by orthogeriatricians—from 1.5 to 4.0 hours. An increase of 2.5 hours per patient was associated with a relative reduction in mortality of 3.4% (95% confidence interval 0.9% to 5.9%, P = 0.01). This corresponds to an absolute reduction of approximately 0.3%. Higher numbers of orthogeriatrician hours were associated with higher rates of prompt surgery, but were independently associated with lower mortality. CONCLUSION: in the context of initiatives to improve hip fracture care, we identified statistically significant and robust associations between increased orthogeriatrician hours per patient and reduced 30-day mortality

Mixed-valent ruthenium oxide - ruthenium cyanide inorganic film on glassy carbon electrodes as an amperometric sensor of aliphatic alcohols

A mixed-valent ruthenium oxide-ruthenium cyanide film on glassy carbon (GC/mvRuO-RuCN) electrode exhibits excellent electrocatalytic activity toward oxidation of simple aliphatic alcohols and polyhydric compounds in acidic media. Electrochemical formation of the ruthenium oxide-based chemically modified electrode can be accomplished by potential cycling or potentiostatic control in diluted sulfuric acid solutions. The attractive electrooxidation capabilities of hydroxyl-containing compounds at this modified electrode are highlighted in terms of sensitivity, stability, and catalytic action. Remarkably, the molar response of the catalytic oxidation increases on increasing the chain length of aliphatic alcohols. For example, the molar response ratio between 1-butanol and methanol is 37 in 25 mM sulfuric acid. Chromatographic separations with electrochemical detection using the GC/mvRuO-RuCN modified electrode allo rr very simple quantitation of aliphatic alcohols in real samples with linear calibration plots over about 3 orders of magnitude. The detection limits for ethanol, 1-propanol, 1-butanol, and 1-pentanol are 4, 0.8, 1, and 2 nmol injected (S/N = 3), respectively

Halos show the path to perfection : peripheral iodo-substituents improve the efficiencies of bis(diimine)copper(I) dyes in dye-sensitized solar cells

The homoleptic copper(I) complexes [CuL2][PF6] (L = 4,4′-bis(4-halophenyl)-6,6′-dimethyl-2,2′-bipyridine with halogen = F (2) and Cl (3)) have been prepared and characterized, and their absorption spectroscopic and electrochemical properties compared to that with L = 4,4′-bis(4-bromophenyl)-6,6′-dimethyl-2,2′-bipyridine (4). The synthesis of [CuL2][PF6] (L = 4,4′-bis(4-iodophenyl)-6,6′-dimethyl-2,2′-bipyridine, 5) resulted in a mixture of [Cu(5)2][PF6] and [Cu(5)(MeCN)2][PF6]; variable temperature 1H NMR spectroscopy confirmed that the complexes are in equilibrium in CD3CN solution. The structure of [Cu(5)(MeCN)2][PF6] was determined by single crystal X-ray crystallography, and confirms a distorted tetrahedral geometry for the copper(I) centre. The heteroleptic dyes [Cu(1)(2)]+, [Cu(1)(3)]+, [Cu(1)(4)]+ and [Cu(1)(5)]+ (1 = ((6,6′-dimethyl-[2,2′-bipyridine]-4,4′-diyl)bis(4,1-phenylene))bis(phosphonic acid)) have been assembled by ligand exchange between [CuL2]+ and TiO2 functionalized with the anchoring ligand 1, and the performances of the dyes in fully masked dye-sensitized solar cells (DSCs) have been measured and compared. On the day of DSC fabrication, the trend for the global efficiencies, η, depends on the halo-substituent in the order I > F ≈ Br > Cl. Ripening of the DSCs occurs and after 7 days, the dependence of η on the halo-atom is in the order I > Cl ≈ F ≈ Br; the highest η is 3.16% for [Cu(1)(5)]+ compared to 7.63% for N719. Compared to the other halo-functionalized dyes, [Cu(1)(5)]+ shows an extended spectral response to longer wavelength, with enhanced electron injection. The results of DFT calculations suggest that the better dye performance of [Cu(1)(5)]+ may be associated with improved electron transfer over the halogen of the aryl substituent from the reduced electrolyte. The assembly of anchored dye [Cu(1)(5)]+ by treating functionalized-TiO2 with a 1 : 1 mixture of [Cu(MeCN)4]+ and 5, yields a dye which gives a DSC performance that matches that made by ligand exchange using [Cu(5)2][PF6] and [Cu(5)(MeCN)2][PF6]