Prevention of osteoporotic refractures in regional Australia

Objective: Clinical guidelines recommend that patients who sustain a minimal trauma fracture (MTF) should receive a bone mineral density (BMD) scan and bisphosphonate (or equivalent) therapy if diagnosed with osteoporosis. A pilot fracture liaison service (FLS) was implemented in regional NSW to improve adherence to the guidelines. Design: Prospective cohort study with an historical control. Setting: Primary care. Participants: Control (n = 47) and cohort (n = 93) groups comprised patients consenting to interview who presented with a MTF to the major referral hospital 4 months before and 12 months after FLS implementation respectively. Main outcome measures: Primary outcome measures were the rates of BMD scans and anti-osteoporotic medication initiation/review after MTF. Hospital admission data were also examined to determine death and refracture rates for all patients presenting during the study period with a primary diagnosis of MTF within 3 years of their initial fracture. Results: Although there was no improvement in BMD scanning rates, the reported rate of medication initiation/review after fracture was significantly higher (P \u3c 0.05) in the FLS cohort. However, once adjusted for age, this association was not significant (P = 0.086). There was a lower refracture rate during the cohort period (P = 0.013), however, there were significantly more deaths (P = 0.035) within 3 years of initial fracture. When deaths were taken into account via competing risk regression, patients in the cohort period were significantly less likely to refracture than those in the control period (Hazard ratio = 0.576, P = 0.032). Conclusions: A rurally based nurse-led FLS was associated with modest improvement after MTF. Consideration should be given to ways to strengthen the model of care to improve outcomes

Application of computer-aided dispatch in law enforcement: An introductory planning guide

A set of planning guidelines for the application of computer-aided dispatching (CAD) to law enforcement is presented. Some essential characteristics and applications of CAD are outlined; the results of a survey of systems in the operational or planning phases are summarized. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with numerous examples. Detailed descriptions of typical law enforcement CAD systems, and a list of vendor sources, are given in appendixes

Entrapment: an important mechanism to explain the shortwave 3D radiative effect of clouds

Several mechanisms have previously been proposed to explain differences between the shortwave reflectance of realistic cloud scenes computed using the 1D independent column approximation (ICA) and 3D solutions of the radiative transfer equation. When the sun is low in the sky, interception of sunlight by cloud sides tends to increase reflectance relative to ICA estimates that neglect this effect. When the sun is high, 3D radiative transfer tends to make clouds less reflective, which we argue is explained by the mechanism of “entrapment” whereby horizontal transport of radiation beneath a cloud layer increases the chances, relative to the ICA, of light being absorbed by cloud or the surface. It is especially important for multilayered cloud scenes. We describe modifications to the previously described Speedy Algorithm for Radiative Transfer through Cloud Sides (SPARTACUS) to represent different entrapment assumptions, and test their impact on 65 contrasting scenes from a cloud-resolving model. When entrapment is represented explicitly via a calculation of the mean horizontal distance traveled by reflected light, SPARTACUS predicts a mean “3D radiative effect” (the difference in top-of-atmosphere irradiances between 3D and ICA calculations) of 8.1 W m−2 for overhead sun. This is within 2% of broadband Monte Carlo calculations on the same scenes. The importance of entrapment is highlighted by the finding that the extreme assumptions in SPARTACUS of “zero entrapment” and “maximum entrapment” lead to corresponding mean 3D radiative effects of 1.7 and 19.6 W m−2, respectively

A photoelectron imaging and quantum chemistry study of the deprotonated indole anion

Indole is an important molecular motif in many biological molecules and exists in its deprotonated anionic form in the cyan fluorescent protein, an analogue of green fluorescent protein. However, the electronic structure of the deprotonated indole anion has been relatively unexplored. Here, we use a combination of anion photoelectron velocity-map imaging measurements and quantum chemistry calculations to probe the electronic structure of the deprotonated indole anion. We report vertical detachment energies (VDEs) of 2.45 ± 0.05 eV and 3.20 ± 0.05 eV, respectively. The value for D₀ is in agreement with recent high-resolution measurements whereas the value for D₁ is a new measurement. We find that the first electronically excited singlet state of the anion, S₁(ππ*), lies above the VDE and has shape resonance character with respect to the D₀ detachment continuum and Feshbach resonance character with respect to the D₁ continuum

The Morality of Moral Education

The Background - Moral Education as the Traditional Source of Personal Development. One of the abiding interests of moral philosophy is how some measure of competence at existence can not only be attained, but attained to an excellent degree. The idea that man is born imperfect but may so order his life that he approaches a more complete state of perfection has been echoed in the words and deeds of men through the ages. It is reflected in our willingness to revere those men and women who in their lives neared the condition of existential entelechy. Throughout the ages, for instance, humankind has sought out heroes and martyrs who by virtue of their superior conduct and more impressive virtues have become the models upon which lesser men and women model their own lives

Differentiation state-specific mitochondrial dynamic regulatory networks are revealed by global transcriptional analysis of the developing chicken lens.

The mature eye lens contains a surface layer of epithelial cells called the lens epithelium that requires a functional mitochondrial population to maintain the homeostasis and transparency of the entire lens. The lens epithelium overlies a core of terminally differentiated fiber cells that must degrade their mitochondria to achieve lens transparency. These distinct mitochondrial populations make the lens a useful model system to identify those genes that regulate the balance between mitochondrial homeostasis and elimination. Here we used an RNA sequencing and bioinformatics approach to identify the transcript levels of all genes expressed by distinct regions of the lens epithelium and maturing fiber cells of the embryonic Gallus gallus (chicken) lens. Our analysis detected more than 15,000 unique transcripts expressed by the embryonic chicken lens. Of these, more than 3000 transcripts exhibited significant differences in expression between lens epithelial cells and fiber cells. Multiple transcripts coding for separate mitochondrial homeostatic and degradation mechanisms were identified to exhibit preferred patterns of expression in lens epithelial cells that require mitochondria relative to lens fiber cells that require mitochondrial elimination. These included differences in the expression levels of metabolic (DUT, PDK1, SNPH), autophagy (ATG3, ATG4B, BECN1, FYCO1, WIPI1), and mitophagy (BNIP3L/NIX, BNIP3, PARK2, p62/SQSTM1) transcripts between lens epithelial cells and lens fiber cells. These data provide a comprehensive window into all genes transcribed by the lens and those mitochondrial regulatory and degradation pathways that function to maintain mitochondrial populations in the lens epithelium and to eliminate mitochondria in maturing lens fiber cells

Longitudinal Assessment of Antisaccades in Patients with Multiple Sclerosis

We have previously demonstrated that assessment of antisaccades (AS) provides not only measures of motor function in multiple sclerosis (MS), but measures of cognitive control processes in particular, attention and working memory. This study sought to demonstrate the potential for AS measures to sensitively reflect change in functional status in MS. Twenty-four patients with relapsing-remitting MS and 12 age-matched controls were evaluated longitudinally using an AS saccade task. Compared to control subjects, a number of saccade parameters changed significantly over a two year period for MS patients. These included saccade error rates, latencies, and accuracy measures. Further, for MS patients, correlations were retained between OM measures and scores on the PASAT, which is considered the reference task for the cognitive evaluation of MS patients. Notably, EDSS scores for these patients did not change significantly over this period. These results demonstrate that OM measures may reflect disease evolution in MS, in the absence of clinically evident changes as measured using conventional techniques. With replication, these markers could ultimately be developed into a cost-effective, non-invasive, and well tolerated assessment tool to assist in confirming progression early in the disease process, and in measuring and predicting response to therapy

Diploma in Education? Rethinking the Curriculum.

For well over half a century the traditional end-on diploma year has been under fire from university departments, students, and the teaching profession. How is it possible in one year for students to reach adequate levels of knowledge and understanding in a large number of subjects, epistemologicalIy diverse and frequently outside their undergraduate experience? The answer of course, is that it is not possible to believe otherwise is to labour under gross delusion. A university department of education, acting with the best of intentions, cannot give more than cursory attention to even the most essential elements of a preservice programme within an abbreviated academic year

SPATIAL ANALYSIS OF GRASSHOPPER DENSITY AS INFLUENCED BY ANTHROPOGENIC HABITAT CHANGES

The rangeland environment in southern Idaho has been heavily impacted by human activities. Invasion by exotic plant species, frequent fires, grazing pressure, and other ecological disturbances have greatly affected the structure and dynamics of grasshopper populations. Quantification of spatial patterns of grasshopper density and species composition is important in order to determine their influence on grassland ecosystems, as well as evaluating managerial decisions concerning vegetation manipulations, grazing practices, and spraying programs. A spatial statistical approach to modeling the heterogeneity of grasshopper populations is presented, and the impact of vegetation and grazing treatments on grasshopper density is investigated. Empirical applications are demonstrated with reference to repeated field surveys conducted over several years in south central Idaho

Moderate influenza vaccine effectiveness in Victoria, Australia, 2011

We used a sentinel general practitioner (GP) network to conduct surveillance for laboratory-confirmed influenza amongst patients presenting with influenza-like illness (ILI) in Victoria, Australia in 2011. The test-negative variation of the case control study design was used to estimate effectiveness for seasonal trivalent influenza vaccine. Cases and controls were ILI patients that tested positive and negative for influenza, respectively. Vaccination status was recorded by GPs and vaccine effectiveness (VE) was calculated as (1-adjusted odds ratio)x100%. There were 529 patients included in the study, of which 29% were influenza-positive. Twelve percent of study participants were reported as vaccinated, 6% of cases and 15% of controls. Adjusted VE against all influenza was 56%, but not statistically significant. There was generally little variation in VE estimates when stratified by virus type and subtype, which is consistent with good matches between circulating strains and the vaccine strains. The VE was higher among adults of working age than among children