Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle

Summary The International Osteoporosis Foundation (IOF) Capture the Fracture Campaign aims to support implementation of Fracture Liaison Services (FLS) throughout the world. Introduction FLS have been shown to close the ubiquitous secondary fracture prevention care gap, ensuring that fragility fracture sufferers receive appropriate assessment and intervention to reduce future fracture risk. Methods Capture the Fracture has developed internationally endorsed standards for best practice, will facilitate change at the national level to drive adoption of FLS and increase awareness of the challenges and opportunities presented by secondary fracture prevention to key stakeholders. The Best Practice Framework (BPF) sets an international benchmark for FLS, which defines essential and aspirational elements of service delivery. Results The BPF has been reviewed by leading experts from many countries and subject to beta-testing to ensure that it is internationally relevant and fit-for-purpose. The BPF will also serve as a measurement tool for IOF to award ‘Capture the Fracture Best Practice Recognition’ to celebrate successful FLS worldwide and drive service development in areas of unmet need. The Capture the Fracture website will provide a suite of resources related to FLS and secondary fracture prevention, which will be updated as new materials become available. A mentoring programme will enable those in the early stages of development of FLS to learn from colleagues elsewhere that have achieved Best Practice Recognition. A grant programme is in development to aid clinical systems which require financial assistance to establish FLS in their localities. Conclusion Nearly half a billion people will reach retirement age during the next 20 years. IOF has developed Capture the Fracture because this is the single most important thing that can be done to directly improve patient care, of both women and men, and reduce the spiralling fracture-related care costs worldwide.</p

SOLVENT EFFECTS ON THE HYDRATION OF CYCLOHEXENE CATALYZED BY A STRONG ACID ION-EXCHANGE RESIN .2. EFFECT OF SULFOLANE ON THE REACTION-KINETICS

The kinetics of the' hydration of cyclohexene, catalyzed by a strong acid ion-exchange resin, have been studied in a packed bed reactor at temperatures between 353 and 413 K and a pressure of 20 bar. The kinetic rate constants were measured as a function of temperature and solvent composition (0-90 mol % solfolane in water). Macroporous Amberlite XE 307, a strong acid ion-exchange resin, was used as a catalyst. The influence of the solvent composition on the rate constant, which follows Arrhenius behavior, can be understood from changes in the activity coefficients of the reactant, the catalyst, and the activated complex. The decrease in rate constant between 0 and 60 mol % sulfolane is caused mainly by stabilization of cyclohexene. The observed increased rate constant above 60 mol % sulfolane is explained by an increased proton activity with increasing sulfolane content

SOLVENT EFFECTS ON THE HYDRATION OF CYCLOHEXENE CATALYZED BY A STRONG ACID ION-EXCHANGE RESIN .3. EFFECT OF SULFOLANE ON THE EQUILIBRIUM CONVERSION

The liquid-phase hydration of cyclohexene, a pseudo-first-order reversible reaction catalyzed by a strong acid ion-exchange resin, was investigated in solvent mixtures of water and sulfolane. Macroporous Amberlite XE 307 was used because of its superior catalytic activity. Chemical equilibrium conversions were measured as a function of temperature, 353 K <T <423 K, and solvent composition (between 0 and 90 mol % sulfolane in water). A decrease by a factor of 3 and 6 is observed in the experimentally measured equilibrium conversion for solvent mixtures with 60 and 90 mol % sulfolane, respectively. This effect is explained in terms of activity coefficients of the reaction species involved. Classical methods of thermodynamics allowed the computation of the equilibrium constant K(a), as K(a) = 2.37 X 10(-5) exp(30236/RT). From use of the predictive UNIFAC method to describe the liquid-phase nonideality, it was possible to estimate the equilibrium conversion of cyclohexene for every solvent composition and temperature. The predicted equilibrium conversions agree well with experimental results

SYNTHESIS OF METHYL TERT-BUTYL ETHER CATALYZED BY ACIDIC ION-EXCHANGE RESINS - INFLUENCE OF THE PROTON ACTIVITY

The catalytic activity of various strong acid ion-exchange resins on the synthesis of methyl tert-butyl ether (MtBE) from methanol and isobutene has been investigated. Relative to Amberlyst 15, Kastel CS 381 and Amberlyst CSP have similar rate constants, whereas Duolite ES 276 and Amberlyst XE 307 have significantly higher and Duolite C26 and Duolite C16P substantially lower rate constants. All resins show a great decrease in catalytic activity if part of the protons is exchanged by sodium ions. At 10% proton capacity the rate constants per equivalent acid are reduced by a factor of 9 (for Amberlyst XE 307 and Kastel CS 381) to more than a factor 20 for Amberlyst 15 and Duolite ES 276, resulting in 100-200 times lower MtBE production rates. Depending on the catalyst applied, mass transfer limitations start to occur between 50 and 80 degrees C. Values of the effective diffusion coefficient of isobutene varied between 0.4 x 10(-9) and 4.1 x 10(-9) m(2) s(-1) at 80 degrees C.</p

SOLVENT EFFECTS IN THE LIQUID-PHASE HYDRATION OF CYCLOHEXENE CATALYZED BY A MACROPOROUS STRONG ACID ION-EXCHANGE RESIN

The liquid-phase hydration of cyclohexene, a pseudo first order reversible reaction catalyzed by a strong acid ion exchange resin, macroporous Amberlite XE 307, was investigated in solvent mixtures of water and sulfolane. A decrease by a factor of 3 and 6 is observed in the experimentally measured equilibrium conversion for solvent mixtures with 60 and 90 mol% sulfolane, respectively. Addition of sulfolane to the reaction mixture causes a decrease in intrinsic reaction rate constant, but the overall conversion rate is substantially increased due to both the dramatic increase of the solubility of cyclohexene in the aqueous phase by sulfolane addition and the increased proton activity for sulfolane molfractions above 0.7

INFLUENCE OF THE ISOBUTENE METHANOL RATIO AND OF THE METHYL TERT-BUTYL ETHER CONTENT ON THE REACTION-RATE OF THE SYNTHESIS OF METHYL TERT-BUTYL ETHER

The forward reaction rate constant of the MtBE synthesis was determined for different reaction mixture compositions. The forward rate constant decreases continuously with increasing isobutene/methanol ratio, while an increase in reaction rate constant is observed with an increasing amount of MtBE in the reaction mixture. This effect has not been reported before. These so-called solvent effects could be explained by using a pseudo-homogeneous reaction rate model in combination with the transition state theory. Not only changes in activity of the initial state (reactants and ion exchange resin) but also changes in the activity of the activated complex turned out to Contribute to the solvent effects observed. Changes in the rate caused by changes in the activity of the activated complex are not accounted for in the existing homogeneous and heterogeneous models such as the Langmuir-Hinshelwood model