Psychiatric illness predicts poor outcome after surgery for hip fracture: a prospective cohort study

Background. Hip fracture is common in the elderly. Previous studies suggest that psychiatric illness is common and predicts poor outcome, but have methodological weaknesses. Further studies are required to address this important issue. Methods. We prospectively recruited 731 elderly participants with hip fracture in two Leeds hospitals. Psychiatric diagnosis was made within 5 days of surgery using the Geriatric Mental State schedule and other standardized instruments, and data on confounding factors was collected. Main study outcomes were length of hospital stay, and mortality over 6 months after fracture. Results. Fifty-five per cent of participants had cognitive impairment (dementia in 40% and delirium in 15%), 13% had a depressive disorder, 2% had alcohol misuse and 2% had other psychiatric diagnoses. Participants were likely to remain in hospital longer if they suffered from dementia, delirium or depression. The relative risks of mortality over 6 months after hip fracture were increased in dementia and delirium, but not in depression. Conclusions. Psychiatric illness is common after hip fracture, and has significant effects on important outcomes. This suggests a need for randomized, controlled trials of psychiatric interventions in the elderly hip fracture population

Patterns of Late Cenozoic exhumation deduced from apatite and zircon U-He ages from Fiordland, New Zealand

New apatite and zircon (U-Th)/He ages from the Fiordland region of New Zealand's South Island expand on earlier results and provide new constraints on patterns of Late Cenozoic exhumation and cooling across this region. Zircon (U-Th)/He cooling ages, in combination with increased density of apatite ages, show that in addition to a gradual northward decrease in cooling ages that was seen during an earlier phase of this study, there is also a trend toward younger cooling ages to the east. Distinct breaks in cooling age patterns on southwestern Fiordland appear to be correlated to the location of previously mapped faults. The northward decrease in ages may reflect asynchronous cooling related to migration in the locus of exhumation driven by subduction initiation, or it may reflect synchronous regional exhumation that exposed different structural levels across Fiordland, or some combination of these effects. In either case, differential exhumation accommodated by major and minor faults that dissect Fiordland basement rocks apparently played an important role in producing the resulting age patterns

Hybridized polymer matrix composites

The extent to which graphite fibers are released from resin matrix composites that are exposed to fire and impact conditions was determined. Laboratory simulations of those conditions that could exist in the event of an aircraft crash and burn situation were evaluated. The effectiveness of various hybridizing concepts in preventing this release of graphite fibers were also evaluated. The baseline (i.e., unhybridized) laminates examined were prepared from commercially available graphite/epoxy, graphite/polyimide, and graphite/phenolic materials. Hybridizing concepts investigated included resin fillers, laminate coatings, resin blending, and mechanical interlocking of the graphite reinforcement. The baseline and hybridized laminates' mechanical properties, before and after isothermal and humidity aging, were also compared. It was found that a small amount of graphite fiber was released from the graphite/epoxy laminates during the burn and impact conditions used in this program. However, the extent to which the fibers were released is not considered a severe enough problem to preclude the use of graphite reinforced composites in civil aircraft structure. It also was found that several hybrid concepts eliminated this fiber release. Isothermal and humidity aging did not appear to alter the fiber release tendencies

Insights from unifying modern approximations to infections on networks

Networks are increasingly central to modern science owing to their ability to conceptualize multiple interacting components of a complex system. As a specific example of this, understanding the implications of contact network structure for the transmission of infectious diseases remains a key issue in epidemiology. Three broad approaches to this problem exist: explicit simulation; derivation of exact results for special networks; and dynamical approximations. This paper focuses on the last of these approaches, and makes two main contributions. Firstly, formal mathematical links are demonstrated between several prima facie unrelated dynamical approximations. And secondly, these links are used to derive two novel dynamical models for network epidemiology, which are compared against explicit stochastic simulation. The success of these new models provides improved understanding about the interaction of network structure and transmission dynamics

COOL and Consumers' Willingness to Pay in the Fresh Produce Industry - Some Initial Impressions from the Field

The debate about Country-of-Origin labeling (COOL) has centered on the projected benefits and costs of its implementation. This study uses data from a Vickery auction (n=320) to estimate willingness to pay for COOL. Preliminary findings suggest, on average, consumers value COOL, are not homogenous, and prefer fresh produce grown in the U.S.Food Consumption/Nutrition/Food Safety, International Relations/Trade,

COOL AND CONSUMERS' WILLINGNESS TO PAY IN THE FRESH PRODUCE INDUSTRY - SOME INITIAL IMPRESSIONS FROM THE FIELD

The debate about Country-of-Origin labeling (COOL) has centered on the projected benefits and costs of its implementation. This study uses data from a Vickery auction (n=200) to estimate willingness to pay for COOL. Preliminary findings suggest, on average, consumers value COOL, are not homogeneous, and prefer fresh produce grown in the U.S.Consumer/Household Economics,

Social encounter networks : collective properties and disease transmission

A fundamental challenge of modern infectious disease epidemiology is to quantify the networks of social and physical contacts through which transmission can occur. Understanding the collective properties of these interactions is critical for both accurate prediction of the spread of infection and determining optimal control measures. However, even the basic properties of such networks are poorly quantified, forcing predictions to be made based on strong assumptions concerning network structure. Here, we report on the results of a large-scale survey of social encounters mainly conducted in Great Britain. First, we characterize the distribution of contacts, which possesses a lognormal body and a power-law tail with an exponent of −2.45; we provide a plausible mechanistic model that captures this form. Analysis of the high level of local clustering of contacts reveals additional structure within the network, implying that social contacts are degree assortative. Finally, we describe the epidemiological implications of this local network structure: these contradict the usual predictions from networks with heavy-tailed degree distributions and contain public-health messages about control. Our findings help us to determine the types of realistic network structure that should be assumed in future population level studies of infection transmission, leading to better interpretations of epidemiological data and more appropriate policy decisions

Lipopolysaccharide and toll-like receptor 4 in dogs with congenital portosystemic shunts

Surgical attenuation of a congenital portosystemic shunt (CPSS) results in increased portal vein perfusion, liver growth and clinical improvement. Portal lipopolysaccharide (LPS) is implicated in liver regeneration via toll-like receptor (TLR) 4 mediated cytokine activation. The aim of this study was to investigate factors associated with LPS in dogs with CPSS. Plasma LPS concentrations were measured in the peripheral and portal blood using a limulus amoebocyte lysate (LAL) assay. LPS concentration was significantly greater in the portal blood compared to peripheral blood in dogs with CPSS (P = 0.046) and control dogs (P = 0.002). LPS concentrations in the peripheral (P = 0.012) and portal (P = 0.005) blood of dogs with CPSS were significantly greater than those of control dogs. The relative mRNA expression of cytokines and TLRs was measured in liver biopsies from dogs with CPSS using quantitative PCR. TLR4 expression significantly increased following partial CPSS attenuation (P = 0.020). TLR4 expression was significantly greater in dogs that tolerated complete CPSS attenuation (P = 0.011) and those with good portal blood flow on pre-attenuation (P = 0.004) and post-attenuation (P = 0.015) portovenography. Serum interleukin (IL)-6 concentration was measured using a canine specific ELISA and significantly increased 24 h following CPSS attenuation (P < 0.001). Portal LPS was increased in dogs with CPSS, consistent with decreased hepatic clearance. TLR4 mRNA expression was significantly associated with portal blood flow and increased following surgery. These findings support the concept that portal LPS delivery is important in the hepatic response to surgical attenuation. Serum IL-6 significantly increased following surgery, consistent with LPS stimulation via TLR4, although this increase might be non-specific

Perceptions of knowledge sharing among small family firm leaders: a structural equation model

Small family firms have many unique relational qualities with implications for how knowledge is passed between individuals. Extant literature posits leadership approach as important in explaining differences in knowledge-sharing climate from one firm to another. This study investigates how leadership approaches interact with family influence to inform perceptions of knowledge sharing. We utilize survey data (n = 110) from owner-managers of knowledge-intensive small family firms in Scotland. Our findings present a choice in leadership intention, contrasting organization-focused participation against family-influenced guidance. Insight is offered on the implications of this leadership choice at both organizational and familial level

GeoZui3D: Data Fusion for Interpreting Oceanographic Data

GeoZui3D stands for Geographic Zooming User Interface. It is a new visualization software system designed for interpreting multiple sources of 3D data. The system supports gridded terrain models, triangular meshes, curtain plots, and a number of other display objects. A novel center of workspace interaction method unifies a number of aspects of the interface. It creates a simple viewpoint control method, it helps link multiple views, and is ideal for stereoscopic viewing. GeoZui3D has a number of features to support real-time input. Through a CORBA interface external entities can influence the position and state of objects in the display. Extra windows can be attached to moving objects allowing for their position and data to be monitored. We describe the application of this system for heterogeneous data fusion, for multibeam QC and for ROV/AUV monitoring