Evaluation of minimal fracture liaison service resource : costs and survival in secondary fracture prevention-a prospective one-year study in South-Finland

Background Fracture liaison service (FLS) is a secondary prevention model for identification of patients at risk for fragility fractures. Aims This study was conducted to evaluate the number and costs of secondary prevention of low-energy fractures in the city of Kouvola in Finland. Methods Women aged >= 45 years and men >= 60 years treated in the emergency department with a low-energy fracture were identified. Laboratory testing, BMI, and DXA scans were performed. Fracture Risk Assessment Tool was used. The direct FLS costs were calculated. Survival was analyzed using univariate and multivariate analysis and the life-table method. Results 525 patients with 570 fractures were identified. The mean age of women was 73.8 years and of men 75.9 years. Most patients sustained wrist (31%), hip (21%) or proximal humerus (12%) fractures. 41.5% of the patients had osteoporosis according to DXA scans. 62% of patients used calcium and vitamin D daily and 38% started anti-osteoporotic medication. Protective factors for survival were: age <80 years, female sex, and S-25OHD concentration of 50-119 nmol/L. Excess mortality was highest among patients with a fracture of the femur. The total annual direct costs of FLS were 1.3% of the costs of all fractures. Discussion Many low-energy fracture types were associated with excess mortality. The use of anti-osteoporotic medication was not optimal. Conclusions FLS increased the catchment of low-energy fracture patients and was inexpensive. However, identification, evaluation and post-fracture assessment of patients should be expedited. Rehabilitation of hip fracture patients needs to be improved.Peer reviewe

Comment on "1/f noise in the Bak-Sneppen model"

Contrary to the recently published results by Daerden and Vanderzande [Phys. Rev. E 53, 4723 (1996)], we show that the time correlation function in the random-neighbor version of the Bak-Sneppen model can be well approximated by an exponential giving rise to a 1/f2 power spectrum.Comment: 2 pages, 2 figure

Cycling injuries and alcohol

Background: Most of the cycling accidents that occur in Finland do not end up in the official traffic accident statistics. Thus, there is minimal information on these accidents and their consequences, particularly in cases in which alcohol was involved. The focus of the present study is on cycling accidents and injuries involving alcohol in particular. Methods: Data on patients visiting the emergency department at North Kymi Hospital because of a cycling accident was prospectively collected for two years, from June 1, 2004 to May 31, 2006. Blood alcohol concentration (BAC) was measured on admission with a breath analyser. The severity of the cycling injuries was classified according to the Abbreviated Injury Scale (AIS). Results: A total of 217 cycling accidents occurred. One third of the injured cyclists were involved with alcohol at the time of visiting the hospital. Of these, 85% were males. A blood alcohol concentration of Conclusions: Cyclists involved with alcohol were, in most cases, heavily intoxicated and were not wearing a bicycle helmet. Head injuries were more common among these cyclists than among sober cyclists. As cycling continues to increase, it is important to monitor cycling accidents, improve the accident statistics and heighten awareness of the risks of head injuries when cycling under the influence of alcohol. (c) 2018 Elsevier Ltd. All rights reserved.Peer reviewe

Measurement and modeling of ablation of the bottom of supraglacial lakes in western Greenland

We report measurements of ablation rates of the bottom of two supraglacial lakes and of temperatures at different depths collected during the summers of 2010 and 2011 in west Greenland. To our knowledge, this is the first time that such data sets are reported and discussed in the literature. The measured ablation rates at the bottom of the two lakes are of the order of ∼6 cm/day, versus a rate of ∼2.5–3 cm/day in the case of bare ice of surrounding areas. Though our measurements suggest the presence of a vertical temperature gradient, it is not possible to draw final conclusions as the measured gradient is smaller than the accuracy of our temperature sensors. In-situ measurements are compared with the results of a thermodynamic model forced with the outputs of a regional climate model. In general, the model is able to satisfactorily reproduce the measured quantities with RMSE of the order of 3–4 cm for the ablation and ∼1.5°C in the case of water temperature. Our results confirm that the ablation at the bottom of supraglacial lakes plays an important role on the overall lake volume with the ablation in the case of ice covered by a lake being 110–135% of that over bare ice at nearby locations. Beside ice sheet hydrological implications, melting at the bottom of a supraglacial lake might affect estimates of lake volume from spaceborne visible and near-infrared measurements

A Chinese Model for Labour in Europe?

Based on long-term fieldwork in multiple locations, our article questions the approach that posits a Chinese model of work and employment relations as increasingly exporting its form of labour management and dominating worldwide. It does so by focusing on Europe and discussing two labour regimes considered as typically Chinese: the Chinese fashion workshops in the Italian fashion industry, and the Foxconn electronics plants in the Czech Republic. Our findings bring new insights to bear on issues for which research is still thin on the ground and challenge the hypothesis of a \u2018Chinesisation\u2019 of work and employment practices in Chinese small firms and MNCs operating in Europe. We move the focus away from the simple analysis of firm management prevailing in the literature and suggest that, in order to understand the firm\u2019s behaviours, the role of the state, the unions, the migrant workers and the role of temporary work agencies should all be taken into consideration

Time--delay autosynchronization of the spatio-temporal dynamics in resonant tunneling diodes

The double barrier resonant tunneling diode exhibits complex spatio-temporal patterns including low-dimensional chaos when operated in an active external circuit. We demonstrate how autosynchronization by time--delayed feedback control can be used to select and stabilize specific current density patterns in a noninvasive way. We compare the efficiency of different control schemes involving feedback in either local spatial or global degrees of freedom. The numerically obtained Floquet exponents are explained by analytical results from linear stability analysis.Comment: 10 pages, 16 figure