A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival

Background and Aims: Reoperations after operative treatment of hip fracture patients may be associated with higher costs and inferior survival. We examined the acute hospital costs, long-term reoperation rates, and survival of patients with a new hip fracture. Materials and Methods: A total of 490 consecutive new hip fracture patients treated at a single center between 31 December 2004 and 6 December 2006 were analyzed retrospectively. Fractures were classified according to Garden and AO. All medical records were checked manually. The costs of reoperations were calculated using the diagnosis-related groups (DRG)-based prices. Survival analysis was performed using the life-table method. The follow-up time was 10 years. Results: In all, 70/490 patients (14.3%) needed reoperations. Of all reoperations, 34.2% were performed during the first month and 72.9% within 1 year after the primary operation. The hemiarthroplasty dislocation rate was 8.5%, and mechanical failures of osteosynthesis occurred in 6.2%. Alcohol abuse was associated with a heightened risk of reoperation. The mean direct costs of primary fracture care were lower than the mean costs of reoperations (euro7500 vs euro9800). The mortality rate at 10 years was 79.8% among non-reoperated patients and 62.9% among reoperated patients. Conclusions: According to our hypothesis, the cost per patient of reoperation in acute care was 31% higher than the corresponding cost of a primary operation. Reoperations increased the overall immediate costs of index fractures by nearly 20%. One-third of all reoperations were performed during the first month and almost 75% within 1 year after the primary operation.Peer reviewe

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

Regional High-Resolution Benthic Habitat Data From Planet Dove Imagery For Conservation Decision-Making and Marine Planning

High-resolution benthic habitat data fill an important knowledge gap for many areas of the world and are essential for strategic marine conservation planning and implementing effective resource management. Many countries lack the resources and capacity to create these products, which has hindered the development of accurate ecological baselines for assessing protection needs for coastal and marine habitats and monitoring change to guide adaptive management actions. The PlanetScope (PS) Dove Classic SmallSat constellation delivers high-resolution imagery (4 m) and near-daily global coverage that facilitates the compilation of a cloud-free and optimal water column image composite of the Caribbean’s nearshore environment. These data were used to develop a first-of-its-kind regional thirteen-class benthic habitat map to 30 m water depth using an object-based image analysis (OBIA) approach. A total of 203,676 km2 of shallow benthic habitat across the Insular Caribbean was mapped, representing 5% coral reef, 43% seagrass, 15% hardbottom, and 37% other habitats. Results from a combined major class accuracy assessment yielded an overall accuracy of 80% with a standard error of less than 1% yielding a confidence interval of 78–82%. Of the total area mapped, 15% of these habitats (31,311.7 km2) are within a marine protected or managed area. This information provides a baseline of ecological data for developing and executing more strategic conservation actions, including implementing more effective marine spatial plans, prioritizing and improving marine protected area design, monitoring condition and change for post-storm damage assessments, and providing more accurate habitat data for ecosystem service models

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

An Evaluation Model For Web-based 3D Mass Customization Toolkit Design

The development of geometric modelling technologies and web technologies provides the ability to present a virtual 3D product in a mass customization (MC) toolkit. Compared with 2D graphic toolkits, 3D toolkit design requires better consideration of individual customer needs, consumer and toolkit interaction, and also a means of integrating with the underlying technical infrastructure. However, there is currently no widely accepted model or criteria to regulate and evaluate 3D MC toolkit design. Given these considerations, in this paper we provide an evaluation model for web-based 3D toolkits and a heuristic evaluation of two representative commercial web-based 3D toolkits. The evaluation results indicate the usefulness and effectiveness of the model as a scale for evaluating 3D toolkits. It also reveals that despite a fair amount of effort that has been devoted to theoretical research, current 3D toolkits are still at an early development stage. We therefore conclude this paper by identifying and encouraging further topics and questions as directions for future research

Working people with type 1 diabetes in the Finnish population

Peer reviewe

Survival in amoeba: a major selection pressure on the presence of bacterial copper and zinc resistance determinants?: identification of a "copper pathogenicity island"

The presence of metal resistance determinants in bacteria usually is attributed to geological or anthropogenic metal contamination in different environments or associated with the use of antimicrobial metals in human healthcare or in agriculture. While this is certainly true, we hypothesize that protozoan predation and macrophage killing are also responsible for selection of copper/zinc resistance genes in bacteria. In this review, we outline evidence supporting this hypothesis, as well as highlight the correlation between metal resistance and pathogenicity in bacteria. In addition, we introduce and characterize the "copper pathogenicity island" identified in Escherichia coli and Salmonella strains isolated from copper- and zinc-fed Danish pigs

Vitamin D Induction of the Human Antimicrobial Peptide Cathelicidin in the Urinary Bladder

The urinary tract is frequently being exposed to potential pathogens and rapid defence mechanisms are therefore needed. Cathelicidin, a human antimicrobial peptide is expressed and secreted by bladder epithelial cells and protects the urinary tract from infection. Here we show that vitamin D can induce cathelicidin in the urinary bladder. We analyzed bladder tissue from postmenopausal women for expression of cathelicidin, before and after a three-month period of supplementation with 25-hydroxyvitamin D3 (25D3). Cell culture experiments were performed to elucidate the mechanisms for cathelicidin induction. We observed that, vitamin D per se did not up-regulate cathelicidin in serum or in bladder tissue of the women in this study. However, when the bladder biopsies were infected with uropathogenic E. coli (UPEC), a significant increase in cathelicidin expression was observed after 25D3 supplementation. This observation was confirmed in human bladder cell lines, even though here, cathelicidin induction occurred irrespectively of infection. Vitamin D treated bladder cells exerted an increased antibacterial effect against UPEC and colocalization to cathelicidin indicated the relevance of this peptide. In the light of the rapidly growing problem of resistance to common urinary tract antibiotics, we suggest that vitamin D may be a potential complement in the prevention of UTI

From Producer Innovation to User and Open Collaborative Innovation

In this paper we assess the economic viability of innovation by producers relative to two increasingly important alternative models: innovations by single user individuals or firms, and open collaborative innovation. We analyze the design costs and architectures and communication costs associated with each model. We conclude that both innovation by individual users and open collaborative innovation increasingly compete with and may displace producer innovation in many parts of the economy. We explain why this represents a paradigm shift with respect to innovation research, policymaking, and practice. We discuss important implications and offer suggestions for further research

The Ustilago maydis Effector Pep1 Suppresses Plant Immunity by Inhibition of Host Peroxidase Activity

The corn smut Ustilago maydis establishes a biotrophic interaction with its host plant maize. This interaction requires efficient suppression of plant immune responses, which is attributed to secreted effector proteins. Previously we identified Pep1 (Protein essential during penetration-1) as a secreted effector with an essential role for U. maydis virulence. pep1 deletion mutants induce strong defense responses leading to an early block in pathogenic development of the fungus. Using cytological and functional assays we show that Pep1 functions as an inhibitor of plant peroxidases. At sites of Δpep1 mutant penetrations, H2O2 strongly accumulated in the cell walls, coinciding with a transcriptional induction of the secreted maize peroxidase POX12. Pep1 protein effectively inhibited the peroxidase driven oxidative burst and thereby suppresses the early immune responses of maize. Moreover, Pep1 directly inhibits peroxidases in vitro in a concentration-dependent manner. Using fluorescence complementation assays, we observed a direct interaction of Pep1 and the maize peroxidase POX12 in vivo. Functional relevance of this interaction was demonstrated by partial complementation of the Δpep1 mutant defect by virus induced gene silencing of maize POX12. We conclude that Pep1 acts as a potent suppressor of early plant defenses by inhibition of peroxidase activity. Thus, it represents a novel strategy for establishing a biotrophic interaction