Fracture clinic redesign reduces the cost of outpatient orthopaedic trauma care

Objectives: “Virtual fracture clinics” have been reported as a safe and effective alternative to the traditional fracture clinic. Robust protocols are used to identify cases that do not require further review, with the remainder triaged to the most appropriate subspecialist at the optimum time for review. The objective of this study was to perform a “top-down” analysis of the cost effectiveness of this virtual fracture clinic pathway. Methods: National Health Service financial returns relating to our institution were examined for the time period 2009 to 2014 which spanned the service redesign. Results: The total staffing costs rose by 4% over the time period (from £1 744 933 to £1 811 301) compared with a national increase of 16%. The total outpatient department rate of attendance fell by 15% compared with a national fall of 5%. Had our local costs increased in line with the national average, an excess expenditure of £212 705 would have been required for staffing costs. Conclusions: The virtual fracture clinic system was associated with less overall use of staff resources in comparison to national cost data. Adoption of this system nationally may have the potential to achieve significant cost savings

The History of Galaxy Formation in Groups: An Observational Perspective

We present a pedagogical review on the formation and evolution of galaxies in groups, utilizing observational information from the Local Group to galaxies at z~6. The majority of galaxies in the nearby universe are found in groups, and galaxies at all redshifts up to z~6 tend to cluster on the scale of nearby groups (~1 Mpc). This suggests that the group environment may play a role in the formation of most galaxies. The Local Group, and other nearby groups, display a diversity in star formation and morphological properties that puts limits on how, and when, galaxies in groups formed. Effects that depend on an intragroup medium, such as ram-pressure and strangulation, are likely not major mechanisms driving group galaxy evolution. Simple dynamical friction arguments however show that galaxy mergers should be common, and a dominant process for driving evolution. While mergers between L_* galaxies are observed to be rare at z < 1, they are much more common at earlier times. This is due to the increased density of the universe, and to the fact that high mass galaxies are highly clustered on the scale of groups. We furthermore discus why the local number density environment of galaxies strongly correlates with galaxy properties, and why the group environment may be the preferred method for establishing the relationship between properties of galaxies and their local density.Comment: Invited review, 16 pages, to be published in ESO Astrophysics Symposia: "Groups of Galaxies in the Nearby Universe", eds. I. Saviane, V. Ivanov, J. Borissov

Characterization of an inversion on the long arm of chromosome 10 juxtaposing D10S170 and RET and creating the oncogenic sequence RET/PTC

RET/PTC is a transforming sequence created by the fusion of the tyrosine kinase domain of the RET protooncogene with the 5\u2032 end of the locus D10S170 designated by probe H4 and is frequently found activated in human papillary thyroid carcinomas. RET and D10S170 have been mapped to contiguous regions of the long arm of chromosome 10: q11.2 and q21, respectively. To identify the mechanism leading to the generation of the oncogenic sequence RET/PTC, a combined cytogenetic and molecular analysis of several cases of papillary thyroid carcinomas was done. In four cases the results indicated that these tumors had RET/PTC activation and a paracentric inversion of the long arm of chromosome 10, inv(10)(q11.2q21), with breakpoints coincident with the regions where RET and D10S170 are located. Therefore, a chromosome 10q inversion provides the structural basis for the D10S170-RET fusion that forms the hybrid transforming sequence RET/PTC

Development of improved nickel catalysts for sorption enhanced CO2 methanation

Sorption enhanced CO2 methanation is a complex process in which the key challenge lies in the combined optimization of the catalyst activity and water adsorption properties of the zeolite support. In the present work, improved nickel-based catalysts with an enhanced water uptake capacity were designed and catalytically investigated. Two different zeolite frameworks were considered as supports for nanostructured Ni, and studied with defined operation parameters. 5Ni/13X shows significantly increased, nearly three-fold higher, operation time in the sorption enhanced CO2 methanation mode compared to the reference 5Ni/5A, likely due to its higher water sorption capacity. Both catalysts yield comparable CO2 conversion in conventional CO2 methanation (without water uptake). Regeneration of the catalysts performance is possible via a drying step between methanation cycles under both reducing and oxidizing atmospheres; however, operation time of 5Ni/13X increases further after drying under air

The Drivers of Income Inequality in Rich Countries

Rising income inequality has recently come centre-stage as a core societal concern for rich countries. The diagnosis of the forces driving inequality upwards and their relative importance remains hotly contested, notably with respect to the roles of globalization versus technology and of market forces versus institutions and policy choices. This survey provides a critical review and synthesis of recent research. The focus is on income inequality across the entire distribution, rather than only on what has been happening at the very top. We pay particular attention to including what has been learned from the analysis of micro-data, to ensuring that the coverage is not unduly US-centric, and to analyses of the interrelations between the different drivers of inequality. The marked differences in inequality trends across countries and time-periods reflect how global economic forces such as globalisation and technological change have interacted with differing national contexts and institutions. Major analytical challenges stand in the way of a consensus emerging on the relative importance of different drivers in how income inequality has evolved in recent decades

Thermodynamics and classification of cosmological models in the Horava-Lifshitz theory of gravity

We study thermodynamics of cosmological models in the Horava-Lifshitz theory of gravity, and systematically investigate the evolution of the universe filled with a perfect fluid that has the equation of state $p=w\rho$, where $p$ and $\rho$ denote, respectively, the pressure and energy density of the fluid, and $w$ is an arbitrary real constant. Depending on specific values of the free parameters involved in the models, we classify all of them into various cases. In each case the main properties of the evolution are studied in detail, including the periods of deceleration and/or acceleration, and the existence of big bang, big crunch, and big rip singularities. We pay particular attention on models that may give rise to a bouncing universe.Comment: revtex4, 21 figures. New references added & some changes made in Introduction. Version to appear in JCA