Summary
Due to the huge gap in the care of patients with osteoporosis and fragility fractures, we aimed to explore the effectiveness of the osteoporosis liaison service (OLS) in osteoporosis care. We ...found that OLS can improve osteoporosis care, including increasing medication compliance, increasing calcium/vitamin D/protein intake, and reducing fall rate.
Introduction
A significant gap exists in the care of patients with osteoporosis and fragility fractures. This study aimed to evaluate 1-year outcomes of an osteoporosis liaison service (OLS) program that includes two independent components: medication management services (MMS) to improve medication adherence and fracture liaison services (FLS) for secondary prevention.
Methods
Patients with new hip fracture or untreated vertebral fractures enrolled in the FLS program (
n
= 600), and those with osteoporosis medication management issues but not necessarily fragility fractures enrolled in the MMS program (
n
= 499) were included. To evaluate outcomes, care coordinators assessed baseline items adapted from the 13 Best Practices Framework (BPF) standards of the International Osteoporosis Foundation, with telephone follow-up every 4 months for 1 year.
Results
Mean age of this cohort was 76.2 ± 10.3 years, 78.8% were female. After 1-year participation in the program, all patients had received bone mineral density tests, and medication adherence for the entire cohort at 12 months was 91.9 ± 19.6%, with significant improvement in fall rates (23.4% reduction), exercise rates (16.8% increase), calcium intake (26.5% increase), vitamin D intake (26.4% increase), and adequate protein intake (17.3% increase) (all
p
< 0.05). After 1-year OLS program, the overall rates of mortality, incident fracture, and falls were 6.6%, 4.0%, and 24.3%, respectively.
Conclusions
The OLS program is associated with improved osteoporosis care, including increased medication adherence, calcium/vitamin D and protein intake, and reduced fall rate.
In specific solid-state materials, under the right conditions, collections of magnetic dipoles are known to spontaneously form into a variety of rather complex geometrical patterns, exemplified by ...vortex and skyrmion structures. While theoretically, similar patterns should be expected to form from electrical dipoles, they have not been clearly observed to date: the need for continued experimental exploration is therefore clear. In this Letter we report the discovery of a rather complex domain arrangement that has spontaneously formed along the edges of a thin single crystal ferroelectric sheet, due to surface-related depolarizing fields. Polarization patterns are such that nanoscale “flux-closure” loops are nested within a larger mesoscale flux closure object. Despite the orders of magnitude differences in size, the geometric forms of the dual-scale flux closure entities are rather similar.
Postprocedural infections by Mycobacterium abscessus complex are increasing worldwide, and the source and route of transmission are infrequently identified. Here the extension of a previous ...clustering of paediatric patients with surgical site infections due to a single strain of the subspecies M. massiliense is reported. The investigation was conducted at a 2200-bed teaching hospital in Taiwan and included microbial surveillance of the environment (water, air, equipment and supplies) and a case–control study. We performed molecular identification and typing of the isolates by a trilocus sequencing scheme, confirmed by multilocus sequencing typing and pulsed-field gel electrophoresis. We investigated 40 patients who developed postprocedure soft tissue or bloodstream infections by M. massiliense (TPE101) during a 3-year period. Thirty-eight patients were identified at hospital A, and one newborn and her mother were identified at hospital B (185 km from hospital A). A case–control study identified the association of invasive procedures (adjusted odds ratio, 9.13) and ultrasonography (adjusted odds ratio, 2.97) (both p <0.05) with acquiring the outbreak strain. Isolates from the cases and unopened bottles of ultrasound transmission gel were all of strain ST48 and indistinguishable or closely related by pulsed-field gel electrophoresis. After replacement of contaminated gel, no new cases were detected during 18 months' follow-up. This investigation identified the use of contaminated gel as the common source causing an outbreak on a larger scale than had been recognized. Our findings halted production by the manufacturer and prompted revision of hospital guidelines.
We demonstrate microwave-mediated distant magnon-magnon coupling on a superconducting circuit platform, incorporating chip-mounted single-crystal Y_{3}Fe_{5}O_{12} (YIG) spheres. Coherent level ...repulsion and dissipative level attraction between the magnon modes of the two YIG spheres are demonstrated. The former is mediated by cavity photons of a superconducting resonator, and the latter is mediated by propagating photons of a coplanar waveguide. Our results open new avenues toward exploring integrated hybrid magnonic networks for coherent information processing on a quantum-compatible superconducting platform.
Background
In experimental early painful diabetic neuropathy, persistent hyperglycaemia induces dys‐regulated sodium channel (Navs) expression in the dorsal root ganglion (DRG) and activates ...microglia in the spinal dorsal horn (SDH). However, information on diabetes‐induced chronic neuropathic pain is limited. Therefore, we investigated abnormal Navs in the DRG and activated glial cells in the SDH of diabetic rats with chronic neuropathic pain.
Methods
Sixty‐six rats were divided into diabetic and control groups: control rats (n = 18; 1 mL of normal saline via the right femoral vein) and diabetic rats n = 48; 60 mg/kg streptozotocin (STZ) via the right femoral vein. Hindpaw behavioural tests, Navs expression in the DRG, activation of glial cells in the SDH and the number of neurons in the SDH were measured at 1 and 2 weeks, and 1, 2, 3 and 6 months following saline and STZ administration.
Results
All diabetic rats exhibited hyperglycaemia from day 7 to 6 months. The diabetic rats decreased withdrawal threshold to mechanical stimuli but had blunted responses to thermal stimuli. Consistent up‐regulation of Nav1.3 and down‐regulation of Nav1.8 was observed. Microglial cells were activated early in the SDH and lasted for 6 months. A positive correlation between mechanical allodynia, Nav1.3 and microglial activation was observed. In addition, microglia activation in the SDH of STZ‐induced diabetes was mediated, in part, by phosphorylation of p‐38 mitogen‐activated protein kinase.
Conclusions
Diabetic rats showed hindpaw mechanical allodynia for 6 months. Persistent mechanical allodynia was positively associated with sustained increased activation of Nav1.3 and increased p38 phosphorylation in activated microglia.
Wheat accounts for more than 50% of Australia's total grain production. The capability to generate accurate in-season yield predictions is important across all components of the agricultural value ...chain. The literature on wheat yield prediction has motivated the need for more novel works evaluating machine learning techniques such as random forests (RF) at multiple scales. This research applied a Random Forest Regression (RFR) technique to build regional and local-scale yield prediction models at the pixel level for three southeast Australian wheat-growing paddocks, each located in Victoria (VIC), New South Wales (NSW) and South Australia (SA) using 2018 yield maps from data supplied by collaborating farmers. Time-series Normalized Difference Vegetation Index (NDVI) data derived from Planet's high spatio-temporal resolution imagery, meteorological variables and yield data were used to train, test and validate the models at pixel level using Python libraries for (a) regional-scale three-paddock composite and (b) individual paddocks. The composite region-wide RF model prediction for the three paddocks performed well (
= 0.86,
= 0.18 t ha
). RF models for individual paddocks in VIC (
= 0.89,
= 0.15 t ha
) and NSW (
= 0.87,
= 0.07 t ha
) performed well, but moderate performance was seen for SA (
= 0.45,
= 0.25 t ha
). Generally, high values were underpredicted and low values overpredicted. This study demonstrated the feasibility of applying RF modeling on satellite imagery and yielded 'big data' for regional as well as local-scale yield prediction.
In this report, we demonstrate the implementation of biomimetic nanostructured antireflection coatings with polymethyl methacrylate (PMMA) layer on the micro-textured surface of silicon crystalline ...solar cells. To reduce cost, the process combines colloidal lithography, cast molding method, and reversal nanoimprint lithography. The technique is simple, low cost, and does not cause damage to the thin and brittle conventional crystalline solar cells. The antireflection properties of this biomimetic nanostructure coating are considered as effective as those of a conventional single-layer SiNx thin film. The resultant structures alone could reduce the average reflectance of solar cell from 13.2% to 7.8% and enhance power conversion efficiency from 12.85% to 14.2%.
Glycogen synthase kinase 3 beta (GSK3β) is highly inactivated in epithelial cancers and is known to inhibit tumor migration and invasion. The zinc-finger-containing transcriptional repressor, Slug, ...represses E-cadherin transcription and enhances epithelial-mesenchymal transition (EMT). In this study, we find that the GSK3β-pSer9 level is associated with the expression of Slug in non-small cell lung cancer. GSK3β-mediated phosphorylation of Slug facilitates Slug protein turnover. Proteomic analysis reveals that the carboxyl terminus of Hsc70-interacting protein (CHIP) interacts with wild-type Slug (wtSlug). Knockdown of CHIP stabilizes the wtSlug protein and reduces Slug ubiquitylation and degradation. In contrast, nonphosphorylatable Slug-4SA is not degraded by CHIP. The accumulation of nondegradable Slug may further lead to the repression of E-cadherin expression and promote cancer cell migration, invasion and metastasis. Our findings provide evidence of a de novo GSK3β-CHIP-Slug pathway that may be involved in the progression of metastasis in lung cancer.
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