A novel fracture liaison service using digital health: impact on mortality in hospitalized elderly osteoporotic fracture patients.

We examined the performance of an intelligent fracture liaison service (FLS) assisted by digital health (DH) to reduce all-cause mortality (ACM) risk. According to our findings, the new FLS reduced ACM by 36%. INTRODUCTION: A well-designed secondary prevention program known as FLS enhances the bone densitometry-based assessment rate as well as osteoporosis (OP) medication usage following a fracture. However, there are only a few reports on FLS incorporating DH, and it remains unclear whether this integration has influenced patient ACM, which refers to the overall death rate from any cause during the study period. METHODS: This retrospective observational study was conducted on data from the Fragility Fracture Registration System database linked to the Regional Health Registration Platform of Kunshan City and the Population Death Registration System of Jiangsu Province for one tertiary-level A hospital in China. Patients aged ≥ 50 years, who experienced an OP fracture between January 1, 2017, and July 27, 2022, requiring hospitalization, were selected for analysis. We compared the outcomes of patients who received routine fragility fracture management (the no-FLS group) or FLS (the FLS group). We employed multivariable Cox regression with inverse probability weighting based on the propensity score (PS). RESULTS: Of 2317 patients, 756 (32.6%) received FLS and 1561 (67.4%) did not. Using PS matching, we minimized the baseline characteristic differences between the two groups in the propensity score-matched samples, relative to the unmatched samples. Based on our analysis, the new FLS reduced ACM by 36% (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.47 to 0.87; P-value = 0.004). Moreover, FLS patients experienced further reductions in fall-related mortality, refracture rate, and total refracture-related hospital costs, and had increased dual-energy X-ray absorptiometry (DXA) testing and treatment initiation rates, relative to the no-FLS patients. CONCLUSIONS: A new FLS model implementation assisted by DH can effectively reduce ACM among elderly patients with OP fractures requiring surgery. In future investigations, we recommend examining the scalability of this model.

Single-cell transcriptomes and runx2b-/- mutants reveal the genetic signatures of intermuscular bone formation in zebrafish.

Intermuscular bones (IBs) are mineralized spicules, present in the myosepta of many, but not all, teleost species. IBs are often small and sharp, and they consequently limit how the fish can be processed; the IBs may cause injury or trauma if lodged in consumers' throats or mouths, and therefore affect the appeal of the fish to many consumers. The development of IBs in teleosts is still not fully understood and the molecular basis of IB development remains to be established. Here, the characteristics of IB tissue are evaluated based on single-cell transcriptomics in wild-type zebrafish. The analysis defined 18 distinct cell types. Differentiation trajectories showed that IBs are derived from tendons and that a core tendon-osteoblast cell lineage is related to IB formation. In particular, the functions of 10 candidate genes were evaluated via CRISPR-Cas9 mutants. Among those, runx2b-/- mutants completely lost IBs, while swimming performance, growth and bone mineral density were not significantly different from runx2b+/+ zebrafish. Comparative single-cell RNA sequencing (scRNA-seq) analysis in runx2b-/- and runx2b+/+ zebrafish revealed the role of osteoblasts in IB formation. In addition, differentially expressed genes were enriched in the transforming growth factor ß/bone morphogenetic protein (TGF-ß/BMP) pathway after runx2b deletion. This study provides evidence for the crucial role of runx2b regulation in IB formation. Genetic breeding can target runx2b regulation and generate strains of commercial fish species without IBs, which can improve the safe consumption and economic value of many farmed fish species.

Methyl 4-amino-2-chloro-pyrimidine-5-carboxyl-ate.

In the title compound, C6H6ClN3O2, all non-H atoms are approximately coplanar [maximum deviation = 0.012 (4) Å]; an intra-molecular N-H⋯O hydrogen bond occurs between the amino group and the carbonyl group. In the crystal, mol-ecules are linked by N-H⋯N hydrogen bonds into supra-molecular chains propagated along [101].

[Secondary aerosol formation through photochemical reactions estimated by using air quality monitoring data in the downtown of Pudong, Shanghai].

Analyses of diurnal patterns of PM10 in the downtown of Pudong, Shanghai have been performed in this study at different daily ozone maximum concentrations (O(3,max)) from May to October, 2010. In order to evaluate secondary aerosol formation at different ozone levels, CO was used as a tracer for primary aerosol, and 0(3, max) was used as an index for photochemical activity. Results show that along with increasing of O3 concentration, the concentration of primary and secondary aerosol was increased respectively from 0. 036 to 0.044 mg x m(-3) and from 0.018 to 0.055 mg x m(-3). The ratio of secondary to primary aerosol was increased from 49.8% to 124.5%. Furthermore, along with the increase of O(3, max) the forming time of O(3,max) and secondary aerosol was changed respectively from 13:00 to 14:00 and from 11:00-20:00 to 09:00-20:00. At the same time, the chemical composition of PM2.5 was different at different photochemical levels. PM(2.5) was composed of 12.0% organic carbon (OC), 18.7% sulfate (SO4(2-1)), 13.1% nitrate (NO3-) and 4.5% element carbon (EC) when O(3, max) was < 0.10 mg x m(-3) and PM2.5 was composed of 20.0% organic carbon (OC), 22.9% sulfate, 23.1% nitrate and 4.7% element carbon (EC) with O(3, max) > 0. 20 mg x m(-3). These results approved that the photochemical reactivity promoted the production of SO4(2-), NO3- and OC.

tert-Butyl 2-(6-{2-[2-(4-fluoro-phen-yl)-5-isopropyl-3-phenyl-4-(phenyl-carbamo-yl)pyrrol-1-yl]eth-yl}-2,2-dimethyl-1,3-dioxan-4-yl)acetate.

The title compound, C40H47FN2O5, crystallizes with two independent but similar mol-ecules in the asymmetric unit. In the crystal, mol-ecules are linked into chains along [100] by inter-molecular N-H⋯O hydrogen bonds.

N-[5-(Di-phenyl-phosphorylmeth-yl)-4-(4-fluoro-phen-yl)-6-iso-propyl-pyrimi-din-2-yl]-N-methyl-methane-sulfonamide.

In the title compound, C28H29FN3O3PS, the pyrimidine ring is oriented at a dihedral angle of 50.9 (2)° with respect to the floro-benzene ring, while the two phenyl rings bonding to the same P atom are twisted with respect to each other, making a dihedral angle of 62.2 (2)°. In the crystal, mol-ecules are linked by weak C-H⋯O and C-H⋯F hydrogen bonds into a three-dimensional supra-molecular architecture.

4-Diphenyl-phosphanyl-1,5-naphthyridine.

The asymmetric unit of the title compound, C(20)H(15)N(2)P, contains two independent mol-ecules with similar structures. The 1,5-naphthyridine ring system is nearly planar, with maximum deviations of 0.010 (3) and 0.012 (3) Å; its mean plane is oriented with respect to the two phenyl rings at 79.69 (12) and 84.00 (10)° in one mol-ecule, and at 74.25 (12) and 82.05 (11)° in the other. The two phenyl rings are twisted with respect to each other with a dihedral angle of 75.96 (14)° in one mol-ecule and 86.30 (13)° in the other.

[Characteristics of ambient VOCs and their role in O3 formation: a typical air pollution episode in Shanghai urban area].

The concentration, speciation and chemical reactivity of ambient volatile organic compounds (VOCs) in shanghai city were analyzed and measured by using online gas chromatography with flame ionization detection systems (GC-FID) during a typical air pollution episode (from Oct. 30th to Nov. 2nd, 2010) and 55 kinds of VOCs were detected. The results show that averaged concentrations of VOCs was 27 x 10(-9) before the episode, and then dramatically increased by 3 times (87 x 10(-9)) in the episode than the former, the main components were alkanes (35.2 x 10(-9)), aromatics (30.0 x 10(-9)), alkenes (21.6 x 10(-9)). Furthermore, the maximum ozone formation potential (PhiOFP) is analyzed and showed that PhiOFP (in the episode) > PhiOFP (after the episode) PhiOFP (before the episode). Before the episode, the percent of PhiOFP for aromatics 53.0% , alkenes 36. 1% and alkanes 11.7%; in the episode, the percent of PhiOFP for aromatics 54.7%, alkenes 36.7% and alkanes 9.8%; after the episode, the percent of PhiOFP for alkenes 52.7%, aromatics 36.0% and alkanes 13.2%. Alkenes (C2-C4) and aromatics (C6-C8) are the main components for the ozone formation, namely toluene, m,p-xylene, 1,3-butadiene, propene, ethene et al. In addition, the relationship is negative and nonlinear between the O3 and PhiOFP. And efficiencies of PhiOFP formed into O3 are below 20. 0% in different stage of episode. This is very important and meaningful for the quantitative evaluate the influence of VOCs towards O3.

Ethyl 1-[(4-acetyl-2-methoxy-phen-oxy)meth-yl]cyclo-propane-1-carboxyl-ate.

In the title compound, C(16)H(20)O(5), the dihedral angle between the planar rings, viz. benzene and cyclo-propane, is 52.1 (2)°. Mol-ecules are connected in the crystal via weak inter-molecular C-H⋯O hydrogen bonds, forming chains in the [001] direction.

Methyl 5-bromo-6-methyl-picolinate.

The title compound, C(8)H(8)BrNO(2), does not show any significant inter-molecular π-π or C-H⋯π inter-actions in the crystal packing except for one weak Br⋯Br [3.715 (1) Å] inter-action.

An emission inventory of marine vessels in Shanghai in 2003.

We developed an air pollutant emission inventory for marine vessels in the Shanghai Port in 2003. We estimated emissions under cruising and maneuvering conditions based on two categories of vessels: (1) vessels in the Outer Port, which enter the area following notification of the Shanghai Maritime Safety Administration, a division of the Ministry of Communications of P.R. China; and (2) vessels in internal waterways, which enter those waters following notification of the local Port Administration Centers. Vessels in the Outer Port consist of three subcategories: (1) international vessels that are engaged in foreign commerce; (2) domestic vessels traveling along the downstream portion of the Huangpu River; and (3) domestic vessels traveling along the coast. We also estimate emissions from vessels over 1000 DWT operating under hotelling conditions in the Outer Port. In 2003, the total number of calls was approximately 1.3 million, of which 57% is attributed to vessels in internal waterways and 43% to vessels in the Outer Port. Total marine emissions for NOx, SO2, PM, HC, and CO2 in 2003 are estimated to be 58,160, 51,180, 6960, 4560, and 3,012,800 tons, respectively. Emissions are allocated to 1 km x 1 km grid cells for the 129 km x 102 km Shanghai Port study domain.

Fabrication and analysis of a Fabry-Perot cavity with a micromechanical wet-etching process.

We present a novel low-cost and batch fabrication method to fabricate a Fabry-Perot (FP) cavity with a micromechanical wet-etching process, through which FP cavities can be achieved with a cavity length of from several micrometers to tens of micrometers. The parallelism of mirror elements can be well achieved without electrostatic control. The quality of an etched surface can be greatly improved by the oxidation polish process. FP cavities with a finesse of approximately 50 are achieved. Analysis shows that the effective finesse is dominated mainly by the quality of the etched surface.