Ankle fracture patterns in drivers are associated with femoral fracture,higher BMI,and advanced age

Objective: Despite advances in vehicle safety systems, motor vehicle crashes continue to cause ankle fractures. This study attempts to provide insight into the mechanisms of injury and to identify the at-risk population groups.

Methods: A study was made of ankle fractures patients treated at an urban level 1 trauma center following motor vehicle crashes, with a concurrent analysis of a nationally representative crash data set. The national data set focused on ankle fractures in drivers involved in frontal crashes. Statistical analysis was applied to the national data set to identify factors associated with fracture risk.

Results: Malleolar fractures occurred most frequently in the driver's right foot due to pedal interaction. The majority of complex/open fractures occurred in the left foot due to interaction with the vehicle floor. These fractures occurred in association with a femoral fracture, but their broad injury pattern suggests a range of fracture causation mechanisms. The statistical analysis indicated that the risk of fracture increased with increasing driver body mass index (BMI) and age.

Conclusions: Efforts to reduce the risk of driver ankle injury should focus on right foot and pedal interaction. The range of injury patterns identified here suggest that efforts to minimize driver ankle fracture risk will likely need to consider injury tolerances for flexion, pronation/supination, and axial loading in order to capture the full range of injury mechanisms. In the clinical environment, physicians examining drivers after a frontal crash should consider those who are older or obese or who have severe femoral injury without concurrent head injury as highly suspicious for an ankle injury.     

Sustainable Development and Strategic Thinking

From an economic point of view, the industrial economy is efficient to overcome situations of a scarcity of goods. From a technological point of view, the resource efficiency of the manufacturing processes of the industrial economy has been permanently improved during the last 200 years. In addition, cleaner processes have been developed. However, from an ecologic point of view, an increasing world population with increasing consumption has produced a ＂global footprint＂ which approaches the carrying capacity of the planet. A circular economy and its high-value spin-offs-a lake economy and a performance or functional service economy-can fulfil customers＇ needs with considerably less resource consumption, less environmental impairment in production and considerably less end-of-life product waste, especially in situations of affluence, when a considerable stock of physical goods and infrastructures exists. Also, in situations of a scarcity of natural resources, both energy and materials, often characterised by rapidly rising resource prices, the economic actors of a circular economy have a high competitive advantage over the actors of the industrial economy, due to much lower procurement costs for materials and energy. From a social point of view, a circular economy increases the number of skilled jobs in regional enterprises. However, the shift from a linear manufacturing economy to a circular or service economy means a change in economic thinking from flow （throughput） management to stock （asset） management： in a manufacturing economy with largely unsaturated markets, total wealth increases through accumulation as resource throughput （flow） is transformed into a higher stock of goods of better quality （but in a manufacturing economy with largely saturated markets, wealth represented by the stock of goods will no longer increase）; in a circular or service economy, total wealth increases through a smart management of existing physical assets （stock） that are adapted to changes in both technology and customer demand. This second approach not only applies to physical capital but equally to social capital, such as health and education and green GDP. To measure the social wealth of a population, it is not the amount of money spent on schools and hospitals that matters, butif this expenditure has led to a better education of the students, and a better health of the people.     

Natural and man-made organobromine compounds in marine biota from Central Norway

Brominated organic pollutants were found in selected samples of mollusk tissue, fish liver, as well as in the eggs and livers of shag from three sites in Central Norway. More than 80 organobromines were identified owing to the defined isotope ratio acquired by GC/ECNI-MS. However, only a few peaks could be assigned to anthropogenic brominated flame retardants (polybrominated diphenyl ethers). Most of the organobromine compounds detected were unknown or halogenated natural products. The known halogenated natural products MHC-1 and TBA were abundant in all samples and usually between equally abundant, and up to 50 fold more concentrated than the major polybrominated diphenyl ether congener BDE 47. The halogenated natural products BC-2 (2-MeO-BDE 68) and BC-3 (6'-MeO-BDE 47), were on level with BDE 100 which was the second most abundant BDE congener in many samples. The previously identified natural polybrominated hexahydroxanthene derivatives (PBHDs) were detected for the first time in bird eggs. Being major contaminants in bird eggs, PBHDs were only present at low levels in bird liver from nestlings originating from the same clutch. Such differences were detected for several other major contaminants. One unknown tetrabromo compound particularly abundant in mussels from Munkholmen was studied by GC/MS and the molecular ion was detected at m/z 446. The abundance of the most important unknown compounds did not correlate with BDEs and they most likely represent halogenated natural products. This study supports that halogenated natural products have to be treated as serious contaminants of marine coastal waters. Our data suggest that their abundance is highest in habitats along the shoreline. Thorough examination of these compounds in environmental samples is an important task.     

Biomagnification of anthropogenic and naturally-produced organobrominated compounds in a marine food web from Sydney Harbour, Australia

Polybrominated diphenyl ethers (PBDEs) and naturally-produced organobrominated compounds, such as methoxylated PBDEs (MeO-PBDEs), have been scarcely studied in the Southern Hemisphere. Yet, sources of the latter group of compounds were found in Southern regions, specifically in Australia. The environmental distribution and biomagnification potential of organobrominated compounds were therefore investigated in a representative aquatic food chain (invertebrates and fish) from the Sydney Harbour, Australia. Mean PBDE concentrations ranged from 6.4 ng/g lipid weight (lw) in squid to 115 ng/g lw in flounder. BDE 47 was the dominant congener, followed by BDE 100. Mean levels of MeO-PBDEs (sum of congeners 2’-MeO-BDE 68 and 6-MeO-BDE 47) were as high as 110 ng/g lw in tailor, with a slight dominance of 2’-MeO-BDE 68. Polybrominated hexahydroxanthene derivates (PBHDs), another class of naturally-produced compounds, were found at variable concentrations and ranged from 4.7 ng/g lw in fanbelly and 146 ng/g lw in tailor. The tribrominated PBHD isomer dominated in the samples, except for luderick and squid. The lower levels of PBDEs found in luderick from the harbour compared to those obtained from the upper Parramatta River indicated a terrestrial (anthropogenic) origin of PBDEs, while the higher levels of MeO-PBDEs and PBHDs in the samples from the harbour confirmed the marine (natural) origin of these compounds. The highest trophic magnification factor (TMF) was found for sum PBDEs (3.9), while TMFs for sum MeO-PBDEs and sum PBHDs were 2.9 and 3.4, respectively. This suggests that biomagnification occurs in the studied aquatic food chain for anthropogenic brominated compounds, but also for the naturally-produced organobromines.     

Synthesis of effects in four Arctic subregions

An assessment of impacts on Arctic terrestrial ecosystems has emphasized geographical variability in responses of species and ecosystems to environmental change. This variability is usually associated with north-south gradients in climate, biodiversity, vegetation zones, and ecosystem structure and function. It is clear, however, that significant east-west variability in environment, ecosystem structure and function, environmental history, and recent climate variability is also important. Some areas have cooled while others have become warmer. Also, east-west differences between geographical barriers of oceans, archipelagos and mountains have contributed significantly in the past to the ability of species and vegetation zones to relocate in response to climate changes, and they have created the isolation necessary for genetic differentiation of populations and biodiversity hot-spots to occur. These barriers will also affect the ability of species to relocate during projected future warming. To include this east-west variability and also to strike a balance between overgeneralization and overspecialization, the ACIA identified four major sub regions based on large-scale differences in weather and climate-shaping factors. Drawing on information, mostly model output that can be related to the four ACIA subregions, it is evident that geographical barriers to species re-location, particularly the distribution of landmasses and separation by seas, will affect the northwards shift in vegetation zones. The geographical constraints--or facilitation--of northward movement of vegetation zones will affect the future storage and release of carbon, and the exchange of energy and water between biosphere and atmosphere. In addition, differences in the ability of vegetation zones to re-locate will affect the biodiversity associated with each zone while the number of species threatened by climate change varies greatly between subregions with a significant hot-spot in Beringia. Overall, the subregional synthesis demonstrates the difficulty of generalizing projections of responses of ecosystem structure and function, species loss, and biospheric feedbacks to the climate system for the whole Arctic region and implies a need for a far greater understanding of the spatial variability in the responses of terrestrial arctic ecosystems to climate change.     

Uncertainties and recommendations

An assessment of the impacts of changes in climate and UV-B radiation on Arctic terrestrial ecosystems, made within the Arctic Climate Impacts Assessment (ACIA), highlighted the profound implications of projected warming in particular for future ecosystem services, biodiversity and feedbacks to climate. However, although our current understanding of ecological processes and changes driven by climate and UV-B is strong in some geographical areas and in some disciplines, it is weak in others. Even though recently the strength of our predictions has increased dramatically with increased research effort in the Arctic and the introduction of new technologies, our current understanding is still constrained by various uncertainties. The assessment is based on a range of approaches that each have uncertainties, and on data sets that are often far from complete. Uncertainties arise from methodologies and conceptual frameworks, from unpredictable surprises, from lack of validation of models, and from the use of particular scenarios, rather than predictions, of future greenhouse gas emissions and climates. Recommendations to reduce the uncertainties are wide-ranging and relate to all disciplines within the assessment. However, a repeated theme is the critical importance of achieving an adequate spatial and long-term coverage of experiments, observations and monitoring of environmental changes and their impacts throughout the sparsely populated and remote region that is the Arctic.     

Configuration of a functional department: A study of contextual and structural variables

This study investigates whether departments performing the same functions in different firms incur similar changes in structural configuration in response to industry-wide stimuli. Based on the proposition that the context of functional departments is similar across firms, changes in differentiation, integration, and perspective are hypothesized. Managers' perceptions of the validity of a series of statements to conditions five to 10 years ago and to present conditions are contrasted and show statistically significant shifts in these structural configurations. This change is confirmed by the analysis of responses of other managers in different departments within the same firms. Correlation analysis shows significant agreement among alternative measures of the same aspects of structure, and significant comovement among different structural dimensions. The later result supports the quantum theory of organizations.