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Like many countries around the world, Brazil has seen a significant increase in the utilization of electric vehicles. During the pandemic, the country saw an increase of 80% in utilization [...]

Although vehicle combustion has experienced a great evolution over the last several decades, it still is regarded as a major problem in terms of greenhouse gas emissions. Brazil emilLed 2.175 [...]

This work studies the hydrogenation processes (HDO and HDA) of bio-oils, using guaiacol (2-methoxyphenol) and anisole (methoxybenzene) and the feed mixture on Ni and Mo catalysts supported on SBA-15 and alumina supports in a fixed bed reactor. SBA-15 catalysts presented higher activity than the alumina catalyst, which is due to the greater surface area and lower acidity of the former. The influence of temperature on the process was also studied, at 200, 250 and 300 °C, and it was found that the conversions of guaiacol and anisole are relatively high at 300 °C. The best results for the guaiacol and anisole mixture for HDO deoxygenation was observed at 200 °C for the Ni-Mo/SBA-15 catalyst (96.5%), compared to 75.3% for the Ni-Mo/γ-Al2O3catalyst.

Zusammenfassung: Hintergrund: Kombinationen von Frakturen des Femurschafts mit einer hüftnahen Komponente stellen eine Herausforderung für den behandelnden Unfallchirurgen dar, da es sich um unterschiedliche Frakturentitäten mit jeweils eigenen Behandlungskonzepten handelt. Material und Methoden: In einer retrospektiven Untersuchung wurden Inzidenz, Behandlungsstrategie und Outcome dieser Verletzung ausgewertet. Vom 01.01.2001–31.07.2007 wurden alle Patienten mit Femurfrakturen erfasst, die in einem Traumazentrum der Stufe I behandelt wurden. Ergebnisse: Insgesamt wurden 1935 Patienten in die Studie eingeschlossen, wovon 21 Patienten 22 Frakturen als Kombination aus Schaftfraktur mit hüftnaher Komponente erlitten (1,1%). Unter zusätzlicher Berücksichtigung der Kombination von Femurfrakturen mit Kniegelenkbeteiligung und des Acetabulums mit Femurschaftfrakturen ergab sich ein Anteil an Kettenverletzungen des Femurs von 3,1%. Der Anteil an polytraumatisierten Patienten bei Vorliegen von Kombinationsfrakturen des Femurschafts und des proximalen Femurs betrug 64%. Der überwiegende Anteil dieser Patienten von 73% konnte mit einem einzigen Implantat zur Behandlung beider Frakturanteile versorgt werden. Die führende Verletzungskomponente war in 8 Fällen die hüftnahe Fraktur, hier kam es in einem Fall zur Ausbildung einer Pseudarthrose des Schenkelhalses, ansonsten konsolidierten alle Frakturen nach durchschnittlich 4,7 Monaten. Alle Verletzungen wurden bei der Primärdiagnostik erkannt, wobei der Anteil an durchgeführten Ganzkörper-CT 73% betrug. Eine primär definitive operative Versorgung erfolgte bei 59% der Patienten. An Komplikationen ergaben sich 2 korrekturbedürftige Rotationsfehler sowie eine problemlos ausbehandelte postoperative Infektion. Schlussfolgerung: Die Behandlung der Kombinationsfraktur des Femurs aus schaft- und hüftnaher Komponente bleibt eine Herausforderung, wobei sich die diagnostische Sicherheit durch den regelhaften Einsatz der Ganzkörper-CT im Rahmen der Polytraumadiagnostik verbessert hat und mit dem langen PFN und dem AFN zwei exzellente Implantate zur Verfügung stehen, die den Anforderungen beider Verletzungskomponenten gerecht werden.

Traffic noise, e.g. from aircraft, significantly contributes to an increased risk of cardiovascular or metabolic diseases in the general population by brain-dependent stress reactions leading to higher levels of circulating stress hormones and vasoconstrictors, all of which cause hypertension, oxidative stress, and inflammation. With the present experimental studies, we provide for the first time molecular mechanisms responsible for successful noise mitigation: Physical exercise, intermittent fasting, and pharmacological activation of the adenosine monophosphate-activated protein kinase (AMPK), a metabolic master regulator protein, prevent cardiovascular damage caused by noise exposure, such as hypertension, endothelial dysfunction, and reactive oxygen species formation (e.g. free radicals) and inflammation.These beneficial mitigation manoeuvers are secondary to an activation of the endothelial AMPK, thereby mimicking the antidiabetic drug metformin.Graphical Abstract

Incisional negative pressure wound therapy (iNPWT) has shown effectiveness in the treatment of high-risk surgical wounds. Especially patients with diabetes-induced peripheral arterial disease undergoing major limb amputation have a high intrinsic risk for post-surgical wound infections. While normal gauze wound dressings do not cause stimulation of microvasculature, iNPWT might improve wound healing and reduce wound complications. The purpose of this study was to systematically review the literature for rates of wound complications and readmissions, as well as post-surgical 30-day mortality.We conducted a systematic review searching the Cochrane, PubMed, and Ovid databases. Inclusion criteria were the modified Coleman methodology Score >60, non-traumatic major limb amputation, and adult patients. Traumatic amputations and animal studies were excluded. Relevant articles were reviewed independently by referring to the title and abstract. In a meta-analysis, we compared 3 studies and 457 patients.A significantly overall lower rate of postoperative complications is associated with usage of iNPWT (odds ratio (OR) = 0.52; 95% CI: 0.30–0.89; P = 0.02). There was no significant improvement for 30-day mortality, when iNPWT was used (OR= 081; 95% CI: 0.46 – 1.45; P = 0.48). Nevertheless, we did not noteasignificant difference in the readmission rate or revision surgery between the two groups.Overall, the usage of iNPWT may reduce the risk of postoperative wound complications in major lower limb amputations but does not improve 30-day mortality rates significantly. However, to anticipate surgical-site infection, iNPWT has shown effectiveness and thus should be used whenever applicable.

Objective: G72 is among the most frequently replicated vulnerability genes for schizophrenia and bipolar disorder. The authors previously found identical haplotypes of markers M23 and M24 to be associated with schizophrenia, bipolar disorder, and panic disorder. Given both the well-recognized familial clustering across these disorders and recent linkage findings implicating the region harboring G72 in the etiology of major depression and panic disorder, we can hypothesize that G72 should also be involved in the etiology of major depression. Neuroticism, measuring trait anxiety, may be the endophenotypic link underlying genetic associations with G72 across diagnostic boundaries. The authors tested whether the previously observed risk haplotypes are also associated with major depression and neuroticism. Method: The authors performed a standard haplotype analysis in a group of 500 major depression patients and 1,030 population-based comparison subjects. The authors also performed an exploratory analysis on 10 additional G72 markers using a novel haplotype-sharing approach. They performed a quantitative trait haplotype analysis in an independent group of 907 individuals phenotyped for neuroticism. Results: The previously identified M23-M24 risk haplotype was significantly associated with major depression and high levels of neuroticism. The haplotype-sharing analysis also implicated the same region, whereas more proximal markers showed no association with major depression. Conclusions: This is the first study to the authors' knowledge to implicate the G72 locus in the etiology of major depression and neuroticism. The results strengthen the notion of a genetic overlap between diagnoses, commonly conceptualized as distinct entities. Neuroticism may constitute the common underlying endophenotypic link.

The Optimal Planning Through Implementation of Mobility Management program, funded by the European Union, has been largely successful in improving accessibility in London, England, and Amsterdam, the Netherlands. The use of public transport in Amsterdam increased by 13% while the use of bicycles among businesses in London increased by 13%.

Hintergrund: Die patellofemorale Instabilität zählt zu den häufigsten Pathologien des Kniegelenks. Die Planung und Durchführung patellastabilisierender Operationen ist sehr variabel. Bezüglich der operativen Maßnahmen kommt der präoperativen Planung, gerade im Hinblick auf die häufig hohe Komplexität der zugrundeliegenden Pathologien, eine entscheidende Bedeutung zu. Fragestellung: Ziel dieser Studie war es, die aktuelle Versorgungsrealität in Bezug auf Planung und Durchführung patellastabilisierender Operationen unter Mitgliedern der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU) abzubilden. Des Weiteren sollte erhoben werden, ob ggf. automatisierte Analysen der zugrundeliegenden Anatomie die Planung und Durchführung patellastabilisierender Operationen (im Primär- und Revisionsfall) beeinflussen würden. Material und Methoden: Unter allen aktiven Mitgliedern der DGOU wurde per Mail eine anonymisierte Online-Umfrage mit 16 Fragen erhoben. 7974 Mitglieder wurden angeschrieben, 393 Rückmeldungen konnten anschließend analysiert werden. Ergebnisse: Die MPFL-Plastik (89,8?%) ist die am häufigsten durchgeführte Operation zur Patellastabilisierung. Dahinter folgen Tuberositasversatzoperationen (64,9?%), Korrekturosteotomien (51,2?%) und Trochleaplastiken (19,9?%). Die Wahl bezüglich des operativen Vorgehens fällt überwiegend auf Grundlage einer Kombination aus klinischen und radiologischen Befunden (90,3?%). Für die Entscheidung zur Operation werden hauptsächlich MRT-Bildgebung (81,2?%), Standard-Röntgenbilder (77,4?%) und Beinganzaufnahmen (76,6?%) herangezogen. Insgesamt würden 59,3?% der Befragten eine automatisierte Analyse für eine vereinfachte präoperative Planung und die Detektion von entscheidenden radiologischen Parametern (59,0?%) in Anspruch nehmen, sofern diese zur Verfügung stünden. Diskussion: Die Erhebungen dieser Umfrage unter Mitgliedern der DGOU weisen die MPFL-Plastik als zentralen Ansatzpunkt zur operativen Behandlung patellofemoraler Instabilitäten aus, diagnostisch ist die MRT-Bildgebung essenziell. Durch eine zukünftige Etablierung automatisierter Software-gestützter Analysemethoden könnte bei einer Vielzahl von Operateuren eine Erweiterung der radiologisch berücksichtigten Parameter in der Planung patellastabilisierender Operationen erreicht werden.

Fibular fixation to treat distal lower-leg fractures is a controversial intervention. To ensure better stability itself, better rotational stability, and to prevent secondary valgus dislocation – all these are justifications for addressing the fibula via osteosynthesis. High surgical costs followed by increased risks are compelling reasons against it. The purpose of this study was to systematically review the literature for rates of malunion and malrotation, as well as infections and nonunions.We conducted a systematic review searching the Cochrane, PubMed, and Ovid databases. Inclusion criteria were modified Coleman Methodology Score (mCMS) > 60, a distal lower-leg fracture treated by nailing, and adult patients. Biomechanical and cadaver studies were excluded. Relevant articles were reviewed independently by referring to title and abstract. In a meta-analysis, we compared five studies and 741 patients.A significantly lower rate of valgus/varus deviation is associated with fixation of the fibula (OR= 0.49; 95% CI: 0.29–0.82; p = .006). A higher risk for pseudarthrosis was revealed when the fibula underwent surgical therapy, but not significantly (OR= 1.46; 95% CI: 0.76–2.79; p = .26). Nevertheless, we noted an increased risk of postoperative wound infection following fibular plating (OR= 1.90; 95% CI: 1.21–2.99; p = .005). There was no statistically significant difference in the rate of nonunions between the two groups.Overall, the stabilization of the fibula may reduce secondary valgus/varus dislocation in distal lower-leg fractures but is associated with an increased risk of postoperative wound infections. The indication for fibula plating should be made individually.Cite this article: EFORT Open Rev2021;6:816-822. DOI: 10.1302/2058-5241.6.210003

The aging of our society is associated with an increasing number of insufficiency fractures of the pelvis and the current standard of care is pain control and early mobilization. The aim of this study was to explore whether parathyroid hormone (PTH) treatment can support bone healing in these patients.We conducted a systematic review searching the databases PubMed, Embase and Cochrane. Our primary outcome was fracture healing, secondary outcome measures comprised pain, mobility and patient-reported outcome measures (PROMs).Eight articles were included in the qualitative synthesis, of which two were included in a meta-analysis. However, only three studies were comparative including one randomized controlled trial. Fracture healing and reported pain were assessed after eight weeks, and were significantly improved in the group being treated with PTH (p < 0.01) in the meta-analysis. All articles described a positive effect for PTH on fracture healing and pain.Our systematic review indicates that there is a positive effect of PTH treatment on healing and pain in patients with insufficiency fracture in the pelvic ring, but further research is necessary.Cite this article: EFORT Open Rev2021;6:9-14. DOI: 10.1302/2058-5241.6.200029

Five compositions of the system LaFe0.2Cr0.8-XCoXO3(x= 0.0, 0.2, 0.4, 0.6, 0.8) were synthesized by using a combustion technique to investigate the structural and morphological properties of doped LaCrO3perovskite oxides. The optimal physicochemical conditions for the synthesis of the materials from citrate precursors at low temperature were studied through gravimetric and differential thermal analysis (TGA-DTA). X-ray diffraction (XRD) and electron microscopy (SEM-TEM) characterization of the calcined oxides confirmed the formation of a single perovskite-type structure in all the materials. The incorporation of cobalt into the structure was associated with an evolution from a rhombohedral R3-cto an orthorhombic Pnma 62structure, with nanometric particle sizes and relevant surface properties. The results obtained from Raman and X-ray photoelectron spectroscopy (XPS) evidenced that the chemical composition and the electronic stateof the cations were in accordance with the proposed system and the employed synthesis method. The conversion of CO and O2was between 83.5 and 100% for all oxides, depending on the cobalt content, and the positive effect of temperature on the conversion and the selectivity for the formation of CO2. Stability tests confirmed a stable conversion of CO and O2, with high initial values around 96% ± 0.97, which stabilized at 83.5% ± 0.87 for the less reactive materials.

Resistance element welding (REW) is an appropriate thermal-based joining method for joining hybrid materials with other structural steel grades, e.g. high-strength steels. Due to insufficient knowledge on the application of this joining process in combination with these new hybrid materials, deeper investigations were done regarding the suitability of the process and specific boundary conditions. This article introduces by giving a summary of the material properties, the boundary conditions and the welding process itself. Afterwards, the pre-assembly step of the elements and the resulting handling strength of the pre-assembled elements are discussed for two different hybrid material thicknesses. Weldability lobes are compared for REW with and without additional adhesives so that appropriate process parameters are defined. Due to a possible industrial application, relevant production-related disturbance variables are addressed as well. Therefore, the impact on the resulting joint properties, e.g. nugget size, is evaluated for different offsets of the electrodes and different gap sizes between the sheets as well as for both orientations of the polarity. The article closes with a comparison of the resulting load-bearing capacities of the REW-joints with those manufactured by resistance spot shunt welding and self-pierce riveting with semi-hollow rivets.

Postcombustion CO2capture technologies need to undergo several costly scale-up stages before their deployment to the industry. Rigorous process models with uncertainty quantification generate more informative simulations that can offer increased design confidence, and a measure of the technical risk the modeled system carries, enabling the effective development of fewer prototypes during scale-up. To assist the development and scale-up of fixed bed CO2adsorption technologies, we propose a framework for the quantification of uncertainty applied to the process of CO2adsorption using zeolite 13X. Two major sources of uncertainty are considered at the small, laboratory scale in the Langmuir adsorption model: parameter uncertainty and model-form discrepancy. First, the parameter uncertainty is quantified and analyzed, followed by the quantification and analysis of the parameter uncertainty and model-form discrepancy together. The uncertainty is quantified via Bayesian statistical calibration of the Langmuir isotherm model to experimental adsorption isotherm data. Orthogonal discrepancy terms are added to the Langmuir model, leading to a discrepancy-augmented sorbent model that adjusts for physical and chemical deficiencies of the pure Langmuir model (e.g., accounting for adsorption of multiple species on multiple sites instead of the assumed monolayer homogeneous adsorption). Model-form discrepancy is also caused by the deviation of the sorbent model from reality across scales; therefore, its inclusion in the adsorption model developed using data from the small-scale system improves inference and process model predictions at the large, fixed bed process scale. To study the propagation of the small-scale uncertainty to process scale, a rigorous one-dimensional dynamic, nonisothermal mathematical model of a fixed bed adsorber is developed. Both the parameter and model-form uncertainties are propagated through the adsorber model to evaluate the resulting uncertainty in key performance measures such as the breakthrough time. Results show that, if only parameter uncertainty is considered, it can lead to a highly conservative design of the adsorber resulting in higher capital investment. A third source of uncertainty, boundary data variability, is also studied at the process scale by means of sensitivity analysis: the effect of changes in the reactor inlet gas composition, flow rate, and temperature are examined.

Cultured human bone marrow stromal (mesenchymal) stem cells (hBM‐MSCs) are heterogenous cell populations exhibiting variable biological properties. Quantitative high‐content imaging technology allows identification of morphological markers at a single cell resolution that are determinant for cellular functions. We determined the morphological characteristics of cultured primary hBM‐MSCs and examined their predictive value for hBM‐MSC functionality. BM‐MSCs were isolated from 56 donors and characterized for their proliferative and differentiation potential. We correlated these data with cellular and nuclear morphological features determined by Operetta; a high‐content imaging system. Cell area, cell geometry, and nucleus geometry of cultured hBM‐MSCs exhibited significant correlation with expression of hBM‐MSC membrane markers: ALP, CD146, and CD271. Proliferation capacity correlated negatively with cell and nucleus area and positively with cytoskeleton texture features. In addition, in vitro differentiation to osteoblasts as well as in vivo heterotopic bone formation was associated with decreased ratio of nucleus width to length. Multivariable analysis applying a stability selection procedure identified nuclear geometry and texture as predictors for hBM‐MSCs differentiation potential to osteoblasts or adipocytes. Our data demonstrate that by employing a limited number of cell morphological characteristics, it is possible to predict the functional phenotype of cultured hBM‐MSCs and thus can be used as a screening test for “quality” of hBM‐MSCs prior their use in clinical protocols.

Nonunions are a relevant economic burden affecting about 1.9% of all fractures. Rather than specifying a certain time frame, a nonunion is better defined as a fracture that will not heal without further intervention.Successful fracture healing depends on local biology, biomechanics and a variety of systemic factors. All components can principally be decisive and determine the classification of atrophic, oligotrophic or hypertrophic nonunions. Treatment prioritizes mechanics before biology.The degree of motion between fracture parts is the key for healing and is described by strain theory. If the change of length at a given load is > 10%, fibrous tissue and not bone is formed. Therefore, simple fractures require absolute and complex fractures relative stability.The main characteristics of a nonunion are pain while weight bearing, and persistent fracture lines on X-ray.Treatment concepts such as ‘mechanobiology’ or the ‘diamond concept’ determine the applied osteosynthesis considering soft tissue, local biology and stability. Fine wire circular external fixation is considered the only form of true biologic fixation due to its ability to eliminate parasitic motions while maintaining load-dependent axial stiffness. Nailing provides intramedullary stability and biology via reaming. Plates are successful when complex fractures turn into simple nonunions demanding absolute stability. Despite available alternatives, autograft is the gold standard for providing osteoinductive and osteoconductive stimuli.The infected nonunion remains a challenge. Bacteria, especially staphylococcus species, have developed mechanisms to survive such as biofilm formation, inactive forms and internalization. Therefore, radical debridement and specific antibiotics are necessary prior to reconstruction.Cite this article: EFORT Open Rev2020;5:46-57. DOI: 10.1302/2058-5241.5.190037

There is substantial evidence that bank rating data display non-Markovian structures. We introduce a non-Markovian parameter in a simple model for rating transition histories. Accounting for the frequent statistical obstacle of partially missing transitions, we make use of the expectation maximisation (EM) algorithm to estimate all model parameters and find a marked non-Markovian effect for our data.

In this work, we developed experimental model of cobalt heterogeneous catalyst, inserting the active phase into a nanoporous material ordered with the purpose of structurally elucidating the processes that occur during the interaction of the model with molecules. We synthesized the models by inserting cobalt species into a Faujasite zeolite and performed detailed studies of the complexes formed in the interaction of these models with water and carbon dioxide emphasizing electron densities. Regarding the interaction of Faujasite with water, X-ray diffraction showed the physical adsorption of a dense monomolecular film in the nanoporous space. There was no evidence of water entering the sodalite cage. The cell parameter increased with the degree of hydration for Faujasite containing cobalt (CoY). In the case of dehydrated material, cobalt occupied the sites within the hexagonal prism (I) and the sodalite cage (I′). The carbon dioxide adsorbs bridges between adjacent compensation cations located in II. We tested the catalyst models for the oxidation of carbon monoxide and the combustion of hydrogen at low temperatures. The CoY and CoYt models showed different performances in these reactions. The electron density map obtained during the exposure of the CoY model to the oxidation reaction conditions of the CO showed the cobalt within the smallest cavities of the zeolite. In the combustion of hydrogen in CoY, there was consumption of reagents in the temperature range 30–100 °C.

Starting with a brief presentation of the boundary conditions and the refill friction stir spot welding of high strength aluminum alloys, this paper introduces the quality criteria of refill friction stir spot welded joints. Afterwards, the paper discusses the influences of the process parameters on the joint formation and load-bearing capacities. Due to possible industrial application fields in automotive and airplane production, in which the combination with sealer or adhesives gets increasingly important, hybrid joining (combination of spot-shaped refill friction stir spot welds and sealer or adhesives) will also be discussed. Due to increased tool wear and contamination, different strategies for driving the polymer out of the joint area will be shown and compared. As the assurance of the joint quality with the help of nondestructive testing (NDT) plays an important role, an ultrasonic-based testing procedure will be shown. Additionally, a repair concept by “over-welding” will be investigated by destructive and nondestructive (ultrasonic testing procedure) testing for selected failure modes. The paper closes with specific recommendations for the realization of elementary and hybrid refill friction stir spot welded joints which meet the quality demands, and an outlook for further research steps will be given.

Male sex represents one of the major risk factors for severe COVID-19 outcome. However, underlying mechanisms that mediate sex-dependent disease outcome are as yet unknown. Here, we identify the CYP19A1gene encoding for the testosterone-to-estradiol metabolizing enzyme CYP19A1 (also known as aromatase) as a host factor that contributes to worsened disease outcome in SARS-CoV-2-infected males. We analyzed exome sequencing data obtained from a human COVID-19 cohort (n = 2,866) using a machine-learning approach and identify a CYP19A1-activity-increasing mutation to be associated with the development of severe disease in men but not women. We further analyzed human autopsy-derived lungs (n = 86) and detect increased pulmonary CYP19A1expression at the time point of death in men compared with women. In the golden hamster model, we show that SARS-CoV-2 infection causes increased CYP19A1expression in the lung that is associated with dysregulated plasma sex hormone levels and reduced long-term pulmonary function in males but not females. Treatment of SARS-CoV-2-infected hamsters with a clinically approved CYP19A1 inhibitor (letrozole) improves impaired lung function and supports recovery of imbalanced sex hormones specifically in males. Our study identifies CYP19A1as a contributor to sex-specific SARS-CoV-2 disease outcome in males. Furthermore, inhibition of CYP19A1 by the clinically approved drug letrozole may furnish a new therapeutic strategy for individualized patient management and treatment.

Atypical femoral fractures (AFF) are stress or ‘insufficiency’ fractures, often complicated by the use of bisphosphonates or other bone turnover inhibitors. While these drugs are beneficial for the intact osteoporotic bone, they probably prevent a stress fracture from healing which thus progresses to a complete fracture.Key features of atypical femoral fractures, essential for the diagnosis, are: location in the subtrochanteric region and diaphysis; lack of trauma history and comminution; and a transverse or short oblique configuration.The relative risk of patients developing an atypical femoral fracture when taking bisphosphonates is high; however, the absolute risk of these fractures in patients on bisphosphonates is low, ranging from 3.2 to 50 cases per 100,000 person-years.Treatment strategy in patients with AFF involves: radiograph of the contralateral side (computed tomography and magnetic resonance imaging should also be considered); dietary calcium and vitamin D supplementation should be prescribed following assessment; bisphosphonates or other potent antiresorptive agents should be discontinued; prophylactic surgical treatment of incomplete AFF with cephalomedullary nail, unless pain free; cephalomedullary nailing for surgical fixation of complete fractures; avoidance of gaps in the lateral and anterior cortex; avoidance of varus malreduction.Cite this article: EFORT Open Rev2018;3:494-500. DOI: 10.1302/2058-5241.3.170070.

AimsThe best method of treating unstable pelvic fractures that involve the obturator ring is still a matter for debate. This study compared three methods of treatment: nonoperative, isolated posterior fixation and combined anteroposterior stabilization.Patients and MethodsThe study used data from the German Pelvic Trauma Registry and compared patients undergoing conservative management (n = 2394), surgical treatment (n = 1345) and transpubic surgery, including posterior stabilization (n = 730) with isolated posterior osteosynthesis (n = 405) in non-complex Type B and C fractures that only involved the obturator ring anteriorly. Calculated odds ratios were adjusted for potential confounders. Outcome criteria were intraoperative and general short-term complications, the incidence of nerve injuries, and mortality.ResultsOperative stabilization reduced mortality by 36% (odds ratio (OR) 0.64, 95% confidence interval (CI) 0.42 to 0.98) but the incidence of complications was twice as high (OR 2.04, 95% CI 1.57 to 2.64). Mortality and the incidence of neurological deficits at discharge were no different after isolated posterior or combined anteroposterior fixation. However, the odds of both surgical (98%, OR 1.98, 95%CI 1.22 to 3.22) and general complications (43%, OR 1.43, 95% CI 1.02 to 2.00) were higher in the group with the more extensive surgery.ConclusionOperative stabilization is recommended for non-complex unstable pelvic fractures. The need for anterior fixation of obturator ring fractures should, however, be considered critically.Cite this article: Bone Joint J2018;100-B:973–83.

Background: Articular cartilage defects often result in pain, loss of function and finally osteoarthritis. Developing cell-based therapies for cartilage repair is a major goal of orthopaedic research. Autologous chondrocyte implantation is currently the gold standard cell-based surgical procedure for the treatment of large, isolated, full thickness cartilage defects. Several disadvantages such as the need for two surgical procedures or hypertrophic regenerative cartilage, underline the need for alternative cell sources. Objective: Mesenchymal stem cells, particularly synovium-derived mesenchymal stem cells, represent a promising cell source. Synovium-derived mesenchymal stem cells have attracted considerable attention since they display great chondrogenic potential and less hypertrophic differentiation than mesenchymal stem cells derived from bone marrow. The aim of this review was to summarize the current knowledge on the chondrogenic potential for synovial stem cells in regard to cartilage repair purposes. Results: A literature search was carried out identifying 260 articles in the databases up to January 2017. Several in vitro and initial animal in vivo studies of cartilage repair using synovia stem cell application showed encouraging results. Since synvoium-derived stem cells are located in the direct vicinity of cartilage and cartilage lesions these cells might even contribute to natural cartilage regeneration. The only one published human in vivo study with 10 patients revealed good results concerning postoperative outcome, MRI, and histologic features after a two-stage implantation of synovial stem cells into an isolated cartilage defect of the femoral condyle. Conclusion: Synovium-derived stem cells possess great chondrogenic potential and showed encouraging results for cartilage repair purposes. Furthermore, synovial stem cells play an important role in joint homeostasis and possibly in natural cartilage repair. Further studies are needed to elucidate the interplay of synovial stem cells and chondrocytes, and the promising role of synovium-derived stem cells in cartilage tissue engineering.

Die Förderung der Reflexionsfähigkeit ist eine ordinär mit der pflegepädagogischen Bildung verwobene Aufgabe. Neben der Entwicklung einer reflexionsfördernden Kultur gilt es gleichsam verbindliche Strukturen sowohl auf curricularer als auch auf Handlungsebene zu schaffen. Auf Handlungsebene kann z.B. der Reflexionszyklus von Graham Gibbs Verwendung finden. Auf curricularer Ebene können Eckpfeiler wie z.B. Portfolios, Journals, Lernberatung, Methoden aus der Theaterpädagogik, Methoden zur Förderung des kritischen Denkens oder Service-Learning verankert werden.

Störungen sind untrennbar mit dem Lehrerberuf verbunden. Dabei können sich Störungen in ihrer Art bezüglich Intensität und dem Grad der Aktivität unterscheiden. Ursachen von Störungen werden in endogene und exogene differenziert. Allerdings sind Störungen in der Regel multikausal. Prinzipiell gilt es präventive Strategien reaktiven vorzuziehen. Als letztes Mittel der Wahl stehen Sanktionsmaßnahmen zur Verfügung.

In the global market of the engineering sector, products can only be economically successful when they are extraordinarily light, safe, environment-friendly, and favorable compared to the competitors’ products. Because of new regulations for the reduction of CO2 emissions, especially the automotive industry is increasingly focusing on weight reduction in the car body structure through multi-material design with high-strength steels and aluminum. Conventional joining technologies for the body shop are often not applicable for these dissimilar material joints, for which reason new technologies must be invented. The hybrid thermal-mechanical joining technologies “resistance element welding” and “friction element welding” have been invented in recent years and are suitable for the high-volume production of multi-material structures with ultra-high-strength steels. Multi-material joints require effective corrosion protection measures. This paper presents how suitable process parameters can be determined for these two innovative technologies. Moreover, it shows the influence of a zinc-based anticorrosive fastener coating on the process parameters, the load-bearing capacity, and the corrosion behavior of the joints.

Using in situ X-ray diffraction and the Rietveld method combined with the maximum entropy method, we investigated the interaction of water with sodium faujasite and determined the sodium and water sorption sites as a function of water content. From the information contained in the lowest diffraction-angle peaks, we found that water also interacts with faujasite, forming a shell-like layer inside the supercages located at a mean distance of 2.8 Å from the pore-wall oxygens. For water-saturated faujasite, this shell has a surface density comparable to liquid water. The ion-exchange sites and ordered water found inside the supercage are embedded in this layer. We included the water shell contribution in Rietveld refinements by modeling it as a hollow sphere scatterer inside the faujasite supercages, and the refined water and cation quantities have agreed with nominal values.

Technology for thwarting intruders into telecommunications and computer networks is potentially useful for providing better services to businesses. Toggle switches ordinarily used by subscribers for controlling basic security operations can also be utilized for controlling line/trunk groups. Proctor and Assocs.' Secured System Access Line, which was originally designed for thwarting hackers, is increasingly being used in place of toggle switches in networks., Innovations designed to thwart network intruders can add other services to business systems. On the way to making the world--or at least computer and telecom networks--safe from hackers, you just [...]