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Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Computationally hard combinatorial optimization problems (COPs) are ubiquitous in many applications. Various digital annealers, dynamical Ising machines, and quantum/photonic systems have been developed for solving COPs, but they still suffer from the memory access issue, scalability, restricted applicability to certain types of COPs, and VLSI-incompatibility, respectively. Here we report a ferroelectric field effect transistor (FeFET) based compute-in-memory (CiM) annealer for solving larger-scale COPs efficiently. Our CiM annealer converts COPs into quadratic unconstrained binary optimization (QUBO) formulations, and uniquely accelerates in-situ the core vector-matrix-vector (VMV) multiplication operations of QUBO formulations in a single step. Specifically, the three-terminal FeFET structure allows for lossless compression of the stored QUBO matrix, achieving a remarkably 75% chip size saving when solving Max-Cut problems. A multi-epoch simulated annealing (MESA) algorithm is proposed for efficient annealing, achieving up to 27% better solution and ~ 2X speedup than conventional simulated annealing. Experimental validation is performed using the first integrated FeFET chip on 28nm HKMG CMOS technology, indicating great promise of FeFET CiM array in solving general COPs.Yin et al. realize a FeFET based compute-in-memory annealer as an efficient combinatorial optimization solver through algorithm-hardware co-design with a FeFET chip, matrix lossless compression, and a multi-epoch simulated annealing algorithm. [ABSTRACT FROM AUTHOR]

Transposable elements (TEs) are a major constituent of human genes, occupying approximately half of the intronic space. During pre-messenger RNA synthesis, intronic TEs are transcribed along with their host genes but rarely contribute to the final mRNA product because they are spliced out together with the intron and rapidly degraded. Paradoxically, TEs are an abundant source of RNA-processing signals through which they can create new introns1, and also functional2 or non-functional chimeric transcripts3. The rarity of these events implies the existence of a resilient splicing code that is able to suppress TE exonization without compromising host pre-mRNA processing. Here we show that SAFB proteins protect genome integrity by preventing retrotransposition of L1 elements while maintaining splicing integrity, via prevention of the exonization of previously integrated TEs. This unique dual role is possible because of L1's conserved adenosine-rich coding sequences that are bound by SAFB proteins. The suppressive activity of SAFB extends to tissue-specific, giant protein-coding cassette exons, nested genes and Tigger DNA transposons. Moreover, SAFB also suppresses LTR/ERV elements in species in which they are still active, such as mice and flies. A significant subset of splicing events suppressed by SAFB in somatic cells are activated in the testis, coinciding with low SAFB expression in postmeiotic spermatids. Reminiscent of the division of labour between innate and adaptive immune systems that fight external pathogens, our results uncover SAFB proteins as an RNA-based, pattern-guided, non-adaptive defence system against TEs in the soma, complementing the RNA-based, adaptive Piwi-interacting RNA pathway of the germline. SAFB proteins protect genome integrity by preventing retrotransposition of L1 elements yet maintaining splicing integrity, via prevention of the exonization of previously integrated transposable elements, a major constituent of human genes. [ABSTRACT FROM AUTHOR]

Purpose: Periprosthetic femoral fractures (PFF) according to type Vancouver C are less common and outcome is limited reported. Therefore, we conducted this retrospective single center study. Methods: We performed analysis of patients who underwent open reduction and internal fixation (ORIF) with locking plates for PPF occurring distally of a primary standard hip stem. Data on demographics, revisions, fracture patterns, and mortality were evaluated. At least two years after operation, we examined outcome using the Parker and Palmer mobility score. Primary aim of this study was revision, outcome and mortality. Secondary aim was evaluation of fracture subtypes within type Vancouver C fractures. Results: Between 2008 and 2020, 383 patients with periprosthetic femoral fracture after hip replacement were surgically treated according to our database. Among them, 40 patients (10.4%) with type Vancouver C fractures were enrolled for this study. The mean patient age was 81.5 years (59–94) at the time of fracture. Thirty-three patients were women, and 22 fractures were on the left side. Without exception, locking plates were used. The 1-year mortality rate for the sample was 27.5% (n = 11). Three revisions (7.5%) were performed for plate breakage. Rate of infection and non-union was zero. Three different fracture patterns were assessed: (1) transverse or oblique fractures below the tip of the stem (n = 9); (2) spiral-shaped fractures within the diaphysis (n = 19); and (3) burst fractures at the supracondylar region (n = 12). Demographic or outcome effects between fracture patterns were not found. On average of 4.2 years (2.0–10.4) after treatment, the mean reported Parker score was 5.5 (1–9). Conclusion: ORIF with a single lateral locking plate is safe for type Vancouver C fractures with a well-fixed hip stem. Therefore, we do not recommend routinely revision arthroplasty or orthogonal double plating. Three subtypes of fractures within Vancouver C demonstrated no significant differences in baseline data and outcome. [ABSTRACT FROM AUTHOR]

Copyright of Die Orthopädie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Non-volatile memories (NVMs) have the potential to reshape next-generation memory systems because of their promising properties of near-zero leakage power consumption, high density and non-volatility. However, NVMs also face critical security threats that exploit the non-volatile property. Compared to volatile memory, the capability of retaining data even after power down makes NVM more vulnerable. Existing solutions to address the security issues of NVMs are mainly based on Advanced Encryption Standard (AES), which incurs significant performance and power overhead. In this paper, we propose a lightweight memory encryption/decryption scheme by exploiting in-situ memory operations with negligible overhead. To validate the feasibility of the encryption/decryption scheme, device-level and array-level experiments are performed using ferroelectric field effect transistor (FeFET) as an example NVM without loss of generality. Besides, a comprehensive evaluation is performed on a 128 × 128 FeFET AND-type memory array in terms of area, latency, power and throughput. Compared with the AES-based scheme, our scheme shows ~22.6×/~14.1× increase in encryption/decryption throughput with negligible power penalty. Furthermore, we evaluate the performance of our scheme over the AES-based scheme when deploying different neural network workloads. Our scheme yields significant latency reduction by 90% on average for encryption and decryption processes.Existing solutions based Advanced Encryption Standard to address the security issues of nonvolatile memories incurs significant performance and power overhead. Here, the authors propose a lightweight XOR-gate based encryption/decryption technique by exploiting in-situ array operations, which achieves significant area/latency/power reduction compared to conventional designs. [ABSTRACT FROM AUTHOR]

Advancements in AI led to the emergence of in-memory-computing architectures as a promising solution for the associated computing and memory challenges. This study introduces a novel in-memory-computing (IMC) crossbar macro utilizing a multi-level ferroelectric field-effect transistor (FeFET) cell for multi-bit multiply and accumulate (MAC) operations. The proposed 1FeFET-1R cell design stores multi-bit information while minimizing device variability effects on accuracy. Experimental validation was performed using 28 nm HKMG technology-based FeFET devices. Unlike traditional resistive memory-based analog computing, our approach leverages the electrical characteristics of stored data within the memory cell to derive MAC operation results encoded in activation time and accumulated current. Remarkably, our design achieves 96.6% accuracy for handwriting recognition and 91.5% accuracy for image classification without extra training. Furthermore, it demonstrates exceptional performance, achieving 885.4 TOPS/W–nearly double that of existing designs. This study represents the first successful implementation of an in-memory macro using a multi-state FeFET cell for complete MAC operations, preserving crossbar density without additional structural overhead. Designing efficient in-memory-computing architectures remains a challenge. Here the authors develop a multi-level FeFET crossbar for multi-bit MAC operations encoded in activation time and accumulated current with experimental validation at 28nm achieving 96.6% accuracy and high performance of 885 TOPS/W. [ABSTRACT FROM AUTHOR]

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study aimed to estimate the survival rate after proximal femoral fracture insult and identify the subgroup of centenarians with a high risk. Methods: Records of patients (≥ 65 years) who underwent surgery for PFF between 2006 and 2020 were retrieved from the electronic databases of three hospitals. Overall, 22 demographic, perioperative, and postoperative variables were analyzed for all patients > 99 years of age. The effect of anemia, time to surgery, surgical procedure, place of residence, and dementia on complications and survival were evaluated. Results: The study included 85 patients (women n = 71; men n = 14; median age, 100 years; range 100–106 years). Over the study period, the prevalence of centenarians with PFF increased (0.94%). The overall complication rate was 28% (in-hospital death, n = 16; infection, n = 1; hematoma, n = 1; implant failure, n = 1; cardiac decompensation, n = 3; pneumonia with delirium, n = 1; urinary tract infection, n = 1). The 30-day, 3-month, 6-month, and 1-year mortality rates for the study group were 27.1%, 42.4%, 55.3%, and 61.2%, respectively. Median survival was 150 days (range 1–1942 days). Patients with dementia (n = 47) had a shorter survival time than patients without dementia (n = 38) (hazard ratio 1.75; 95% confidence interval 1.04, 2.95). Preoperative anemia, time to surgery, or necessary surgical procedure had no impact on survival. Conclusions: The prevalence of centenarians undergoing surgery for PFF is increasing. In-hospital mortality is high, and dementia is a risk factor impacting survival. The rates of surgical revision and general complications are low, and the chosen predictors had no significant impact on these outcomes. The survival rate after discharge from hospital seems to be comparable to the estimated survival rate of uninjured centenarians. [ABSTRACT FROM AUTHOR]

Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hyperdimensional computing (HDC) is a brain-inspired computational framework that relies on long hypervectors (HVs) for learning. In HDC, computational operations consist of simple manipulations of hypervectors and can be incredibly memory-intensive. In-memory computing (IMC) can greatly improve the efficiency of HDC by reducing data movement in the system. Most existing IMC implementations of HDC are limited to binary precision which inhibits the ability to match software-equivalent accuracies. Moreover, memory arrays used in IMC are restricted in size and cannot immediately support the direct associative search of large binary HVs (a ubiquitous operation, often over 10,000+ dimensions) required to achieve acceptable accuracies. We present a multi-bit IMC system for HDC using ferroelectric field-effect transistors (FeFETs) that simultaneously achieves software-equivalent-accuracies, reduces the dimensionality of the HDC system, and improves energy consumption by 826x and latency by 30x when compared to a GPU baseline. Furthermore, for the first time, we experimentally demonstrate multi-bit, array-level content-addressable memory (CAM) operations with FeFETs. We also present a scalable and efficient architecture based on CAMs which supports the associative search of large HVs. Furthermore, we study the effects of device, circuit, and architectural-level non-idealities on application-level accuracy with HDC. [ABSTRACT FROM AUTHOR]

Background: The effects of immediate operation on hip fracture (HF) are unclear. Therefore, we investigated the influence of time to operation within 12 h vs. > 12–24 h on survival and adverse events. Methods: This retrospective study was based on our database from 2006 to 2019. Patients ≥ 20 years of age with operations for HF were included. A total of 40 characteristics were analyzed for operations within 12 h (group 1) and > 12–24 h (group 2) after admission. The primary endpoint was survival at 1 year after operation. Secondary endpoints were revision surgery for any reason, infection, and serious adverse events. Results: A total of 1015 patients received operations within 12 h (group 1), and 985 patients received operations > 12–24 h (group 2) after admission. The mean age of the patients was 78.8 ± 12.3 years. Patients in group 1 were younger and had better health status and shorter hospitalizations than those in group 2. However, no differences were found for revision surgery, infection or adverse events. The mortality rates at 30 days, 90 days, 6 months, and 1 year were 6.2, 11.8, 15.9, and 21.0%, respectively. The mortality rate at day 30 was significantly better (p = 0.04) in group 1, but no further differences in survival were observed (hazard ratio 1.071; 95% confidence interval 0.864–1.328; log rank 0.179). A subgroup analysis of geriatric patients ≥ 65 years assessed no differences according the primary and secondary endpoints. Conclusions: Within the limits of single-center analysis, the patients receiving treatment for HF within 12 h were younger and healthier and had the benefits of shorter hospitalizations and a higher 30-day survival rate than patients treated > 12–24 h after admission. At the endpoint 1 year after operation, no differences were observed in adverse events or survival rates. [ABSTRACT FROM AUTHOR]

Purpose: Two-stage exchange is the treatment of choice for periprosthetic joint infection (PJI). Factors and outcomes associated with infection recurrence for hip PJI are limited. The primary aim of this study was to determine factors associated with infection recurrence after two-stage exchange. Secondary aims were survival, mobility, and the EuroQol five-dimension scale (EQ-5D-5L) health state.Methods: We retrospectively investigated patients with two-stage exchange for hip PJI at our institution from 2006 to 2017. Follow-up was conducted for a minimum of four years after the reimplantation.Results: We included 135 patients with 139 hip PJIs. The mean age of the patients was 69.6 years (range 32-88). The infection recurrence rate was 14.4% (n = 20) after a mean follow-up of 8.0 years (range 4.0-13.1). Four factors for recurrence were identified at the time of the first stage: previous orthopaedic diagnoses (p < 0.001), type of explanted prosthesis (p = 0.004), cultured microorganisms (p = 0.033), and sinus tract (p = 0.035). A longer surgical reimplantation time (p = 0.015) was the only one factor found at the second stage. The estimated Kaplan-Meier survival for the total sample was 9.0 years (95% confidence interval 8.3-9.8), without significant difference for those with infection recurrence compared to recurrence-free patients (log-rank 0.931). At the time of follow-up, 89 patients were alive. For these patients, Parker mobility score (p = 0.102), EuroQol five-dimensional scale (p = 0.099), and EQ Visual Analogue Scale (EQ-VAS) (p = 0.027) were inferior in those with infection recurrence, but significance was found only for VAS.Conclusion: In this study with mid- to long-term follow-up, five factors for infection recurrence were identified. Recurrence did not affect survival, but health-related quality of life was inferior compared to recurrence-free patients. The results suggest that the period of the first stage including previous orthopaedic diagnoses requires more consideration in the future. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The embryonic stem cell test (EST) represents the only validated and accepted in vitro system for the detection and classification of compounds according to their developmental and reproductive teratogenic potency. The widespread implementation of the EST, however, in particular for routine application in pharmaceutical development, has not been achieved so far. Several drawbacks still limit the high-throughput screening of potential drug candidates in this format: The long assay period, the use of non-homogeneous viability assays, the low throughput analysis of marker protein expression and the compatibility of the assay procedures to automation. We have therefore introduced several advancements into the EST workflow: A reduction of the assay period, an introduction of homogeneous viability assays, and a straightforward analysis of marker proteins by flow cytometry and high content imaging to assess the impact of small molecules on differentiation capacity. Most importantly, essential parts of the assay procedure have been adapted to lab automation in 96-well format, thus enabling the interrogation of several compounds in parallel. In addition, extensive investigations were performed to explore the predictive capacity of this next-generation EST, by testing a set of well-known embryotoxicants that encompasses the full range of chemical-inherent embryotoxic potencies possible. Due to these significant improvements, the augmented workflow provides a basis for a sensitive, more rapid, and reproducible high throughput screening compatible platform to predict in vivo developmental toxicity from in vitro data which paves the road towards application in an industrial setting. [ABSTRACT FROM AUTHOR]

Purpose: For this retrospective cohort study, we assessed pertrochanteric fracture types AO/OTA 31-A2. PFNA and DHS were the devices used. We determined both devices in relation to peri-operative variables, postoperative radiographic measurements, implant-related complications and mortality up to 2 years. The null hypothesis was no effect between the two devices. Methods: This single-centre study was conducted based on our computerized data. The treatment period ranged from 2006 to 2015. Only patients with type AO/OTA 31-A2 fractures and an age ≥ 65 years were included. Apart from descriptive variables, the following measurements were assessed: (1) duration of surgery, (2) blood loss, (3) transfusion, (4) hospitalization, (5) tip-apex distance (TAD), (6) fracture reduction, (7) screw position, (8) implant-related complications, and (9) mortality. The follow-up was 2 years for each living patient. Missing data were evaluated by telephone call. Results: A total of 375 consecutive patients were enrolled into three groups: (1) 75 patients treated with DHS and antirotation screw (ARS); (2); 100 patients treated with DHS + ARS + TSP (trochanteric stabilization plate); and (3) 200 patients treated with PFNA. Apart from dementia, the descriptive data (e.g., age and BMI) demonstrated no effects between the three groups. Compared to PFNA, DHS with or without TSP was adversely affected by a longer operation time, higher blood loss, increase in transfusion, and more implant-related complications including cut-out, infection and failure. The rate of cut-out was significantly higher in TAD ≥ 25 mm (p = 0.005), and PFNA demonstrated significantly better TAD measurements (p = 0.001), better fracture reduction (0.002), more central-central screw positions (p = 0.014), and less poor screw placement (p = 0.001). The mortality rate was without effect between the three groups (log rank 0.698). Conclusions: DHS with or without TSP was associated with significantly higher rates of implant-related complications based on inferior radiographic measurements. Therefore, we only recommend PFNA for the treatment of proximal type AO/OTA 31-A2 femoral fractures. Level of evidence: Therapeutic level III. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess patients with Parkinson's disease (PD) in comparison with patients without PD for the treatment of hip fractures. Therefore, we performed a mono-centre study including 145 patients with PD and 2135 consecutive patients without PD as a concurrent group (C). Methods: For analysis, we used our database, in which any type of hip fracture was enrolled. The study period ranged from 2007 to 2017, and the patient age was ≥ 60 years. Overall, 10 variables were included. The primary measures were operations for any reason, infection, dislocation, failure, and mortality. The secondary outcome was any de novo fracture based on a new fall. The follow-up period for every living patient was 2 years after the operation. Any missing data were retrospectively evaluated via telephone. The hypothesis was no effect between the two groups. Results: No significant differences were observed regarding revision (p = 0.348), infection (p = 0.207), dislocation (p = 0.785), failure of internal fixation (p = 0.368), failure of replacement (p = 0.174), and de novo fractures (p = 0.287). However, patients with PD sustained a contralateral hip fracture significantly more often (p < 0.001). Kaplan–Meier survival analysis demonstrated no effects up to 2 years after the operation (log rank 0.259). Conclusion: Compared to a concurrent group, patients with PD demonstrated no more complications and similar mortality rates within 2 years after surgery. The rate of dislocation after hip replacement was also not increased. A contralateral hip fracture was the most common de novo fracture in PD. Further studies should investigate measures reducing the risk for any new falls in PD. [ABSTRACT FROM AUTHOR]

In this work, the influence of 0.5 at.% and 1 at.% Y additions on the high-temperature oxidation resistance of the equiatomic alloy NbMoCrTiAl at 1000 °C in air was investigated. Continuous isothermal and cyclic thermogravimetric experiments were conducted to characterize the oxidation kinetics of the alloys. Various analytical methods such as X-ray diffraction and electron microscopy with energy-dispersive X-ray spectroscopy were used to study the growth, morphology and composition of the oxide scales. It was found that the Y additions led to the formation of Al2Y phase along grain boundaries. The isothermal oxidation experiments of both Y-containing alloys showed lower oxidation rates after a short period of transient oxidation probably due to a reduction of fast-growing and voluminous Nb2O5 oxides within the oxide layer. During the steady-state period, however, oxidation of Al2Y caused local stresses resulting in crack formation and subsequent breakaway oxidation, i.e. pronounce increase in the oxidation rates. The cyclic oxidation experiments revealed lower oxidation rates and thinner, more adherent oxide scales formed on the alloy NbMoCrTiAl1Y compared to NbMoCrTiAl. The increased scale adherence was attributed to the formation of pegs due to the oxidation of Al2Y phase at the oxide/metal interface. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess patients treated for interprosthetic femoral fractures (IFFs).Method: Based on our database, we performed a retrospective single-center analysis of patients who underwent surgery for the treatment of IFFs. We evaluated patient demographics, fracture patterns, type of surgery, revision, and mortality for a minimum of one year after treatment. Outcomes were assessed via telephone using the Parker score.Results: Fifty consecutive patients were enrolled. An analysis of fracture patterns revealed three different types: proximal (n = 19), intermediate (n = 13), and distal (n = 18). Treatment included internal fixation for stable components and revision arthroplasty for loose implants; and a lateral locking plate was the most commonly applied device. The mean follow-up time of the total sample was 5.7 years after the operation. The total revision rate was 22%, and the highest revision rate was documented for revision arthroplasty. The one year mortality rate for the sample was 14%, and fracture patterns and treatment revealed no effects on mortality. Living patients (n = 23) were followed up for an average of 4.9 years after treatment. Only six patients reported the best Parker score (mean, 5.0; range 0-9).Conclusion: IFFs can be divided into three groups irrespective of the type of stem or bone quality, but fixation (stable or loose) must also be considered to determine the treatment. Fracture patterns and treatment revealed no effects on mortality. There are many treatment options but no single solution for IFFs. [ABSTRACT FROM AUTHOR]

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We examined 438 fresh skulls of pine marten (Martes martes) from Germany to check for the presence of the cranial trematode Troglotrema acutum. The parasite was detected in the frontal sinuses of one 3-year-old road-killed male from the Rhoen Mountains (Thuringia). We detected 19 adult T. acutum and 34 eggs. The infested pine martens showed no deformations or lesions of the skull. This is the first time that specimens of the trematode were recovered from a pine marten from Germany, but the low prevalence of 0.23% confirms that the pine marten is only a rare host of T. acutum. [ABSTRACT FROM AUTHOR]

Expansions of short tandem repeats are genetic variants that have been implicated in several neuropsychiatric and other disorders, but their assessment remains challenging with current polymerase-based methods1–4. Here we introduce a CRISPR–Cas-based enrichment strategy for nanopore sequencing combined with an algorithm for raw signal analysis. Our method, termed STRique for short tandem repeat identification, quantification and evaluation, integrates conventional sequence mapping of nanopore reads with raw signal alignment for the localization of repeat boundaries and a hidden Markov model-based repeat counting mechanism. We demonstrate the precise quantification of repeat numbers in conjunction with the determination of CpG methylation states in the repeat expansion and in adjacent regions at the single-molecule level without amplification. Our method enables the study of previously inaccessible genomic regions and their epigenetic marks. Expansions of short tandem repeats linked to neuropsychiatric disorders are measured by single-molecule sequencing. [ABSTRACT FROM AUTHOR]

Purpose: We performed a monocenter cohort study to determine surgical revision and mortality after sustaining an initial and a non-simultaneous contralateral proximal femoral fracture. Methods: We identified all patients surgically treated for a contralateral femoral fracture between 2006 and 2015. Patient demographic characteristics and follow-up were identified by our electronic database; failed information regarding revision and mortality were obtained by telephone, as well as the evaluation of the mobility for all alive patients. The endpoint of the study was set for every patient at least 2 years postoperatively. Results: Within a total of 2296 patients, we identified 250 patients (10.8%) treated for a contralateral fracture. The mean interval between the two occurrences was 5.2 years and the mean age at the time of contralateral fracture was 84.4 years. Almost every third fracture occurred later than 5 years after the initial fracture, and even every tenth fracture later than 10 years. More than 50% of the patients also had dementia at this time. The total surgical revision rate was 17.2% after initial, and 20.4% after contralateral fracture, but this difference was statistically not significant (p = 0.31). However, revisions for infection or hematoma were more than twice after contralateral fracture (p = 0.006). The 1-year mortality rate was 36%, and dementia (log rank p < 0.001) and male gender (log rank p < 0.001) were significant negative predictors for the survival rate. After a mean of 42 months, the follow-up of the 67 alive patients recorded a mean Parker Score of 5.2 items. Conclusion: Contralateral femoral fracture was accompanied by a higher revision and mortality rate—but patients were also 5 years older. Dementia and male gender were significant negative variables for the survival time. In the future, the highest priority will be the prophylaxis of falling to avoid or at least to decline the number of these fractures in geriatric patients. [ABSTRACT FROM AUTHOR]

European populations of free-living wildcats have been shown to be exposed to cat viruses. Luxembourg has a high degree of habitat fragmentation, and hybridisation rates between domestic cats and wildcats are high. We therefore assessed the seroprevalence of six viruses in 34 serum samples collected between 2001 and 2016 from wildcats in Luxembourg. The values for feline leukemia virus (FeLV; 52.9%) and feline coronavirus (FCoV; 47.1%) were amongst the highest reported for wildcats. We found evidence for the cumulative likelihood of exposure to FCoV affecting its seroprevalence. Routine monitoring of viral agents in this strictly protected species should be considered. [ABSTRACT FROM AUTHOR]

Purpose: Long-term results after treatment of calcaneal fractures are rare. For this reason, we conducted a retrospective follow-up after a minimum of 20 years post surgery.Methods: Between 1990 and 1994, a total of 66 patients received surgical treatment for displaced calcaneal fractures. At that time, osteosynthesis was performed using small, one-third tubular plates. After collecting empirical data, we conducted a follow-up at least 20 years post surgery using X-ray imaging and clinical questionnaires (AOFAS and SF-36 questionnaire).Results: It was possible to recruit a total of 22/66 patients (33 %) after a mean of 22 years (range, 20-24) post surgery. With regard to the AOFAS scores (mean value, 74 points), 12 showed very good or good results, four showed average and six poor results. Patients with orthopaedic shoes also had low AOFAS scores. The Boehler's angle had been increased from +2° prior to surgery to +21° post-operatively. At the time of follow-up, the mean value was +17°. The angle correlated with the AOFAS score. Also, the SF-36 physical score was clearly reduced when compared to a general population, and correlated significantly with the AOFAS score.Conclusion: There is still no evidence that open reduction and internal fixation of calcaneal fractures results in better outcomes than conservative therapy. This has been confirmed by our long-term results that provided disillusioning results: in a small population, only 55 % of the patients showed very good or good clinical overall results. Furthermore, SF-36 showed impaired physical subscores, which correlated significantly with the AOFAS. [ABSTRACT FROM AUTHOR]

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The high-temperature oxidation behavior of a new family of refractory high-entropy alloys (HEAs) with compositions of W-Mo-Cr-Ti-Al, Nb-Mo-Cr-Ti-Al and Ta-Mo-Cr-Ti-Al was studied at 1000 and 1100 °C. Based on these equimolar starting compositions, the main incentive of this study was to select the most promising alloy system whose properties may then be successively improved. Despite the high amount of refractory elements, Ta-Mo-Cr-Ti-Al showed good oxidation resistance at 1000 and 1100 °C. Moderate values of mass gain and complex oxidation kinetics were observed for the W- and Nb-containing HEAs. These alloys formed inhomogeneous oxide scales possessing regions with thick and porous layers as well as areas revealing quite thin oxide scales due to the formation of discontinuous Cr- and Al-rich scales. The most promising behavior was shown by the alloy Ta-Mo-Cr-Ti-Al which followed the parabolic rate law for oxide growth due to the formation of a thin and compact Al-rich layer. [ABSTRACT FROM AUTHOR]

The European wildcat, Felis silvestris silvestris, serves as a prominent target species for the reconnection of central European forest habitats. Monitoring of this species, however, appears difficult due to its elusive behaviour and the ease of confusion with domestic cats. Recently, evidence for multiple wildcat occurrences outside its known distribution has accumulated in several areas across Central Europe, questioning the validity of available distribution data for this species. Our aim was to assess the fine-scale distribution and genetic status of the wildcat in its central European distribution range. We compiled and analysed genetic samples from roadkills and hundreds of recent hair-trapping surveys and applied phylogenetic and genetic clustering methods to discriminate wild and domestic cats and identify population subdivision. 2220 individuals were confirmed as either wildcat (n = 1792) or domestic cat (n = 342), and the remaining 86 (3.9 %) were identified as hybrids between the two. Remarkably, genetic distinction of domestic cats, wildcats and their hybrids was only possible when taking into account the presence of two highly distinct genetic lineages of wildcats, with a suture zone in central Germany. 44 % of the individual wildcats where sampled outside the previously published distribution. Our analyses confirm a relatively continuous spatial presence of wildcats across large parts of the study area in contrast to previous analyses indicating a highly fragmented distribution. Our results suggest that wildcat conservation and management should take advantage of the higher than previously assumed dispersal potential of wildcats, which may use wildlife corridors very efficiently. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the outcome of surgically-treated periprosthetic femoral fractures with an orthogonal double plate system. Methods: We performed a retrospective study of ten patients (mean age 79.5 years) surgically treated for periprosthetic femoral fractures using orthogonal double plating (lateral and additional anterior plate position) from 2010 to 2013. The patients' demographic characteristics, complications and initial follow-up data were retrieved from our institutional database. After a minimum of six months post-surgery, we performed a radiological and clinical follow-up. Results: The surgical indications for orthogonal plating were heterogenic; five patients were treated for periprosthetic fractures around their total hip prosthesis. One was treated for a fracture around a total knee prosthesis and one for an interprosthetic fracture. Additionally, three patients were treated for postoperative implant failure after the stabilisation of periprosthetic fractures around a total hip prosthesis (one) or total knee prosthesis (two). Osteosynthesis was performed using locking compression plates exclusively (length between eight and 20 holes). After a mean follow-up of 22.6 months (range, six to 42 months), two patients died, but their deaths were due to old age morbidity and were unrelated to the surgery. Surgical revision for implant failure was necessary for only one female patient due to a breakage of the lateral plate. In addition, no other failures, such as infection or non-union, were observed. At the time of follow-up, seven out of ten patients were mobile and subjectively satisfied in regards to their outcome. Conclusions: Based on a small number of cases, we were able to show for the first time that the use of orthogonal double plating is not associated with an increased rate of complications in patients with periprosthetic femoral fractures and stable components. Moreover, orthogonal double plating can be used successfully as a salvage procedure. At the time of follow up, seven out of ten patients were mobile. More cases must be investigated to validate our findings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the outcome of unstable type C pelvic fractures treated with posterior stabilisation and the anterior subcutaneous internal fixator (ASIF).Methods: Altogether, 36 consecutive patients were treated for unstable type C pelvic ring fractures using posterior stabilisation and ASIF. After a minimum of 18 months, the clinical and radiological outcome was retrospectively investigated.Results: Overall, three patients (8.3%) died, and 31 patients (86%) were available for follow-up after a mean of 4.5 years. Thirty of 31 patients (97%) showed radiographic bone consolidation of both the posterior and anterior pelvic ring. Only one non-union and two infections due to the anterior device were observed. The total German pelvic outcome score showed an excellent or good rating for 64.5% of the patients, and a fair or poor for 35.5%. The SF-12 questionnaire showed a significantly reduced total score for physical and mental health compared to a general reference population.Conclusions: The ASIF represents an innovative surgical procedure for the treatment of type C pelvic ring fractures. In the medium term, patient satisfaction was high and the complication rate was low, despite the small number of patients. More cases must be investigated before the procedure can be recommended in general, possibly replacing the external fixator for the treatment of pelvic ring fractures in the future. [ABSTRACT FROM AUTHOR]

Purpose: Percutaneous reduction and periarticular screw implantation techniques have been successfully introduced in acetabular surgery. The advantages of this less invasive approach are attenuated by higher risks of screw misplacement. Anatomical landmarks are strongly needed to prevent malplacement. This cadaver study was designed to identify reliable anatomical osseous landmarks in the pelvic region for screw placement in acetabular surgery. Gender differences were specifically addressed. Methods: Twenty-seven embalmed cadaveric hemipelvic specimens (13 male, 14 female) were used. After soft-tissue removal, anterior and posterior column acetabular screw placement was conducted by one orthopaedic trauma surgeon under direct vision. Each column was addressed by antegrade and retrograde screw insertion. Radiographic verification of ideal screw placement was followed by assessment of the distance from the different entry points to adjoining anatomical osseous structures. Results: For anterior column screw positioning, the posterior superior iliac spine (PSIS), posterior inferior iliac spine (PIIS), iliopectineal eminence and centre of the symphysis were most reliable regarding gender differences. For posterior column screw positioning, the distance to the anterior superior iliac spine (ASIS) and the ischial tuberosity showed the lowest deviation between the different gender specimens. Highest gender differences were seen in relation to the cranial rim of the superior pubic ramus in retrograde anterior column screw positioning ( p = 0.002). Most landmarks could be targeted within a 2.5-cm range in all specimens. Conclusions: The findings emphasise the relevance of osseous landmarks in acetabular surgery. By adhering to easily identifiable structures, screw placement can be safely performed. Significant gender differences must be taken into consideration during preoperative planning. [ABSTRACT FROM AUTHOR]

In a recent study published in this journal it was claimed that the rate of publications from US-based authors in the human embryonic stem cell (hESC) research field was slowing or even declining from 2008 to 2010. It was assumed that this is the result of long-term effects of the Bush administration's funding policy for hESC research and the uncertain policy environment of recent years. In the present study, we analyzed a pool of more than 1,700 original hESC research papers published world-wide from 2007 to 2011. In contrast to the previous study, our results do not support the hypothesis of a decline in the productivity of US-based research but rather confirm a nearly unchanged leading position of US research in the hESC field with respect to both publication numbers and impact of research. Moreover, we analyzed about 500 papers reporting original research involving human induced pluripotent stem cells (hiPSCs) published through 2011 and found a dominant position of US research in this research field as well. [ABSTRACT FROM AUTHOR]

A number of key regulators of mouse embryonic stem (ES) cell identity, including the transcription factor Nanog, show strong expression fluctuations at the single-cell level. The molecular basis for these fluctuations is unknown. Here we used a genetic complementation strategy to investigate expression changes during transient periods of Nanog downregulation. Employing an integrated approach that includes high-throughput single-cell transcriptional profiling and mathematical modelling, we found that early molecular changes subsequent to Nanog loss are stochastic and reversible. However, analysis also revealed that Nanog loss severely compromises the self-sustaining feedback structure of the ES cell regulatory network. Consequently, these nascent changes soon become consolidated to committed fate decisions in the prolonged absence of Nanog. Consistent with this, we found that exogenous regulation of Nanog-dependent feedback control mechanisms produced a more homogeneous ES cell population. Taken together our results indicate that Nanog-dependent feedback loops have a role in controlling both ES cell fate decisions and population variability. [ABSTRACT FROM AUTHOR]

Forced expression of proneural transcription factors has been shown to direct neuronal conversion of fibroblasts. Because neurons are postmitotic, conversion efficiencies are an important parameter for this process. We present a minimalist approach combining two-factor neuronal programming with small molecule-based inhibition of glycogen synthase kinase-3? and SMAD signaling, which converts postnatal human fibroblasts into functional neuron-like cells with yields up to >200% and neuronal purities up to >80%. [ABSTRACT FROM AUTHOR]

Introduction: CT scans are deemed to be the gold standard for the evaluation of calcaneal fractures. However, the reliability of the interpretation has not been studied systematically. Patients and methods: In a prospective multicenter study, the CT data set of five different fractures was presented to 57 evaluators. The participating surgeons were asked to assess calcaneal fractures on the basis of a multiple choice questionnaire. The CT scans were validated by the intraoperative findings. The questionnaires were compared to the model solution of three foot and ankle surgeons. The intra- and interrater reliability was calculated. Results: The proportion of intraobserver agreement was 82%. Cohen's kappa was κ = 0.748 with P < 0.0001. In total, 61% of the items were answered similarly to the model answer. Only 27% of the evaluators were able to correctly classify the fracture according to Sanders and 63% of the evaluators agreed that surgical procedure was necessary. The more experienced the surgeon, the higher was the interrater agreement. Conclusion: This is the first study to systematically analyze the reliability of the interpretation of CT scans of calcaneal fractures. This was found to be unsatisfactory. Future studies must show, if specific interventions, e.g., teaching programs or image procession modalities (e.g., 3D reconstructions), are capable of improving the quality of interpretation of CT scans for calcaneal fractures. [ABSTRACT FROM AUTHOR]

Stem cells are defined as self-renewing cell populations that can differentiate into multiple distinct cell types. However, hundreds of different human cell lines from embryonic, fetal and adult sources have been called stem cells, even though they range from pluripotent cells—typified by embryonic stem cells, which are capable of virtually unlimited proliferation and differentiation—to adult stem cell lines, which can generate a far more limited repertoire of differentiated cell types. The rapid increase in reports of new sources of stem cells and their anticipated value to regenerative medicine has highlighted the need for a general, reproducible method for classification of these cells. We report here the creation and analysis of a database of global gene expression profiles (which we call the ‘stem cell matrix’) that enables the classification of cultured human stem cells in the context of a wide variety of pluripotent, multipotent and differentiated cell types. Using an unsupervised clustering method to categorize a collection of ∼150 cell samples, we discovered that pluripotent stem cell lines group together, whereas other cell types, including brain-derived neural stem cell lines, are very diverse. Using further bioinformatic analysis we uncovered a protein–protein network (PluriNet) that is shared by the pluripotent cells (embryonic stem cells, embryonal carcinomas and induced pluripotent cells). Analysis of published data showed that the PluriNet seems to be a common characteristic of pluripotent cells, including mouse embryonic stem and induced pluripotent cells and human oocytes. Our results offer a new strategy for classifying stem cells and support the idea that pluripotency and self-renewal are under tight control by specific molecular networks. [ABSTRACT FROM AUTHOR]

Neural stem cells are a self-renewing population that generates the neurons and glia of the developing brain. They can be isolated, proliferated, genetically manipulated and differentiated in vitro and reintroduced into a developing, adult or pathologically altered CNS. Neural stem cells have been considered for use in cell replacement therapies in various neurodegenerative diseases, and an unexpected and potentially valuable characteristic of these cells has recently been revealed — they are highly migratory and seem to be attracted to areas of brain pathology such as ischaemic and neoplastic lesions. Here, we speculate on the ways in which neural stem cells might be exploited as delivery vehicles for gene therapy in the CNS. [ABSTRACT FROM AUTHOR]