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Context. On 2020 November 29, the first widespread solar energetic particle (SEP) event of solar cycle 25 was observed at four widely separated locations in the inner (≲1 AU) heliosphere. Relativistic electrons as well as protons with energies > 50 MeV were observed by Solar Orbiter (SolO), Parker Solar Probe, the Solar Terrestrial Relations Observatory (STEREO)-A and multiple near-Earth spacecraft. The SEP event was associated with an M4.4 class X-ray flare and accompanied by a coronal mass ejection and an extreme ultraviolet (EUV) wave as well as a type II radio burst and multiple type III radio bursts. Aims. We present multi-spacecraft particle observations and place them in context with source observations from remote sensing instruments and discuss how such observations may further our understanding of particle acceleration and transport in this widespread event. Methods. Velocity dispersion analysis (VDA) and time shift analysis (TSA) were used to infer the particle release times at the Sun. Solar wind plasma and magnetic field measurements were examined to identify structures that influence the properties of the energetic particles such as their intensity. Pitch angle distributions and first-order anisotropies were analyzed in order to characterize the particle propagation in the interplanetary medium. Results. We find that during the 2020 November 29 SEP event, particles spread over more than 230° in longitude close to 1 AU. The particle onset delays observed at the different spacecraft are larger as the flare–footpoint angle increases and are consistent with those from previous STEREO observations. Comparing the timing when the EUV wave intersects the estimated magnetic footpoints of each spacecraft with particle release times from TSA and VDA, we conclude that a simple scenario where the particle release is only determined by the EUV wave propagation is unlikely for this event. Observations of anisotropic particle distributions at SolO, Wind, and STEREO

Summary:Fracture-related infection (FRI) is a severe complication after bone injury and can pose a serious diagnostic challenge. Overall, there is a limited amount of scientific evidence regarding diagnostic criteria for FRI. For this reason, the AO Foundation and the European Bone and Joint Infection Society proposed a consensus definition for FRI to standardize the diagnostic criteria and improve the quality of patient care and applicability of future studies regarding this condition. The aim of this article was to summarize the available evidence and provide recommendations for the diagnosis of FRI. For this purpose, the FRI consensus definition will be discussed together with a proposal for an update based on the available evidence relating to the diagnostic value of clinical parameters, serum inflammatory markers, imaging modalities, tissue and sonication fluid sampling, molecular biology techniques, and histopathological examination. Second, recommendations on microbiology specimen sampling and laboratory operating procedures relevant to FRI will be provided.Level of Evidence:Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

Summary:Fracture-related infection (FRI) is a major complication in musculoskeletal trauma and one of the leading causes of morbidity. Standardization of general treatment strategies for FRI has been poor. One of the reasons is the heterogeneity in this patient population, including various anatomical locations, multiple fracture patterns, different degrees of soft-tissue injury, and different patient conditions. This variability makes treatment complex and hard to standardize. As these infections are biofilm-related, surgery remains the cornerstone of treatment, and this entails multiple key aspects (eg, fracture fixation, tissue sampling, debridement, and soft-tissue management). Another important aspect, which is sometimes less familiar to the orthopaedic trauma surgeon, is systemic antimicrobial therapy. The aim of this article is to summarize the available evidence and provide recommendations for systemic antimicrobial therapy with respect to FRI, based on the most recent literature combined with expert opinion.Level of Evidence:Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.

Introduction: One of the most challenging musculoskeletal complications in modern trauma surgery is infection after fracture fixation (IAFF). Although infections are clinically obvious in many cases, a clear definition of the term IAFF is crucial, not only for the evaluation of published research data but also for the establishment of uniform treatment concepts. The aim of this systematic review was to identify the definitions used in the scientific literature to describe infectious complications after internal fixation of fractures. The hypothesis of this study was that the majority of fracture-related literature do not define IAFF. Material and methods: A comprehensive search was performed in Embase, Cochrane, Google Scholar, Medline (OvidSP), PubMed publisher and Web-of-Science for randomized controlled trials (RCTs) on fracture fixation. Data were collected on the definition of infectious complications after fracture fixation used in each study. Study selection was accomplished through two phases. During the first phase, titles and abstracts were reviewed for relevance, and the full texts of relevant articles were obtained. During the second phase, full-text articles were reviewed. All definitions were literally extracted and collected in a database. Then, a classification was designed to rate the quality of the description of IAFF. Results: A total of 100 RCT's were identified in the search. Of 100 studies, only two (2%) cited a validated definition to describe IAFF. In 28 (28%) RCTs, the authors used a self-designed definition. In the other 70 RCTs, (70%) there was no description of a definition in the Methods section, although all of the articles described infections as an outcome parameter in the Results section. Conclusion: This systematic review shows that IAFF is not defined in a large majority of the fracture-related literature. To our knowledge, this is the first study conducted with the objective to explore this important issue. The lack of a consensus

Fracture-related infection (FRI) is a common and serious complication in trauma surgery. Accurately estimating the impact of this complication has been hampered by the lack of a clear definition. The absence of a working definition of FRI renders existing studies difficult to evaluate or compare. In order to address this issue, an expert group comprised of a number of scientific and medical organizations has been convened, with the support of the AO Foundation, in order to develop a consensus definition.The process that led to this proposed definition started with a systematic literature review, which revealed that the majority of randomized controlled trials in fracture care do not use a standardized definition of FRI. In response to this conclusion, an international survey on the need for and key components of a definition of FRI was distributed amongst all registered AOTrauma users. Approximately 90% of the more than 2000 surgeons who responded suggested that a definition of FRI is required. As a final step, a consensus meeting was held with an expert panel. The outcome of this process led to a consensus definition of FRI.Two levels of certainty around diagnostic featu

One of the most challenging complications in trauma surgery is infection after fracture fixation

The problem of determining the response of tree ring width growth to monthly climate is examined in this study. The objective is to document which of the available regression methods are best suited to deciphering the complex link between tree growth variation and climate. Tree-ring response function analysis is used to determine which instrumental climatic variables are best associated with tree-ring width variability. Ideally such a determination would be accomplished, or verified, through detailed physiological monitoring of trees in their natural environment. A statistical approach is required because such biological studies on mature trees are currently too time consuming to perform. The use of lagged climatic data to duplicate a biological, rather than a calendar, year has resulted in an increase in the degree of intercorrelation (multicollinearity) of the independent climate variables. The presence of multicollinearity can greatly affect the sign and magnitude of estimated regression coefficients. Using series of known response, the effectiveness of five different regression methods were objectively assessed in this study. The results from each of the 2000 regressions were compared to the known regression weights and a measure of relative efficiency computed. The results indicate that ridge regression analysis is, on average, four times more efficient (average relative efficiency of 4.57) than unbiased multiple linear regression at producing good coefficient estimates. The results from principal components regression are slight improvements over those from multiple linear regression with an average relative efficiency of 1.45.

The purpose was to evaluate airport impact on nearby residential property values (RPV). The hypothesis was that a relationship between noise levels, and nearby RPV could be identified and quantified. The objective was to model a relationship between housing location with respect to an airport and housing value, taking into consideration other relevant factors. Evaluation of aviation facilities impact on RPV was based on a sample of 587 single-family houses sold during 1984 and 1985. Selling price was used as the dependent variable. Independent variables included physical characteristics of a house, distance to the closest airport, accessibility of a house to the urban area, and supply and demand for houses. Distance to nearest airport was used as a surrogate for aircraft noise level. Study indicated that impact of aviation facilities on RPV could be quantified using selling price of a house as the dependent variable and distance from an airport as a primary independent variable along with physical characteristics of a house. Effect of an airport on RPV appears dependent not only on distance, but also on type of airport and selling price of a house. Davis-Monthan Airport (DM), a military airport, has a significantly greater impact than Tucson International Airport (TIA), a commercial airport. DM impact was greatest on houses priced above sample median. However, lower priced houses were effected more when the impact was expressed as a percent of selling price. DM impact area was approximately 2 miles from the airport, while TIA impact was about 1 mile from the facility. Distance from DM was the most significant variable in describing variation in selling price for houses closest to this facility. Living area of a house was also a very significant variable. Distance to TIA was not very significant in evaluating selling price variation. Living area and age of a house were generally the most significant variables describing selling price variation for TIA subset.