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Objective: This study examined how individuals' ideal weight and weight discrepancy (between ideal and actual weight) changed over the life course and across cohorts. Methods: The study used population-representative longitudinal data collected in the Netherlands (N = 61,431 observations between 2007 and 2018 among N = 13,409 individuals aged 16 to 80 and born 1927-2000). Results: Ideal weight increased linearly with age. Weight discrepancy showed a bellshaped age pattern. Approximately half of the age-related increase in ideal weight was associated with concurrent increases in actual weight. Ideal weight and weight discrepancy increased slightly across cohorts. The cohort-related increase in ideal weight vanished after adjusting for change in actual weight. Analyses of population heterogeneity showed similar patterns of change in both outcomes across groups, although levels differed by gender, education, and migration status even after adjusting for differences in actual weight between these groups. Conclusion: These results show that ideal weight and weight discrepancy in the Netherlands change substantially with age and modestly across cohorts. Potential explanations include changes in physical appearance and in the importance of physical appearance. [ABSTRACT FROM AUTHOR]

There is robust evidence that people with higher incomes tend to have higher self-esteem, but little is known about how changes in income and self-esteem are related within individuals. Some theories predict that increased earnings lead to higher self-esteem, others that increased self-esteem leads to higher earnings, and still others that there should be no within-person associations between these variables. We tested these theories in 4-year longitudinal data from more than 4,000 adult participants from a Dutch representative sample. Results indicated significant between-person associations between income and self-esteem, consistent with prior research. Within-person effects suggested that increases in self-esteem are a function of previous increases in income more than the other way around. These links held when analyses controlled for employment status, and they generalized across gender, age, and educational background. Overall, the findings provide evidence for theories that consider self-esteem as both a source and a consequence of personal earnings. [ABSTRACT FROM AUTHOR]

Objective: This study examined how individuals’ ideal weight and weight discrepancy (between ideal and actual weight) changed over the life course and across cohorts.Methods: The study used population-representative longitudinal data collected in the Netherlands (N = 61,431 observations between 2007 and 2018 among N = 13,409 individuals aged 16 to 80 and born 1927–2000).Results: Ideal weight increased linearly with age. Weight discrepancy showed a bell-shaped age pattern. Approximately half of the age-related increase in ideal weight was associated with concurrent increases in actual weight. Ideal weight and weight discrepancy increased slightly across cohorts. The cohort-related increase in ideal weight vanished after adjusting for change in actual weight. Analyses of population heterogeneity showed similar patterns of change in both outcomes across groups, although levels differed by gender, education, and migration status even after adjusting for differences in actual weight between these groups.Conclusion: These results show that ideal weight and weight discrepancy in the Netherlands change substantially with age and modestly across cohorts. Potential explanations include changes in physical appearance and in the importance of physical appearance.

Purpose: The purpose of this historical review is to illustrate the progression and evolution of treatment for distal femur fractures. Methods: Scientific literature was searched for descriptions of treatment for distal femur fractures to provide an in-depth overview of the topic, with emphasis on the evolution of surgical constructs used to treat these fractures. Results: Prior to the 1950s, distal femur fractures were treated nonoperatively, resulting in considerable morbidity, limb deformity, and limited function. As principles of surgical intervention for fractures emerged in the 1950s, surgeons developed conventional straight plates to better stabilize distal femur fractures. Angle blade plates and dynamic condylar screws emerged out of this scaffolding to prevent post-treatment varus collapse. Meanwhile, intramedullary nails, and later, in the 1990s, locking screws, were introduced to minimize soft tissue disruption. Treatment failure led to the development of locking compression plates with the advantage of accommodating either locking or nonlocking screws. Despite this advancement, the rare but significant incidence of nonunion has not been eliminated, leading to the recognition of the biomechanical environment as important for prevention and the development of active plating techniques. Conclusion: Emphasis for the surgical treatment of distal femur fractures has incrementally progressed over time, with initial focus on complete stabilization of the fracture while the biological environment surrounding the fracture was ignored. Techniques slowly evolved to minimize soft tissue disruption, allow more ease of implant placement at the fracture site, and attend to the systemic health of the patient, while simultaneously ensuring appropriate fracture fixation. Through this dynamic process, the desired results of complete fracture healing and maximization of functional outcomes have emerged. [ABSTRACT FROM AUTHOR]

• Built three fixation models: medial support pad (MSP)+LISS, antero-medial plate (AMP)+LISS, and medial plate (MP)+LISS. • Model of MSP+LISS showed better biomechanical performance than the double-plate model, testified by finite element analysis. • With finite element analysis, medial plate (MP)+LISS provided better biomechanical support than antero-medial plate (AMP)+LISS. In this study, we evaluated the biomechanical characteristics of different locations of medial fixation strategies in double-plate osteosynthesis for fixing AO/ASIF type 33-C2 femoral fractures by means of finite element analysis. We used 3-matic software and UG-NX software to construct AO/ASIF type 33-C2 Femoral fractures and lateral less invasive stabilization system (LISS) plates, medial plates (MPs), and medial support pads (MSPs), respectively. Then, the LISS, MP and MSP were assembled into the fracture model separately to form three fixation models: MSP+LISS, anteromedial plate (AMP+LISS), and MP+LISS. In the next procedure, we performed finite element analysis using ANSYS software after meshing the elements of the models in HyperMesh 11.0 software. Loading conditions including lateral-medial four-point bending, anterior-posterior four-point bending, axial loading, and torsional loading were applied to evaluate the biomechanical advantages among the three fixation types. We observed the peak Von Mises Stress (VMS) value, maximum displacement, bending angle in the coronal plane of the fracture, and torsional angle of the fracture to assess the degree of plate deformation and fixation stability. Our results showed that in both lateral-medial four-point bending and anterior-posterior four-point bending, the calculations of MP+LISS were marginally better than those of AMP+LISS. However, with the action of axial loading and torsional loading, the deformation of MP+LISS was distinctly smaller than that of AMP+LISS, and the fixation stability of MP+LISS was also prominently better. Under lateral-medial four-point bending, the VMS on the lateral plate of MSP+LISS (59.977 MPa) was approximately half of the two double-plate models. Under anterior and posterior four-point bending, the 38.209 MPa peak VMS of MSP+LISS was still superior to the other two double-plate models. Under torsional loading, the peak VMS (347.75 MPa), the maximum torsional angle of the femoral head (7.852 °), and the torsional angle of fracture (0.036 °) of MSP+LISS preceded those of the other two models. However, under axial loading, the peak VMS (76.376 MPa) and the maximum displacement (3.1798 mm) of MSP+LISS were slightly higher than those of MP+LISS. The MSP+LISS model showed better biomechanical performance than the double-plate models, which might be an effective solution for the treatment of comminuted distal femur fractures. [ABSTRACT FROM AUTHOR]

This study sought to examine the stability and change of the 5 items of the Satisfaction With Life Scale over several years. The multi-trait-multi-state model was used to separate the variance components attributable to stable influences, time-varying situational influences, and random measurement error. The study used two partially overlapping samples of Dutch adults surveyed annually over 8 and 5 years (N1 = 9,300, N2 = 6,770). Results show that between 54% and 63% of the variance in items is stable over time, whereas between 6% and 26% of the variance is due to occasion-specific influences (i.e., situational influences present at each measurement time and person-situation interactions). Between 15% and 36% of the variance is due to measurement error. All items show a similar degree of stability over time. However, the first 3 items (measuring current life satisfaction) show higher reliability, whereas the last 2 items (measuring past life satisfaction) are less reliable. The study has several implications for measuring life satisfaction in cross-sectional and longitudinal studies. For example, the results suggest that the first 3 items are more sensitive to and better reflect current situational factors than the last 2 items. In contrast, the last 2 items reflect more unsystematic and random influences that are more independent of current life situations. Thus, relying on the last 2 items may lead to an underestimation of the reactivity of life satisfaction judgments to current life situations. [ABSTRACT FROM AUTHOR]

Background: Nonunion following treatment of supracondylar femur fractures with lateral locked plates (LLP) has been reported to be as high as 21 %. Implant related and surgeon-controlled variables have been postulated to contribute to nonunion by modulating fracture-fixation construct stiffness. The purpose of this study is to evaluate the effect of surgeon-controlled factors on stiffness when treating supracondylar femur fractures with LLPs: 1. Does plate length affect construct stiffness given the same plate material, fracture working length and type of screws? 2. Does screw type (bicortical locking versus bicortical nonlocking or unicortical locking) and number of screws affect construct stiffness given the same material, fracture working length, and plate length? 3. Does fracture working length affect construct stiffness given the same plate material, length and type of screws? 4. Does plate material (titanium versus stainless steel) affect construct stiffness given the same fracture working length, plate length, type and number of screws?Methods: Mechanical study of simulated supracondylar femur fractures treated with LLPs of varying lengths, screw types, fractureworking lenghts, and plate/screw material. Overall construct stiffness was evaluated using an Instron hydraulic testing apparatus.Results: Stiffness was 15 % higher comparing 13-hole to the 5-hole plates (995 N/mm849N vs. /mm, p = 0.003). The use of bicortical nonlocking screws decreased overall construct stiffness by 18 % compared to bicortical locking screws (808 N/mm vs. 995 N/mm, p = 0.0001). The type of screw (unicortical locking vs. bicortical locking) and the number of screws in the diaphysis (3 vs. 10) did not appear to significantly influence construct stiffness (p = 0.76, p = 0.24). Similarly, fracture working length (5.4 cm vs. 9.4 cm, p = 0.24), and implant type (titanium vs. stainless steel, p = 0.12) did also not appear to effect stiffness.Discussion: Using shorter plates and using bicortical nonlocking screws (vs. bicortical locking screws) reduced overall construct stiffness. Using more screws, using unicortical locking screws, increasing fracture working length and varying plate material (titanium vs. stainless steel) does not appear to significantly alter construct stiffness. Surgeons can adjust plate length and screw types to affect overall fracture-fixation construct stiffness; however, the optimal stiffness to promote healing remains unknown. [ABSTRACT FROM AUTHOR]

The main problem in content-based image retrieval (CBIR) systems is the semantic gap which needs to be reduced for efficient retrieval. The common imaging signs (CISs) which appear in the patient's lung CT scan play a significant role in the identification of cancerous lung nodules and many other lung diseases. In this paper, we propose a new combination of descriptors for the effective retrieval of these imaging signs. First, we construct a feature database by combining local ternary pattern (LTP), local phase quantization (LPQ), and discrete wavelet transform. Next, joint mutual information (JMI)–based feature selection is deployed to reduce the redundancy and to select an optimal feature set for CISs retrieval. To this end, similarity measurement is performed by combining visual and semantic information in equal proportion to construct a balanced graph and the shortest path is computed for learning contextual similarity to obtain final similarity between each query and database image. The proposed system is evaluated on a publicly available database of lung CT imaging signs (LISS), and results are retrieved based on visual feature similarity comparison and graph-based similarity comparison. The proposed system achieves a mean average precision (MAP) of 60% and 0.48 AUC of precision-recall (P-R) graph using only visual features similarity comparison. These results further improve on graph-based similarity measure with a MAP of 70% and 0.58 AUC which shows the superiority of our proposed scheme. [ABSTRACT FROM AUTHOR]

Background : bicondylar tibial plateau fractures need surgical treatment to achieve good clinical results. The locking plate combines the technical advantages of an angular stable plate with those of the modern biological plating technique. Aim of the study: to verify management of bicondylar tibial plateau fractures by single lateral locked plate including patient selection, fracture type suitable for this kind of surgery, timing of surgery, operative technique, postoperative instructions and follow up. Patients and Methods: between January 2018 and February 2019, 20 patients with a mean age of 38 years (Range: 24-57 years) with bicondylar tibial plateau fractures with or without metaphyseal extension. Patients were diagnosed clinically, checked with standard X-rays, CT was done for all cases. Patients were treated by single lateral anatomically contoured locked plate through LISS or polyaxial locking plate systems with or without additional screws from medial side. Results: the mean Functional Rasmussen Knee score at last follow-up was 94.7% ranged between 83.3% and 100%. The mean Anatomical Rasmussen Knee score at last follow-up was 92.2% ranged between 77.7% and 100%. Mean Functional Rasmussen Knee score of patients had (Schatzker V fractures) was 96%, however it was 82.5% in those had (Schatzker VI fractures). Conclusion: surgical treatment of bicondylar tibial plateau fractures with the single lateral locked plate that was evaluated in our study can lead to a good functional and anatomical outcome and considered an effective system for providing fracture stabilization provided that the correct surgical technique is used. [ABSTRACT FROM AUTHOR]

Treatment of complex osteoporotic distal femur fractures with the Less Invasive Stabilization System (LISS) has been associated with high complication rates. The aim of this study was to investigate the biomechanical competence of two different techniques of augmented versus conventional LISS plating. Unstable distal femoral fracture AO/OTA 33‐A3 was created via osteotomies in artificial femora simulating osteoporotic bone. Three study groups, consisting of 10 specimens each, were created for fixation with either LISS plate, LISS plate with additional polylactide intramedullary graft, or LISS plate plus medial locking plate (double plating). All specimens were non‐destructively tested under axial (20–150 N) and torsional (0–4 Nm) quasi‐static loading. Each bone‐implant construct was tested with two different working length (WL) configurations (long and short) of the LISS plate. Relative movements between the most medial superior and inferior osteotomy aspects were investigated via three‐dimensional motion tracking analysis. Double plating revealed significantly smaller longitudinal and shear displacement than the other two techniques (p ≤ 0.001). In addition, LISS plus graft fixation was with significantly less longitudinal displacement in comparison to conventional LISS plating (p < 0.001). Long WL resulted in significantly higher longitudinal and shear displacement compared to short WL for LISS and LISS plus graft (p ≤ 0.032), but not for double plating (p > 0.999). In conclusion, intramedullary grafting resulted in significantly increased fracture stability under axial loading in comparison to conventional LISS plating. Although it was not efficient enough to provide comparable stability to double plating, intramedullary grafting may be considered as a useful biological alternative to the latter in a surgeon's armamentarium. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2604–2611, 2018. This study investigated the biomechanical competency of two different techniques of augmented versus conventional LISS plating on distal femur fractures. Double plating revealed significantly smaller longitudinal and shear displacement than the other two techniques (p ≤ 0.001). LISS plus graft fixation was with significantly less longitudinal displacement compared to conventional LISS plating (p < 0.001). Intramedullary grafting resulted in significantly increased fracture stability under axial loading in comparison to conventional LISS plating. [ABSTRACT FROM AUTHOR]

In the traditional secret image sharing schemes, a dealer shares a secret image among a group of participants and an authorized subset of the participants with their shadow images can cooperate to retrieve the secret image. However, for a long live secret image, the intruders may have adequate time to gain enough amounts of the shadow images. In this paper, we propose a proactive secret image sharing scheme based on LISS. In the scheme, shadow images are updated periodically by the shareholders without changing the original secret image such that the previous shares are invalid and the secret image can be reconstructed only by the shadow images in the current period. The experimental results demonstrate that the proposed scheme can recover the secret image losslessly and the embedding capacity is acceptable. The quality of the shadow images may reduce after every refreshing operation. Nevertheless, the scheme is still applicable when the number of updating times is less than ten. [ABSTRACT FROM AUTHOR]

The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. The aim of this systematic review is to conduct a network meta-analysis of randomized controlled trials (RCTs) comparing clinical outcomes between dynamic hip screws (DHS), Medoff sliding plating, percutaneous compression plating (PCCP), proximal femoral nails (PFN), Gamma nails and less invasive stabilization system fixation in femoral trochanteric fractures in the elderly. These clinical outcomes consist of total intra-operative time, intra-operative fluoroscopy time, intra-operative blood loss, blood component transfusion, length of hospital stay, postoperative general complications, wound complications, late complications and reoperation rates. This systematic review was conducted using PubMed and Scopus search engines for RCTs comparing clinical outcomes between treatments from inception to February 22, 2015. Thirty-six of 785 studies identified were eligible. Compared to the other implants, PCCP showed the lowest total operative time and units of blood transfusion with an unstandardized mean difference (UMD) of 29.27 min (95% CI 5.24, 53.50) and 0.89 units (95% CI 0.52, 1.25). The lowest incidence of general complications, wound complications and late complications of PCCP was 0.09 (95% CI 0.04, 0.18), 0.01 (95% CI 0.01, 0.04) and 0.05 (95% CI 0.02, 0.11), respectively, when compared to others. The lowest fluoroscopic time was with DHS with an UMD of 0.24 min (95% CI 0.16, 0.32), whereas the lowest blood loss and shortest hospital stay were with PFN with an UMD of 233.61 ml of blood loss (95% CI 153.17, 314.04) and 7.23 days of hospital stay (95% CI 7.15, 7.31) when compared to all other fixation methods. Reoperation rates of all implants had no statistically significant difference. The network meta-analysis suggested that fixation with PCCP significantly shortens operative time and decreases the units of blood transfusion required, while also lowering risks of general complications, wound complications and late complications when compared to fixation. Use of PFN showed the least intra-operative blood loss and shortest hospital stay. Multiple active treatment comparisons indicate that PCCP fixation in trochanteric fractures in the elderly is the treatment of choice in terms of intra-operative outcomes and postoperative complications. [ABSTRACT FROM AUTHOR]

Introduction: This prospective case series study aimed to assess the value of the Less Invasive Stabilization System (LISS) to treat closed Segmental Tibial Fractures (STFs) using a proposed surgical technique. Materials and methods: Between August 2010 and January 2014, 21 consecutive recently (within 1 week) closed STFs that matched the inclusion criteria were enrolled. Patients were treated with the 13-hole LISS plate. All patients were followed up every 2 weeks for the first 2 months, then every month for the rest of the first 6 months and then every 6 months thereafter. Patients were assessed radiologically during the follow-up appointments and clinically at the final visit by the Lower Extremity Functional Scale (LEFS) to evaluate the result. Results: The mean time to union of the proximal fracture was 15.72 ± 2.78 (range: 12–20) weeks and for the distal fracture was 20 ± 2.22 (range: 16–24) weeks, excluding delayed union in three patients. All patients except the three showed radiological observable callus in a mean duration of 4.95 (range: 3–7) weeks. The mean final follow-up LEFS was 72.4 (range: 60–80). Conclusion: The mean time to union of the proximal fracture was shorter than the distal fracture. The use of LISS to treat closed STFs using the proposed surgical technique has proved to give favorable results. Further studies using the described technique are needed to justify the achieved results. Level of evidence: IV (Prospective case series).

Purpose: Locked plate (LP) and retrograde intramedullary nail (RIN) are the most commonly used treatment options for periprosthetic femur fracture above total knee arthroplasty (TKA). Controversy still exists regarding which is better. Therefore we performed a meta-analysis to compare their clinical results.Methods: A comprehensive search was conducted through PubMed, EMBase and the Cochrane Collaboration Library. Six comparative studies (265 patients) were included for the meta-analysis.Results: No statistically significant differences were found between the LP group and RIN group in terms of six month union rate (OR, 1.19; 95 % CI, 0.52-2.69; P = 0.68), union time (WMD, 0.22; 95 % CI, -0.41 to 0.84; P = 0.50), operation time (WMD, 0.54; 95 % CI, -13.09 to 14.17; P = 0.94) or complication rate (OR, 0.79; 95 % CI, 0.22-2.91; P = 0.73). The LP fixation may have a relatively higher re-operation rate (OR, 5.17; 95 % CI, 1.02-26.27; P = 0.05) compared with RIN. The mean union time was 4.0 months in the LP group and 3.7 months in the RIN group.Conclusion: This meta-analysis found no statistically significant difference in six month union rate, union time, operation time and complication rate between the LP group and RIN group. The RIN fixation may have a potential of lower re-operation rate compared with LP. The mean union time was 4.0 months in the LP group and 3.7 months in the RIN group. [ABSTRACT FROM AUTHOR]

Mangrove, the intertidal halophytic vegetation, are one of the most significant and diverse ecosystem in the world. They protect the coast from sea erosion and other natural disasters like tsunami and cyclone. In view of their increased destruction and degradation in the current scenario, mapping of this vegetation is at priority. Globally researchers mapped mangrove vegetation using visual interpretation method or digital classification approaches or a combination of both (hybrid) approaches using varied spatial and spectral data sets. In the recent past techniques have been developed to extract these coastal vegetation automatically using varied algorithms. In the current study we tried to delineate mangrove vegetation using LISS III and Landsat 8 data sets for selected locations of Andaman and Nicobar islands. Towards this we made an attempt to use segmentation method, that characterize the mangrove vegetation based on their tone and the texture and the pixel based classification method, where the mangroves are identified based on their pixel values. The results obtained from the both approaches are validated using maps available for the region selected and obtained better accuracy with respect to their delineation. The main focus of this paper is simplicity of the methods and the availability of the data on which these methods are applied as these data (Landsat) are readily available for many regions. Our methods are very flexible and can be applied on any region. [ABSTRACT FROM AUTHOR]

The LISS online panel has made extra efforts to recruit and retain households that were not regular users of the Internet into the study. Households were provided with computers and/or Internet when necessary. Including these cases made the panel more representative of the Dutch population, by bringing in respondents who were more likely to be older, to live in single-person homes, and to have migration backgrounds. This article replicates five published articles that used LISS data and explores how the conclusions in these articles would have been different had the LISS panel not included the non-Internet households. There are strong demographic differences between the Internet and non-Internet households, and estimates of means would in many cases be biased if these households had not been included. However, across the five replicated studies, few of the published model estimates are substantively affected by the inclusion of these households in the LISS sample. [ABSTRACT FROM AUTHOR]

Background: External fixation of tibial fractures using a locking plate has been reported with favorable results in some selected patients. However, the stability of external plate fixation in this fracture pattern has not been previously demonstrated. We investigated the stability of external plate fixation with different plate-bone distances. Methods: In this study, the computational processing model of external fixation of a distal tibial metaphyseal fracture utilizing the contralateral femoral less invasive stabilization system plate was analyzed. The plate was placed on the anteromedial aspect of tibia with different plate-bone distances: 1, 10, 20, and 30 mm. Results: Under axial load, the stiffness of construct in all groups was higher than intact tibia. Under axial load with an internal rotational force, the stiffness of construct with 1 and 10 mm plate-bone distances was similar to that of an intact tibia and the stiffness of the construct with 20 and 30 mm distances was lower than that of an intact tibia. Under axial load with an external rotational force, the stiffness of the construct in all groups was lower than that of an intact tibia. The maximum plate stresses were concentrated at the two most distal screws and were highest in the construct with the 10 mm plate-bone distance, and least in the construct with a 1 mm plate-bone distance. Conclusions: To guarantee a stable external plate fixation in distal tibial fracture, the plate-bone distance should be less than 30 mm. [ABSTRACT FROM AUTHOR]

Introduction Difficult removal of locking plates including less invasive stabilisation systems (LISSs) and locking compression plates (LCPs) sometimes occur. However, investigations of the mechanisms and correlated factors of complicated removal remain scant. This study aims to identify correlated factors for the difficult removal of locking plates and to propose suggestions for decision making regarding implant removal and the prevention of complicated removal. Materials and methods In total, 308 consecutive patients who underwent LCP/LISS removal from Sep. 2004 to Nov. 2013 were assessed. Using the Mann–Whitney U test, we analysed the correlation between difficult removal and the duration between open reduction and internal fixation (ORIF) and implant removal as well as the correlation between difficult removal and the patients’ age. Using Chi Square test, we assessed the correlations between complicated removal and the size, location, insertion technique and cortical purchase of the locking head screw (LHS). Correlated factors were separately determined in upper and lower extremities. Rates of difficult removal in different fracture locations were evaluated, and postoperative complications were documented. Results Of the total 308 patients, thirty-seven had intra-operative difficulties, and six patients experienced postoperative complications. Six out of fifteen patients with peri-elbow fractures and five out of seventeen patients with femur fractures suffered difficult removal, while four out of one hundred patients with malleolar fractures had intra-operative difficulties. Difficulties were experienced with 30 of 338 LCPs, 7 of 32 LISSs, 67 of 1533 small-diameter (≤3.5-mm) LHSs, and 12 of 442 large-diameter (≥4.5-mm) LHSs. Three LCPs and seventeen small-diameter LHSs were retained. A longer interval between ORIF and removal, younger age and bicortical screws correlated with difficult removal in the upper extremities, and a longer duration before removal, small-diameter LHS and minimally invasive insertion of LHS were predictors in the lower extremities. Conclusions Complications occur with LCP/LISS removal, and it should not be a routine procedure. If removal is indicated, performing surgery as soon as radiographs show fracture healing is recommended. Different considerations should apply when making decisions and removing implants from patients with different fracture sites. [ABSTRACT FROM AUTHOR]

Attrition is the process of dropout from a panel study. Earlier studies into the determinants of attrition study respondents still in the survey and those who attrited at any given wave of data collection. In many panel surveys, the process of attrition is more subtle than being either in or out of the study. Respondents often miss out on one or more waves, but might return after that. They start off responding infrequently, but more often later in the course of the study. Using current analytical models, it is difficult to incorporate such response patterns in analyses of attrition. This article shows how to study attrition in a latent class framework. This allows the separation of different groups of respondents, that each follow a different and distinct process of attrition. Classifying attriting respondents enables us to formally test substantive theories of attrition and its effects on data accuracy more effectively. [ABSTRACT FROM AUTHOR]

The research aims to make inventory of carbon of a fragment of Araucaria Forest using data from medium spatial resolution sensors. Satellite data from ASTER, TM and LISS were used to obtain the radiometric data. The above ground biomass and carbon data (biophysical data) were derived from the continuous forest inventory located in São João do Triunfo, PR. The methodology consisted of establishing the empirical relationship between spectral and biophysical data sets using linear regression. Except for the TM data, which showed unsatisfactory results, the use of ASTER and LISS satellite data was suited to forest carbon inventory by remote sensing, with errors lower than those set in traditional inventory campaigns (α < 0,05). [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Reported initial success rates after lateral locked plating (LLP) of distal femur fractures have led to more concerning outcomes with reported nonunion rates now ranging from 0 to 21%. Reported factors associated with nonunion include comorbidities such as obesity, age and diabetes. In this study, our goal was to identify patient comorbidities, injury and construct characteristics that are independent predictors of nonunion risk in LLP of distal femur fractures; and to develop a predictive algorithm of nonunion risk, irrespective of institutional criteria for clinical intervention variability. Patients and methods: A retrospective review of 283 distal femoral fractures in 278 consecutive patients treated with LLP at three Level1 academic trauma centers. Nonunion was liberally defined as need for secondary procedure to manage poor healing based on unrestricted surgeon criteria. Patient demographics (age, gender), comorbidities (obesity, smoking, diabetes, chronic steroid use, dialysis), injury characteristics (AO type, periprosthetic fracture, open fracture, infection), and management factors (institution, reason for intervention, time to intervention, plate length, screw density, and plate material) were obtained for all participants. Multivariable analysis was performed using logistic regression to control for confounding in order to identify independent risk factors for nonunion. Results: 28 of the 283 fractures were treated for nonunion, 13 were referred to us from other institutions. Obesity (BMI>30), open fracture, occurrence of infection, and use of stainless steel plate were significant independent risk factors (P <0.01). A predictive algorithm demonstrates that when none of these variables are present (titanium instead of stainless steel) the risk of nonunion requiring intervention is 4%, but increases to 96% with all factors present. When a stainless plate is used, obesity alone carries a risk of 44% while infection alone a risk of 66%. While Chi-square testing suggested no institutional differences in nonunion rates, the time to intervention for nonunion varied inversely with nonunion rates between institutions, indicating varying trends in management approach. Discussion: Obesity, open fracture, occurrence of infection, and the use of stainless steel are prognostic risk factors of nonunion in distal femoral fractures treated with LLP independent of differing trends in how surgeons intervene in the management of nonunion. [Copyright &y& Elsevier]

The purpose of this study was to examine measurement invariance of the Dutch version of the Satisfaction with Life Scale between groups based on gender, age, education, perceived difficulty of the survey, perceived clarity of the survey, and national background. A nationally representative Dutch sample was used (N = 5369). Multiple-groups confirmatory factor analysis was conducted to test measurement invariance. Full metric and scalar invariance were supported for all groups studied. These results indicate that the items of the scale are understood and answered similarly by all groups. Therefore, the 5 items of the Satisfaction with Life Scale measure the same construct in all groups. In other words, the differences in the life satisfaction scores are indicative of actual differences in life satisfaction rather than measurement artifacts and biases. This means that the levels of life satisfaction can be meaningfully compared between groups in The Netherlands.

Aquest treball està concebut com a working paper i analitza l'aplicació judicial de les regles de la Llei de serveis de la societat de la informació i de comerç electrònic en matèria de responsabilitat dels prestadors de serveis d'intermediació. En els cinc anys de vigència de la Llei, encara són poques les resolucions dictades, però s'han plantejat ja conflictes de tipologia variada. Un dels punts més conflictius en la interpretació d'aquestes normes és el sentit que s'hagi de donar al requisit de mancar de coneixement efectiu per a poder gaudir de l'exclusió de responsabilitat en els casos d'allotjament de dades i en els supòsits de provisió d'enllaços. La interpretació d'aquest punt ha estat clarament divergent en les resolucions judicials que coneixem. El treball presta especial atenció a aquest problema, i n'analitza també d'altres, com són el relatiu a l'admissibilitat d'accions d'aturada i el problema més elemental de la inaplicació pura i simple de la llei.

Background: The treatment of distal femoral fractures has been associated with a high rate of complications for a long period of time. Although implant and surgical techniques have improved, plate osteosynthesis and intramedullary nailing have been accompanied by a high rate of infection, non-union and malalignment. The gently manipulation of the soft tissue envelopes by using "biological" osteosynthesis and minimally invasive approaches has resulted in a decrease in complications rates and led to the concept of the less invasive stabilization system (LISS). This is an extramedullary-applied internal fixator (locking plate) shaped according to the local anatomy of the distal femur. One of the limits of this system is the fixed-angle position of the locking screws into the plate. In the last years, the poliaxial locking plates had evolved, over passing the inconvenient of the fixed-angle position of the screws. This type of the screw allows also interfragmentary compression across the plate for intercondylar fractures. The purpose of this study was to review the experience and evolution of our practice from intrammedullary device to polyaxial locking plates, in the last two years (2010 and 2011). Material and method: In a retrospective consecutive study, 21 patients with 22 distal femoral fractures where treated with: S 2 retrograde nail Stryker (2 patients - 9.1%), LISS Synthes (5 patients - 22.7%) or NCB plate Zimmer (14 patients - 15 fractures - 68.2%). We lost 5 patients after 1 month of follo-up. The medium follow-up for the rest of the patients was 6.2 months. Results: We had no deep wound infection (0%). We had 1 fracture (5.9 %) of the proximal end of the plate (solved with a long Gamma nail) and 2 non-unions (11.75%) which consolidated after the treatment (one solved with a vascularised bone graft fibula and one associated with a plate failure, solved with plate changing and bone grafting). From the functional point of view, 11 patients (64.7%) had a knee flexion greater than 110º, 4 patients (23.5%) had a knee flexion between 90º - 110º and 2 patients (11.8%) had a knee flexion between 75º-90º. The average consolidation time for the 14 non-complicated fractures was 16 weeks. Conclusions: The minimally invasive techniques (intramedullar or paracortical) for distal femoral fractures stabilisation promotes early mobilization and rapid rates of bony and clinical healing, without primary bone grafting and very low rate of infection (in our study 0%). [ABSTRACT FROM AUTHOR]

The incidence of periprosthetic fractures rises continuously with increasing life expectancy of the population. Periprosthetic fractures tend to occur intraoperatively and postoperatively due to factors related to individual patients, specific implants and surgical techniques. The treatment of these fractures is not only technically demanding but also susceptible to complications. Depending on the fracture type, fracture localization, stability of the prosthesis and the general condition of the often multimorbid patients, osteosynthesis or revision of the prosthesis is indicated individually. The Vancouver classification was used for a systematic presentation of the indications, surgical techniques and results of osteosynthesis for both intraoperatively and postoperatively occurring periprosthetic fractures of the femur in total hip arthroplasty. [ABSTRACT FROM AUTHOR]

Abstract: Background: Fragility fractures are a major health care problem worldwide. Due to the ageing population an increase of distal femoral fractures is to be expected. We studied the long-term functional outcome and their influencing factors in geriatric patients with LISS-plated distal femoral fractures. Patients and methods: A cohort study with functional long-term follow up examination was carried out in a level one trauma centre on distal femoral fracture patients 65 years and older. Of 53 consecutive patients who were treated in our hospital, 43 patients with a mean age of 80 years met our inclusion criteria. 48.8% died within the study period of 5.3 years. On the remaining patients the residential status, the Barthel index and the Parker score were assessed. Results: The mean Barthel index was 47.7 and the mean Parker score was 3.5. 23% were found to be totally housebound and 26% were not able to perform any social activity. Only 18% were able to walk unaided. Patients with any medical complication had significantly higher mortality rates. Patients with extraarticular fractures had better mobility scores. Nursing home residents showed higher mortality rates but compared to patients coming from their own home the difference regarding Barthel and Parker scores remained non-significant. Conclusion: This study documents the poor functional long-term outcome of geriatric patients with distal femoral fractures. In comparison to other fragility fracture patients it seems that this population is at higher risk to die in-hospital during their perioperative course. Medical complications have to be avoided as they were found to be associated with worse functional outcome and higher mortality rates. An osteoporosis therapy may be associated with reduced mortality rates also in these patients. [Copyright &y& Elsevier]

Abstract: The purpose of present study was to evaluate the role of LISS after a large series of patients in whom a fracture around the knee had been treated with this uniform technique. Between April 2004 and September 2006, 210 patients with a total of 216 fractures around the knee were treated with LISS, all at the Affiliated Hospital to Nantong University. Patients were followed for a mean of 27 months (range 12–42 months). 26 patients were excluded from the study. The remaining 184 patients with a total of 189 fractures of either distal femur (85 cases) or proximal tibia (104 cases) were available for analysis. The mean age of these patients was 49 years (range 18–82 years). Immediate postoperative X-rays showed the alignment of bone and joint was satisfactorily maintained with LISS in all cases and an ideal implant position in 176 cases (93%). All cases healed the fracture without non-union. The mean time to union was 15 weeks (range 12–27 weeks) for the femoral and 16 weeks (range 12–27 weeks) for the tibia fractures. Functional assessment was performed using HSS (hospital for special surgery) score. At the time of the latest follow-up, 158 patients (86%) had an excellent or good outcome. Overall, 3 patients were subject to a salvage operative procedure due to implant failure. Three cases underwent secondary bone graft for open fractures. Superficial and deep infection was found each in one patient and both were treated successfully. Hardware prominence irritation was found in 2 patients. LISS was removed in 27 patients after bone healing, and this procedure was neither less invasive nor easy as imagined. The results indicate the LISS system is perfect but by no means unique in the treatment of the fractures around the knee. The fixation is adequate enough to maintain alignment and obtain union with a low incidence of complications even in patients with osteoporotic bone. We firmly believe favourable results can be achieved when this device is combined with correct indications as well as skillful techniques. [Copyright &y& Elsevier]

Abstract: Purpose: The purpose of this systematic review was to assess the literature evaluating the clinical and radiological outcomes following less invasive surgical stabilisation system (LISS) fixation of distal femoral fractures (AO 32/33). Methods: A review of EMBASE, Medline, CINAHL and AMED from their inception to November 2008, sources of grey literature and a pertinent hand search of specialist orthopaedic journals was undertaken. Results: Twenty-one studies assessing 663 patients with 694 fractures were reviewed. The findings suggest that the LISS system may be an appropriate fixation method for the management of distal femoral fractures. However, there remains a high incidence of loss of reduction (n =134; 19%), delayed or non-union (n =40; 6%) and implant failure (n =38; 5%). On analysis, such complications were largely confined to articles published before 2005, therefore during the infancy of the widespread clinical application of this trauma system. On critical appraisal, the evidence-base remains limited by recruiting small, under-powered sample sizes and poorly accounting for confounding variables such as osteoporosis, diabetes, multi-trauma and fracture classification. Conclusion: Further study is required to assess the outcomes of LISS fixation in specific patient populations, and to compare the outcome of this fixation method to condylar plates and intrameduallary devices, to determine the optimal management strategy for this complex patient group. [Copyright &y& Elsevier]

Abstract: The goal of fracture fixation is to achieve bone healing and restore the function of the injured limb in the shortest possible time without compromising safety. Newer technologies such as the locking compression plate (LCP) and its derivatives are valuable additions to the orthopaedic traumatologist''s armamentarium. As with any emerging technology, the indications will be extended until a threshold is reached and the limitations of the technology are seen. It is vital that surgeons involved in fracture care are aware of when locked plating is superior to other methods and also when they should use another treatment modality. This paper reviews the use of locked plating as a fixation method. Five topics covered in this review are: a historical perspective on locked plating, general indications, specific modes and techniques, patterns of failure, and an anatomical overview of current indications for locked plating. [Copyright &y& Elsevier]

Summary: Longer patient survival and the extension of joint arthroplasty to older patients means that osteoporotic fractures of the femur are often associated with joint implants. This poses a significant trauma work load. This problem is likely to increase over time. The management of these periprosthetic fractures may be difficult and strategies are not universally agreed. Revision arthroplasty, single or double plate fixation with or without augmentation with methylmethacrylate or bone grafting, are all variously advocated in the literature for different indications. We retrospectively identified 28 elderly patients consecutively treated in our institution with Less Invasive Stabilisation System (LISS) plate fixation for osteoporotic and periprosthetic fractures of the femur. We present prospectively collected data for clinical and radiographic follow-up and patient outcomes. Patients had a mean age of 86.7 years. A fall from a standing height was the most common mechanism of injury. No cases of non-union were seen in survivors. Mortality in the first year was a major complication (5 patients). Rates of revision surgery were low (2 patients). Most patients required a formal period of rehabilitation, however, only half of the patients were successfully discharged to their own homes. The LISS plate provides good fixation in osteoporotic periprosthetic fractures of the femur. It restores a stable limb allowing early weight bearing as well as achieving clinical and radiographic union. Patients return to mobility levels approaching their pre-injury status although most benefit from a formal period of rehabilitation. In this patient group, the LISS plate often outlives the patient. [Copyright &y& Elsevier]

Abstract: Fifty periprosthetic supracondylar femur fractures above a total knee arthroplasty were reviewed. Fractures were closed Lewis and Rorabeck type II with a stable prosthesis. Twenty-nine patients (group I), were treated with locked condylar plating. Twenty-one patients (group II) were treated with nonlocked plating systems or intramedullary fixation. Minimum follow-up was 1.7 years. There were 5 malunions (20%) in group I and 9 (47%) in group II (P < .05). There were no nonunions in group I and 3 (16%) in group II. Complication rates were 12% in group I, compared to 42% in group II. Group I patients had less operative blood loss, healed in better alignment, and had greater knee motion. All 7 patients treated with a retrograde intramedullary nail developed a malunion or nonunion. Locked plating is a reliable treatment for periprosthetic supracondylar femur fractures. We experienced a lower complication, revision, malunion, and nonunion rate with locked plating versus conventional treatment options. [Copyright &y& Elsevier]

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Summary: Recent publications have reported encouraging results with a locked plating system in the management of periprosthetic femoral fractures. However, data on mid- or long-term functional outcome is not available. Here we report on the mid-term functional outcome of 16 patients with a periprosthetic femoral fracture following total hip arthroplasty managed with the LISS-system at a 3-year follow-up. Functional outcome was measured using the Harris Hip score and the Karnofsky activity index. The Harris Hip score and the Karnofsky activity index averaged 79.5 points and 81%, respectively. There were a total of two major complications due to screw pullout representing a complication rate of 13%. This series suggests that the management of periprosthetic femoral fractures with the LIS-System results in a good mid-term functional outcome. [Copyright &y& Elsevier]

Abstract: The present investigation is a prospective study comparing the use of locked plates and classic double plates for the repair of bicondylar tibial plateau fractures. Eighty-four patients with bicondylar tibial plateau fractures were treated with plate fixation by either a locked plate (Less Invasive Stabilization System, LISS) or classic double plates (DP). All patients were followed for a minimum of 24 months. Outcomes were assessed by recording the surgical experience with each approach, post-operative complications and improvements in knee function as measured by the Hospital for Special Surgery (HSS) score. For all patients, no differences in the mechanisms of injury, fracture type, open fracture grade, mean age, gender distribution, associated medical conditions, pre-surgical stay, surgical time, bony union rate or radiographic healing times were observed between the two groups. Also, the HSS score and incidences of infection, seroma, hematoma, deep venous thrombosis, loss of reduction, loss of alignment, hardware failure and overall post-operative complications were all similar in both groups (P >0.05). Wound size and blood loss were significantly less in the LISS group than in the DP group (both P <0.05). A significantly higher incidence of post-operative malalignment of the proximal tibia (P =0.041) and a trend toward significance of a higher incidence of symptomatic hardware irritation (P =0.057) were observed in the LISS group compared to the DP group. In conclusion, LISS provides an alternative treatment for bicondylar tibial plateau fractures, but it may not replace the conventional two-incision double plating technique as the standard of care. [Copyright &y& Elsevier]

Abstract: Periprosthetic fractures involving a total knee arthroplasty pose a challenging treatment problem with a prevalence of up to 2.5% in the literature (Instr Course Lect 2001;50:379-389). The supracondylar region of the femur is commonly involved, often with minimal available bone in contact with the components. The clinical challenges are particularly more complex in the case of a combined distal femoral and proximal tibial periprosthetic fracture. This injury is considered a “floating prosthesis” injury because of the complete separation of the prosthesis from the remaining skeleton. In this report, a floating prosthesis injury, in combination with a femoral shaft fracture, is treated with 2 locking plates using a minimally invasive technique, with limited blood loss, immediate pain relief after surgery, and successful healing of all fractures with minimal deformity. [Copyright &y& Elsevier]

Summary: Periprosthetic femoral fractures associated with well-fixed total hip or total knee prostheses present a challenging management problem as these injuries typically occur in osteoporotic bone. Conventional management entails extensive periosteal stripping to allow for plate fixation. We reviewed a consecutive series of patients who sustained fractures associated with a well fixed total knee prosthesis, a total hip prosthesis, or both. Twenty four patients with a mean age of 69.4 years were included. All patients underwent fixation via percutaneous insertion techniques with a first generation locking plate and screws (LISS—Less Invasive Skeletal Stabilization, Synthes, Paoli, PA). Three patients sustained fractures distal to a well-fixed total hip prosthesis, eighteen fractures occurred above a well-fixed total knee femoral component, and three were interprosthetic. The mean length of time from the index procedure to fracture was 76 months, range (2–172 months). Blood loss was minimal in each case, with a mean operative time of 90min (range 60–120min). Twenty one of twenty four went on to unite at a mean 6.2 months (range 3–19 months). Three patients underwent further surgery. One failure of fixation was encountered. Percutaneous fixation is technically demanding as it requires stable fixation without direct visualisation of the fracture site or the entire fixation device. Our results suggest percutaneous fixation with the LISS plate is an effective although technically demanding method of treatment. Complication rates were comparable to existing reports of this treatment method, and appear to be improved over traditional methods of fixation. [Copyright &y& Elsevier]

We present a case illustrating the successful use of the internal fixation LISS in an osteoporotic nonunion of the distal femur, where classic osteosynthesis has failed. The LISS plate with its angular stability offered the possibility to achieve excellent purchase in the severely porotic and partially destroyed bone. In combination with the use of an autologeous bone graft laterally and a strut cortical autograft medially, a mechanical support and an osteoinductive stimulus was provided and the extremity could be saved by this procedure. [ABSTRACT FROM AUTHOR]

Introduction: Periprosthetic fractures of the femur present a challenging surgical problem. The aim of this study was to retrospectively evaluate the outcome of periprosthetic fractures stabilised with an angular stable, less invasive stabilisation system (LISS). Patients and Methods: Thirteen patients (ten total hip-, two total knee-, one total hip- and knee-arthroplasty) with periprosthetic fractures were treated with the LISS internal fixator (in ten cases minimal invasive). Six patients had previous operations due to periprosthetic fractures. The average follow-up period was 20 months, follow-up rate 85%. Results: All fractures showed radiographic fracture healing without implant loosening. Except one patient, all patients had returned to their pre-operative activity level. No early post-operative complications were seen. There was one implant failure after 4 months and two cases of malunion. Conclusion: The cases showed the internal fixator to be effective for the stabilisation of periprosthetic fractures, even in cases of poor bone quality with good functional outcomes. The internal fixator, with the option of minimal invasive application, is the preferred method of osteosynthesis in periprosthetic fractures. [ABSTRACT FROM AUTHOR]