Abstract Background Fractures of the proximal femur commonly occur but the majority of orthopaedic surgeons do not consider general hardware removal as a routine necessity. Indications and time ...interval for hardware removal in this special selected patient group is still controversial. Therefore we performed a retrospective study to address the following questions: 1) Is there a difference between the medically- (infection, mechanical problems, implant failure) and non-medically indicated group (patients demand, meteoro-sensitivity, foreign body sensation) in relation to complications? 2) Is there a correlation regarding time interval between implantation and removal comparing these two groups? 3) Is there a context related refracture rate? 4) Should non-medically indicated implant removal (IR) be performed due to persistent pressure from the patient? Hypothesis We hypothesized that non-medically indicated implant removals should be avoided due to a significantly higher number of associated complications. Patients and methods A total of 371 consecutive patients with 424 hardware removal procedures following a proximal femur fracture, between 08/1992 and 11/2008, have been included. Study population was divided into two groups according to their indication for implant removal: medically indicated group (MIR) consisted of 299 patients (80.59%) and 72 patients (19.41%) were assigned to the non-medically indicated (NMIR) group. Results In the NMIR subgroup a total of ( n = 21) 28% complications occurred compared to 11.46% in the MIR subgroup; ( P < 0.005), 86.51% of IR in the MIR group were performed within 1.5 years, compared to 79.17% in the NMIR group after 2 to 3.5 years (NS). In the MIR group 1 refracture occurred, compared to 4 in the NMIR group (NS). Conclusion Non-medically indicated implant removal should be avoided due to the higher complication rate of 28%. Surgeons and patients should be aware of the imminent complications and therefore implant removal should only be performed for good medical reasons. Level of evidence Level IV. Historical case study.
We report the measurement of the one-dimensional charged kaon correlation functions using 600GeV/cΣ−, π− and 540GeV/cp beams from the SELEX (E781) experiment at the Fermilab Tevatron. K±K± ...correlation functions are studied for three transverse pair momentum, kT, ranges and parameterized by a Gaussian form. The emission source radii, R, and the correlation strength, λ, are extracted. The analysis shows a decrease of the source radii with increasing kaon transverse pair momentum for all beam types.
Fractures of the proximal femur commonly occur but the majority of orthopaedic surgeons do not consider general hardware removal as a routine necessity. Indications and time interval for hardware ...removal in this special selected patient group is still controversial. Therefore we performed a retrospective study to address the following questions: 1) Is there a difference between the medically- (infection, mechanical problems, implant failure) and non-medically indicated group (patients demand, meteoro-sensitivity, foreign body sensation) in relation to complications? 2) Is there a correlation regarding time interval between implantation and removal comparing these two groups? 3) Is there a context related refracture rate? 4) Should non-medically indicated implant removal (IR) be performed due to persistent pressure from the patient?
We hypothesized that non-medically indicated implant removals should be avoided due to a significantly higher number of associated complications.
A total of 371 consecutive patients with 424 hardware removal procedures following a proximal femur fracture, between 08/1992 and 11/2008, have been included. Study population was divided into two groups according to their indication for implant removal: medically indicated group (MIR) consisted of 299 patients (80.59%) and 72 patients (19.41%) were assigned to the non-medically indicated (NMIR) group.
In the NMIR subgroup a total of (n=21) 28% complications occurred compared to 11.46% in the MIR subgroup; (P<0.005), 86.51% of IR in the MIR group were performed within 1.5years, compared to 79.17% in the NMIR group after 2 to 3.5years (NS). In the MIR group 1 refracture occurred, compared to 4 in the NMIR group (NS).
Non-medically indicated implant removal should be avoided due to the higher complication rate of 28%. Surgeons and patients should be aware of the imminent complications and therefore implant removal should only be performed for good medical reasons.
Level IV. Historical case study.
The new coronavirus 2 (SARS-CoV-2) is known to be also shed through feces, which makes wastewater-based surveillance possible, independent of symptomatic cases and unbiased by any testing strategies ...and frequencies. We investigated the entire population of the Principality of Liechtenstein with samples from the wastewater treatment plant Bendern (serving all 39,000 inhabitants). Twenty-four-hour composite samples were taken once or twice a week over a period of 6 months from September 2020 to March 2021. Viral RNA was concentrated using the PEG centrifugation method followed by reverse transcription quantitative PCR. The aim of this research was to assess the suitability of SARS-CoV-2 fragments to relate the viral wastewater signal to the incidences and assess the impact of the emerging B.1.1.7. variant. The viral load in the wastewater peaked at almost 9 × 10
viral fragments per person equivalent (PE) and day on October 25, and showed a second peak on December 22 reaching a viral load of approximately 2 × 10
PE
d
. Individual testing showed a lag of 4 days and a distinct underestimation of cases at the first peak when testing frequency was low. The wastewater signal showed an immediate response to the implementation of non-pharmaceutical interventions. The new virus variant B.1.1.7. was first detected in wastewater on December 23, while it was first observed with individual testing on January 13, 2021. Further, our data indicate that the emergence of new virus variant may change the wastewater signal, probably due to different shedding patterns, which should be considered in future models.
Classical particle drifts are known to have substantial impacts on fluxes of particles and heat through the edge plasmas in both tokamaks and stellarators. Here we present results from the first ...dedicated investigation of drift effects in the W7-X stellarator. By comparing similar plasma discharges conducted with a forward- and reverse-directed magnetic field, the impacts of drifts could be isolated through the observation of up-down asymmetries in flux profiles on the divertor targets. In low-density plasmas, the radial locations of the strike lines (i.e. peaks in the target heat flux profiles) exhibited discrepancies of up to 3 cm that reversed upon magnetic field reversal. In addition, asymmetric heat loads were observed in regions of the target that are shadowed by other targets from parallel flux from the core plasma. A comparison of these asymmetric features with the footprints of key topological regions of the edge magnetic field on the divertor suggests that the main driver of the asymmetries at low density is poloidal E × B drift due to radial electric fields in the scrape-off layer and private flux region. In higher-density plasmas, upper and lower targets collected non-ambipolar currents with opposite signs that also inverted upon field reversal. Overall, in these experiments, almost all up-down asymmetry could be attributed to the field reversal and, therefore, field-dependent drifts.
Despite tremendous progress in the understanding of COVID-19, mechanistic insight into immunological, disease-driving factors remains limited. We generated maVie16, a mouse-adapted SARS-CoV-2, by ...serial passaging of a human isolate. In silico modeling revealed how only three Spike mutations of maVie16 enhanced interaction with murine ACE2. maVie16 induced profound pathology in BALB/c and C57BL/6 mice, and the resulting mouse COVID-19 (mCOVID-19) replicated critical aspects of human disease, including early lymphopenia, pulmonary immune cell infiltration, pneumonia, and specific adaptive immunity. Inhibition of the proinflammatory cytokines IFNγ and TNF substantially reduced immunopathology. Importantly, genetic ACE2-deficiency completely prevented mCOVID-19 development. Finally, inhalation therapy with recombinant ACE2 fully protected mice from mCOVID-19, revealing a novel and efficient treatment. Thus, we here present maVie16 as a new tool to model COVID-19 for the discovery of new therapies and show that disease severity is determined by cytokine-driven immunopathology and critically dependent on ACE2 in vivo.
We report the first observation of two Cabibbo-suppressed decay modes, Ξc+→Σ+π−π+ and Ξc+→Σ−π+π+. We observe 59±14 over a background of 87, and 22±8 over a background of 13 events, respectively, for ...the signals. The data were accumulated using the SELEX spectrometer during the 1996–1997 fixed target run at Fermilab, chiefly from a 600GeV/cΣ− beam. The branching ratios of the decays relative to the Cabibbo-favored Ξc+→Ξ−π+π+ are measured to be B(Ξc+→Σ+π−π+)/B(Ξc+→Ξ−π+π+)=0.48±0.20, and B(Ξc+→Σ−π+π+)/B(Ξc+→Ξ−π+π+)=0.18±0.09, respectively. We also report branching ratios for the same decay modes of the Λc+ relative to Λc+→pK−π+.
Introduction
We aimed to give a global overview of trends in access to sexual and reproductive health and rights (SRHR) during the coronavirus disease 2019 (COVID‐19) pandemic and what is being done ...to mitigate its impact.
Material and methods
We performed a descriptive analysis and content analysis based on an online survey among clinicians, researchers, and organizations. Our data were extracted from multiple‐choice questions on access to SRHR services and risk of SRHR violations, and written responses to open‐ended questions on threats to access and required response.
Results
The survey was answered by 51 people representing 29 countries. Eighty‐six percent reported that access to contraceptive services was less or much less because of COVID‐19, corresponding figures for surgical and medical abortion were 62% and 46%. The increased risk of gender‐based and sexual violence was assessed as moderate or severe by 79%. Among countries with mildly restrictive abortion policies, 69% had implemented changes to facilitate access to abortion during the pandemic, compared with none among countries with severe restrictions (P < .001), 87.5% compared with 46% had implemented changes to facilitate access to contraception (P = .023). The content analysis showed that (a) prioritizations in health service delivery at the expense of SRHR, (b) lack of political will, (c) the detrimental effect of lockdown, and (d) the suspension of sexual education, were threats to SRHR access (theme 1). Requirements to mitigate these threats (theme 2) were (a) political will and support of universal access to SRH services, (b) the sensitization of providers, (c) free public transport, and (d) physical protective equipment. A contrasting third theme was the state of exception of the COVID‐19 pandemic as a window of opportunity to push forward women's health and rights.
Conclusions
Many countries have seen decreased access to and increased violations of SRHR during the COVID‐19 pandemic. Countries with severe restrictions on abortion seem less likely to have implemented changes to SRHR delivery to mitigate this impact. Political will to support the advancement of SRHR is often lacking, which is fundamental to ensuring both continued access and, in a minority of cases, the solidification of gains made to SRHR during the pandemic.
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