The impact of the AO foundation on fracture care : an evaluation of 60 years AO foundation

Objectives Sixty years ago, the Association of Osteosynthesis (AO) was founded with the aim to improve fracture treatment and has since grown into one of the largest medical associations worldwide. Aim of this study was to evaluate AO's impact on science, education, patient care and the MedTech business. Design/methods Impact evaluations were conducted as appropriate for the individual domains: Impact on science was measured by analyzing citation frequencies of publications promoted by AO. Impact on education was evaluated by analyzing the evolution of number and location of AO courses. Impact on patient care was evaluated with a health economic model analyzing cost changes and years of life gained through the introduction of osteosynthesis in 17 high-income countries (HICs). Impact on MedTech business was evaluated by analyzing sales data of AO-associated products. Results Thirty-five AO papers and 2 major AO textbooks are cited at remarkable frequencies in high ranking journals with up to 2000 citations/year. The number of AO courses steadily increased with a total of 645'000 participants, 20‘000 teaching days and 2‘500 volunteer faculty members so far. The introduction of osteosynthesis saved at least 925 billion Swiss Francs [CHF] in the 17 HICs analyzed and had an impact on avoiding premature deaths comparable to the use of antihypertensive drugs. AO-associated products generated sales of 55 billion CHF. Conclusion AO's impact on science, education, patient care, and the MedTech business was significant because AO addressed hitherto unmet needs by combining activities that mutually enriched and reinforced each other

Impact of osteosynthesis in fracture care : a cost comparison study

Aim: To estimate the health economic impact of osteosynthesis (OS) in fracture care over six decades in 17 high-income countries. Patients & methods: Applying a decision tree model, we assumed a hypothetical absence of OS and compared OS (intervention) with conservative treatment (CONS; comparator). We included patients with femur, tibia and radius fractures (age <65 years) and for proximal femur fractures also elderly patients (≥70 years). Results: We estimated savings in direct and indirect costs of 855 billion Swiss francs in the working age population in addition to 4.6 million years of life gained. In the elderly population, 69 billion Swiss francs were saved in direct costs of proximal femur fractures in addition to 73 million years of life gained. Conclusion: OS contributed to maximize health gains of society

Postmating Female Control: 20 Years of Cryptic Female Choice

Cryptic female choice (CFC) represents postmating intersexual selection arising from female-driven mechanisms at or after mating that bias sperm use and impact male paternity share. Although biologists began to study CFC relatively late, largely spurred by Eberhard's book published 20 years ago, the field has grown rapidly since then. Here, we review empirical progress to show that numerous female processes offer potential for CFC, from mating through to fertilization, although seldom has CFC been clearly demonstrated. We then evaluate functional implications, and argue that, under some conditions, CFC might have repercussions for female fitness, sexual conflict, and intersexual coevolution, with ramifications for related evolutionary phenomena, such as speciation. We conclude by identifying directions for future research in this rapidly growing field

Sperm Swimming Velocity Predicts Competitive Fertilization Success in the Green Swordtail Xiphophorus helleri

Sperm competition is expected to favour the evolution of traits that influence the performance of sperm when they compete to fertilize a female's eggs. While there is considerable evidence that selection favours increases in sperm numbers, much less is known about how sperm quality contributes towards competitive fertilization success. Here, we determine whether variation in sperm quality influences competitive fertilization success in the green swordtail Xiphophorus helleri, a highly promiscuous livebearing fish. We use artificial insemination as a method of controlled sperm delivery and show that sperm swimming velocity is the primary determinant of fertilization success when ejaculates from two males compete to fertilize a female's eggs. By contrast, we found no evidence that sperm length had any effect on siring success. We also found no evidence that pre- and postcopulatory sexual traits were phenotypically integrated in this species, suggesting that the previous observation that reproductive skew favours males with high mating rates is unlikely to be due to any direct association between sperm quality and male sexual ornamentation

Health economic impact of the technology “osteosynthesis” on fracture care : an economic analysis for 17 high income countries over the course of 60 years

Objectives: After the inception of the AO Foundation in1958, fracture osteosynthesis (OS) was introduced in Switzerland and in the following 2 to 3 decade globally. OS has revolutionized fracture care. However, there has never been a formal impact evaluation of OS as a medical innovation. It was the aim to estimate the health economic impact of OS in fracture care for three index bones over 60 years in 17 high-income countries. Methods: A modelling approach using a decision tree was applied for this cost comparison study. To do so, a (hypothetical) absence of the OS technology was presumed and OS (intervention) was compared with conservative treatment (CONS; comparator) from a societal perspective. We included fracture patients with femur, tibia and radius fractures (age ,65yr.); for proximal femur fractures elderly patients ($70yr.) were also included. Outcomes were differences between OS and CONS in years of life gained (YLG), direct and indirect costs (2015 Swiss Francs for all modelled years; discount rate 3%). We used data from the Swiss Accident Insurance, OECD and World Bank. From our base case Switzerland, we extrapolated our results to 16 other high-income countries from four continents (Europe, North America, Asia, Australia) and performed sensitivity analyses. Results: In the working age population, CHF 855 bn. (sensitivity analysis: min. CHF 360 bn. to max. CHF 1213 bn.) were saved in direct and indirect costs over 6 decades in 17 countries for femur, tibia and radius fractures. 4.6 million YLG were gained in this age group (2/3 of them before age 65 and included in indirect costs). In the elderly population with proximal femur fractures, CHF 69 bn. were saved in direct costs in addition to 73 million YLG. Conclusions: The health economic impact of OS was substantial over six decades. It resulted important productivity gains and YLG

Labeling the human skeleton with 41Ca to assess changes in bone calcium metabolism

ISSN:1618-2650ISSN:1618-264