Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Science of \u27Sully\u27

Assistant Professor at UND Aerospace discusses the story of an aircraft emergency landing on the Hudson River in 2009, now featured in a top box office motion picture Nick Wilson, assistant professor of aviation at the University of North Dakota’s John D. Odegard School of Aerospace Sciences, has a unique connection to the emergency landing on the Hudson River of U.S. Airways Flight 1549 on Jan. 15, 2009. The famous “landing” and courageous airline captain that made it happen are subjects of a major motion picture, “Sully,” currently No. 1 in the country, based on box-office returns. As a systems and procedures instructor for the Airbus 320 (A320) — the aircraft flown by Airline Capt. Chesley Sullenberger — Wilson provided initial and continuing-qualification training for captains and first officers at a major airline for five years. Many of those aviators are still active crewmembers flying the A320 today. Wilson remembers the incident well. He also recalls discussing assessments of the incident with his colleagues as they watched the story unfold on national television. “Whenever an incident or accident occurs,” Wilson says, “it’s really important not to make initial assessments without more detail. That’s a common outcome with the media.” Rare incident Wilson says the National Transportation Safety Board and FAA took a long hard look at the checklists and procedures associated with the incident. One of the aspects that made this incident so unique was the dual-engine failure, which, at such low altitudes, is extremely uncommon. Because of the rarity, checklists associated with a dual-engine failures were not optimized, specifically procedures associated with “ditching” the aircraft. The importance of including low-altitude engine failures in checklists is apparent when one considers the lack of safe places to force land an aircraft in heavily congested cities like New York City. Seeing \u27Sully\u27 Though Wilson has not been able to see “Sully” yet, he is looking forward to the opportunity. He’s eager to see how much detail of the incident the filmmakers covered. When speaking to people who aren’t pilots, Wilson offers advice on how to best enjoy the film: “One thing I would say to the general public watching the movie would be – ‘Take in as much of this experience as you can, because it certainly is going to be exciting,’” Wilson said. “’but also, research the topic in more detail. What I can’t comment on is how accurate the movie is compared to the realities that the flight crew faced. I’m certain they made an attempt to realize that and that’s the difference between making a movie and actually facing an emergency.’” Judgment call Flight 1549, piloted by Sullenberger, departed LaGuardia Airport in New York City just before 3:30 p.m. After climbing to 3,000 feet, the aircraft struck a flock of Canada geese, which caused damage to its engines and resulted in a loss of thrust for both. Sullenberger opted to land in the nearby Hudson River after judging that he could not return to LaGuardia or any other airport. Through quick decision-making, Sullenberger and crew were able to safely guide the aircraft on to the Hudson with no loss of life. Wilson commends Sullenberger on his decision. “The captain elected, and arguably very rightly so, to land in the Hudson where there would be the least potential loss of life, and it ultimately resulted in no loss of life, which is quite amazing,” Wilson said. Interestingly, the A320 involved in the Hudson River landing was equipped to handle an over-water landing. At the time of the incident, this was not common with the entire U.S. Airways fleet nor the fleets of many other major air carriers. This equipment was not a requirement for the route of Flight 1549, however, having passenger life vests and escape rafts on board ended up being advantageous in the rescue effort

A soaring soul

After what seemed like weeks of cloud filled skies darkening the University of North Dakota, the sun finally shed a little light on a remembrance ceremony held for longtime University of North Dakota faculty member Glinda Crawford on Friday, July 15. Rows of chairs for visitors lined the sidewalk next to the Soaring Eagle Prairie Garden, which Crawford was instrumental in creating, as people began to trickle in. Within a matter of minutes, the seats were filled, and visitors began lining the sides of the chairs, standing and talking as they awaited the beginning of the ceremony. Crawford, professor emerita, spent many years as a member of the sociology department at UND and also was a home economics teacher at the school. She also was an artist, environmentalist and ecologist whose legacy lives on in the Soaring Eagle Prairie garden, on the main UND quad south of the Chester Fritz Library. Crawford, and her husband, Richard, a UND Chester Fritz Distinguished Professor of biology emeritus, retired in 2005, when they moved back to Glinda’s native Missouri. Glinda died in January. She was 67. As Richard and Melanie Crawford, daughter of Glinda, made their way toward the remembrance ceremony, they were engulfed by a crowd of well-wishers who embraced them as they neared, sharing a few words and a few tears. Robert Newman, an associate professor of biology at UND and a friend of both Richard and Glinda, looked skyward and reflected on the day. “I can see elements of Glinda’s presence everywhere,” Newman says. “This is the first sunny day in weeks I can remember.” Beautiful day As 10:30 a.m., approached, Courtney Souvannasacd, with UND’s American Indian Student Services, addressed the crowd from a podium. She adjusted the microphone and welcomed everyone. “Glinda must be upon us,” she said,” because we have a beautiful day.” Souvannasacd invited Michelle Kozel, also with American Indian Student Services, to join her at the podium. Kozel began saying simple words and phrases that might inspire memories of Glinda, such as “friend,” “mother,” “planting seeds,” “generosity,” “eagles” and “honey bees.” The words resonated with the attendees, many of whom nodded and slowly wiped away tears. Souvannasacd then asked everyone to stand and remove their hats as the Rivers Edge Drum corps performed a prayer song. A cool breeze flowed in as the drum beats intensified, providing temporary relief from the steadily warming sun. Kathy Fick, a minister at the Christus Rex Lutheran Campus Center, then led the crowd in a prayer, reflecting on Crawford’s impact on UND and everywhere she has ever been. Kay Mendick, director of the UND Women’s Center recalled how she always looked up to Crawford as a teacher and a friend. “It’s like she’s standing here right next to me saying ‘Get busy! We have so much work to do!’” Mendick said. “I love that woman with all my heart. She will always be a part of everyone’s life.” ‘Tracks we leave’ Students, peers, family and friends of Crawford followed Medick with more testimonies of how Crawford touched their lives. Roberta Beauchamp, a fundraiser with the UND Alumni Association and Foundation, announced the endowment of a scholarship in Crawford’s name, to be given out annually to select students. Richard Crawford and Melanie Crawford added a few words in remembrance of their wife and mother. Melanie fought back tears as she thanked everyone in attendance. Richard simply said, “we will be known forever by the tracks we leave, and Glinda is leaving some big tracks.” The ceremony concluded with everyone holding hands and creating a large circle around the Soaring Eagle Prairie Garden as the Rivers Edge Drum corps played a final song. As the circle slowly rotated around the garden to the beat of the drums, some people simply side stepped while others move their hips and looked toward the sky. As they gazed upward, several people in attendance notice a hawk slowly circling overheard, while a monarch butterfly fluttered in the garden -- both creatures were favorites of Crawford. Lyrics sang by the Rivers Edge Drum corps filled the garden, providing a lasting impression to the event: There’s nothing in this world I wouldn’t do to be there holding you. So don’t you cry, close your eyes and I will be there holding you

On the big stage

Led by UND distinguished professor of chemistry, Mark Hoffmann, Grand Forks plays host to international theoretical chemical physics conference With a population of only 55,000, setting a world stage in Grand Forks, N.D., was no easy task. But on July 17, that goal became a reality as the Ninth Tri-annual International Society for Theoretical Chemical Physics (ISTCP) conference kicked off with an introduction from the University of North Dakota’s own Chester Fritz Distinguished Professor of Chemistry Mark Hoffmann. As the chairman for this year’s ISTCP Conference, Hoffmann, associate vice president for research capacity building at UND, has overseen preparations for the event, along with the organizing committee, since the bid to hold the conference in Grand Forks was won three years ago. The conference brought together international members of a select scientific community that strives to develop and apply new methodologies in the field of chemical physics. The work they do has practical applications in developing pollution-abatement technology and has implications for energy in both extraction and renewable methods, along with several other applications and new materials. Mostly, those attending were faculty members from universities around the world. Representatives from countries such as Germany, Great Britain, Norway, Sweden, Poland, Japan and China were in attendance. Kicking it off Buses carrying travelers from far and wide arrived and began unloading a cargo of scientists and professors from universities around the world. As they made their way into the Alerus Conference Center, the attendees were warmly greeted by members of UND’s Chemistry Department, students and faculty alike, who were volunteering their time and working the registration tables. “I’m deeply humbled that participation is truly international with talks by presenters from 27 different countries and posters from 14 different countries,” Hoffmann says. “Participation is also good from across the U.S., we have participation from 25 states and posters from 17 states.” As more and more people arrived, they began congregating in front of the registration table with as much deep conversation as fits of laughter shared between old friends. Fashioned with green lanyards that read www.visitgrandforks.com and small green bags containing information specific to the conference, international tongues began conversing and filling the room. Scientists and professors from around the globe gathered and shared ideas and insight -- a goal Hoffmann hoped to achieve when he began this endeavor three years ago. “I was very excited to see everything begin after all of the planning,” Hoffmann says. “I was also very humbled that all these people were coming here. There was a touch of nervousness, and maybe a touch of fear, but overall I was excited.” In one of the Alerus Center ballrooms, upwards of 30 tables, seating 10 apiece, laid before a prominent stage with two projection screens on either side. As he waited for his time to deliver his opening remarks, Hoffmann stood in a small group discussing the activities about to take place, three years of planning and preparing leading to this moment. “The tone of a meeting can be set early on,” Hoffmann said. “You can make a good start go bad but it’s very difficult to take a bad start and make a meeting go well.” As Hoffmann took the stage, he kicked off his speech by giving credit to all the people who assisted him in making the conference possible, including UND Provost and Vice President for Academic Affairs, Tom DiLorenzo and former UND President Robert Kelley, who together, believed in the conference and supported it. Native American intro As Hoffmann wrapped up his opening remarks, he invited the crowd to enjoy a performance by a local American Indian drum circle. The three performers stood and began beating their drums and singing along to the beat. Members of the worldwide community looked on in wonderment as they witnessed the drum circle perform. Within seconds of the performance beginning, the crowd slowly rose to their feet as a sign of respect. As the beat intensified, and the voices of the performers grew louder, the attention of the convention was unmistakably on the performers. As the drum circle concluded their performance, a thunderous round of applause ensued. Week of events For the rest of the week, the conference was packed with presentations, symposia and poster sessions. World-renowned chemical physicists shared their knowledge and expertise with attentive groups. The focus of the symposia ranged from the study of complex materials (of material science or biological interests) to relativistic and quantum electrodynamic (QED) effects that probe some of the most fundamental aspects of the universe. Attending every event was impossible, but Hoffmann oversaw the conference as a whole from day one until its completion. Coming together After three years of hard work, Hoffmann’s vision came together, with the conference going as planned and no issues. “I was really happy, but I also realize the enormous contributions other people made to this as well,” Hoffmann says. “This was especially true of Cathy Lerud and Carla Kellner (UND employees in Experimental Program to Stimulate Completive Research – EPSCoR--office), as well as the people at the Alerus. What looked like little details were only little if they were done right.” Now that the conference has come and passed, Hoffmann has a lasting impression of his hard work, complete with fond memories and exceptional execution. “I couldn’t be more pleased. And I’m also really tired; there’s a lot of relief. A lot of time and a lot of work is now in the rear view mirror.

UND lauds new federal law on Air Traffic Control hiring practices

Legislation emphasizes value of degree from a certified aviation training schools, ensures better job opportunities for students For the past two years, Paul Drechsel, assistant chair for the University of North Dakota Air Traffic Control Program , has been on a mission to make the road to becoming an air traffic controller (ATC) a little less bumpy. That’s why Drechsel, an associate professor of aviation at UND’s John D. Odegard School of Aerospace Sciences , is lauding recently signed legislation out of Congress. The new law reverses federal aviation hiring policies that, in a sense, would have diminished a degree from certified ATC training institution such as UND. In June, the Government Accountability Office found that the Federal Aviation Administration (FAA) transitioned to its new hiring policies without the proper implementation and planning among other concerns. The new FAA reauthorization bill, signed by President Obama last month, alters ATC hiring processes launched in 2014. The new legislation breaks down job opening for aspiring controllers in into two separate pools. One pool includes applicants who have successfully completed ATC training from an approved institution, such as UND, or eligible veterans. “That is very important,” Drechsel said. “Instead of ATC jobs being open to anybody, it now signifies that our degree is very important for these students to have an opportunity to become employed.” The other pool holds individuals who apply under a vacancy announcement from the FAA. Because of this, UND graduates looking to secure a career in ATC now have a distinct advantage when pursuing a job as a controller. The FAA will open its next hiring bid from Aug. 8-15, and the revamped policies are included for this new round of hires. Another change that UND officials are happy about is that the FAA is no longer allowed to use biographical assessments to determine hiring eligibility. Before the change, the biographical assessments comprised a number of survey questions unrelated to one’s actual education or training to be a successful air traffic controller. “Now we’re taking individuals who have been trained and have a degree in ATC management and know what the job entails,” Drechsel said. “They’ve done hands-on simulation training in order to acquire the skills needed to successfully manage air traffic.” Direct impacts When the FAA implemented the new hiring practices in 2014, Drechsel contacted North Dakota’s Congressional Delegation and explained its shortcomings and direct impacts to students and institutions such as UND. “Without their help, none of this could have changed,” Drechsel said. “So I really want to commend our Delegation and their staff for a lot of the work they’ve done.” U.S. Sen. John Hoeven said UND’s program does an outstanding job preparing students to become highly qualified Air Traffic Controllers. “We worked to advance this legislation because it takes an important step forward in addressing problems with the FAA’s hiring process by ensuring that graduates of FAA certified Collegiate Training Initiatives schools like UND get the opportunity they deserve.” The new FAA bill had a range of other important provisions for UND including language that reauthorized the UND-based Northern Plains Unmanned Aircraft Systems Test Site and six other UAS test sites for three more years, according to Hoeven. ‘Burdensome, abrupt’ U.S. Sen. Heidi Heitkamp said the FAA reauthorization bill fixed burdensome requirements for small aircraft pilots in North Dakota and UND aviation students. “We can build the infrastructure our state needs to support a growing and thriving population, and we can do it by supporting the extensive training programs at UND through a streamlined hiring process to create a strong air traffic control workforce for years to come,” Heitkamp said. U.S. Rep. Kevin Cramer had conversations with FAA Administrator Michael Huerta about the abrupt changes and alleged impropriety in the ATC hiring process in addition to asking for an FAA investigation. He also co-sponsored several bills addressing the ATC hiring issue. “I was concerned about the FAA’s lack of transparency in changing its hiring process with so little advance notice or explanation,” said Cramer. “It especially impacted students like those at UND planning to pursue an ATC career with the FAA.

Slippery when dry

UND mechanical engineer Suroijt Gupta is re-envisioning the modern engine through an agreement with the U.S. Army to reduce the need for oil-based lubricants When people imagine the machines of the future, they might envision flying cars or engines that run without gasoline. University of North Dakota Assistant Professor of Mechanical Engineering Surojit Gupta has his own futuristic vision: an engine that doesn’t need oil. Gupta recently started a Cooperative Research and Development Agreement with the U.S. Army Research Lab worth about $360,000 over three years. Per the agreement, Gupta and his team of graduate students will assist the Army in creating self-lubricating materials and high temperature propulsion systems. UND’s Mechanical Engineering Department is part of the College of Engineering and Mines. Part one of the project is to design solid lubricant materials. The materials will be able to withstand higher temperatures than current designs, making the need for oil a thing of the past. Part two involves designing high-temperature materials for high-powered turbines. Turbines are currently manufactured with nickel-based alloys, which have lower functional temperatures. Though it’s too early to say how long the materials would last, Gupta insists the materials will have a longer life than current traditional oil-based machinery and will be better for the environment. “As you can imagine, if you eliminate oil from machinery you can reduce the cost so much,” says Gupta, who earlier this year was named the winner of the 2016 Global Young Investigator Award at an international conference in Florida. Civilian applications, too If Gupta and his team are successful, their designs would enable devices to fly for longer in complex combat and peacetime environments to provide improved medical support or protection to friendly troops on ground. Gupta believes the day will come when his research will shift from creating self-lubricating materials to actually applying those novel materials to real-world machines. He says the most realistic application for these new materials is in an aerospace environment, perhaps, in the form of a shaft and gearbox that will be made of UND’s new multifunctional materials. These materials also might be used for numerous civilian applications, such as oil-free engines and other devices — such as polymer contact devices solid lubrication is needed,” Gupta said. “Normally when you have cars we tend to replace oil, and changing oil is always a problem,” Gupta said. “Imagine if we have structures where you don’t need to change the oil in the system; we can use the solid lubricants and eliminate the oil. We don’t need any kind of coolant system -- that will eliminate the cost of that as well as reduce pollution.

Open for business

Ribbon-cutting ceremony at UND’s newest building, Robin Hall, signals ‘visionary’ development in UAS education and research in North Dakota and beyond A buzz of excitement filled one of the University of North Dakota’s newest buildings on Tuesday, July 26, as University officials, dignitaries and members of the public gathered to cut the ribbon on Robin Hall on the far west side of campus. Several distinguished speakers took the podium one after another, including Sen. John Hoeven, R-N.D., Rep. Kevin Cramer, R-N.D., UND President Mark Kennedy among many others, to recognize the people who made the new building – primarily, UND’s new home for Unmanned Aircraft Systems education and research -- possible. Robin Hall also will be home to the Northern Plains Unmanned Aircraft Systems Test Site, one of only six test sites for UAS development in the country. Speaking to Si and Betty Robin, lead benefactors for whom the building is named, Hoeven said, “visionary things don’t happen without visionaries,” to which the crowd generously applauded. The Robins are behind the success of Sensor Systems, a California-based manufacturer of aerospace antenna. The 66,000-square-foot Robin Hall is being funded largely by private donations and $1.5 million in matches from the North Dakota State Board of Higher Education Challenge Fund. The state authorized UND to spend up to$25 million on the project. It’s being built and managed by the Aerospace Foundation, the private-sector support arm of UND Aerospace. Self-guided tours As the ribbon was cut, the words “we’re officially open for business” resonated throughout the crowd as the attendees began their self-guided tours of Robin Hall. Entering Robin Hall through the automatic doors on the north side, a grand auditorium is set just to the left. Fashioned with student study areas, Robin Hall has a huge projection screen and nine thin, rectangular televisions lining above and below a staircase leading to an open balcony overlooking it. Down the hallway, just through the northern entrance, an “Aerostop” store is located with large panels of glass lining the front, providing a view of all the UND Aerospace and Unmanned Aircraft Systems (UAS) items and memorabilia available for purchase. Just across the Aerostop is a massive “UND Aerospace Legacy Wall,” which pays tribute to donors and contributors to the new building: James C. Ray, Clay Lacy, Joe Clark and the Robins. Beyond the auditorium are classrooms and a small “hangar,” designated as a flight-test lab, where UAS students can practice maneuvers with one of the several unmanned systems available to them. The upper levels of the building are filled with classrooms, student study rooms, common areas, boardrooms and administrative offices. The entire building is in the form of a picturesque pillar covered with glass windows and reaching high above every structure around it, signifying the “sky is the limit” for aviation at UND

Social\u27 networking

UND students in the Department of Social Work find excitement and a culture of caring while conducting fieldwork in Malmö, Sweden It isn’t often that a student travels more than 4,000 miles to complete an internship, but that’s exactly what University of North Dakota students Bailey Kitko and Bridget Hill have done. But before they left, Kitko and Hill had to make sure they were ready. On a warm summer day, they made their way to the Kenneth Dawes Conference Room in Gillette Hall at UND to meet with several professors and advisors for an official orientation to their study abroad block field Internship in Malmö, Sweden. “(Orientation) was helpful, but honestly, I was prepared for whatever obstacles came my way,” Kitko said. “Excitement of a new place to call ‘home’ -- at least for a while -- can do wonders for one\u27s perspective and optimism.” Joining the orientation team remotely from Norway, Melissa Gjellstad, UND Associate Professor of Norwegian, helped answer many of Kitko and Hill’s questions about living and working in Sweden. The orientation covered everything from safety and comportment, to money and sightseeing to practical preparations to combating fatigue and homesickness. Emily Dougherty, UND Education Abroad program manager, presented the students with tips and resources to help make their stay in Malmö successful and safe. Additional advice was offered from faculty members Bret Weber and Jayasundara, whose travels to Malmö and previous field experiences provided direction and helpful hints for managing the adventure ahead. Living abroad Now that the women are in Sweden, they are immersing themselves into the culture and enjoying their time, while staying busy at the same time. “Excitement and curiosity have been two of my most felt feelings since I\u27ve arrived,” Kitko says. “Whether in my agency or just wandering the streets and immersing myself into the Swedish culture. A person can\u27t truly prepare for what to expect when relocating somewhere new, especially abroad. Therefore, it\u27s important to keep an open mind about everything and to really embrace the motto of ‘go with the flow.’” “Sweden has a very holistic approach when it comes to helping people,” Hill said. “The United States is hierarchical and Sweden is horizontal, meaning organizations and agencies are flat. Everyone\u27s input is welcomed and collaboration is deemed more important than only one person\u27s input. “I learned about ‘flat organizations’ in classes, but living in one is extraordinary. People come first, then paperwork. Relationships with clients are significant and more important above all else. It is wholesome and holistic. I will bring a lot of these techniques back with me.” Bilateral agreement This innovative program was made possible through a bilateral agreement and memorandum of understanding with Malmö University in Sweden, put in place in January after a year of hard work and coordination by the UND Social Work faculty team. The Social Work Department is part of the UND College of Nursing and Professional Disciplines. The agreement encompasses four options: a study abroad Internship, a two-week study abroad policy course in February or next year, a traditional 20-week semester exchange in the fall 2017, and the hosting of Swedish students for campus-based classes or volunteering at local community-based agencies. Additionally, the faculty is exploring joint grant opportunities. Jonas Christensen, international coordinator for Malmö University’s Social Work Department, who visited UND last March, plans to return to teach and conduct comparative research in partnership with UND faculty during the upcoming spring semester. ‘Intern’ationalization During their internship, Kitko and Hill will be working with migrant and refugee populations in Malmö. Kitko, an undergraduate social work student, will be working with migrant adolescent youth who entered Sweden unattended. Hill, who is pursuing her master’s degree, will be working with migrant people who are homeless and whose plans to find employment in Sweden have not yet materialized. “I would like to thank the social work department, especially Dheeshana (Jayasundara, Kitko and Hill’s field liaison from UND ), whom I will have regular contact with while in Malmö,” Kitko said. “I would also really like to thank Jonas Christensen and Johanna Ivarsson from Malmö University. They have been very welcoming and accommodating. Without the assistance from them, this would not be possible.” UND Social Work Department Chair Carenlee Barkdull expressed appreciation for Malmö University faculty who have gone “above and beyond” to support Kitko and Hill in securing internships this fall, and for providing orientation and supports to them while they are in Sweden. “Internationalization is one of our department’s strategic initiatives,” Barkdull said. “We are so proud of this partnership, which adds another unique tool for preparing social workers for practice in an increasingly global, diverse world.