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

Detection of Simian Immunodeficiency Virus in Macaque Lymph Nodes With a SIV mac

A tritium‐labeled DNA envelope gene probe was used to detect Simian Immunodeficiency Virus in formalin fixed lymph nodes from rhesus monkeys experimentally inoculated with SIVmac251. Cells containing SIV RNA produced strong hybridization signal and were present in small numbers in biopsy specimens and in much greater numbers in lymph nodes collected at autopsy. SIV‐infected cells were morphologically identified as lymphocytes and macrophages

Pliocene climate variability : Northern Annular Mode in models and tree-ring data

The Northern Annular Mode (NAM) and its regional expression, the North Atlantic Oscillation (NAO) are the primary interannual oscillatory systems in the Northern Hemisphere. In the modern climate, NAM has been linked with a number of weather extremes, including large terrestrial temperature increases and extreme snowfalls. Its connection to climate is more controversial, although a change in its behaviour between 1970 and 2000 coincided with rapid temperature increases in the Northern Hemisphere. The North Atlantic and Nordic Seas are a key component in Pliocene climate, showing the largest increases from modern sea surface temperature. To understand these changes and the ability of climate models to reproduce them, we must consider simulations of the NAM. Here we show that existing mid-Pliocene simulations exhibit large changes to the mean state and variability in the North Atlantic and a significant dampening of the NAO. Through sensitivity experiments this change is primarily attributed to the impact of the lowering of the Rocky Mountains. As the timing of Rocky Mountains uplift is still disputed, simulations of the North Atlantic region contain significant uncertainty, particularly relating to interannual variability and its climate feedbacks. New high temporal resolution climate proxy data is required to test these model reconstructions. Here we report new annual resolution data and an analysis of climate variability from fossil tree-rings. These fossils, from sites in the Canadian Arctic, provide support for a strong North Atlantic Oscillation during the Pliocene

Current threats faced by Neotropical parrot populations

Berkunsky I, Quillfeldt P, Brightsmith DJ, et al. Current threats faced by Neotropical parrot populations. Biological Conservation. 2017;214:278-287.Psittaciformes (parrots, cockatoos) are among the most endangered birds, with 31% of Neotropical species under threat. The drivers of this situation appear to be manifold and mainly of anthropogenic origin. However, this assessment is based on the last extensive consultation about the conservation situation of parrots carried out in the 1990s. Given the rapid development of anthropogenic threats, updated data are needed to strategize conservation actions. Using a population approach, we addressed this need through a wide-ranging consultation involving biologists, wildlife managers, government agencies and non-governmental conservation organizations. We gathered up-to-date information on threats affecting 192 populations of 96 Neotropical parrot species across 21 countries. Moreover, we investigated associations among current threats and population trends. Many populations were affected by multiple threats. Agriculture, Capture for the Pet Trade, Logging, each of them affected > 55% of the populations, suggesting a higher degree of risk than previously thought. In contrast to previous studies at the species level, our study showed that the threat most closely associated with decreasing population trends is now Capture for the local Pet Trade. Other threats associated with decreasing populations include Small-holder Farming, Rural Population Pressure, Nest Destruction by Poachers, Agro-industry Grazing, Small-holder Grazing, and Capture for the international Pet Trade. Conservation actions have been implemented on < 20% of populations. Our results highlight the importance of a population-level approach in revealing the extent of threats to wild populations. It is critical to increase the scope of conservation actions to reduce the capture of wild parrots for pets

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar