Limited genetic diversity found among genotypes of the Entada landrace (Ensete ventricosum, (Welw.) Chessman) from Ethiopia.

The Entada landrace of enset (Ensete ventricosum (Welw.) Chessman) is probably the most unique indigenous crop in Ethiopia, being maintained and utilized by the Ari people in the South of Ethiopia. Here we describe genetic diversity, selection signatures and relationship of Entada with cultivated and wild enset using 117 Entada genotypes collected from three Entada growing regions in Ethiopia (Sidama, South and North Ari). A total number of 1,617 high-quality SNP markers, obtained from ddRAD-sequences, were used for the diversity studies. Phylogenetic analysis detected a clear distinction between cultivated enset, Entada and wild enset with Entada forming a completely separated clade. However, extremely short branch lengths among the Entada genotypes indicate very little molecular evolution in the Entada lineages. Observed and expected heterozygosities were high, 0.73 and 0.50, respectively. Overall, our results strongly indicate that the Entada genotypes we have studied originated from one or a few clonal lineages that have been propagated and spread among farmers as clones. Prolonged clonal propagation of heterozygous genotypes from a single or few founding lineages has led to populations with very little or no diversity between genotypes, and high heterozygosity within genotypes. Signatures of directional selection were identified at eight loci based on an FST outlier analysis. Four candidate genes detected are involved in axillary shoot growth and might be involved in controlling natural sucker formation in Entada.

A novel deep ensemble-based model with outlier removal and order-invariant ranking for carbon dioxide emission prediction.

Excessive carbon dioxide ( CO 2 ) emissions pose a formidable challenge, driving global climate change and necessitating urgent attention. Striking a balance between curbing CO 2 emissions and fostering economic growth hinges upon the ability to reliably forecast CO 2 emissions. Such forecasts are indispensable for policymakers as they endeavor to make informed decisions and proactively implement mitigation measures. In this research, we introduce an innovative deep ensemble prediction model for CO 2 emissions. This model is constructed around four parallel Long Short-Term Memory (LSTM) neural networks, complemented by a novel Multi-Layer Perception (MLP)-based ensemble framework, equipped with an outlier detection mechanism and an order-invariant ranking module. To enhance prediction accuracy and stability, a k-nearest neighbor (KNN)-based outlier detection module is employed to identify non-outliers and reasonable predictions for the ensemble models. Additionally, a novel feature ranking module is proposed to mitigate prediction fluctuations. The performance evaluation of our model is conducted using historical CO 2 emission data spanning from 1971 to 2021, encompassing six representative countries. Our findings demonstrate that the proposed methodology outperforms existing approaches across various evaluation metrics, offering considerably reduced prediction variances and greater stability. Moreover, long-term CO 2 emission predictions for the corresponding six countries have been provided, which might offer policymakers some basis for making decisions.

Energy-Efficient Anomaly Detection and Chaoticity in Electric Vehicle Driving Behavior.

Detection of abnormal situations in mobile systems not only provides predictions about risky situations but also has the potential to increase energy efficiency. In this study, two real-world drives of a battery electric vehicle and unsupervised hybrid anomaly detection approaches were developed. The anomaly detection performances of hybrid models created with the combination of Long Short-Term Memory (LSTM)-Autoencoder, the Local Outlier Factor (LOF), and the Mahalanobis distance were evaluated with the silhouette score, Davies-Bouldin index, and Calinski-Harabasz index, and the potential energy recovery rates were also determined. Two driving datasets were evaluated in terms of chaotic aspects using the Lyapunov exponent, Kolmogorov-Sinai entropy, and fractal dimension metrics. The developed hybrid models are superior to the sub-methods in anomaly detection. Hybrid Model-2 had 2.92% more successful results in anomaly detection compared to Hybrid Model-1. In terms of potential energy saving, Hybrid Model-1 provided 31.26% superiority, while Hybrid Model-2 provided 31.48%. It was also observed that there is a close relationship between anomaly and chaoticity. In the literature where cyber security and visual sources dominate in anomaly detection, a strategy was developed that provides energy efficiency-based anomaly detection and chaotic analysis from data obtained without additional sensor data.

Prototyping a Secure and Usable User Authentication Mechanism for Mobile Passenger ID Devices for Land/Sea Border Control.

As the number of European Union (EU) visitors grows, implementing novel border control solutions, such as mobile devices for passenger identification for land and sea border control, becomes paramount to ensure the convenience and safety of passengers and officers. However, these devices, handling sensitive personal data, become attractive targets for malicious actors seeking to misuse or steal such data. Therefore, to increase the level of security of such devices without interrupting border control activities, robust user authentication mechanisms are essential. Toward this direction, we propose a risk-based adaptive user authentication mechanism for mobile passenger identification devices for land and sea border control, aiming to enhance device security without hindering usability. In this work, we present a comprehensive assessment of novelty and outlier detection algorithms and discern OneClassSVM, Local Outlier Factor (LOF), and Bayesian_GaussianMixtureModel (B_GMM) novelty detection algorithms as the most effective ones for risk estimation in the proposed mechanism. Furthermore, in this work, we develop the proposed risk-based adaptive user authentication mechanism as an application on a Raspberry Pi 4 Model B device (i.e., playing the role of the mobile device for passenger identification), where we evaluate the detection performance of the three best performing novelty detection algorithms (i.e., OneClassSVM, LOF, and B_GMM), with B_GMM surpassing the others in performance when deployed on the Raspberry Pi 4 device. Finally, we evaluate the risk estimation overhead of the proposed mechanism when the best performing B_GMM novelty detection algorithm is used for risk estimation, indicating efficient operation with minimal additional latency.

Genome scans for selection signatures identify candidate virulence genes for adaptation of the soybean cyst nematode to host resistance.

Plant pathogens are constantly under selection pressure for host resistance adaptation. Soybean cyst nematode (SCN, Heterodera glycines) is a major pest of soybean primarily managed through resistant cultivars; however, SCN populations have evolved virulence in response to selection pressures driven by repeated monoculture of the same genetic resistance. Resistance to SCN is mediated by multiple epistatic interactions between Rhg (for resistance to H. glycines) genes. However, the identity of SCN virulence genes that confer the ability to overcome resistance remains unknown. To identify candidate genomic regions showing signatures of selection for increased virulence, we conducted whole genome resequencing of pooled individuals (Pool-Seq) from two pairs of SCN populations adapted on soybeans with Peking-type (rhg1-a, rhg2, and Rhg4) resistance. Population differentiation and principal component analysis-based approaches identified approximately 0.72-0.79 million SNPs, the frequency of which showed potential selection signatures across multiple genomic regions. Chromosomes 3 and 6 between population pairs showed the greatest density of outlier SNPs with high population differentiation. Conducting multiple outlier detection tests to identify overlapping SNPs resulted in a total of 966 significantly differentiated SNPs, of which 285 exon SNPs were mapped to 97 genes. Of these, six genes encoded members of known stylet-secreted effector protein families potentially involved in host defence modulation including venom-allergen-like, annexin, glutathione synthetase, SPRYSEC, chitinase, and CLE effector proteins. Further functional analysis of identified candidate genes will provide new insights into the genetic mechanisms by which SCN overcomes soybean resistance and inform the development of molecular markers for rapidly screening the virulence profile of an SCN-infested field.

Testing Outlier Detection Algorithms for Identifying Early Stage Solute Clusters in Atom Probe Tomography.

Atom probe tomography (APT) is commonly used to study solute clustering and precipitation in materials. However, standard techniques used to identify and characterize clusters within atom probe data, such as the density-based spatial clustering applications with noise (DBSCAN), often underperform with respect to small clusters. This is a limitation of density-based cluster identification algorithms, due to their dependence on the parameter Nmin, an arbitrary lower limit placed on detectable cluster sizes. Therefore, this article attempts to consider the characterization of clustering in atom probe data as an outlier detection problem of which k-nearest neighbors local outlier factor and learnable unified neighborhood-based anomaly ranking algorithms were tested against a simulated dataset and compared to the standard method. The decision score output of the algorithms was then auto thresholded by the Karcher mean to remove human bias. Each of the major models tested outperforms DBSCAN for cluster sizes of <25 atoms but underperforms for sizes >30 atoms using simulated data. However, the new combined k-nearest neighbors (k-NN) and DBSCAN method presented was able to perform well at all cluster sizes. The combined k-NN and seven methods are presented as a new approach to identifying clusters in APT.

Application of multivariate binary logistic regression grouped outlier statistics and geospatial logistic model to identify villages having unusual health-seeking habits for childhood malaria in Malawi.

BACKGROUND: Early diagnosis and prompt treatment of malaria in young children are crucial for preventing the serious stages of the disease. If delayed treatment-seeking habits are observed in certain areas, targeted campaigns and interventions can be implemented to improve the situation. METHODS: This study applied multivariate binary logistic regression model diagnostics and geospatial logistic model to identify traditional authorities in Malawi where caregivers have unusual health-seeking behaviour for childhood malaria. The data from the 2021 Malawi Malaria Indicator Survey were analysed using R software version 4.3.0 for regressions and STATA version 17 for data cleaning. RESULTS: Both models showed significant variability in treatment-seeking habits of caregivers between villages. The mixed-effects logit model residual identified Vuso Jere, Kampingo Sibande, Ngabu, and Dzoole as outliers in the model. Despite characteristics that promote late reporting of malaria at clinics, most mothers in these traditional authorities sought treatment within twenty-four hours of the onset of malaria symptoms in their children. On the other hand, the geospatial logit model showed that late seeking of malaria treatment was prevalent in most areas of the country, except a few traditional authorities such as Mwakaboko, Mwenemisuku, Mwabulambya, Mmbelwa, Mwadzama, Zulu, Amidu, Kasisi, and Mabuka. CONCLUSIONS: These findings suggest that using a combination of multivariate regression model residuals and geospatial statistics can help in identifying communities with distinct treatment-seeking patterns for childhood malaria within a population. Health policymakers could benefit from consulting traditional authorities who demonstrated early reporting for care in this study. This could help in understanding the best practices followed by mothers in those areas which can be replicated in regions where seeking care is delayed.

Misexpression of inactive genes in whole blood is associated with nearby rare structural variants.

Gene misexpression is the aberrant transcription of a gene in a context where it is usually inactive. Despite its known pathological consequences in specific rare diseases, we have a limited understanding of its wider prevalence and mechanisms in humans. To address this, we analyzed gene misexpression in 4,568 whole-blood bulk RNA sequencing samples from INTERVAL study blood donors. We found that while individual misexpression events occur rarely, in aggregate they were found in almost all samples and a third of inactive protein-coding genes. Using 2,821 paired whole-genome and RNA sequencing samples, we identified that misexpression events are enriched in cis for rare structural variants. We established putative mechanisms through which a subset of SVs lead to gene misexpression, including transcriptional readthrough, transcript fusions, and gene inversion. Overall, we develop misexpression as a type of transcriptomic outlier analysis and extend our understanding of the variety of mechanisms by which genetic variants can influence gene expression.

Conservation genomics of the wild pumpkin Cucurbita radicans in Central Mexico: The influence of a changing environment on the genetic diversity and differentiation of a rare species.

The genetic diversity found in natural populations is the result of the evolutionary forces in response to historical and contemporary factors. The environmental characteristics and geological history of Mexico promoted the evolution and diversification of plant species, including wild relatives of crops such as the wild pumpkins (Cucurbita). Wild pumpkin species are found in a variety of habitats, evidencing their capability to adapt to different environments. Despite the potential value of wild Cucurbita as a genetic reservoir for crops, there is a lack of studies on their genetic diversity. Cucurbita radicans is an endangered species threatened by habitat destruction leading to low densities in small and isolated populations. Here, we analyze Genotype by Sequencing genomic data of the wild pumpkin C. radicans to evaluate the influence of factors like isolation, demographic history, and the environment shaping the amount and distribution of its genetic variation. We analyzed 91 individuals from 14 localities along its reported distribution. We obtained 5,107 SNPs and found medium-high levels of genetic diversity and genetic structure distributed in four main geographic areas with different environmental conditions. Moreover, we found signals of demographic growth related to historical climatic shifts. Outlier loci analysis showed significant association with the environment, principally with precipitation variables. Also, the outlier loci displayed differential changes in their frequencies in response to future global climate change scenarios. Using the results of genetic structure, outlier loci and multivariate analyses of the environmental conditions, we propose priority localities for conservation that encompass most of the genetic diversity of C. radicans.

Outlier detection for keystroke biometric user authentication.

User authentication is a fundamental aspect of information security, requiring robust measures against identity fraud and data breaches. In the domain of keystroke dynamics research, a significant challenge lies in the reliance on imposter datasets, particularly evident in real-world scenarios where obtaining authentic imposter data is exceedingly difficult. This article presents a novel approach to keystroke dynamics-based authentication, utilizing unsupervised outlier detection techniques, notably exemplified by the histogram-based outlier score (HBOS), eliminating the necessity for imposter samples. A comprehensive evaluation, comparing HBOS with 15 alternative outlier detection methods, highlights its superior performance. This departure from traditional dependence on imposter datasets signifies a substantial advancement in keystroke dynamics research. Key innovations include the introduction of an alternative outlier detection paradigm with HBOS, increased practical applicability by reducing reliance on extensive imposter data, resolution of real-world challenges in simulating fraudulent keystrokes, and addressing critical gaps in existing authentication methodologies. Rigorous testing on Carnegie Mellon University's (CMU) keystroke biometrics dataset validates the effectiveness of the proposed approach, yielding an impressive equal error rate (EER) of 5.97%, a notable area under the ROC curve of 97.79%, and a robust accuracy (ACC) of 89.23%. This article represents a significant advancement in keystroke dynamics-based authentication, offering a reliable and efficient solution characterized by substantial improvements in accuracy and practical applicability.

Multiparametric identification of putative senescent cells in skeletal muscle via mass cytometry.

Senescence is an irreversible arrest of the cell cycle that can be characterized by markers of senescence such as p16, p21, and KI-67. The characterization of different senescence-associated phenotypes requires selection of the most relevant senescence markers to define reliable cytometric methodologies. Mass cytometry (a.k.a. Cytometry by time of flight, CyTOF) can monitor up to 40 different cell markers at the single-cell level and has the potential to integrate multiple senescence and other phenotypic markers to identify senescent cells within a complex tissue such as skeletal muscle, with greater accuracy and scalability than traditional bulk measurements and flow cytometry-based measurements. This article introduces an analysis framework for detecting putative senescent cells based on clustering, outlier detection, and Boolean logic for outliers. Results show that the pipeline can identify putative senescent cells in skeletal muscle with well-established markers such as p21 and potential markers such as GAPDH. It was also found that heterogeneity of putative senescent cells in skeletal muscle can partly be explained by their cell type. Additionally, autophagy-related proteins ATG4A, LRRK2, and GLB1 were identified as important proteins in predicting the putative senescent population, providing insights into the association between autophagy and senescence. It was observed that sex did not affect the proportion of putative senescent cells among total cells. However, age did have an effect, with a higher proportion observed in fibro/adipogenic progenitors (FAPs), satellite cells, M1 and M2 macrophages from old mice. Moreover, putative senescent cells from muscle of old and young mice show different expression levels of senescence-related proteins, with putative senescent cells of old mice having higher levels of p21 and GAPDH, whereas putative senescent cells of young mice had higher levels of IL-6. Overall, the analysis framework prioritizes multiple senescence-associated proteins to characterize putative senescent cells sourced from tissue made of different cell types.

When an extra rejection class meets out-of-distribution detection in long-tailed image classification.

Detecting Out-of-Distribution (OOD) inputs is essential for reliable deep learning in the open world. However, most existing OOD detection methods have been developed based on training sets that exhibit balanced class distributions, making them susceptible when confronted with training sets following a long-tailed distribution. To alleviate this problem, we propose an effective three-branch training framework, which demonstrates the efficacy of incorporating an extra rejection class along with auxiliary outlier training data for effective OOD detection in long-tailed image classification. In our proposed framework, all outlier training samples are assigned the label of the rejection class. We employ an inlier loss, an outlier loss, and a Tail-class prototype induced Supervised Contrastive Loss (TSCL) to train both the in-distribution classifier and OOD detector within one network. During inference, the OOD detector is constructed using the rejection class. Extensive experimental results demonstrate that the superior OOD detection performance of our proposed method in long-tailed image classification. For example, in the more challenging case where CIFAR100-LT is used as in-distribution, our method improves the average AUROC by 1.23% and reduces the average FPR95 by 3.18% compared to the baseline method utilizing Outlier Exposure (OE). Code is available at github.

Identifying dysregulated regions in amyotrophic lateral sclerosis through chromatin accessibility outliers.

The high heritability of amyotrophic lateral sclerosis (ALS) contrasts with its low molecular diagnosis rate post-genetic testing, pointing to potential undiscovered genetic factors. To aid the exploration of these factors, we introduced EpiOut, an algorithm to identify chromatin accessibility outliers that are regions exhibiting divergent accessibility from the population baseline in a single or few samples. Annotation of accessible regions with histone chromatin immunoprecipitation sequencing and Hi-C indicates that outliers are concentrated in functional loci, especially among promoters interacting with active enhancers. Across different omics levels, outliers are robustly replicated, and chromatin accessibility outliers are reliable predictors of gene expression outliers and aberrant protein levels. When promoter accessibility does not align with gene expression, our results indicate that molecular aberrations are more likely to be linked to post-transcriptional regulation rather than transcriptional regulation. Our findings demonstrate that the outlier detection paradigm can uncover dysregulated regions in rare diseases. EpiOut is available at github.com/uci-cbcl/EpiOut.

Motion-robust free-running volumetric cardiovascular MRI.

PURPOSE: To present and assess an outlier mitigation method that makes free-running volumetric cardiovascular MRI (CMR) more robust to motion. METHODS: The proposed method, called compressive recovery with outlier rejection (CORe), models outliers in the measured data as an additive auxiliary variable. We enforce MR physics-guided group sparsity on the auxiliary variable, and jointly estimate it along with the image using an iterative algorithm. For evaluation, CORe is first compared to traditional compressed sensing (CS), robust regression (RR), and an existing outlier rejection method using two simulation studies. Then, CORe is compared to CS using seven three-dimensional (3D) cine, 12 rest four-dimensional (4D) flow, and eight stress 4D flow imaging datasets. RESULTS: Our simulation studies show that CORe outperforms CS, RR, and the existing outlier rejection method in terms of normalized mean square error and structural similarity index across 55 different realizations. The expert reader evaluation of 3D cine images demonstrates that CORe is more effective in suppressing artifacts while maintaining or improving image sharpness. Finally, 4D flow images show that CORe yields more reliable and consistent flow measurements, especially in the presence of involuntary subject motion or exercise stress. CONCLUSION: An outlier rejection method is presented and tested using simulated and measured data. This method can help suppress motion artifacts in a wide range of free-running CMR applications.

Chemoinformatic regression methods and their applicability domain.

The growing interest in chemoinformatic model uncertainty calls for a summary of the most widely used regression techniques and how to estimate their reliability. Regression models learn a mapping from the space of explanatory variables to the space of continuous output values. Among other limitations, the predictive performance of the model is restricted by the training data used for model fitting. Identification of unusual objects by outlier detection methods can improve model performance. Additionally, proper model evaluation necessitates defining the limitations of the model, often called the applicability domain. Comparable to certain classifiers, some regression techniques come with built-in methods or augmentations to quantify their (un)certainty, while others rely on generic procedures. The theoretical background of their working principles and how to deduce specific and general definitions for their domain of applicability shall be explained.

Decoding intelligence via symmetry and asymmetry.

Humans use pictures to model the world. The structure of a picture maps to mind space to form a concept. When an internal structure matches the corresponding external structure, an observation functions. Whether effective or not, the observation is self-consistent. In epistemology, people often differ from each other in terms of whether a concept is probabilistic or certain. Based on the effect of the presented IG and pull anti algorithm, we attempt to provide a comprehensive answer to this problem. Using the characters of hidden structures, we explain the difference between the macro and micro levels and the same difference between semantics and probability. In addition, the importance of attention is highlighted through the combination of symmetry and asymmetry included and the mechanism of chaos and collapse revealed in the presented model. Because the subject is involved in the expression of the object, representationalism is not complete. However, people undoubtedly reach a consensus based on the objectivity of the representation. Finally, we suggest that emotions could be used to regulate cognition.

Population genetics and phylogeographic history of the insular lizard Podarcis lilfordi (Gunther, 1874) from the Balearic Islands based on genome-wide polymorphic data.

Islands provide a great system to explore the processes that maintain genetic diversity and promote local adaptation. We explored the genomic diversity of the Balearic lizard Podarcis lilfordi, an endemic species characterized by numerous small insular populations with large phenotypic diversity. Using the newly available genome for this species, we characterized more than 300,000 SNPs, merging genotyping-by-sequencing (GBS) data with previously published restriction site-associated DNA sequencing (RAD-Seq) data, providing a dataset of 16 island populations (191 individuals) across the range of species distribution (Menorca, Mallorca, and Cabrera). Results indicate that each islet hosts a well-differentiated population (F ST = 0.247 ± 0.09), with no recent immigration/translocation events. Contrary to expectations, most populations harbor a considerable genetic diversity (mean nucleotide diversity, P i = 0.144 ± 0.021), characterized by overall low inbreeding values (F IS < 0.1). While the genetic diversity significantly decreased with decreasing islet surface, maintenance of substantial genetic diversity even in tiny islets suggests variable selection or other mechanisms that buffer genetic drift. Maximum-likelihood tree based on concatenated SNP data confirmed the existence of the two major independent lineages of Menorca and Mallorca/Cabrera. Multiple lines of evidence, including admixture and root testing, robustly placed the origin of the species in the Mallorca Island, rather than in Menorca. Outlier analysis mainly retrieved a strong signature of genome differentiation between the two major archipelagos, especially in the sexual chromosome Z. A set of proteins were target of multiple outliers and primarily associated with binding and catalytic activity, providing interesting candidates for future selection studies. This study provides the framework to explore crucial aspects of the genetic basis of phenotypic divergence and insular adaptation.

A GM-JMNS-CPHD Filter for Different-Fields-of-View Stochastic Outlier Selection for Nonlinear Motion Tracking.

Most multi-target movements are nonlinear in the process of movement. The common multi-target tracking filtering methods directly act on the multi-target tracking system of nonlinear targets, and the fusion effect is worse under the influence of different perspectives. Aiming to determine the influence of different perspectives on the fusion accuracy of multi-sensor tracking in the process of target tracking, this paper studies the multi-target tracking fusion strategy of a nonlinear system with different perspectives. A GM-JMNS-CPHD fusion technique is introduced for random outlier selection in multi-target tracking, leveraging sensors with limited views. By employing boundary segmentation from distinct perspectives, the posterior intensity function undergoes decomposition into multiple sub-intensities through SOS clustering. The distribution of target numbers within the respective regions is then characterized by the multi-Bernoulli reconstruction cardinal distribution. Simulation outcomes demonstrate the robustness and efficacy of this approach. In comparison to other algorithms, this method exhibits enhanced robustness even amidst a decreased detection probability and heightened clutter rates.

Outlier detection in spatial error models using modified thresholding-based iterative procedure for outlier detection approach.

BACKGROUND: Outliers, data points that significantly deviate from the norm, can have a substantial impact on statistical inference and provide valuable insights in data analysis. Multiple methods have been developed for outlier detection, however, almost all available approaches fail to consider the spatial dependence and heterogeneity in spatial data. Spatial data has diverse formats and semantics, requiring specialized outlier detection methodology to handle these unique properties. For now, there is limited research exists on robust spatial outlier detection methods designed specifically under the spatial error model (SEM) structure. METHOD: We propose the Spatial-Θ-Iterative Procedure for Outlier Detection (Spatial-Θ-IPOD), which utilizes a mean-shift vector to identify outliers within the SEM. Our method enables an effective detection of spatial outliers while also providing robust coefficient estimates. To assess the performance of our approach, we conducted extensive simulations and applied it to a real-world empirical study using life expectancy data from multiple countries. RESULTS: Simulation results showed that the masking and JD (Joint Detection) indicators of our Spatial-Θ-IPOD method outperformed several commonly used methods, even in high-dimensional scenarios, demonstrating stable performance. Conversely, the Θ-IPOD method proved to be ineffective in detecting outliers when spatial correlation was present. Moreover, our model successfully provided reliable coefficient estimation alongside outlier detection. The proposed method consistently outperformed other models (both robust and non-robust) in most cases. In the empirical study, our proposed model successfully detected outliers and provided valuable insights in the modeling process. CONCLUSIONS: Our proposed Spatial-Θ-IPOD offers an effective solution for detecting spatial outliers for SEM while providing robust coefficient estimates. Notably, our approach showcases its relative superiority even in the presence of high leverage points. By successfully identifying outliers, our method enhances the overall understanding of the data and provides valuable insights for further analysis.

Femoral Coronal Malalignment is Associated With Failure in Mobile-Bearing Medial Unicompartmental Knee Arthroplasty.

BACKGROUND: Femur-first (FF) technique for mobile-bearing medial unicompartmental knee arthroplasty (UKA) has been described as an alternative to tibia-first (TF) technique. The aim of this study was to compare the radiographic results in UKAs using FF or TF techniques and their influence on failure rates. METHODS: We retrospectively reviewed 288 UKAs with a minimum 2-year follow-up. There were 147 knees in the TF and 141 knees in the FF cohorts. Alignment parameters and overhang were assessed as outliers and far outliers. The mean follow-up was 6 years (range, 2 to 16), the mean age was 63 years (range, 27 to 92), and 45% of patients were women. Univariate and multivariate statistical analyses were carried out with Cox regression models. RESULTS: There were 13 and 6 revisions in the TF and FF cohorts, respectively. The FF had lower rates of femoral coronal alignment (FCA) or femoral sagittal alignment outliers compared to the TF (5.7% versus 19%, P = .011). Tibial coronal alignment and tibial sagittal alignment did not significantly differ between the techniques (22.7% in FF versus 29.9% in TF, P = .119). Overhang outliers did not differ significantly between the groups. Younger age was associated with a higher revision rate (P = .006), while FF versus TF, sex, body mass index, and postoperative mechanical axis did not show statistically significant associations. In multivariate analysis, FCA outliers and younger age were significantly associated with revision. CONCLUSIONS: The FF technique in mobile-bearing UKA resulted in fewer FCA outliers compared to TF. Despite improved knee alignment with the FF technique, FCA outliers and younger age were associated with a higher revision rate, independent of technique.