Negative effects of nitrogen deposition on Swiss butterflies.

Nitrogen (N) deposition from agriculture and combustion of fossil fuels is a major threat to plant diversity, but its effects on organisms at higher trophic levels are unclear. We investigated how N deposition may affect species richness and abundance (number of individuals per species) in butterflies. We reviewed the peer-reviewed literature on variables used to explain spatial variation in butterfly species richness and found that vegetation variables appeared to be as important as climate and habitat variables in explaining butterfly species richness. It thus seemed likely that increased N deposition could indirectly affect butterfly communities via its influence on plant communities. To test this prediction, we analyzed data from the Swiss biodiversity monitoring program for vascular plants and butterflies in 383 study sites of 1 km2 that are evenly distributed throughout Switzerland. The area has a modeled N deposition gradient of 2-44 kg N ha-1 year-1 . We used traditional linear models and structural equation models to infer the drivers of the spatial variation in butterfly species richness across Switzerland. High N deposition was consistently linked to low butterfly diversity, suggesting a net loss of butterfly diversity through increased N deposition. We hypothesize that at low elevations, N deposition may contribute to a reduction in butterfly species richness via microclimatic cooling due to increased plant biomass. At higher elevations, negative effects of N deposition on butterfly species richness may also be mediated by reduced plant species richness. In most butterfly species, abundance was negatively related to N deposition, but the strongest negative effects were found for species of conservation concern. We conclude that in addition to factors such as intensified agriculture, habitat fragmentation, and climate change, N deposition is likely to play a key role in negatively affecting butterfly diversity and abundance.

Efectos Negativos del Depósito de Nitrógeno sobre las Mariposas Suizas Resumen El depósito de nitrógeno (N) proveniente de la agricultura y la quema de combustibles fósiles es una gran amenaza para la diversidad botánica, pero sus efectos sobre organismos que se encuentran en niveles tróficos más altos no están claros. Investigamos cómo el depósito de N puede afectar a la riqueza y abundancia (número de individuos por especie) de especies de mariposas. Analizamos la literatura revisada por pares sobre las variables usadas para explicar la variación espacial en la riqueza de especies de mariposas y descubrimos que las variables de vegetación resultaron ser tan importantes como las variables climáticas y de hábitat para explicar la riqueza de especies de mariposas. Por lo tanto, parece probable que el incremento en el depósito de N podría afectar indirectamente a las comunidades de mariposas por medio de su influencia sobre las comunidades botánicas. Para probar esta predicción analizamos datos del programa de monitoreo de biodiversidad suiza de plantas vasculares y mariposas en 383 sitios de estudio de 1 km2 que están distribuidos uniformemente por toda Suiza. El área tiene un gradiente modelado de depósito de N de 2-44 kg N ha−1 año−1 . Usamos modelos lineales tradicionales y modelos de ecuación estructural para inferir los determinantes de la variación espacial en la riqueza de especies de mariposas en Suiza. El nivel elevado de depósito de N estuvo vinculado consistentemente con la diversidad baja de mariposas, lo que sugiere una pérdida neta de diversidad de mariposas causada por el incremento en el depósito de N. Nuestra hipótesis establece que, a elevaciones bajas, el depósito de N puede contribuir a la reducción en la riqueza de especies de mariposas por medio del enfriamiento microclimático debido al incremento en la biomasa de las plantas. A elevaciones más altas, los efectos negativos del depósito de N sobre la riqueza de especies de mariposas también podrían ser mediados por la riqueza reducida de especies de plantas. En la mayoría de las especies de mariposas, la abundancia tuvo una relación negativa con el depósito de N, pero el efecto negativo más fuerte se halló para las especies de importancia para la conservación. Concluimos que además de los factores como la agricultura intensificada, la fragmentación del hábitat y el cambio climático, el depósito de N probablemente tenga un papel importante en los efectos negativos sobre la diversidad y abundancia de mariposas.

Does the type of surgical approach affect the clinical outcome of total knee arthroplasty?

BACKGROUND: The aim of the study was to investigate the issue of medial midvastus (MMV) vs. medial parapatellar (MPP) approaches in total knee arthroplasty (TKA). It was hypothesized that the two surgical approaches would produce significantly different results with respect to patient-reported knee score outcome (hypothesis 1), short-term postoperative range of motion (ROM) (hypothesis 2), long-term postoperative ROM (hypothesis 3) and prosthesis survival (hypothesis 4). METHODS: A retrospective comparative study design was applied. Data sets were obtained from the state arthroplasty registry. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) data were analyzed from preoperative and 1 year postoperatively. The ROM data were analyzed for the time points preoperative, postoperative days 4 and 10 and 1 year. RESULTS: Available were 627 cases (407 MMV vs. 220 MPP) and 1 year postoperatively there were no significant differences between groups regarding the WOMAC scores (hypothesis 1). Early postoperatively on days 4 and 10 after TKA there were no differences between groups (p = 0.305 and p = 0.383, respectively, hypothesis 2). Likewise, ROM did not significantly differ between the groups 1 year after TKA (p = 0.338, hypothesis 3). The 5­year prosthesis survival did not differ between the groups and showed 94.46% (95% confidence interval, CI 90.69-96.73%) in the MMV group and 94.33% (95% CI 89.96-96.83%) in the MPP group (p = 0.664, hypothesis 4). CONCLUSION: Both surgical approaches produce equivalent clinical results in terms of early postoperative ROM, late postoperative ROM and 1­year WOMAC. The same prosthesis survival rates can be expected.

Treatment of tibial nonunion with bone defect using a heterotopic ossification as autologous bone graft: literature overview and case report.

INTRODUCTION: Nonunion after open fracture of the lower leg is a frequent complication with a prevalence of up to 40%. In cases with major bone defects, revision of the osteosynthesis with bone grafting is commonly performed. Until today, there is no report on treatment of a tibial nonunion with transplantation of a heterotopic ossification. PRESENTATION OF CASE: We present a case of a 27-year-old male patient, who suffered from a paragliding accident with major injuries. An open fracture of the lower leg (Gustilo-Anderson IIIB) was initially treated with external fixation and vacuum-assisted closure, followed by reamed intramedullary nailing. The tibia resulted in a bone defect situation with nonunion. It was successfully treated with revision, fibular osteotomy and transplantation of a heterotopic ossification, harvested from the ipsilateral hip. CONCLUSION: In special cases, autologous transplantation of a mature heterotopic ossification is an attractive bone graft option in treating nonunion defects.

Estimating Effects of Species Interactions on Populations of Endangered Species.

Global change causes community composition to change considerably through time, with ever-new combinations of interacting species. To study the consequences of newly established species interactions, one available source of data could be observational surveys from biodiversity monitoring. However, approaches using observational data would need to account for niche differences between species and for imperfect detection of individuals. To estimate population sizes of interacting species, we extended N-mixture models that were developed to estimate true population sizes in single species. Simulations revealed that our model is able to disentangle direct effects of dominant on subordinate species from indirect effects of dominant species on detection probability of subordinate species. For illustration, we applied our model to data from a Swiss amphibian monitoring program and showed that sizes of expanding water frog populations were negatively related to population sizes of endangered yellow-bellied toads and common midwife toads and partly of natterjack toads. Unlike other studies that analyzed presence and absence of species, our model suggests that the spread of water frogs in Central Europe is one of the reasons for the decline of endangered toad species. Thus, studying population impacts of dominant species on population sizes of endangered species using data from biodiversity monitoring programs should help to inform conservation policy and to decide whether competing species should be subject to population management.

Development and initial evaluation of a point-of-care educational app on medical topics in orthogeriatrics.

INTRODUCTION: Research by AOTrauma's orthogeriatrics education taskforce identified ongoing educational needs for surgeons and trainees worldwide regarding the medical management of older adults with a fracture. To address practicing surgeons' preference for increased use of mobile learning, a point-of-care educational app was planned by a committee of experienced faculty. The goals were to deliver the app to surgeons, trainees, and other healthcare professionals, to measure usage, and to evaluate the impact on patient care. MATERIALS AND METHODS: The committee of geriatricians and surgeons designed and developed four modules on osteoporosis, delirium, anticoagulation, and pain based on published evidence and the content was programmed into mobile app formats. A registration form was integrated and a 14-question online evaluation survey was administered to users. RESULTS: The AOTrauma Orthogeriatrics app was installed by 17,839 users worldwide between September 2014 and October 2015: Android smartphones (44%), iPhones (32%), iPads (15%), Android tablets (9%). 920 users registered and 100 completed the online evaluation: orthopedic/trauma surgeons (67%), residents/fellows (20%), and other professionals (13%). Ratings for all aspects were 4 or higher on a 1-5 Likert scale (5 = Excellent). 80% of evaluation respondents found the answer to their question or educational need on their last visit, and 26 of 55 respondents (47%) reported making a change in an aspect of their management of patients as a result of their learning from the app. CONCLUSION: The orthogeriatrics app reached its intended audiences and was rated highly as a method of providing education to help improve patient care. Content input by experienced faculty and app improvements based on user feedback were key contributors to successful implementation.

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures.

INTRODUCTION: Postoperative complications after hip fractures in osteoporotic bone such as implant cutout can be reduced by the use of specially designed implants or additional cement augmentation. It is not yet clear at which degree of osteoporosis, patients will profit from implant augmentation or specially designed implants for geriatric patients. As the surgeon ideally should obtain information on local bone quality at the site of implant anchorage already preoperatively, the aim of the study was to develop an easily applicable radiographic method to estimate bone quality in those patients. MATERIALS AND METHODS: 75 patients with unilateral hip fracture were included. Preoperatively, a CT scan with a calibration device was conducted. Postoperatively, DXA scans were performed. The proposed method measures local cancellous bone mineral density in the contralateral and uninjured femoral head. As a control, 15 young and healthy non-osteoporotic subjects were included. Inter- and intraobserver reliability was investigated for a subgroup of 20 patients. RESULTS: Study group patients had a mean BMD measured by CT scans of 194.2 mg/cm(3) (SD 40.4). There was a statistically significant correlation with data from DXA scans (r = 0.706, p < 0.001). The control group was significantly younger and showed a significantly higher BMD when compared to the study group (p < 0.001). Reliability evaluation showed no statistically significant difference in inter- and intraobserver measurements. Interclass correlation proved to be very high. CONCLUSION: The proposed method is an easily applicable, reliable and useful tool to estimate bone quality preoperatively using the contralateral hip as a reference. Obtained data may facilitate the decision-making towards the use of further therapeutic measures to improve implant anchorage in osteoporotic bone such as bone cement augmentation. Thus, our method allows for a more individualized surgical treatment of hip fracture patients adapted to the estimated cancellous bone quality of the patient.

Estimating unbiased phenological trends by adapting site-occupancy models.

As a response to climate warming, many animals and plants have been found to shift phenologies, such as appearance in spring or timing of reproduction. However, traditional measures for shifts in phenology that are based on observational data likely are biased due to a large influence of population size, observational effort, starting date of a survey, or other causes that may affect the probability of detecting a species. Understanding phenological responses of species to climate change, however, requires a robust measure that could be compared among studies and study years. Here, we developed a new method for estimating arrival and departure dates based on site-occupancy models. Using simulated data, we show that our method provided virtually unbiased estimates of phenological events even if detection probability or the number of sites occupied by the species is changing over time. To illustrate the flexibility of our method, we analyzed spring arrival of two long-distance migrant songbirds and the length of the flight period of two butterfly species, using data from a long-term biodiversity monitoring program in Switzerland. In contrast to many birds that migrate short distances, the two long-distance migrant songbirds tended to postpone average spring arrival by -0.5 days per year between 1995 and 2012. Furthermore, the flight period of the short-distance-flying butterfly species apparently became even shorter over the study period, while the flight period of the longer-distance-flying butterfly species remained relatively stable. Our method could be applied to temporally and spatially extensive data from a wide range of monitoring programs and citizen science projects, to help unravel how species and communities respond to global warming.

Warming underpins community turnover in temperate freshwater and terrestrial communities.

Rising temperatures are leading to increased prevalence of warm-affinity species in ecosystems, known as thermophilisation. However, factors influencing variation in thermophilisation rates among taxa and ecosystems, particularly freshwater communities with high diversity and high population decline, remain unclear. We analysed compositional change over time in 7123 freshwater and 6201 terrestrial, mostly temperate communities from multiple taxonomic groups. Overall, temperature change was positively linked to thermophilisation in both realms. Extirpated species had lower thermal affinities in terrestrial communities but higher affinities in freshwater communities compared to those persisting over time. Temperature change's impact on thermophilisation varied with community body size, thermal niche breadth, species richness and baseline temperature; these interactive effects were idiosyncratic in the direction and magnitude of their impacts on thermophilisation, both across realms and taxonomic groups. While our findings emphasise the challenges in predicting the consequences of temperature change across communities, conservation strategies should consider these variable responses when attempting to mitigate climate-induced biodiversity loss.

Thermophilisation of communities differs between land plant lineages, land use types and elevation.

Bryophytes provide key ecosystem services at the global scale such as carbon storage and primary production in resource limited habitats, but compared to vascular plants knowledge on how these organisms face recent climate warming is fragmentary. This is particularly critical because bryophytes differ fundamentally from vascular plants in their ecophysiological and biological characteristics, so that community alterations most likely have different dynamics. In a comparative approach, we analysed thermophilisation of bryophyte and vascular plant communities in 1146 permanent plots distributed along an elevational gradient of nearly 3.000 m in Switzerland (Central Europe) that were visited in 5-years intervals between 2001 and 2021. We estimated thermophilisation from changes in unweighted mean temperature indicator values of species, compared it to expected thermophilisation rates given the shift of isotherms and addressed differences between the two lineages, major land use types (managed grasslands, forests, unmanaged open areas), life strategy types (long- and short-lived species) and in elevation. Thermophilisation of bryophyte communities was on average 2.1 times higher than of vascular plant communities and at high elevations it approximated the expected rate given the shift of isotherms. Thermophilisation of both, bryophyte and vascular plant communities was not driven by a loss of cryophilic species but by an increase in thermophilic and mesophilic species, indicating an in-filling process. Furthermore, our data show that thermophilisation is higher in managed grasslands than in forests. We suggest that the higher responsiveness of bryophytes compared to vascular plants depends on their poikilohydry and dispersal capacity and that lower thermophilisation of forests communities is related to the buffering effect of microclimatic conditions in the interior of forests. Our study emphasises the heterogeneity of climate warming effects on plants because response dynamics differ between taxonomic groups as well as between land use types and along elevational gradients.

The cumulative impacts of droughts and N deposition on Norway spruce (Picea abies) in Switzerland based on 37 years of forest monitoring.

Norway spruce is one of the most important tree species in Central Europe, however, it is facing major problems with recent droughts. In this study we present 37 years (1985-2022) of long-term forest observation data on 82 different forest sites across Switzerland including 134'348 tree observations. The sites consists of managed spruce or mixed forest stands with beech (Fagus sylvatica) and comprise large gradients in altitude (290-1870 m), precipitation (570-2448 mm a-1), temperature (3.6-10.9 °C) or total nitrogen deposition (8.5-81.2 kg N ha-1 a-1). Long-term tree mortality has increased more than fivefold due to the multiple drought years 2019, 2020 and 2022, which is more than double the increase following the 2003 drought. We used a Bayesian multilevel model including three years of lagged drought indicator to predict spruce mortality. Besides stand age, the most important factors were drought and N deposition. Especially under drought conditions spruce mortality was increased on sites with high N deposition. Moreover, N deposition increased the imbalance of foliar phosphorus concentrations, with negative impacts on tree mortality. Mortality was increased by a factor of 1.8 in spruce compared to mixed beech and spruce stands. Stands with high mortality rates showed previously an increased proportion of trees with damaged crowns, especially after the droughts of 2003 and 2018. Taken together, we found evidences of an increase in spruce mortality droughts amplified under high N depositions. The perennial drought of 2018-2020 resulted in a cumulative spruce mortality of 12.1 % (564 dead trees in 82 sites) in only three years. With a Bayesian change-point regression framework we estimated a critical empirical load for nitrogen of 10.9 ± 4.2 kg N ha-1 a-1, which is in line with current thresholds, above which future plantings of spruce in Switzerland may not be a sustainable option due to the observed interaction between drought and nitrogen deposition.

The epidemiology of sports-related injuries in older adults: a central European epidemiologic study.

BACKGROUND AND AIMS: The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. METHODS: Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. RESULTS: A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. CONCLUSION: Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.

Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data.

BACKGROUND: Osteoporotic fractures of the proximal humerus show an increasing incidence. Osteoporosis not only influences the fracture risk after low-energy trauma, but also affects the mechanical stability of internal fixation. Preoperative assessment of the local bone quality may be useful in the surgical treatment of patients sustaining these injuries. The aim of the present study was to present a method for the preoperative assessment of the local cancellous bone mineral density (BMD) of the proximal humerus using CT data. METHODS: In the first part of the study, CT scans of 30 patients with unilateral fractures of the proximal humerus after low-energy trauma were used. The local BMD was assessed on the contralateral uninjured side. All 30 patients additionally underwent dual-emission X-ray absorptiometry (DXA) of the lumbar spine, proximal femur, and forearm of the side of the uninjured proximal humerus within 6 weeks after trauma. Three independent trauma surgeons performed measurements on the uninjured proximal humerus twice with a time interval of 4 weeks in order to assess the inter- and intraobserver reliability of the method. In the second part of the study, the local BMD of 507 patients with either proximal humerus fractures or chronic shoulder instability was assessed by a single trauma surgeon. In both parts, the average HU values in standardized ROIs of the humeral head were automatically calculated after correcting for HU values below the water equivalent. A linear calibration equation was computed for the calculation from HU to BMD using a calibration device (EFP). RESULTS: The intra- and interobserver reliability was high (ICC > 0.95). Correlation coefficients between the local BMD of the proximal humerus and other anatomical sites were between 0.35 (lumbar spine) and 0.64 (forearm). We found a high correlation between the local BMD and age. The BMD in the fracture group was significantly lower than in the instability group. These patients were significantly older and more likely to be female. CONCLUSION: Our method may provide a preoperative tool for the assessment of the local bone quality of the proximal humerus using CT data. Therapeutic adjustments such as augmentation or primary arthroplasty may be considered in patients with very low local BMD.

Temporal changes in the Swiss flora: implications for flower-visiting insects.

BACKGROUND: Local floristic diversity has massively decreased during the twentieth century in Central Europe even though in the 1990s diversity began increasing again in several regions. However, little is known whether this increase is equally distributed among plant groups with different reproductive traits. METHODS: Our study is based on data of the Swiss Biodiversity Monitoring Program. In this program, plant species occurrence is recorded since 2001 in 450 regularly distributed 1 km2 study sites. For all 1774 plant species registered in the study, we researched data on flower/pseudanthium type and colour, reproductive system, and groups of flower visitors. We then tested whether temporal changes in species frequency were equally distributed among species with different trait states. RESULTS: Species richness and functional richness significantly increased in the study sites while functional evenness decreased. The frequency of wind-pollinated species increased more strongly than that of insect-pollinated species. Further, the frequency of species with simple, open insect-pollinated flowers and pseudanthia visited by generalist groups of insects increased slightly more strongly than the frequency of species with complex flowers visited by more specialized groups of flower visitors. Additionally, the frequency of self-compatible species increased significantly more than that of self-incompatible species. Thus, the overall increase in local plant species richness in Switzerland is mostly driven by wind- and generalist insect-pollinated, self-compatible species. In contrast, species with complex flowers, which are essential for specialized groups of flower visitors and species with self-incompatible reproductive systems profited less. CONCLUSIONS: Our study thus emphasizes the need to consider functional traits in the planning and monitoring of conservation activities, and calls for a special focus on plant species with specialized reproductive traits.

Hierarchical change-point regression models including random effects to estimate empirical critical loads for nitrogen using Bayesian Regression Models (brms) and JAGS.

The concept of critical loads is used in the framework of the Convention on Long-range Transboundary Air Pollution (UNECE) to define thresholds below which no damaging effects on habitats occur based on the latest scientific knowledge. Change-point regression models applied in a Bayesian framework are useful statistical tools to estimate critical empirical loads. While hierarchical study designs are common in ecological research, previous methods to estimate critical loads using change-point regression did not allow to analyse data collected under such a design. This method update provides an implementation of hierarchical data structure by including random effects such as study sites or as in this example tree species within the Bayesian approach of change-point regression models using two different approaches. The example data set is an European wide gradient study of the impact of climate change and air pollution on forest tree health assessed by foliar nutrient status of nitrogen (N) to phosphorus (P) from 10 different conifer tree species originated from 88 forest sites and 9 countries covering 22 years (1995-2017). Both modelling approaches using JAGS and Bayesian Regression Models using 'Stan' (brms) resulted in reasonable and similar estimations of the critical empirical load for nitrogen (CLempN) for temperate forests. These methodological examples of using different approaches of Bayesian change-point regression models dealing with random effects could prove useful to infer CLempN for other ecosystems and long-term data sets.•Hierarchical change-point regression models are suitable for estimating critical empirical loads.•The Bayesian framework of these models provides the inclusion of the current critical load and various confounding or modifying variables.•Here we present two ways of implementing hierarchical data sets in Bayesian change-point regression models using JAGS and brms.

Different roles of concurring climate and regional land-use changes in past 40 years' insect trends.

Climate and land-use changes are main drivers of insect declines, but their combined effects have not yet been quantified over large spatiotemporal scales. We analysed changes in the distribution (mean occupancy of squares) of 390 insect species (butterflies, grasshoppers, dragonflies), using 1.45 million records from across bioclimatic gradients of Switzerland between 1980 and 2020. We found no overall decline, but strong increases and decreases in the distributions of different species. For species that showed strongest increases (25% quantile), the average proportion of occupied squares increased in 40 years by 0.128 (95% credible interval: 0.123-0.132), which equals an average increase in mean occupancy of 71.3% (95% CI: 67.4-75.1%) relative to their 40-year mean occupancy. For species that showed strongest declines (25% quantile), the average proportion decreased by 0.0660 (95% CI: 0.0613-0.0709), equalling an average decrease in mean occupancy of 58.3% (95% CI: 52.2-64.4%). Decreases were strongest for narrow-ranged, specialised, and cold-adapted species. Short-term distribution changes were associated to both climate changes and regional land-use changes. Moreover, interactive effects between climate and regional land-use changes confirm that the various drivers of global change can have even greater impacts on biodiversity in combination than alone. In contrast, 40-year distribution changes were not clearly related to regional land-use changes, potentially reflecting mixed changes in local land use after 1980. Climate warming however was strongly linked to 40-year changes, indicating its key role in driving insect trends of temperate regions in recent decades.

Long-term functional outcome in geriatric hip fracture patients.

BACKGROUND: Fragility fractures are a major health care problem worldwide. The proportion of the geriatric population and the overall life expectancy will increase. Hip fractures are the most common fragility fractures needing surgery and nowadays treatment concepts are changing. We studied the long-term functional outcome and their influencing factors in patients treated without any interdisciplinary aspects. DESIGN AND SETTING: A retrospective cohort study with functional long-term follow-up examination was carried out in a level one trauma centre on hip fracture patients 80 years old and above treated without any formalized interdisciplinary aspects ("usual care"). PATIENTS: Of 281 consecutive patients who were treated 2005 and 2006 with usual care, 246 patients with a mean age of 86.8 years met our inclusion criteria. 69.1% died within the study period of 4.9 years. On the remaining patients, the residential status, the Barthel Index and the Parker Score were assessed. RESULTS: The mean Barthel Index was 49.6 and the mean Parker Score was 2.7. More than one-fourth of the survivors were found to be bedridden and 45% were not able to walk outside. 88% are bound to one floor and only 8% are able to walk unaided. Patients with more comorbidities and patients with subsequent fractures had significant higher mortality rates. Patients with trochanteric fractures had significant better functional outcome scores compared to patients with femoral neck fractures. Nursing home residents showed significant higher mortality rates and lower functional outcome scores. Patients who were transferred to a nearby acute geriatric hospital for further treatment had significantly higher functional outcome scores. CONCLUSION: This paper shows the frustrating long-term outcome of geriatric hip fracture patients but it also suggests that an early geriatric intervention may lead to better function.

Environmental and Anthropogenic Factors Shape Major Bacterial Community Types Across the Complex Mountain Landscape of Switzerland.

Mountain areas harbor large climatic and geographic gradients and form numerous habitats that promote high overall biodiversity. Compared to macroorganisms, knowledge about drivers of biodiversity and distribution of soil bacteria in mountain regions is still scarce but a prerequisite for conservation of bacterial functions in soils. An important question is, whether soil bacterial communities with similar structures share environmental preferences. Using metabarcoding of the 16S rRNA gene marker, we assessed soil bacterial communities at 255 sites of a regular grid covering the mountainous landscape of Switzerland, which is characterized by close location of biogeographic regions that harbor different land-use types. Distribution of bacterial communities was mainly shaped by environmental selection, as revealed by 47.9% variance explained by environmental factors, with pH (29%) being most important. Little additional variance was explained by biogeographic regions (2.8%) and land-use types (3.3%). Cluster analysis of bacterial community structures revealed six bacterial community types (BCTs), which were associated to several biogeographic regions and land-use types but overall differed mainly in their preference for soil pH. BCT I and II occurred at neutral pH, showed distinct preferences for biogeographic regions mainly differing in elevation and nutrient availability. BCT III and IV differed only in their preferred soil pH. BCT VI occurred in most acidic soils (pH 3.6) and almost exclusively at forest sites. BCT V occurred in soils with a mean pH of 4 and differed from BCT VI in preference for lower values of organic C, total nitrogen and their ratio. Indicator species and bipartite network analyses revealed 3,998 OTUs associating to different levels of environmental factors and BCTs. Taxonomic classification revealed opposing associations of taxa deriving from the same phyla. The results revealed that pH, land-use type, biogeographic region, and nutrient availability were the main factors shaping bacterial communities across Switzerland. Indicator species and bipartite network analyses revealed environmental preferences of bacterial taxa. Combining information of environmental factors and BCTs yielded increased resolution of the factors shaping soil bacterial communities and provided an improved biodiversity framework. OTUs exclusively associated to BCTs provide a novel resource to identify unassessed environmental drivers.

Band-structure-dependent demagnetization in the Heusler alloy Co2Mn(1-x)FexSi.

We investigate the ultrafast demagnetization for two Heusler alloys (Co2Mn(1-x)FexSi) with a different lineup of the minority band gap and the Fermi level. Even though electronic spin-flip transitions are partially blocked by the band gap in one compound, the respective magnetization dynamics, as measured by the time-resolved Kerr effect, are remarkably similar. Based on a dynamical model that includes momentum and spin-dependent carrier scattering, we show that the magnetization dynamics are dominated by hole spin-flip processes, which are not influenced by the gap.

Texture analysis, bone mineral density, and cortical thickness of the proximal femur: fracture risk prediction.

OBJECTIVE: The objectives of this study were to perform a clinical study analyzing bone quality in multidetector computed tomographic images of the femur using bone mineral density (BMD), cortical thickness, and texture algorithms in differentiating osteoporotic fracture and control subjects; to differentiate fracture types. METHODS: Femoral head, trochanteric, intertrochanteric, and upper and lower neck were segmented (fracture, n = 30; control, n = 10). Cortical thickness, BMD, and texture analysis were obtained using co-occurrence matrices, Minkowski dimension, and functional and scaling index method. RESULTS: Bone mineral density and cortical thickness performed best in the neck region, and texture measures performed best in the trochanter. Only cortical thickness and texture measures differentiated femoral neck and intertrochanteric fractures. CONCLUSIONS: This study demonstrates that differentiation of osteoporotic fracture subjects and controls is achieved with texture measures, cortical thickness, and BMD; however, performance is region specific.

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients.

BACKGROUND: As the world population ages, the number of hip-related fractures in the elderly is steadily increasing. These fractures generate a major worldwide healthcare problem and frequently lead to deterioration of life quality, mobility and independence in activity of daily life of geriatric patients. At present, many studies have investigated and proved benefits of multidisciplinary orthogeriatric care for elderly hip-fracture patients. Only few studies however, have analyzed treatment concepts for those patients directly following discharge from hospital in specialized rehabilitation centers. The aim of this study was to evaluate effects of a multidisciplinary inpatient rehabilitation on the short- and long-term functional status of geriatric patients who suffered from hip fracture. METHODS: A total of 161 hip-fracture patients aged 80 years and above, or additionally 70 years and above suffering from age-typical multimorbidity were included in this study. Patients who had an initial Barthel Index lower than 30 points were excluded from this study, as most of these patients were not able to attend a therapy at the rehabilitation center due to a poor functional status. The patients were separated into two subgroups dependent on the availability of treatment spots at the rehabilitation center. No other item was used to discriminate between the groups. Group A (n = 95) stayed an average of 21 days at an inpatient rehabilitation center that specialized in geriatric patients. Group B (n = 66) underwent the standard postoperative treatment and were sent home with further treatment by their general practitioner, nursing staff and physiotherapists. To evaluate the patients' functional status over the course of time we used the Barthel Index, which was evaluated for every patient on the day of discharge, as well as during checkups after 3, 6 and 12 months. RESULTS: The average Barthel Index at the day of discharge was 57.79 ± 14.92 points for Group A and 56.82 ± 18.76 points for Group B (p = 0.431). After 3 months, the average Barthel Index was 82.43 points for Group A and 73.11 points for group B (p = 0.005). In the 6-month checkup Group A's average Barthel Index was 83.95 points and Group B's was 74.02 points (p = 0.002). After 12 months, patients from Group A had an average Barthel Index of 81.21 while patients from Group B had an average Barthel Index of 69.85 (p = 0.005). CONCLUSION: The results of this study reveal a significantly better outcome concerning both, short-term and long-term functional status after 3, 6 and 12 months for geriatric hip-fracture patients, who underwent an inpatient treatment in a rehabilitation center following the initial therapy.