Purpose: Neck of Femur (NOF) fracture is a common injury with high mortality that all orthopaedic departments must contend with [1]. The aim of this study was to report incidence and mortality of NOF fractures occurring while patients were being admitted to hospital for other conditions.Methods: A retrospective review was performed of all NOF fracture admissions between 1st of Jan 2010 to 31st of Dec 2012 at a University Hospital trauma centre. Fractures were divided according to the location where the fracture occurred, either in the community (acute NOF) or in-hospital (in-hospital NOF).Results: In-hospital mortality, 30-day, 90-day and 1 year mortality were recorded. There were 1086 patients in the acute NOF fracture group (93.9%) and 70 patients in the in-hospital group (6.1%) over three years. The odds of inpatient death was 2.25 times higher for inpatient NOFs (p=0.012). 86% of all in-hospital NOF fractures occurred on medical and rehabilitation wards. NOF fractures result in increased mortality and morbidity.Conclusion: All patients in hospital should be assessed to identify those at high risk of falls and implemented measures should be taken to reduce this.

Purpose: To measure and quantitatively characterize an activity generated by the neurons of the visual cortex (VC) in response to graded luminous intensity contrast stimuli using a 1.5 Tesla scanner. Materials and Methods:Functional magnetic resonance imaging (fMRI) of the vc with the intrinsic blood oxygenation level dependent (BOLD) mechanism was performed by using a paradigm with a 5 ϫ 5 flashing checkerboard pattern flickering eight times per second at eight luminance contrasts presented in a randomized order. The changes of the luminance contrast were obtained by varying the luminance intensity of the white checkerboard squares. Each of eight trials, corresponding to eight luminance contrasts, consisted of six "rest" and six "activation" epochs, repeated five times, amounting to 60 measurement periods per trial. During each epoch, 10 contiguous oblique axial-to-coronal slices covering the calcarine fissure region and parallel to a line through the anterior-posterior commissure (AC-PC) markers were acquired using a gradient-recalled echo planar imaging (GRE-EPI) sequence. Results:The measurements showed changes in the activation extent in the VC following the stimulus' rising luminance intensity contrast. In addition, the fMRI signal in those activated areas present throughout all eight trials, referred to as "common" voxels in this report, showed an increasing trend as a function of the rising luminance intensity contrast. Conclusion:These results suggest that the processes of the neuronal recruitment that affects the extent and number of activated neurons, and the neuronal enhancement that defines the magnitude of the neuronal activation are dependent on the luminance intensity contrast. These changes can be visualized and quantified using BOLD fMRI at 1.5 Tesla.

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Introduction Personal protective equipment (PPE) may protect health-care workers from COVID-19 infection and limit nosocomial spread to vulnerable hip fracture patients. Methods We performed a cross-sectional survey amongst orthopaedic trainees to explore PPE practice in 19 hospitals caring for hip fracture patients in the North West of England. Results During the second wave of the pandemic, 14/19 (74%) hospitals experienced an outbreak of COVID-19 amongst staff or patients on the orthopaedic wards. An FFP3 respirator mask was used by doctors in only 6/19 (32%) hospitals when seeing patients with COVID-19 and a cough and in 5/19 (26%) hospitals when seeing asymptomatic patients with COVID-19. A COVID-19 outbreak was reported in 11/13 (85%) orthopaedic units where staff wore fluid resistant surgical masks compared to 3/6 (50%) units using an FFP3 respirator mask (RR 1.69, 95% CI 0.74-3.89) when caring for symptomatic patients with COVID-19. Similarly, a COVID-19 outbreak was reported in more orthopaedic units caring for asymptomatic patients with COVID-19 where staff wore fluid resistant surgical masks (12/14 (86%)) as compared to an FFP3 respirator mask (2/5 (40%)) (RR 2.14, 95% CI 0.72-6.4). Conclusion Urgent re-evaluation of PPE use is required to reduce nosocomial spread of COVID-19, amongst highly vulnerable patients with hip fracture.

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