In cynomolgus and rhesus monkeys high levels of antibodies could be achieved in a dose dependent fashion, with a robust memory CD4 recall response to TpD in all animals that received sufficient doses of

vaccine. For mouse experiments female 6–8-week-old Balb/C mice (Jackson Laboratories) were housed and handled at Vivisource (Cambridge, MA) in accordance to Institutional Animal Care and Use Committee (IACUC) requirements. For vaccine injections, mice were injected subcutaneously with a single www.selleckchem.com/products/cb-839.html bolus of nanoparticle preparations in PBS (50 μl/limb). Mice were injected 3 times (1 prime and 2 boosts immunizations) with 2-week intervals between immunizations. For serum collection, blood was collected by lateral tail vain bleeding 12 days after each immunization and after that as indicated. At the termination of the experiment, mice were euthanized by CO2 asphyxiation and blood collected by cardiac puncture. For long term memory recall assays Balb/C mice were inoculated on days 0, 14 and 28 with nicotine nanoparticles containing R848 and either TpD or ovalbumin 323–339 (Ova) peptide. Spleens were harvested between 122 and 152

days after final inoculation and both CD4+ and CD11c+ cells were isolated Selleck Bcl-2 inhibitor directly ex vivo by MACS cell separation system (Miltenyi, Cambridge, MA). Cells were incubated at 37 °C at a 10:1 ratio (500,000 CD4 T cells to 50,000 dendritic cells) with 10uM peptide. Supernatants were harvested 18 h later and assayed for IFN-γ by ELISA. For Rhesus macaques (Macaca mulatta) experimental procedures as outlined in Harvard Medical Associates standing committee on animal’s protocol # 04758 were followed throughout the study. The study followed The Public Health Service (PHS) Policy CYTH4 on Humane Care and Use of Laboratory Animals, and was administered in accordance with IACUC requirements. Four, three year old Rhesus macaques received a total of three vaccinations at 4-week intervals. At each procedure time point, the animals were sedated with 10 mg/kg ketamine-HCl administered intramuscularly. 1 mL of the test substance was administered via the subcutaneous route. Briefly,

the skin on the quadriceps was shaved, wiped with alcohol and allowed to dry. The immunizing material was then administered via a 23 gauge, 1-inch needle. The animals were monitored and returned to their home cage when awake. The animals were weighed when sedated for each procedure. Blood samples (in 10 mL round bottom tubes with EDTA; used for ELISPOT) and 5 mL of serum (used for antibody analysis) were collected at approximately bi-weekly intervals. For the cynomolgus monkey study, animal welfare was in compliance with the U.S. Department of Agriculture’s (USDA) Animal Welfare Act (9 CFR Parts 1–3). The Guide for the Care and Use of Laboratory Animals, Institute of Laboratory Animal Resources, National Academy Press, Washington, D.C., 1996, was followed. The non-clinical laboratory (MPI Research, Inc.

The high effectiveness against both G1P[8] and G2P[4] suggests that the predominance of G2P[4] is most likely a cyclical pattern selleck chemical of rotavirus strains occurrence in Brazil

as previously reported [38] and [39]. This study avoided the possibility of artificially reducing effectiveness by using controls without diarrhea rather than controls with diarrhea and (potential false) no rotavirus in stool. Using EIA, PAGE and RT-PCR we confirmed that all cases were true cases of RV-A. The data collection strategy allowed us to obtain individual data, to control for possible confounding and verify interactions in overall VE. After controlling for seven variables, no confounding was identified. We were unable to investigate either if effectiveness declines after two years of second dose vaccine or whether there is an interaction with oral poliovirus vaccine as the two vaccines are given at the same time. We assumed non differential missingness in the sensitivity analysis. Although

this was a case control study recall bias is not relevant because we did not rely on recall of vaccination; we used a record (vaccine card) for establishment of the main exposure. Only 73% of genotypes of the RV-A positive sample were identified. This could hide the circulation of other genotypes, although, we were able to estimate genotype-specific VE for the most common circulating strains. Selleckchem Lumacaftor In conclusion, we showed consistent effectiveness of two-dose oral monovalent vaccine in preventing hospital admissions of Brazilian children with RV-A AD, closer to European than Africa VE. Protection lasted for two years and it was similar against G1P[8] and G2P[4] and slightly lower against non G1/G2.The first dose already conferred some protection. The findings of the study supports the continued use of rotavirus in the Brazilian National Immunization Thalidomide Program and the monitoring for early detection of emergence of unusual and novel rotavirus genotypes. Since this vaccine (which requires only two doses and is co-administered with other vaccines) provides adequate protection,

the benefits of a change to a multivalent vaccine requiring three doses might are questionable: this may not increase protection and lead to incomplete vaccination schemes. It might be useful to conduct cost-effectiveness studies to inform national immunization policy. In addition, other effectiveness studies should investigate what is behind the observed variation in monovalent rotavirus vaccine VE. Finally, it is important to identify early emergence of unusual and novel rotavirus genotypes so that the vaccine effectiveness can be verified. All authors confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could influence its outcome. MYTI designed the study, managed the field work, analyzed and interpreted the data and wrote the paper.

Ethanol first pass metabolism occurs in the gut wall primarily by alcohol dehydrogenases, and in the liver also through CYP2E1 ( Lieber and Abittan, 1999). The latter has been shown to Selleckchem SAR405838 metabolize other drugs such as theophylline and acetaminophen, and is inhibited by disulfiram. The findings obtained in this study support that the increased levels of propoxyphene most likely is an effect of interactions at the metabolic level. Propoxyphene

is a weak base with a pKa of ∼9.5 and hence, will be completely ionized in both the gastric and intestinal compartment. Experimental results of other such model compounds studied herein and previously ( Fagerberg et al., 2010) predict that ethanol will not increase the solubility of propoxyphene and this factor will Dabrafenib therefore not affect the absorption. Another physiological factor affected by ethanol intake is the gastric emptying rate. Ethanol delays gastric emptying rate compared to intake of e.g. water, but the extent to which seems to be dependent on several different factors and e.g. gender (Horikoshi et al., 2013), alcohol concentration and type of alcohol containing beverage (Franke et al., 2004) that is ingested have been suggested to affect emptying rate.

The complex interplay between alcohol containing beverages and gastric emptying rate made us decide to use the fasted state gastric emptying rate defined in the GI-Sim during simulations. A delayed transport of drug from the gastric compartment would likely reduce the absorption rate and increase Tmax. On the other hand, the delay could lead to more of the dose reaching

the absorptive compartments of the small intestine in solution rather than as solid particles. If so, all compounds with high solubility in gastric media (whether because of ionization or increased solubility with ethanol) should show increased absorption. Indeed a large number of pharmacokinetic and pharmacodynamic interactions between ethanol and drugs have been reported in the literature see e.g. ( Carnitine palmitoyltransferase II Fraser, 1997 and Weathermon and Crabb, 1999). However, the focus of this study was to reveal the effect that changes in solubility have on the resulting absorption and for this reason, only this parameter was allowed to influence the simulations. The compounds selected for this study were selected as model compounds on the basis of their diverse physicochemical properties and not that increased absorption rate would potentially lead to serious ADRs. A significant Sapp increase due to the presence of ethanol in the intestinal fluid does not necessarily imply that ADRs will occur if the drugs are taken together with liquor. Instead it should be viewed as one risk indicator among many.

In consideration of these findings, SipC seems to be a promising candidate as a protective antigen. Because the N-terminal region of SipC may cause the insolubility of recombinant proteins and does not include the T cell epitope, the amino acid residues from 201 to 409, selleck products corresponding

to the C-terminus of SipC (cSipC), were used in this study. Two types of cSipC fusion proteins, conjugated to either the N-terminus or C-terminus of FliC, were constructed in order to determine any differences in their immunogenicity. The present study attempted to evaluate the immunological properties of recombinant L. casei producing fusion antigens composed of FliC and cSipC in vitro and in vivo. An innate immune response through TLR5 was determined using human intestinal Caco-2 epithelial cells. Caco-2 cells express TLR5 and are responsive to flagellin [17] but are not responsive to TLR2 or TLR4 agonists due to the absence of TLR4

expression and the low expression level of TLR2, TLR1, and TLR6 [18], [19] and [20]. TLR5-stimulating activity was detected by the release of interleukin 8 (IL-8) from a Caco-2 cell culture [21]. Induction of acquired immunity was determined by parenteral immunization of mice followed by detection of antigen-specific Sotrastaurin nmr antibodies and cytokines. A list of recombinant strains used in the present study is shown in Table 1. A plasmid-free strain of L. casei IGM393 and recombinant strains including a FliC-expressing strain (LCF) and a non-expressing control strain carrying pLPEmpty (LCN),

which were constructed in Metalloexopeptidase the previous study, were grown in de Mann Rogosa and Sharpe (MRS) broth (Difco). Erythromycin (5 μg/ml) was added to MRS only for recombinant strains. As described previously, Lactobacillus-carrying medium (LCM) supplemented with 1% mannitol and 5 μg/ml erythromycin was used for induction of the expression of heterologous antigens [5]. A human clinical isolate of Salmonella enterica serovar Enteritidis (SE) #40 [22] was cultured in Luria–Bertani (LB) broth (Difco). For the cloning of plasmids, Escherichia coli JM109, grown in LB medium containing 100 μg/ml ampicillin, was used in this study. Preparation of the SE antigen, the truncated C-terminus of SipC (cSipC), was performed using a histidine-tagged system in accordance with the manufacturer’s instructions (Qiagen). Briefly, the partial sipC gene encoding cSipC (amino acid residues 201–409) was amplified from SE chromosomal DNA by PCR with a set of primers, IGM389 (ccc cgg atc cga atg aaa gag gcg cgc tta aa) and IGM390 (ggg gct cga gag cgc gaa tat tgc ctg cga). The amplified DNA fragment was digested with BamHI and XhoI and inserted into the BamHI–SalI sites of pQE31. E. coli M15 was then transformed with the ligated plasmid. The expression and purification of His-tagged protein (His-cSipC) were carried out under denaturing conditions. The protein was renatured by dialysis against PBS.

Furthermore, the previous study did not evaluate the therapeutic effect of the vaccine on diseased dogs. Another study evaluating the therapeutic efficacy of the vaccine was performed by Miret et al. in Brazil [26] using vaccine components manufactured by the same organizations and processes as used for the present studies. Vaccinated dogs in the Miret et al. study responded immunologically

to the vaccine antigen and had a better survival rate than either no treatment or Glucantime treatment, even though dogs in the Vaccine-alone group remained symptomatic and parasite-positive [26]. In contrast, improvements in both survival rate and clinical symptoms occurred with the weekly vaccination schedule (for a total this website of 4 or 6 injections) of the present studies. This vaccine schedule contrasts with the schedules used in the two previous studies in which three injections were given at either 3- or 4-week intervals

[25] and [26], and the schedule also differs from that typically used for a prophylactic vaccination. While prophylactic vaccination requires a good MK-8776 purchase quality long-term memory T-cell response, a therapeutic vaccine may require large numbers of effector T-cells specialized at killing those Leishmania parasites already present in the infected host. Differences in vaccination schedules between pre- and post-exposure are well-known for rabies, and such an exhaustive schedule as weekly injections, which may prevent induction of memory responses, could still be beneficial for the purpose of a therapeutic treatment. In the future, it will be valuable to determine how the vaccination schedule affects immune responses (measurements

that might include the ratio of antigen-specific effector vs. memory T cells) as well as the therapeutic efficacy of a vaccine. Also, it may be useful to evaluate the vaccine in other geographic areas that Cediranib (AZD2171) have a significant number of CVL cases, such as the European Mediterranean coastline. As no plan was made to periodically check the treated dogs after the conclusion of the Open Trial (Study #1), it is not possible to determine whether there was differential long-term survival of the study groups. Although at least six dogs from the Vaccine group in this first study are known to still be alive and have remained leishmaniasis-free, it is not clear whether the vaccine provided longer term protection from re-infection in some dogs compared to a Glucantime cure. Moreover, in the absence of interim biopsies or serum evaluations and because no preventative measures (netting, insecticide-treated collars) were enforced on the owners, it cannot be ruled out that some dogs were re-infected over the course of the study. The possibility needs to be explored that periodic boosting with the therapeutic (or a different prophylactic) vaccine may be beneficial at, say, 12 or 24 month intervals after the initial course of treatment.

The results for all these outcomes conclusively indicate no therapeutic benefit from dynamic splints. Of course, the interpretation of these results relies on the definition of a sufficiently important treatment effect. We articulated a sufficiently important treatment effect

for each outcome prior to commencement of the study based on clinical judgement and the recommendations of others. These were set at 10 degrees for all active wrist movements and 2 points for the two COPM items. Some may argue that we set these too high in which case the interpretation of our results would differ and leave open the possibility of detecting a treatment effect INCB024360 with a larger sample. Others may argue that wrist extension should not have been the primary outcome but instead PRHWE. We nominated wrist extension as our primary outcome because we were concerned about power and reasoned that splints could not be expected to change more meaningful measures of activity limitation or participations restrictions without an underlying change in wrist extension. As it turned out these concerns were unfounded and our measures of PRHWE had greater precision than our measures of wrist extension. Our failure to demonstrate a treatment effect may also have been due to poor compliance with the splinting regimen. Participants Sorafenib price were instructed to wear

the splint for at least 6 hours a day. It was difficult to attain accurate data on how often the splints were worn. However, our Rolziracetam best estimate suggests that most participants did not wear the splints for 6 hours a day. Nonetheless, adherence reflects the realities of wearing splints and was probably better than could be expected in clinical practice especially as we regularly reviewed participants and instructed them to record adherence in diaries. Perhaps the results would have

been different if the participants had worn the splints for more than 6 hours a day and/or more than 8 weeks. However, participants are unlikely to tolerate wearing splints for longer periods of time. For example, some disliked the look of the splints and others complained about the limitations the splints imposed on day-to-day activities. Alternatively, it is possible that the splints were ineffective because they did not provide a sufficient stretch. We do not know precisely how much stretch was applied but the splints were adjusted regularly to ensure they pulled the wrist into as much wrist extension as tolerated. This mimics current clinical practice and it is unlikely participants would have tolerated more stretch. Interestingly, all participants showed improvements in all outcomes over time. While it is tempting to interpret these findings as evidence of the effectiveness of the advice and home exercise program given to all participants and/or evidence about the good typical recovery following wrist fractures, neither interpretation is valid.

Soluble proteins were purified from bacterial lysates by glutathione-affinity chromatography

as previously described [29], then analysed by sodium-dodecyl-sulphate (SDS) polyacrylamide gel electrophoresis (PAGE). GST-fused proteins from inclusion bodies (insoluble fraction) were dissolved in a CAPS buffer (CAPS 50 mM, DTT 1 mM and Sarkosyl 0.3%), hence denaturing the proteins [30]. The dissolved and denatured protein was dialyzed overnight against 20 mM Tris–HCl pH 8.5. Insoluble proteins dissolved in CAPS buffer/dialysed are referred Vemurafenib datasheet to as ‘CAPS-denatured proteins’ throughout the text. Purified proteins were quantified by two different methods: (i) a Bradford assay at 595 nm and (ii) UV spectrophotometry at 280 nm (extinction coefficient determined from aa sequences of each fusion protein). Concentration measurements were consistent using both methods. Relative amounts of proteins to be injected were based on copy number considerations in a BTV particle, as determined by X-ray crystallography (780 copies for VP7, 360 copies for VP5 and 180 copies for VP2 [1]). Seven

groups of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 with 100 μl of soluble protein/Montanide ISA 50V emulsion (Table 1). Three groups of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 with 100 μl of CAPS-denatured protein/Montanide ISA 50V emulsion (Table 1). A group of six Balb/c mice were injected subcutaneously at days 0, 14 and 28 each with 100 μl of Zulvac-4® Bovis. Sera were used for normalisation of ELISA results. A group of six control Balb/c mice which were not immunised with any of the antigens was selleckchem also included. Six groups of six IFNAR−/− mice were injected subcutaneously at days 0, 14 and 28 with: a mixture of VP2 Phosphatidylinositol diacylglycerol-lyase domain 1 (VP2D1) and VP2 domain 2 (VP2D2) in Montanide, then challenged with (i) BTV-4 or (ii)

BTV-8; or a mixture of VP2D1 + VP2D2 + VP5Δ1–100/Montanide, then challenged with (iii) BTV-4 or (iv) BTV-8; or a mixture VP2D1 + VP2D2 + VP5Δ1–100 + VP7/Montanide, then challenged with (v) BTV-4 or (vi) BTV-8 (Table 1). Blood samples were collected at day 0 and day 28. The mice received an intravenous lethal [31] challenge on day 40, with 103 pfu of BTV-4-italy03 (homologous-challenge), or 10 pfu of BTV-8-28 (heterologous-challenge). Blood was collected on the day of challenge (day 40), then at days 2, 3, 4, 5, 7, 10 and 12 p.i. Sera were tested for anti-VP2, anti-VP5 and anti-VP7 antibodies by ELISA and immunofluorescence and for NAbs by PRNT. Two groups of six IFNAR−/− mice were injected subcutaneously with VP5Δ1–100 on days 0, 14 and 28. These groups were not challenged with BTV-4 or BTV-8. Two additional groups of six IFNAR−/− mice were immunised with VP7 on days 0, 14 and 28, then challenged at day 40 with either BTV-4 or BTV-8. Two groups of non-immunised mice were used as positive controls, to confirm lethality of BTV-4 or BTV-8 challenge-strains.

baseline seronegative subjects (Table 4), and subjects who were baseline seropositive demonstrated 36 month antibody levels similar to those achieved by baseline seronegative subjects. Baseline HPV 16 DNA positive vs. negative subjects had Everolimus similar

36 month antibody levels, whereas 36 month antibody levels for HPV 18 DNA positive vs. negative subjects were approximately 2- to 3-fold higher. However, this difference did not achieve statistical significance (Table 5). Among subjects enrolled in this 2-dose vs. 3-dose Q-HPV vaccine trial, HPV 16 antibodies measured by the cLIA, TIgG and PsV NAb assays remained detectable for at least 36 months for all subjects. In contrast, beginning at 18 months post-vaccine, the cLIA was unable to detect HPV 18 antibodies in a subset SAR405838 cell line of subjects, while HPV 18 antibodies remained detectable for at least 36 months in most subjects by the TIgG assay and in all subjects by the PsV NAb assay (NTpartial endpoint). Other studies have demonstrated that up to 40 percent of vaccinated subjects lose detectable

HPV 18 cLIA antibodies over time, but vaccine efficacy in preventing subsequent HPV 18 infection is maintained [4], [5] and [6]. Consistent with our observations, when such individuals are tested by the TIgG [15] or a PsV NAb assay [16], HPV 18 antibodies remain detectable in the majority of individuals for at least 48 months. We demonstrated that HPV 16 and HPV 18 antibody titres reach a plateau about 18 months post-vaccine for both 2- and 3-dose regimens, and remain essentially unchanged through to 36 months. This is encouraging from a public health perspective and suggests that detectable antibodies may be maintained long-term following a 2-dose vaccine schedule MycoClean Mycoplasma Removal Kit in young girls. Correlation coefficients for HPV 18 for all three assays were very similar, whereas for HPV 16, correlation between the PsV NAb and the TIgG assay was closer than either the PsV NAb or TIgG assays vs. the cLIA. There were a number of

subjects with low levels of HPV 16 cLIA antibodies who displayed high levels of PsV NAb. For HPV 18, the cLIA and PsV NAb were more closely correlated. For those samples which lost detectable HPV 18 cLIA antibodies, the corresponding PsV NAb levels were typically low, confirming the close correlation. These findings likely reflect the more limited array of HPV antibodies detected by the cLIA due to its monoclonal antibody design or may reflect the composition of the PsV. Of interest, Hernandez et al. reported that HPV 16 antibodies detected by enzyme immunoassay (EIA) against either L1 or L1-L2 VLPs correlated well with the results of a PsV NAb assay. However, for HPV 18, EIA antibodies against L1-L2 VLPs correlated better with the PsV NAb assay than EIA antibodies against L1 VLPs. These authors suggest that L1-L2 VLPs likely more closely resemble native virions than L1 VLPs [17].

1). The cellular immune response was also analyzed by monitoring the secretion of cytokine by splenocytes of vaccinated AP24534 and challenged mice after in vitro incubation with the NH36 antigen. The results are summarized in Fig. 10. The ELISA-analysis

of the cytokines secreted by splenocytes after in vitro incubation with NH36 antigen was performed after challenge ( Fig. 10). The secretion of TNF-α was increased by the CA3X, CA4 and the control R vaccines while the secretion of IFN-γ was enhanced above the saline control only by the control R vaccine. The IL-10 secretion was enhanced only by the CA4 vaccine. It is worth noting that the increase in the number of sugar units of the C-28 learn more attached to the carbohydrate chain of saponins is positively

correlated to the increase in secretion of TNF-α (p < 0.001) and of IFN-γ (p = 0.026) and to the decrease in secretion of IL-10 (p = −0.008). Secretion of TNF-α was more intense than that of IFN-γ. Our results disclose the protective adjuvant potential of CA3 and CA4 saponins and suggest that the addition of one sugar unit on the C-28 attached chain of CA4 determines a significant increase in its adjuvant potential. Furthermore, the impact of the increase of the C-28 attached sugar chain of C. alba was compared in the Balb/c mice model, using the CA2 and the CA3X saponins ( Fig. 1) as controls. The IDR response was enhanced only by the CA4 and the R saponin above the saline controls ( Fig. 11). In correlation to that, only the CA4 and the R saponin reduced the parasite load when compared to saline control ( Fig. 11), confirming the superiority of CA4. The reduction determined by CA4 was stronger than that of CA2 and CA3X, and, as described in Fig. 7, not different from the protection induced by CA3. Maximal parasite load reduction was achieved by the R saponin control PD184352 (CI-1040) group ( Fig. 11). There was a positive correlation between the increase in IDR measures and in the number of sugar units attached to the triterpene-C-28 (p < 0.0001). Supporting our hypothesis

of the superiority of the CA4 saponin, on the other hand, the LDU values decreased with the increase of the sugar chain (p = −0.014). The hydrophile/lipophile balance calculation performed according to the Davies and Riedel method disclosed an HLB = 12.7 for CA2, HLB = 15.8 for both CA3 and CA3X and an HLB = 19.9 for CA4 saponin confirming its higher hydrophilicity. The analysis of the hemolytic capacity of C. alba saponins ( Table 1) disclosed that saponins CA2, CA3 and CA4 share a high HD50 (175 μg/ml) which means that they are poorly hemolytic and that the hemolytic capacity, differently from what happens with the HLB, does not increase in positive correlation with the number of sugar units linked to the sapogenin.

This is the first study on the application of Kinesio Taping according to the recommendations of Kenzo Kase

for low back pain. It used a robust research design and achieved high follow-up. However, the protocol was not registered Epacadostat in vitro prospectively. The exclusion criteria were designed to obtain a homogeneous cohort of adults with chronic low back pain. However, this limits the applicability of our results to, for example, older and younger people than those we studied. Another study limitation is that we only investigated the short-term results of Kinesio Taping and cannot draw conclusions on its longer-term effects, which deserve investigation in future randomised clinical trials. Moreover, in clinical practice, therapists may not apply Kinesio Taping alone as an isolated intervention in people with chronic non-specific low back pain. Further research is required on the use of Kinesio Tape in combination with other manual therapies and/or active exercise programs. In conclusion, individuals with chronic non-specific low back pain experienced Rapamycin nmr statistically significant improvements immediately after the application of Kinesio Taping in disability, pain, isometric endurance of the

trunk muscles, and perhaps trunk flexion range of motion. However, the effects were generally small and only the improvements in pain and trunk muscle endurance were observed four weeks after oxyclozanide the week with the tape in situ. Further research is warranted on outcomes after Kinesio Taping applications for longer time periods and/or in combination with exercise programmes. eAddenda: Table 3 available

at jop.physiotherapy.asn.au Ethics: Informed consent was obtained from each participant before entering the study, which was performed in accordance with the Helsinki Declaration (2008 modification) on research projects and with national legislation on clinical trials (Law 223/2004 6 February), biomedical research (Law 14/2007 3 July), and participant confidentiality (Law 15/1999, 13 December). The study was approved by the Ethics And Research Committee of the University of Almeria. Competing interests: None declared. Support: Nil. “
“Falls are a major health problem for older people, with 30–35% of those who live in the community falling at least once a year (Granacher et al 2011, Rubenstein and Josephson 2002). However, falls incidence is about three times higher in institutionalised older people than those in the community (Cameron et al 2010). About 20% of falls require medical attention: 15% result in joint dislocations and soft tissue bruising and contusions, while 5% result in fractures, with femoral neck fractures occurring in 1–2% of falls (Granacher et al 2011, Kannus et al 1999). Fall-related injuries are also associated with substantial economic costs.