Season of the year influences infection rates following total hip arthroplasty

To research the influence of season of the year on periprosthetic joint infections. METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections (mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West (P \u3c 0.05 for all) but not the Northeast (P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West. CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty (THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs. © The Author(s) 2017

Interacting classical and quantum particles

We apply Hall and Reginatto's theory of interacting classical and quantum ensembles to harmonically coupled particles, with a view to understanding its experimental implications. This hybrid theory has no free parameters and makes distinctive predictions that should allow it to be experimentally distinguished from quantum mechanics. It also bears on the questions of quantum measurement and quantum gravity.Comment: 7 pages, 6 figure

When grassroots innovation movements encounter mainstream institutions: implications for models of inclusive innovation

Grassroots innovation movements (GIMs) can be regarded as initiators or advocates of alternative pathways of innovation. Sometimes these movements engage with more established science, technology and innovation (STI) institutions and development agencies in pursuit of their goals. In this paper, we argue that an important aspect to encounters between GIMs and mainstream STI institutions is the negotiation of different framings of grassroots innovation and development of policy models for inclusive innovation. These encounters can result in two different modes of engagement by GIMs; what we call insertion and mobilization. We illustrate and discuss these interrelated notions of framings and modes of engagement by drawing on three case studies of GIMs: the Social Technologies Network in Brazil, and the Honey Bee Network and People's Science Movements in India. The cases highlight that inclusion in the context of GIMs is not an unproblematic, smooth endeavour, and involves diverse interpretations and framings, which shape what and who gets included or excluded. Within the context of increasing policy interest, the analysis of encounters between GIMs and STI institutions can offer important lessons for the design of models of inclusive innovation and development

When is it Safe for Patients to Drive after Right Total Hip Arthroplasty?

Introduction: Driving restrictions after total hip arthroplasty (THA) can be inconvenient and burdensome for patients. When patients may safely be allowed to drive remains controversial. Most studies recommend 6 weeks but recent advances in surgical approach, pain management and rapid recovery may have changed this time frame. The purpose of this study was to prospectively evaluate driving safety after THA through brake reaction time

Accuracy of prospective two-dimensional/Doppler echocardiography in the assessment of reparative surgery

Between January 1987 and January 1989, all 129 patients (aged 11 days to 25 years, median 39 months) undergoing both an echocardiographic examination and cardiac catheterization after reparative surgery were prospectively included in a study to assess the accuracy of combined two-dimensional and Doppler color flow imaging. The patient diagnoses were transposition of the great arteries (n = 20), tetralogy of Fallot (n = 38), coarctation of the aorta (n = 24), complete atrioventricular (AV) canal (n = 15), atrial septal defect (n = 8), ventricular septal defects (n = 3), pulmonary stenosis (n = 4), aortic stenosis (n = 8) and subaortic stenosis (n = 9).In arterial tract stenosis, there was high correlation between Doppler estimates and catheterization-derived measurements of residual right ventricular outflow tract obstruction in patients after the arterial switch operation for transposition of the great arteries (r = 0.95) as well as in patients after corrective repair of tetralogy of Fallot (r = 0.84).In semilunar/AV valve regurgitation, graded as none, mild, moderate or severe, echocardiographic estimates correlated exactly with angiographic grading in 84% and differed by one angiographic grade in the other 16%.In residual left to right shunting, no hemodynamically significant shunt was missed by echocardiography. For residual shunts at the ventricular level (n = 32), addition of Doppler color flow imaging improved the sensitivity (from 63% to 94%) and the negative predictive value (from 88% to 98%).In elevated right ventricular pressure, Doppler-derived right ventricular-right atrial pressure estimates in 24 patients correlated well with catheterization measurements (r = 0.93).Combined two-dimensional and Doppler color flow echocardiography was highly accurate in the prospective evaluation of these four types of postoperative residua

Comparing different methods of learning in the development of social accountability and CanMEDS roles in medical students

Abstract Objective: Medical students at the University of British Columbia undertake a population health course that aims to cultivate social accountability and CanMEDS roles. Students choose between Discussion Group Option (DGO), Community Service Learning Option (CSLO), or Self-Directed Project Option (SDPO). The objective of this study was to evaluate the effectiveness of these three different learning options in developing social accountability and CanMEDS roles in medical students. Methods: Expert consultation and literature review were undertaken to develop a self-report survey. Students who had completed the course from 2009 to 2013 were surveyed. The results were analyzed to evaluate differences between groups. Results: We recruited 168 participants with equal representation from each option. CSLO and SDPO students reported greater development of social accountability and CanMEDS roles from the course compared to DGO students. In addition, CSLO and SDPO students reported greater academic output and satisfaction from their experience. Conclusion: Students who participated in community-based or project-based learning reported significantly better acquisition of social accountability and CanMEDS roles compared to students who engaged in group discussion.  Résumé Objectif: Les étudiants en médecine de l’Université de la Colombie-Britannique suivent un cours sur la santé de la population qui vise à cultiver la responsabilité sociale et les rôles CanMEDS. Les étudiants choisissent entre l’option de discussion de groupe (DGO, de l’anglais), l’option d’apprentissage par l’engagement communautaire (CSLO, de l’anglais) ou l’option de projet autonome (SDPO, de l’anglais). L’objectif de cette étude était d’évaluer l’efficacité de ces trois options d’apprentissage différentes pour le développement de la responsabilité sociale et des rôles CanMEDS chez les étudiants en médecine. Méthodes: Des consultations d’experts et une revue de la littérature ont été entreprises afin de concevoir un sondage d’autodéclaration. Les étudiants ayant complété le cours de 2009 à 2013 ont été interrogés. Les résultats ont été analysés afin d’évaluer les différences entre les groupes. Résultats: Nous avons recruté 168 participants, avec une représentation égale pour chaque option. Les étudiants des groupes CSLO et SDPO ont déclaré plus de développement de leur sens de responsabilité sociale et des rôles CanMEDS à la suite du cours, en comparaison aux étudiants du groupe DGO. De plus, les étudiants des groupes CSLO et SDPO ont rapporté un plus grand nombre de réalisations scolaires et une meilleure satisfaction par rapport à leur expérience. Conclusion: Les étudiants qui ont participé à l’apprentissage par l’engagement communautaire ou par l’entremise d’un projet autonome ont rapporté une acquisition nettement meilleure de la responsabilité sociale et des rôles CanMEDS, en comparaison aux étudiants qui ont participé à une discussion de groupe.

TESLA-X: An effective method to search for sub-threshold lensed gravitational waves with a targeted population model

Strong gravitational lensing can produce copies of gravitational-wave signals from the same source with the same waveform morphologies but different amplitudes and arrival times. Some of these strongly-lensed gravitational-wave signals can be demagnified and become sub-threshold. We present TESLA-X, an enhanced approach to the original GstLAL-based TargetEd Subthreshold Lensing seArch (TESLA) method, for improving the detection efficiency of these potential sub-threshold lensed signals. TESLA-X utilizes lensed injections to generate a targeted population model and a targeted template bank. We compare the performance of a full template bank search, TESLA, and TESLA-X methods via a simulation campaign, and demonstrate the performance of TESLA-X in recovering lensed injections, particularly targeting a mock event. Our results show that the TESLA-X method achieves a maximum of $\sim 20\%$ higher search sensitivity compared to the TESLA method within the sub-threshold regime, presenting a step towards detecting the first lensed gravitational wave. TESLA-X will be employed for the LIGO-Virgo-KAGRA's collaboration-wide analysis to search for lensing signatures in the fourth observing run