The Prevalence of Bacterial Infection in Patients Undergoing Elective ACDF for Degenerative Cervical Spine Conditions: A Prospective Cohort Study With Contaminant Control

Study Design: Prospective cohort study. Objectives: To determine the prevalence of bacterial infection, with the use of a contaminant control, in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods: After institutional review board approval, patients undergoing elective ACDF were prospectively enrolled. Samples of the longus colli muscle and disc tissue were obtained. The tissue was then homogenized, gram stained, and cultured in both aerobic and anaerobic medium. Patients were classified into 4 groups depending on culture results. Demographic, preoperative, and postoperative factors were evaluated. Results: Ninety-six patients were enrolled, 41.7% were males with an average age of 54 ± 11 years and a body mass index of 29.7 ± 5.9 kg/m2. Seventeen patients (17.7%) were considered true positives, having a negative control and positive disc culture. Otherwise, no significant differences in culture positivity was found between groups of patients. However, our results show that patients were more likely to have both control and disc negative than being a true positive (odds ratio = 6.2, 95% confidence interval = 2.5-14.6). Propionibacterium acnes was the most commonly identified bacteria. Two patients with disc positive cultures returned to the operating room secondary to pseudarthrosis; however, age, body mass index, prior spine surgery or injection, postoperative infection, and reoperations were not associated with culture results. Conclusion: In our cohort, the prevalence of subclinical bacterial infection in patients undergoing ACDF was 17.7%. While our rates exclude patients with positive contaminant control, the possibility of contamination of disc cultures could not be entirely rejected. Overall, culture results did not have any influence on postoperative outcomes

Total elbow arthroplasty: a prospective clinical outcome study of Discovery Elbow System with a 4-year mean follow-up

BACKGROUND: Total elbow arthroplasty (TEA) is increasingly used for the treatment of advanced elbow conditions to reduce pain and improve function. However, TEA is still associated with a higher complication rate than total hip and knee arthroplasty despite advances in the design and surgical techniques. This prospective clinical study reports the outcome of the Discovery Elbow System (Biomet, Warsaw IN, USA), which has been in clinical use in the United Kingdom since 2003. METHODS: The study included a total of 100 Discovery Elbows (April 2003 to January 2010) with a minimum 2-year follow-up, including 75 primary and 25 revisions (60% women and 40% men; mean age, 62 years). Outcome was assessed by means of the Liverpool Elbow Score, pain experience, patient satisfaction, range of motion, and radiographic imaging. RESULTS: The mean follow-up period was 48.5 months (range, 24-108 months). The Liverpool Elbow Score improved from 3.79 to 6.36 (P < .001). The percentage of pain-free patients was substantially increased from 7% preoperatively to 64% at the final follow-up. The patient satisfaction rate was over 90%. The flexion-extension arc and pronation-supination arc increased from 72° to 93° and from 86° to 111°, respectively (P < .001). Major postoperative complications included deep infection (2%), progressive aseptic loosening requiring revision (primary, 5%; revision 12%), persistent ulnar neuropathy (3%), and periprosthetic fracture (primary, 6.8%; revision, 8%). CONCLUSION: The Discovery Elbow System resulted in improved function, reduced pain, and high patient satisfaction. Long-term results are required to assess the survivorship of this syste

Mapping the human genetic architecture of COVID-19

The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-19(1,2), host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases(3-7). They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.Radiolog

Crypte archeologique

It is a traveller's story repeated throughout the decades. The first-time visitor to Paris arrives in the city armed with a checklist of 'must-see' wonders -- sites viewed in photographs so often that they are imprinted in the mind's eye. And, unlike so many other places, in Paris every monument equals or surpasses expectation: the Eiffel Tower dazzles with its elegant simplicity; the proud dominance of the Arc de Triomphe inspires, and the sheer enormity of the Louvre leaves the onlooker speechless and confused as to where, exactly, to begin a tour. However, turning left off of the final corner of Rue Saint Louis en-L'Ile one is confronted with a sight that defies literal description. The facade of Notre Dame de Paris is one of the most photographed, replicated, and described pieces of architecture in the world. It is also amongst the most spectacular examples of human dedication, reverence, and sheer effort. After the facts of its construction are absorbed (to name just one: the cathedral was under constant construction for over two centuries), its towering, intricate, and flawless details can consume hours of neck-straining inspection and scrutiny. So awe-inspiring is Notre Dame's presence that most visitors fail to realise an equally impressive testament to mankind's capabilities lies directly beneath their feet, a treasure trove of archaeological wisdom and remains that date back to 27 BC

'The Decision', a case study: LeBron James, ESPN and questions about US sports journalism losing its way

When reigning NBA Most Valuable Player, LeBron James announced that he was leaving the Cleveland Cavaliers to join the Miami Heat via free agency in a nationally televised special on 8 July 2010, it set off a firestorm of controversy throughout US sports journalism and popular culture. While the media criticised ESPN, the self-proclaimed 'Worldwide Leader in Sports', for its lack of journalistic integrity in the broadcasting of James' announcement as a one-hour live special entitled The Decision, James himself was vilified in the press as 'arrogant', 'selfish' and 'a traitor'. By taking LeBron James' decision to join the Heat as a case study, this article proposes that James and ESPN are inextricably intertwined, for they operate under the same set of governing philosophies. Through analysis of their enmeshed relationship, alarming issues are raised regarding US sports journalism: the growing confusion regarding ethics, the spread of opportunism for profit and the media's imposition of nostalgic values on the modern athlete - values of which today’s sportsman has little or no concept. As a result of this analysis, conclusions are drawn regarding the current inability of US sports journalism to police itself

A quantum bridge between right and left hemisphere genius: a novel and exegesis

This practice-led PhD consists of two elements-a novel titled Saoradh and an accompanying exegesis which discusses the processes, techniques, methods and creative pathways utilised when producing the novel. The novel is set in the United States of America and the Republic of Ireland, from the 1920s to the 1950s and follows the paths of characters dealing with profound aspects of the human condition. The exegesis interrogates the practice of creation of the novel through five distinct perspectives; character versus plot, structure, landscape, narration and creative process. The novel’s inception, creation and production is tracked, both in real time and through reflective practice, offering new insights into ways of working for the Creative Writing student and practitioner. The reflection on practice is grounded in a psychological model that is compatible with literary models of textual analysis. Creative practice is in turn embedded in a larger conceptual matrix; the quantum field. As demonstrated by the character of Rory in the novel, the proposition of separation between the functional aspects of the brain’s left hemisphere and the creative possibilities of interplay between the right hemisphere and the quantum field are put forth. The novel is held up for comparison to the works of other authors, to provide alternative approaches however, the focus of the exegesis is always on my own practice of creative writing

Posthumous book a mark of genius

Although unfinished, The Pale King refines David Foster Wallace's tradition as an originator of meticulously constructed sentences

RECENT RESEARCH ON RED SQUILL AS A RODENTICIDE

Red squill has been used in rodent control for several hundred years but in the United States its use has decreased since the 1950s. However, there is now a recognized need for rodenticides with different kinds of toxic activity. Red squill is being investigated as an acute rodenticide and an economic crop for the southwestern states. Clones from a prior USDA collection have been assayed by high-performance liquid chromatography and selections are being propagated in California and Arizona. The major toxicant, scilliroside, is relatively fast acting, causing convulsions and death to rats and mice. This glycoside is also strongly emetic to humans, cats and dogs, affording a safety factor uncommon to high-toxicity rodenticides. Our chemical, processing, agronomic, and toxicological studies are a technical basis for further developing this potentially superior rodenticide

Acting versus thinking: social commentary in the literary non-fiction of Hunter S. Thompson and David Foster Wallace

Abstract not available

Videoconferencing and PhD supervision: a case study

Abstract not available