Development of outbred CD1 mouse colonies with distinct standardized gut microbiota profiles for use in complex microbiota targeted studies.

Studies indicate that the gut microbiota (GM) can significantly influence both local and systemic host physiologic processes. With rising concern for optimization of experimental reproducibility and translatability, it is essential to consider the GM in study design. However, GM profiles can vary between rodent producers making consistency between models challenging. To circumvent this, we developed outbred CD1 mouse colonies with stable, complex GM profiles that can be used as donors for a variety of GM transfer techniques including rederivation, co-housing, cross-foster, and fecal microbiota transfer (FMT). CD1 embryos were surgically transferred into CD1 or C57BL/6 surrogate dams that varied by GM composition and complexity to establish four separate mouse colonies harboring GM profiles representative of contemporary mouse producers. Using targeted 16S rRNA amplicon sequencing, subsequent female offspring were found to have similar GM profiles to surrogate dams. Furthermore, breeding colonies of CD1 mice with distinct GM profiles were maintained for nine generations, demonstrating GM stability within these colonies. To confirm GM stability, we shipped cohorts of these four colonies to collaborating institutions and found no significant variation in GM composition. These mice are an invaluable experimental resource that can be used to investigate GM effects on mouse model phenotype

An Assessment of the Mathematics Information Processing Scale: A Potential Instrument for Extending Technology Education Research

Many argue that the United States is falling behind other countries in technology innovation. Some attribute this situation to ineffective education in the areas of math, science, and technology. Research using affective measures has provided evidence of links between student attitudes in math and technology education. With the aim of extending the research, this study examines the psychometric properties of the Mathematics Information Processing Scale1 (MIPS). The MIPS uses both cognitive and affective measures to explore various dimensions of students’ approaches to learning statistics and mathematics. The original study used exploratory factor analysis, while this study uses confirmatory factor analysis to revise the MIPS instrument. By combining both cognitive and affective measures in a single instrument, the MIPS offers the potential to contribute new research knowledge toward the goal of improving math and technology education

Evaluación de un Sistema de Electrocoagulación de Flujo Continuo para la Remoción de Cromo (VI) y DQO de Curtiembre-Huachipa-2018.

El objetivo de la investigación fue evaluar el nivel de eficiencia de un sistema de electrocoagulación de flujo continuo para la remoción de cromo (VI) Y DQO de Curtiembre - Huachipa – 2018. Se planteó bajo la perspectiva de un diseño completo al azar (DCA) siendo dieciséis tratamientos con tres repeticiones y como unidad experimental la celda de electrocoagulación de flujo continua. Se construyó un prototipo a escala de laboratorio para un régimen continuo, con una capacidad de 2 litros. Los electrodos fueron de aluminio y hierro con una distancia entre placas de 10mm. Se realizó utilizando diferentes intensidades de corriente, siendo estos: I1=6A, I2=7A, I3=8A y I4=9A; las pruebas se ajustaron a 4 valores de tiempo: t1=15min, t2=20min, t3=25min, t4=30min. Se lograron porcentajes de remoción de 84.96% para Cromo (VI) y 80.53% para DQO. Se determinó que las condiciones óptimas son la aplicación de una intensidad de corriente de 9A en un tiempo de 20 min. Se calculó una velocidad de remoción de -1.9764x10-8 M/s para Cromo (VI) y -1.274x10-5 M/s para DQO; así mismo se halló que el orden de reacción es de primer orden. Se estimó que el costo de operación de una celda electroquímica es S/. 7.70 por cada m3 de agua tratada; a partir de los obtenido en el prototipo al tratar 2L que incluye el costo de energía que equivale a S/. 0.004 y el costo del electrodo S/. 0.0037. La aplicación de un sistema de electrocoagulación de flujo continuo para el tratamiento de efluente residual de la industria curtiembre, en la etapa de curtido al cromo es eficiente en la remoción de DQO y Cromo (VI), debido a las características fisicoquímicas del efluente. Se recomienda para próximas experimentaciones de electrocoagulación, implementar mecanismos de agitación o hidráulicos, para mayores efectos de eficiencia

Do Younger TKR and THR Patients Have Similar Disability at Time of Surgery as Older Adults? Lessons from FORCE-TJR

Introduction: The number of US patients under 65 year old who are undergoing total knee replacement (TKR) and total hip replacement (THR) has been rising, raising concerns that younger patients may receive surgery prematurely. Therefore, we examined demographics and clinical factors and compared the severity of operative knee pain and functional status in younger versus older TKR patients from a US national sample. Materials & methods: The FORCE-TJR registry gathers data from patients, surgeons and hospitals on sociodemographic factors (age, sex, race), BMI, comorbid conditions using the modified Charlson comorbidity scores, burden of musculoskeletal disease using the Knee/Hip injury and Osteoarthritis Outcome Score (KOOS/HOOS) in both knees and hips, emotional health based on the Short Form 36 (SF-36) Mental Component Score (MCS) and physical function based on the Physical Component Score (SF-36 PCS). Results: We analysed data from 2035 younger (\u3c65) and 3084 older (≥65) TKR patients and 1780 younger and 1831 older THR patients. Younger TKR and THR patients were more likely nonwhite (TKR: 13.1% vs. 6.6%; THR: 51.7% vs. 48.3%),), with greater body mass index (mean BMI TKR: 33.1 vs. 30.5; THR: 29.9 vs. 28.4), smokers, had fewer number of comorbid conditions. Younger TKR patients reported lower emotional health (MCS 49.1 vs. 52.6), greater joint pain, stiffness and functional impairment (based on estimated WOMAC) and global functional impairment (using PCS). Younger THR patients reported greater joint pain, stiffness and functional impairment (estimated WOMAC) but not global function. Conclusion: At the time of TKR and THR, younger patients have fewer medical illnesses, but higher rates of obesity and smoking as well as lower mental health scores. Younger have the same or greater joint specific and global functional impairment compared to older patients, suggesting surgeons use comparable standards for selecting TKR and THR candidates in younger and older adults

Predictors of Patient-reported Outcomes after TKR not Included in Risk Models Based on Administrative Data

Introduction: Because total knee replacement (TKR) surgery is performed to relieve pain and improve physical function in patients with advanced arthritis, patient-reported outcomes (PROs) are important to assess TKR effectiveness. The UK and others require PROs. Understanding pre-existing clinical factors that influence PROs after surgery is needed before comparing PROs across providers. We evaluated the roles of medical and musculoskeletal comorbidities in explaining variation in 6 month post-TKR pain relief and functional gain in a national cohort of TKR patients. Materials & methods: FORCE-TJR, funded by the Agency for Healthcare Research and Quality (AHRQ), is a national consortium in which 100% patients, surgeons and hospitals submit data: patients demographics (age, gender, BMI, race), complete medical and musculoskeletal comorbidities, PROs including SF-36 Physical Component Score (PCS), Knee injury and Osteoarthritis Outcome Score (KOOS), clinically refined adverse events and implant data. Predictors of change in pre-to-6 month post-TKR pain and function were examined using linear mixed models adjusting for clustering within site. Results: TKR patients had a mean age of 67 years, mean BMI of 31.2, were 63% female and 4.5% black, 9% with Charlson Comorbidity Index (CCI) of 2-5, 15% with CCI of 6, 7% moderate/severe pain in 2-3 knee/hip joints, 27% moderate/severe lumbar pain. After adjusting for socio-demographic factors, significant predictors of poorer 6 month post-TKR pain included poorer emotional health, higher CCI, 1-2 nonsurgical hip/knee joints with moderate/severe pain, any lumbar pain at time of TKR. These same factors also predicted poorer 6 month function. Conclusion: Before adopting PROs as a standard measure of TKR outcome, a complete understanding of pre-existing clinical factors associated with poorer pain relief and functional gain is needed. Greater musculoskeletal, and medical, comorbid conditions were associated with post-operative PROs and should be included in risk-adjustment models before cross-hospital comparisons can be made

Differential Burden of Musculoskeletal Pain in Blacks and Whites at the Time of Total Joint Replacement Surgery

Introduction: The existence of racial disparities in total knee (TKR) and hip (THR) replacement outcomes is well established. The role of musculoskeletal co-morbidities among black and white TKR patients at the time of surgery were investigated in a prospective cohort enrolled in the FORCE-TJR consortium of 131 surgeons in 22 US states. Materials & methods: Descriptive analyses were performed on 3,306 TKR and 2,439 THR patients. Data included sociodemographic factors (age, sex, race), BMI, comorbid conditions using the modified Charlson comorbidity scores, burden of musculoskeletal disease using the Knee/Hip injury and Osteoarthritis Outcome Score (KOOS/HOOS) in both knees and hips, emotional health based on the Short Form 36 (SF-36) Mental Component Score (MCS) and physical function based on the Physical Component Score (SF-36 PCS). Factors associated with pre-operative surgical joint pain and function were examined using multivariate stepwise linear regression models. Results: Compared to Whites, Blacks (143 hips and 201 knees) reported worse surgical joint pain (mean pain: 39.3 vs. 49.2 (hip); 43.4 vs. 53.2 (knee)), poorer surgical joint function (mean function: 38.9 vs. 45.7 (hip); 45.9 vs. 53.4 (knee)), poorer global function (mean PCS: 30.0 vs. 31.6 (hip); 31.3 vs. 33.1 (knee)), and more non-operative joints pain. (All p\u3c0.03). In adjusted multivariable models, differences at the time of surgery in surgical joint symptoms and global function were explained by differences in musculoskeletal pain in the hips, knees, and low back. Conclusion: Greater burden of musculoskeletal pain explains differences in pre-operative pain and function between Blacks and Whites and likely impacts rehabilitation and subsequent TJR outcomes

Differential burden of musculoskeletal pain in African Americans and whites patients at the time of total joint replacement surgery

Objective: African Americans patients have greater operative joint pain and functional limitation at the time of total joint replacement (TJR) compared to white patients. We examined the factors associated with this apparent disparity. Methods: A consecutive sample of 5745 patients with advanced knee and hip osteoarthritis [who elected to undergo TJR in 2011-201] reported, preoperatively, medical comorbidities, operative and non-operative hip/ knee pain using Hip and Knee Disability and Osteoarthritis Outcome Scores (HOOS/KOOS), function using Short Form 36 Physical Component Score (PCS). Total burden of musculoskeletal pain was quantified as moderate/severe pain in non-operative hip and knee joints and lumbar back pain using Oswestry Disability Index (ODI). Associations among race, medical co-morbidites (modified Charlson), total musculoskeletal pain burden, operative joint pain, and functional limitations were examined using multivariable regression models. Results:Compared to Whites, African Americans (143 hips and 201 knees) reported worse surgical joint pain (mean pain: 39.3 vs. 49.2 [hip]; 43.4 vs. 53.2 [knee]), poorer surgical joint function (mean function: 38.9 vs. 45.7 [hip]; 45.9 vs. 53.4 [knee]), poorer global function (mean PCS: 30.0 vs. 31.6 [hip]; 31.3 vs. 33.1 [knee]), and more non-operative joints pain (p Conclusions: Greater burden of musculoskeletal pain explains differences in pre-operative pain and function between African American and white patients and likely impacts rehabilitation and subsequent TJR outcomes

Greater Co-morbidity Burden is Associated with Greater Pain and Disability at Time of Total Knee Replacement Among African American Patients

Introduction: The existence of racial disparities in total joint replacement (TJR) care is well established based on Medicare and VA data.1,3 As compared to white patients, African American TJR patients have lower utilization rates, more pain, poorer function at the time of surgery, and higher post-operative complication rates.2,3 We analyzed a national prospective total knee replacement (TKR) cohort to further investigate patterns of medical and musculoskeletal co-morbidities among African American and white TKR patients. Methods: Descriptive analyses were performed on a national database (FORCE-TJR) of 3,313 TKR patients from 107 orthopedic surgeons. Data collected include patient sociodemographics (age, gender, race, education, insurance, household income, smoking status), modified Charlson co-morbidity scores, and pre-operative and post-operative pain and function scores (SF-36 PCS and MCS, WOMAC, KOOS/HOOS ADL score). To assess the total musculoskeletal pain burden, WOMAC pain scores were recorded for non-operative weight bearing joints as well as Oswestry low back pain scores. Multivariate models are in progress. Results: Preliminary descriptive analyses demonstrate a higher medical co-morbidity burden in African American TKR patients as compared to whites (COPD, DM, smoking), as well as worse baseline pain (mean WOMAC pain score = 43.46 vs. 52.92, p Conclusion: Preliminary results demonstrate significant differences in medical and musculoskeletal co-morbidities that correlate with poorer pain and function scores in African American patients at the time of TKR

Comprehensive Data Management System for National Patient-Centered Outcomes Research for Comparative Effectiveness in Total Joint Replacement

Introduction: The Agency for Healthcare Research and Quality (AHRQ) funded research program, Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR), is a national patient-centered outcomes research registry. To serve such multi-center longitudinal patient-reported outcomes research, we designed an innovative system to support systematic data collection, management and quality monitoring for long-term outcome evaluation of care. Methods: The system structure design explicitly considered the continuum of study procedures, including patient enrollment, patient-reported baseline and follow-up surveys, joint implant components, and ambulatory record review for future potential adverse events. Patient enrollment process is recorded through a web-based data capture system. Patient-reported outcomes are completed by patients via scannable paper or web-based standardized surveys before and after surgery. Patient risk factors and implant components are collected from community-based orthopedic practices and hospital operating rooms. All data from the different sources are combined into a centralized database. Quality checks and monitoring processes are routinely conducted for each source of data. De-identified data are cleaned and scored for research analysis and surgeon quality reporting. Results: This system for the registry program was initiated in 2011. As of Feburary 2014, over 16,000 patients have been enrolled from more than 130 surgeons in 22 states. The centralized database integrating data from patients, surgeons and hospitals is updated weekly. Cleaned, scored data are provided quaterly for all surgeons to review their site- and individual-surgeon-specific outcomes through web reports. Discussion: This comprehensive data management system is expected to enhance future uses of multi-source data to guide surgeon decisions and drive quality improvement. We anticipate that this system will facilitate translation of data integration to broad clinical research to inform best practices in TJR

Does Functional Gain and Pain Relief After TKR and THR Differ by Patient Obese Status?

Introduction: Obesity is an important predictor of functional status and pain after total knee (TKR) and total hip (THR) replacement. However, variations in pre-post TKR and THR changes in function and pain by obesity status remain to be examined. Material & Methods: Pre- and 6 month post surgery data were collected on 2,964 primary TKR and 2,040 primary THR patients between 5/2011 and 3/2013. Data included demographics, comorbidities, operative joint pain severity based on the Knee Injury or Hip Disability and Osteoarthritis Outcome Score (KOOS/HOOS), WOMAC pain (higher is better), physical function (SF-36 PCS, higher is better), mental health (SF-36 MCS), and musculoskeletal burden of illness. Pre-post changes in PCS and pain were analyzed using descriptive statistics. Results: TKR patients were average 67 years, 61% women, 93% whites, 13% under or normal weight, 33% overweight, 29% obese, 15% severely obese, 9% morbidly obese. Greater level of obesity was associated with lower PCS at baseline and 6 month, lower pain scores at baseline but larger improvement post-op. Pre to-6 month PCS did not differ by obesity status. At 6 months morbidly obese patients had slightly lower/worse pain score. THR patients were average 65 years, 62% women, 95% whites, 27% under/normal weight, 38% overweight, 23% obese, 9% severely obese, 4% morbidly obese. Greater level of obesity was associated with lower PCS at baseline and 6 month, poorer baseline pain score but larger improvement post-op. Mean changes in pre-to-6 month PCS did not differ by obesity status. Conclusion: At 6 months after TKR, severely obese patients (BMI\u3e35) reported improvements in both pain and function equal to or greater than patients with BMI35 had lower mean functional gain than those with BM