Perioperative safety of two-team simultaneous bilateral total knee arthroplasty in the obese patient

<p>Abstract</p> <p>Background</p> <p>Although the rates of perioperative morbidity and mortality with simultaneous bilateral total knee arthroplasty remain a concern, multiple studies have shown the procedure to be safe in selected patient populations. Evidence also remains mixed regarding the outcomes of total knee arthroplasty in obese patients. The purpose of this paper is to compare the rates of perioperative morbidity and mortality in consecutive obese patients undergoing two-team simultaneous bilateral total knee arthroplasty and unilateral total knee arthroplasty.</p> <p>Methods</p> <p>The records on all two-team simultaneous total knee arthroplasties and unilateral total knee arthroplasties from October 1997 to December 2007 were reviewed. A total of 151 patients with a body mass index (BMI) >30 undergoing two-team simultaneous total knee arthroplasty and 148 patients with a BMI >30 undergoing unilateral total knee arthroplasty were retrospectively reviewed and analyzed to determine perioperative morbidity and mortality as well as one-year mortality rates.</p> <p>Results</p> <p>Preoperative patient characteristics did not show any significant differences between groups. The simultaneous bilateral group had significantly longer operative times (127.4 versus 112.7 minutes, p < 0.01), estimated blood loss (176.7 versus 111.6 mL, p = 0.01), percentage of patients requiring blood transfusion (64.9% versus 13.9%, p < 0.01), length of hospital stay (3.72 versus 3.30 days, p < 0.01), and percentage of patients requiring extended care facility usage at discharge (63.6% versus 27.8%, p < 0.01). No significant difference between unilateral and bilateral groups was seen in regards to total complication rate, major or minor complication subgroup rate, or any particular complication noted. Doubling the variables in the unilateral group for a staged total knee arthroplasty scenario did create significant increases over the simultaneous data in almost every data category.</p> <p>Conclusions</p> <p>Two-team simultaneous total knee arthroplasty appears to be safe in obese patients, with similar complication rates as compared to unilateral procedures. Two-team simultaneous total knee arthroplasty also appears to have potential benefits over a staged procedure in the obese patient, although more study is required regarding this topic.</p

Senior Recital, Erik Schmidt, percussion

The presentation of this senior recital will fulfill in part the requirements for the Bachelor of Music degree in Performance. Erik Schmidt studies percussion with Dr. Justin Alexander

A novel approach to estimate product-specific greenhouse gas emissions for 23,550 Australian packaged foods and beverages

Greenhouse gas emissions (GHGe) data are predominantly available for agricultural commodities and broad dietary patterns. However, data on commonly consumed, multi-ingredient food products as sold in supermarkets and retail outlets are mostly absent. We developed a novel approach to estimate product-specific GHGe for individual packaged foods and beverages marketed in Australia in 2019. Ingredient lists for 23,550 packaged products were systematically disaggregated and a linear program was used to estimate ingredient proportions in each product. Ingredient-specific, cradle-to-farm gate GHGe values were identified from five life cycle assessment data sources. Weighted GHGe values for each ingredient were summed up to a product-specific GHGe estimate that was then additionally adjusted for processing and transport-related emissions to account for most attributable emissions from cradle-to-retail. To assess validity, GHGe for food categories, estimated as the median of product-specific GHGe estimates, were compared against existing GHGe values for analogous food groups. The included products contained 897 different ingredients for which GHGe values were determined using data from 433 life cycle assessments. The estimated median for cradle-to-retail GHGe for all products was 2.35 kg CO2eq/kg product (interquartile range, IQR, [1.24, 4.53]). Product-specific GHGe estimates varied substantially within food categories; the 25th and 75th percentile of GHGe values differed by 2-fold or more for most. ‘Meat and meat products’ had the highest median GHGe value and broadest range of estimates (6.81 kg CO2eq/kg product, IQR [5.84, 29.2]). ‘Fruit, vegetables, nuts and legumes’ had the lowest median GHGe (1.20 kg CO2eq/kg product). Median category values for product-specific GHGe estimates aligned well with values for 34 food groups previously reported (R2 = 98.6%). Our approach provides a novel method for estimating product-specific GHGe for Australian packaged foods and beverages. The study enabled clear differentiation between products within a given category due to the unique ingredient proportion estimation method, while retaining good comparability against values derived using existing methods. These data have significant potential for driving industry actions and informing government policies

Switches in food and beverage product purchases can reduce greenhouse gas emissions in Australia

Switching between similar food and beverage products may reduce greenhouse gas emissions (GHGe). Here, using consumer data linked to 23,550 product-specific GHGe values, we estimated annual GHGe attributable to product purchases consumed at home in Australia and calculated reductions from specific switches. Potential changes to mean Health Star Rating, mean energy density and the proportion of ultraprocessed foods purchased were assessed. Approximately 31 million tonnes of GHGe were attributable to products consumed at home in 2019, the three highest contributors of GHGe being ‘meat and meat products’ (49%), ‘dairy’ (17%) and ‘non-alcoholic beverages’ (16%). Switching higher-emission products for ‘very similar’ lower-emission products could reduce total emissions by 26%. Switches to ‘less similar’ lower-emission products could lead to a 71% reduction. Switches had little impact on the average Health Star Rating, energy density of purchases and proportion of ultraprocessed foods purchased. Directing manufacturing and marketing towards lower-environmental-impact products and signposting such options to consumers are key

Modifying the Health Star Rating nutrient profiling algorithm to account for ultra‐processing

Aim: To modify the Australian and New Zealand Health Star Rating to account for ultra‐processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit). Methods: Data was cross‐sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five ‘negative’ points added to ultra‐processed products (modification 1; inclusion approach); (2) ultra‐processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 ‘negative’ points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1–3 or core. Results: All Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category. Conclusions: If ultra‐processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra‐processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians

Columbus State University Honors College: Senior Theses, Fall 2020/Spring 2021

This is a collection of senior theses written by honors students at Columbus State University during the Fall 2020 and Spring 2021 semesters.https://csuepress.columbusstate.edu/honors_theses/1002/thumbnail.jp

The effects of experimentally induced changes in ego states on pronunciation ability in a second language: An exploratory study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34041/1/0000318.pd

Identifying environmental and management factors that may be associated with the quality of life of kennelled dogs (Canis familiaris)

Abstract This paper describes the use of a validated quality of life assessment tool (described elsewhere) to identify environmental and management factors that may affect quality of life in dogs kennelled in rehoming centres. Dogs were allocated to one of four treatment groups, all of which had a positive (0.0 - 1.0) average quality of life score: long stay dogs with an enriched routine had a mean score of 0.477; long stay dogs with a standard routine had a mean score of 0.453; newly admitted dogs with an enriched routine had a mean score of 0.399; and newly admitted dogs with a standard routine had a mean score of 0.362. Only 2 of the dogs had a negative score (-1.0 - 0.0). Thirteen rehoming centre managers completed a questionnaire relating to the kennel environment and management practices of their rehoming centres. The environmental and management factors� associations with quality of life scores, collected from 202 dogs from the 13 rehoming centres using this scoring system, were analysed as fixed factors in a linear mixed-effect model, with rehoming centre fitted as a random factor, and a multiple linear regression model. There was a statistically significant association between quality of life scores and rehoming centre (H(12)&#xa0;=&#xa0;54.153, p &lt;0.001), however, the fitted linear mixed-effect model did not improve upon the null model and therefore cannot be used to explain the 29 variance in quality of life scores attributed to rehoming centre. The multiple linear regression model explained 42 of the variation in quality of life scores (F(10,131)&#xa0;=&#xa0;9.318, p&#xa0;&lt;&#xa0;0.001): the provision of bunk beds increased quality of life scores by 0.3 (t&#xa0;=&#xa0;3.476, p&#xa0;&lt;&#xa0;0.001); provision of 30&#xa0;minutes or more of staff or volunteer interaction increased scores by 0.26 (t&#xa0;=&#xa0;-2.551, p&#xa0;=&#xa0;0.012); grooming dogs decreased scores by 0.404 (t&#xa0;=&#xa0;3.326, p&#xa0;=&#xa0;0.001); exercising dogs more than once a day decreased scores by 0.173 (t&#xa0;=&#xa0;-3.644, p&#xa0;=&#xa0;&lt;0.001), whereas exercising dogs for 30&#xa0;minutes or more increased quality of life scores by 0.213 (t&#xa0;=&#xa0;-2.374, p&#xa0;=&#xa0;0.019) and the provision of less common types of exercise increased scores by 0.504 (t&#xa0;=&#xa0;5.120, p&#xa0;&lt;&#xa0;0.001); training dogs for 30&#xa0;minutes or more every day increased scores by 0.688 (t&#xa0;=&#xa0;3.040, p&#xa0;=&#xa0;0.003) and training dogs less than daily decreased scores by 0.393 (t&#xa0;=&#xa0;-4.245, p&#xa0;&lt;&#xa0;0.001); feeding a diet of dry and wet food compared to dry food alone decreased scores by 0.08 (t&#xa0;=&#xa0;-2.331, p&#xa0;=&#xa0;0.021); and a quiet environment increased scores by 0.275 (t&#xa0;=&#xa0;-3.459, p&#xa0;&lt;&#xa0;0.001). These results suggest that environmental design and kennel management have an impact on the quality of life of kennelled dogs and should be considered carefully in decision-making processes. However, further study may be required as grooming and exercising dogs more than once per day decreased quality of life scores, which are not obviously intuitive results

A comparative study of the fecal microbiota of gray seal pups and yearlings ‐ a marine mammal sentinel species

Gray seals (Halichoerus grypus) can act as sentinel species reflecting the condition of the environment they inhabit. Our previous research identified strains of pathogenic Campylobacter and Salmonella, originating from both human and agricultural animal hosts, on rectal swabs from live gray seal (H. grypus) pups and yearlings on the Isle of May, Scotland, UK. We examined rectal swabs from the same pup (n = 90) and yearling (n = 19) gray seals to gain further understanding into the effects of age-related changes (pup vs. yearling) and three different natal terrestrial habitats on seal pup fecal microbiota. DNA was extracted from a subset of rectal swabs (pups n = 23, yearlings n = 9) using an optimized procedure, and the V4 region of the 16S ribosomal RNA gene was sequenced to identify each individual's microbiota. Diversity in pup samples was lower (3.92 ± 0.19) than yearlings (4.66 ± 0.39) although not significant at the p = 0.05 level (p = 0.062) but differences in the composition of the microbiota were (p