Risk of cancer following primary total hip replacement or primary resurfacing arthroplasty of the hip : A retrospective cohort study in Scotland

Acknowledgements: We are grateful to Lee Barnsdale, Doug Clark, and Richard Dobbie for advice and assistance with data preparation before analysis, and to the three anonymous referees for their helpful comments and suggestions.Peer reviewedPublisher PD

Scottish theme towns: have new identities enhanced development?

Three small towns in southwest Scotland have recently been branded as distinct theme towns, based on books, artists and food. This is an attempt to make them more attractive to visitors and thereby improve their economy. The objective of this research is to establish whether the new identities possessed by the towns have enhanced their development. It is argued, using data reviewing the past decade, that they have all developed, albeit at different rates, in terms of the economy and culture. Moreover, it is maintained that social capital has been enhanced and is a factor whose importance has been under-appreciated by planners and observers of this type of process. The relevance of the new identity to the pre-branding identity is also seen as a factor in successful development and ideas of authenticity and heritage are brought to bear on the relationship

Preventive measures in infancy to reduce under-five mortality: a case-control study in The Gambia.

OBJECTIVE: To investigate the relationship between child mortality and common preventive interventions: vaccination, trained birthing attendants, tetanus toxoid during pregnancy, breastfeeding and vitamin A supplementation. METHODS: Case-control study in a population under demographic surveillance. Cases (n = 141) were children under five who died. Each was age and sex-matched to five controls (n = 705). Information was gathered by interviewing primary caregivers. RESULTS: All but one of the interventions - whether the mother had received tetanus toxoid during pregnancy - were protective against child mortality after multivariate analysis. Having a trained person assisting at child birth (OR 0.2 95% CI 0.1-0.4), receiving all vaccinations by 9 months of age (OR 0.1; 95% CI 0.01-0.3), being breastfed for more than 12 months (Children breastfed between 13 and 24 months OR 0.1 95% CI 0.03-0.3, more than 25 months OR 0.1 95% CI 0.01-0.5) and receiving vitamin A supplementation at or after 6 months of age (OR 0.05; 95% CI 0.01-0.2) were protective against child death. CONCLUSIONS: This study confirms the value of at least four available interventions in the prevention of under-five death in The Gambia. It is now important to identify those who are not receiving them and why, and to intervene to improve coverage across the population

Garside and quadratic normalisation: a survey

Starting from the seminal example of the greedy normal norm in braid monoids, we analyse the mechanism of the normal form in a Garside monoid and explain how it extends to the more general framework of Garside families. Extending the viewpoint even more, we then consider general quadratic normalisation procedures and characterise Garside normalisation among them.Comment: 30 page

The effect of COVID-19 restrictions on rehabilitation and functional outcome following total hip and knee arthroplasty during the first wave of the pandemic

Aims: The primary aim was to assess the patient-perceived effect of restrictions imposed due to COVID-19 on rehabilitation following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Secondary aims were to assess perceived restrictions, influence on mental health, and functional outcome compared to patients undergoing surgery without restriction. Methods: During February and March 2020, 105 patients underwent THA (n = 48) or TKA (n = 57) and completed preoperative and six-month postoperative assessments. A cohort of 415 patients undergoing surgery in 2019 were used as the control. Patient demographic data, BMI, comorbidities, Oxford Hip Score (OHS) or Knee Score (OKS), and EuroQoL five-domain (EQ-5D) score were collected preoperatively and at six months postoperatively. At six months postoperatively, the 2020 patients were also asked to complete a questionnaire relating to the effect of the social restrictions on their outcome and their mental health. Results: Nearly half of the patients (47.6%, n = 50/105) felt that the restrictions imposed by COVID-19 had limited their rehabilitation and were associated with a significantly worse postoperative OKS (p < 0.001), EQ-5D score (p < 0.001), and lower satisfaction rate (p = 0.019). The reasons for the perceived limited rehabilitation were: being unable to exercise (n = 32, 64%), limited access to physiotherapy (n = 30, 60%), and no face-to-face follow-up (n = 30, 60%). A quarter (n = 26) felt that their mental health had deteriorated postoperatively; 17.1% (n = 18) felt depressed and 26.7% (n = 28) felt anxious. Joint-specific scores and satisfaction for the 2020 group were no different to the 2019 group, however patients undergoing THA in 2020 had a significantly worse postoperative EQ-5D compared to the 2019 cohort (difference 0.106; p = 0.001) which was not observed in patients undergoing TKA. Conclusion: Half of the 2020 cohort felt that their rehabilitation had been limited and was associated with worse postoperative Oxford and EQ-5D scores, and lower rates of patient satisfaction, but relative to the 2019 cohort their overall outcomes were no different, with the exception of THA patients who had a worse general health score. Level of evidence: Prospective study, Level 2

Acoustic cues to tonal contrasts in Mandarin: Implications for cochlear implants

The present study systematically manipulated three acoustic cues-fundamental frequency (f0), amplitude envelope, and duration-to investigate their contributions to tonal contrasts in Mandarin. Simplified stimuli with all possible combinations of these three cues were presented for identification to eight normal-hearing listeners, all native speakers of Mandarin from Taiwan. The f0 information was conveyed either by an f0-controlled sawtooth carrier or a modulated noise so as to compare the performance achievable by a clear indication of voice f0 and what is possible with purely temporal coding of f0. Tone recognition performance with explicit f0 was much better than that with any combination of other acoustic cues (consistently greater than 90% correct compared to 33%-65%; chance is 25%). In the absence of explicit f0, the temporal coding of f0 and amplitude envelope both contributed somewhat to tone recognition, while duration had only a marginal effect. Performance based on these secondary cues varied greatly across listeners. These results explain the relatively poor perception of tone in cochlear implant users, given that cochlear implants currently provide only weak cues to f0, so that users must rely upon the purely temporal (and secondary) features for the perception of tone. (c) 2008 Acoustical Society of America

Chemical Characterization and Source Apportionment of Household Fine Particulate Matter in Rural, Peri-urban, and Urban West Africa

Household air pollution in sub-Saharan Africa and other developing regions is an important cause of disease burden. Little is known about the chemical composition and sources of household air pollution in sub-Saharan Africa, and how they differ between rural and urban homes. We analyzed the chemical composition and sources of fine particles (PM2.5) in household cooking areas of multiple neighborhoods in Accra, Ghana, and in peri-urban (Banjul) and rural (Basse) areas in The Gambia. In Accra, biomass burning accounted for 39–62% of total PM2.5 mass in the cooking area in different neighborhoods; the absolute contributions were 10–45 μg/m3. Road dust and vehicle emissions comprised 12–33% of PM2.5 mass. Solid waste burning was also a significant contributor to household PM2.5 in a low-income neighborhood but not for those living in better-off areas. In Banjul and Basse, biomass burning was the single dominant source of cooking-area PM2.5, accounting for 74–87% of its total mass; the relative and absolute contributions of biomass smoke to PM2.5 mass were larger in households that used firewood than in those using charcoal, reaching as high as 463 μg/m3 in Basse homes that used firewood for cooking. Our findings demonstrate the need for policies that enhance access to cleaner fuels in both rural and urban areas, and for controlling traffic emissions in cities in sub-Saharan Africa