Disease burden of and expectations from surgery in patients prior to total knee arthroplasty:Results of the prospective FInGK study

Background: Disease burden in patients prior to total knee arthroplasty (TKA) varies widely between studies and countries. We aimed to characterize individuals undergoing TKA and examine their expectations from the surgery, focusing on variations in disease burden. Methods: Consecutive patients undergoing primary TKA in a German university hospital were recruited. A questionnaire including information on disease burden, preoperative expectations from surgery, health care utilization, demography, and socioeconomics was collected one day prior to surgery and linked to data from medical records. Patients were categorized into disease burden quartiles using the Western Ontario and McMaster Universities Osteoarthritis Index’ (WOMAC) total score. Subsequently, study population's characteristics and expectations from surgery were analyzed stratified by disease burden. Results: A total of 196 patients were included (41 % male; mean age: 68.2 years). The median WOMAC was 52.0 (IQR: 41.0–58.0). Patients in Q1 were more often males (Q1: 63 % vs Q4: 29 %) and had a shorter duration of complaints with the impaired knee. They were also less restricted in social participation, reported less often signs of depression, and were less often treated with physiotherapy (Q1: 27 % vs Q4: 54 %). Furthermore, expectations from surgery were highest in patients with a low disease burden. Conclusion: We found large variations in disease burden with a considerable number of patients undergoing TKA whose functional capacity is still maintained and for which guideline-recommended conservative treatment options are not fully exhausted. Further research on this subgroup as well as establishing an international consensus on specific thresholds for TKA indication are needed.</p

Disease burden of and expectations from surgery in patients prior to total knee arthroplasty:Results of the prospective FInGK study

Background: Disease burden in patients prior to total knee arthroplasty (TKA) varies widely between studies and countries. We aimed to characterize individuals undergoing TKA and examine their expectations from the surgery, focusing on variations in disease burden. Methods: Consecutive patients undergoing primary TKA in a German university hospital were recruited. A questionnaire including information on disease burden, preoperative expectations from surgery, health care utilization, demography, and socioeconomics was collected one day prior to surgery and linked to data from medical records. Patients were categorized into disease burden quartiles using the Western Ontario and McMaster Universities Osteoarthritis Index’ (WOMAC) total score. Subsequently, study population's characteristics and expectations from surgery were analyzed stratified by disease burden. Results: A total of 196 patients were included (41 % male; mean age: 68.2 years). The median WOMAC was 52.0 (IQR: 41.0–58.0). Patients in Q1 were more often males (Q1: 63 % vs Q4: 29 %) and had a shorter duration of complaints with the impaired knee. They were also less restricted in social participation, reported less often signs of depression, and were less often treated with physiotherapy (Q1: 27 % vs Q4: 54 %). Furthermore, expectations from surgery were highest in patients with a low disease burden. Conclusion: We found large variations in disease burden with a considerable number of patients undergoing TKA whose functional capacity is still maintained and for which guideline-recommended conservative treatment options are not fully exhausted. Further research on this subgroup as well as establishing an international consensus on specific thresholds for TKA indication are needed.</p

Use of Physiotherapy Prior to Total Knee Arthroplasty-Results of the Prospective FInGK Study

Background: Data regarding physiotherapy (PT) utilization prior to total knee arthroplasty (TKA) are insufficient. Therefore, this study aims to examine which percentage of patients receive PT within 12 months prior to TKA and which factors are associated with its use. Methods: Consecutive patients (≥18 years) undergoing primary or revision TKA in a German university hospital were recruited. A questionnaire including information on PT utilization, demography, and socioeconomics was collected one day prior to surgery and linked to medical hospital records. Multivariable logistic regression was conducted to determine variables associated with the use of PT. Results: A total of 241 out of 283 (85%) patients participated (60% female; mean age: 68.4 years). Overall, 41% received PT at least once during 12 months prior to TKA, women more frequently than men (48% vs. 29%). Although high disease burden was associated with increased utilization, about one in two in this condition did not receive PT. Multivariable logistic regression showed that age 75+ years, low education level, and moderate-to-severe depressive symptoms were associated with decreased PT utilization. Conclusions: We found low use of recommended PT management in patients prior to TKA. This potential underuse was even higher in some vulnerable subgroups, indicating inequalities. Prescribers as well as patients should integrate PT more consistently into osteoarthritis management

Disease burden of and expectations from surgery in patients prior to total knee arthroplasty:Results of the prospective FInGK study

Background: Disease burden in patients prior to total knee arthroplasty (TKA) varies widely between studies and countries. We aimed to characterize individuals undergoing TKA and examine their expectations from the surgery, focusing on variations in disease burden. Methods: Consecutive patients undergoing primary TKA in a German university hospital were recruited. A questionnaire including information on disease burden, preoperative expectations from surgery, health care utilization, demography, and socioeconomics was collected one day prior to surgery and linked to data from medical records. Patients were categorized into disease burden quartiles using the Western Ontario and McMaster Universities Osteoarthritis Index’ (WOMAC) total score. Subsequently, study population's characteristics and expectations from surgery were analyzed stratified by disease burden. Results: A total of 196 patients were included (41 % male; mean age: 68.2 years). The median WOMAC was 52.0 (IQR: 41.0–58.0). Patients in Q1 were more often males (Q1: 63 % vs Q4: 29 %) and had a shorter duration of complaints with the impaired knee. They were also less restricted in social participation, reported less often signs of depression, and were less often treated with physiotherapy (Q1: 27 % vs Q4: 54 %). Furthermore, expectations from surgery were highest in patients with a low disease burden. Conclusion: We found large variations in disease burden with a considerable number of patients undergoing TKA whose functional capacity is still maintained and for which guideline-recommended conservative treatment options are not fully exhausted. Further research on this subgroup as well as establishing an international consensus on specific thresholds for TKA indication are needed.</p

Disease burden of and expectations from surgery in patients prior to total knee arthroplasty:Results of the prospective FInGK study

Background: Disease burden in patients prior to total knee arthroplasty (TKA) varies widely between studies and countries. We aimed to characterize individuals undergoing TKA and examine their expectations from the surgery, focusing on variations in disease burden. Methods: Consecutive patients undergoing primary TKA in a German university hospital were recruited. A questionnaire including information on disease burden, preoperative expectations from surgery, health care utilization, demography, and socioeconomics was collected one day prior to surgery and linked to data from medical records. Patients were categorized into disease burden quartiles using the Western Ontario and McMaster Universities Osteoarthritis Index’ (WOMAC) total score. Subsequently, study population's characteristics and expectations from surgery were analyzed stratified by disease burden. Results: A total of 196 patients were included (41 % male; mean age: 68.2 years). The median WOMAC was 52.0 (IQR: 41.0–58.0). Patients in Q1 were more often males (Q1: 63 % vs Q4: 29 %) and had a shorter duration of complaints with the impaired knee. They were also less restricted in social participation, reported less often signs of depression, and were less often treated with physiotherapy (Q1: 27 % vs Q4: 54 %). Furthermore, expectations from surgery were highest in patients with a low disease burden. Conclusion: We found large variations in disease burden with a considerable number of patients undergoing TKA whose functional capacity is still maintained and for which guideline-recommended conservative treatment options are not fully exhausted. Further research on this subgroup as well as establishing an international consensus on specific thresholds for TKA indication are needed.</p

The effects of fastening strength on the variation in stress-free temperature in continuous welded rail

Continuous welded rail (CWR) is a fundamental component of any modern track structure and has several advantages over former types of rail joining processes. The reduction in maintenance and related costs has become the most attractive property of CWR although careful monitoring and maintenance of CWR is essential to ensure safe train operations. Management of the stress-free temperature (SFT) of any section of CWR in order to prevent rail breaks and lateral buckling that could lead to derailments is a vital duty of the track maintenance team. Variations in the SFT are influenced by a number of external factors. This paper describes experimental field and laboratory tests carried out to investigate to what extent the fastening strength influences the variation in SFT in CWR track on Fist fastenings and two types of pads. The research established a nonlinear relationship between clamping force and rail movement through the fasteners as well as a strongly linear relationship between clamping force and the variation in SFT. It is also demonstrated that although the friction coefficient of the pad has an influence on rail movement through the fastener, the primary factor influencing SFT variations is the clip force. This paper concludes by quantifying the relationship between clamping force and the expected variation in SFT with clear guidelines on the management of the SFT in CWR.http://pif.sagepub.comhb2016Civil Engineerin

Co‐Creatively Producing Knowledge With Other‐Than‐Human Organisms in a (Bio)Technology‐Controlled Artistic Environment

Along with the increasing awareness about the destructive force of humankind on nature, existential questions about how to create a more sustainable relationship with the natural world have emerged. To acquire a more eco‐friendly attitude, we need to go beyond the well‐established knowledge cultures that highlight a nature versus culture dichotomy. This study focuses on bio art as an epistemic vehicle to re‐imagine our understanding of and connection to the natural world. Drawing on the theoretical stance of philosophical posthumanism, we discuss how artistic co‐creation processes involving humans and other‐than‐humans hold the potential to introduce a shift in our worldview from anthropocentric to ecocentric. We further question what this shift might imply for how we approach the complex relationship between humans and other‐than‐humans in our own research. We conducted a within‐case and cross‐case analysis of five bio art projects that previously won the Bio Art & Design Award (2018–2020). To analyze the data, we used a combined approach of visual and context analysis and material semiotics. Qualitative interviews were used as a data collection technique to investigate the lived experiences of both artists and scientists involved in the projects. Our findings suggest that bio art’s epistemic significance can primarily be found in its multispecies perspective: By following the wills and ways of bio‐organisms, bio art makes the invisible connection between nature and culture visible. Bio art can provoke our thinking about how to include and approach other‐than‐human agency in the context of socially engaged research practices

Geo-Information Harvesting from Social Media Data

As unconventional sources of geo-information, massive imagery and text messages from open platforms and social media form a temporally quasi-seamless, spatially multi-perspective stream, but with unknown and diverse quality. Due to its complementarity to remote sensing data, geo-information from these sources offers promising perspectives, but harvesting is not trivial due to its data characteristics. In this article, we address key aspects in the field, including data availability, analysis-ready data preparation and data management, geo-information extraction from social media text messages and images, and the fusion of social media and remote sensing data. We then showcase some exemplary geographic applications. In addition, we present the first extensive discussion of ethical considerations of social media data in the context of geo-information harvesting and geographic applications. With this effort, we wish to stimulate curiosity and lay the groundwork for researchers who intend to explore social media data for geo-applications. We encourage the community to join forces by sharing their code and data.Comment: Accepted for publication IEEE Geoscience and Remote Sensing Magazin

Geo-Information Harvesting from Social Media Data

As unconventional sources of geo-information, massive imagery and text messages from open platforms and social media form a temporally quasi-seamless, spatially multiperspective stream, but with unknown and diverse quality. Due to its complementarity to remote sensing data, geo-information from these sources offers promising perspectives, but harvesting is not trivial due to its data characteristics. In this article, we address key aspects in the field, including data availability, analysisready data preparation and data management, geo-information extraction from social media text messages and images, and the fusion of social media and remote sensing data. We then showcase some exemplary geographic applications. In addition, we present the first extensive discussion of ethical considerations of social media data in the context of geo-information harvesting and geographic applications. With this effort, we wish to stimulate curiosity and lay the groundwork for researchers who intend to explore social media data for geo-applications. We encourage the community to join forces by sharing their code and data