Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Stakeholder Perspectives on Humanistic Implementation of Computer Perception in Health Care: Qualitative Study

Background: Computer perception (CP) technologies-including digital phenotyping, affective computing, and related passive sensing approaches-offer unprecedented opportunities to personalize health care, especially mental health care, yet they also provoke concerns about privacy, bias, and the erosion of empathic, relationship-centered practice. At present, it remains elusive what stakeholders who design, deploy, and experience these tools in real-world settings perceive as the risks and benefits of CP technologies. Objective: This study aims to explore key stakeholder perspectives on the potential benefits, risks, and concerns associated with integrating CP technologies into patient care. A better understanding of these concerns is crucial for responding to and mitigating such concerns via design implementation strategies that augment, rather than compromise, patient-centered and humanistic care and associated outcomes. Methods: We conducted in-depth, semistructured interviews with 102 stakeholders involved at key points in CP\u27s development and implementation: adolescent patients (n=20) and their caregivers (n=20); frontline clinicians (n=20); technology developers (n=21); and ethics, legal, policy, or philosophy scholars (n=21). Interviews (~ 45 minutes each) explored perceived benefits, risks, and implementation challenges of CP in clinical care. Transcripts underwent thematic analysis by a multidisciplinary team; reliability was enhanced through double coding and consensus adjudication. Results: Stakeholders raised concerns across 7 themes: (1) Data Privacy and Protection (88/102, 86.3%); (2) Trustworthiness and Integrity of CP Technologies (72/102, 70.6%); (3) direct and indirect Patient Harms (65/102, 63.7%); (4) Utility and Implementation Challenges (60/102, 58.8%); (5) Patient-Specific Relevance (24/102, 23.5%); (6) Regulation and Governance (17/102, 16.7%); and (7) Philosophical Critiques of reductionism (13/102, 12.7%). A cross-cutting insight was the primacy of context and subjective meaning in determining whether CP outputs are clinically valid and actionable. Participants warned that without attention to these factors, algorithms risk misclassification and dehumanization of care. Conclusions: To operationalize humanistic safeguards, we propose personalized road maps : co-designed plans that predetermine which metrics will be monitored, how and when feedback is shared, thresholds for clinical action, and procedures for reconciling discrepancies between algorithmic inferences and lived experience. Road maps embed patient education, dynamic consent, and tailored feedback, thereby aligning CP deployment with patient autonomy, therapeutic alliance, and ethical transparency. This multistakeholder study provides the first comprehensive, evidence-based account of relational, technical, and governance challenges raised by CP tools in clinical care. By translating these insights into personalized road maps, we offer a practical framework for developers, clinicians, and policy makers seeking to harness continuous behavioral data while preserving the humanistic core of care

Variation in reproductive success across captive populations: methodological differences, potential biases and opportunities

Our understanding of fundamental organismal biology has been disproportionately influenced by studies of a relatively small number of ‘model’ species extensively studied in captivity. Laboratory populations of model species are commonly subject to a number of forms of past and current selection that may affect experimental outcomes. Here, we examine these processes and their outcomes in one of the most widely used vertebrate species in the laboratory – the zebra finch (Taeniopygia guttata). This important model species is used for research across a broad range of fields, partly due to the ease with which it can be bred in captivity. However despite this perceived amenability, we demonstrate extensive variation in the success with which different laboratories and studies bred their subjects, and overall only 64% of all females that were given the opportunity, bred successfully in the laboratory. We identify and review several environmental, husbandry, life-history and behavioural factors that potentially contribute to this variation. The variation in reproductive success across individuals could lead to biases in experimental outcomes and drive some of the heterogeneity in research outcomes across studies. The zebra finch remains an excellent captive animal system and our aim is to sharpen the insight that future studies of this species can provide, both to our understanding of this species and also with respect to the reproduction of captive animals more widely. We hope to improve systematic reporting methods and that further investigation of the issues we raise will lead both to advances in our fundamental understanding of avian reproduction as well as to improvements in future welfare and experimental efficiency

Variation in reproductive success across captive populations:methodological differences, potential biases and opportunities

Our understanding of fundamental organismal biology has been disproportionately influenced by studies of a relatively small number of ‘model’ species extensively studied in captivity. Laboratory populations of model species are commonly subject to a number of forms of past and current selection that may affect experimental outcomes. Here, we examine these processes and their outcomes in one of the most widely used vertebrate species in the laboratory – the zebra finch (Taeniopygia guttata). This important model species is used for research across a broad range of fields, partly due to the ease with which it can be bred in captivity. However despite this perceived amenability, we demonstrate extensive variation in the success with which different laboratories and studies bred their subjects, and overall only 64% of all females that were given the opportunity, bred successfully in the laboratory. We identify and review several environmental, husbandry, life-history and behavioural factors that potentially contribute to this variation. The variation in reproductive success across individuals could lead to biases in experimental outcomes and drive some of the heterogeneity in research outcomes across studies. The zebra finch remains an excellent captive animal system and our aim is to sharpen the insight that future studies of this species can provide, both to our understanding of this species and also with respect to the reproduction of captive animals more widely. We hope to improve systematic reporting methods and that further investigation of the issues we raise will lead both to advances in our fundamental understanding of avian reproduction as well as to improvements in future welfare and experimental efficiency

Variation in reproductive success across captive populations: methodological differences, potential biases and opportunities

Our understanding of fundamental organismal biology has been disproportionately influenced by studies of a relatively small number of ‘model’ species extensively studied in captivity. Laboratory populations of model species are commonly subject to a number of forms of past and current selection that may affect experimental outcomes. Here, we examine these processes and their outcomes in one of the most widely used vertebrate species in the laboratory – the zebra finch (Taeniopygia guttata). This important model species is used for research across a broad range of fields, partly due to the ease with which it can be bred in captivity. However despite this perceived amenability, we demonstrate extensive variation in the success with which different laboratories and studies bred their subjects, and overall only 64% of all females that were given the opportunity, bred successfully in the laboratory. We identify and review several environmental, husbandry, life-history and behavioural factors that potentially contribute to this variation. The variation in reproductive success across individuals could lead to biases in experimental outcomes and drive some of the heterogeneity in research outcomes across studies. The zebra finch remains an excellent captive animal system and our aim is to sharpen the insight that future studies of this species can provide, both to our understanding of this species and also with respect to the reproduction of captive animals more widely. We hope to improve systematic reporting methods and that further investigation of the issues we raise will lead both to advances in our fundamental understanding of avian reproduction as well as to improvements in future welfare and experimental efficiency