The impact of socioeconomic status on implant selection for patients undergoing hip arthroplasty

© 2015, UTMJ. All rights reserved. Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA) that preserves proximal femoral bone stock. Patient socioeconomic status (SES) has been demonstrated to impact access to care for numerous healthcare interventions but little is known about its impact on HRA when compared to THA. The aim of this study was to investigate whether there are disparities in SES for patients receiving HRA or THA. A retrospective database review was conducted comprising 617 hip arthroplasty patients (310 HRA, 307 THA). Patient postal code was used as a surrogate marker for patients’ SES and referenced against Canada Census Tract data to determine patient income. Patients greater than 70 years of age and those who underwent THA as revision or for fractures were excluded from the study. There were 465 patients included in the analysis comprised of 273 HRA and 192 THA patients. HRA patients ($33,240, SD$8,206) had a significantly higher mean income than THA patients ($29,365, SD$7,119, p\u3c0.001). The percentage of patients that underwent HRA compared to THA increased as patients’ SES increased. Patients with an income greater than $25,000 were significantly more likely to undergo HRA rather than THA (OR ≥1.76), compared to patients with an income less than$25,000 in whom THA was more likely. There appears to be a disparity in SES between patients who receive HRA and THA. Further work is needed to better understand the factors that influence the choice of hip replacement for patients requiring surgical intervention

Integrating Business Intelligence And Decision Focused Database Methods: A Prescriptive Principles Approach

Inasmuch as the field of Management Information Systems has seen significant changes, business school curriculums have not kept pace with the growing demands in the market. This approach closes that gap between the needs of the market and the products, or students, universities are supplying. Using Prescriptive Principles, this module gives students a business question to be answered, has the instructor demonstrate SQL functions and querying techniques, sets the scene for the students to reflect on the application of this business intelligence project, encourages students to use their previous experience to develop a business strategy to utilize the insight gained from their developed SQL functions, and finally sets up a frame work whereby their findings can be presented to their peers, as business “stakeholders,” and demonstrate their new understanding. Such a method will create students capable of understanding code, but more so, it will create students who will understand how that code can help sustain a business’s growth strategy and its bottom-line

Method of fabricating multiwavelength infrared focal plane array detector

A multiwavelength local plane array infrared detector is included on a common substrate having formed on its top face a plurality of In.sub.x Ga.sub.1-x As (x.ltoreq.0.53) absorption layers, between each pair of which a plurality of InAs.sub.y P.sub.1-y (y.ltoreq.1) buffer layers are formed having substantially increasing lattice parameters, respectively, relative to said substrate, for preventing lattice mismatch dislocations from propagating through successive ones of the absorption layers of decreasing bandgap relative to said substrate, whereby a plurality of detectors for detecting different wavelengths of light for a given pixel are provided by removing material above given areas of successive ones of the absorption layers, which areas are doped to form a pn junction with the surrounding unexposed portions of associated absorption layers, respectively, with metal contacts being formed on a portion of each of the exposed areas, and on the bottom of the substrate for facilitating electrical connections thereto

Hypoxic repeat sprint training improves rugby player's repeated sprint but not endurance performance

This study aims to investigate the performance changes in 19 well-trained male rugby players after repeat-sprint training (six sessions of four sets of 5 × 5 s sprints with 25 s and 5 min of active recovery between reps and sets, respectively) in either normobaric hypoxia (HYP; n = 9; F₁O₂ = 14.5%) or normobaric normoxia (NORM; n = 10; F₁O₂ = 20.9%). Three weeks after the intervention, 2 additional repeat-sprint training sessions in hypoxia (F₁O₂ = 14.5%) was investigated in both groups to gauge the efficacy of using "top-up" sessions for previously hypoxic-trained subjects and whether a small hypoxic dose would be beneficial for the previously normoxic-trained group. Repeated sprint (8 × 20 m) and Yo-Yo Intermittent Recovery Level 1 (YYIR1) performances were tested twice at baseline (Pre 1 and Pre 2) and weekly after (Post 1-3) the initial intervention (intervention 1) and again weekly after the second "top-up" intervention (Post 4-5). After each training set, heart rate, oxygen saturation, and rate of perceived exertion were recorded. Compared to baseline (mean of Pre 1 and Pre 2), both the hypoxic and normoxic groups similarly lowered fatigue over the 8 sprints 1 week after the intervention (Post 1: -1.8 ± 1.6%, -1.5 ± 1.4%, mean change ± 90% CI in HYP and NORM groups, respectively). However, from Post 2 onwards, only the hypoxic group maintained the performance improvement compared to baseline (Post 2: -2.1 ± 1.8%, Post 3: -2.3 ± 1.7%, Post 4: -1.9 ± 1.8%, and Post 5: -1.2 ± 1.7%). Compared to the normoxic group, the hypoxic group was likely to have substantially less fatigue at Post 3-5 (-2.0 ± 2.4%, -2.2 ± 2.4%, -1.6 ± 2.4% Post 3, Post 4, Post 5, respectively). YYIR1 performances improved throughout the recovery period in both groups (13-37% compared to baseline) with unclear differences found between groups. The addition of two sessions of "top-up" training after intervention 1, had little effect on either group. Repeat-sprint training in hypoxia for six sessions increases repeat sprint ability but not YYIR1 performance in well-trained rugby players

RIPK3 restricts viral pathogenesis via cell death-independent neuroinflammation

Receptor-interacting protein kinase-3 (RIPK3) is an activator of necroptotic cell death, but recent work has implicated additional roles for RIPK3 in inflammatory signaling independent of cell death. However, while necroptosis has been shown to contribute to antiviral immunity, death-independent roles for RIPK3 in host defense have not been demonstrated. Using a mouse model of West Nile virus (WNV) encephalitis, we show that RIPK3 restricts WNV pathogenesis independently of cell death. Ripk3(-/-) mice exhibited enhanced mortality compared to wild-type (WT) controls, while mice lacking the necroptotic effector MLKL, or both MLKL and caspase-8, were unaffected. The enhanced susceptibility of Ripk3(-/-) mice arose from suppressed neuronal chemokine expression and decreased central nervous system (CNS) recruitment of T lymphocytes and inflammatory myeloid cells, while peripheral immunity remained intact. These data identify pleiotropic functions for RIPK3 in the restriction of viral pathogenesis and implicate RIPK3 as a key coordinator of immune responses within the CNS

Photonic Passbands and Zeropoints for the Stromgren uvby system

Photonic passbands have been derived for the uvby standard system by convolving the original filter passbands of Str\"omgren and Perry with atmospheric extinction and the QE of a cooled 1P21 photomultiplier tube. Using these new passbands, synthetic photometry was calculated for all the stars in the extensive NGSL and MILES spectrophotometric libraries and compared with the homogenised b-y, m1 and c1 indices in the Hauck-Mermilliod 1998 catalog and the derived u - v and v - b colors. Excellent agreement between observed and synthetic photometry was achieved with regression slopes near unity. Slightly better fits were obtained by considering stars with b-y 0.5, separately. It is recommended that these new passbands be used together with the provided transformation equations to generate synthetic photometry from model atmosphere fluxes and observed spectrophotometry. Synthetic photometry was also carried out using the natural system of the 4-channel spectrograph-photometers and those of Cousins and Eggen in order to explore the systematic dfferences that could be expected between their instrumental systems and the standard system.Comment: 15 pages, including 10 figure

Simulation of Blast Waves with Headwind

The blast wave resulting from an explosion was simulated to provide guidance for models estimating risks for human spacecraft flight. Simulations included effects of headwind on blast propagation, Blasts were modelled as an initial value problem with a uniform high energy sphere expanding into an ambient field. Both still air and cases with headwind were calculated

Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas.

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this rare cutaneous lymphoma. Thirty-four patients with a median age of 77 years (range 19-89 years) presented primarily with extensive annular necrotic plaques or tumor lesions with frequent mucous membrane involvement. The 5-year survival was 32% with a median survival of 12 months. A subset of 17 patients had a prodrome of chronic patches prior to the development of aggressive ulcerative lesions. We identified cases with lack of CD8 or αβ T-cell receptor expression yet with similar clinical and pathological presentation. Allogeneic stem cell transplantation provided partial or complete remissions in 5/6 patients. We recommend the term primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphoma as this more broad designation better describes this clinical-pathologic presentation, which allows the inclusion of cases with CD8 negative and/or αβ/γδ T-cell receptor chain double-positive or double-negative expression. We have identified early skin signs of chronic patch/plaque lesions that are often misdiagnosed as eczema, psoriasis, or mycosis fungoides. Our experience confirms the poor prognosis of this entity and highlights the inefficacy of our standard therapies with the exception of allogeneic stem cell transplantation in selected cases