Risk of bias and the reporting of surgeons' experience in randomized controlled trials of total hip and total knee arthroplasty: A systematic review

Rationale, aims, and objectives: The potential bias introduced by surgeons' lack of comparable, relevant experience when performing the procedures in different arms of randomized controlled trials (RCTs) is arguably not well-managed or reported. The aim of this work was to review the frequency and nature with which surgeons' relevant experience is reported in RCTs of total hip (THA) and total knee arthroplasty (TKA), and to relate this to other risk of bias domains for this study design. Methods: A systematic review of RCTs comparing different minimally invasive procedures for TKA and comparisons of THA and hemiarthroplasty (HA). We searched MEDLINE, EMBASE, Science Citation Index, The Cochrane Library, Conference Proceedings Citation Index-Science (CPCI-S), Current Controlled Trials, and Clinical Trials.gov. Results: Seventy-five relevant RCTs were identified, 65 RCTs comparing minimally invasive with standard or other minimally invasive approaches to TKA, and 10 for THA compared with HA. Risk of bias based on the reported details of surgeons' relevant experience was categorized as low, high, or unclear. There was a clear distinction before and after 2009, with a substantial decrease in trials at high or unclear risk of bias after this date. There were no strong associations between this domain and other, standard risk of bias domains for RCTs. Conclusion: The surgeons' relevant experience in an evaluated procedure is often poorly reported but has improved since 2009. The variable is not adequately captured by any other risk of bias domain. Future work should concentrate on conducting research on a much larger sample of studies and in procedures other than knee and hip arthroplasty

Multiple parallel skin markers for minimal incision lumbar disc surgery; a technical note

BACKGROUND: Spinal surgery depends on accurate localization to prevent incorrect surgical approaches. The trend towards minimally invasive surgery that minimizes surgical exposure and reduces postoperative pain increasingly requires surgeons to accurately determine the operative level before an incision is made. Preoperative localization with a C-arm image intensifier is popular, but the exposure of both patients and theatre staff to radiation is a disadvantage, as well as being time-consuming. METHODS: We describe a simple surgical tool developed to help localize exact spinal levels in conjunction with a simple AP X-ray film immediately before surgery. Multiple parallel skin markers were made using a circular oven rack comprising multiple 1.5 cm spaced parallel wires attached to a circular outside rim. The longest line was placed on the line of the postero-superior iliac spine (PSIS) over the junction of the L5-S1 region. RESULTS AND CONCLUSIONS: Based on the film taken, the incision can be accurately made at the intended level. The incision wound can be minimized to 3.0 cm even when using conventional disc surgery instruments

Ocean temperature and salinity components of the Madden-Julian oscillation observed by Argo floats

New diagnostics of the Madden-Julian Oscillation (MJO) cycle in ocean temperature and, for the first time, salinity are presented. The MJO composites are based on 4 years of gridded Argo float data from 2003 to 2006, and extend from the surface to 1,400 m depth in the tropical Indian and Pacific Oceans. The MJO surface salinity anomalies are consistent with precipitation minus evaporation fluxes in the Indian Ocean, and with anomalous zonal advection in the Pacific. The Argo sea surface temperature and thermocline depth anomalies are consistent with previous studies using other data sets. The near-surface density changes due to salinity are comparable to, and partially offset, those due to temperature, emphasising the importance of including salinity as well as temperature changes in mixed-layer modelling of tropical intraseasonal processes. The MJO-forced equatorial Kelvin wave that propagates along the thermocline in the Pacific extends down into the deep ocean, to at least 1,400 m. Coherent, statistically significant, MJO temperature and salinity anomalies are also present in the deep Indian Ocean

Instability in a marginal coral reef: the shift from natural variability to a human-dominated seascape

As global climate change drives the demise of tropical reef ecosystems, attention is turning to the suitability o refuge habitat. For the Great Barrier Reef, are there historically stable southern refugia where corals from th north might migrate as climate changes? To address this question, we present a precise chronology of margina coral reef development from Moreton Bay, southeast Queensland, Australia. Our chronology shows that ree growth was episodic, responding to natural environmental variation throughout the Holocene, and tha Moreton Bay was inhospitable to corals for about half of the past 7000 years. The only significant change ii coral species composition occurred between similar to 200 and similar to 50 years ago, following anthropogenic alterations of th, bay and its catchments. Natural historical instability of reefs, coupled with environmental degradation sinc, European colonization, suggests that Moreton Bay offers limited potential as refuge habitat for reef species or human time scales

Does the lateral intercondylar ridge disappear in ACL deficient patients?

The aim of this study was to determine whether there is a difference in the presence of the lateral intercondylar ridge and the lateral bifurcate ridge between patients with sub-acute and chronic ACL injuries. We hypothesized that the ridges would be present less often with chronic ACL deficiency. Twenty-five patients with a chronic ACL injury were matched for age and gender to 25 patients with a sub-acute ACL injury. The lateral intercondylar ridge and lateral bifurcate ridge were scored as either present, absent, or indeterminate due to insufficient visualization by three blinded observers. The kappa for the three observers was .61 for the lateral intercondylar ridge and .58 for the lateral bifurcate ridge. The lateral intercondylar ridge was present in 88% of the sub-acute patients and 88% of the chronic patients. The lateral bifurcate ridge was present in 48% of the sub-acute and 48% of the chronic patients. This matched-pairs case–control study was unable to show a difference in the presence of the femoral bony ridges between patients with acute and chronic ACL injuries. The authors would suggest looking for the ridges as a landmark of the native ACL insertion site during ACL reconstruction in both acute and chronic ACL injuries

The reliability and validity of the Chinese version of Abbreviated PAD Emotion Scales

The study aimed at testing the reliabilityand validity of the Chinese version of Abbreviated PAD Emotion Scales using a Chinese sample. 297 Chinese undergraduate students were tested with the Chinese version of Abbreviated PAD Emotion Scales; 98 of them were retested with the same scales after seven days in order to assess thetest-retest reliability; and 102 of them were tested with SCL-90 at the same time which was intended as criteria for validity to assess the criterion validity. The results showedthat the Chinese version of Abbreviated PAD Emotion Scales displayed satisfying reliability and validity on P (pleasure-displeasure), only moderate reliability and validityon D (dominance-submissiveness), but quite low reliability and validity on A(arousal-nonarousal)The study aimed at testing the reliability and validity of the Chinese version of Abbreviated PAD Emotion Scales using a Chinese sample. 297 Chinese undergraduate students were tested with the Chinese version of Abbreviated PAD Emotion Scales; 98 of them were retested with the same scales after seven days in order to assess the test-retest reliability; and 102 of them were tested with SCL-90 at the same time which was intended as criteria for validity to assess the criterion validity. The results showed that the Chinese version of Abbreviated PAD Emotion Scales displayed satisfying reliability and validity on P (pleasure-displeasure), only moderate reliability and validity on D (dominance-submissiveness), but quite low reliability and validity on A (arousal-nonarousal)

The numerical simulation of continuous Nd : YAG laser-annealing of InP

The semiconductor solid phase epitaxial model of continuous laser-annealing is used to simulate the laser-annealing process of different doping concentration of InP at the continuous Nd:YAG laser. Specially, quasi-static model is used to simulate the radial heat dissipation from radiant region to radiationless region. At the same time, thermal conductivity and optical absorption coefficient varied with temperature is also considered. The method of hidden-form different is used in solving one-dimensional, non-homogeneous, nonlinear partial differential equation of heat conduction. At the room temperature T-0=300K and the power intensity of laser I-0=800W/cm(2), the result is that the temperature of surface reaches about 1290K after 3.8sec