Risk of <i>Staphylococcus aureus</i> bacteraemia in patients with rheumatoid arthritis and the effect of orthopaedic implants on the risk: a nationwide observational cohort study

It remains disputed how much the risk of Staphylococcus aureus bacteraemia (SAB) is increased in patients with rheumatoid arthritis (RA), and the extent to which orthopaedic implants explain the risk. We assessed SAB incidence rates (IRs) and incidence rate ratios (IRRs), comparing RA patients with a general population cohort (GPC) and individuals with versus without orthopaedic implants. Danish residents aged ≥ 18 years without prior RA or SAB (=GPC) were followed up for RA and microbiologically verified SAB events (1996–2017). IRRs were calculated by age- and sex-stratified Poisson regression adjusted for age, comorbidities, calendar year, and socioeconomic status. The GPC comprised 5 398 690 individuals. We identified 33 567 incident RA patients (=RA cohort) (median follow-up 7.3 years, IQR 3.6–12.3). We observed 25 023 SAB events (n = 224 in the RA cohort). IRs per 100 000 person-years were 81.0 (RA cohort) and 29.9 (GPC). IRs increased with age. Adjusted IRRs in 18–59-year-old RA patients were 2.6 (95% confidence interval 1.8–3.7) for women and 1.8 (1.1–3.1) for men, compared with same sex and age group GPC. IRRs declined with age. Compared with the GPC without implants, IRRs for RA patients with implants ranged from 1.9 (1.3–2.8) (women ≥ 70 years) to 5.3 (2.2–12.8) (18–59-year-old men). In this nationwide registry-based cohort study RA was a risk factor for SAB, and orthopaedic implants further increased the risk. Clinicians should be aware of potential SAB in patients with RA and orthopaedic implants

Dem Andenken an Helmut Wyklicky (1921–2007) gewidmet. Veröffentlichungen der Kommission für Geschichte der Naturwissenschaften, Mathematik und Medizin|Ernst Fuchs und die Weltgeltung der Wiener Ophthalmologischen Schule um 1900 Veröffentlichungen der Kommission für Geschichte der Naturwissenschaften, Mathematik und Medizin 69|

IndiGolog is a programming language for autonomous agents that sense their environment and do planning as they operate. Instead of classical planning, it supports high-level program execution. The programmer provides a high-level nondeterministic program involving domain-specific actions and tests to perform the agent¿s tasks. The IndiGolog interpreter then reasons about the preconditions and effects of the actions in the program to find a legal terminating execution. To support this, the programmer provides a declarative specification of the domain (i.e., primitive actions, preconditions and effects, what is known about the initial state) in the situation calculus. The programmer can control the amount of nondeterminism in the program and how much of it is searched over. The language is rich and supports concurrent programming. Programs are executed online together with sensing the environment and monitoring for events, thus supporting the development of reactive agents. We discuss the language, its implementation, and applications that have been realized with it