Obituary: Arthur Cruickshank 1932 - 2011. A native Gondwanan, who studied the former continent's fossil tetrapods

Dr Arthur Richard Ivor Cruickshank died on 4th December 2011, aged 79, in the Borders General Hospital, Melrose, Scotland. Arthur Cruickshank was part of the post-war generation of palaeontologists who laid the foundations on which today’s researchers build. Appropriately for someone from an expatriate Scots family living in Kenya, much of his work was on the extinct reptiles of the great southern palaeocontinent of Gondwana

Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery – a systematic review and meta-analysis

SummaryObjectiveTo determine if pre-operative interventions for hip and knee osteoarthritis provide benefit before and after joint replacement.MethodSystematic review with meta-analysis of randomised controlled trials (RCTs) of pre-operative interventions for people with hip or knee osteoarthritis awaiting joint replacement surgery.Standardised mean differences (SMD) were calculated for pain, musculoskeletal impairment, activity limitation, quality of life, and health service utilisation (length of stay and discharge destination). The GRADE approach was used to determine the quality of the evidence.ResultsTwenty-three RCTs involving 1461 participants awaiting hip or knee replacement surgery were identified. Meta-analysis provided moderate quality evidence that pre-operative exercise interventions for knee osteoarthritis reduced pain prior to knee replacement surgery (SMD (95% CI)=0.43 [0.13, 0.73]). None of the other meta-analyses investigating pre-operative interventions for knee osteoarthritis demonstrated any effect. Meta-analyses provided low to moderate quality evidence that exercise interventions for hip osteoarthritis reduced pain (SMD (95% CI)=0.52 [0.04, 1.01]) and improved activity (SMD (95% CI)=0.47 [0.11, 0.83]) prior to hip replacement surgery. Meta-analyses provided low quality evidence that exercise with education programs improved activity after hip replacement with reduced time to reach functional milestones during hospital stay (e.g., SMD (95% CI)=0.50 [0.10, 0.90] for first day walking).ConclusionLow to moderate evidence from mostly small RCTs demonstrated that pre-operative interventions, particularly exercise, reduce pain for patients with hip and knee osteoarthritis prior to joint replacement, and exercise with education programs may improve activity after hip replacement

Effectiveness of resistance training and associated program characteristics in patients at risk for type 2 diabetes:a systematic review and meta-analysis

BACKGROUND: Resistance training (RT) is an effective intervention for glycemic control and cardiometabolic health in individuals with type 2 diabetes (T2D). However, the use of RT in individuals at risk for T2D to prevent or delay the onset of T2D, and RT program characteristics that are most effective are still unknown. The purpose of this review is to determine the effects of RT on cardiometabolic risk factors in those at risk for T2D and to examine RT program characteristics associated with intervention effectiveness. METHODS: PubMed, Cochrane, Web of Science, and Embase databases were systematically searched for published controlled trials that compared cardiometabolic outcomes in adults with cardiometabolic risk for those that underwent an RT intervention with those that did not. A systematic review and meta-analysis was conducted to determine the effect of RT on glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body fat percentage (BF%), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Additional analyses examined effects of intervention duration and dietary intervention on FPG and TG. RESULTS: Fourteen trials with 668 participants were included. For RT compared to controls, the standardized mean difference (SMD) was −1.064 for HbA1c (95% confidence interval [CI] −1.802 to −0.327; p=0.005), −0.99 for FPG (95% CI −1.798 to −0.183; p=0.016), −0.933 for TC (95% CI −1.66 to −0.206; p=0.012), −0.840 for BF% (95% CI −1.429 to −0.251; p=0.005), −0.693 for HDL (95% CI −1.230 to −0.156; p=0.011), −1.03 for LDL (95% CI −2.03 to −0.050; p=0.039), and −0.705 for TG (95% CI −1.132 to −0.279; p=0.001). CONCLUSIONS: RT is beneficial for improving glycemic control, BF%, and blood lipids in those at risk for diabetes. The addition of a dietary component did not result in larger reductions in FPG and TG than RT alone. PROSPERO REGISTRATION ID: CRD42019122217 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40798-021-00321-x

Are weekend inpatient rehabilitation services value for money? An economic evaluation alongside a randomized controlled trial with a 30 day follow up

BACKGROUND: Providing additional Saturday rehabilitation can improve functional independence and health related quality of life at discharge and it may reduce patient length of stay, yet the economic implications are not known. The aim of this study was to determine from a health service perspective if the provision of rehabilitation to inpatients on a Saturday in addition to Monday to Friday was cost effective compared to Monday to Friday rehabilitation alone. METHODS: Cost utility and cost effectiveness analyses were undertaken alongside a multi-center, single-blind randomized controlled trial with a 30-day follow up after discharge. Participants were adults admitted for inpatient rehabilitation in two publicly funded metropolitan rehabilitation facilities. The control group received usual care rehabilitation services from Monday to Friday and the intervention group received usual care plus an additional rehabilitation service on Saturday. Incremental cost utility ratio was reported as cost per quality adjusted life year (QALY) gained and an incremental cost effectiveness ratio (ICER) was reported as cost for a minimal clinically important difference (MCID) in functional independence. RESULTS: 996 patients (mean age 74 (standard deviation 13) years) were randomly assigned to the intervention (n = 496) or the control group (n = 500). Mean difference in cost of AUD$1,673 (95$41,825 (95% CI -2,817 to 74,620) per QALY gained for the intervention group. The ICER found a saving of AUD$16,003 (95% CI -3,074 to 87,361) in achieving a MCID in functional independence for the intervention group. If the willingness to pay per QALY gained or for a MCID in functional independence was zero dollars the probability of the intervention being cost effective was 96% and 95%, respectively. A sensitivity analysis removing Saturday penalty rates did not significantly alter the outcome. CONCLUSIONS: From a health service perspective, the provision of rehabilitation to inpatients on a Saturday in addition to Monday to Friday, compared to Monday to Friday rehabilitation alone, is likely to be cost saving per QALY gained and for a MCID in functional independence. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry November 2009 ACTRN1260900097321

The de Morton Mobility Index (DEMMI) provides a valid method for measuring and monitoring the mobility of patients making the transition from hospital to the community: an observational study

QuestionIsthe de Morton Mobility Index (DEMMI) valid for measuring the mobility of patients making the transition from hospital to the community?DesignObservational cohort study.Participants696 consecutive patients admitted to 11 Transition Care Programs for multidisciplinary care in Victoria and Tasmania during a 6-month period. The DEMMI and Modified Barthel Index were administered within 5 working days of admission and discharge from the Transition Care Program.Outcome measuresThe DEMMI and Modified Barthel Index.ResultsNeither the DEMMI nor the Modified Barthel Index had a floor or ceiling effect. Similar evidence of convergent, discriminant and known-groups validity were obtained for each instrument. The DEMMI was significantly more responsive to change than the Modified Barthel Index using criterion- and distribution-based methods. The minimum clinically important difference estimates represented similar proportions of the scale width for the DEMMI and Modified Barthel Index and were similar using criterion- and distribution-based estimates. Rasch analysis identified the DEMMI as essentially unidimensional in a Transition Care Program cohort and therefore can be applied to obtain interval level measurement. Rasch analysis demonstrated that the DEMMI was administered similarly by physiotherapists and allied health assistants under the direction of a physiotherapist.ConclusionThe DEMMI and Modified Barthel Index are both valid measures of activity limitation for Transition Care Program patients. The DEMMI has a broader scale width, provides interval level measurement, and is significantly more responsive to change than the Modified Barthel Index for measuring the mobility of Transition Care Program patient

Isothiourea-catalysed acylative kinetic resolution of aryl-alkenyl (sp2 vs. sp2) substituted secondary alcohols

We would like to thank the Engineering and Physical Sciences Research Council and CRITICAT Centre for Doctoral Training [Ph.D. studentship to S.F.M.; Grant code: EP/L016419/1 and EP/J018139/1] and The Leverhulme Trust [Early Career Fellowship to J.E.T.; ECF-2014-005] for financial support. A.D.S. thanks the Royal Society for a Wolfson Merit Award.The non-enzymatic acylative kinetic resolution of challenging aryl–alkenyl (sp2 vs. sp2) substituted secondary alcohols is described, with effective enantiodiscrimination achieved using the isothiourea organocatalyst HyperBTM (1 mol %) and isobutyric anhydride. The kinetic resolution of a wide range of aryl–alkenyl substituted alcohols has been evaluated, with either electron-rich or naphthyl aryl substituents in combination with an unsubstituted vinyl substituent providing the highest selectivity (S=2–1980). The use of this protocol for the gram-scale (2.5 g) kinetic resolution of a model aryl–vinyl (sp2 vs. sp2) substituted secondary alcohol is demonstrated, giving access to >1 g of each of the product enantiomers both in 99:1 e.r.Publisher PDFPeer reviewe

Zero and Finite Temperature Quantum Simulations Powered by Quantum Magic

We present a comprehensive approach to quantum simulations at both zero and finite temperatures, employing a quantum information theoretic perspective and utilizing the Clifford + $k$Rz transformations. We introduce the "quantum magic ladder", a natural hierarchy formed by systematically augmenting Clifford transformations with the addition of Rz gates. These classically simulable similarity transformations allow us to reduce the quantumness of our system, conserving vital quantum resources. This reduction in quantumness is essential, as it simplifies the Hamiltonian and shortens physical circuit-depth, overcoming constraints imposed by limited error correction. We improve the performance of both digital and analog quantum computers on ground state and finite temperature molecular simulations, not only outperforming the Hartree-Fock solution, but also achieving consistent improvements as we ascend the quantum magic ladder. By facilitating more efficient quantum simulations, our approach enables near-term and early fault-tolerant quantum computers to address novel challenges in quantum chemistry.Comment: 12 pages, 9 figure