Current Strategies in Prevention of Postoperative Infections in Spine Surgery.

Study Design: Narrative review. Objectives: Postoperative surgical site infections (SSIs) are among the most common acute complications in spine surgery and have a devastating impact on outcomes. They can lead to increased morbidity and mortality as well as greater economic burden. Hence, preventive strategies to reduce the rate of SSIs after spine surgery have become vitally important. The purpose of this article was to summarize and critically analyze the available evidence related to current strategies in the prevention of SSIs after spine surgery. Methods: A literature search utilizing Medline database was performed. Relevant studies from all the evidence levels have been included. Recommendations to decrease the risk of SSIs have been provided based on the results from studies with the highest level of evidence. Results: SSI prevention occurs at each phase of care including the preoperative, intraoperative, and postoperative periods. Meticulous patient selection, tight glycemic control in diabetics, smoking cessation, and screening/eradication of Conclusions: Although preventive strategies are already in use alone or in combination, further high-level research is required to prove their efficacy in reducing the rate of SSIs in spine surgery before evidence-based standard infection prophylaxis guidelines can be built

Analysis of Underground Storage Tanks System Materials to Increased Leak Potential Associated with E15 Fuel

The Energy Independence and Security Act (EISA) of 2007 was enacted by Congress to move the nation toward increased energy independence by increasing the production of renewable fuels to meet its transportation energy needs. The law establishes a new renewable fuel standard (RFS) that requires the nation to use 36 billion gallons annually (2.3 million barrels per day) of renewable fuel in its vehicles by 2022. Ethanol is the most widely used renewable fuel in the US, and its production has grown dramatically over the past decade. According to EISA and RFS, ethanol (produced from corn as well as cellulosic feedstocks) will make up the vast majority of the new renewable fuel requirements. However, ethanol use limited to E10 and E85 (in the case of flex fuel vehicles or FFVs) will not meet this target. Even if all of the E0 gasoline dispensers in the country were converted to E10, such sales would represent only about 15 billion gallons per year. If 15% ethanol, rather than 10% were used, the potential would be up to 22 billion gallons. The vast majority of ethanol used in the United States is blended with gasoline to create E10, that is, gasoline with up to 10% ethanol. The remaining ethanol is sold in the form of E85, a gasoline blend with as much as 85% ethanol that can only be used in FFVs. Although DOE remains committed to expanding the E85 infrastructure, that market will not be able to absorb projected volumes of ethanol in the near term. Given this reality, DOE and others have begun assessing the viability of using intermediate ethanol blends as one way to transition to higher volumes of ethanol. In October of 2010, the EPA granted a partial waiver to the Clean Air Act allowing the use of fuel that contains up to 15% ethanol for the model year 2007 and newer light-duty motor vehicles. This waiver represents the first of a number of actions that are needed to move toward the commercialization of E15 gasoline blends. On January 2011, this waiver was expanded to include model year 2001 light-duty vehicles, but specifically prohibited use in motorcycles and off-road vehicles and equipment. UST stakeholders generally consider fueling infrastructure materials designed for use with E0 to be adequate for use with E10, and there are no known instances of major leaks or failures directly attributable to ethanol use. It is conceivable that many compatibility issues, including accelerated corrosion, do arise and are corrected onsite and, therefore do not lead to a release. However, there is some concern that higher ethanol concentrations, such as E15 or E20, may be incompatible with current materials used in standard gasoline fueling hardware. In the summer of 2008, DOE recognized the need to assess the impact of intermediate blends of ethanol on the fueling infrastructure, specifically located at the fueling station. This includes the dispenser and hanging hardware, the underground storage tank, and associated piping. The DOE program has been co-led and funded by the Office of the Biomass Program and Vehicle Technologies Program with technical expertise from the Oak Ridge National Laboratory (ORNL) and the National Renewable Energy Laboratory (NREL). The infrastructure material compatibility work has been supported through strong collaborations and testing at Underwriters Laboratories (UL). ORNL performed a compatibility study investigating the compatibility of fuel infrastructure materials to gasoline containing intermediate levels of ethanol. These results can be found in the ORNL report entitled Intermediate Ethanol Blends Infrastructure Materials Compatibility Study: Elastomers, Metals and Sealants (hereafter referred to as the ORNL intermediate blends material compatibility study). These materials included elastomers, plastics, metals and sealants typically found in fuel dispenser infrastructure. The test fuels evaluated in the ORNL study were SAE standard test fuel formulations used to assess material-fuel compatibility within a relatively short timeframe. Initially, these material studies included test fuels of Fuel C, CE10a, CE17a, and CE25a. The CE17a test fuel was selected to represent E15 since surveys have shown that the actual ethanol upper limit can be as high as 17%. Later, CE50a and CE85a test fuels were added to the investigation and these results are being compiled for a follow-on report to be published in 2012. Fuel C was used as the baseline reference and is a 50:50 blend of isooctane and toluene. This particular composition was used to represent premium-grade gasoline and was also used as the base fuel for the ethanol blends, where it is denoted by 'C' in the fuel name. The level of ethanol is represented by the number following the letter E. Therefore a 10% blend of ethanol in Fuel C is written as CE10a, where 'a' represents an aggressive formulation of the ethanol that contains water, NaCl, acetic and sulfuric acids per the SAE J1681 protocol

Association Between COVID-19 and Mortality in Hip Fracture Surgery in the National COVID Cohort Collaborative (N3C): A Retrospective Cohort Study

BACKGROUND: This study investigated the outcomes of coronavirus disease (COVID-19)-positive patients undergoing hip fracture surgery using a national database. METHODS: This is a retrospective cohort study comparing hip fracture surgery outcomes between COVID-19 positive and negative matched cohorts from 46 sites in the United States. Patients aged 65 and older with hip fracture surgery between March 15 and December 31, 2020, were included. The main outcomes were 30-day all-cause mortality and all-cause mortality. RESULTS: In this national study that included 3303 adults with hip fracture surgery, the 30-day mortality was 14.6% with COVID-19-positive versus 3.8% in COVID-19-negative, a notable difference. The all-cause mortality for hip fracture surgery was 27.0% in the COVID-19-positive group during the study period. DICUSSION: We found higher incidence of all-cause mortality in patients with versus without diagnosis of COVID-19 after undergoing hip fracture surgery. The mortality in hip fracture surgery in this national analysis was lower than other local and regional reports. The medical community can use this information to guide the management of hip fracture patients with a diagnosis of COVID-19

A many-analysts approach to the relation between religiosity and well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N=10,535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β=0.120). For the second research question, this was the case for 65% of the teams (median reported β=0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

A Many-analysts Approach to the Relation Between Religiosity and Well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N = 10, 535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β = 0.120). For the second research question, this was the case for 65% of the teams (median reported β = 0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

Student, staff and faculty knowledge of AED placement at the University of Toledo Health Science Campus

Scholarly project (M.S.)