Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018

Background and purpose - Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort. Patients and methods - We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates. Results - 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3-3.2) for ASA class II and 3.2 (2.0-5.1) for ASA class III-IV compared with ASA class I, 1.4 (1.1-1.7) for bleeding > 500 mL compared with 120 minutes compared with 45-59 minutes, and 2.6 (1.4-4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7-3.3) for BMI of 31-35 and 5.0 (3.5-7.1) for BMI of > 35 compared with patients with BMI of 21-25. Interpretation - We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed.Peer reviewe

Reviews and syntheses : Arctic fire regimes and emissions in the 21st century

In recent years, the pan-Arctic region has experienced increasingly extreme fire seasons. Fires in the northern high latitudes are driven by current and future climate change, lightning, fuel conditions, and human activity. In this context, conceptualizing and parameterizing current and future Arctic fire regimes will be important for fire and land management as well as understanding current and predicting future fire emissions. The objectives of this review were driven by policy questions identified by the Arctic Monitoring and Assessment Programme (AMAP) Working Group and posed to its Expert Group on Short-Lived Climate Forcers. This review synthesizes current understanding of the changing Arctic and boreal fire regimes, particularly as fire activity and its response to future climate change in the pan-Arctic have consequences for Arctic Council states aiming to mitigate and adapt to climate change in the north. The conclusions from our synthesis are the following. (1) Current and future Arctic fires, and the adjacent boreal region, are driven by natural (i.e. lightning) and human-caused ignition sources, including fires caused by timber and energy extraction, prescribed burning for landscape management, and tourism activities. Little is published in the scientific literature about cultural burning by Indigenous populations across the pan-Arctic, and questions remain on the source of ignitions above 70 degrees N in Arctic Russia. (2) Climate change is expected to make Arctic fires more likely by increasing the likelihood of extreme fire weather, increased lightning activity, and drier vegetative and ground fuel conditions. (3) To some extent, shifting agricultural land use and forest transitions from forest-steppe to steppe, tundra to taiga, and coniferous to deciduous in a warmer climate may increase and decrease open biomass burning, depending on land use in addition to climate-driven biome shifts. However, at the country and landscape scales, these relationships are not well established. (4) Current black carbon and PM2.5 emissions from wildfires above 50 and 65 degrees N are larger than emissions from the anthropogenic sectors of residential combustion, transportation, and flaring. Wildfire emissions have increased from 2010 to 2020, particularly above 60 degrees N, with 56% of black carbon emissions above 65 degrees N in 2020 attributed to open biomass burning - indicating how extreme the 2020 wildfire season was and how severe future Arctic wildfire seasons can potentially be. (5) What works in the boreal zones to prevent and fight wildfires may not work in the Arctic. Fire management will need to adapt to a changing climate, economic development, the Indigenous and local communities, and fragile northern ecosystems, including permafrost and peatlands. (6) Factors contributing to the uncertainty of predicting and quantifying future Arctic fire regimes include underestimation of Arctic fires by satellite systems, lack of agreement between Earth observations and official statistics, and still needed refinements of location, conditions, and previous fire return intervals on peat and permafrost landscapes. This review highlights that much research is needed in order to understand the local and regional impacts of the changing Arctic fire regime on emissions and the global climate, ecosystems, and pan-Arctic communities.peerReviewe

Gendered self-views across 62 countries: A test of competing models

Social role theory posits that binary gender gaps in agency and communion should be larger in less egalitarian countries, reflecting these countries’ more pronounced sex-based power divisions. Conversely, evolutionary and self-construal theorists suggest that gender gaps in agency and communion should be larger in more egalitarian countries, reflecting the greater autonomy support and flexible self-construction processes present in these countries. Using data from 62 countries (N = 28,640), we examine binary gender gaps in agentic and communal self-views as a function of country-level objective gender equality (the Global Gender Gap Index) and subjective distributions of social power (the Power Distance Index). Findings show that in more egalitarian countries, gender gaps in agency are smaller and gender gaps in communality are larger. These patterns are driven primarily by cross-country differences in men’s self-views and by the Power Distance Index (PDI) more robustly than the Global Gender Gap Index (GGGI). We consider possible causes and implications of these findings.info:eu-repo/semantics/acceptedVersio

Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018

Background and purpose - Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort.Patients and methods - We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates.Results - 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3-3.2) for ASA class II and 3.2 (2.0-5.1) for ASA class III-IV compared with ASA class I, 1.4 (1.1-1.7) for bleeding > 500 mL compared with 120 minutes compared with 45-59 minutes, and 2.6 (1.4-4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7-3.3) for BMI of 31-35 and 5.0 (3.5-7.1) for BMI of > 35 compared with patients with BMI of 21-25.Interpretation - We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed.</p

Aims and challenges of handicraft and home economics education in Estonia

The content sharing link for your article is https://rdcu.be/blNrMPeer reviewe

Structural Analysis of Prolyl Oligopeptidases Using Molecular Docking and Dynamics: Insights into Conformational Changes and Ligand Binding

Prolyl oligopeptidase (POP) is considered as an important pharmaceutical target for the treatment of numerous diseases. Despite enormous studies on various aspects of POPs structure and function still some of the questions are intriguing like conformational dynamics of the protein and interplay between ligand entry/egress. Here, we have used molecular modeling and docking based approaches to unravel questions like differences in ligand binding affinities in three POP species (porcine, human and A. thaliana). Despite high sequence and structural similarity, they possess different affinities for the ligands. Interestingly, human POP was found to be more specific, selective and incapable of binding to a few planar ligands which showed extrapolation of porcine POP in human context is more complicated. Possible routes for substrate entry and product egress were also investigated by detailed analyses of molecular dynamics (MD) simulations for the three proteins. Trajectory analysis of bound and unbound forms of three species showed differences in conformational dynamics, especially variations in β-propeller pore size, which was found to be hidden by five lysine residues present on blades one and seven. During simulation, β-propeller pore size was increased by ∼2 Å in porcine ligand-bound form which might act as a passage for smaller product movement as free energy barrier was reduced, while there were no significant changes in human and A. thaliana POPs. We also suggest that these differences in pore size could lead to fundamental differences in mode of product egress among three species. This analysis also showed some functionally important residues which can be used further for in vitro mutagenesis and inhibitor design. This study can help us in better understanding of the etiology of POPs in several neurodegenerative diseases

Gendered self-views across 62 countries: a test of competing models

Social role theory posits that binary gender gaps in agency and communion should be larger in less egalitarian countries, reflecting these countries’ more pronounced sex-based power divisions. Conversely, evolutionary and self-construal theorists suggest that gender gaps in agency and communion should be larger in more egalitarian countries, reflecting the greater autonomy support and flexible self-construction processes present in these countries. Using data from 62 countries (N = 28,640), we examine binary gender gaps in agentic and communal self-views as a function of country-level objective gender equality (the Global Gender Gap Index) and subjective distributions of social power (the Power Distance Index). Findings show that in more egalitarian countries, gender gaps in agency are smaller and gender gaps in communality are larger. These patterns are driven primarily by cross-country differences in men’s self-views and by the Power Distance Index (PDI) more robustly than the Global Gender Gap Index (GGGI). We consider possible causes and implications of these findings