Intradepartmental System of Allocating Operating Room Block Time and its Financial Impact at The University of New Mexico Department of Orthopaedics & Rehabilitation: A Preliminary Report

Background: Within a hospital, the operating room (OR) is one of the most critical and expensive resources. Labor productivity is maximized by filling allocated surgical block time with as many hours of cases as possible. We have found that the intradepartmental block time release system at our institution has improved access to operating time, resulting in a substantial financial advantage within the department. Methods: The annual charges and collections produced by the pick-up of intradepartmental released block time during the past 4 fiscal years (July 1-June 30) was assessed at both the main hospital and an outpatient surgical center. Results: There is a general, year-over-year trend of increasing charges and collections from the intradepartmental release of OR time. The average gross collection rate for OR pick-up time is 30%, which matches the average collection rate of about 30% for our department. At the main inpatient hospital, the orthopaedic spine service typically comprises the mostreleased OR block time. In the outpatient setting, typically the orthopaedic hand service captures the most released OR block time. Conclusions: The early release of allocated block time on an internal level may help schedule patients in an easier manner, with decreased patient wait times than other methods, and maintain the overall revenue within the department. Further studies that quantify surgeon satisfaction would help strengthen the use and validation of this system

A framework for the development of a global standardised marine taxon reference image database (SMarTaR-ID) to support image-based analyses

Video and image data are regularly used in the field of benthic ecology to document biodiversity. However, their use is subject to a number of challenges, principally the identification of taxa within the images without associated physical specimens. The challenge of applying traditional taxonomic keys to the identification of fauna from images has led to the development of personal, group, or institution level reference image catalogues of operational taxonomic units (OTUs) or morphospecies. Lack of standardisation among these reference catalogues has led to problems with observer bias and the inability to combine datasets across studies. In addition, lack of a common reference standard is stifling efforts in the application of artificial intelligence to taxon identification. Using the North Atlantic deep sea as a case study, we propose a database structure to facilitate standardisation of morphospecies image catalogues between research groups and support future use in multiple front-end applications. We also propose a framework for coordination of international efforts to develop reference guides for the identification of marine species from images. The proposed structure maps to the Darwin Core standard to allow integration with existing databases. We suggest a management framework where high-level taxonomic groups are curated by a regional team, consisting of both end users and taxonomic experts. We identify a mechanism by which overall quality of data within a common reference guide could be raised over the next decade. Finally, we discuss the role of a common reference standard in advancing marine ecology and supporting sustainable use of this ecosystem

Psychosocial and Demographic Factors Influencing Pain Scores of Patients with Knee Osteoarthritis

Background: Noted levels of pain in patients with diagnosed osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system. However, the results of pain levels in patients with knee OA may be influenced by factors other than the patient’s actual physical discomfort or disease severity, including demographic and psychosocial variables. We retrospectively examined 355 patients with knee OA who had reported associated pain levels using a 0- to 10-point rating scale. Methods: Data obtained from the medical records of patients were Kellgren-Lawrence (KL) grade, demographic characteristics, body mass index (BMI), concomitant disorders, drug use, alcohol use, smoking, health insurance status, knee OA treatment, and knee-surgery recommendation. Univariate and multivariate analyses determined correlation with reported pain scores. Results: KL grade showed no correlation with pain scores (P = 0.2). Younger age, ethnicity, and higher BMI were significantly associated with higher scores (P = 0.03, P \u3c 0.001, and P \u3c 0.001, respectively). Native American or Hispanic ethnicity remained significant on multivariate analysis (P \u3c 0.001). All psychosocial factors and other categories showed correlation, excluding diagnosis of posttraumatic stress disorder (P = 0.2); current opioid prescription and depression retained significance with higher pain scores (P \u3c 0.001 and P = 0.002, respectively). Conclusions: To provide more effective care, clinicians should be aware that demographic and psychosocial factors may be important determinants of pain levels reported by patients

Expression of three zebrafish orthologs of human FMR1-related genes and their phylogenetic relationships

The original publication can be found at www.springerlink.comThe human fragile X mental retardation syndrome is caused by expansions of a CGG repeat in the FMR1 gene. FXR1 and FXR2 are autosomal paralogs of FMR1. The products of the three genes, FMRP, FXR1P, and FXR2P, respectively, belong to a family of RNA-binding proteins. While the FMR1-related gene family is well described in human, mouse and Drosophila, little is known about zebrafish (Danio rerio) orthologs of these genes. Here we collate the known FMR1-related gene sequences from zebrafish, examine their regions of structural conservation, and define their orthologies with the human genes. We demonstrate that zebrafish possess only three FMR1-related genes, FMR1, FXR1 and FXR2, and these are orthologous to the human FMR1, FXR1 and FXR2 genes respectively. We examine the spatiotemporal pattern of transcription of the zebrafish genes from 0 hours post fertilisation (hpf) until 24 hpf. Expression of FMR1, FXR1 and FXR2 is widespread throughout this time. However, relative to surrounding tissues, expression of FXR2 is raised in adaxial and somitic cells by 12 hpf while FXR1 expression is high in the anterior of the embryo, and is raised in adaxial cells by 12 hpf. Distinct patterns (and levels) of expression are seen for the different genes later in development. At 24 hpf, FXR1 and FXR2 transcripts show complex distribution patterns in somites. The expression of the FMR1-related gene family in zebrafish tissues is broadly consistent with expression in mouse and human, supporting the idea that zebrafish should be an excellent model organism in which to study the functions of the vertebrate FMR1-related gene family.Tucker Ben, Richards Robert and Lardelli Michae