Cost-Effectiveness of Alternative Anticoagulation Strategies for Postoperative Management of Total Knee Arthroplasty Patients.

Objective: To evaluate the cost-effectiveness of prolonged (35-day) and standard-duration (14-day) anticoagulation therapy following total knee arthroplasty (TKA).

Methods: Using Markov modeling, we assessed clinical and economic outcomes of 14-day and 35-day anticoagulation therapy following TKA with rivaroxaban, low molecular weight heparin (LMWH), fondaparinux, warfarin, and aspirin. Incidence of complications of TKA and anticoagulation therapy (deep vein thrombosis [DVT], pulmonary embolism [PE], prosthetic joint infection [PJI], and bleeding) were derived from published literature.

Separate brain areas for processing human and dog faces as revealed by awake fMRI in dogs (Canis familiaris).

Functional magnetic resonance imaging (fMRI) has emerged as a viable method to study the neural processing underlying cognition in awake dogs. Working dogs were presented with pictures of dog and human faces. The human faces varied in familiarity (familiar trainers and unfamiliar individuals) and emotional valence (negative, neutral, and positive).

Neurofunctional correlates of geometry and feature use in a virtual environment.

There are mixed results regarding the differentiation of neurofunctional correlates of spatial abilities. Previous studies employed complex environments or alternate memory tasks which could potentially add to inconsistencies across studies of navigation. To help elucidate the existing mixed findings, we conducted a study in a simplistic environment without a supplemental memory task in order to examine navigationally relevant neural function using fMRI.

Reproducibility of the Measurement of Bulk/Tapped Density of Pharmaceutical Powders Between Pharmaceutical Laboratories.

The bulk properties of a powder are dependent on the preparation, treatment, and storage of the sample, that is, how it was handled. The particles can be packed to have a range of bulk densities and, moreover, the slightest disturbance of the powder bed may result in a changed bulk density. Thus, the bulk density of a powder is often difficult to measure with good reproducibility and, in reporting the results, it is essential to specify how the determination was made.

Burden of gluteal fibrosis and post-injection paralysis in the children of Kumi District in Uganda.

Background: The purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.

Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age < 18 yrs) diagnosed with either PIP or GF from Kumi Hospital in Kumi, Uganda between 2013 and 2015. We estimated the prevalence as a ratio of the number of children seen with each disorder over the total population of children seen for any musculoskeletal complaint in musculoskeletal clinic and total population of children seen for any medical complaint in the outreach clinic.

Adverse Events and Resource Use Before and After Treat-to-Target in Rheumatoid Arthritis: A Post Hoc Analysis of a Randomized Controlled Trial.

Objective: Treat-to-target (TTT) is an accepted paradigm for care of patients with rheumatoid arthritis (RA). Because TTT can be associated with more medication switches, concerns arise regarding whether implementing TTT may increase adverse events and/or resource use. The aim of this study was to examine adverse events and resource use during the preintervention and intervention periods of the TTT intervention trial.

Strategies for Managing the Costs of Chronic Illness in the Context of Limited Financial Resources: A Qualitative Study in Dominican Persons With Arthritis.

Objective: Persons who reside in low- and middle-income countries often have insufficient resources to pay for treatments prescribed for their medical conditions. The aim of this study was to determine, using qualitative methods, how patients with arthritis in the Dominican Republic manage the costs associated with chronic illnesses.

Methods: We conducted individual interviews with 17 Dominican adults with advanced arthritis who were undergoing total knee replacement or total hip replacement at a hospital in Santo Domingo, Dominican Republic.

Association of Changes in Effusion-Synovitis With Progression of Cartilage Damage Over Eighteen Months in Patients With Osteoarthritis and Meniscal Tear.

Objective: Synovitis is a feature of knee osteoarthritis (OA) and meniscal tear and has been associated with articular cartilage damage. This study was undertaken to examine the associations of baseline effusion-synovitis and changes in effusion-synovitis with changes in cartilage damage in a cohort with OA and meniscal tear.

Methods: We analyzed data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of surgery versus physical therapy for treatment of meniscal tear.

Spoilers Affect the Enjoyment of Television Episodes but Not Short Stories.

While spoilers are culturally regarded as something that detracts enjoyment from a narrative, research has presented a complicated picture. When Leavitt and Christenfeld presented participants plot-crucial information to individuals before reading a short story, the story was subsequently enjoyed as much as, or more than, unspoiled stories. Other research shows that these findings may be driven by an interaction of individual differences, such as need for cognition, rather than a broad spoiling effect.

Cost-Effectiveness of Diet and Exercise for Overweight and Obese Patients With Knee Osteoarthritis.

Objective: The Intensive Diet and Exercise for Arthritis (IDEA) trial showed that an intensive diet and exercise (D+E) program led to a mean 10.6-kg weight reduction and 51% pain reduction in patients with knee osteoarthritis (OA). The aim of the current study was to investigate the cost-effectiveness of adding this D+E program to treatment in overweight and obese (body mass index >27 kg/m ) patients with knee OA.

Associations among knee muscle strength, structural damage, and pain and mobility in individuals with osteoarthritis and symptomatic meniscal tear.

Background: Sufficient lower extremity muscle strength is necessary for performing functional tasks, and individuals with knee osteoarthritis demonstrate thigh muscle weakness compared to controls. It has been suggested that lower muscle strength is associated with a variety of clinical features including pain, mobility, and functional performance, yet these relationships have not been fully explored in patients with symptomatic meniscal tear in addition to knee osteoarthritis. Our purpose was to evaluate the associations of quadriceps and hamstrings muscle strength with structural damage and clinical features in individuals with knee osteoarthritis and symptomatic meniscal tear.

Occult paroxysmal atrial fibrillation in non-cryptogenic ischemic stroke.

Objective: To determine the prevalence and risk factors for paroxysmal atrial fibrillation (PAF) diagnosis in non- cryptogenic ischemic stroke (CIS) patients.

Methods: In this pilot-prospective cohort study of non-CIS patients from September 2014 to September 2017, 53 patients were enrolled. 51/53 patients were implanted within 10 days of stroke onset with the Reveal LINQ insertable cardiac monitor and monitored until PAF detection or a minimum of 12 months.

North American Football Fans Show Neurofunctional Differences in Response to Violence: Implications for Public Health and Policy.

While social and behavioral effects of violence in the media have been studied extensively, much less is known about how sports affect perceptions of violence. The current study examined neurofunctional differences between fans and non-fans of North American football (a contact sport) while viewing violent imagery. Participants viewed images of violence in both football and non-football settings while high-resolution functional magnetic resonance imaging (fMRI) data were acquired from their brains.

Zinc Nanoparticles Enhance Brain Connectivity in the Canine Olfactory Network: Evidence From an fMRI Study in Unrestrained Awake Dogs.

Prior functional Magnetic Resonance Imaging (fMRI) studies have indicated increased neural activation when zinc nanoparticles are added to odorants in canines. Here we demonstrate that zinc nanoparticles up-regulate directional brain connectivity in parts of the canine olfactory network. This provides an explanation for previously reported enhancement in the odor detection capability of the dogs in the presence of zinc nanoparticles.

Causes and Treatment of Acute Ischemic Stroke During Pregnancy.

Purpose Of Review: Treatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and prevention options, including associated risks specific to the pregnant and puerperal state.

Relationship Between Patient-Reported Swelling and Magnetic Resonance Imaging-Defined Effusion-Synovitis in Patients With Meniscus Tears and Knee Osteoarthritis.

Objective: Synovitis is a prevalent feature in patients with knee osteoarthritis (OA) and meniscal tear and is associated with pain and cartilage damage. Patient-reported swelling is also prevalent in this population. The aim of this study was to investigate the cross-sectional association between patient-reported swelling and effusion-synovitis detected by magnetic resonance imaging (MRI) in patients with OA and meniscal tear.

Willingness of older adults to participate in a randomized trial of conservative therapies for knee pain: A prospective preference assessment.

Background: In preparation for a trial of physical therapy (PT) for patients with degenerative meniscal tear and knee osteoarthritis, we conducted a prospective preference assessment -- a methodology for estimating the proportion of eligible subjects who would participate in a hypothetical randomized trial.

Methods: We identified patients seeking care from the practices of five orthopedic surgeons. Patients completed a survey asking about their willingness to participate in a hypothetical trial, their treatment preferences, their knee pain, and demographic variables.

Factors influencing the enrollment in randomized controlled trials in orthopedics.

Background: Low enrollment rates are a threat to the external validity of clinical trials. The purpose of this study was to identify factors associated with lower enrollment rates in randomized controlled trials (RCTs) involving orthopedic procedures.

Methods: We performed a search in PubMed/MEDLINE for RCTs that involved any orthopedic surgical procedure, compared different intraoperative interventions, were published in English in a peer-reviewed journal between 2003 and 2014, and reported the numbers of both enrolled and eligible subjects.

Investigation of the Behavioral Characteristics of Dogs Purpose-Bred and Prepared to Perform Detection of Person-Borne Explosives.

Specialized detector dogs are increasingly being utilized for the detection of modern threats. The (VW) dog was developed to create a dog phenotype ideally suited for detecting hand-carried and body-worn explosives. VW dogs (VWDs) are trained to sample and alert to target odors in the aerodynamic wakes of moving persons, which entrains vapor and small particles from the person.

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey.

Purpose: The purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.

Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age < 18 years) seen at Kumi Hospital in Kumi, Uganda, between January 2013 and December 2015. For each patient, we recorded the age, sex, diagnosis, and treatment recommendation.

A Conceptual Model for the Evaluation of Surgical Missions.

Background: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually.

Comparing cognition by integrating concept learning, proactive interference, and list memory.

This article describes an approach for training a variety of species to learn the abstract concept of same/different, which in turn forms the basis for testing proactive interference and list memory. The stimulus set for concept-learning training was progressively doubled from 8, 16, 32, 64, 128 . .