Clinical measurements versus patient-reported outcomes: analysis of the American Shoulder and Elbow Surgeons physician assessment in patients undergoing reverse total shoulder arthroplasty.

BackgroundThe American Shoulder and Elbow Surgeons (ASES) score is composed of a patient-reported portion and a physician assessment. Although the patient-reported score is frequently used to assess postoperative outcomes after shoulder arthroplasty, no previous studies have used the physician-assessment component. This study evaluated the relationship of the ASES physician-assessment measurements with patient-reported shoulder and general health outcomes.MethodsA retrospective review of a prospectively collected multicenter database was used to analyze patients who underwent primary reverse total shoulder arthroplasty (RTSA) from 2012 to 2015 with a minimum 2-year follow-up. ASES physician-assessment and patient-reported components and 12-Item Short Form Health Survey (SF-12) general health questionnaires were obtained preoperatively and 2 years postoperatively. The relationship between ASES physician measurements with ASES patient-reported outcome (PRO) scores and SF-12 Physical and Mental domain scores was assessed with Pearson correlation coefficients.ResultsIncluded were 74 patients (32 men; mean age, 69.2 years; body mass index, 29.4 kg/m2). Preoperative physician measurements and PRO scores were not significantly correlated. Postoperatively, only the ASES physician-measured active (R = 0.54, P < .01) and passive forward flexion (R = 0.53, P < .01) demonstrated moderate correlation with ASES patient scores. The remaining clinical measurements had no significant correlations with ASES patient or SF-12 scores. During the 2-year period, only improvements in active forward flexion correlated with improvements in ASES patient scores (R = 0.36, P < .01).ConclusionsLittle correlation exists between clinical measurements from the ASES physician component and PROs, including the ASES patient-reported and SF-12 general health surveys, in RTSA patients. Improvement in active forward flexion is the only clinical measurement correlated with PRO improvement at 2 years

The global distribution of Bacillus anthracis and associated anthrax risk to humans, livestock and wildlife.

Bacillus anthracis is a spore-forming, Gram-positive bacterium responsible for anthrax, an acute infection that most significantly affects grazing livestock and wild ungulates, but also poses a threat to human health. The geographic extent of B. anthracis is poorly understood, despite multi-decade research on anthrax epizootic and epidemic dynamics; many countries have limited or inadequate surveillance systems, even within known endemic regions. Here, we compile a global occurrence dataset of human, livestock and wildlife anthrax outbreaks. With these records, we use boosted regression trees to produce a map of the global distribution of B. anthracis as a proxy for anthrax risk. We estimate that 1.83 billion people (95% credible interval (CI): 0.59-4.16 billion) live within regions of anthrax risk, but most of that population faces little occupational exposure. More informatively, a global total of 63.8 million poor livestock keepers (95% CI: 17.5-168.6 million) and 1.1 billion livestock (95% CI: 0.4-2.3 billion) live within vulnerable regions. Human and livestock vulnerability are both concentrated in rural rainfed systems throughout arid and temperate land across Eurasia, Africa and North America. We conclude by mapping where anthrax risk could disrupt sensitive conservation efforts for wild ungulates that coincide with anthrax-prone landscapes

The Iterative Signature Algorithm for the analysis of large scale gene expression data

We present a new approach for the analysis of genome-wide expression data. Our method is designed to overcome the limitations of traditional techniques, when applied to large-scale data. Rather than alloting each gene to a single cluster, we assign both genes and conditions to context-dependent and potentially overlapping transcription modules. We provide a rigorous definition of a transcription module as the object to be retrieved from the expression data. An efficient algorithm, that searches for the modules encoded in the data by iteratively refining sets of genes and conditions until they match this definition, is established. Each iteration involves a linear map, induced by the normalized expression matrix, followed by the application of a threshold function. We argue that our method is in fact a generalization of Singular Value Decomposition, which corresponds to the special case where no threshold is applied. We show analytically that for noisy expression data our approach leads to better classification due to the implementation of the threshold. This result is confirmed by numerical analyses based on in-silico expression data. We discuss briefly results obtained by applying our algorithm to expression data from the yeast S. cerevisiae.Comment: Latex, 36 pages, 8 figure

Lameness of Equines: Discussion of Most Common Types

When the automobile replaced the driving and riding horse as a means of transportation and the tractor and truck began to replace the draft horse, the problem of lameness became progressively less important. Now with the return of the light horse to popularity the veterinarian is again confronted with this old-time problem

Utilizing Accelerometer Telemetry Tags to Compare Red Snapper (Lutjanus campechanus) Behavior on Artificial and Natural Reefs

The Texas Parks and Wildlife Department Artificial Reef Program has deployed over 2,800 hectares of reefing area composed of petroleum platforms, steel vessels, and concrete. Artificial reefs have been shown to support many important reef fishes such as red snapper (Lutjanus campechanus), however, few studies have compared fish behavior on artificial reefs and natural habitats. We examined activity levels, behavioral patterns and habitat preferences of red snapper over natural reefs, oil platforms and submerged ships. Telemetry tags (Sonotronics model MTT) with tri-axial acceleration range, average depth, and average temperature were programmed to optimize data collection and tag life. Tags were then calibrated with captive fish to determine behavioral categories. Fifty-five wild snapper were caught and surgically implanted at depth to reduce barotrauma and predation, then monitored for one year. Overall dynamic body acceleration (ODBA) as the sum of x, y and z acceleration range was used to estimate activity levels of red snapper residing at each reef type. A variety of residency times were detected on all reef types and fish commonly moved between reefs. Acceleration and depth data indicated that time of day, depth use, lunar cycle, and season influence red snapper movement and behavior. Average ODBA was significantly higher over artificial than natural reefs (p = 0.03) during May 2016 suggesting that red snapper behave differently on artificial habitats. On-going research will determine if higher activity levels recorded on artificial reefs are due to increased feeding opportunities, spawning behavior or increased conspecific interactions

Sport in the city: measuring economic significance at the local level

In many cities throughout Europe, sport is increasingly being used as a tool for economic revitalisation. While there has been a growth in literature relating to the specific economic impacts of sports-led development, including professional sport facilities, teams, and sport events, limited research has been undertaken on the contribution of the whole sport sector to output and employment. In the United Kingdom (UK), studies have focused on evaluating sport-related economic activity at the national level, yet despite the increasing use of sport for local economic development little research has been undertaken at the city level. To address this situation, this article uses the National Income Accounting framework to measure the economic importance of sport in Sheffield, UK. It shows that the value-added in 1996/97 was 165.61m or 4.11% of Gross Domestic Product (GDP), approximately twice the amount predicted from current national estimates. It is argued that this can primarily be explained by previous studies under-estimating the economic importance of sport, largely due to methodological differences. It goes on to suggest that future research on the significance of sport should be undertaken at the local level to provide policymakers with information at the spatial level where regeneration programmes are being implemented.</p

Design and rationale of a multi-center, pragmatic, open-label randomized trial of antimicrobial therapy - the study of clinical efficacy of antimicrobial therapy strategy using pragmatic design in Idiopathic Pulmonary Fibrosis (CleanUP-IPF) clinical trial

Compelling data have linked disease progression in patients with idiopathic pulmonary fibrosis (IPF) with lung dysbiosis and the resulting dysregulated local and systemic immune response. Moreover, prior therapeutic trials have suggested improved outcomes in these patients treated with either sulfamethoxazole/ trimethoprim or doxycycline. These trials have been limited by methodological concerns. This trial addresses the primary hypothesis that long-term treatment with antimicrobial therapy increases the time-to-event endpoint of respiratory hospitalization or all-cause mortality compared to usual care treatment in patients with IPF. We invoke numerous innovative features to achieve this goal, including: 1) utilizing a pragmatic randomized trial design; 2) collecting targeted biological samples to allow future exploration of 'personalized' therapy; and 3) developing a strong partnership between the NHLBI, a broad range of investigators, industry, and philanthropic organizations. The trial will randomize approximately 500 individuals in a 1:1 ratio to either antimicrobial therapy or usual care. The site principal investigator will declare their preferred initial antimicrobial treatment strategy (trimethoprim 160 mg/ sulfamethoxazole 800 mg twice a day plus folic acid 5 mg daily or doxycycline 100 mg once daily if body weight is < 50 kg or 100 mg twice daily if ≥50 kg) for the participant prior to randomization. Participants randomized to antimicrobial therapy will receive a voucher to help cover the additional prescription drug costs. Additionally, those participants will have 4-5 scheduled blood draws over the initial 24 months of therapy for safety monitoring. Blood sampling for DNA sequencing and genome wide transcriptomics will be collected before therapy. Blood sampling for transcriptomics and oral and fecal swabs for determination of the microbiome communities will be collected before and after study completion. As a pragmatic study, participants in both treatment arms will have limited in-person visits with the enrolling clinical center. Visits are limited to assessments of lung function and other clinical parameters at time points prior to randomization and at months 12, 24, and 36. All participants will be followed until the study completion for the assessment of clinical endpoints related to hospitalization and mortality events. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02759120

A Review of Web-Based Job Advertisements for Australian Event Management Positions

Strong growths in the Australian event management industry, ongoing technological changes and the internationalisation of the market place has spurred the need for appropriately educated and trained event managers and for a re-evaluation of educational and job training curriculum to meet these new challenges. In order for Australia to position itself as a world leader in event management, it is important to provide consistent high professional standards and event managers that not only meet, but exceed the demands of the industry. While there is some literature that focuses on the tourism and leisure job market (Crossley, 1992; Keung & Pine, 2000), and a small but developing literature base that focuses on event management training (Harris & Jago, 1999; Hawkins & Goldbatt, 1995) relatively little consideration has been given to a national agenda for event management skilling. To provide an indication of current employer requirements, a nationwide study of job advertisements in event management has commenced. The aims of the study are to further the understanding of the educational needs and training requirements of the industry; to ascertain the learned skills and personal attributes sought from event managers; to determine the compatibility of industry demands with current educational and vocational provisions; and to suggest post-secondary institutional avenues through which event management education and training needs can be pursued. This is an ongoing study and it is hoped that it will contribute towards a broad scale understanding of the event management job market. More importantly however, it can be used as the basis for curriculum evaluation and training needs, and create a better understanding and compatibility between event management education and industry practice. This paper reports the preliminary results from a content analysis of approximately 100 web-based job advertisements. Email alert accounts were established with several search engines to gather a sample of event management related job advertisements from around Australia. An analytical framework was devised for the analysis of the advertisements themselves. The results reveal several interesting trends including the geographical concentration of the event management job market, the range of industries that require event management specialists or event management skills, and a series of required skills and key attributes of event managers. The results of this study establish a platform from which to develop a classification of event management skills required by the industry