The influence of femoral component design on postoperative periprosthetic femoral fracture after uncemented direct anterior total hip arthroplasty in the elderly.

INTRODUCTION: Aging populations and expanding indications will greatly increase the volume of total hip arthroplasty (THA) in all age groups, including patients over 70 years old. Minimally invasive, uncemented direct anterior THA offers potential advantages for treating elderly patients. However, literature indicates higher risks of postoperative periprosthetic femur fractures (PPFFs) with both direct anterior THA and uncemented femoral stems. This retrospective study investigates the influence of femoral stem design on PPFF incidence in uncemented direct anterior THA among patients older than 70 years. METHODS: 557 primary THAs in patients aged 70 or over were reviewed for PPFFs from a consecutive series of 2011 patients undergoing direct anterior THA from a fellowship-trained adult reconstruction surgeon from 2015 to 2020. Exclusion criteria included age (<70) and posterior approach. For the first cohort of 361 patients (79 of which passed exclusion criteria) the surgeon used a single-tapered, proximally porous coated, collarless titanium stem. For the next 1650, (478 of which passed exclusion), the surgeon used a dual-tapered, collared, hydroxyapatite-coated titanium stem. Included patients were carefully monitored until March 2021 for PPFFs. A Fisher's exact test was used to compare the incidence PPFFs between the 2 implant designs. RESULTS: 2 of 79 (2.5%) patients had atraumatic PPFFs at an average of 19.5 days post-operatively in the first cohort. Both experienced a Vancouver type B2 periprosthetic fracture and required femoral revision. No patients (0/478, 0%) in the second group sustained a PPFF. (P = 0.0199). CONCLUSION: In this comparison, the dual-taper, hydroxyapatite-coated implant had a significantly lower PPFF rate among elderly patients than a single-taper, proximally porous stem without a collar.

Egg viability decreases rapidly with time since ovulation in the rainbow darter Etheostoma caeruleum: implications for the costs of choosiness.

Egg viability in the rainbow darter Etheostoma caeruleum, a fish apparently lacking female mate choice, was found to decline rapidly after ovulation. It was observed that the majority of a female's clutch may fail to hatch if she is prevented from mating for as little as 6 h. These data suggest that exercising female mate preferences may be selectively disfavoured in E. caeruleum due to the high cost of delaying mating.

Influence of sex and habitat on the size and shape of anal and dorsal fins of the blackstripe topminnow Fundulus notatus.

The size and shape of the anal and dorsal fin in the blackstripe topminnow Fundulus notatus from lake and stream habitats across multiple ages and sexes were examined. Differences in the size and shape of anal and dorsal fins were sex-specific and not related to habitat differences. Males have longer and more pointed anal fins and longer, larger and more pointed dorsal fins than females. These sex differences occur predominantly in the older age class. The angle (i.e. pointedness) of the dorsal and anal fins is tightly correlated suggesting that fins follow a similar growth trajectory as individuals become sexually mature.

Fish and robot dancing together: bluefin killifish females respond differently to the courtship of a robot with varying color morphs.

The experimental integration of bioinspired robots in groups of social animals has become a valuable tool to understand the basis of social behavior and uncover the fundamental determinants of animal communication. In this study, we measured the preference of fertile female bluefin killifish (Lucania goodei) for robotic replicas whose aspect ratio, body size, motion pattern, and color morph were inspired by adult male killifish. The motion of the fish replica was controlled via a robotic platform, which simulated the typical courtship behavior observed in killifish males. The positional preferences of females were measured for three different color morphs (red, yellow, and blue). While variation in preference was high among females, females tend to spend more time in the vicinity of the yellow painted robot replicas. This preference may have emerged because the yellow robot replicas were very bright, particularly in the longer wavelengths (550­700 nm) compared to the red and blue replicas. These findings are in agreement with previous observations in mosquitofish and zebrafish on fish preference for artificially enhanced yellow pigmentation.

Reproductive isolation between two darter species is enhanced and asymmetric in sympatry.

Robust reproductive isolation was found between the rainbow darter Etheostoma caeruleum and the orangethroat darter Etheostoma spectabile, as more offspring were produced when conspecific males and females were crossed as compared with heterospecific crosses. Furthermore, fewer eggs resulted from heterospecific crosses involving sympatric E. spectabile females than those using allopatric E. spectabile females, while a similar pattern was not observed in heterospecific crosses using E. caeruleum females. These results suggest that reinforcement, i.e. selection for pre-zygotic reproductive barriers driven by reduced hybrid fitness, may have contributed to the evolution and maintenance of reproductive barriers between these potentially hybridizing species in sympatry.

Is short-term remediation after OSCE failure sustained? A retrospective analysis of the longitudinal attainment of underperforming students in OSCE assessments.

BACKGROUND: Significant improvements in the delivery of criterion-based assessment techniques have improved confidence in standard setting and assessment quality. However, for underperforming students, a lack of evidence about longitudinal performance of this group poses dilemmas to educators when making decisions about the timing and nature of remediation. AIM: To investigate the longitudinal performance of the UK undergraduate medical degree students, with a particular focus on comparing the poorly performing students (i.e. those with borderline or failing grades) with the main cohort of students. METHOD: Over a 5-year period, 3200-student objective structured clinical examination (OSCE) assessments from a single medical school were investigated. A poorly performing subgroup of 125 students was identified and their longitudinal performance in the final 3 years of the undergraduate medical degree analysed. RESULT: The relative performance of this student group declines across serial OSCEs, despite current methods of 'remediation and retest'. CONCLUSIONS: This analysis demonstrates that typically students in the poorly performing subgroup achieve only short-term success with traditional remediation and retest models, and critically show an absence of longitudinal improvement. There is a clear need for institutions to develop profiling models that can help identify this student group and develop effective, research led models of remediation.

Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent.

OBJECTIVE: Previous studies indicate that flexible footwear, which mimics the biomechanics of walking barefoot, results in decreased knee loads in patients with knee osteoarthritis (OA) during walking. However, the effect of flexible footwear on other activities of daily living, such as descending stairs, remains unclear. Our objective was to evaluate the influence of inexpensive and minimalist footwear (Moleca) on knee adduction moment (KAM) during stair descent of elderly women with and without knee OA. METHODS: Thirty-four elderly women were equally divided into an OA group and a control group (CG). Stair descent was evaluated in barefoot condition, while wearing the Moleca, and while wearing heeled shoes. Kinematics and ground reaction forces were measured to calculate KAM by using inverse dynamics. RESULTS: The OA group experienced a higher KAM during midstance under the barefoot condition (233.3%; P = 0.028), the Moleca (379.2%; P = 0.004), and heeled shoes (217.6%; P = 0.007). The OA group had a similar knee load during early, mid, and late stance with the Moleca compared with the barefoot condition. Heeled shoes increased the knee loads during the early-stance (versus barefoot [16.7%; P < 0.001] and versus the Moleca [15.5%; P < 0.001]), midstance (versus barefoot [8.6%; P = 0.014] and versus the Moleca [9.5%; P = 0.010]), and late-stance phase (versus barefoot [10.6%; P = 0.003] and versus the Moleca [9.2%; P < 0.001]). In the CG, the Moleca produced a knee load similar to the barefoot condition only during the early-stance phase. CONCLUSION: Besides the general foot protection, the inexpensive and minimalist footwear contributes to decreasing knee loads in elderly women with OA during stair descent. The loads are similar to the barefoot condition and effectively decreased when compared with heeled shoes.

The effects of water depth and light on oviposition and egg cannibalism in the bluefin killifish Lucania goodei.

This study showed that sex and depth had strong effects on egg cannibalism, whereas water clarity (clear v. tea-stained) had no effect on cannibalism or oviposition in the bluefin killifish Lucania goodei. These results are consistent with the extreme levels of iteroparity in L. goodei where females appear to spread their eggs across multiple locations and depths presumably to avoid egg predation.

Collaboration across the pond: the multi-school progress testing project.

This collaborative project between the National Board of Medical Examiners and four schools in the UK is investigating the feasibility and utility of a cross-school progress testing program drawing on test material recently retired from the United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge (CK) examination. This article describes the design of the progress test; the process used to build, translate (localize), review, and finalize test forms; the approach taken to (web-based) test administration; and the procedure used to calculate and report scores. Results to date have demonstrated that it is feasible to use test items written for the US licensing examination as a base for developing progress test forms for use in the UK. Some content areas can be localized more readily than others, and care is clearly needed in review and revision of test materials to ensure that it is clinically appropriate and suitably phrased for use in the UK. Involvement of content experts in review and vetting of the test material is essential, and it is clearly desirable to supplement expert review with the use of quality control procedures based on the item statistics as a final check on the appropriateness of individual test items.

Does organic farming benefit farmland birds in winter?

The generally higher biodiversity on organic farms may be influenced by management features such as no synthetic pesticide and fertilizer inputs and/or by differences in uncropped habitat at the site and landscape scale. We analysed bird and habitat data collected on 48 paired organic and conventional farms over two winters to determine the extent to which broad-scale habitat differences between systems could explain overall differences in farmland bird abundance. Density was significantly higher on organic farms for six out of 16 species, and none on conventional. Total abundance of all species combined was higher on organic farms in both years. Analyses using an information-theoretic approach suggested that both habitat extent and farm type were important predictors only for starling and greenfinch. Organic farming as currently practised may not provide significant benefits to those bird species that are limited by winter food resources, in particular, several declining granivores.

The frequency of anti-beta2-glycoprotein I antibodies is low and these antibodies are associated with pulmonary hypertension in mixed connective tissue disease.

The objective of this study is to evaluate the prevalence of antiphospholipid antibodies, mainly anti-beta(2)-glycoprotein I (anti-beta(2)-GPI), and their possible clinical and laboratory relevance in mixed connective tissue disease (MCTD). This study included 39 consecutive patients with MCTD (Kasukawa's criteria) from January, 2005, to March, 2007, and compared them with 21 age- and sex-matched healthy controls. IgG and IgM anticardiolipin (aCL) and anti-beta(2)-GPI were measured by ELISA. Lupus anticoagulant (LA) was detected by functional coagulation tests. Medium to high titres of aCL and anti-beta(2)-GPI antibodies were found in sera from four (10.2%) MCTD patients. One of these patients was found to be positive for IgM aCL, IgM anti-beta(2)-GPI and LA antibodies simultaneously. Additionally, this patient had a previous history of foetal loss in the second trimester and new-onset pulmonary arterial hypertension (PAH). The other three patients had none of the manifestations of antiphospholipid syndrome (APS) or PAH. The mean value of IgG anti-beta(2)-GPI was higher among those MCTD patients with PAH than in the group without PAH (34.2 +/- 46.8 vs 12.3 +/- 9.1, P = 0.018). None of the controls were positive for antiphospholipid antibodies. High to moderate titres of anti-beta(2)-GPI as well as APS were rare in MCTD, and these antibodies may be correlated with the development of PAH in these patients.

Impact of speed change on estimated journey time: failure of drivers to appreciate relevance of initial speed.

Higher speeds are associated with increases in the probability of crashing and the severity of the outcome. Logically drivers speed to save time, and research evidence supports this assertion. It is therefore important to investigate drivers' understanding of how speed change impacts on journey time. Since it is likely that drivers do not appreciate the reciprocal nature of the function which links these two variables, and its implications, two predictions can be made: the impact of a speed change will be underestimated at low speeds and overestimated at high speeds. This issue was addressed through four questions generated by manipulating Speed Change (increase versus decrease) and Starting Speed (30 mph versus 60 mph) with the participants being asked how they felt these variables would impact on journey time. These were included in a large survey addressing speed-related issues. Participants were a representative quota sample of 1005 UK drivers, interviewed by questionnaire. The findings indicated that three of the four questions produced results consistent with the predictions made. Furthermore, a repeated measures factorial ANOVA indicated that there was no real appreciation of how starting speed impacted on journey time. A disordinal interaction provided evidence that drivers wrongly believed that as starting speed increased the impact of a speed rise also increased; the opposite is true. For speed decreases, drivers appeared to think that starting speed had little impact on the amount of time saved. It is recommended that these findings be integrated into driver training and speed awareness courses.

An experimental investigation of dynamic behavior in FePt systems.

Magnetic relaxation experiments have been used to investigate the non-equilibrium dynamics of FePt nanoparticles. The system exhibits ageing at low temperatures, as well as a narrow energy distribution of the barrier to reversal. These properties were found susceptible to being affected by particle size, matrix and applied field strength. An analysis based on broad rate distributions is presented and compared with results obtained using energy barrier and viscosity interpretations. We find that a single broad distribution of relaxation times suggestive of cooperative effects is sufficient to explain the experimental results.

A preliminary investigation of the running digit span as a test of working memory.

The objective of this study was to compare performance on different versions of the running span task, and to examine the relationship between task performance and tests of episodic memory and executive function. We found that the average capacity of the running span was approximately 4 digits, and at long sequence lengths, performance was no longer affected by varying the running span window. Both episodic and executive function measures correlated with short and long running spans, suggesting that a simple dissociation between immediate memory and executive processes in short and long running digit span tasks may not be warranted.

Speciation in killifish and the role of salt tolerance.

Species pairs whose distributions are tied to environmental conditions provide intriguing candidates for the study of ecological speciation. Here, we examine the role that adaptation to salinity has played in the divergence between two closely related species, Lucania goodei and Lucania parva, whose distributions reflect salinity (L. goodei- fresh water, L. parva- euryhaline). We first tested whether these two species display local adaptation and, subsequently, tested for ecological, genic and behavioural isolation by performing crosses within and between L. goodei and L. parva and raising offspring under various salinities. We found strong evidence for differential adaptation to salinity and also for behavioural isolation where animals preferentially mated with conspecifics over heterospecifics. However, we found no evidence for F1 hybrid inviability. We discuss the general lack of evidence for genic isolation in teleost fish and whether this is a real phenomenon or simply a reflection of experimental design.

Capillaroscopy is a dynamic process in mixed connective tissue disease.

To determine the clinical relevance of 'scleroderma-pattern' (SD-pattern) in mixed connective tissue disease (MCTD), 63 (MCTD) patients (Kasukawa's criteria) were consecutively selected. The main inclusion criterion was availability of previous nailfold capillaroscopy (NC) five years before inclusion. At entry, organ involvement and autoantibody evaluation were performed. The mean age and disease duration were 45.3 +/- 10 and 8.45 +/- 5.42 years, respectively. SD-pattern was observed in 41 patients at entry (65%) and in 45 at previous NC (71.5%), P = 0.20. Ten patients (16%) changed NC, seven normalized, and three developed SD-pattern. Disease duration, number and frequency of organ involvement were similar in patients with and without SD-pattern. In contrast, analysis of each SD-pattern parameter revealed a significantly lower frequency of moderate/severe avascular areas (AA) at entry compared to previous examination (26.5 versus 53%, P = 0.013). Moreover, 76% of patients with interstitial lung disease (HRCT) had AA at entry, whereas only 24% of patients with this alteration did not have this NC finding (P = 0.017). Furthermore, reduced capillary density was more frequently observed in patients taking immunosuppressive therapy than in those without this medication (66.7 versus 33.3%, P = 0.001). NC in MCTD is a dynamic process and analysis of each SD-pattern parameter seems to be a good indicator of lung involvement and disease severity.