Future Revisions Research Articles

BIO7: PAL-LR: a Reduced Resistance, Concentric-Gated Artificial Membrane Lung for Pediatric End-Stage Lung Failure

Purpose: This work focuses on the development of the Low Resistance Pediatric MLung (PAL-LR) with the goal of serving as a pumpless (pulmonary artery to left atrium) bridge-to-transplant device for small children with end-stage lung failure. Methods: The PAL-LR doubles the exposed fiber length of the Pediatric Artificial MLung. 9 PAL-LR MLungs were fabricated using polymethylpentene fibers (surface area: 0.44 m2). In vitro benchtop studies tested gas exchange and pressure drop performance (n=6). In an acute in vivo study, 3 PAL-LRs were anastomosed from the femoral vein to the jugular vein in an ovine model to assess hemocompatibility, device blood flow, pressure drop, and gas exchange. A centrifugal pump (Model 550 Bio-Console; Medtronic, Minneapolis, MN) was used pre-device to maintain flows of 1 L/min while sweep gas was supplied for each blood flow rate at a 1:1 sweep:blood flow ratio. Results: For in vitro tests, average rated blood flow (outlet SO2 of 95%) was 2.46±0.22 L/min with a pressure drop of 25.7±3.1 mmHg. At the targeted pediatric flow rate of 1 L/min, the PAL-LR pressure drop was 8.6 mmHg compared to 25 mmHg of the PAL. At rated flow, the average O2 and CO2 transfer rates were 101.75±10.81 and 77.93±8.40 mL/min, respectively. The average maximum O2 and CO2 exchange efficiencies are 215.75±22.93 and 176.99±8.40 mL/(min*m2), respectively. In vivo tests revealed an average outlet SO2 of 100%, and average pressure drop of 2±0 mmHg for a blood flow of 1.07±0.02 L/min. After 5 hours of extracorporeal use per lung, the platelets increased 3.54% for the first lung, and decreased 0.21% and 0.17% for the second and third lungs, respectively. Analysis revealed some clotting at the outlet and around gates, likely due to recirculation which will be mitigated in future revisions. Summary: Having a lower resistance, the PAL-LR is a promising step closer to a pumpless artificial membrane lung that alleviates right ventricular strain associated with idiopathic pulmonary hypertension.

Projections and Epidemiology of Revision Hip and Knee Arthroplasty in the United States to 2040-2060

National projections of future joint arthroplasties are useful in understanding the changing burden of surgery and related outcomes on the health system. The aim of this study is to update the literature by producing Medicare projections for revision total joint arthroplasty procedures from 2040 through 2060.The study uses 2000-2019 data from the CMS Medicare Part-B National Summary and combines procedure counts using CPT codes for revision total joint arthroplasty procedures. In 2019, revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) procedures totaled 53,217 and 30,541, respectively, forming a baseline from which we generated point forecasts between 2020 and 2060 and 95% forecast intervals (FI).On average, the model projects an annual growth rate of 1.77% for rTHAs and 4.67% for rTKAs. By 2040, rTHAs were projected to be 43,514 (95% FI = 37,429-50,589) and rTKAs were projected to be 115,147 (95% FI = 105,640-125,510). By 2060, rTHAs was projected to be 61,764 (95% FI = 49,927-76,408) and rTKAs were projected to be 286,740 (95% FI = 253,882-323,852).Based on 2019 total volume counts, the log-linear exponential model forecasts an increase in rTHA procedures of 42% by 2040 and 101% by 2060. Similarly, the estimated increase for rTKA is projected to be 149% by 2040 and 520% by 2060. An accurate projection of future revision procedure demands is important to understand future healthcare utilization and surgeon demand. This finding is only applicable to the Medicare population and demands further analysis for other population groups.

텍스트 마이닝을 활용한 국가수준 유치원 교육과정에서 나타난 유아 중심 및 놀이 중심 교육과정의 의미 재탐색

Objectives This study aimed to rethinking the meaning of child-centered and play-centered curriculum, which are continuously emphasized in the national kindergarten curriculum, focusing on keywords related to ‘child-centered’ and ‘play-centered’. Methods The national kindergarten curriculum and curriculum manual were collected to investigate the meaning of a children-centered and play-centered curriculum. Text mining analysis was conducted through four stages using R. In step 1, the data collection and analysis units were planned. In step 2, pre-data manipulation was performed for data analysis. In step 3, keyword analysis and co-occurrence network analysis were conducted. Finally, in step 4, the analysis results were visualized. Results First, I analyzed the meaning of ‘child-centered’ curriculum by focusing on prenominal expressions that describe child-centeredness, such as ‘experience,’ ‘interest,’ and ‘spontaneity,’ and found that the degree centrality was high for the words child, interest, and experience, and teachers which represent educational targets and curriculum operators. The betweenness centrality indicated a strong emphasis on children's experiences, and the closeness centrality revealed a strong emphasis on activities. Next, I analyzed the meaning of ‘play-centered’ curriculum by focusing on the word ‘play’, and found that the degree of centrality was strong for the words education and activity, the betweenness centrality was prominent for the word interest, and the closeness centrality was evident for the words teacher and teacher's play support in relation to play-centered curriculum and operation. Conclusions This study will contribute to the future revision of the national kindergarten curriculum by providing a conceptual overview for clarifying the terms child-centered and play-centered.

A Digital Concordance of Etruscan, Faliscan, and Early Latin Inscriptions from Etruria

Abstract Epigraphic concordances (lists which give corresponding references for two or more epigraphic corpora) are an indispensable resource for any scholar whose work relates to inscriptions. Despite their usefulness, there are inherent issues with conventional concordances of the type found at the back of epigraphic corpora. This article presents a digital concordance for Etruscan, Faliscan and early Latin inscriptions from Etruria. The concordance, which is contained in a CSV file, is downloadable from the repository Zenodo, and allows for both free-text searches and reordering according to each included corpus. The digital format allows for future revision and correction; an email address dedicated to feedback from the scholarly community has been set up. The corpora included in the concordance are chosen to make the concordance a comprehensive resource for both contemporary scholarly use and study of the history of epigraphy.

Advancing Commotio cordis Safety Standards Using the Total Human Models for Safety (THUMS).

Commotio cordis is one of the leading causes of sudden cardiac death in youth baseball. Currently, there are chest protector regulations regarding the prevention of Commotio cordis in baseball and lacrosse; however, they are not fully optimized. For the advancement of Commotio cordis safety, it is vital to include various age groups and a variety of impact angles in the testing process. This study employed finite element models and simulated Commotio cordis-inducing baseball collisions for different velocities, impact angles, and age groups. Commotio cordis risk response was characterized in terms of left ventricular strain and pressure, chest band and rib deformation, and force from impact. Normalized rib and chest band deformation when correlated with left ventricular strain resulted in R2 = 0.72, and R2 = 0.76, while left ventricular pressure resulted in R2 = 0.77, R2 = 0.68 across all velocities and impact angles in the child models. By contrast, the resultant reaction force risk metric as used by the National Operating Committee on Standards for Athletic Equipment (NOCSAE) demonstrated a correlation of R2 = 0.20 in the child models to ventricular strain, while illustrating a correlation to pressure of R2 = 0.74. When exploring future revisions to Commotio cordis safety requirements, the inclusion of deformation-related risk metrics at the level of the left ventricle should be considered.

Clinical features, treatment and outcomes of Italian children with enthesitis-related arthritis and juvenile psoriatic arthritis: a cross-sectional cohort study.

Limited information is available on the clinical features, treatment modalities and outcomes of the juvenile idiopathic arthritis (JIA) categories of enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA). This study was aimed to describe the characteristics of Italian children with ERA and JPsA and to compare them with those of patients with the other categories of JIA. Patients were part of a multinational sample included in a study aimed to investigate the prevalence of disease categories, treatment approaches, and disease status in patients from across different geographical areas (EPOCA Study). All patients underwent a retrospective assessment, based on the review of clinical chart, and a cross-sectional evaluation, which included assessment of physician- and parent-reported outcomes and laboratory tests, and recording of ongoing therapies. Of the 9081 children with JIA enrolled in the EPOCA Study, 1300 were recruited at 18 paediatric rheumatology centres in Italy. 45 (3.5%) had ERA and 49 (3.8%) had JPsA. Several remarkable differences in demographic features and frequency of articular and extra-articular manifestations, disease damage, impairment in physical function and health-related quality of life, school-related problems, comorbidities, and ongoing treatments were observed between ERA and JPsA and the other JIA categories. We described the characteristics of Italian children with ERA and JPsA and highlighted their peculiarities and their differences from the other JIA subsets. These data provide useful insights for future revisions of JIA classification and a benchmarking against which the features from other cohorts may be compared.

117. Comparative Analysis of Two Hemiarthroplasty Techniques for Symptomatic Distal Radial Ulnar Joint

PURPOSE: Young patients are not impervious to distal radioulnar joint (DRUJ) instability, deformities, and pain. The purpose of this study was to compare and assess the superiority of two techniques of hemiarthroplasty for the treatment of symptomatic DRUJ in a young cohort. METHODS: Thirty-four hemiarthroplasties were performed between 2010 and 2020 by three surgeons at one tertiary medical center. Patients were identified retrospectively and stratified into two groups by implant type: partial ulnar head (A), and Pyrocarbon MCP (B) (off label) (Image 1). Demographics and outcomes were extracted from the electronic medical record. RESULTS: Between the two groups, objective measures of wrist range of motion, grip strength, and pain showed similar findings with improvement across all categories. Statistically significant findings were observed with respect to reduction in pain in both groups as well as improvement in wrist flexion in the pyrocarbon group. Post-operative complications warranting surgical intervention occurred in 10 patients. Of these ten were 2 in the ulnar head implant group; pain and reduced range of motion necessitated one revision to an Aptis implant and one revision to a pyrocarbon implant. In the Pyrocarbon group, 8 surgical interventions were required: 3 pinning in supination for reduced range of motion, 1 exchange with a smaller size implant due to pain, 1 addition of meniscal allografting for pain, and three conversions to Aptis implants for pain and instability. CONCLUSIONS: Painful DRUJs in young patients warrant a surgical intervention which preserves stability and provides longevity with possibility for revision during their lifetime. Hemiarthroplasty allows for preservation of stability, seen in 33/34 patients in this study, with improved symptom management which was seen in 29/34 patients. This study found equal efficacy of the standard ulnar head implant to that of the off-label use of the MCP Pyrocarbon implant. However, the osteointegration of the partial ulnar head implant means future revision would have increased risk of complication. As well, the metallic head of the partial ulnar head implant is known to cause osteolysis of the radial fossa making it less ideal for young patients with future decades of implant wear. Due to these limitations and the similar efficacy, we recommend the use of this prothesis in young patients with symptomatic DRUJ.

Evolution, systematics and historical biogeography of Palparini and Palparidiini antlions (Neuroptera: Myrmeleontidae): Old origin and in situ diversification in Southern Africa

AbstractPalparine and palparidiine antlions constitute an emblematic clade of large and occasionally colourful insects that are only distributed in the western portion of the Eastern hemisphere, with about half of the known species diversity occurring exclusively in Southern Africa. Little is known about their evolutionary history, and the boundaries and relationships of most genera are still unresolved. In this study, we analyse a molecular dataset consisting of seven loci (five mitochondrial and two nuclear genes) for 144 antlion species and provide the first phylogenetic hypothesis for a representative sampling of Palparini and Palparidiini (62 Palparini species, representing 15 of the 17 known genera, and all three known Palparidiini species). In addition, we reconstruct their timing of diversification and historical biogeography. The resulting tree indicates that several extant palparine genera are polyphyletic or paraphyletic and provides interesting leads that ought to be helpful for future taxonomic revisions; it also enables us to re‐evaluate the taxonomic utility and relevancy of a number of morphological characters that were previously used to define some genera. Molecular dating analyses indicate that the most recent common ancestor of both groups originated about 92 million years ago (Ma) in the Late Cretaceous. Finally, the results of historical biogeography analyses provide strong support for an origin in Southern Africa, which further acted as both a cradle of diversification and a springboard for successive waves of northern dispersals.

Cognitive enhancement interventions are effective for schizophrenia: why not provide them early?

Cognitive enhancement interventions are effective for schizophrenia: why not provide them early?

The struggle with transnormativity: Non-binary identity work, embodiment desires, and experience with gender dysphoria

I examine how non-binary people who have considered, or accessed, gender-affirming health care experience accountability to transnormativity using 12 in-depth interviews conducted between 2018 and 2019 in a midwestern American city. I detail how non-binary people who want to embody genders that are still largely culturally unintelligible think about identity, embodiment, and gender dysphoria. Using grounded theory methodology, I find that non-binary identity work around medicalization differs from that of transgender men and women in three primary ways: 1) regarding how they understand and operationalize gender dysphoria, 2) in relation to their embodiment goals, and 3) concerning how they experience pressure to medically transition. Non-binary people describe increased ontological uncertainty about their gender identities when researching gender dysphoria that is contextualized by an internalized sense of accountability to the transnormative expectation for medicalization. They additionally anticipate a potential medicalization paradox, where accessing gender-affirming care leads to a different type of binary misgendering and risks making their gender identities less, rather than more, culturally intelligible to others. Non-binary people also experience external accountability to transnormativity as pressure from trans and medical communities to think about dysphoria as inherently binaristic, embodied, and medically treatable. These findings indicate that non-binary people experience accountability to transnormativity differently than trans men and women. Since non-binary people and their body projects often disrupt the transnormative tropes that are the framework for trans medicine, they find trans therapeutics, and the diagnostic experience of gender dysphoria, uniquely problematic. Non-binary experiences of accountability to transnormativity indicate the need to re-center trans medicine to better accommodate non-normative embodiment desires and focus future diagnostic revisions of gender dysphoria to emphasize the social aspects of trans and non-binary experience.

Shear Strength Prediction of Steel-Fiber-Reinforced Concrete Beams Using the M5P Model

This article presents a mathematical model developed using the M5P tree to predict the shear strength of steel-fiber-reinforced concrete (SFRC) for slender beams using soft computing techniques. This method is becoming increasingly popular for addressing complex technical problems. Other approaches, such as semi-empirical equations, can show known inaccuracies, and some soft computing methods may not produce predictive equations. The model was trained and tested using 332 samples from an experimental database found in the previous literature, and it takes into account independent variables such as the effective depth d, beam width bw, longitudinal reinforcement ratio ρ, concrete compressive strength fc, shear span to effective depth ratio a/d, and steel fiber factor Fsf. The predictive performance of the proposed M5P-based model was also compared with the one of existing models proposed in the previous literature. The evaluation revealed that the M5P-based model provided a more consistent and accurate prediction of the actual strength compared to the existing models, achieving an R2 value of 0.969 and an RMSE value of 37.307 for the testing dataset. It was found to be a reliable and also straightforward model. The proposed model is likely to be highly helpful in assessing the shear capacity of SFRC beams during the pre-planning and pre-design stages and could also be useful to help for future revisions of design standards.

Cerebral Attacks in MOG Antibody-Associated Disease: Clinical Spectrum and Fulfillment of ADEM criteria (S40.007)

Cerebral Attacks in MOG Antibody-Associated Disease: Clinical Spectrum and Fulfillment of ADEM criteria (S40.007)

DNA barcoding and morphology reveal European and western Asian Arctiavillica (Linnaeus, 1758) as a complex of species (Lepidoptera, Erebidae, Arctiinae).

Currently, the genus Arctia Schrank, 1802 includes approximately 16 species in the Palaearctic region, depending on the taxonomic interpretation. Here, populations of the Arctiavillica (Linnaeus, 1758) morphospecies complex were studied from Europe to the Middle East (Turkey, northern Iran) by molecular methods. Morphological treatment has traditionally revealed the presence of five nominal taxa: A.villica (Linnaeus, 1758), A.angelica (Boisduval, 1829), A.konewkaii (Freyer, 1831), A.marchandi de Freina, 1983, and A.confluens Romanoff, 1884. The molecular approach tests whether they represent well-delimited species. Subsequently, this study corroborates the suitability of the mitochondrial cytochrome c oxidase subunit 1 (COI) marker sequence for species delimitation. In total, 55 barcodes of the Arctiavillica complex were compared, and two molecular species delimitation algorithms were applied to reveal the potential Molecular Operational Taxonomic Units (MOTUs), namely the distance-based Barcode Index Number (BIN) System, and the hierarchical clustering algorithm based on a pairwise genetic distances approach using the Assemble Species by Automatic Partitioning (ASAP). The applied ASAP distance-based species delimitation method for the analysed dataset revealed an interspecific threshold of 2.0-3.5% K2P distance as suitable for species identification purposes of the Iberian A.angelica and the Sicilian A.konewkaii and less than 2% for the three taxa of the A.villica clade: A.villica, A.confluens, and A.marchandi. This study contributes to a better understanding of the taxonomy of the genus Arctia and challenges future revision of this genus in Turkey, the Caucasus, Transcaucasia as well as northern Iran using standard molecular markers.

Searching for evidence in public health emergencies: a white paper of best practices.

Information professionals have supported medical providers, administrators and decision-makers, and guideline creators in the COVID-19 response. Searching COVID-19 literature presented new challenges, including the volume and heterogeneity of literature and the proliferation of new information sources, and exposed existing issues in metadata and publishing. An expert panel developed best practices, including recommendations, elaborations, and examples, for searching during public health emergencies. Project directors and advisors developed core elements from experience and literature. Experts, identified by affiliation with evidence synthesis groups, COVID-19 search experience, and nomination, responded to an online survey to reach consensus on core elements. Expert participants provided written responses to guiding questions. A synthesis of responses provided the foundation for focus group discussions. A writing group then drafted the best practices into a statement. Experts reviewed the statement prior to dissemination. Twelve information professionals contributed to best practice recommendations on six elements: core resources, search strategies, publication types, transparency and reproducibility, collaboration, and conducting research. Underlying principles across recommendations include timeliness, openness, balance, preparedness, and responsiveness. The authors and experts anticipate the recommendations for searching for evidence during public health emergencies will help information specialists, librarians, evidence synthesis groups, researchers, and decision-makers respond to future public health emergencies, including but not limited to disease outbreaks. The recommendations complement existing guidance by addressing concerns specific to emergency response. The statement is intended as a living document. Future revisions should solicit input from a broader community and reflect conclusions of meta-research on COVID-19 and health emergencies.

Clinical Characterization and Predictive Factors for Progression in a Cohort of Patients with Interstitial Lung Disease and Features of Autoimmunity: The Need for a Revision of IPAF Classification Criteria.

Background and Objectives: The "interstitial pneumonia with autoimmune features" (IPAF) criteria have been criticized because of the exclusion of usual interstitial pneumonia (UIP) patients with a single clinical or serological feature. To classify these patients, the term UIPAF was proposed. This study aims to describe clinical characteristics and predictive factors for progression of a cohort of interstitial lung disease (ILD) patients with at least one feature of autoimmunity, applying criteria for IPAF, specific connective tissue diseases (CTD), and a definition of UIPAF when possible. Methods: We retrospectively evaluated data on 133 consecutive patients with ILD at onset associated with at least one feature of autoimmunity, referred by pulmonologists to rheumatologists from March 2009 to March 2020. Patients received 33 (16.5-69.5) months of follow-up. Results: Among the 101 ILD patients included, 37 were diagnosed with IPAF, 53 with ILD-onset CTD, and 11 with UIPAF. IPAF patients had a lower prevalence of UIP pattern compared to CTD-ILD and UIPAF patients (10.8% vs. 32.1% vs. 100%, p < 0.01). During the follow-up, 4 IPAF (10.8%) and 2 UIPAF (18.2%) patients evolved into CTD-ILD. IPAF patients presented features not included in IPAF criteria, such as sicca syndrome (8.1%), and were more frequently affected by systemic hypertension (p < 0.01). Over one year, ILD progression (greater extent of fibrosis on HRCT and/or decline in PFTs) was less frequent in the IPAF group compared to CTD-ILD and UIPAF (32.3% vs. 58.8% vs. 72.7, p = 0.02). A UIP pattern and an IPAF predicted a faster (OR: 3.80, p = 0.01) and a slower (OR: 0.28, p = 0.02) ILD progression, respectively. Conclusions: IPAF criteria help identify patients who might develop a CTD-ILD, even though a single clinical or serological feature is respected. Future revisions of IPAF criteria should include sicca syndrome and separate UIP-pattern into a different definition (UIPAF), given its association with a different prognosis, independently from ILD classification.

Comparison of Percutaneous Interventional Ablation-Osteoplasty-Reinforcement-Internal Fixation (AORIF), Long Intramedullary Nailing, and Hemiarthroplasty for the Treatment of Focal Metastatic Osteolytic Lesions in the Femoral Head and Neck

Osteolytic metastatic lesions in the femoral head and neck are traditionally treated with intramedullary long nailing (IM) or hemiarthroplasty (HA). Recovery, surgical complications, and medical co-morbidities delay oncologic care. This study sought to elucidate the comparative efficacy of percutaneous ablation-osteoplasty-reinforcement-internal fixation (AORIF), IM, and HA in stabilizing osteolytic lesions in the femoral head and neck. A retrospective study of 67 patients who underwent IM, AORIF, or HA for osteolytic femoral head and neck lesions was performed. Primary outcome was assessed using a combined pain and ambulatory score (Range 1-10: 1=bedbound, 10=normal ambulation) at firstfollow-up (~2weeks). Surgical complications associated with each treatment were compared. Sixty-seven patients (mean age, 65±13, 36 men and 31 women) underwent IM (40), AORIF (19), and HA (8) with a mean follow-up of 9±11months. Two patients in the IM group (5%), three in the AORIF group (16%), and none in the HA (0%) group required revision procedures. AORIF demonstrated superior early improvement in combined pain and ambulatory function scores by 3.0points [IQR=2.0] (IM p=0.0008, HA p=0.0190). Odds of post-operative complications was 10.3times higher in HA than IM (95% confidence interval 1.8 to 60.3). Future revision procedures were not found to be statistically significant between AORIF and IM (p=0.234). A minimally invasive interventional skeletal procedure for focal femoral head and neck osteolytic lesions may serve as an effective alternative treatment to traditional surgical approaches, conferring a shorter recovery time and fewer medical complications.

Design of a Secure Automated Driving Systems Test Data Interface

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;Vehicles equipped with Level 4 and 5 autonomy will need to be tested according to regulatory standards (or future revisions thereof) that vehicles with lower levels of autonomy are currently subject to. Today, dynamic Federal Motor Vehicle Safety Standards (FMVSS) tests are performed with human drivers and driving robots controlling the test vehicle’s steering wheel, throttle pedal, and brake pedal. However, many Level 4 and 5 vehicles will lack these traditional driver controls, so it will be impossible to control these vehicles using human drivers or traditional driving robots. Therefore, there is a need for an electronic interface that will allow engineers to send dynamic steering, speed, and brake commands to a vehicle. This paper describes the design and implementation of a market-ready Automated Driving Systems (ADS) Test Data Interface (TDI), a secure electronic control interface which aims to solve the challenges outlined above. The interface consists of a communication port integrated into automobiles which lack traditional manual controls. Via this interface dynamic test scenarios can be executed by plugging in a Vehicle Control Unit (VCU), which is an element of the TDI hardware/firmware intended to be available only to authorized users. Physically, the VCU can interface with the On-board Diagnostics (OBD) OBD-II connector that is present on essentially all modern automobiles. This paper also describes a demonstration of the complete VCU with the secure TDI using a vehicle equipped with a Dataspeed drive-by-wire kit, with its steering, throttle, and brake control systems mimicking the behavior of an autonomous subject vehicle.&lt;/div&gt;&lt;/div&gt;

Psychometric evaluation of the WHODAS 2.0 and prevalence of disability in a Swedish general population

BackgroundThe World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a generic questionnaire that captures health and disability-related functioning information corresponding to six major life domains: Cognition, Mobility, Self-care, Getting along, Life activities, and Participation. The WHODAS 2.0 is used in a wide range of international clinical and research settings. A psychometric evaluation of WHODAS 2.0, Swedish version, in the general population is lacking, together with national reference data to enable interpretation and comparison. This study aims to evaluate the psychometric properties of the Swedish 36-item version of WHODAS 2.0 and describe the prevalence of disability in a Swedish general population.MethodsA cross-sectional survey was performed. Internal consistency reliability was assessed with Cronbach’s alpha. The construct validity was evaluated with item-total correlation, Pearson’s correlation between the WHODAS 2.0 domains and the RAND-36 subscales, analysis of known groups by one-way ANOVA, and analysis of the factor structure by confirmatory factor analysis.ResultsThree thousand four hundred and eighty two adults aged 19–103 years (response rate 43%) participated. Significantly higher degrees of disability were reported by the oldest age group (≥ 80 years), adults with a low level of education, and those on sick leave. Cronbach’s alpha was from 0.84 to 0.95 for the domain scores and 0.97 for the total score. The item-scale convergent validity was satisfactory, and the item-scale discriminant validity was acceptable except for the item about sexual activity. The data partially supported the factor structure, with borderline fit indices.ConclusionThe psychometric properties of the self-administered Swedish 36-item version of the WHODAS 2.0 are comparable to those of other language versions of the instrument. Data of the prevalence of disability in Swedish general population enables normative comparisons of WHODAS 2.0 scores of individuals and groups within clinical practice. The instrument has certain limitations that could be improved on in a future revision. The test–retest reliability and responsiveness of the Swedish version of WHODAS 2.0 for different somatic patient populations remain to be evaluated.

Anatomical knee endoprostheses – does a better-fit lead to better outcomes? A review article

Introduction. Total knee replacement is the most efficient method of treating end-stage osteoarthritis of the knee joint. The surgery aims to relieve patients of pain, restore range of motion and improve patients’ quality lives. Prostheses design is still being modified and improved through cooperation between orthopaedic surgeons and engineers. Some of the most modern solutions aimed to fit native patients’ anatomy as much as possible are anatomic knee systems. Materials and methods. The literature was reviewed, and articles related to the subject were researched. Therefore, publications including keywords such as total knee replacement, anatomic implants and morphometric implants were searched in the PubMed, Cochrane and Google Scholar databases. All data was selected and verified individually. Analysis and synthesis of studies were prepared separately. Results. Many studies describe the advantages of anatomic prostheses over standard prostheses. Anatomical prostheses have a broader range of available sizes, thus providing better coverage of the distal end of the femur and the proximal tibia, allowing for the resection of less bone tissue, which is beneficial in the event of a possible need for a future revision of the endoprosthesis, enabling better selection of the tibial element rotation by better matching to the tibial plateau, which affects the alignment and patellar movement, and the structure of the trochlear geometry that also affects the patellar movement and reduces the risk of trochlear dysplasia. Conclusions. Anatomical implants enable better alignment of the prosthesis elements and the native femoral and tibial bone. Using these models makes it possible to obtain a greater range of motion and, consequently, improved functional outcomes compared to non-anatomical ones. It also enables less bone resection and better radiological outcomes.

Who is Andesiops peruvianus (Ulmer, 1920) (Ephemeroptera: Baetidae)? New insight from the type basin using morphological and molecular analyses

Andesiops peruvianus (Ulmer, 1920) is a small minnow mayfly with a distribution throughout the Andes Mountains, mainly in lotic environments. In recent years, the taxonomic status of the species has been shifting, even finding out molecular and morphological evidence to consider it as a cryptic species. In this work, we collected seven specimens of A. peruvianus from the Lake Titicaca in Peru, the type locality and perform molecular and morphological analyses to test their relationship with specimens from other regions. The species delimitation analysis revealed the existence of five MOTUs for specimens identified as A. peruvianus along the Andes Mountains, while the Lake Titicaca specimens formed a single MOTU with high interspecific distance. In this MOTU were found specimens with different types of abdominal gills, from translucent to markedly tracheated supporting the hypothesis of phenotypic plasticity at the abdominal gill level. Also, an extension in the range of tarsal claw denticles, from 10-12 to 10-14, were observed, higher than what were found in other regions. Our results support A. peruvianus as a species complex and reveal A. peruvianus from Titicaca as a single MOTU. Future morphological revisions of topotype specimens as well as from other Andean regions are required to strengthen the diagnosis of informative characteristics at both the larval and adult stage to elucidate the real status of the species.