The circulating platelet aggregates were measured in 90 patients admitted to the Clinical Hospital Split because of myocardial infarction developed in the costal region of Middle Dalmatia. They were ...divided into three groups, each consisting of 30 patients affected by coronary incident developed during the three most characteristic weather types in the region: sirocco, bora and calm weather. All the patients have had elevated values of circulating thrombocyte aggregates, but the patients in the sirocco group exhibited significantly higher values (34.77% +/- 11.67%) than the patients in both bora (27.93% +/- 11.72%; p < 0.05) and the calm weather groups (23.5% +/- 10.62%; p < 0.01). In the control group of 10 healthy examinees the values of circulating platelet aggregates were within normal range during all the three weather types (5.85% +/- 0.70%, 5.24 +/- 0.51% and 5.18 +/- 0.59%, in case of sirocco, bora and calm weather, respectively). The three groups were not significantly different regarding the values of creatinine kinase, which means that the infarct size was not the probable cause of the observed differences in platelet aggregability. Taking into account our previous finding of increased incidence of coronary events during sirocco, these results suggest that increased platelet aggregability is a contributing factor to the risk of myocardial infarction during such a weather.
Consumers are fundamental to organisational functioning and survival. Their loyalty, commitment, product acceptance and good long-term relationships with firms and brands are underpinned by their ...trust. Unfortunately, over the last decade or so, we have witnessed some of the more spectacular violations of consumer trust in the history of business. This has led to negative consequences, such as loss of competitive advantage, rage, lack of commitment and decrease in turnover. Consequently, study of trust repair has become an important theoretical concern for a growing number of trust scholars. This article reviews and synthesises existing theory and research on the topic. It first sketches general characteristics of the consumer trust repair literature, including its meta-theoretical underpinning. It then identifies specific strategies associated with consumer trust repair and synthesises them into five categories of trust repair strategies. In addition, this paper highlights theoretical processes that explain why/how trust repair strategies work. Third, the paper proposes six fruitful avenues for future research. This study contributes to the field of consumer trust repair research by critically reviewing and synthesising emerging theory and research on strategies associated with consumer trust repair, by showing why and how these strategies work and by identifying most fruitful research areas.
Measuring the selective fitness advantages provided by driver mutations has the potential to facilitate a precise quantitative understanding of cancer evolution. However, accurately measuring the ...selective advantage of driver mutations has remained a challenge in the field. Early studies reported small selective advantages of drivers, on the order of 1%, whereas newer studies report much larger selective advantages, as high as 1,200%. In this article, we argue that the calculated selective advantages of cancer drivers are dependent on the underlying mathematical model and stage of cancer evolution and that comparisons of numerical values of selective advantage without regard for the underlying model and stage can lead to spurious conclusions.
The widespread adoption of remote and hybrid work due to COVID-19 calls for studies that explore the ramifications of these scenarios for office workers from an occupational health and wellbeing ...perspective. This paper aims to identify the needs and challenges in remote and hybrid work and the potential for a sustainable future work environment. Data collection involved two qualitative studies with a total of 53 participants, who represented employees, staff managers, and service/facility providers at three Swedish public service organisations (primarily healthcare and infrastructure administration). The results describe opportunities and challenges with the adoption of remote and hybrid work from individual, group, and leadership perspectives. The main benefits of remote work were increased flexibility, autonomy, work-life balance and individual performance, while major challenges were social aspects such as lost comradery and isolation. Hybrid work was perceived to provide the best of both worlds of remote and office work, given that employees and managers develop new skills and competencies to adjust to new ways of working. To achieve the expected individual and organisational benefits of hybrid work, employers are expected to provide support and flexibility and re-design the physical and digital workplaces to fit the new and diverse needs of employees.
Background and Aims
To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies.
Material and Methods
Four background ...review publications served to elaborate this consensus report.
Results and Conclusions
Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre‐clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP‐2) and autologous platelet concentrates (APCs) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) “minimally manipulated” whole tissue fractions; (b) ex vivo expanded “uncommitted” stem/progenitor cells; and (c) ex vivo expanded “committed” bone‐/periosteum‐derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA) or bone marrow aspirate concentrations (BMAC), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair.
Abstract Total hip arthroplasty (THA) implant usage has evolved as experience has been gained with newer implant designs. The purpose of this study was to characterize trends in THA implant usage ...between 2001 and 2012. The Orthopedic Research Network, which includes 174 hospitals and ~ 105,000 THA, was used to evaluate trends in fixation, bearings, acetabular cup and liner, and femoral head usage. In 2012, 93% of THAs were cementless; 56% of THA bearings were metal-HXLPE; and 35% were ceramic-HXLPE. 99% of acetabular cups were modular. 61% of femoral heads were metal, 39% were ceramic, 51% were 36 mm, and 28% were 32 mm. THA implant usage trends favor cementless fixation, metal-on-polyethylene or ceramic-on-polyethylene bearings, modular acetabular cups, and large diameter femoral heads.
Catestatin (CST) is an important peptide that influences various inflammatory diseases. Our goal was to investigate CST concentrations in patients with RA compared to healthy subjects. This ...cross-sectional observational study included 80 patients with RA and 80 healthy control subjects. Demographic characteristics and laboratory parameters were recorded. Serum CST levels were determined by an enzyme-linked immunosorbent assay (ELISA). Serum CST levels were significantly higher in RA patients than in the control group (10.53 ± 3.90 vs 5.24 ± 2.37 ng/mL, p < 0.001). In RA patients, there was a statistically significant correlation between CST and patient age (r = 0.418, p < 0.001) and both DAS28 (r = 0.469, p < 0.001) and HAQ scores (r = 0.483, p < 0.001). There was a statistically significant correlation between serum CST levels and RA duration (r = 0.583, p < 0.001). Multiple linear regression analysis showed that serum CST levels retained a significant association with RA duration (β ± SE, 0.13 ± 0.04, p = 0.002) and DAS28 score (0.94 ± 0.45, p = 0.039) after model adjustment for age, body mass index (BMI) and HAQ score, with serum CST levels as a dependent variable. These findings imply that CST is possibly associated with RA complex pathophysiology and disease activity. However, future larger multicentric longitudinal studies are necessary to define the role of CST in RA.
Background
Cost estimates derived from traditional hospital cost accounting systems have inherent limitations that restrict their usefulness for measuring process and quality improvement. Newer ...approaches such as time-driven activity-based costing (TDABC) may offer more precise estimates of true cost, but to our knowledge, the differences between this TDABC and more traditional approaches have not been explored systematically in arthroplasty surgery.
Questions/purposes
The purposes of this study were to compare the costs associated with (1) primary total hip arthroplasty (THA); (2) primary total knee arthroplasty (TKA); and (3) three surgeons performing these total joint arthroplasties (TJAs) as measured using TDABC versus traditional hospital accounting (TA).
Methods
Process maps were developed for each phase of care (preoperative, intraoperative, and postoperative) for patients undergoing primary TJA performed by one of three surgeons at a tertiary care medical center. Personnel costs for each phase of care were measured using TDABC based on fully loaded labor rates, including physician compensation. Costs associated with consumables (including implants) were calculated based on direct purchase price. Total costs for 677 primary TJAs were aggregated over 17 months (January 2012 to May 2013) and organized into cost categories (room and board, implant, operating room services, drugs, supplies, other services). Costs derived using TDABC, based on actual time and intensity of resources used, were compared with costs derived using TA techniques based on activity-based costing and indirect costs calculated as a percentage of direct costs from the hospital decision support system.
Results
Substantial differences between cost estimates using TDABC and TA were found for primary THA (USD 12,982 TDABC versus USD 23,915 TA), primary TKA (USD 13,661 TDABC versus USD 24,796 TA), and individually across all three surgeons for both (THA: TDABC = 49%–55% of TA total cost; TKA: TDABC = 53%–55% of TA total cost). Cost categories with the most variability between TA and TDABC estimates were operating room services and room and board.
Conclusions
Traditional hospital cost accounting systems overestimate the costs associated with many surgical procedures, including primary TJA. TDABC provides a more accurate measure of true resource use associated with TJAs and can be used to identify high-cost/high-variability processes that can be targeted for process/quality improvement.
Level of Evidence
Level III, therapeutic study.
Abstract Introduction The purpose of this study was to evaluate the changing incidence of hip arthroscopy procedures among newly trained surgeons in the United States, the indications for hip ...arthroscopy, and the reported rate of post-operative complications. Methods The ABOS database was used to evaluate the annual incidence of hip arthroscopy procedures between 2006–2010. Procedures were categorized by indication and type of procedure. The rate of surgical complications was calculated and compared between the published literature and hip arthroscopy procedures performed for femoroacetabular impingement (FAI)/osteoarthritis (OA) and for labral tears among the newly trained surgeon cohort taking the ABOS Part II Board exam. Results The overall incidence of hip arthroscopy procedures performed by ABOS Part II examinees increased by over 600% during the 5-year period under study from approximately 83 in 2006 to 636 in 2010. The incidence of hip arthroscopy for FAI/OA increased steadily over the time period under study, while the incidence of hip arthroscopy for labral tears was variable over time. The rate of surgical complications was 5.9% for hip arthroscopy procedures for a diagnosis of FAI/OA vs. 4.4% for a diagnosis of labral tear ( P = 0.36). Conclusions The incidence of hip arthroscopy has increased dramatically over the past 5 years, particularly for the indication of FAI/OA. Reported surgical complication rates are relatively low, but appear higher than those rates reported in previously published series. Appropriate indications for hip arthroscopy remain unclear.
PDF
